Form CJ-D301 Schedule A "Financial Statement Template" - Massachusetts

What Is Form CJ-D301 Schedule A?

This is a legal form that was released by the Massachusetts Department of Revenue - a government authority operating within Massachusetts. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2011;
  • The latest edition provided by the Massachusetts Department of Revenue;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CJ-D301 Schedule A by clicking the link below or browse more documents and templates provided by the Massachusetts Department of Revenue.

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Download Form CJ-D301 Schedule A "Financial Statement Template" - Massachusetts

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FINANCIAL STATEMENT SCHEDULE A
Name:
Docket No.
MONTHLY SELF-EMPLOYMENT OR BUSINESS INCOME
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)
$
$
CJ-D 301 Schedule A (4/07)
CGF
Page 1 of 2
FINANCIAL STATEMENT SCHEDULE A
Name:
Docket No.
MONTHLY SELF-EMPLOYMENT OR BUSINESS INCOME
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)
$
$
CJ-D 301 Schedule A (4/07)
CGF
Page 1 of 2
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.
PERCENTAGE OF INCOME RECEIVED
EXPENSES INCURRED
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
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)
CGF
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