PURE ROMANCE TAX ORGANIZER

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PURE ROMANCE TAX ORGANIZER This tax organizer has been developed to assist you in collecting and summarizing the information needed for your Pure Romance business. The following pages contain many of the common items of income and expenses associated with your business. Please review every item listed as they may apply to your specific situation. The following information will be requested by most tax advisors when filing your tax information. GENERAL INFORMATION Consultant name and number: Address: Home phone: _ Work phone: _ Cell: Fax: E-mail address: Social security number: Date of birth: What month and year did your join Pure Romance? You were recruited by: County in which you live: _ School district: Do you live within the city limits (subject to city income taxes)? Yes No

SOURCES OF INCOME *Please be sure to include your official Form 1099-MISC issued by Pure Romance Total sales for 2011 (Sales before shipping, tax and discounts on customer orders) Total shipping income collected Total override bonuses plus taxable prizes & awards received (Box 7 on your 1099-MISC) COST OF GOODS SOLD 2010 Ending inventory value (at your cost) (enter -0- if this was your first year with Pure Romance) Total retail and net purchases (at your cost) (from your Pure Romance invoices) Items taken from inventory for personal use Returns and allowances NOT warrantied back to corp 2011 Ending inventory value (at your cost) as of 12/31/2011 Approximate date ending inventory was taken:

EXPENSES ADVERTISING Business cards, labels, stationery Fair booths/bridal shows Film & film developing Fliers and newsletters Greeting cards Newspaper ads Prizes and awards Promotional tools Pure Romance clothing, decals, etc. Sales literature Other: $ BAD DEBTS: (If originally claimed as sales & there is reason to believe the debt will never be collected) Customers NSF checks $ Other bad debts (document & verify): DUES & PUBLICATIONS: Membership in business related organizations $ Subscriptions to business publications FREIGHT: UPS/U.S. Postal service mailing charges Shipping paid to Pure Romance (invoices) $ INSURANCE Self-employed health insurance (if applicable) $ Business auto insurance General business insurance INTEREST (business related interest only) Interest paid on loans for purchasing business Property, i.e. copier, computer, etc. Credit card finance interest paid for purchasing business property and/or inventory LEGAL AND PROFESSIONAL SERVICES $

Business related accounting fees Tax return preparation fees OFFICE EXPENSES Calculator Copying and printing (not claimed elsewhere) Folders, staples, pens, etc. Ink cartridges Organizers and planners (i.e. Daytimers) Paper Miscellaneous $ $ Assets purchased (for business use) % Pure Romance business use Purchase date Computer / / Copying machine / / Desk / / Fax machine / / File cabinets / / Printer / / Shelves / / Telephone/Answering machine / / Television/VCR / / Typewriter / / Digital or video camera / / Purchase price (including sales tax) REPAIRS: Cost of repairing business equipment RETIREMENT PLANS: I have the following retirement plans established: Individual Retirement Account (IRA) Roth IRA Simplified Employee Pension Plan (SEP) Simple IRA SUPPLIES: Paper products on Pure Romance invoices Baskets Books, CD s and DVD s Motivational/Training tapes Packaging materials Ribbons and decorative supplies $_ 2011 Amount contributed $ $

Storage, inventory containers Other miscellaneous supplies: TRAVEL: BUSINESS TRAVEL: Annual Convention Annual Training Location Las Vegas Cincinnati Transportation Lodging Parking, taxis & tolls Telephone Dry cleaning/laundry Market Training PR University Other MEALS AND ENTERTAINMENT (Including tips): (Receipt is mandatory if a business meal is over $75. If a business meal is under $75, a receipt is not required but the taxpayer is still required to document date, time, place and business purpose, as well as the individual(s) the meal was with). The best advice is to always get a detailed receipt. Breakfasts _ Lunches Dinners Travel meals (Convention, training, etc.) TELEPHONE EXPENSES: Do you have more than one telephone line in your home? Yes No My monthly base telephone rate is _ (Only if you have a dedicated Pure Romance telephone line coming into the home) Total long distance charges (Do not include monthly base rate) % related to Pure Romance % ~OR~ Actual Pure Romance long distance charges _ Do you own a cell phone? Date purchased Purchase price

Total cell phone charges _ % related to Pure Romance % Total internet charges % related to Pure Romance % Website fees Voice mail fees WAGES: Wages paid for: Office assistants/secretarial Childcare _ (Must provide name, social security number and address of childcare provider below) SSN/FEIN#: Other: OTHER EXPENSE: Meeting room fees Open houses Total people attending home meetings Other miscellaneous expenses: $ ESTIMATED TAX PAYMENTS MADE: Date due Date paid Check # Federal State Local First quarter Second quarter Third quarter Fourth quarter

HOME OFFICE EXPENSE Valuation of your home: Purchase price Value of the land included in the purchase price of your home Cost of improvements to your home Month and year acquired Percentage your home is used for your business: Area of home used for business (sq. feet) Total living area square footage of home $ $ $ $ Expenses for business use: Direct expenses: Painting of business part of home Repairs to business part of home Other direct expenses _ Indirect expenses (annualized): Mortgage interest Real estate taxes Insurance (Homeowner s or Renter s) Rent (if applicable) Repairs and Maintenance Utilities: Electric Gas/Oil $ $ $ $ $ $ $ $ $ $

Water & Sewer Trash disposal $ $

AUTOMOBILE EXPENSES Car #1 Car #2 Do your own or lease your car? Lease Own Lease Own Year, Model & Make of car Date I started driving my auto for business Total Pure Romance business related miles Total of ALL mileage driven for months indicated above ACTUAL EXPENSES: Gasoline, oil, lubrication, etc. Repairs Tires, supplies, etc. Lease payments (if applicable) Auto insurance Tags and licenses Interest on auto loan (if applicable) Car washes Auto club membership fees (ie. AAA) Parking fees Tolls QUESTIONS, SUGGESTIONS AND/OR COMMENTS