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Get SD DSS-EA-320 2002

SD EForm - 0990 V1 Complete and use the button at the end to print for mailing. HELP DSS-EA-320 04/02 SELF-EMPLOYMENT LEDGER This form must be completed correctly or it will be returned RECIPIENT NAME BUSINESS NAME DATES COVERED 15th THROUGH 14TH HOURS WORKED THIS REPORTING PERIOD GROSS INCOME minus TOTAL EXPENSES DSS REMINDER Business shelter cost must be deducted if business property is connected to the home property. ADJUSTED INCOME Allowable Business Expenses Most business expenses may be subtracted from your selfemployment income but not all the expenses can be. Please contact your caseworker if you have any question on whether or not to list a business expense below. Examples of expenses that are allowed and could be listed include l Amounts paid for items needed in the business such as supplies repairs advertising feed seeds fertilizer etc* goods required for the self-employment business. Capital assets and durable goods are generally objects used in business that are expected to last a long time such as tractors combines buildings etc* If the home is connected to the business property farm only the business portion of shelter expenses may be used as a deduction* If the business meets office in the home requirements the business portion of shelter expenses may be used as a deduction if the household requests it. Monthly telephone charge unless there is a separate business phone long distance telephone charges that are business related may be deducted however. Mileage expenses from the home to the first and last work location cannot be deducted even if the business is located in the home. Mileage deductions are only allowed for trips between business sites not for commuting from the home to the business. INCOME MONEY RECEIVED BY RECIPIENT DATE RECEIVED TYPE OF INCOME AMOUNT EXPENSE COSTS OF SELF-EMPLOYMENT PAID EXPENSE Use back side if more space is needed SIGNATURE ON THE BACK PAGE IS REQUIRED The form is not acceptable without a signature. Total I certify that I have receipts or some type of verification on file for all income and expenses reported on this form and I will keep them on file for at least one year from date reported* I declare and affirm under the penalties of perjury that the information has been examined by me and to the best of my knowledge and belief is in all things true and correct. ADJUSTED INCOME Allowable Business Expenses Most business expenses may be subtracted from your selfemployment income but not all the expenses can be. Please contact your caseworker if you have any question on whether or not to list a business expense below. Please contact your caseworker if you have any question on whether or not to list a business expense below. Examples of expenses that are allowed and could be listed include l Amounts paid for items needed in the business such as supplies repairs advertising feed seeds fertilizer etc* goods required for the self-employment business. Examples of expenses that are allowed and could be listed include l Amounts paid for items needed in the business such as supplies repairs advertising feed seeds fertilizer etc* goods required for the self-employment business. Capital assets and durable goods are generally objects used in business that are expected to last a long time such as tractors combines buildings etc* If the home is connected to the business property farm only the business portion of shelter expenses may be used as a deduction* If the business meets office in the home requirements the business portion of shelter expenses may be used as a deduction if the household requests it. .

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