General Business Information First Name * Last Name * Email * Phone: * Principal Business or Profession: Employer I.D. Number: Business Name: * Business Street Address: * Street Address 2: City: * State: * Postal Code: * Foreign only – Province/State, Country, Postal Code: Accounting method: Accrual Cash Other Inventory method, if not cash: Lower of Cost or Market Other Change of inventory method: Yes No Filing Year: Prior Year: Activity Type – Some investment is NOT at risk You started or acquired this business during the filing year You disposed of this property during the filing year Did you make any payments in the filing year that would require you to file Form(s) 1099? Yes No If “Yes”, did you or will you file all required Forms 1099? Yes No Other Information Filing Year – Family Health Coverage: Prior Year – Family Health Coverage: Income Filing Year – Gross receipts or sales: Prior Year – Gross receipts or sales: Filing Year – Returns and allowances: Prior Year – Returns and allowances: Filing Year – Other income: Prior Year – Other income: Cost of Goods Sold Filing Year – Inventory at beginning of the year: Prior Year – Inventory at beginning of the year: Filing Year – Purchases (less cost of items withdrawn for personal use): Prior Year – Purchases (less cost of items withdrawn for personal use): Filing Year – Cost of labor: Prior Year – Cost of labor: Filing Year – Materials and supplies: Prior Year – Materials and supplies: Filing Year – Other costs (list): Prior Year – Other costs (list): Filing Year – Inventory at end of year: Prior Year – Inventory at end of year: Expenses Filing Year – Advertising: Prior Year – Advertising: Filing Year – Car and truck expenses: Prior Year – Car and truck expenses: Filing Year – Commissions and fees: Prior Year – Commissions and fees: Filing Year – Contract labor: Prior Year – Contract labor: Filing Year – Depletion: Prior Year – Depletion: Filing Year – Employee benefit programs: Prior Year – Employee benefit programs: Filing Year – Insurance (other than health): Prior Year – Insurance (other than health): Filing Year – Mortgage interest (paid to banks, etc.): Prior Year – Mortgage interest (paid to banks, etc.): Filing Year – Other interest: Prior Year – Other interest: Filing Year – Legal and professional services: Prior Year – Legal and professional services: Filing Year – Office expense: Prior Year – Office expense: Filing Year – Pension and profit sharing plans: Prior Year – Pension and profit sharing plans: Filing Year – Rent or lease (vehicles, machinery, and equipment): Prior Year – Rent or lease (vehicles, machinery, and equipment): Filing Year – Rent (other business property): Prior Year – Rent (other business property): Filing Year – Repairs and maintenance: Prior Year – Repairs and maintenance: Filing Year – Supplies: Prior Year – Supplies: Filing Year – Taxes and licenses (including real estate taxes): Prior Year – Taxes and licenses (including real estate taxes): Filing Year – Travel: Prior Year – Travel: Filing Year – Total meals and entertainment: Prior Year – Total meals and entertainment: Filing Year – Utilities: Prior Year – Utilities: Filing Year – Wages: Prior Year – Wages: Additional Information Other expenses (list): Other comments or detail: Submit