Chase Sample Profit & Loss Statement Template Page 2
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1
2SAMPLE 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. I/we understand that knowingly submitting false
information may constitute fraud.
Borrower Name(s) ______________________________________________________________________________
Signature ___________________________________________________ Date _____________________________
Signature ___________________________________________________ Date _____________________________
D16205 PL 0812
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