Free fillable online - Massachusetts

FINANCIAL STATEMENT SCHEDULE A
Name: GROSS MONTHLY RECEIPTS Monthly Business Expenses
Cost of goods sold Advertising Bad Debts Motor Vehicles: Gas Insurance Maintenance Registration Commissions Depletion Dues and Publications Employee Benefit Programs Freight Insurance (other than health), please specify type of insurance: $ $ Interest on mortgage to banks Interest on loans Legal and Professional services Office expenses Laundry and cleaning Pension and profit sharing Rent on leased equipment Machinery/Equipment Other business property Repairs Supplies Taxes Travel Meals and entertainment Utilities and phones Wages Other expenses (specify) $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

Docket No. MONTHLY SELF-EMPLOYMENT OR BUSINESS INCOME

$ $ $ $ $ $ $ $ $

CJ-D 301 Schedule A (4/07)

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FINANCIAL STATEMENT SCHEDULE A
TOTAL MONTHLY EXPENSES WEEKLY BUSINESS INCOME (Gross monthly receipts less total monthly expenses divided by 4.3.) Enter this amount in Section II, line (d) of CJ-D 301-L or Section 2(d) of CJ-D 301-S. NATURE OF SELF-EMPLOYMENT OR BUSINESS 1. Is this business seasonal in nature? Yes No

2. If a seasonal business, please specify percentage of income received and expenses incurred for each month of the year. MONTH January February March April May June July August September October November December 3. State whether your business accounts on a calendar year basis or fiscal year basis: CALENDAR FISCAL PERCENTAGE OF INCOME RECEIVED EXPENSES INCURRED

4. If your business accounts on a fiscal year basis, give the starting and ending dates of your chosen fiscal year:

starting

ending

5. State your gross receipts, year to date: 6. State your gross expenses, year to date:

CJ-D 301 Schedule A (4/07)

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