Schedule K-1

Schedule K-1 (Form 1120S) Shareholder's Share of Income, Credits, Deductions, etc. 0.• Keep for your records 2017 Shareholders Name Social Security Number Part I Information About the Corporation A Corporation's Employer Identification Number B Corporation's Name Address City State ZIP Code C IRS Center where corporation filed return Part II Information About the Shareholder Shareholder is Taxpayer . ..n D Shareholder's Identifying Number E Shareholder's Name Address City Spouse. . . Joint . . . State ZIP Code F Shareholder's percentage of stock ownership for tax year At-Risk Status (check one): All investment in corporation is at-risk Some investment in corporation not at-risk Final / Amended Final K-1 and Amended K-1 Checkboxes Final K-1 n Amended K-1 Part III Shareholder's Share of Current Year Income, Deductions, Credits, Other Items Check Type of Activity Reported on this Schedule K-1: Business . Other Rental Activities ► Other (investment club. etc.) ► Rental Real Estate ► 1 Ordinary business income (loss) Check if "materially" participated in the business activities ►n 2 Net rental real estate income (loss) Check if "materially" participated in rental real estate activities ► Check if "actively" participated in rental real estate activities ► Check if rental of property is a type subject to recharacterization rules . . ► Check if rental real estate activity is a trade or business. ► 3 Other net rental income (loss) Check if rental of property is a type subject to recharacterization rules . . . . ► Check if rental activity is a trade or business ► 4 Interest income Interest income from U.S. obligations included in box 4 5 a Ordinary dividends 5 b Qualified dividends Interest income from U.S. obligations included in box 5 6 Royalties Double-click to link royalties to Schedule E Worksheet ► EFTA01222000 Page 2 Corporation Name: Part III Shareholder's Share of Current Year Income, Deductions, Other Items (continued) 7 Net short-term capital gain (loss) 8 a Net long-term capital gain (loss) 8 b Collectibles (28%) gain (loss) 8 c Unrecaptured section 1250 gain 9 10 11 12 13 14 15 16 17 Net section 1231 gain (loss) Other income (loss) Code Description Amount Section 179 deduction Other deductions Code Description Amount Credits & credit recapture Code Description Amount Foreign transactions A Name of country or U.S. possession. . . . Code Description Amount Alternative minimum tax (AMT) items Code Description Amount Items affecting shareholder basis Code Description Amount Other information Code Description Amount EFTA01222001 Page 3 Corporation name: Section Al Passive Activity Adjustment to Income or Loss — For Regular Tax Purposes Passive status (a) (b) (c) (d) Passive Activity Gain (Loss) Suspended Net Loss Income (Loss) Limited by Loss Income Suspended Description Form 6198 Carryover (Loss) for if Applicable From Allowed Current Prior Year Year Enter as Negative Regular Tax 1 2 3 4 5 6 7 8 9 Ordinary Income (loss) for Schedule E: a Ordinary income (loss) pass through. . . b Section 179 expense c Section 59(e)(2) expense d Unreimbursed expenses e Depletion expense f Interest expense g Total Ordinary income (loss) for Form 1040: a Recoveries (bad debt, etc .) b Cancellation of debt income c Total Total ordinary income (loss) Add 1g, 2c Commercial revitalization deduction: a Commercial revitalization deduction . . . . b Memo: Net to Sch E. Line lg less 4a. . . Short-term capital gain (loss) for Sch D: a Non-portfolio capital gain (loss) b Installment sale c Sale of assets d Sale of S corporation interest e Total Long-term capital gain (loss) for Sch D: a Non-portfolio capital gain (loss) b Installment sales c Sale of assets d Sale of S corporation interest e Total Section 1231 gain (loss) for Form 4797: a Section 1231 gain (loss) pass through . . b Installment sales c Sale of assets d Total Ordinary gain (loss) for Form 4797: a Ordinary gain (loss) pass-through b Installment sales c Sale of assets d Sale of S corporation interest e Total Total Combine lines 3,4a.5e,6e,7d,8e. . EFTA01222002 Page 4 Corporation name: Section Passive Activity Adjustment to Income or Loss — Alternative Minimum Tax Purposes Passive Activity Income (Loss) Description (a) Gain (Loss) Limited by Form 6198 if Applicable (b) Suspended Loss Carryover From Prior Year Enter as Negative (c) Net Income (Loss) Allowed (d) Loss Suspended for Current Year 1 2 3 4 5 6 7 13 9 Ordinary Income (loss) for Schedule E: a Ordinary income (loss) pass through. . . b Section 179 expense c Section 59(e)(2) expense d Unreimbursed expenses e Depletion expense f Interest expense g Total Ordinary Income (loss) for Form 1040: a Recoveries (bad debt, etc .) b Cancellation of debt income c Total Total ordinary Income (loss) Add 1g, 2c Commercial revitalization deduction: a Commercial revitalization deduction . . . . b Memo: Net to Sch E. Line 1g less 4a . Short-term capital gain (loss) for Sch D: a Non-portfolio capital gain (loss) b Installment sale c Sale of assets d Sale of S corporation interest e Total Long-term capital gain (loss) for Sch D: a Non-portfolio capital gain (loss) b Installment sales c Sale of assets d Sale of S corporation interest e Total Section 1231 gain (loss) for Form 4797: a Section 1231 gain (loss) pass through . . b Installment sales c Sale of assets d Total Ordinary gain (loss) for Form 4797: a Ordinary gain (loss) pass-through b Installment sales c Sale of assets d Sale of S corporation interest e Total Total Combine lines 3,4a,Se,6e,7d,13e. . EFTA01222003 Page 5 Corporation Name Section Cl Description Passive Income and Loss Nonpassive Income and Loss (1) Loss K-1 (g) Income K-1 (h) Loss K-1 (I) Section 179 (9 Income K-1 Income and Loss Reported on Schedule E, Supplemental Income or Loss EFTA01222004