Text extracted via OCR from the original document. May contain errors from the scanning process.
30600 TELEGRAPH ROAD, SUITE 1131
BINGHAM FARMS, MI 48025-4531
TELE: 248/642-2803
FAX: 248/642-7236
27 HIGH TECH BLVD
THOMASVILLE, NC 27360
DEAR PARTNER:
ATTACHED IS YOUR COPY OF THE 2011 PARTNERSHIP FORM 1065
SCHEDULE K-1. THIS SCHEDULE SUMMARIZES YOUR INFORMATION FROM
INCOME, FORM 1065.
SCHEDULE K-1, PAGE 2. IF YOUR RETURN WILL BE PREPARED BY
INFORMATION.
CONFIDENTIAL
SDNY_GM_00032908
EFTA 00143521
EFTA01252612
651111
Schedule K-1
(Farm 1066)
Department of the treasury
Internal Revenue Se-vice
For cairds• yevit2C1' of tax
you booming
2011
Final K-1
I
Amended K-1
OMB No.1545-009
Partner's Share of Current Year Income,
Deductions, Credits, and Other Items
Partner's Share of Income, Deductions,
Credits, etc.
0. See separate Instmdlons.
1 Ordinary business Income (loss)
0.
16 Credits
1W Wei real Of WA 'nosy* QS)
14
Information About the Partnership
3 ether net rental Income (loss)
16 Foreign tra 'sections
A Partnership's employer identification number
4 Guaranteed payments
B Partnership's name, address, city, state, and ZIP code
959 W. ST. CLAIR AVENUE, 3RD FLOOR
CLEVELAND OH 44113
C IRS Center where partnership Ned return
C INC INNATI
OH
5 Interest Income
325 500.
63 Ordinary dividends
17 Alternative min tax (AMT) Items
D r
Check it his is a publicly traded partnership (PIP)
lib pleaded dividends
7 loyalties
8 Net shod-term capital gat (loss)
nondeductible expenses
18 Tax-exempt income and
Part
Information About the Partner
F Partner's name, address, city. state. and ZIP code
27 HIGH TECH BLVD
THOMASVILLE, NC 27360
O I__I General Paltrier or LLC
IX, Limited partner or other LLC
member-manager
_ member
H ®Domestic partner
L__1 Foreign partner
I
What type otenhly is this partner? PARTNERSHIP
J
K
L
Partners share of profit, loss, and capital:
Beginning
Ending
Prot
12.5000000%
12.5000000%
Loss
12.5000000%
12.5000000%
Capital
12.5000000%
12.5000000%
Partners share of labielles at year end:
Nonrecourse
(lathed nonrecourse financing
Recourse
$
0
Partners capital account analysis:
Beginning capital account
$
499,932.
Capital contributed during the year
75.
Current year increase (decrease)
296,987.
Withdrawals & distribution
796,9944
Ending Capital account
0.
M
Tax bass
El Other (explain)
M Old the partner contribute property with a built-in gain or loss?
n.J Yes
IX] No
It 'Yoe, attach statement (see InstructiOnS)
El say
L. Sectior. 704(b) book
11761
11-04-1' LHA For Paperwork Reduction Act Notice, see instructions tor Form 1056
14030406 759398 7676
ila Net longsterrn capital gain (loss)
9b Colectibles (26%) gain (loss)
9c Unrecaptured sec 1250 gain
19 Distrbudorts
796,994.
10 ler section 1231 gain (loss)
11
20 OtheriMommticc
A
325,500.
B
28,507.
r income (loss)
12 Section 179 deduction
13 Other deductions
K*
28,507.
91*
6.
14 Selfromployment earnings (loss)
.
$.0 attached statement for additional information
CON? DENITTAL LLC
Schedule K-1 (Form 1085) 2011
2
7676
1
SDNY_GM_00032909
EFTA 00143522
EFTA01252613
26-3296234
SCHEDULE K-1
SUBJECT TO THE 2% FLOOR BOX 13, CODE K
DESCRIPTION
AMOUNT
MANAGEMENT FEE
28,507.
TOTAL TO SCHEDULE K-1, BOX 13, CODE K
28,507.
SCHEDULE K-1
OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION
AMOUNT
MISCELLANEOUS
6.
TOTAL TO SCHEDULE K-1, BOX 13, CODE W
6.
PARTNER NUMBER 2
14030406 759398 7676
CONMEYENFTTALLLc
7676
1
SDNY_GM_00032910
EFTA ((1143523
EFTA01252614
Schedule K-1 ;Form 13$51 2011
Page 2
This list Identifies the codes used on Schedule K-1 for all partners and provides summarized reporting information for partners who tile
Form 1040. For detailed reporting and riling Information, see the separate Partner's Instructions for Schedule K.1 and the Instructions
lor your Income tax return.
3.
4.
5.
es
ab.
7.
6.
go.
00.
De.
'C.
>drag bueira• ~me »mil Dot -op whether the Isccere Foes; n
padelvili
4ospentre end et.« Or year renan at kneed.
thatt• lose
~VI Moan,
Neveenere Idea
Nowt,
Inneos
Na rental nat ~ate ', iche (Weal
Oter net torte! let
(en)
Net Won*
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(Ittentabed *roe*
Intent 'row%
Croke), toy der*
Cueetto diver%
Floyetcs
Nei ein't•Orrr cap la pen (bes;
Not lorp-Inno cap% pan Fess)
~Idea
OW OFF Sent
Urdecep‘be sect on 1250 paln
Net asclon 1231 gain Ma)
01- Income (beat
Co*
A CI'«
h% on* 97%1
R Irv>, anbuy converstons
C Sta. 1255 ccotrecht & since*
•
Mlnira ettplotettion aste ~ph"
E
Cancelled« el debt
F Oh« ',cane >Ode)
12. Nttr '79,let at en
13. Otteactens
A Cash cont.:tot** 00%)
▪
Ciehrantabutleat i33%)
C Not
corlrbukcros 'X%)
D Not
zorhttutcret X%)
CNN% pain prapertt la • 50%
orpw ~On 4»tti
F Copies pain property (20•Al
O CankleueoneF00%;
4wanrant ametes: expense
I
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lazorto
J Beeler 591%2i uor can
K Detkatens porno te t2% Scot)
L Dflotens **tole :nowt
M Amounis pot 'or medics irs4brsoir
N Ea mime' »31Es-we bet
O Depended :al *rat*
P PrsprodueiroFrkWUHnea
O Centre% al rettlislIxellor defluCtiOn
•
rental led ellaie•CbrtIce
A Peniorsrld ade
•
Elebteststan «per* ea:K.4101
T Ornalle pront&los wa.itiat
Irlflon
U Cut ed Predal on ~Des Wean,
%%Were gem W2 wow
SY Oter*OuCtar•
Reportes
Sn the 3irda'e Irlitadihre
beta". o E. Inc
i
2d. coke,* 4,
eclat.» E Ore 2d *moron 7/
Screed* E. Ilre 2.4 coda*, 9
Sao the aroet'e hetntellore
&tedub E. lire 26. Cal ee%L9
Sae the 4aelnet's hel.'UCtiors
ScFedub E. lire M, “It.civ, 1)
Fri 1040 Um. Se
Foot. 1040. it* 95
Fair 1040. Ule
6Crequ11 E. lire 3o
&tidal, D. ere 5
Schedule 0, line 12
26% Rate O. Weeks**, • % 4
t(oeedue0 Inottatices)
the ~a*
Infractor •
Eta lim Praha bean dore
Rao the artnet's Inslructbre
Soothe Pt/9
Sett
Fa* 6787 line I
See Pew 636
Form 1049 Ins 21 et Ferri 982
See tl*PdFxits I fl
an
See :reParries **eta*
See tre Porn« e »r..etune
F41'1494.2, line I
Soneugle L lire 19
Se. to Penny(' Initlitetens
Sole:Iale A fine 23
Sena, 45 A Une 28
Selec UNA ile • r rorn '040. '929
Sae te Perrot • tcCond
Fenn 241' imp 12
See UV:brews ~Cab
See Fors 8682 tomavers
Se•IM7direts betrovett
Seel* atale inetnctkore
See Fors 8003 Inultuesone
Forte 8933 Inn 7b
Form 8933 lino 17
See me 'sire'. ImaruCtItxs
14. Set deroorral ~lops lb«
ho* ryca. Iwo a soclon 179 aechalten et pry perIneolevel cleductont. see
the arnet • Istnictlers bate comniting Senedde 5!
A Nr oerrinpe
ton
eel estfloyrrent
6 Ora% %mop et Ilshop 'am%
C Ores* rrol.birn income
Credits
A Lety.Inccarerousiry creole
DenctOn 420X58 tont pre-2018
•
o non
fl Lew-lreerreroLsIrp email lott
lawn pre2091 aaclinpe
C Low-IrCefre ratioS CMG Peeler.
t2p51)tiein poel-2C07 h Maps
•
Low.lecome hatalr9
Who;
Intro post-2037 bulltInap
E Coated rehab Item exprxnuree
pila hew eillebl
F Ode eerie ran sedate co.-. te
G Other arts ~tie
11 ~tad
Celina Baled credit
I
*Coil& awl Oettinsk Dinka; luns
e**1
91752
'144.11
Beredt 196. Steelton A ot
See the artery InetiaXIS*
Scone 3artnet's h-cduc*.iris
See the ~Ws fl ing:Ions
:ern ICAO, line 7' c4eGic oox lb
See Ise Netne* Me:Notions
It
19
20
Code
•
Wolc °Dam, nity aver,
K
Dlabbled runs ceec.1
L
Errpeatrfrent acne and rowed
carrn,,iti‘y efrOlOrneht stat
IV Credit ter exateeleo march
~MI es
N Credit br vapbyer soda occur ty
arld Vaditare Wee
O Deco& Wtrholdng
P Cille end%
18.
