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NAME_______________________________________ YEAR________________
Principal Business, Product or Service______________________________________________________
Business Name & Address_______________________________________________________________
_______________________________________________________________
Do you deduct expenses for business use of your home? If NO proceed to Section 1. If YES fill in the
Following section:
Square feet of home __________ Square feet of business use area__________
Amount of time home used for business as in day care or storage __________
Utilities: Heat $___________ Electric $__________
Telephone $___________ Prop. Tax $__________
Mortgage Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . __________
Repairs to office area only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . __________
Repairs to common areas like roof, siding etc. . . . . . . . . . . . . . . __________
Casualty losses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . __________
Home Owners insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . __________
GROSS RECEIPTS OR SALES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
Inventory at beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
Purchases of Goods for Resale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
Less: Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________
Advertising ____________ Repairs & maintenance ____________
Car & truck expense ____________ Supplies ____________
Commissions & fees ____________ Taxes & licenses ____________
Insurance: Travel, meals, entertainment:
Liability ____________ Travel ____________
Workman’s Comp ____________ Meals & entertainment ____________
Business vehicles ____________ Utilities ____________
Personal vehicles ____________ Wages ____________
Employee health ____________ Off Road Fuel (Gal______) ____________
Personal health ____________ Diesel (Gal_____) ____________
Interest: Gasoline (Gal_____) ____________
Mortgage ____________ Other Expenses:
Other ____________ ______________________ ____________
Legal & Professional ____________ ______________________ ____________
Office expense ____________ ______________________ ____________
Rent of lease: ______________________ ____________
Vehicles ____________ ______________________ ____________
Other business property ____________ ______________________ ____________
(OVER PLEASE)
WHAT WAS BOUGHT DATE COST AFTER TRADE-IN WHAT WAS TRADED IN
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EQUIPMENT SOLD (NOT TRADED)
WHAT KIND DATE SOLD DATE BOUGHT SOLD ($)
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