Profit & Loss Statement (Sample)
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1
2PROFIT & LOSS STATEMENT
(Sample)
Any borrower(s) who is/are self-employed or an independent contractor should complete this form if they do not
already have their own profit and loss form. (An individual profit and loss statement is needed for every business.)
Company Name: ______________________________________________
Percent of Ownership: _________
Company Address: ____________________________________________________________________________
Type of Business: _____________________________________________________________________________
Borrower(s): _________________________________________________________________________________
Loan Number: _________________________
Report Dates: (From) ____________ (To) ____________
(The information below must be year to date and must include a minimum of 4 months of Income and Expenses. The
Report “To” date cannot exceed the date of this form.)
Please fill in the fields that apply to your business.
GROSS INCOME
Definition
Expense
Income
Total amount of income from the sales or services, before
Gross Income
$
subtracting expenses.
Any other additional funds earned throught the company, such as:
Other Income
$
paymens from people leasing space or payments from investors.
Total Gross Income
Income before taxes
$
EXPENSES
Definition
Expense
Income
Cost of Goods Sold
Direct costs to produce or obtain the goods sold by the company.
$
Accounting and Legal Fees
$
$
Advertising Expenses
Do not include Home Owner's Insurance.
$
Insurance
Maintenance and Repairs
$
Supplies
$
Payroll Expenses
Salaries and wages from borrower(s) on the mortgage loan.
$
Salaries and wages for employees who are not borrwer(s) on the
$
Payroll Expenses
mortgage loan.
Postage
$
Payroll Expenses, paid to the Borrower(s), require paystubs within the last 30days. Business bank statements may
be required.
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