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Property Supplemental Income Form

Income or Loss From Rental Real Estate and Royalties
A Did you make any payments in 2021 that would require you to file Form(s) 1099? (see instructions) YesNo
B If “Yes,” did you or will you file required Forms 1099? YesNo
1a Physical address of each property (street, city, state, ZIP code)
A
B
C
1b Type of Property (from list below)
A
B
C
2 For each rental real estate property listed above, report the number of fair rental and personal use days.
Fair Rental Days Personal Use Days
A
B
C
Type of Property:
1 Single Family Residence 3 Vacation/Short-Term Rental 5 Land 7 Self-Rental
2 Multi-Family Residence 4 Commercial 6 Royalties
Income: Properties: A B C
3 Rents received 3
4 Royalties received 4
Expenses:
5 Advertising 5
6 Auto and travel (see instructions) 6
7 Cleaning and maintenance 7
8 Commissions 8
9 Insurance 9
10 Legal and other professional fees 10
11 Management fees 11
12 Mortgage interest paid to banks, etc. (see instructions) 12
13 Other interest 13
14 Repairs 14
15 Supplies 15
16 Taxes 16
17 Utilities 17
18 Depreciation expense or depletion 18
19 Other 19
20 Total expenses. Add lines 5 through 19 20
Signature of Taxpayer:      Signature of Spouse:     
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