Foreipn tftruSII3fili
A Nano of count, *W9
peeeslon
B (Uwe soot% ear ell ea tees
C One* .tcorre bowls et partner
lend
1-Olidgn gran 'Prune room« r partnwealp awed
U Pion ce~y
E Gowns coteacel
F 071•F
Cleducdons Wozatet1 and ttopo•Xonal et partner br '
G hterest =dense
H Oher
Otdi.cerhe atoaeloe end esca0oned et pertrorenip
Income
I
Pale we **WY
▪
Gerard <savvy
K Mar
Other Inkrnmon
L
- 010 lardy. taus pee
IV This lanky. tilisid erAnaa
N ~on
fr *tee wadable br crec Ft
O %yips &bap tress *cep*
P
Extra,taliCrteJ heats sae non
O Otheeoregn *reaction
17. Mew*" trait% m W (AU') hens
A Peat- 488 *taw* on a:X*7%M
B Adjualed gan 44 lass
111
C Deort es tetra him ad & plet
O 0 µe. d peolmtine won Income
gat. & goobers -*Cyclone
F
Ottiet ditr tetra
- 444-exerot income era rcAacsseenft expert«
A
-ix-extrxt: %brow %cone
9 Other tex•exterp: Mows
C Norcecext riln expo**
Ono *no*
A Caw rd Markle/GM escort
B OistrlostIon su*ect te seclos 737
C Othe4 PeoPe4Y
02**Lnlerreten
A lastmeht Mrerw
tl hvearent ~erne%
C Fuel taxmall Ir1nflor
•
(*Wed reelatiltains «pandit-to,
(et« ton or* mat watt
E
aegis of tray; 0-..urrny
•
mocier.vre
cw-Vwne rousinp
amid :Paton 42:02
O RoCapeare of as-Income %mina
Met:~
▪
Receptare el investment atoll
I
Reeeplare Wolter at
J ..004-1~4 Interest coolitlobl
bng-trir contreza
•
Look-bete inteneet hed-let rOnKedi
TIMM
L Diepos tire oi CA:0*M with
~eon 179 Saw**
M Receptareca %Con 179 cleciactlen
N Interest «penes ror *roan pant
O radian 463(X* htabalen
P Staten 463A7g Illtenapon
O Sect* 128C06 giconstlen
N Peet« ado**, to produclon
exavelturee
•
CCF reeetalled ~fetal.
T
fkrilazie .4s:inert:a - rat ana
U Arnakrat, o' ralor•Viabn coat*
listen *dross teutoblrootne
W Precares1045or pan 2,551
X
Sectb4 1090 inbrntelon
Other Infarrnatbs
Parti r
Sea ho Part-r
Feen 'CAC. I* 62
Sat I% Pert-as Instr-cficots
Fix% 'I'd Pert I
Forn 'I'd Par I
Fern 9,6, Pen I
Fern
Pall
tot to 1/41, SG', SCGite
)
Forn 'I'd dart i
Fox
'
o Prll
con,- 1'6 Pat II
FOCI, 11. 6, Ira 12
Worn 9873
Fern 5.573
See Fs >911:r•Fe Inetruclion
Sue do 'died.
IsIno-Uara one
VW latrraelore br
Fear 6251
rent 1040, tab
Soo w0>rMyO ir stneotbas
Sat Ds New* Irets.ct
)
See 174e Petty* IrAtnalotat
l'orn 4962. I* 4e
Form 4902. Ins
Fora 4138
Sat Lie Pertret9 Inflation
Sc. hwn Pr^Ma Ins:ration°
N0,8811, In* 8
Fart ear. I ve
See Fos, 4256
See *a Pea:let's **Atone
Sea Fonn 8097
Ses Fos, 5503
Seethe Patina's
Instrielleo*
2
14030406 759398 7676
CONMDENTrAL"'
7676
1
SDNY_GM_00032911
EF1'A_00143524
EFTA01252615
BOARDWALK
000
PIPELINE PARTNERS0
ssAUTOPSCH
334 96 PS3 720146A24-2-1
L4646 2 AT U.374
329 SEABREEZE AVENUE
PALM BEACH FL 33480-6132
February 27, 2012
Dear Unittiolder:
Enclosed is your Boardwalk Pipeline Partners, LP tax package for 2011. This package
contains Important information that you will need to prepare your federal and state
income tax returns for 2011 - please do not discard.
In the tax package, Boardwalk Pipeline Partners, LP is providing the following documents to
you:
I. Schedule K-1, (Form 1065)
2. Schedule K-1, Additional Information
3. State Income Schedule
4. Ownership Schedule
5. Sales Schedule (if Applicable)
6. Individualized Income Tax Reporting Package instructions
7. Graphic Guide of Federal Tax Forms
8. Partner's Instructions for Schedule K-1, Form 1065
9. Reminder of Eligibility Standards
Please carefully review the information on your Ownership Schedule. If the information is
inaccurate, please contact us as explained on the form. We will issue a corrected Schedule
K-1, State Schedule, Ownership Schedule, and Sales Schedule, if applicable, as soon as
possible.
The enclosed general instructions and graphic guide are provided for your general guidance,
and are not intended to be, nor should they be construed as tax advice. The tax information in
this package, as reflected on the schedules provided, is based on existing federal and state tax
laws and regulations as interpreted by the General Partner. Before completing any tax filing,
we recommend that you consult with your tax advisor.
If you should have any questJons regarding this tax package, please call toll free (866)
867-5085 or logon to our tax package support website at
wataxnackagesunport.comiboardwalk
Sincerely,
Boardwalk Pipeline Partners, ONFIDENTIAL
h • IS.
I II
crfiklki"Me123nik-21flkn
EFTA_00 143525
EFTA01252616
2011 STATE SCHEDULE,
AND SCHEDULE K-1 ADDITIONAL INFORMATION
PARTNER NAME:
r
ARTNERSHIP
(Duo to rounding enticing
State Information
l° Fedond intuit)
Federal end Stale differences, totals may not woo
Os
(I)
Ovary booms= lucre(-)
(2)
Interest bone
(1)
Net Shod-Term Capitol Oaln
orlon(-)
(4)
Not long-Tem, Copilot Olt
or Loser)
:5)
&
Ramiro
gl;
ertemsoyelMnimtes lax
Degreclellon & Oen Adlyeroxt
AL
-02
0
0
4
289
1
AR
-263
0
0
13
832
2
—
FL
-10
0
0
1
03
0
L
-3
0
0
0
11
0
IN
-in
0
0
9
568
1
KS
-3
0
0
0
10
0
KY
-809
1
0
43
2.666
a
LA
I
-Z064
2
0
100
&TN
14
0
MS
-1,149
1
0
61
3.772
OK
-66
0
0
'
3
166
0
20-3265814
The ps rtrorstip has °poultice& in many status. You may bo required to file a tax return with those steins. Each state 55 klentlhed by a to latter cot In tho for let COME of this
stile& la with the epplIcabln amounts reported in Colum ns (I) through (6). Differences between state ernounle and forkvel arnsunts mu due to rooming and vatialsons between
federal and stale kerns lax laws. Please consult your tax advisor.
Do not attach these schedules to your Federal or State Incomo Tax Returns.
See tax Instruodons for additional information.
2011 SCHEDULE K-1 ADDITIONAL INFORMATION
1311
1372
1313
1374
13T5
Total Expenses
1316
Total Expenses allocable to DPGR
20Y1
Total Gross Receipts
DPGR Gross Receipts
Total CGS
CGS allocable to DPGR
20,372
0
0
0
Gross Receipts
21,977
0
20,372
.131: The additional information provided for line 13T is not relevant to most individuals. It is used by unitholders who are
engaged in production activities to calculate their domestic production activities deduction under Section 199.
'Contact the partnership if you need additional information to calculate your Section 199 domestic production activities
deduction.
.20Y: Please note that IRS Code Section 7430Ai alkiitmEintisibrable
been included in box 1 of your schedule K-1.
/W4
SASHIMI
C
gni \ re rifintreeln
F
F
EFTA_00 143526
EFTA01252617
El Fuel K-1
[I] Amendoi K-1
651111
0M6 No 1545 3099
K
E
Domestic partner
J
What type of unity is this partner?
Schedule K-1
(Fenn 1065)
Di:ointment of the f Posta).
For calendar your 2011. or lax
Internal Revenue Surma:
year bealunaw
ending
Partner's Share of Income, Deductions,
Credits, etc.
► See back of form and separate Instructions.
2011
,20
F
r
Partner's Share of Current: ear Income,
Deductions, Credlte, and Other items, ;
1 Granary business Income (less)
-6,208
2 Not rental real estate Income (loss)
16 erodes
'11110(01411I0r1 AboUfthe Partnemthig
A
Partnership's ernployer ckmlificston number
3 Other net rental Income (loss)
4 Guaranteed payments
El
Partnership's name, address. city. slate. and ZIP code
9 GREENWAY PLAZA, SURE 2800
HOUSTON. TX 77046
5 interest income
6
as &Meaty dividends
flb Quailed dhriderth
C
IRS Center where partnership bbd return
Ogden, UT
D
❑check if this is a publicly traded parlruethiP (PT?)
7 Royalties
a Not short-term caReal Oain (beg)
18 Foreign IsaneactIons
.. Ardor:nailer) About thePartnet-ft.,,:..-...
E
Partner Mona( ing number
9a Net kno.tarrn capital pain (less)
328
F
Partners name address. ray, Mate, and DP rode
329 SEABREEZE AVENUE
PALM BEACH FL 33480
CollerAibles (28%) gel (loss)
Unreraplumd section 1260 gain
17
Merriam niriantrn tax (NAT) to
A
41
10 Net section 1231 gain (Ion)
rt
General partner or LLC
m,
United partner or other LLC
member-manager
member
D Foreign W tner
PARTNERSHIP
Partner's mare of profit, loss. and modal (Ann instruction,*
Beabning
Loss
0 001780 1%1
Profit
0.001780
Capital
0.001780 %
K
Partner's Matte Of IMMIIIMe al year end:
Ending
0.001727 14
0.001727 %
0.001727 %
Nenr000urse
Qualified 1,0111MOUISO finandng
Recourse
53,207
$
L
Partners capital account enstysle:
Beginning ea peel account . . . . $
86,881
Capital contriontol dkra3 the sear. $
0
Conway-ear inauesc (decrease).
-5,909
Withdrawals 8 distributions
.
(7.333)
Ending capital account . .
. $
73,639
Tier buss
CI GM' El Section 701(0) book
Other (espial) Outside Tax Basis
M
Did the partner conailern property with a DA .In gala a Ion?
El Yes
El No
11 'Yee', solace stakununt (sop Instrucbins)
For Paperwork Reduction Act Nonce, see Instructions for Form 1085.
11 Other Income (loss)
12 Soclion 179 deduction
13 Other deductions
A
11
T•
STMT
18 Taken:apt Int
is and
nondeductible expenses
10 CIeldbutne
A
24
7,333
14 Solt-employment earnings (loss)
•
•
•
•
-
•
.
•
-
-
•
-
•
.
•
.
•
.
•
•
•
.
a diet lawman
A
V
6
-6,207
20,372
. .
'See attached statement for additional Information.
For IRS Use Ordy
CM, No. 11394R
I
Schedule K-1 (Form 10116) 2011
7/0.1W4 • • 044414
CONFIDENTIAL
CrittIV
ttM
M(111014
EF1'A_00143527
EFTA01252618
Schedule K-1 Q one 1065) 2011
v
Paw
This list identifies the codes used on Schedule K-1 for all eminent and provides summarized reporting information for
For detailed reporting and filing Information. sea the separate Partners Instructions for Scheduler K-1 and the instructions
1. Ordinary business income (loss). Oetterille whether tne income gess) ks
Code
patoiw or nonpasslas owl enter on your return as follows.
