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:
May 2010 June 2010 July 2010
Total Income:$
Total Income:$
Total Income:$
Expenses:
Depreciation:$
Insurance:$
Rent:$
Repairs:$
Security System:$
Utilities and Services:$
Meals and Snacks:$
Car:$
Real Estate Taxes:$
Qualified Mortgage
Insurance Premiums:
$
Deductible Mortgage
Interest:
$
Casualty Losses:$
Miscellaneous:$
Expenses:
Depreciation:$
Insurance:$
Rent:$
Repairs:$
Security System:$
Utilities and Services:$
Meals and Snacks:$
Car:$
Real Estate Taxes:$
Qualified Mortgage
Insurance Premiums:
$
Deductible Mortgage
Interest:
$
Casualty Losses:$
Miscellaneous:$
Expenses:
Depreciation:$
Insurance:$
Rent:$
Repairs:$
Security System:$
Utilities and Services:$
Meals and Snacks:$
Car:$
Real Estate Taxes:$
Qualified Mortgage
Insurance Premiums:
$
Deductible Mortgage
Interest:
$
Casualty Losses:$
Miscellaneous:$


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