Profit and Loss Form

A Profit and Loss Statement is a financial document that summarizes the revenues and expenses incurred by your business during a specific period of time. To show proof of income, you can submit a copy of a current three (3) month P&L with your application. For example, if you submit your application in November, your P&L would show your revenues and expenses for the months of August, September, and October. For an explanation of business expenses used by family child care providers and other small businesses, please click here.

Business: Phone:
Address: City:  State: Zip:
November 2011 December 2011 January 2012
Total Income:$
Total Income:$
Total Income:$
Expenses:
Depreciation:$
Insurance:
(other than health)
$
Rent or Lease:$
Repairs and
Maintenance:
$
Office Expense:$
Utilities:$
Travel, Meals,
and Entertainment:
$
Car and Truck
Expenses:
$
Wages:$
Legal and
Professional Services:
$
Interest:$
Advertising:$
Miscellaneous:$
Expenses:
Depreciation:$
Insurance:
(other than health)
$
Rent or Lease:$
Repairs and
Maintenance:
$
Office Expense:$
Utilities:$
Travel, Meals,
and Entertainment:
$
Car and Truck
Expenses:
$
Wages:$
Legal and
Professional Services:
$
Interest:$
Advertising:$
Miscellaneous:$
Expenses:
Depreciation:$
Insurance:
(other than health)
$
Rent or Lease:$
Repairs and
Maintenance:
$
Office Expense:$
Utilities:$
Travel, Meals,
and Entertainment:
$
Car and Truck
Expenses:
$
Wages:$
Legal and
Professional Services:
$
Interest:$
Advertising:$
Miscellaneous:$


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