J Work opportunity credit
partners who flit Fenn 1040.
for your Income tax return.
awn' on
Report on
K Olcoblod access crecil
Passive lose
Sea the Partner's Instnicbons
L En opowerrnont zone and
Passive Income
Schedule E, Ilno 28, column (g)
renewal community
Nonpossive km*
Schedule E, line 28, solemn 08
unipkwilwrit credit
See the Partner's Instruclkvis
honpassive income
&heat E. Ere 28, cubes W
IA Cask for Increasing research
2. Net
Income
See the Partner's Inotiuctbos
octivides
rents real estate
(loss)
3 Other net rental Income (lose)
N Credn for employe social
Not inceinu
SciwAdo E, line 28, column (g)
security and Medicare taxes
Net IOUs
See the Partner's InstnietiOnS
0 Backup withholding
Form 1040. Ilne 62
4. Guaranteed payments
Schedule h. Ire 28, column (0
P Other credits
See tho Partnere Instructions
& Interest Income
Form 1040, Itne 83
16. Foreign transactions
Co. Ordinary dvklends
Form 1040, Ian 8a
A Name of country or U.S.
Ob. Qualified dividends
Form 1040, lino !lb
pons surion
7. Royalties
Schedule F, Ilne 3b
0 Oros" income from all Stances
Funn 1116, Part I
8. Net short term capital gain (loss)
Schedule 0. line 5
C (suss Income sourced at
ea. Net long-term capital gain (loss)
Schedule O. line 12
partner level
9b. Collecteiles (28%) gain Mss)
28% Irate Gan Worksheet, In 4
Forolgn pros.; berme sauced et partnership lever
(Schedule D instructions)
9c. Unrccaphired section 1250 gain
See the Partner's Instruclk>ne
D Passive category
E General category
Form 1110, Part I
:y i
10. Nat section 1231 gain (lose)
See the Partners instructiorn
F Other
11. Other Income (loss)
Cluduclkers ailucatod and op p 111OThed t partner level
Code
G Interest °sconce
Form 1116, Pert I
A Other particle lucerne (IOW)
Sea the Partnor's Instructions
11 Other
Form 1115, Peel I
Involuntary conversions
See the Pennies Instructions
Deductions allocated end apportioned al fiarfnerstsp Wel re renfign souse
C Sec. 1256 contacts 8 straddles
form 8781, line 1
Income
0 Mining exploration costs recapture See Pub, 535
I
Passive category
E Cancellation of aebt
Form 1040, Me 21 or Feint 982
J Gcaornl category
I Forn11116, Part I
F Other income puss)
Soo tho Penns's Instructive;
K Other
12. Section 179 deduction
See the Parlisis Instructions
Other InlorrnetIon
13. Other deductions
L Told foreign taxes peel
Form 1118, Part II
A Cash contriburkms (5094)
IN Total foreign taxes accrued
Fen 1116, Pert II
B Cash contributions (30%)
N riocuctlal to taxes avallithite for credit Form 1116, line 12
C Ncncasto ontr,totions (50%)
0 Posen trust QM", (wants
Form 88/3
Nencash contributions (30%)
See the Partner's
P Exuaterritski Income cialis.Ort
form 8873
E Caplet gain property to a 50%
hrebucliorn
o
Other foreign Sanaa lord
See the Partner's Instructions
creanuedon (30%)
17. Alternative minimum tax (AMT) Items
F Capital gain property p0%)
A Post,1998 deprataber aeuslinent
O C.cranbutions (1CO%)
B Adjusted gut cr loss
1 See the Partner's
H kivesiment Interest expense
Form 4952. line 1
C Depletion (other than oil 6 gas)
Instructs:am and
I
Deductions— myeby Income
Schedule E. line 19
D 01, tps, b gerAmered- gross hen
the Instructions inn
J Section 5900(2)ostAnilldreil
See the Partner's lesouctions
E
011, gos, 6 geolhawal- deductions
Form 6251
K Deductions—portfolio (2% flow)
Schedule A, line 23
F Other Mil Items
L Deductions —portfolio (ell's')
Schedule A. line 28
18. Tax-exempt Income and nondeductible expenses
Amounts paid fo, medical :nsuninco Schedule A, line 1 cc fpm 1040, line 29
A Tax-exempt Interest Income
Form 1040, line 8b
N Educaticnai assistance benefits
Soo goo Pannor's Instructions
B Other tailieXerreS Intone
Sea the Partner's Instructions
0 Dependent care benefits
Form 2441, We 12
C Nondeductible expenses
See the Partner's Instructors
P Preen:due-Eve perk's' tixperiSOS
See the Partners Instructions
19. Distributions
0
Commercial revitalisation deduction See Form 8682 netructions
A Gash and marketable securities
from rent rent estate activitks
B Gstribution stabled to section 73/
See the Partner's Instructions
R Pensions and IRAs
See the Partner's Instructions
C Other property
$ Reforostation expense deduction
See the Partner's Instructions
20. Other Information
T Domestic production activities
See Fenn 8903 instrualluns
A Investment m' ane
Form 4952, lino 4a
Intormation
B Investment expenses
Form 4852, line 6
U Ouallicd procklettun see:MS Mem.) Form 8933. line 7b
C Fuel tax credit information
Form 4136
V Employer's Form W-2 wages
Form 8903, line 17
D Duetted rehabilitation expenditures See the Partners Infiructinne
W Other deductions
Soo the Partners Instructions
(other than rental rod estate)
14. Self-employment earnings Mss)
E Basis of energy property
See the Porter's Instructions
Note. l7 you have a section I79 deduction or any panner-ievet deductions, see the
F Recapture of low-income housing
Farm 8611, line 8
Penner's Instfuchonseelote completing SchedulerSF.
Grade @WOW 42(DOSS
A Not earnings (loss) Irmo
Schedule SE. Sector. A or B
sell-empkwment
G Recapture ut low-Income housing
Form 8611, line 8
credit (other)
B Gross farming or fishing Yvon*
See the Partner's InstArctiens
C Gross non-Nam "come
Soo the Partnets Instrudions
H Recapture of Investment credit
See Form 4255
I
Recapture or °Uwe credits
See the Pounces Instructions
it
Credits
A low.noorne housing credit
J Look-beck Interest-completed
See Form 8807
log-Tenn contracts
(section 42(08 from pre-2008
buildings
K Look-back interest -Mourne lureonst See Form 8865
mod 01.1
B Low-income hosing credit
(other) from pre-2008 buildings
C Low-Income het-ski) Credit
L Dispositions el properly velh
section 179 deductions
neca)h.re of section 179 Oohs-ten
(section 420(58 than
N interest expense for corporate
pop-20e7 buildings
See the Partners Instructions
partners
D Low-income housing credit
(other) from post-2007
buddingS
E Welded rehabilitation
expendii woo (rental rent estate)
0 Social 453(1X3) Information
P Seeks, 453A(c) information
0
Section 1260(b) information
R Interest allocable to production
expenditures
See Mai Partners
Instructions
F Other ranee rod estate °rolls
S
GCE nongualitied withdrawals
G Other rents credits
T
Depletion inronnatice —el end gas
H Undistributed coped gains canna
Finn 1040. line 71: chuck box a
U knomzetan of ref occulalica costs
I
Alcohol and cearlosk bkiluel fuels Sea the Partner's Instructor*
credit
V
Unrelatec buSnan taliable nn
Plosantneut an gain GCBS)
X action 1080 Information
V
011ow informalksi
IN.A.MatIllL,1611/ • a
CONFIDENTIAL
hrhav rIk lfrPontiol4iNVO
EFTA_00143528
EFTA01252619
2011 OWNERSHIP SCHEDULE
PARTNER NAME:
ACCOUNT NUMBER:
141 0022488551
/ PARTNERSHIP
This schedule details your hetory of ovmerNhip of Boardwalk Madam Partners, LP bras though 2011. The cocked tax paelcs,re nitoce yourorraterithleiliitirlara-
ro&Ith
the partnership, and units hold In a broker remount I such inkatnelon ads provided try Ulu broker on your behalf. tI your WOW& do not agree with We tranteCtiOnS sheen. the
enclosed lax Information may be inconaxele. In such an event you may moues! CIMINO* (1) on tie Internet, (2) by mad a (3) by phone. To mquitst changes by tnall, please
mako conections on this sett Wale and wide any needed explanations on this schedule sign the statement bekm and whore tho oarrected schedule betora May 31, 2012 to:
Boardwalk Pipeline Partners. LP
Tax Package Support
P.O. Sox /99060
Dallas, TX 75379.9080
Pion: I-066.807-5005
v awe .taxpacicagosuppot txxr/boardwak
Upon receipt, a revised K-1 we he torwardod to Urn address on your kl-edule K-1. This schedule dues tool have to be returned unless anemias hove been made.
It Is Important that you submit corrections to the partnership by May 31. 2012. Corrections submitted to the partnersNp after May 31. 2012, may result in a repel ItXtlali to
include Form 8002 - Notice ci Inconsistent Treatment or Administrative Adaratment Request (MR) to your return. Cone-dens submitted altar May 31. 2012, will not be reflected
h the perinendep's tax return filed with the Internal Rcemnuo Samna The Partnership ass Its Wend tax return with the Option, UT IRS Sonic° Conlon.
TRANSACTION
BROKER OR
DESCRIPTION
DATE
UNITS
AC
BUY
12-10-2009
141
3500 0000
3600.0000
The Information reported on this schedule, as corrected, accurately and completely presents my ownership history through 12131111.
By signing this schedule, I authorize the Partnership to make the corrections as indicated above to my Schedule K-1.
&9".;ijat
I ILMN I IAL
grimy eseleYMPAletlin
EFTA 00143529
EFTA01252620
March 6, 2012
Blue Chip Capital, LLC
27 High Tech Blvd.
Thomasville, NC 27360
Dear Blue Chip Capital, LLC,
Enclosed is your 2011 Schedule K-1 (Form 1065), Partner's Share of Income, Credits,
Deductions, etc., which has been filed with the 2011 Form 1065 U.S. Return of Partnership
Income of Level Management, LLC.
The amounts reported to you on lines 1-20 of the Schedule K-1 (Form 1065), Partner's Share of
Income, Credits, Deductions, etc., represent your share of income, credits, deductions, and other
information to be reported on the appropriate lines of your tax return. The IRS has substantially
changed the Schedule K-1 by utilizing codes on some lines to identify the item and provide
reporting information. These codes are identified on page 2 of the K-1.
