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efta-efta01221900DOJ Data Set 9OtherSchedule K-1
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DOJ Data Set 9
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efta-efta01221900
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Schedule K-1
(Form 1065)
Schedule K-1 Partnership
Additional Information
For Boxes 4, 9c, 11, 12, 13, 15, 16, 17, 18, and 20
• Keep for your records
2017
Name(s) Shown on Return
Social Security Number
Partnership Name
Box 4 : Guaranteed payments
1 Guaranteed payments for services
2 Guaranteed payments for use of capital
Box 9c : Unrecaptured section 1250 gain
1 Included in net section 1231 gain
2 Included in long-term gain — passed through from estate, trust. REIT or mutual fund . . .
3 Included in long-term gain — from disposition of interest in a partnership
4 Total box 9c
Box 11 : Other income (loss)
Code A : Other portfolio income (loss)
1 Income or loss from REMIC — residual holder
2 Excess inclusion from REMIC
3 Section 212 expense from REMIC
4 Other portfolio income (loss) to be reported on Schedule E, page 2 (enter description):
5 Other (enter description):
6 Total box 11, code A
Code B : Involuntary conversions
1 Loss from casualty or theft of trade. business, rental, or royalty property
2 Loss from casualty or theft of income-producing and employee property
3 Gain from casualty or theft
4 Total box 11. code B
Code F : Other Income
1 Recoveries (bad debt, prior tax, etc. reported on Form 1040, line 21)
2 Ordinary gain (loss) (reported on Form 4797. Part II)
3 Net short-term capital gain (loss) not portfolio income
4 Net long-term capital gain (loss) not portfolio income
5 Other nonpassive income (loss) to be reported on Schedule E, page 2 (enter description):
6 Other (enter description):
7 Total box 11, code F
EFTA01221900
Page 2
Partnership Name:
Box 12: Section 179 deduction
1 Section 179 carryover from prior year Form 4562
2 Section 179 deduction allowed per current year Form 4562 (see Help)
3 Cost of eligible Qualified Disaster Area (ODA) Section 179 property placed in service . . . .
4 State section 179 expense information:
State ►
State 179 . ►
Reserved . ►
ORP . . . •
State ►
State 179 . ►
Reserved . ►
ORP . . . ►
State ►
State 179 . ►
Reserved . ►
ORP
. . . ►
State ►
State 179 . ►
Reserved . ►
ORP . . . ►
5 Check to reduce self-employment income by Section 179 deduction,
unreimbursed expenses. depletion, and intangible drilling costs
►
Yes
No
Box 13 : Other deductions
Code J : Section 59(e)(2) expenditures
1
Expenditure description . . . .
Code R : Pensions and IRAs
1
Payments made to a traditional IRA
2
Payments made to a Roth IRA
3 a Payments made to a Keogh
b Type of Keogh (Select One)
►
4
Payments made to a SEP
5
Payments made to a SIMPLE retirement plan
6
Employer matching contribution to SIMPLE retirement plan
7
Payments made to an Individual 401(k) plan
8
Payments made to a Roth 401(k) plan
9
Employer matching contribution to 401(k) plan
10
Total box 13. code R
Code T : Domestic production activities information
1
Gross receipts
2
Cost of goods sold
3
Deductions - directly allocable . .
4
Deductions - not directly allocable
5
Form W-2 Wages
All
Sources
Non-
Domestic
Production
Domestic Production
Total
Oil
Other than
Oil
Code U : Domestic production activities income
1
Oil-related qualified production activities income
Code W : Other deductions
1
Other taxes
2
Other miscellaneous itemized deductions (2% floor)
3
Penalty on early withdrawal of savings
4
Section 754 depreciation
5
State income tax withheld
State name
►
6
Other nonpassive deduction to be reported on Schedule E, page 2 (enter description):
7
Investment interest expense to be reported on Schedule E, page 2:
a
Total investment interest expense
b
Disallowed investment interest expense:
(1) Computed disallowed investment interest expense
(2) Enter disallowed investment interest expense here
►
C
Allowed investment interest expense
8
Other (enter description):
9
Total box 13, code W
' Manually enter item here and on appropriate tax form or schedule.
EFTA01221901
Page 3
Partnership Name:
Box 15 : Credits
Code E: Qualified rehabilitation expenditures (also for Box 20, Code D)
1 Select qualified rehabilitation expenditures property type . .
Codes F, G, M and P : Other credits
Form
Description
Rental
Real Estate
Other
Rental
Other
5884
5884-A
6478
6765
6765
8820
8826
8830
8834
8835
8835
8844
8845
8846
8864
8874
8881
8882
8896
8900
8904
8906
8908
8910
8911
8923
8932
8933
8936
8941
Work opportunity credit
Employee retention credit
Alcohol and cellulosic biofuel fuels
Credit for increasing research (GBC)
Credit for increasing research (ESBC)
Orphan drug credit
Disabled access credit
Enhanced Oil Recovery credit
Qualified plug-in electric vehicle credit
Renewable electricity production (Part I)
Renewable electricity production (Part II)
Empowerment zone credit
Indian employment credit
Credit for employer social security taxes
Biodiesel fuels credit
New markets credit
Small employer pension startup
Credit for employer provided child care facilities
Low sulfur diesel fuel credit
Qualified railroad track maintenance credit . . .
