Self-Employed Income And Expenditure Sheet

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Self-Employed Income and Expenditure Sheet
For the period from
to
Number of weeks/days
Date self employment started
Hours worked per week
Nature of business
Income
Total invoiced or billed, including gratuities and tips
£
Expenditure
Please provide receipts as evidence the above, we can not allow for expenses unless receipts are provided .
Accountancy or book-keeping charges
£
Advertising
£
Bank charges
£
Business entertainment
£
Business rates (NNDR)
£
Capital repayments on loans, mortgages or hire purchase agreements
£
Carriage or packing and delivery costs
£
Cleaning for business use only
£
Drawings (wages or salaries paid to owners of the business)
£
Heat, light, hot water for business use only
£
Hire or leasing charges
£
Insurance
£
Interest on loans, mortgages or hire purchase agreements
£
Money spend setting up or expanding the business
£
Petrol for business use only
£
Special clothing
£
Stock or materials necessary to carry out your business
£
Subscriptions to professional organisations
£
Telephone for business use only
£
Use of home as office
£
Wages or salaries paid to employees (excluding drawings)
£
Water Rates for business use only
£
If you have any other expenses not listed above please provide details
£
£
£
Total Expenditure
£
Net Profit i.e. total income less total expenditure
£
Declaration
I confirm that the information I have given is true and complete. I will tell the housing benefit section immediately of the income I
receive from self-employment increases or decreases.
Signature of the person running the business
Name of the person running the business
Address of the claim for housing or council tax benefit
Benefit reference number if known
Note:
When completed return to: Woking Borough Council
You need to send 3 months bank statements for the
Benefits Section
bank accounts that you use in connection with your
Civic Offices
self employed business.
Gloucester Square
We may ask for additional evidence or bank
Woking
statements to enable us to assess your claim.
Surrey
GU21 6YL

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