Client Information

Business Name *

First Name *

Last Name *

Business Address *

City *

Phone *

Email *

Employer Identification Number (EIN) (if applicable):

Business Details

Business Entity *

Nature of Business *

Business Established, when?: *

Accounting Method: *

Income Information

Total Gross Income: *

Provide a summary of total income received for the year (attach documentation such as invoices, 1099 forms, etc.).

Business Expenses

Advertising:

Supplies:

Insurance (Other than Health):

Rent/Lease:

Utilities

Repairs and Maintenance:

Legal and Professional Services:

Travel and Meals:

Employee Wages:

Contract Labor:

Other Expenses:

Home Office Deduction (if applicable)

Do you use a part of your home for business?

Total Square Footage of Home:

Square Footage Used Exclusively for Business:

Home Office Expenses:

Mortgage Interest or Rent:
Utilities (Electricity, Water, Gas):
Home Insurance:
Repairs and Maintenance:
Other Home Office Expenses (Please specify):

Vehicle Information (if used for business)

Fuel:
Maintenance and Repairs:
Insurance:
Lease Payments (if applicable):
any other expense

Do you have written records to support your business mileage?

Business Assets

Did you purchase any business assets (e.g., equipment, furniture) during the year? *

If yes, please provide the following details for each asset:

Did you sell or dispose of any business assets during the year? *

Additional Information

Estimated Tax Payments:

Business Loans:

Other Important Details:

Acknowledgment and Signature

I certify that the information provided on this form is accurate and complete to the best of my knowledge. I understand that providing false or misleading information may result in penalties.

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Today's Date of Acknowledgment *

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