Table of Contents
Info Sheet Name: _______________________________________________________________________ SSN: ______-____-_________ Tax ID #: _____________________________________ Partner Name: ________________________________________________________________ Dependent(s): _________________________________________________________________ _____________________________________________________________________________ Mailing Address: ______________________________________________________________ _____________________________________________________________________________ Farm Address: ________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Banking Information Bank: __________________________________________________________________ Accountant Manager: ____________________________________________________ Accountant Information Name: _____________________________________ Phone Number: ______________ Email: _________________________________________________________________ Lawyer Information Name: _____________________________________ Phone Number: ______________ Email: _________________________________________________________________ Retirement/Financial Advisor Information Name: _____________________________________ Phone Number: ______________ Email: _________________________________________________________________
Loan Officer Information Name: _____________________________________ Company: __________________ Email: ____________________________________ Phone Number: _______________ Name: _____________________________________ Company: __________________ Email: ____________________________________ Phone Number: _______________ Insurance Information Name: _____________________________________ Company: __________________ Email: ____________________________________ Phone Number: _______________ Name: _____________________________________ Company: __________________ Email: ____________________________________ Phone Number: _______________ Essential Suppliers (Veterinarians, feed supply, seed supply, etc) Company: _______________________________ Salesman: _____________________ Email: ____________________________________ Phone Number: _______________ Company: _______________________________ Salesman: _____________________ Email: ____________________________________ Phone Number: _______________ Company: _______________________________ Salesman: _____________________ Email: ____________________________________ Phone Number: _______________
INCOME
RECORD OF DEPOSIT Date
Deposit No.
Source
Gross Amount Cash Withheld
Net Deposit
3
RECORD OF DEPOSIT Date
Deposit No.
Source
Gross Amount Cash Withheld
Net Deposit
3
RECORD OF DEPOSIT Date
4
Deposit No.
Source
Gross Amount Cash Withheld
Net Deposit
5
Dec Final Jan Adv Jan Final Feb Adv Feb Final Mar Adv Mar Final Apr Adv Apr Final May Adv May Final June Adv June Final July Adv July Final Aug Adv Aug Final Sept Adv Sept Final Oct Adv Oct Final Nov Adv Nov Final Dec Adv Total
Date
Pounds
Advance
Gross Hauling
Marketing
Prom. _______
Prom. _______
________
Assign. to Assign. to ______ ______
Farm Operating Expenses (deductions) and Assignments
MILK SALES
Net
Dec Final Jan Adv Jan Final Feb Adv Feb Final Mar Adv Mar Final Apr Adv Apr Final May Adv May Final June Adv June Final July Adv July Final Aug Adv Aug Final Sept Adv Sept Final Oct Adv Oct Final Nov Adv Nov Final Dec Adv Total
Date
Pounds
Advance
Gross Marketing
Prom. _______
Prom. _______
________
Assign. to Assign. to ______ ______
Farm Operating Expenses (deductions) and Assignments
MILK SALES Hauling
Net
6
Total
Date
Pounds
Advance
Gross Hauling
Marketing
Prom. _______
Prom. _______
________
Assign. to ______
Farm Operating Expenses (deductions) and Assignments
MILK SALES
record s of t farm financial transactions
7
Assign. to ______
Net
Total
Date
Pounds
Advance
Gross Marketing
Prom. _______
Prom. _______
________
Assign. to ______
Farm Operating Expenses (deductions) and Assignments
