Use this form to report costs incurred while you were working for someone else as an independent contractor.
PROJECT START DATE: <date>
PROJECT COMPLETION DATE: <date>
TYPE OF PROJECT: <description>
PROJECT FEE: <$amount>
ADDITIONAL EXPENSES: <$amount>
DESCRIPTION OF ADDITIONAL EXPENSES: <description>
TOTAL EXPENSES: <$amount>
ADDITIONAL INFORMATION: <additional expense information>
_________________________________
Signature of contractor
SS#: <SS#>
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