Monthly Self Employment Worksheet

Date

MonthDayYear
Date
Hour Minutes
Monthly Self Employment Worksheet
Name*

First NameLast Name
Reporting Month*
Social Security Number
Email*
example@example.com
Type of Business
Household Number
Number of Boarders in Household
Average number of hours worked per week at Self-Employment during this reporting period
Income
(Line 1) Gross Income (Including rental / lease of self-employment property sale of goods, services, property and equipment, roomer boarder income)*
Amount will be Zero "0" unless changed
(Line 2) Returns and Allowances*
Amount will be Zero "0" unless changed
(Line 3) Gross Profit (Subtract Line 1 from Line 2)
(Line 4) Other Income, including Capital Gains (Profit from the sale of company assets)*
Amount will be Zero "0" unless changed
(Line 5) Total Gross Income (Add Lines 3 and 4)*
Please attach verification of all income here

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Expenses
(Line 6) Advertising Costs*
Amount will be Zero "0" unless changed
(Line 7) Bad Debts from sales or services *
Amount will be Zero "0" unless changed
(Line 8) Vehicle Expenses*
Amount will be Zero "0" unless changed
(Line 9) Commissions and Fees*
Amount will be Zero "0" unless changed
(Line 10) Cost of goods sold *
Amount will be Zero "0" unless changed
(Line 10a) Cost for personal use*
Amount will be Zero "0" unless changed
(Line 11) Subtract Line 10a from Line 10
(Line 12) Employee Taxes*
Amount will be Zero "0" unless changed
(Line 13) Insurance*
Amount will be Zero "0" unless changed
(Line 14) Loan Payments for assets, equipment, land / property*
Amount will be Zero "0" unless changed
(Line 15) Taxes and / or Insurance not included in loan*
Amount will be Zero "0" unless changed
(Line 16) Legal and professional services*
Amount will be Zero "0" unless changed
(Line 17) Office expenses*
Amount will be Zero "0" unless changed
(Line 18) Pension and profit sharing plans (Employees)*
Amount will be Zero "0" unless changed
(Line 19) Rent or Lease*
Amount will be Zero "0" unless changed
(Line 19a) Vehicles, machinery, and equipment*
Amount will be Zero "0" unless changed
(Line 19b) Other Business Property*
Amount will be Zero "0" unless changed
(Line 20) Repairs and maintenance*
Amount will be Zero "0" unless changed
(Line 21) Supplies and materials*
Amount will be Zero "0" unless changed
(Line 22) Taxes and licenses for business*
Amount will be Zero "0" unless changed
(Line 23) Travel, meals, and entertainment*
Amount will be Zero "0" unless changed
(Line 23a) Travel for business*
Amount will be Zero "0" unless changed
(Line 23b) Meals and entertainment*
Amount will be Zero "0" unless changed
(Line 23c) Less cost for personal expense*
Amount will be Zero "0" unless changed
(Line 24) Subtract Line 23c from Line 23b
(Line 25) Portion of rent / utilities used as Self Employment expenses*
Amount will be Zero "0" unless changed
(Line 26) Wages to employees*
Amount will be Zero "0" unless changed
(Line 27) Total Expenses (Add Lines 6 thru 26)
(Line 28) Net Profit or (Loss) Subtract Line 27 from Line 5
Please attach verification of all expenses here

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Monthly Self Employment Worksheet

Income

Expenses