Enclosed is your 2011 Schedule NC K-1, Partner's Share of Income, Adjustments, and Credits
(Form D-403), which has been filed with the 2011 Form D-403 Partnership Income Tax Return
of Level Management, LLC.
Should you have any questions regarding this information, please do not hesitate to call.
Sincerely,
Level Management, LLC
19401 Old Jetton Road
Cornelius, NC 28031
CONFIDENTIAL
SDNY_GM_00032917
EFFA_00143530
EFTA01252621
651111
Final K•1
Amended K-1
cs.l o. I%! OAS
Schedule K-1
(Form 1065)
For cearde•
smote
tie TI•asiiry
year begiintrg
Interna
o Rcnrca
erel rtl
Partner's Share of Income, Deductions,
Credits, etc.
•
See
ZU I I
year 20II. or Se
.2011
ii
t lin Partner's Share of Current Year Income,
and Other Items
Deductions, Credits
1 Ordinary business income (loss)
—75.
15 Credits
separate instructions.
2
Net rental teal estaa .ntorre (loss)
3 Other net rental income (loss)
16 Foreign transactions
Part
Partnership
Ice i I Information About the
4 Guaranteed payments
A Partnership's employer identification nJrnber
5 Interest income
B Partnership's name, address, city, state, and ZIP code
Level Management, LLC
19401 Old Jetton Road
Cornelius, NC 28031
6a Ordinary dividends
6b Oualfied dividencs
C RS Center where partnership filed return
Cincinnati, OH
7 Royalties
Cr
K Check if this is a publicly traded partnership (PTP)
8 Net shock= capital gain dm*
Partner
9a Net long-term capital gain (loss) 17 Malawi minimum tai (AID Items
'Pelt If:`? Information About the
£ P r
ng number
9b Collectibles (28%) gain (loss)
F Partner's name, address, city, state, end ZIP code
Bluer Chip Capital, LLC
27 High Tech Blvd.
Thomasville, NC 27360
9c Unrecaptured section 1250 gain
10
Net section 1231 gain (loss)
18
roai_ccledxemcFi
e expenses
tncomoiii-d
n
11
Other Income (loss)
G
H
I
J
ki General partner or LLC
ULimrted
member-manager
partner or other
LLC member
Foreign partner
g Domestic partner
I
What type of entity is this partner? Partnership
19 Distrbutions
Partner's share of profit, loss, and capital
Beginning
Profit
25.00000 6
(see instructions):
Ending
25. 00000 it
12 Section 179 deduction
13 Other deductions
20
Other information
Loss
25.00000 8
25.00000 It
Capital
25.00000 6
25.00000 6
K Partner's share of liabilities at year end:
Nonrocourse
Qualified nonreocasse financing
Recourse
$
$
14
A
C
Seltemployment earnings (loss)
-75.
0.
$
L.
M
Partner's capital account analysis:
Beginning capital account
Capital contributed during the year
Current year increase (decrease)
Withdrawals and distributions
Ending capital account
1Tax basis
0 GAAP
11Other (exp'ain)
Did tie partner contribute progerty with
n Yes
Ril No
It vat atiac- tateme-1 (son instlx:Ione)
$
1, 022. See attached statement for additional information.
$
0
R
R
u
E
II r
Y
$
—75.
$
$
947.
I Section 704(b) book
a built.in gain or ;ass?
BAA For Paperwork Reduction Act Notice, see instructions for Form 1065.
Schedule 141 (Form 1065) 2011
?TnAD312
CONFIDENTIAL
SDNY_GM_00032916
EF1'A_0014353 I
EFTA01252622
•
Schedule K-1 (Form 1068) 2011 Blue Chio Capital, LLC
This list identifies the codes used on Schedule K-1 for all partners and provides summarized
and filing information, see the separate Partner's Instrixtons for Schedule K-1 and the in
&dimity business Income (Mt). Determine wrote: the tithe (as) is passim
or nonpassve and ente• on you roam as follows.
26-3172589
Page 2
reporting information for partners who file Form 1040. For detailed reporting
oru for your Income tax return.
Code
Report on
J woer, opportailly creel
K DIsab ad access credit
L Eincostnett here at rerewel content t'
enpbynent Cie*
M
'stemming resectionadmit
N Cr
e
eme 'or employer See, åraeny and
MMediate
O DadoQ till'ou it
P Ober atilt
Fondue innwectIona
A Nine el corny re U.S.pcwenten
B Gross Irene hon all maims
het 1116. Part I
C Gross Ira-cent sourced at puff 'owl
Foreign gross Income sourced at partnership level
D Passim category
E Gororal category
— Fenn 1'16, Part I
Fouler
Deductions allocated and apportioned at partner level
G Intros) emense
Form 1'16, Part I
H Other
Form 1116, Per. I
Deductions allocated and apportioned at partnership level to
foreign sauce income
I Nut Catty
J General catty
j— Fun 1116. Pad
K cow
Other Information
L Tom' Poleige. Mies paid
Form 1116, Part II
M Tola tot' tit
terser:
Porn' 1116, Part II
N Rettlion In taxes available lee tort
Font 1116, lire '2
O Feeee2.1 Peel% Weed reedit
set 8873
P fatabardkeekil imorae exclaim
tone 8973
Q tee, 'wet tfersacliars
See tee aster's rebuctoN
Alternate minimum tax (ANT) It..,,.
A Post-1936 top tetnaten attest
B Adhabt gat or loss
Set PC Porters
C Dept« tier ten ul & gas)
InstmcLons at
D OF. gas, & geol trite — glees incite)
the instrutiens ter
E O gee, & gccrecino — deck:tons
Fern 6251
F Omer AM( ten
Texecampt Mene and nondeductible extreme
A —external interest «erne
Form '040. !AO 8b
B Mel leeexefee interne
See tic Peewes l'eskittllors
C elee•dedexlib'e exmenses
See Vie Farmers Intuit«
Distributes
A Cat, ard reeeketabla remits
B Olt :ton abject to mil« 737
C ter gruorty
Otte information
A nettmer income
twin 4952, lie
B test/nail! detellSere
Fan 4952, I le 5
C I' reel tax «det Ma-malice
Fern 4136
D Oca hod echoblitairanatettres Mew tan
rental real adalo)
See It Parse's Imsuclions
E Dash el enemy pretty
see gm Patts testtre
F Ro!:,,pure e
emote bottle act teen
420(9))
Fom 8611. he 8
G Recaptac d lowirate hoists credit tit)
Fern 8611. he 8
H Ruramme or eta:rent (mitt
Fcem 4255
I Recarac d oat ~its
Soo to Portreis lastncjors
J Lookbeck enamel — completed
ktioven otitis
See Form 8697
K Look-beck interest — «one
tweet meth«
See Fenn 8866
L
perpeth
Ø
i 179 doguctruro
M Recaptin d sedan 179 dadsibon
N Interest expense 'or carport porters
O Seder 4630(3) IriNfrniNf'
P Sector 453A(c) etenrahri
•
Semboril2S0(b) infirettion
—
See It Pamor's
R Intent:. &beams to product« okicedites
S CC? rotated withirats
7 Dept« irdwrrance — oil ard gas
U Ateetzertior of 'reforest« cots
Unrelated bisiress mite income
W Procielterior gain (1cØ)
X SØ 1080 ireormetion
Y Other inform:ion
Passere loss
%mkt emorre
\oncassiw tws
Wriest, rnoorro
Report on
See ire Paters Inneliene
Schedc e E. I no 23, column Co)
Soho& o E. I'm 23, :tom D')
Stitt e E. ne 28, twin 0)
2 Het rental real *stele Income etas)
Sto Inc Partners Innucticris
3 Other reel net income post
Nei tote:
Sett* E. re 28, column (g)
Net low
St Its Partiers I mittens
16
4 Guarantied payments
Schedule E. ire 28. Ølen 0)
5 interest Income
Font 'C40. Ina ea
6a Ordinary dividends
Fern :C/.O, Ina 9a
6b Qualified dividends
Fein 1Y.0, :
9:
7 aoyata:
Schedule E, one 30
8 Net short'« capital gain Voss)
»trek C. me 5
9a Nat long-term capital gain Goat
Schott C, ene 12
9b Collectibles (Mitt
tat
28% Rale Gain totter, Sr.
4 (S.tortle D Instructions
9c Unmeeptwed section 1250 gain
See Ihe Pate's Inahrbors
10 esAseciltfil231 gen (him)
See ete Pate's Instriere
11 Other Income Co..)
Code
A Stet polloi o Aroma (oss)
See he Partners Insbursons
B «akin:my coaveis ens
See to Peter's irtsaudeons
C Section 1256 contract ard straddles
tam 6781. fee I
D Met) export« costs roc:split
See Pub 515
E Carew NI« el deb:
Farr
Inc 2'
Form 982
F it« Imo« COM)
See he PietrlerS Ins/iv:tons
12 Secdon 179 ~Lotion
Soo he Partners Iralrentem
13 Other deductions
A Cat ~kittens (50%)
B Cash cakeibalcae Oilt)
17
C Names^ contributions (S")
— See he Pa'ir's
D licecast. conlellAticeS (20%)
Instraoces
E Capita gee proPerly
• 50%
moan sateen :33%)
F Cap« gain properly (20%)
G Cot out OM (100%)
H Iowa-neat tares, exits.
Form
bre
18
?eductens — reset), income
SOWS* E, eire 19
J Section 59(0(4 erienditums
See Pe Parser's Irdricriens
K Deductions — pent o (2% loci)
Sctduk A, lins 23
L Deducicus — pomp io «ewe
Sdiedule A, lino 28
19
M Ahots oak's readied
thedukr A, lit 1 Or
instme
Fan 1240, ire 29
N EckcalcAr assistance theft
Sea Pe Partners 'retest's
0 Dementier: rare bet Is
Fan
Ire '2
20
P Pmproattleve «sod «tenses
Sae
Partners rencemons
Q Cionenemei reset:ratan dedsclion ham
re tit real *sleek «haws
See Forn 8582 Instates
R Pete«, ard lits
See line Parser's 'relhatione
S Ratorton otne-ne decktual
See tee Parter's «trea ters
T trust :roil ton actratee ter
.
fortratkr.
Son Fern 8903 Instruct«
U
mcdurilon activities mom.
Fern 8903. 'Me 70
V
inployets Firm
veges
Fern 8903, .ire '7
W et-er imlbstres
See tue Partners fal.C.)005
14 setemproymene earnings (loss)
Neta. ;Jau :tea rection 779 ded.cecu or ety partnor.
