Client Intake Form
Mobile Remote Apostille Loan Signing Notary
(817) 726-2181
Self-Employed, Independent Contractors, Sole Proprietors, Single LLC’s and 1099-MISC with box 7 income listed must complete the form below. Instructions: List all expense, except for meals - Only add expenses that correspond to the income categories above.
Business Name:
Type of Business:
Address:
Did you begin the business this year?YesNo
INCOME
Gross Income
Returns
COGS (if you sell product)
Total Income
COGS Cost of Goods Sold. (Only use this section if you sell product)
Opening Inventory (value of inventory on 1/1 - the 1st year it is 0)
Inventory Purchases
Materials & Supplies
Ending Inventory (value of inventory on 12/31)
BUSINESS AUTO MILEAGE
Type of Auto:
Date you began using it for business:
Business Miles driven this year:
Other Miles driven this year:
You only need to continue with auto section if you spend a lot on maintenance (otherwise the mileage rate above will be a better deduction)
Gas/oil
Insurance
Licenses/Registration
Repair/Maintenanc
Parking/Tolls
Other:
BUSINESS TRAVEL
Airfare
Lodging
Meals while away from home
Bus, train, taxi, parking, tolls
BUSINESS EXPENSES
Advertising (Website, Business cards, Marketing, etc.)
Commissions & fees you paid
Contract labor
Health Insurance if not covered by spouse or employer plan
Mortgage interest (business)
Interest on business credit cards
Legal & Professional Services
Office Expense (ink, paper, e
Rent of machinery, instruments, storage, studio/office space
Repairs/Maintenance
Supplies (supplies unique to your business, i.e. acupuncture needles)
Taxes & Licenses
Meals/Entertainment ($ you spent with the expectation of making money)
Utilities for a business property (not including home office)
Wages you paid an employee
Internet
Training, Cont. Ed., Conferenc
Cell Phone (business use % on
Trade Publications, Subscriptio
Postage/Shipping
Memberships, Dues
Client Gifts
Promotional Items
Local Transportation, Parking/To
Uniform Purchase/Maintenance (i.e. dry cleaning of lab coat, scrubs, etc)
HOME OFFICE (Only if space is exclusively used for business and it is for your employer’s convenience not yours, i.e. they don’t offer you a work space)
Square feet used for business
Total square footage of home
Total utilities (electric, gas, garbag
Rent (total for the year)
Renter’s Insurance
$ spent specifically on the office spac
If you own your home also include:
Mortgage Interest
Property Taxes
Homeowner’s Insurance
If you want to take more than the $1500 safe harbor home office deduction we’ll need to depreciate the structure every year. If you already have a depreciation schedule make sure I have your last year’s tax return so I can follow it. Otherwise, answer the following:
Date you purchased the property
Date you began using the home of
Purchase price or Fair Market Value on the date it became a home office (whichever is lower)
Value of the land*
Looking on the real estate assessment for the property to figure out what the land portion is on the property tax.
Did you purchase anything over $500 for the business this year? If so please fill out the following per item:
Item Name
Date purchased
Price
Percent of business use %
If you have more of these list below.
Use this space to tell us anything else you think we should know or list any items you’re wondering if you can deduct:
Your Email
*Only the structure is depreciated. You must figure out the land value. You can do this by:
1. Finding it on the appraisal,
2. Getting an appraisal if you haven’t,
3. Looking at sales of comparable raw land in your area,
Signature of Taxpayer:
Signature of Spouse:
Please prove you are human by selecting the plane.