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Personal Information

Driver's Name:

Corporation Name:

Leased To :

For Month Ending: [Choose One]

Email:

 

Expenses

Note: Do not record expenses that are deducted from your settlements.

If no item expenses, enter "00".

Personally Paid Items	Amount
#170 Taxes - Personal Estimates:
#205 Taxes - Payroll:
#505 Bank & C.C.I.S. Fees:	[?]
#510 Bonds:
#525 Fuel Expenses:	[?]
#529 Health Insurance:
#530 Insurance:	[?]
#534 Accounting Fees:
#540 Motels and Lodging:	[?]
#545 Office Supplies:	[?]
#555 Misc Expenses:	[?]
#560 Permits and License:	[?]
#565 Postage/Courier Fees:	[?]
#570 Taxes - Heavy Vehicle Use:
#575 Telephone:	[?]
#580 Tire Expense:	[?]
#585 Repairs/Parts/Services:	[?]
#587 Truck Supplies:	[?]
#590 Truck Wash:	[?]
#595 Refrigeration Fuel:	[?]
#600 Unloading/Lumper:	[?]
#605 Weights and Tolls (Full Amount):
Truck Payment:
Trailer Payment:
#535 Meals and Incidental Expenses:
A. If using per diem rate indicate # Days Out:	[?]

Other / Comments

 

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