DAY CARE INCOME and EXPENSE WORKSHEET YEAR

1 DAY CARE INCOME and EXPENSE WORKSHEETYEAR_____YOUR NAME_____SS # or Federal ID #_____NAME OF DAY CARE BUSINESS_____ADDRESS (if different than your residence)_____How many months was this business in operation during the year?12 Months OR From_____To_____Were you still in business on December 31st?YES NO DAY CARE INCOME INCOME DIRECTLY FROM PARENTSFOOD PROGRAM PAYMENTS:PAYMENTS FROM GOVERNMENT AGENCIEST otal receivedCASH GIFTS FROM PARENTSA mount for your childrenSALES OF EQUIPMENT USED FOR DAY CARE ANDA mount for others DEDUCTED IN THE PASTO ther incomeAUTO EXPENSE .

2 Keep records of mileage for Day Care meetings, shopping trips forsupplies, banking, education, taking children home, to doctor or to you take EXPENSE on mileage basis complete lines 1-10 Your total grocery bill (in an audit, you & Make of Auto (Bring in purchase/sales papers)prove a reasonable amount spent for Purchased: Month, Date, YearAmount spent on Day Odometer Reading: December 31 IRS has used the federal food program allowance to Odometer Reading: January 1cost of food provided to the children. List below the number Miles Driven: Line 3 less Line 4all meals served during year in your home, not just Day Care Miles in Line 5 (do you have evidence to support?))

3 Reimbursed - plus cost of meals purchased in a restaurant, Round Trip Miles (if Day Care not in your home)BREAKFASTT otal and TollsLUNCHEST otal and Taxes (Not Sales Tax)DINNERST otal [continue below if you take actual EXPENSE ]MORNING SNACKST otal , oil, lube, repairs, tires, batteries, insurance, SNACKST otal (fair market value at time of lease $ _____)Cost of Meals Purchased in IN HOME (if licensed, or not required to be)Date Home AcquiredTotal CostCost of LandCost of ImprovementsSquare Footage of HomeSquare Footage Used for Day Care (regularly)Square Footage Used for Day Care (exclusively)HOME RELATED EXPENSES100%Day CarePartialReal Estate TaxesMortgage InterestCasualty LossElectricityHeatInsurance - General PolicyInsurance - Day Care RiderRepairs/MaintenanceWater/Sewer/Garb age/Cable TVRent Paid - if you are a renterOther (specify)

4 If you operated your day care business out of more than one location,call for additional your work hours are irregular, you may claim the hours that youadvertise as business hours as long as you actually care for childrenall of those hours at least some days during the a daily log with Time In and Time Out addition to the hours spent on Day Care, you may claim the timespent on Day Care related jobs such as:cleaning up after childrenfood preparationrecord keepingplanning and preparationother (specify)DAY CARE hours per dayNumber of days during the year whenchildren were in your careIf hours vary, total of hours for YearIN CASE OF AN AUDIT, THESE RECORDS WILL BE CARE BUSINESS expenses (continued)MAJOR PURCHASES and IMPROVEMENTS(Computers, office equipment, furnishings)ItemPurchasedDatePurchasedCo stItemPurchasedDate ofPurchaseCostCHECK LAST YEAR S DEPRECIATION FORM TO SEE IF ALL ITEMS ARE CURRENT*1099s.

5 Amounts of $ or more paid to individuals (notcorporations) for rent, interest, or services rendered to you in yourbusiness, require information returns to be filed by Nonfiling penalty can be $150 each are required to withhold taxes if recipient does not furnishyou with his/her Social Security date of form is January Security #AmountPurpose of Payment W-9s (Request for Payee s Social Security Number) are certify that the amounts shown are true and correct _____please sign 1999-2007 Sauk Rapids Forms, Minneapolis, MN 55407 ADVERTISING/PROMOTION: Newspaper ads,business cards, Day Care t-shirts/sweatshirts, EXPENSE (see other side)EMPLOYEE BENEFITS: Health insurance purchasedfor employeesINSURANCE: Business LiabilityINTEREST:on items used for day care onlyPaid to financial institutionDay Care only credit cardLEGAL & PROFESSIONAL.

6 Day Care only attorney oraccountant feesOFFICE SUPPLIES: Postage, stationery, pens,pencils, small office equipment, holiday or birthdaycards, Day Care record books, calendarsPENSION PLANS: for employeesRENT:Building (if Day Care not in home)Toy rentalVideos / DVDsREPAIRS and MAINTENANCESUPPLIES:Household cleaning supplies, handsoap, tissues, paper towels, paper100%Day CareSharedcups, plates, disposable cutlery, or children s supplies, games,toys, crayons, craft :Real estatePayroll (your share Soc. Sec., Medicare)Federal unemploymentState unemploymentTRAVEL & ENTERTAINMENT: Costs for entertain-ment of parents, tickets to events, WHO, WHEN, WHYUTILITIES & TELEPHONE:Telephone (business line - if you have one)Personal phone (base phone cost not deductible)Extra extension (phone options for Day Care)Long distance costs for Day CareWAGES(bring your copy of W-2s/941s if they havebeen filed)Wages to spouse (subject to payroll tax)Children under 18 (not subject to &Medicare tax)Other wagesBANK CHARGES/OVERDRAFTS.

7 Business accountonly - cost of printed checks, service : For Day Care children - caps, mittens,diapers, & PUBLICATIONS: Day Care license, , Day Care magazines for you or : Workshop registration, books, suppliesFOOD: (see other side)GIFTS: For Day Care children and true employees holiday, birthday, & CLEANING: Professional cleaning offurniture, carpeting, drapes: only a percentage willbe allowed unless you can show that Day Care was100% responsible for related to Day CarePartially related to Day CareUNIFORMS: Furnished to employees and for expenses (not listed elsewhere)