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  1. Revenue Canada        STATEMENT OF BUSINESS/PROFESSIONAL/COMMISSION            Taxation                            INCOME                                     ───────────────────────────────────────────────────────────────────────────────Name:                                         SIN: _ _ _ _ _ _ _ _ _           ───────────────────────────────────────────────────────────────────────────────Type of Business:_______________________  Remittance No.:_____________________                                                                                Address_________________________________  Commodity___________________________                                                                                Period:            to                     Final Year of Business?              ═══════════════════════════════════════════════════════════════════════════════  Income:                                                                            Sales, Commissions, Professional Fees...........................                                                                                              Other Income....................................................                                                                               ────────                Gross Income...........................................                                                                                          Expenses and Allowances:                                                            Accounting, Legal, collection, consulting...............                                                                                                      Advertising, promotion..................................                                                                                                      Bad Debts...............................................                                                                                                      Business Tax, Licenses, dues, fees......................                                                                                                      Convention, Seminar expenses............................                                                                                                      Delivery ...............................................                                                                                                      Equipment Rentals.......................................                                                                                                      Insurance (fire, theft, liability)......................                                                                                                      Interest, bank charges, exchange........................                                                                                                      Meals & Entertainment:  Actual:           x 80%.........                                                                                                      Office Expense and stationery...........................                                                                                                      Supplies................................................                                                                                                                                                                                                                                                                    Travel expenses (except auto)...........................                                                                                                      Other Expenses (specify)                                                                                                                                         ────────────────────────────────.....................                                                                                                         ────────────────────────────────.....................                                                                                                         ────────────────────────────────.....................    ───────────                                                                                                                              Total Expenses...                                                                                   ───────────                                                                                                              Excess of income over expenses...                                                                                   ═══════════