Form Ppa-Bus - Statement Of Financial Condition For Businesses Page 4

ADVERTISEMENT

PPA-BUS
Page 4
SECTION V - INCOME & EXPENSE ANALYSIS
27. Business Income and Expenses For: (Check One) [ ] Fiscal Year Ending
OR [ ] Period
to
Accounting Method: (Check One)
[ ] Cash [ ] Accrual Other:
Annual Income
Amount
Annual Expenses
Amount
$
$
Materials Purchased
Gross Receipts From Sales, Services, etc.
Gross Rental Income
Net Wages & Salaries
Rent or Mortgage Expenses
Interest Income
Installment & Lease Payments
Dividends & Capital Gain Distribution
Supplies & Office Expenses
Royalty Income
Utilities
Commissions
Transportation Expenses
Other Income (Specify)
Repairs & Maintanance
Insurance
Current Taxes
Bad Debts
Travel & Entertainment
Advertising
Other Expenses (Specify)
$
Total Income
Total Expenses
$
28. Net Income (“Total Annual Income” Minus”Total Expenses”)
$
SECTION VI - OTHER INFORMATION
29. Has this business disposed of any assets or property by sale, transfer, exchange, gift, or in any other manner during tha past 18 months?
[ ] Yes
[ ] No
If “Yes”, receiving party:
30. Is a foreclosure proceeding pending on any real estate, equipment or other property that this business owns or has an interest in?
[ ] Yes
[ ] No
31. Is another party holding any assets on behalf of this business?
[ ] Yes
[ ] No
If “Yes”, identify:
32. Is this business a party to any lawsuit now pending?
[ ] Yes
[ ] No
33. Is this business currently under bankruptcy court jurisdiction?
[ ] Yes
[ ] No
If “Yes”, Bankruptcy Case No.:
I/we have examined this Statement of Financial Condition for Businesses and hereby affirm that to the best of my/our knowledge and belief it is true,
correct and complete.
Taxpayer’s Signature
Date
Taxpayer’s Signature
Date
POA Signature
Date
(Must complete Power of Attorney - Use Department of Revenue Form RV-F010380, enclosed)

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Form Rev-484 - Statement Of Financial Condition For Businesses Form Rev-484 - Statement Of Financial Condition For Businesses Financial
Form Rev-484 - Statement Of Financial Condition For Businesses Form Rev-484 - Statement Of Financial Condition For Businesses Financial
Form Rev-484a - Instructions For Completing Statement Of Financial Condition For Businesses Form Rev-484a - Instructions For Completing Statement Of Financial Condition For Businesses Financial
Statement Of Financial Condition For Businesses Form Statement Of Financial Condition For Businesses Form Legal
Form Cd Lo-14c - Statement Of Financial Condition For Business Form Cd Lo-14c - Statement Of Financial Condition For Business Financial
Form M-433(i) - Instructions For Completing Statement Of Financial Condition For Individuals - Department Of Revenue - Massachusetts Form M-433(i) - Instructions For Completing Statement Of Financial Condition For Individuals - Department Of Revenue - Massachusetts Financial
Form 12a638 - Statement Of Financial Condition For Individuals - Revenue Cabinet Of Commonwealth Of Kentucky Form 12a638 - Statement Of Financial Condition For Individuals - Revenue Cabinet Of Commonwealth Of Kentucky Financial
Form Rev-488a Fo - Instructions For Completing Statement Of Financial Condition For Individuals (rev-488a) Form Rev-488a Fo - Instructions For Completing Statement Of Financial Condition For Individuals (rev-488a) Financial
Form Rev-488a - Instructions For Completing Statement Of Financial Condition For Individuals Form Rev-488a - Instructions For Completing Statement Of Financial Condition For Individuals Legal
Form 150-860-009 - Statement Of Financial Condition For Individuals - Oregon Department Of Revenue Form 150-860-009 - Statement Of Financial Condition For Individuals - Oregon Department Of Revenue Financial

Related Categories

Parent category: Financial
Download
Go
Page of 4