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Company Name: Percent of Ownership Company Address: Type of Business: Borrower Name(s): Loan Number: Dates Reported (MM/DD/YY - MM/DD/YY) (Must be minimum of 3 full months) Please fill in the fields that apply to your business GROSS INCOME Gross Sales (Total amount of income from sales or service before subtracting expenses) Other Income (Any other additional funds earned through the company such as payments from people leasing space or payments from investors) Total GROSS INCOME BEFORE TAXES EXPENSES Cost of Goods Sold (Direct costs to produce or obtain the goods sold by the company) Accounting and Legal Fees Advertising Insurance (Do not include homeowner insurance) Maintenance and Repairs Supplies Payroll Expenses (Salaries and wages for borrower(s) on the mortgage loan) Payroll Expenses (Salaries and wages for employees who are not borrower(s) on the mortgage loan) Postage (Over, please) SAMPLE PROFIT LOSS STATEMENT Please fill in the fields that apply to your business Rent Licenses Taxes (Do not include Real Estate taxes on the property do not include Income Taxes on the business - include the total of any other taxes that you have to pay for the business) Telephone Travel/Transportation Utilities Other (Total and explanation of any other expenses not already listed) Total EXPENSES NET INCOME Net Income Before Taxes Taxes (Paid on Business Income) Total NET INCOME AFTER TAXES By signing this document, I/we certify that all the information is truthful..