Panna s untrue:ions belle eocirlebh7 Schedule SF
A Nat «mires (kiss) from se fiereployinenl
B Cross Isning a Intro «vim
C Gross nontann 'etere
15 indite
A
V.M.ir come housing apt t (sedan 42(0(5))
'teal em-20F4 buik ems
B lowincomi Fonsing credit (ege) kern
"2006 buildings
C lovelncomi «tit
cede (sitar 420»))
Iron pc,552(07 mitts
D Lowenconse housing circlet (ocmt) fetal
eeSs..7A:07 bo dint
E Otc Ned
asserdeures (rental
mal estate)
F Other meta teal estate croOits
G Other tit
eeter.e
H thellstelt.Aed caoda fiard CIO«
I Alcchui and halluicsic bithiet Lets credo.
keel decittkens, sae MO
Schedule SE. Sect
A or
See the Pate's best burs
Sue the Pestle. s Intrucaors
See is Penners
instruarom
tome '0"0. Lie 71; mace box a
Seto re Pait-ot telmclions
See the Pater s
nf•St.~113
Term 1040, to 62
Sae the Pater s instructors
See to Patinae's
«merlons
Instexters
PIPA0312 08/18/11
Scheible K-1 (Form 1065) 2011
CONFIDENTIAL
SDNY_GM_00032919
EFTA 00143532
EFTA01252623
NC K-1 (50)
(D•4D3)
11.10.11
2011 Partner's Share of
N.C. Income, Adjustments, and Credits
North Carolina Department of Revenue
For calendar year
2011
or fiscal year beginning
Partner's Identifying Number
Partners Name, Address, and Zip Code
27 HIGH TECH BLVD
THOMASVILLE NC 27360
Partnership's Pro Rata Share items
All Partners
1 Share of partnership income (loss)
2 Additions to income (loss)
a Addition for bonus depreciation
b Other add lions :a imme(lotn) SEE SUP? INFO
3 Deductions from income (loss)
a Deduction for bonus depreciation
b Otly do:Netens from iroorie(less)
4a Share of Tax Credit for Small Businesses That Pay
N.C. Unemployment Insurance
b Share of other tax credits
5 Share of tax withheld from nonwage compensation
paid for personal services performed in N.C.
Nonresidents Only
6 Nonresident's share of N.C. taxable income (loss)
7 Nonresident's share of net tax paid by the manager
of the partnership
SEE SUPPLEMEN'AL INFORMATION
and ending
Federal Employer ID Number
Partnership's Name, Address, and Zip Code
19401 OLD JETTON ROAD
CORNELIUS NC 28031
Amount
-75
50
0
0
0
0
0
0
Individuals Filing Form
D-400 Enter Amount On:
Page 3, Line 38
Page 3, Line 40
Page 3, Line 48
Page 4, ",ine 52
Form 0-4001-C
Form 0-400TC
Page 2, Line 19
Page 4, Line 54
Page 2. Line 20c
VCPMM
'MGM
CONFIDENTIAL
SDNY_GM_00032920
EFIA_001 43533
EFTA01252624
Level Management, LLC
26.3172589
1
FORM D403, SCHEDULE NC K•1(BLUE CHIP CAPITAL LW)
LINE 2 - OTHER ADDITIONS TO FEDERAL INCOME:
50
TOTAL
50
CONFIDENTIAL
SDNY_GM_00032921
EFTA_00 I 43534
EFTA01252625
651111
Schedule K-1
(Form 10651
for oderderyw
COPaltrilell :1 the 70)05ury
yea betnIrg AUGUST 2011
:n<.,
Amanda; <-1
07J9 No '545-0;9:
2C1'. a la.
17 .
2011.
Part III Partner's Share of Current Year Income,
Deductions, Credits, and Other Items
weroal :Laramie Serva
,,,JceDECEMBER 31, 2011
tannery busilass L000me (lass)
I
0 .
16 Credit&
Partner's Share of Income, Deductions,
Credits, etc.
irs see separate I nUrnetloas.
2.w Mira« MIS, IrCill» tea)
I
—2,497. 18EN10flmnw1lons
Part I
Information About the Partnership
Sot-er flat rena. 111:0016 (loss)
A Parinersim $ ertell.or anti) ado?: rumba
4 Guranlood osyments
B Paters( p's name, address, Ny. stats, and ZIP oede
270 LAFAYETTE STREET SUITE 409
NEW YORK, NY
10012
5 !nterest brume
I
2.
6a Ordinery d)Adenos
I
17 aliernatve min ax (ASIT) toms
494.
it__I
eb Oulitioe dvidends
C IRS Cater whore pareierat led retim
CINCINNATI, OH
7 ficya lies
I
D —_ C^eck ri Ibis Is a pubky traded pennorsk•p(PTP)
le Tax-exempt
nomieduelibk
neon anc
expenses
8 NM short-term cap tal pa in Coss)
Part 11
Information About the Partner
ea Nr1Oxpl,rm capital gab (loss)
E Panne's bandying number
90 Calutib es (28%) gain (loss)
10 Cienioutions
7 Parolees name: addreSs. rlty. stater and 7IP conk
27 HIGH TECH BOULEVARD
THOMASVILLE, NC 2736Q
9c Unreeeptured sec 125OØ
20 Clem rrormeton
A
2.
10 :l.et seci{on )231 gan (loss)
ii olle. In t: rt2 . Le SS)
a C
General Bodnar or ti.0
M1 . inred partner or ether LW
memberwalager
mwmm
H M Cones) c putner
ELI Foreign partner
I Vital type of enau is his parbierT PARTNERSHIP
12 Section 17S clerluct on
J Partners rare of profit loss, and aput
Begird's
?rot*
1.3548951%
Fading
1.3548951%
13 ether
W*
dedunkris
79,
-ess
1.7482520%
1.7482520%
Capital
1.7482520%
1.7482520% 14 Soll-empbinent earnings (ass)
A
0.
K Ia
store ot Labia:resat year rid:
Nos:anew% .
. . ....... .... ..... . . ..
Naafi« romecourse Inaoang
ftecoa'pe
$
1,773.
.. .
$
92,108.
*SW attnhed ettren Kr additional I' lo'maten.
$
0.
8
ro
c
7. 2
I. Putairs capital aoccootanelyau
Begrming rap tal aecoun:
Copiral steno:dad durng tbe year
Cureni year nmease (decrease):
Witherabals Pr char aubons
I-- ring capital arsout
$
$
50, 000.
$
—2.587.
Si
$
47.413.
=
Soctbr 704(7) book
gab 01 ion?
LxJ Tax basis
in Ow
LJ Ullel (exolan)
14 OM the par ne cone:nut& properly eve. a buibin
U
Yoe
rf: No
11"res'. Aids satement (sea and:1mm)
'MCI .
. _ ...._ ....
e" .“ 1"... '
....."
t ""
14250323 758241 21146.213
6
2011.03020 MIDWAY ASHLEY CROSSING, LLC 21146_Al
CONFIDENTIAL
SDNY_GM_00032922
EFTA_00143535
EFTA01252626
SCHEDULE K-1
OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION
AMOUNT
TOTAL TO SCHEDULE K-1, BOX 13, CODE W
79.
79.
SCHEDULE K-1
DESCRIPTION
INTEREST INCOME
-2,497.
2.
SCHEDULE K-1 INCOME SUBTOTAL
-2,495.
-79.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL
-79.
NET INCOME (LOSS) PER SCHEDULE K-1
-2,574.
-13.
13.
TOTAL TO SCHEDULE K-1, ITEM L
-2,587.
AMOUNT
TOTALS
PARTNER NUMBER 6
14250323 758241 21146.213
2011.03020 MIDWAY ASHLEY CROSSING, LLC 21146_A1
CONFIDENTIAL
SDNY_GM_00032923
EFTA 00143536
EFTA01252627
6
Se- eddle K- I (form 10651 2; 11
ml, litt ldenede' ne redes ned en Schedole K-1 for all partners ud provides teramatized feportleg Informadoe fer perten who file
Form 1040. Fot detalled reportIng ud %Kna In ornata, see me separate Partners Innvollen for Sch edelt K-1 ud Se Isetructlees
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6
2011.03020 MIDWAY ASRLEY CROSSING, LLC 21146_A1
CONFIDENTIAL
SDNY_GM_00032924
EFTA_00143537
EFTA01252628
6
SCHEDULE
NJK-1
(Form NJ-1065)
2011
PARTNER'S SHARE OF INCOME
For Calendar Year 2011, sr Fiscal Yea Begienir t.
AUG 17 , 2011 mul nag
DEC 31,2011
1019
PART I
General Information
Pawed as Oa Peon FP
lietwallp *Foam! El4
000
•
Ca golt•
Strom Mena*
27 HIGH TECH BOULEVARD
Pareenhal Y"ea• Aeress
270 LAFAYETTE STREET SUITE 409
0e,
Statt
:Pees,
THOMASVILLB, NC 27360
Cal
&ate
mess
NEW YORK, NY 10012
mat type el gritty Spanner?
NP
Enter Partnere percentage
lrofit Searing
-09S Snannc
Caval Cionetila
o':
(i) Beers Decrease
(1) Endo, Year
cr TenrinatIon
1.3548951%
1.3548951%
(see Intrude es)
Dee Pattners Intoest In Pannershy beqbn:
— Fre ALK-1
Arerded IJK-1
Goan
08/17/2011
Rosen
liOnth
.7t,
VW
E. Swig/ fond
I-- Member of Conicssite
1.7482520%
1.7482520%
1.7482520%
1.7482520
PART II
Income Information
boom Cludfleedena
A. Total NstrIbudon
NJ-1040 Fliers
Eater Amounts on.
Lime Stowe Below
B New Jersey
NJ-1040NR Filers
Sone Amoulb
1. Parawisblo [acorns (bse)
-2,495.
2 Nei G. Nyland Payments
3 Parinces all(k)Cortbalbs
4. Dint:Akin Sure of ParnereLlp
Income (bee)
(Lis 1 otos Line 2 maim Line 3)
-2,495.
Line 20 rage 2
Line 22, Page 1
5. Pension
Line 19, Page 2
6. He Gain (loss) from Dsposllion
c4 Ar.Ts as a -In.:bola
Line 18. Page 2
Line Iff. Page 1
PART III Partner's Information
1. Lorre sicleSPanner s Snare o' NJ Tam
1.
Lino 22a, Page 103T-10C
Line 14a, Page 1 031-11CS
Vie 8,P/H1-100
Line 46.11J-1043NR
Line 22, NJ-10630
Une 31A 1..J•1041
2..:-L•tner s Ill Oeclann
2.
3. Purser s &Altered Workshop TaxPod:
-
3.
PART IV • Supplemental Information (Attach Schedule)
*Wel
1141-11
14250323 758241 21146.213
2011.03020 MIDWAY ASHLEY CROSSING, LLC 21146_41
CONFIDENTIAL
SDNY_GM_00032925
EFTA_00143538
EFTA01252629
New York State Department of Taxation and Finance
New York Partners Schedule K-1
Tax Law • Article 22 (Personal Income Tax)
6
Final K-1
For calendar year 2311 or tax year beginning
08-17-2011 and ending
12-31-2011
Amended K-1
Partners: Before completing your income tax ratan, see Form IT-2044RI, Parolees instructions fix Pam IT-201-IP (available at vninctimAy.gov).