OiVgas production from marginal wells credit . .
Distilled spirits credit
Energy efficient home credit
Alternative motor vehicle credit
Alternative fuel vehicle refueling property credit
Mine rescue team training credit
Employer differential wage payments
Carbon dioxide sequestration
Qualified plug-in electric drive vehicle credit
Small employer health insurance premiums. . .
General credits from electing large partnerships
Total of above credits for codes F, G, and P
Total from box 15. codes F. G, and P
EFTA01221902
Page 4
Partnership name:
Box 16 : Foreign transactions
Code F : Foreign gross income from other categories
1 Select category
b•
Codes C, G, and H : Partner level foreign income and expense
Enter U.S. and foreign source (see help)
1 Gross income sourced at partner level
2 Interest expense allocated at partner level
3 Other expenses allocated at partner level
Total
U.S. Source
Foreign
Codes L, M : Foreign taxes paid, Foreign taxes accrued
1
2
a
b
Date paid (if code L) or date accrued (if code M) (mmddyyyy)
Check one:
Claim a credit for foreign taxes paid (complete line 3)
►
Claim a deduction for foreign taxes paid (complete line 4)
►
3
a
If claiming a credit for foreign taxes paid (if code L) or foreign taxes accrued (if code
Do you elect to forego completion of Form 1116?
►
M):
Yes
No
I
b
Double click to link to a copy of Form 1116, Foreign Tax Credit
►
and
c
Select country column for Form 1116
A
and
If also filing Form 2555. Foreign Earned Income Exclusion, check if
earned income from this activity is already entered on Form 2555
gr.
B
C
4
If claiming a deduction for foreign taxes paid (if code L) or foreign taxes accrued (if code M):
a
Check here to deduct foreign taxes (Schedule A, line 8) if there is NO foreign earned
income from this activity reported on Form 2555
Box 17 : Alternative minimum tax (AMT) items
Code B : Adjusted gain or loss
1 Adjustment to Section 1231 gain
2 Adjustment to unrecaptured Section 1250 gain
3 Total box 17. code B
Code F : Other Alternative Minimum Tax (AMT) items
1 Incentive stock options
2 Tax-exempt interest from private activity bonds
State name
►
3 Excess intangible drilling costs (IDCs)
4 Excess depletion. oil and gas
5 Accelerated depreciation of real property (before 1987)
6 Accelerated depreciation of leased property (before 1987)
7 Other (enter description):
8 Total box 17, code F
EFTA01221903
Page 5
Partnership name:
Box 18 : Tax-exempt income and nondeductible expenses
Code A : Tax-exempt interest income
1
Tax-exempt interest income. Enter state(s) and amount(s).
State
Amount
2 Total box 18. code A
Box 20 : Other information
Code E : Basis of Energy Property (Form 3468)
Capacity
Capacity
1
Geothermal property
(kW / MW
Horse
er
Basis
2
Solar property
3
Qualified fuel cell property:
a Pre-10/4/08
b Post-10/3/08
4
Qualified microturbine property
5
Combined heat and power system property
10
Wind facility property (construction began during
2017)
2018)
11
Total box 20, code E
6
Qualified small wind energy property
a 10/4/08 - 12/31/08
b Post-12/31/08
7
Geothermal heat pump systems
8
Qualified investment credit facility property
9
Wind facility property (construction began during
Code T : Oil and Gas Depletion
NOTE: Depletion expense related to Royalty Income should not be entered here. Enter the depletion
expense directly on the Schedule E Worksheet that is linked to the royalty income.
1
Cost depletion
2
Percentage depletion:
a Gross income from oil and gas
b Depletion rate
c Percentage depletion amount (line 11a multiplied by line 11b)
3
Depletion expense (larger of cost depletion or percentage depletion)
Code Z : Other Information
1
Qualifying advanced coal project credit (3468):
a Basis of gasification combined cycle property
b Basis of advanced coal property (Section 48A(d)(3)(B)(ii))
c Basis of advanced coal property (Section 48A(d)(3)(B)(iii))
2
Qualifying gasification project credit (3468):
a Basis of qualifying gasification property that separates at least 75% of emissions
b Basis of qualifying gasification property other than above
3
Qualifying advanced energy project credit (3468)
4
Conservation reserve program payments
5
Other' (enter description):
6
Total box 20. code Z
Outside Expenses
Self-Employed Health Insurance
1 Health insurance premiums paid that were not reported on Form 1095-A
Interest Paid
2 Interest expense from debt used to finance acquisition of partnership interest
Manually enter item here and on appropriate tax form or schedule.
EFTA01221904
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