MILK SALES Hauling
Assign. to ______
Net
8
(OVER 2 YEARS OLD) Date
To Whom Sold
PAGE TOTAL
12
DAIRY YOUNG STOCK SOLD ID
Gross Receipts
Hauling
Comm. or Net Proceeds Check‐off
CALVES SOLD (CALVES, BULL CALVES, FREE MARTINS) Date
To Whom Sold
ID
Gross Receipts
Hauling
Comm. or Net Proceeds Check‐off
PAGE TOTAL
9
LIVESTOCK SALES ____________(Type of Livestock) Date
To Whom Sold
PAGE TOTAL
14
Qty
Total Cost if Weight Purchased
Gross Receipts
Selling Costs
Net Receipts
LIVESTOCK SALES ____________(Type of Livestock) Date
To Whom Sold
Qty
Total Cost if Weight Purchased
Gross Receipts
Selling Costs
Net Receipts
PAGE TOTAL
15
PURCHASED BREEDING LIVESTOCK SOLD Date
To Whom Sold
Culled or Breeding
ID
Date Purchased
Net Receipts
PAGE TOTAL
13
CROP SALES ____________(Type of Crop) Date
To Whom Sold
PAGE TOTAL
16
Qty
Price
Hauling
Comm. / Net Receipts Check‐off
CROP SALES ____________(Type of Crop) Date
To Whom Sold
Qty
Price
Hauling
Comm. / Net Receipts Check‐off
PAGE TOTAL
17
CROP SALES ____________(Type of Crop) Date
To Whom Sold
PAGE TOTAL
18
Qty
Price
Hauling
Comm. / Net Receipts Check‐off
CROP SALES ____________(Type of Crop) Date
To Whom Sold
Qty
Price
Hauling
Comm. / Net Receipts Check‐off
PAGE TOTAL
19
MACHINERY SALES Date
To Whom Sold
Item
Date Originally Pruchased
Amount Received
LAND SALES & BUILDING SALES Date
To Whom Sold
Item
Date Originally Pruchased
Amount Received
23
Custom Work Income Date
To Whom Sold
PAGE TOTAL
20
Custom Work
Service Performed
Acres / Hours Net Receipts
Custom Work Income Date
To Whom Sold
Custom Work
Service Performed
Acres / Hours Net Receipts
PAGE TOTAL
21
OTHER FARM BUSINESS INCOME Date
Item Federal Gas Tax Refund State Gas Tax Refund Government Payments Government Payments Government Payments Government Payments Government Payments Government Payments Government Payments Government Payments Government Payments Government Payments Government Payments Government Payments Patronage Patronage Patronage Patronage Patronage Patronage Patronage Crop Insurance Crop Insurance Crop Insurance Crop Insurance Crop Insurance Crop Insurance Fire Insurance Auto & Truck Insurance Other Other
22
Description
Gross Distribution
Net Receipts
CAPITAL CONTRIBUTION TO THE BUSINESS Property Other Than Cash Contributed Date
Description
Amount
Cash Contributed to the Business Date
Description
Amount
TOTAL
Loans Made to the Business
TOTAL
24
TOTAL
OTHER INCOME Date
From Whom Received
For What
Amount Received
25
EXPENSES
FEED BOUGHT FOR ______________ Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
record s of t farm financial transactions
Page Total
27
FEED BOUGHT FOR ______________ Date
Ckeck No.
Purchased From (Vendor)
Page Total
28
Description
Cost
FEED BOUGHT FOR ______________ Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
29
FEED BOUGHT FOR ______________ Date
Ckeck No.
Purchased From (Vendor)
Page Total
30
Description
Cost
FEED BOUGHT FOR ______________ Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
31
FEED BOUGHT FOR ______________ Date
Ckeck No.
Purchased From (Vendor)
Page Total
32
Description
Cost
LIVESTOCK SUPPLIES Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
33
LIVESTOCK SUPPLIES Date
Ckeck No.
Purchased From (Vendor)
Page Total
34
Description
Cost
BEDDING Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
35
GENERAL SUPPLIES Date
Ckeck No.
Purchased From (Vendor)
Page Total
36
Description
Cost
GENERAL SUPPLIES Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
37
BREEDING FEES Date
Ckeck Firm (Vendor) No.
TOTAL
38
Fee
Date
Ckeck Firm (Vendor) No.
TOTAL
Fee
LIVESTOCK REGISTRATION Date
Ckeck Firm (Vendor) No.
TOTAL
Fee
MILK TESTING Date
Ckeck No.
Description (Vendor)
Fee
TOTAL
39
VETERINARY Date
Ckeck Purchased From No. (Vendor)
TOTAL
40
MEDICINE Fee
Date
Ckeck Purchased From No. (Vendor)
TOTAL
Fee
LIVESTOCK PURCHASED FOR BREEDING Date
Ckeck No.
To Whom Paid (Vendor)
Identification
Age
Total Cost
LIVESTOCK PURCHASED FOR FEEDING Date
Ckeck No.
To Whom Paid (Vendor)
Identification
Age
Total Cost
41
REPAIRS ‐ BUILDING (Business Only) Date
42
Ckeck No.
Please identify if part of a larger project To Whom Paid Description (Vendor)
Cost
REPAIRS ‐ REAL ESTATE (Including Personal Residence) Date
Ckeck No.
To Whom Paid (Vendor)
Description
Cost
43
EQUIPMENT REPAIRS Date
Ckeck No.
Purchased From (Vendor)
Page Total
44
Description
Cost
EQUIPMENT REPAIRS Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
45
EQUIPMENT REPAIRS Date
Ckeck No.
Purchased From (Vendor)
Page Total
46
Description
Cost
EQUIPMENT REPAIRS Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
47
TRUCK EXPENSE
Beginning Mileage: Ending Mileage: Ckeck Vendor / Date No. Description
TRUCK EXPENSE
Cost
TOTAL
TOTAL
48
Cost
TOTAL
TRUCK EXPENSE
Beginning Mileage: Ending Mileage: Ckeck Vendor / Date No. Description
Beginning Mileage: Ending Mileage: Ckeck Vendor / Date No. Description
TRUCK EXPENSE
Cost
Beginning Mileage: Ending Mileage: Ckeck Vendor / Date No. Description
TOTAL
Cost
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
TOTAL
Cost
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
49
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Description Date No.
TOTAL
50
Cost
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
TOTAL
Cost
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Description Date No.
TOTAL
Cost
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
51
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Description Date No.
TOTAL
52
Cost
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
Cost
TOTAL
CUSTOM HIRE EXPENSE
Name: ID: Address: Ckeck Date Description No.
TOTAL
Cost
FUEL EXPENSE GAS Date
Ckeck No.
Vendor
GAS Gal.
Cost
Date
Ckeck No.
Vendor
Gal.
Cost
53
FUEL EXPENSE DIESEL Date
54
Ckeck No.
Vendor
DIESEL Gal.
Cost
Date
Ckeck No.
Vendor
Gal.
Cost
FUEL EXPENSE OIL Date
Ckeck No.
Vendor
GREASE Gal.
Cost
Date
Ckeck No.
Vendor
Gal.
Cost
HEATING OIL Date
Ckeck No.
Vendor
Gal.
Cost
55
SEED Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
CROP SUPPLIES Date
56
Ckeck No.
Purchased From (Vendor)
Description
Cost
CHEMICALS Date
Ckeck No.
Purchased From (Vendor)
Description
Cost
Page Total
57
FERTILIZER AND LIME Date
Ckeck No.
Purchased From (Vendor)
Page Total
58
Description
Cost
RENT
Lessor: ID: Address: Ckeck Date Item No.
RENT
Total Payment
TOTAL
TOTAL
Total Payment
TOTAL
RENT
Lessor: ID: Address: Ckeck Date Item No.
Lessor: ID: Address: Ckeck Date Item No.
RENT
Total Payment
Lessor: ID: Address: Ckeck Date Item No.
Total Payment
TOTAL
59
RENT
Lessor: ID: Address: Ckeck Date Item No.
RENT
Total Payment
TOTAL
TOTAL
60
Total Payment
TOTAL
RENT
Lessor: ID: Address: Ckeck Date Item No.
Lessor: ID: Address: Ckeck Date Item No.
RENT
Total Payment
Lessor: ID: Address: Ckeck Date Item No.
TOTAL
Total Payment
RENT ‐ MACHINERY AND EQUIPMENT Date
Ckeck No.
To Whom Paid (Vendor)
Description
Cost
Page Total
61
INSURANCE (Farm Related) Date
Ckeck No.
To Whom Paid (Vendor)
Total Payment
TAXES ‐ REAL ESTATE Date
Ckeck No.
TOTAL Ckeck No.
To Whom Paid (Vendor)
TOTAL
62
Total Payment
TOTAL
CROP INSURANCE Date
To Whom Paid (Vendor)
Total Payment
Dues, Subscrip., & Meetings Date
Ckeck No.
To Whom Paid (Vendor)
TOTAL
Total Payment
FREIGHT AND TRUCKING (Non‐Milk) Date
Ckeck No.
To Whom Paid (Vendor)
Description
Cost
Page Total
63
ELECTRICITY Date
64
Ckeck No.
Company (Vendor)
TELEPHONE Cost
Date
Ckeck No.
Company (Vendor)
Less Personal Use
Less Personal Use
Farm Share
Farm Share
Cost
OTHER UTILITIES
Date
Ckeck No.
Company (Vendor)
OTHER UTILITIES
Cost
Date
Ckeck No.
Company (Vendor)
Less Personal Use
Less Personal Use
Farm Share
Farm Share
OTHER UTILITIES
Date
Ckeck No.
Company (Vendor)
Cost
OTHER UTILITIES
Cost
Date
Ckeck No.
Company (Vendor)
Less Personal Use
Less Personal Use
Farm Share
Farm Share
Cost
65
CONSERVATION EXPENSES Date
Ckeck No.
To Whom Paid (Vendor)
Total Payment
OFFICE SUPPLIES
Date
Ckeck No.
TOTAL Ckeck No.
To Whom Paid (Vendor)
TOTAL
66
Total Payment
TOTAL
PROFESSIONAL SERVICES Date
To Whom Paid (Vendor)
Total Payment
ACCOUNTING
Date
Ckeck No.
To Whom Paid (Vendor)
TOTAL
Total Payment
REGISTRATION & LICENSES Date
Ckeck No.
To Whom Paid (Vendor)
Total Payment
BANK / LOAN FEES Date
Ckeck No.
TOTAL
____________
Date
Ckeck No.
To Whom Paid (Vendor)
TOTAL
To Whom Paid (Vendor)
Total Payment
TOTAL Total Payment
____________
Date
Ckeck No.
To Whom Paid (Vendor)
Total Payment
TOTAL
67
MISCELLANEOUS Date
Ckeck No.
To Whom Paid (Vendor)
Page Total
68
Description
Cost
69
Date
Vendor
Item Purchased
Full Price (Sticker Price)
Item Traded
Trade Value
CAPITAL PURCHASES ‐ EQUIPMENT AND ANIMALS Cash Paid
Loan Taken
Date
Item Purchased
Full Price (Sticker Price)
Item Traded
Trade Value
Cash Paid
CAPITAL PURCHASES ‐ REAL ESTATE AND IMPROVEMENTS Vendor
Loan Taken
70
SS#: Exemptions: Address: January January January January January Total February February February February February Total March March March March March Total
June Total
May Total
April Total
1 st Quarter Total
April April April April May May May May June June June June
2 nd Quarter Total First 6 month Total
1
Gross Wages
2
FICA EE Share
3 Medicare EE Share
4
LABOR RECORDS FOR: Hours Worked
5 Deductions Fed Tax Withheld
State Tax Withheld
6
Local Tax Withheld / LST
7
(Employee)
8 Addition
Adv. Pmt EIC
9 Net Cash Wage
(2‐3‐4‐6‐7+8)
10 FICA/MED
Farm Share (3+4)
71
72
4 th Quarter Total Full Year Total
October October October October October Total November November November November November Total December December December December December Total
3 rd Quarter Total
July Total August August August August August Total September September September September September Total
July July July July
SS#: Exemptions: Address: 2
Gross Wages
1
Hours Worked
3
FICA EE Share
LABOR RECORDS FOR: Medicare EE Share
4 Fed Tax Withheld
5 Deductions
7 Local Tax Withheld / LST
6 State Tax Withheld Adv. Pmt EIC
8 Addition
(Employee) (2‐3‐4‐6‐7+8)
9 Net Cash Wage
Farm Share (3+4)
10 FICA/MED
73
SS#
SS# Name: Address:
SS# Name: Address:
SS# Name: Address:
SS# Name: Address:
SS# Name: Address:
Name: Address:
TOTALS
Farm Fed ID #: Farm Name: Farm Address:
3
FICA EE Share
2 Gross Wages
5
Medicare EE Fed Tax Share Withheld
4
State Tax Withheld
6
LABOR RECORDS SUMMARY Local Tax Withheld
7
9 8 Addition Adv. Pmt Net Cash EIC Wages
FICA/MED Farm Share
10
DEPOSITS MADE
Date
Ckeck No.
LOCAL TAXES WITH HELD Confirmation Number
Reported Wages
Amount
TOTAL
STATE UNEMPLOYMENT TAXES Date
Ckeck No.
Confirmation Number
Reported Wages
Amount
TOTAL
FEDERAL UNEMPLOYMENT TAXES Date
Ckeck No.
Confirmation Number
TOTAL
74
Reported Wages
Amount
DEPOSITS MADE FEDERAL Date Period
Confirmation No.
TOTAL
STATE Cost
Date Period Confirmation No.
Reported Wages
Cost
TOTAL
75
OWNER'S DRAW NAME:______________________ NAME:______________________ Date
Ckeck No.
Description
TOTAL
76
Cost
Date
Ckeck No.
Description
TOTAL
Cost
OWNER'S DRAW NAME:______________________ NAME:______________________ Date
Ckeck No.
Description
TOTAL
Cost
Date
Ckeck No.
Description
Cost
TOTAL
77
PROPERTY OTHER THAN CASH TAKEN OUT OF BUSINESS NAME:______________________ NAME:______________________ Date
Description
Cost
TOTAL
78
Date
Description
Cost
TOTAL
LOAN PAYMENTS
Creditor: Date
Term:
Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
LOAN PAYMENTS Creditor: Date
Term: Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
79
LOAN PAYMENTS
Creditor: Date
Term:
Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
LOAN PAYMENTS Creditor: Date
Term: Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
beginning balance:
TOTALS:
80
Principal Balance
LOAN PAYMENTS
Creditor: Date
Term:
Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
LOAN PAYMENTS Creditor: Date
Term: Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
81
LOAN PAYMENTS
Creditor: Date
Term:
Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
LOAN PAYMENTS Creditor: Date
Term: Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
beginning balance:
TOTALS:
82
Principal Balance
LOAN PAYMENTS
Creditor: Date
Term:
Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
LOAN PAYMENTS Creditor: Date
Term: Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
83
LOAN PAYMENTS
Creditor: Date
Term:
Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
Principal Balance
beginning balance:
TOTALS:
LOAN PAYMENTS Creditor: Date
Term: Check No.
Total Payment
Interest
Interest Rate: Principal or Addition
beginning balance:
TOTALS:
84
Principal Balance
PERSONAL EXPENSES PERSONAL INCOME TAXES Date
Period
Federal IRS
State
MEDICAL INSURANCE Local
Date
Ckeck Description No.
Total Payment
Jan. 15th $ 4th Q Est. ck.no. Final Payment Last Yr's Tax Final Payment Last Yr's Tax
June 15th 2nd Q Est. Sept 15th 3rd Q Est.
TOTAL
TOTAL
OTHER PERSONAL TAXES Date
Ckeck No.
Description
TOTAL
Total Payment
PERSONAL INTEREST Date
Ckeck Description No.
Total Payment
record s of t farm financial transactions
April 15th 1st Q Est.
TOTAL
85
PERSONAL EXPENSES MEDICINE AND DRUGS Date
Ckeck No.
Description
TOTAL
86
Cost
MEDICINE AND DRUGS Date
Ckeck No.
Description
TOTAL
Cost
PERSONAL EXPENSES MEDICAL AND DENTAL Date
Ckeck No.
Description
TOTAL
Cost
MEDICAL AND DENTAL Date
Ckeck No.
Description
Cost
TOTAL
87
PERSONAL EXPENSES CHARITABLE CONTRIBUTIONS Date
Ckeck No.
Description
TOTAL
88
Cost
CHARITABLE CONTRIBUTIONS Date
Ckeck No.
Description
TOTAL
Cost
PERSONAL EXPENSES CHARITABLE CONTRIBUTIONS Date
Ckeck No.
Description
TOTAL
Cost
CHARITABLE CONTRIBUTIONS Date
Ckeck No.
Description
Cost
TOTAL
89
PERSONAL EXPENSES Date
Ckeck No.
Purchased From
Page Total
90
Description
Cost
PERSONAL EXPENSES Date
Ckeck No.
Purchased From
Description
Cost
Page Total
91
PERSONAL EXPENSES Date
Ckeck No.
Purchased From
Page Total
92
Description
Cost
PERSONAL EXPENSES Date
Ckeck No.
Purchased From
Description
Cost
Page Total
93
Notes
94
Notes
95
Notes
96