PE0060AIW8BWOMD8B00(meMstruckn4
Partnership's name (as shown on Form IT-204)
2011
IT-204-IP
A Mark an X in the box if either applies to you- warty
B Tax sheker reg:stration number. if any
C Busnoss a-located percentage
Pubic:1y traded partnership
Partnership's EIN
Portfolio hvestrnent partrietsit
B
C
Partner's Information (see instructions)
Partners name
Partners ;iciness
27 HIGH TECH BOULEVARD
City
State
THOMASVILLE
• NC
ZIP code
27360
Partneri identityhg number
D The partner b a;,.t-X neemesnr. t.o
General partner or LLC mernber-manager
X
United partner or other LLC member
E what b the tax filing status of the partner? Owt nX n
sc rarer.
'slow 1
Individual
Estate/trust
X
Partnership
F if the wanner is a desregasded silky or grantor trust.
enter the tax ID of the entity or hen/dual reporting the Income, If known
0 Did the partner sot is entire interest durhg the tax year?
G
Yes
No
X
H Pa mars stare of profit, roes, arid capital
Beginning
Ending
1) Profit
HI
1.3549 %
1.3549 %
2) Loss
H2
1.7483 %
1.7483 %
3) Capital
H3
1.7483 %
1.7483 %
Partmesstwoomitimnatimemortiwyear
1) Nonrecourse
11
1,773.
2) Ctialfed ncorecourso *lancing
12
92,108.
3) Recourse
J Partners capital account analysis
1) BegioNng capital account
2) Capital contributed during the year • cash
13
a
50,000.
3) Capital contributed cluing the year • property
A
4) Current year increase (decrease)
A
-2,587.
5)
6)
Withdrawals and distributions • cash
Withdraw is and distributions • property
Js
7) Ending capital account
J7
47,413.
8) Method el accounting (mark an X in me appropriate bog
X
Tax bash
GASP
Book
Other (attach explanation)
K Resident status (mark an X in at Coxes Mal apply)
mEmillearresthint
Yonkers fullyear resident
NYC kill-year resident
NYS part-year resident
Yonkers part-year resident
NYC part-year resident
X
NYS nonresident
Yonkers nonresident
1. If the parner was included it a group return. enter the special NYS lcierrificatlen number, if known
m51
Rinse Me this original scannable form vitth the Tex Department.
CONFIDENTIAL
SDNY_GM_00032926
EFTA_00143539
EFTA01252630
Page 2 o' 4
IT-204-IP (2011)
M 1) Was Form IT-265&E hied with the partnership?
MI
Yon
NO
2) Was Fore MTA-405 E Ned with tho partnership?
ht2
Yes
NO
N NYS estimated tax paid on behalf of partner (from Form IT-2658)
Date
Amount
1) Fast natalknent
Ni
2) Second instalment
N2
3) Third instalment
I43
4) Fourth installment
NO
Total NYS estimated tax paid on behalf of partner (add Ines NI through N4)
0
Estimated MCTMT paid co behalf 01 partner (from Form M74-405)
Date
Amount
1) Fist irstainient
01
2) Second Installment
02
3) bird hstalknent
03
4) Fourth Installment
04
Total estimated MCTMT pa4 on behalf of partner (add Nees Of through O4)
0
Partners share of Income, deductions, etc.
A • Partners distnbutive share horns
I ordinary business income (loss)
1.
B - Federal K-1 amount
1.
C - New York State amount
2 Net rentat real estate hoorre bow)
2.
-2,497.
2.
3 Other net rental income (loss)
3.
3.
4 Guaranteed paymeMs
4.
4.
5 Irtirest Income
5.
2 .
&
6 °refinery dividends
6.
6.
7 Royalties
7.
7.
8 Not short-term capital gar (tea)
e.
8.
9 Net icag•tenn timbal gain (ass)
9.
9.
10 Net section 1231 gain boss)
10.
10.
11 Other Macrae bossiklendry:
11.
11.
12 Sedan 179 deduction
12.
12.
13 Other deductions Identity
SEE STATEMENT
13.
79.
13.
14 Tax preference Items for minimum tax
klandhc
le Not eamnga (loss) from selfemployment
14.
15.
494 .
14.
15.
te Tax exempt inane and rordeductble expenses
18.
16.
17 °Istituto:cis • cash and marketable saturttion
17.
17.
18 DIstributirs otter property
18.
18.
19 Other kerns not Included above that am required to be
reported separately to parbors
idenbry:
SEE STATEMENT
19.
2 .
19.
Partner's share of New York modifications (see Instructions)
20 New York State additions
Number
A - Total amount
B - New Tat State allocated amount
20a. E
Xt. EA-
20o. EA-
20d. E
20e. EA-
20f. EA-
21 Total addition medico-Miens Potts of column A, Men 208 through 200
21.
lane:
17.06.11
Please file this original scannable form with the Tax Department
1/82111019
III IIIBiiig11111101I
CONFIDENTIAL
SDNY_GM_00032927
EFTA_00143540
EFTA01252631
IT-2044P .2011)
Page 3 o• 4
Partner's share of New York modifications (continued)
22 New York State subtractions
Nutter
A- Total amount
22a. E S-
226. E S-
22o. E S-
220. E S-
22e. E S-
221 E S-
8 • New York State allocated amount
23 Total S.rbtractiOn modifications (total of column A, Roes 22e through 220
23.
24 Additions to federal lternzed deductions
Letter
Amount
24a.
24b.
24c.
24d.
24e.
24f.
25 Total additions to federal Itemised clefIliCtIOPS (add Inas 24a through 240
25.
26 Subtractions from federal Itemized deductons
Letter
Amount
26a.
266.
26c.
26d.
26e.
261.
27 Total subtractions from fedora: Seated deductons (add fetes 26e through 267)
27.
28 New York edluEments to tax preferenCe gems
28.
Partner's other information
29a Pfalne's sieve ut New vork source gross income
29a.
29h MOTO allocaton percentage (sec ins!ruCtiOnS)
29b.
2.
Partner's credit information
Part 1 - Pass-through credit bases and factors
Brownfield redevelopment tax credit Warm /T 617 or
A - form IT-611
B • Form IT 611.1
30 Site preparation Credit oorrocoent
30.
30.
31 Tenable property Credit COmpOrert
31.
31.
32 On-site groindwater roniedador croon component
32.
32.
118311.019
Uwe
If
"
Please file this original scannable form with the Tax Department.
CONFIDENTIAL
SDNY_GM_00032928
EFTA_00143541
EFTA01252632
Page ;I of 4
IT-204-1P (2211)
Partner's credit Information (continued;
EZ capital tax credit (FOrm17-602)
33 Codxtutlons of money to EZ community development prate
33.
34 Recapture of credit for Investments In certified EZ businesses
34.
35 Recapture of credit for contrbutris of money to EZ community development projects
35.
OEZE tax reduction credit (Form 17-604)
36 0 -ME employment increase factor
38.
37 O€ZE zone allocation factor
37.
38 OWE benefit period factor
38.
Excelsior bobs program tax credit rear 17-607)
30 Excelsior jobs tax credit component
3g.
40 Excelsior Investment tax cleat component
40.
41 Este:doe research and development tax credit component
41.
42 Exceiske real property tax credit component
42.
Farmers' school tax credit (Form 17-217)
43 Acres of qualfied agricultural property
43.
44 Acres of qualified conservation property
44.
45 Eligible school district property taxes paid
45.
46 Aces of queried agricultural property convened to nonqualtried use
441
Other pass-through credit bases and factors
Credit bases
Code
Amount
Code
Amount
475.
47d.
47b.
47e.
47o.
47f.
Credit factors
Code
Factor
Code
Factor
Code
Factor
47g.
47i.
47k.
47h.
47j.
471.
Part 2 - Pass-through credits, addbacks and recaptures
48 Long-term care lneurarce credit (Form 17-249)
48.
4g investneriore14(nchmling employment Incenthse cm* and hadork barn rehebeftebon credit, Form 17-212)49.
50 Research and development • investment credit (Form (7.2f2)
so.
51 Other passithrough credits
Code
Amount
Code
Amount
51a.
51a.
51b.
Sit
510.
519.
51d.
51h.
52 Addbacks of credits and =satires
Code
Amount
Code
Amount
52a.
52d.
520
We.
52c.
521.
L
$5800,32 a
Please file this original scannable form with the Tax Department.
n en
1184111019
II au ui11'uoini
IIii
CONFIDENTIAL
SDNY_GM_00032929
EFTA_00 I 43542
EFTA01252633
NY IT-204-IP
DESCRIPTION
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE K-1
AMOUNT
79.
0.
79.
0.
NY IT-204-IP
DESCRIPTION
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 19
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE K-1
AMOUNT
2.
0.
•
2.
0.
PARTNER NUMBER 6
CONFIDENTIAL
SDNY_GM_00032930
EFTA_00 143543
EFTA01252634
NC K-1 (39)
(D-403)
2011 Partner's Share of
N.C. Income, AdJustmente, and Credits
Koch Cardin CepaImett 0! Revenue
Fcr clenlar year
or tiecel yoar bop nn Ing
Partnel
Pule er's Name, Address, aid ZIP Code
27 HIGH TECH BOULEVARD
THOMASVILLE NC 27360
08 17 11.
and ending
12 31 11
Fedora
Partnership's Name, Merest and ZIP Code
270 LAFAYETTE STREET SUITE 409
NEW YORK
NY 10012
Pans ushle's Pro Rata Uwe Item;
NI Partners
1. St are of partnorshb ❑oore Coss)
2. Additions to Ind ms (lass)
a. Add dos lo• bonus Comae cn
b. am( additions to ncore (oss)
3. jeducf one Iran Income (lass)
L DuNctitve for bonus depredation
b. Other deducCons tram income (loos)
4. a. Share of Tax Crean for Small asnesses TNT ?ay
PLC Unemploymmt MSJC311C8
h. Stare of other tax credits
5. Slum of tax witheld from tonnage compensation
said ler pectoral senkes performed 11 K.C.
