INCOME AND EXPENSES
BUSINESS
Electric_____________ Water/Sewer________________ Natural Gas____________________
Trash Service__________________________ CAD fees________________________
Wages and payroll expenses (please provide copies of all W-2, W-3, Form 941, 940, and AZ payroll
returns filed for the year)_______________________________
Other expenses- based on your industry:
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Expenses are accepted by the IRS if they are ordinary, necessary and reasonable. Proof of a paid
expense includes the actual receipt, credit card statement and bank statement. Please keep all original
receipts or scan and keep an electronic copy.
Please note: If you have meals and entertainment expenses, you must keep the receipt as well as
document the name and business purpose for the meal or entertainment.
I verify that I have accurate books, records and documentation to support the income and expenses
listed.
Signed: ___________________________________ Date: _________________________