| NAME OF CORPORATION/LLC | | | | | | |
| CORPORATION/LLC INCOME AND EXPENSES FOR TAX YEAR: | _________________________________ | | |
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| SECTION 1 | | SECTION 4 | | |
| INCOME | | | | | VEHICLE INFORMATION | | |
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| | | | | | TYPE OF VEHICLE | | |
| | | | | | TOTAL BUSINESS MILES THIS YEAR | | |
| | | | | | TOTAL PERSONAL MILES THIS YEAR | | |
| | | | | | PURCHASE DATE ( IF CURRENT YEAR) | | |
| | | | | | PURCHASE PRICE (IF CURRENT YEAR) | | |
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| SECTION 2 | | CURRENT YEAR VEHICLE EXPENSES | | |
| EXPENSES | | | | | | | |
| | | | | | GAS/LUBE/OIL | | |
| ACCOUNTING | | | | INSURANCE | | |
| ADVERTISING | | | | INTEREST ON CAR LOAN | | |
| BANK CHARGES | | | | LICENSE AND REGISTRATION | | |
| BUSINESS MEETINGS | | | | REPAIRS | | |
| COMMISSIONS | | | | RENTAL/LEASE PAYMENT | | |
| CONTINUING EDUCATION/TRAINING | | | | | | |
| DUES AND SUBSCRIPTIONS | | | | | | |
| EMPLOYEE BENEFIT PROGRAM | | | | SECTION 5 | | |
| GIFTS TO CUSTOMERS | | | | HOME OFFICE EXPENSES (IF APPLICABLE): | |
| INSURANCE - EMPLOYEES HEALTH | | | | | | |
| INSURANCE - OFFICERS HEALTH | | | | SQUARE FOOTAGE OF HOUSE | | |
| INSURANCE-OTHER | | | | SQUARE FOOTAGE OF OFFICE | | |
| INTEREST FOR CREDIT CARDS/LOANS | | | | INSURANCE | | |
| INTERNET | | | | | RENT | | |
| LEGAL AND PROFESSIONAL | | | | UTILITIES | | |
| LICENSES AND PERMITS | | | | MORTGAGE INTEREST | | |
| MEALS AND ENTERTAINMENT | | | | REAL ESTATE TAXES | | |
| MISCELLANEOUS | | | | PEST CONTROL | | |
| OFFICE EXPENSE | | | | LANDSCAPE | | |
| OUTSIDE SERVICES | | | | REPAIRS & MAINTENANCE | | |
| PENSION/PROFIT SHARING PLANS | | | | | | |
| POSTAGE/FREIGHT | | | | | | |
| PRINTING | | | | | SECTION 6 | | |
| RENT - OFFICE | | | | PURCHASE OF ASSETS | | |
| RENT-EQUIPMENT | | | | | | |
| REPAIR AND MAINTENANCE | | | | | | |
| SUPPLIES | | | | | | | |
| TAXES | | | | | | | |
| TELEPHONE/CELL PHONE | | | | | | |
| TRAVEL/LODGING | | | | | | |
| UTILITIES | | | | | | | |
| WAGES PAID TO EMPLOYEES | | | | | | |
| WAGES PAID TO OFFICERS | | | | | | |
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| SECTION 3 | | SECTION 7 | | |
| OTHER EXPENSES NOT LISTED ABOVE | | | | OTHER ITEMS TO INCLUDE: | | |
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| | | | | | BALANCE IN CHECKING ACCT. @ 12/31 | | |
| | | | | | BALANCE IN SAVINGS ACCT. @ 12/31 | | |
| | | | | | BUSINESS CREDIT CARD DEBT @ 12/31 | | |
| | | | | | OTHER BUSINESS LOANS OR DEBT @ 12/31 | |
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| | | | | | DOCUMENTATION FOR ASSETS BOUGHT THIS YEAR: |
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| | | | | | PURCHASE DOCUMENTS FOR BUSINESS ASSETS |
| | | | | | LOAN DOCUMENTS FOR BUSINESS ASSETS | |
