AO 4OB

STATEMENT OF EARNINGS OF 1. NAME OF REPORTER *  UNITED STATES COURT REPORTERS

(Rev. 12/2016)

2. EMPLOYEE ID * 3. DISTRICT * 4. OFFICIAL DUTY STATION 5. CALENDAR YEAR *

PRIVATE

REPORTING TOTAL

GROSS

OFFICIAL

TRANSCRIPTS

 6. Receipts for transcripts

 7. Attendance fees

INCOME

EXPENSES NET INCOME

 8. Salary, dividends, trust funds, and all other income from private reporting activities

 9. TOTAL GROSS INCOME (Add lines 6 thru 8)

10. Compensation paid to:

a. Substitute reporters due to absence

b. Substitute reporters to assist with daily and hourly  transcript.

c. Note readers

d. Transcribers

e. Typists

f. Scopists

g. Other clerical personnel

11. Employer’s contributions (FICA, etc.)

12. a. Travel incident to private reporting activities b. Travel by substitute reporters and other personnel 13. a. Rent for office space (Including utilities) b. Rent for copy equipment

c. Rent for CAT equipment

d. Other rent (Specify)

14. Equipment repairs and maintenance

15. a. Postage expense

b. Telephone expense

c. Other communication expense (Specify)

16. Supplies and materials

17. Other expenses (Itemize on next page all other expenses claimed)

18. Depreciation of equipment

(Complete schedule on next page.)

19. TOTAL EXPENSES (Add lines 10 thru 18)

(or loss) 20. Line 9 minus Line 19

CERTIFICATION BY COURT REPORTER: By signing this form, I certify under penalty of  perjury pursuant to 28 U.S.C. § 1746 that the foregoing is true and correct.

REVIEW BY COURT OFFICIAL. Individual reviewing this form should sign in the space provided.

21. SIGNATURE 22. DATE 23. SIGNATURE 24. DATE

AO 4OB

(Rev. 12/2016)

-2- DATE 

17. Itemize all other expenses below.

TYPE OF EXPENSE Total Amount Official Amt. Private Amt

Total Expenses:

18. Schedule of Depreciation DESCRIPTION

DATE

COST OR

DEPRECIATION

METHOD OF

LIFE

DEPRECIATION

OF

PROPERTY

ACQUIRED

OTHER BASIS

ALLOWED IN PRIOR YEARS  

COMPUTING DEPRECIATION

OR

RATE

FOR

THIS YEAR

Total Official Amount:

For Official Use Only

Comments Reject