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Self-Employment Deduction Form

Tax Year: 20
Taxpayer Information
First Name:
First name is required.
Last Name:
Last name is required.
Email:
Valid email is required.
Telephone:
Telephone is required.
SSN or EIN:
SSN/EIN is required.
SSN or EIN:
Business Information
Business Name (if any):
Business Type:
Industry:
City:
State:
Business Address:
Income Information
Primary Income Source:
Total Gross Income for Tax Year:
$
Self-Employment Deductions (Enter total annual amounts)
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Additional Deductions (Optional)
1.
$
2.
$
3.
$
Supporting Documents Attached
  • 1099 Forms
  • Mileage Log
  • Other:  
Taxpayer Declaration
I certify that the information provided on this form is true and accurate to the best of my knowledge.

I understand that deductions must comply with IRS rules and may be subject to verification.
Signature:
Date:
Vehicle Use (If Applicable)
Vehicle Used for Business:
Total Miles Driven:
Business Miles:
Personal Miles:
Home Office (If Applicable)
Do you work from home?
Dedicated Office Space Only:
Approx. Square Footage:
Supporting Documents Attached
Other:
Taxpayer Declaration

I certify that the information provided on this form is true and accurate to the best of my knowledge. I understand that deductions must comply with IRS rules and may be subject to verification.

Signature:
Printed Name:
Date: