Monthly Income and Expense Statement Business / Self-employed Clients

If you are a business owner, self-employed, own a corporation or are the sole-proprietor of a business, this form will be used to determine your net monthly income, which will then be in-putted into your “Monthly Income and Expense Statement”. Both forms must be completed and submitted monthly during the duration of your bankruptcy.



    Name of the Corporation (if applicable):

    Total Business Income:
    (Total amount paid to the business during the month prior to expenses or tax remittances) $
    Business Expenses:
    (Expenses paid to generate business income; Do NOT include personal expenses) $
    Licenses, Memberships and Dues $
    WCB & Insurance $
    Rent $
    Interest on Business Loans $
    Maintenance and Repairs $
    Legal, Professional Fees or Accounting $
    Wages Paid to Employees (Do NOT included wages paid to yourself) $
    Phone $
    Utilities (Including internet) $
    Vehicle Expense (only include business use portion) $
    Other Expense (Please describe)
    Other Expense (Please describe)
    Other Expense (Please describe)
    Instalment Payments made to the Canada Revenue Agency (Proof attached is required)
    Total Business Expense $
    Net Business Income (Total Business Income less Total Business Expense) $

    Please continue onto “Monthly Income and Expense Statement” and submit “Net Business Income” under Self-employment Income section.

    The forms submitted through the course of the bankruptcy will be averaged out to determine your surplus income requirement. After submitting the form, please ensure you have also completed the “Monthly Income and Expense Statement”. Should you have questions on how to fill out the form, please contact our office.