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MONTH(S) THIS FORM INCLUDES: INCOME/GROSS SALES:  If you pay yourself a salary or take a draw from your business, please provide copies of your paystubs for the last three months and state the gross amount: EXPENSES – Enter all that apply:  Rent/Mortgage of business premises  Phone/Utilities  Gross Labor Wages (not for self)   Business Taxes (not personal income tax payments) Loan payments: Principle: Interest: Balance:  Bank Charges  License Fees Paid  Legal Fees  Office Supplies  Tools/Equipment  Repairs/Upkeep  Merchandise/Purchases/Cost of Goods  Fuel/Gas  Advertising  Commissions Paid  Shipping  Equipment Rental  Insurance Type of Insurance:  Other Expenses (please list): TOTAL EXPENSES: NET INCOME BUSINESS VEHICLE in your name: Year: Make: Model: BANK ACCOUNTS – Include dates:  Balance in business checking account : Date:  Balance in business savings account : Date: .

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Self Employment Profit & Loss Form

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