Exhibit B-2 (Acceptable Format)
Form 2106-EZ
Department of the Treasury
Internal Revenue Service (99)
Unreimbursed Employee Business Expenses
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Attach to Form 1040 or Form 1040NR.
OMB No. 1545-0074
2011
Attachment
Sequence No. 129A
Your name Occupation in which you incurred expenses
Social security number
You Can Use This Form Only if All of the Following Apply.
• You are an employee deducting ordinary and necessary expenses attributable to your job. An ordinary expense is one that is
common and accepted in your field of trade, business, or profession. A necessary expense is one that is helpful and appropriate for
your business. An expense does not have to be required to be considered necessary.
• You do not get reimbursed by your employer for any expenses (amounts your employer included in box 1 of your Form W-2 are not
considered reimbursements for this purpose).
• If you are claiming vehicle expense, you are using the standard mileage rate for 2011.
Caution: You can use the standard mileage rate for 2011 only if: (a) you owned the vehicle and used the standard mileage rate for the first year
you placed the vehicle in service, or (b) you leased the vehicle and used the standard mileage rate for the portion of the lease period after 1997.
Part I
Figure Your Expenses
1 Complete Part II. Multiply line 8a by 51¢ (.51) for miles driven before July 1, 2011, and by 55.5¢
(.555) for miles driven after June 30, 2011. Add the amounts , then enter the result here . . .
1
2 Parking fees, tolls, and transportation, including train, bus, etc., that did not involve overnight
travel or commuting to and from work . . . . . . . . . . . . . . . . . . .
2
3 Travel expense while away from home overnight, including lodging, airplane, car rental, etc. Do
not include meals and entertainment . . . . . . . . . . . . . . . . . . . .
3
4 Business expenses not included on lines 1 through 3. Do not include meals and
entertainment . . . . . . . . . . . . . . . . . . . . . . . . . . .
4
5 Meals and entertainment expenses: $ × 50% (.50). (Employees subject to
Department of Transportation (DOT) hours of service limits: Multiply meal expenses incurred
while away from home on business by 80% (.80) instead of 50%. For details, see instructions.)
5
6
Total expenses. Add lines 1 through 5. Enter here and on Schedule A (Form 1040), line 21 (or
on Schedule A (Form 1040NR), line 7). (Armed Forces reservists, fee-basis state or local
government officials, qualified performing artists, and individuals with disabilities: See the
instructions for special rules on where to enter this amount.) . . . . . . . . . . . .
6
Part II
Information on Your Vehicle. Complete this part only if you are claiming vehicle expense on line 1.
7 When did you place your vehicle in service for business use? (month, day, year)
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/ /
8 Of the total number of miles you drove your vehicle during 2011, enter the number of miles you used your vehicle for:
a Business
b Commuting (see instructions) c Other
9 Was your vehicle available for personal use during off-duty hours? . . . . . . . . . . . . . . Yes No
10 Do you (or your spouse) have another vehicle available for personal use? . . . . . . . . . . . .
Yes No
11a Do you have evidence to support your deduction? . . . . . . . . . . . . . . . . . . .
Yes No
b If “Yes,” is the evidence written? . . . . . . . . . . . . . . . . . . . . . . . . .
Yes No
For Paperwork Reduction Act Notice, see your tax return instructions.
Form 2106-EZ (2011)