SMALL BUSINESS EXPENSES

DBA/ Business Name: Occupation:

Business Address: Business Phone Number:

Advertising Financial Fees

Marketing $ Payment $
Processing Fees
Promotions $ Bank Fees & $
Interest
Home Office: Do you have a home Y/N Square Rent/Lease $
office or an exclusive area in your home Footage (Equipment)
dedicated to doing business?

Insurance (OTHER THAN HEALTH) $ Rent/Lease $

(Property)
Legal/Professional Services $ Taxes/Licenses $

Office Expense $ Business Travel $

Supplies $ Meals and $

Entertainment
Auto Expenses Make & Model Utilities $

Business Miles Con. Education $

Commuting Miles Bad Debt $

(miles accrued for getting anywhere
other than work or work purposes)

Employee Expenses Value of services

Donated
W2 Wages/Salaries $ Charitable $
Contributions
1099Misc Wages $ Cost of Goods $
Sold
Payroll Expenses Other Expenses $

Reimbursement/Commission Other Expenses $

Depreciation Total Income $

Child Care (please provide end of Total Expenses $
year tuition statement from provider) Total Profit

I declare and affirm under penalty of perjury that the statements made herein are true and correct to the best of
my knowledge, information, and belief. I understand that it is my responsibility to provide proof to the IRS or
any other governmental agency in the event of an audit.
Signature: Date: