om 2106

Department of the Treasury
Internal Revenue Service

Employee Business Expenses
& Attach to Form 1040.

1976

Your name

Social security number | Occupation in which expenses were incurred

Employer's name.

Employer's address

Instructions

Include all expenses you paid or incurred as an employee, or
expenses you charged to your employer (for example, through use
of credit cards), or expenses for which you received an advance,
allowance, or reimbursement. For a more detailed explanation of
these expenses, see instructions for Form 1040.

Include business expenses for which you were paid (reimbursed)

by your employer in Part I, line 6, unless they are included on
your Form W-2. Report any such amounts shown on your Form
W-2 as wages on Form 1040, line 9. Check with your employer if
you doubt whether the payment is included on your Form W-2.

For a detailed explanation of the rules for deductions for travel,
entertainment, and gift expenses, see Publication 463, Travel,
Entertainment, and Gift Expenses.

Use Form 3903 to compute any moving expense deduction.

PART |.—Employee Business Expenses Deductible in Computing Adjusted Gross Income on Form 1040, Line 15c

1 Travel expenses while away from home on business (number of days. ):

(a) Airplane, boat, railroad, etc. fares . . 2. 2 1 ee
(b) Meals and lodging .

(c) Automobile expenses (from Part re WV)

(d) Other (specify) b>

Total travel expenses .

2 Transportation expenses (not between home 2 and w work and not incurred while away from home overnight):

(a) Airplane, bus, railroad, taxi, etc., fares . . . .
(b) Automobile expenses (from PartIV). . . 2. 2 ee
(c) Other (specify) > __

Total transportation expenses .
Outside salesperson’s expenses:
(a) Automobile expenses (from Part IV).
(b) Other (specify) P..

wo

Total outside salesperson’s expenses .

Employee expenses other than traveling, transportation, and outside salesperson’ 's expenses to >the extent of reimbursement .

Total of lines 1, 2, 3, and 4

4

5 .

6 Less: Employer's payments for above expenses (other than amounts included on Form W-2) .
7 Excess expenses (line 5 less line 6). Enter here and include on Form 1040, line 39 .

8

Excess payments (line 6 less line 5). Enter here and include on Form 1040, line 36 .

PART IIl.—Employee Business Expenses which are Deductible if You Itemize Deductions on n Schedule A (Form 1040)

1 Business expenses other than those included above (specify) D>

.

2 Total .

If you itemize your deductions instead of using. the standard deduction, deduct under Miscellaneous. Deductions, Schedule h (Form 1040).

PART II!.—Additional Information to be Furnished When Claiming a Deduction for Educational Expenses

1 Name of educational institution or activity > __.
2 Address >.

3 Were you required to undertake this education to meet the minimum educational requirements to qualify in your

employment, trade or business? . . woe

4 Will the study program undertaken qualify you for a new trade or business?

courses taken and your employment during the period D>.

6 List the principal subjects studied at the educational institution or describe your educational activity >

- J Yes
- [] Yes

[No
O No

5 If your answer to question 3 or 4 is No, state the reason for obtaining the additional education and show the relationship between the

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Form 2106 «1976)


Form 2106 (1976)

Page 2

PART IV.—Automobile Expenses (Use either the regular or the optional method.)

A. Months automobile held for business use .

B. Total mileage for months in A . .
C. Portion of total mileage applicable to business

Automobile 1 Automobile 2 Automobile 3

months

miles
miles

months
miles
miles

months

miles
miles

Regular Method: (Include expenses only for the number of months indicated in A above.)

1 Gasoline, oil, lubrication, etc.
Repairs
Tires, supplies, ete...
Other: (a) Insurance
(b) Taxes
(c) Tags and licenses
(d) Interest .

(e) Miscellaneous. . 2 2 2. 1 ee

2
3
4

5 Total .

Percentage of expense applicable t to business line c above
divided by line B above) .

7 Business portion (line 5 multiplied by line 6).

8 Depreciation from Part VI, column (h) .

9 Line 8 divided by 12 months .

10 Multiply line 9 by A, above
11 Total (line 7 plus line 10) (see line 17)

Optional Method: (The standard mileage rate applies to the ‘total

or are not considered fully depreciated under the straight-line method.

above) of all automobiles that have not been

business miles (line C,
For automobiles that have been or are con-

sidered fully depreciated under the straight-line method, the standard mileage rate is 10 cents per mile for all

business mileage.)

12 Enter 15,000 miles or the mileage on line C above, whichever
issmaller. . . .

13 Multiply line 12 by 156 and enter result

14 Any excess of line C over 15,000 miles

15 Multiply line 14 by 10¢ and enter result
16 Total (line 13 plus line 15)

The optional method cannot be used if you have
claimed depreciation in a prior year using a method

miles | ther than straight line (or if you have claimed addi-
tional first-year depreciation). Use of the optional
miles | Method will not affect a deduction for interest relat-

ing to the automobile nor deductions for State and
local taxes (other than those included in the cost of
gasoline).

Summary:

17 Enter the amount from line 11 or line 16, whichever is used .

18 Add parking fees and tolls . :
19 Total. Enter here and in appropriate sections of Part |, page 1.

PART V.—Computation of Automobile Basis

Old Car Traded In:

Present Car:

1 (a) Total mileage accumulated miles _| 10 Purchase price or other basis

(b) Portion applicable to business miles | 11 Less: Estimated salvage value .

(c) Percentage applicable to business 12 Balance (line 10 less line 11)

(line (b) divided by line (a)) . %_| 13 Line 12 multiplied by percentage on line

2 Purchase price or other basis . 6 of Part IV .
3 Less: Trade-in allowance 14. Less gain or plus (loss) on line 9
4 Difference (line 2 less line 3) .
5 Line 4 multiplied by percentage on line 15 Basis for computing depreciation

1(). Foe Note: if you acquired the vehicle for cash only, or by trade-in
6 Less gain or plus (loss) on previous of another vehicle not used in business, complete only

trade-in . lines 10 through 15. If acquired by trade-in of another

vehicle previ in busi i

7 terre ine Sse) ice pry nd in Busine, colt ne
8 Depreciation allowed or allowable each succeeding year if the percentage of business use
9 Gain (line 8 less line 7) or loss (line 7 changes.)

less line 8) on business portion of car_.

PART VI.—Depreciation of Automobile
Make and style of vehicle segues | 08, Cory” | Segutred” | OR pron years | deprecation = | rife Geos) “era year"
@ ®) @ @) 3) © ® th)

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