Nonrelideets Oily
G. Nonresident's shared K.C. taxable income (bast
7. honfesidonrs share el net bx Pod or the manager
W IM cartneshig
Amoont
-2495
0
0
0
0
0
0
0
0
Individuals Filing Form
0400 Enter Arnold ow
Pape 3,1.0838
Page 3,', ate 40
Page 3, Line 48
Pape 4, Line 52
Torm D-40CIC
Form 0-400fC
Page 2, lino 19
Page 4, Line 54
Page 2, Line 200
CONFIDENTIAL
SDNY_GM_00032931
EFTA _00143544
EFTA01252635
r 1019
6
For calendar year 2011
Partilt($ Identifying number Ile
Partners name. acdress and ZIP code
27 HIGH TECH BOULEVARD
THObfASVILLE, NC 27360
•
K-1
Aleck .. ____ --- -
Partner's Share of Current Year
income, Deductions, Credits, etc.
M)
Federal
K-1 Amounts
06)
Plus or Minus
SCAdpstments
(C)
Arricunts Not
Portlauxl
or
APMutated
to SC
(0)
Amounts ~Gated
or AC90Maned to SC
1 Ordran business income (loss)
2 Net rental real estate income Qom)
3 Olher net rental income doss)
4 &aranteed payments
I
5 Interest income
1
1
STMT
1
1
2
-2,497. 2
647. 2
2
-1,850.
3
3
3
3
4
4
4
4
6
2. 6
5
5
2.
6 Urndenis
6
8
6
6
7 Royaflies
7
7
7
7
8 Net short-term capital pain floss) ,
9 Net bn3•term capitol pakt (loer)
8
8
8
8
9
9
o
9
10 Not Section 1231 gain (bss)
10
10
10
10
11 Other Income floss]
....
11
11
11
11
12 Satin. 179 deduction
12
12
12
12
,,
8 5 13 Other deductions
13
79.13
13
13
79.
SEE STATEMENT
14 Withholchno tax ta wires/00m bonnet
14
O.
Ust applicable South Can:dine tax credits. (Attach an additional sheet a needed)
15
16
18
18
i
17
17
18
18
19 Total South Carciba tax credits .—_,,,,,,,..,,,„____
_,,, .„..
--
....
...,....... ........ .„ .L,,,,,,,, „
19
O.
1775i1 0611-11
ØC1066 K-1
PARTNER'S SHARE OF SOUTH CAROLINA
Rev. 5127/11)
3516
~
Partnership's FEIN
or tax year beginning 08/17/11
and encfr.
Partnership's name, address and ZIP code
2i I
I Amended K1
270 LAFAYETTE STREET SUITE 809
NEW YGRK. NY
10012
Nonresident
L
35151018
J
CONFIDENTIAL
EFTA01252636
SC SCHEDULE K-1
SCHEDULE K-1 ADJUSTMENTS
LINE NO.
DESCRIPTION
AMOUNT
LINE 2
TOTAL OF FORM SC1065, SCHEDULE K-1, COLUMN B
647.
647.
DESCRIPTION
COLA
COL B
COT.. C
COLD
79.
0.
O.
79.
COLUMN TOTAL
79.
0.
0.
79.
SE:ICCMC
PARTNER NUMBER 6
CONFIDENTIAL
SDNY_GM_00032933
EFTA_00143546
EFTA01252637
CONFIDENTIAL
SONV_G1,0069.34
EFTA,103547
EFTA01252638
3
651111
Schedule K.1
germ 1065)
Dscalmenol the Treasury
Irietral Fleveire SOIVrA
Partner's Share of
Credits, etc.
Pot:era. 7our
I '
yes :arming
2011
El 'lie K-1
Armee° K. I
(.11,43 Vc. "5254;99
Part III Partner's Share of Current Year Income,
Deductions, Credits, and Other Items
1 Ordinity Oteness Income (Ws) 16 Cies is
0 .
2 plit wt. POW MIS heem•POIS
- 39 68 8
16 Fol fin :wantons
8 atm net Finial Acre(loss)
Income, Deductions,
►See sterile instrucfions.
Part I
Information About the Partnership
A ParinatsIdo s employer AcnIllIcatc- mem
4 awanleed parents
'VW
s name, addrOSS, CO, slate, rd ZIP cods
270 LAFAYETTE ST. STE 409
NEW YORK, NY 10012
C IRS Cent Ware Dx-stersfip filed returr
CINCINNATI, OH
0
check Iris is e pthlicIy oats] partnership (PIP;
5 nterosfloorte
64 Tinto deeidereds
60 DIelrfied drtiends
17 Mermen min lax (MIT) items
A
9,057.
El*
-3.
7 Peyote's
Plat sholtorn capital lain (loss;
18 Tax-exempt haw and
nondecurale exoenses
Part II
Information About the Partner
E Partner & identify no numbs'
F Partrer s name, addrese CM, state, and 2P mete
27 HIGH TECH BOULEVARD
THOMASVILLE, NC 27360
a
Genial pw:ner or LLC
I.X.I _ir led partner or We. II C
tnember--narager
marDer
H LLI Domestic parley
0
Foreign wrote
I maNNmelAyhmtorme PARTNERSHIP
J Parity's share of weft loss, and caplet
Begieeing
ofr
3.2978723%E
Ending
3.2978723%
10*
4.2553191%
4.2553191%
Glob
4.2553191%
4.2553191%
K Par.nets slime of Whites 21year end:
Nonwourse
$
859.
Quailed luau:course finarcing
$
304,481.
Repourse
$
O.
L Partnets ea account whale:
liegInned coplal account
$
93.155.
Capita csnalcuted d.rinti tho year
$
tamer I year Increase (decrees.)
$
-40,096.
Wm Vara% & Ostibulions
At
12,5354
Ending mpall axoun:
$
40,524.
LE Tax bast
n
SUP
0
Me' (explain)
FA Old ma Nan Or CC 7 ttle minty will a tuill-in 22io 01 I3SS?
El Yes
TI No
If "Ver.attach sist, 321 ;see irstr.ctions)
Upton 40) UFA
le.owee U-IA Foe Paperwork Redett on Mt Nolte, see Instructions for Form 1065.
n
o: longterrr capital pal (loss)
00 Cribct tics (26%)gain (loss)
9c recapaured sec 1250 pin
10 Her .92.1cn 1231 pain doss)
-16.
11 0:hc- Moon° (oss)
10 D strbubans
A
12,535.
20 Other Information
12 Section 179 deduction
13 Mos deductions
W*I
STMT -
14 Sete-rploymcnt ao—lige (loss)
4 I
0.
'See 'Maxie sate-wint for adrift-al Mforrat I> •
For IRS Use Only
09040323 758241 21146.204
2011.03020 MIDWAY PLANTATION LLC.
Schedule K-I (Form 1085) 2011
3
21146_41
CONFIDENTIAL
SDNY_GM_00032935
EFTA_00143548
EFTA01252639
SCHEDULE K-1
OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION
AMOUNT
AMORTIZATION
688.
85.
TOTAL TO SCHEDULE K-1, BOX 13, CODE W
773.
SCHEDULE K-1
GAIN OR LOSS, BOX 17, CODE B
DESCRIPTION
AMOUNT
SECTION 1231 GAIN OR LOSS
SEE FORM 6251 INSTRUCTIONS
TOTAL TO SCHEDULE K-1, BOX 17, CODE B
SCHEDULE K-1
DESCRIPTION
AMOUNT
TOTALS
-39,688.
SECTION 1231 GAIN (LOSS)
-16.
SCHEDULE K-1 INCOME SUBTOTAL
-39,704.
-773.
-773.
NET INCOME (LOSS) PER SCHEDULE K-1
-40,477.
-137.
518.
381.
TOTAL TO SCHEDULE K-1, ITEM L
-40,096.
09040323 758241 21146.204
PARTNER NUMBER 3
2011.03020 MIDWAY PLANTATION LLC.
21146_41
CONFIDENTIAL
SDNY_GM_00032936
EFTA _00 I 43549
EFTA01252640
. 3
Scheduts
(Fcrrt 10601 2011
'This Elet Identifies Mo codes used on Schedule K-1 for all part en aid provides summarized reporting informalloo for petters who flue
Form 1040 For detsik6 reporting and filing inlormattot see the separate Panne, histuctions for 8diedole K-1 edd the Instruct:is
for your income tax return.
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2011.03020 MIDWAY PLANTATION LLC.
3 '
21146_41
CONFIDENTIAL
SDNY_GM_00032937
EFTA_00143550
EFTA01252641
New York Sale Department of Taxation and Finance
•New York Partner's Schedule K-1
Tax Law • Article 22 (Personal Income Tax)
3
Final K-1
For °slender year 2011 or tax year beginning
01-01-2011 andawmg 12-31-2011
Amended K-1
Partners: Before completing your room tax velum, see Form rf.2044P.I. Partner's Nrtitructiona for FonnIT-204-11) (avartable at verny.tax.ny.gon.
Partnership's information (see mrsuct.ons)
Partnership's name (as shear. on Form IT-204)
Pannersho s ON
A Mark an X in the box if either apples to your entity
owe* traded partnershiP
Portfd o investment partnereNp
8 Tax slither registration number. deny
C Business allocation percentage
2011
IT-204-IP
Partner's information (see instructions)
Partners name
Partners address
27 HIGH TECH BOULEVARD
City
State
THOMASVILLE
NC
ZIP code
27360
Paters identifying number
D The partner is a rem an X in Ina apanapalela &NO
General partner or LLC mem terman agar
X
IJrn Red partner or other LLC member
E Malls the tax filing status ol the partner? rex el X r he eocrecremtx.nree. )
Individual
Estate/trust
X
Partnersho
F If the partner is a disregarded entity or grantor tust,
enter the tax ID of the ent ty or Individual reporthg the income, if Imown
F
0 Dki the partner sell its entire interest during the tax year/
0
Yes
No X
H Partners share of profit, loss, and capital
Beginning
Ending
1) Praia
to
3.2979 %
3.2979 %
2) Loss
1-12
4.2553 %
4.2553 %
3) Capital
H3
4.2553 %
4.2553 %
I
Partners share of liabilities at the end of the year
1) Nenracourse
It
859.
2) °oared nonnocatirsa financing
t2
304,481.
3) Recourse
J Partners capital account analysis
13
1) Beginning capital account
J1
93,155.
2)
3)
Capital Canilbuted during the year - cash
Capital contributed during the year - oroperty
a
a
4) Current year nmease (decrease)
J4
-40,096.
5) Wrthcintwals and dIstnbullons - cash
J5
12,535.
8) Withdrawals and distributions • property
46
7) Enting caplet account
Jr
40,524.
8) Method of account ng (mark an X In the acitiocartate bo 4
X
Tax bats
GAAP
Book
Other (attach exPlanatrOM
K Resident status (mark an X an all boxes That apply)
NYS funyear resident
Yonkers luayear resident
NYC fun-year resident
NYS part-year readmit
Yonkers part-year resident
NYC part-year resident
X
NYS nonresident
Yonkers nonresident
L If the partner was included In a group return, enter the special NYS iderton number, it known
L
1181111019
wstm
Please tile this original scannable form with the Tax Department.
