Self-Employment Deduction Form

Tax Year: 20
Taxpayer Information
First Name:
Last Name:
Email:
Telephone:
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.
$
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:
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:
Sign using your mouse or finger.
Printed Name:
Sign Date: