Self-Employed Income Verification – No 1099 Received

If you operated a business, performed contract work, received cash payments, or earned self-employment income but did not receive a Form 1099, you may still be required to report that income on your tax return. Please complete this form so RCJ MULTISERVICES, LLC can properly document your business income and expenses.

1. Taxpayer Information

Full Legal Name

First Name

Middle Name

Last Name

Phone Number

Tax Year

Business Name / DBA

EIN (if applicable)

Type of Business / Business Activity

Date Business Started

2. Business Income

Enter the total amount received from each source during the tax year. Leave blank any source that does not apply.

Important: Report all business income received, even if you did not receive a Form 1099 for the payment.

Cash Received

Checks Received

Zelle

Cash App

Venmo

PayPal

Square / Stripe

Other Payment Processors

Bank Deposits Identified as Business Income

Customer Invoices / Payments

Other Business Income

Total Gross Business Income

Calculated automatically.

3. Income Documentation Upload

Upload any records that support the income reported above. Accepted file types: PDF, JPG, PNG, XLSX, CSV. Maximum 10MB per file; multiple files allowed in each category.

Bank Statements

Maximum file size: 10MB

Payment-App Statements

Maximum file size: 10MB

Invoices

Maximum file size: 10MB

Receipt Books / Receipts

Maximum file size: 10MB

Deposit Records

Maximum file size: 10MB

Customer Payment Records

Maximum file size: 10MB

Bookkeeping Reports / P&L

Maximum file size: 10MB

Job or Appointment Logs

Maximum file size: 10MB

4. Business Expenses

Enter the total amount for each category that applies. Uploading receipts or statements is optional but recommended. Accepted file types: PDF, JPG, PNG, XLSX, CSV (max 10MB per file).

Advertising – Amount

Advertising – Documents (optional)

Maximum file size: 10MB

Supplies – Amount

Supplies – Documents (optional)

Maximum file size: 10MB

Vehicle / Mileage – Amount

Vehicle / Mileage – Documents (optional)

Maximum file size: 10MB

Insurance – Amount

Insurance – Documents (optional)

Maximum file size: 10MB

Rent / Lease – Amount

Rent / Lease – Documents (optional)

Maximum file size: 10MB

Contract Labor – Amount

Contract Labor – Documents (optional)

Maximum file size: 10MB

Repairs and Maintenance – Amount

Repairs and Maintenance – Documents (optional)

Maximum file size: 10MB

Office Expenses – Amount

Office Expenses – Documents (optional)

Maximum file size: 10MB

Professional Fees – Amount

Professional Fees – Documents (optional)

Maximum file size: 10MB

Business Phone / Internet – Amount

Business Phone / Internet – Documents (optional)

Maximum file size: 10MB

Other Expenses – Amount

Other Expenses – Documents (optional)

Maximum file size: 10MB

Total Business Expenses

Calculated automatically.

5. No-1099 Explanation

Please explain why you did not receive a 1099 and describe how you determined the business income reported above.

Examples: cash-paying customers, multiple customers below the 1099 reporting requirements, direct payments from customers, payment apps, invoices, etc.

6. Required Certifications

Please check each box to confirm.

Certification – All Income Disclosed

I certify that I have disclosed all business income received during the tax year, including cash and electronic payments.

Certification – 1099 Responsibility

I understand that not receiving a Form 1099 does not automatically eliminate my responsibility to report business income.

Certification – Expenses Accurate

I certify that the expenses submitted are related to my business and are accurate to the best of my knowledge.

Certification – Additional Documentation

I understand that RCJ MULTISERVICES, LLC may request additional documentation before including income, expenses, deductions, losses, or credits on my tax return.

Certification – No Guarantee

I understand that submitting this form does not guarantee that every expense or deduction submitted will be included on my tax return.

7. Electronic Signature

Type Your Full Legal Name

Date

Electronic Signature

Clear

E-Signature Consent

I agree that my typed name and electronic signature above represent my signature and my certification, as the taxpayer, of all information and statements in this form.

For verification purposes, your IP address and the date and time of submission are recorded with this form.

Preparer Review (Office Use Only)

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Self-Employed Income Verification – No 1099 Received

1. Taxpayer Information

2. Business Income

3. Income Documentation Upload

4. Business Expenses

5. No-1099 Explanation

6. Required Certifications

7. Electronic Signature

Preparer Review (Office Use Only)

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