Form Abl-62 - Affidavit For Nonprofit Private Club Renewal - 2011 Page 2

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Profit and Loss Statement
ABL File #:
Name of business:
Fiscal Year or Calendar Year:
Income
Memberships Dues
Liquor by the Drink (LBD) Sales
Sales – Other
Other (Specify)
Total Income
Operating expenses
Accounting
Postage/printing
Advertising
Rent
Auto expenses
Repairs/Maintenance
Contributions
Salaries
Depreciation
Supplies
Entertainment
Taxes - LBD
Insurance
Taxes - Payroll
Interest
Taxes - Sales
Legal
Telephone
Licenses
Trade Dues
Miscellaneous
Utility
Office expense
Wages
Other (specify)
Other (specify)
TOTAL EXPENSES
Profit/(Loss)
42552026

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