Schedule C Due Diligence Form

Small Business/Self Employment Questions

Please describe your expenses or income details. Do not enter exact dollar amounts or whole numbers (for example, do not enter “3000”)

Full Name *

Phone Number *

Email Address *

What is the name of your business? If no name, put first and last name.

Business EIN, if applicable.

Business Address

Business Number

Describe the nature of the business and the type of work performed, services rendered, or products sold.

Number of employees including yourself.

Number of years in business.

Did you materially participate in the business?

Is your business registered with the state?

If so, what type of business is it?

Have you made any payments that will require you to file forms 1099/1099NEC? If so, do you need assistance filing those forms today?

Business/Self Employment Income & Expenses

Total Income

Expenses

Advertising
Auto Expenses
Commissions
Contract Labor
Depletion
Employee Benefit Program
Insurance (other than health)
Legal & Professional Fees
Meals
Office Expenses
Pension & Profit Sharing
Rent or Lease (Vehicles, Machinery, Other)
Repair & Maintenance
Supplies
Taxes & Licenses
Utilities
Other

Total Expenses

If you do not have any expenses, please explain why.

If you traveled and want to deduct mileage, list vehicle(s) used and mileage for the year.

Depreciation for Vehicle

Type of Vehicle

Year Model

Cost of the Vehicle

Date Purchased

Do you use the vehicle for 100% business?

List all Depreciation items

Please check the following of each form of records that you keep:

By signing below, I certify all information provided on each form for the completion of my tax return is true, valid, and to the best of my knowledge. I accept full responsibility of the statements mentioned above. All disputes regarding this matter shall be forwarded to me with the information found on my tax returns forms. *

Clear

Date *