This form is to assist you in gathering your business-related tax information. Please provide all relevant information. General Business Information

Business Name:
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EIN Number:
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Business Owner:
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Social Security Number:
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Address:
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City:
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State:
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Business Phone:
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Cell:
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Zip code
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Accounting Method:
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Specify
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Inventory at beginning of year $
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Inventory at end of year $
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Gross receipts:
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Total expenses:
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Net Income $
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Did you purchase equipment?
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Specify:
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First time filing a Schedule C?
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Did you use your home in connection with this business?
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General Expenses

Advertising

Amount
Amount
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Have receipts (initial)
Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Commission

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Employee benefits program Insurance

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Mortgage Interest

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Legal and professional Office expenses

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Phone

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Pension & profit sharing plans

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Vehicle, machinery & equipment

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Maintenance

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Supplies

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Taxes-real estate

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
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Travel

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Total meals and entertainment

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Sub-contact labor

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Wages

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Other expenses

Amount
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Have receipts (initial)
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Have check, credit card, statement or documentation
Have check, credit card, statement or documentation
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Vehicle Expenses

Description of vehicle:
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Cost of vehicle $:
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Date placed in service:
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Do you have a mileage log or other written records to support you miles driven?
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Total miles driven:
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Business miles driven:
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Commuting miles:
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Parking fees and tolls $
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Gasoline, lube, oil:
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Insurance $
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Tires, repairs $
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License plate fees/property tax $
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Interest (car loan) $
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If there are no expenses for the Schedule C, explain why
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We prepare the returns from information you furnished us, without verification. Upon examination of the returns by taxing authorities, request may be made for underlying data. We therefore recommend that you preserve all records, which you may be called upon to produce in connection with such an examination. I certify that the information on this and any other form submitted is complete and correct.
Client Signature
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Spouse Signature
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Select a date
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