OMB No. 1545-0139 Employee Business Expenses Form 2106

 See separate instructions.

Department of the Treasury

Internal Revenue Service  Attach to Form 1040.

Attachment

Sequence No. 54

Your name Occupation in which you incurred expenses Social security number

Employee Business Expenses and Reimbursements

Column A Column B

Step 1 Enter Your Expenses Meals and

Entertainment

Other Than Meals

and Entertainment

1

Vehicle expense from line 22 or line 29. (Rural mail carriers: See

instructions.)

1

2

Parking fees, tolls, and transportation, including train, bus, etc., that

did not involve overnight travel or commuting to and from work

2

Travel expense while away from home overnight, including

lodging, airplane, car rental, etc. Do not include meals and

entertainment

3

3

Business expenses not included on lines 1 through 3. Do not

include meals and entertainment

4

4

5 Meals and entertainment expenses (see instructions) 5

Total expenses. In Column A, add lines 1 through 4 and enter the

result. In Column B, enter the amount from line 5

6

6

Note: If you were not reimbursed for any expenses in Step 1, skip line 7 and enter the amount from line 6 on line 8.

Step 2 Enter Reimbursements Received From Your Employer for Expenses Listed in Step 1

Enter reimbursements received from your employer that were not

reported to you in box 1 of Form W-2. Include any reimbursements

reported under code “L” in box 12 of your Form W-2 (see

instructions)

7

7

Step 3 Figure Expenses To Deduct on Schedule A (Form 1040)

8

Subtract line 7 from line 6. If zero or less, enter -0-. However, if

line 7 is greater than line 6 in Column A, report the excess as

income on Form 1040, line 7

8

Note: If both columns of line 8 are zero, you cannot deduct

employee business expenses. Stop here and attach Form

2106 to your return.

9

9

10

In Column A, enter the amount from line 8. In Column B, multiply

line 8 by 50% (.50). (Employees subject to Department of

Transportation (DOT) hours of service limits: Multiply meal

expenses by 65% (.65) instead of 50%. For details, see

instructions.)

Add the amounts on line 9 of both columns and enter the total here. Also, enter the total on

Schedule A (Form 1040), line 20. (Fee-basis state or local government officials, qualified

performing artists, and individuals with disabilities: See the instructions for special rules on

where to enter the total.)  10

For Paperwork Reduction Act Notice, see instructions. Cat. No. 11700N Form 2106 (2003)

Part I

(99)

2003
Form 2106 (2003) Page 2

Vehicle Expenses

Section A—General Information (You must complete this section if you

are claiming vehicle expenses.) (a) Vehicle 1 (b) Vehicle 2

11 Enter the date the vehicle was placed in service 11 / /

12 Total miles the vehicle was driven during 2003 12 miles miles

13 Business miles included on line 12 13 miles miles

14 Percent of business use. Divide line 13 by line 12 14 % %

15 Average daily roundtrip commuting distance 15 miles miles

16 Commuting miles included on line 12 16 miles miles

17 Other miles. Add lines 13 and 16 and subtract the total from line 12 17 miles miles

18 Do you (or your spouse) have another vehicle available for personal use? Yes No

19 Was your vehicle available for personal use during off-duty hours? Yes No

Yes No

21 If “Yes,” is the evidence written? Yes No

20 Do you have evidence to support your deduction?

Section B—Standard Mileage Rate (See the instructions for Part II to find out whether to complete this section or

Section C.)

22 Multiply line 13 by 36¢ (.36) 22

Section C—Actual Expenses (a) Vehicle 1 (b) Vehicle 2

Gasoline, oil, repairs, vehicle

insurance, etc.

23

23

24a Vehicle rentals 24a

b Inclusion amount (see instructions) 24b

c Subtract line 24b from line 24a 24c

Value of employer-provided

vehicle (applies only if 100% of

annual lease value was included

on Form W-2—see instructions)

25

25

26 Add lines 23, 24c, and 25 26

Multiply line 26 by the

percentage on line 14

27

27

28

Depreciation. Enter amount

from line 38 below

28

29 Add lines 27 and 28. Enter total

here and on line 1 29

Section D—Depreciation of Vehicles (Use this section only if you owned the vehicle and are completing Section C

for the vehicle.)

(a) Vehicle 1 (b) Vehicle 2

Enter cost or other basis (see

instructions)

30

30

Enter section 179 deduction

and special allowance (see

instructions)

31

31

Multiply line 30 by line 14 (see

instructions if you claimed the

section 179 deduction or special

allowance)

32

32

Enter depreciation method and

percentage (see instructions)

33

33

Multiply line 32 by the percentage

on line 33 (see instructions)

34

34

35 Add lines 31 and 34 35

Enter the applicable limit explained

in the line 36 instructions

36

36

Multiply line 36 by the

percentage on line 14

37

37

Enter the smaller of line 35 or

line 37. Also enter this amount

on line 28 above

38

38

Part II

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Form 2106 (2003)