Forms C-1, C-2 And C-3 - Business Income And Cost Of Goods Sold - 2016 Page 3

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Business Expenses - Vehicle and
6B
Other Listed Property
2016
Name of Business:
]]]]]]]]]]]]]]
Principal Business or Profession:
]]]
Listed Property Questions for 2016:
Yes
No
Do you have evidence to support your deduction?
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
If Yes, is the evidence written?
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
Do you have evidence to support the business use percentage claimed on listed property?
]]]]]]]]]]]]]]]]]]]]]]]
If Yes, is the evidence written?
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
If you are an employer who provides vehicles for use by employees:
Yes
No
Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your employees?
Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees?
]]
Do you treat all use of vehicles by employees as personal use?
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
Do you provide more than five vehicles to your employees, obtain information from your employees about the use of the
vehicles and retain the information received?
]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]]
Do you meet the requirements for qualified demonstration use by maintaining a written policy statement that prohibits
vehicle use by individuals other than full-time vehicle salespersons, use for personal vacation trips, storage of
personal possessions in the vehicle and limits the total mileage outside the salesperson's normal working hours?
]]]]]]
Vehicle 1
Vehicle 2
Vehicle:
Description of vehicle
]]]]]]]]]]
Date placed in service
]]]]](Mo/Da/Yr)
Do you (or your spouse) have another
vehicle available for your personal use?
Yes
No
Yes
No
Was your vehicle available for use during
off-duty hours?
]]]]]]]]]]]]]
Yes
No
Yes
No
Mileage:
2016 Miles
2015 Miles
2016 Miles
2015 Miles
Total miles
]]]]]]]]]]]]]]]]
Total business miles
]]]]]]]]]]
Total commuting miles for the year
]]
Actual Expenses:
2016 Amount
2015 Amount
2016 Amount
2015 Amount
Gasoline, oil, repairs, insurance, etc
]]
Interest
]]]]]]]]]]]]]]]]]
Taxes
]]]]]]]]]]]]]]]]]]]
Fair market value of leased vehicle
]]
Vehicle rentals/leases
]]]]]]]]]
Worksheet: Business > Auto Information, Depreciation and Listed Property Questions
600163 04-01-16
Forms C-4 and C-5

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