CONFIDENTIAL
SDNY_GM_00032938
EFTA_00143551
EFTA01252642
Page 2 of 4
IT.2041P (2011)
'M 1) Was Form .7.2569E led with the partnership?
2) Was Form MTA-005.E sled with the partnership?
N NYS estimated tax pad an behalf of partner (from Form 124658)
1) First Installment
Ni
2) Second katalmen:
N2
3) Third rata Iment
N3
4) Fourth instaltnent
t44
Total NYS estimated tax paid co behalf of partner (addbees NI through N4)
0
Estimated MCTMT pad on behalf of earner (from Form MTA-405)
1) First instalment
01
2) Second instalknent
02
3) Third nstalment
03
4) Fourth hatallmont
04
Taal estiretod MCTMT paid on behalf of partner (add Ines 01 through O4)
0
Partner's share of income, deductions, etc.
A - nanners ctstrtvtrve share Items
I Ordinary business Income (kiss)
1.
B - Fettersl K-1 amount
1.
C - New York State amount
2 Net rectal real estate Income loss)
2.
—39,688.
2
3 Other net rental Income goes)
3.
3.
4 Guaranteed payments
4.
4.
5 Interest Income
5.
5.
6 Ordinary dividends
&
&
7 Royalties
7.
7.
8 Net shohterm capital gals (1088)
&
&
9 Net lentyterm capital gain (Ices)
9.
9.
10 Net Seeder 1231 cein (loss)
10.
-16.
10.
ft omerromeassmieroM
11.
11.
12 &Niko 179 deduction
12.
12.
13 OthxdalitectionstdenNy:
SEE STATEMENT
13.
773.
13.
14 Tex preference items for minim/am tax
14.
9,054.
14.
Identity:
15 Net earnings ooee) from setternployrnent
15.
15.
18 Taxexem.pt income and nondeductble expenses
18.
18.
17 Disabuticna - cash and marketable securities
17.
12,535.
17.
18 Olabibutlens • other property
It
is.
19 Other items not kicluded above that are requked to be
mewed separately to partners
ldenthy:
19.
19.
M1
Yes
No
M2
Yes
No
Date
N
Date
Smoot
Amount
Partners share of New York modifications (see Instructions)
20 New York State additions
Number
A - Total amount
20a. E A-
20b. E A•
20c. E A-
20d. E A-
20e. E A-
20f. E A-
B - New Yak State allocated amount
21 Total amnion modification (total of cohnnn A, Ines 20a through 200
21.
1182111019
'Z C0.11
Please file this original scannable form with the Tax Department.
CONFIDENTIAL
SDNY_GM_00032939
EFTA 00143552
EFTA01252643
IT-204-IP (2ool)
Page 304
Partner's share of New York modifications (contnued)
22 New York State subtractions
Number
A- Total amount
22a. E S-
aab. E S.
22c. E S-
22d. E S-
22e. ES-
22t ES-
- New York State allocated amount
23 Total subtraction modification, pot/of column A Non 221 thrOUIP 229
2$
24 Additions to federal itemized deductions
Letter
Amount
248.
24b.
24c.
24d.
24e.
24t
25 Total additions to federal dented deduCtiOne (add Inca 24a though 240
25.
26 Subtractions frem federal itemized deductions
Letter
Amount
26b.
a
26d.
26e.
287.
27 Total subtractions from federal Itemized deductIons (add fines 26. through 260
28 New Yon< adjustments to tax preference Meets
Partner's other information
27.
28.
29e. Panties Share of Nei:York source gross income
29a.
29b. MCTD ',location percentage (see Instructions)
29b.
Partner's credit information
Part 1 - Pass-through credit bases and factors
Brownfield redevelopment tax carat (Form IT-611 er !Nil LI)
A Bomi IT-611
B • Ram rreiti
ao Site preparation credit component
30.
30.
31 Tangibe property credit component
31.
31.
32 On-ate groundwater mmediatIon credit component
32.
32.
1183111019
115501
Plea file Lhu anginal scannable form with the Tax Department.
CONFIDENTIAL
SDNY_GM_00032940
EFTA_00 143553
EFTA01252644
Page 4 of 4
IT-204-IP (2011)
Partner's credit information ponmueof
capital tax credit (Form mom
33 Contributions of money to EZ community development prefects
33.
34 Receph.re of credrt for investments in coated EZ businesses
34.
35 Recapture of credit for contributions of money to EZ community development projects
36.
OEZE tax reduction aedt (Form f7-604)
36 OE7_E °moonier: increase factor
35.
37 OEZE zone allocation factor
37.
38 OF2E benefit period factor
38.
Excelsior lobe program tax credit Form IT-607)
30 Excel:Ike Ohs tax credit component
310.
40 Ex.:Chao, bvestment lax credit meltdown
40.
41 Excelsior research and development tax credit component
41.
42 Exoels/or real property tax credit component
42.
Ferman' screed tax a'edt (Form 1T-217)
43 Acres of quaffed op:cultural properly
43.
44 Acres of quaffed conservation property
44.
46 Eigible school district Property taxes paid
40.
46 Acres of minified ageculural property converted to noretualified use
46.
Other pass-through credit bases and factors
Credit bases
Code
Amount
Code
Amount
47a.
47d.
47b.
475.
47c.
47f.
Credit factors
Code
Factor
Code
Factor
Code
Factor
47g.
47h.
471.
47k.
47}
47L
Part 2 - Pass-through credits, addbacks and recaptures
48 Longterm care ertsurar.ce credit (Form IT-249)
48.
49 invasimort credit :idol ,g employment incentive credit end historic ban rehaleilfseon crodit Fore IT-212)49.
50 Research and development • investment credit from IT-212)
50.
51 Other passihrough credits
Code
Amount
Code
Amount
516
61e.
Sib.
S11.
516
61g.
51d.
61h.
52 Addbacks of credits and recaptures
Code
Amount
52a.
620.
Code
Amount
62e.
526
521.
Please Me this original scannable form with the Tax Depalment.
III IA 111111111111111
CONFIDENTIAL
SDNY_GM_00032941
EFTA_00 143554
EFTA01252645
NY IT-204-IP
DESCRIPTION
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE R-1
AMOUNT
AMORTIZATION
688.
0.
85.
0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13
773.
0.
PARTNER NUMBER 3
CONFIDENTIAL
SDNY_GM_00032942
EFTA_00143555
EFTA01252646
NC K-1 (39)
(0-403)
2011 Partners Share of
N.C. Income, Adjustments, and Credits
Mirth Caprice Dacialment zit Netnituc
Far Nfor es year
or *sea" year bapinnlbs
Partner's Identityiap Number
Partner. Name, Address, and ZIP Code
27 HIGH TECH BOULEVARD
THOMASVILLE NC 27360
Partatrabipe Pro Rata Shire Mum
All Parties
1. Scare ot prInershb Seto= (bad)
2. ~Dail° :tome ;mast
a. ACCItia for bonus depredation
b. Ms addlbons to name Ems)
3. Deductions from income (loes)
a. DaductIon IN bonus depredalion
b. Olits dedurdions Dom interne (loss) STMT
4. a. Shared lax Dodd kw Smarr Redness'% Thai Pay
N.C. Unemployment Insurente
c. Snare of orer taxer:4Se
5. SParo or tax udtlihald kom nou
Øe compass can
PaD In' gimlet denial Parfonned m
NoiresIdenta Oily
6. Nonreakent's share cl N.C. tabs income (loss)
7. honresyleale share o' net tax paid by Is reneger
of me parlailf$11T
Cl 01 11
and mere
12 31 11
Federal Employer ID Rovaber
Pa rhierekike Name, Address, ad ZIP Coda
270 LAFAYETTE ST STE 409
NEW YORK
NY 10012
Animist
—39704
119
0
0
773
0
0
0
0
ladhideale Filled Form
0-400 Eater Amonton:
Pape 3,1ine 36
P1;43.1.10, 4C
riape 3, hoe 48
Faired, MFG 62
Fort 3-400TC
Form 04337C
rap 2, Lirm 19
Page 4,1'ne be
base 2, Lire 20c
CONFIDENTIAL
SDNY_GM_00032943
EFTA_00 143556
EFTA01252647
NC SCH K-1
DESCRIPTION
AMOUNT
85
AMORTIZATION
688
TOTAL TO SCHEDULE K-1, LINE 38
773
PARTNER NUMBER 3
CONFIDENTIAL
SDNY_GM_000329441
EFEA_00143557
EFTA01252648
CONFIDENTIAL
SONV_G1,00.S.
EFTA,I0355E
EFTA01252649
5
651111
Mavis K-1
(Form 1006)
fa w.v. yes
Depart-nee et re Inman
yew eyes Ii AUGUST 2011
Elnall(-1
—1 ArnoP,0 K-1
FMB PIO. 15.*Cegi
e.
ROI% cf..
8, 2011
Part III Partner's Share of Current Year Income,
Deductions, Credits, and Other Items
lirerrmi Revenue STAG.
stens, DECEMBER 31, 2011
1 ()limy fiJsiness income (foss)
I
0.
11 Qua
Partner's Share of Income, Deductions,
Credits, etc.
0. See separate instructions.
2 No niwasinnarenion..00..)
I
—4, 065
is FOttiltlitaxecticrs
Part I
Information About the Partnership
3 Other net rents! rcono (i3s3)
I
r m IOytridoiltIcatMn n.rnbe-
4 Guaranteed payrords
I
B Pm rarer p s name, address, dry, absk and ZIP code
270 LAFAYETTE STREET, SUIT 409
NEW YORK, NY 10012
6 lowest *came
I
4.
Go 0rdKary
I
thyldenk
17 Alternains min tor (MIT) items
684
60 Oualilied ONIcionds
I
C IRS Cantu ethers =Inas* firid retro
CINCINNATI, OH
7 Roost es
I
110 LTI Check il Ilia Is a pub** traded parmershin (PTP)
10 ax-wompt bathe end
ondedJclisle evens*.
0 Not shermerT capital gall (loss)
Part II
Information About the Partner
Os nollo10-semi capital 01 Ooss)
1
E Pa
Wen
numb:.
9b Celkokies (28IA) kin (less)
TO ClstrIbutions
F Partners name. address, city, se.to, ard ZIP code
27 HIGH TECH BOULEVARD
THOASVILLE,NQ17360
k 'Enured sod 1258 0491
20 Other
A
Worma'cr
4.
_J
10 Nei sect8n '23' gain (loss)
1
u Mu Inciorm firms)
0 1_1 General pane' a LI C
LxJ LmIleo partner or other RC
mumbermienagor
mamba-
-
K 1.X., Oomeslicparl-er
Foreign partner
I Mat type of ellIty is Mt pater! PARTNERSHIP
12 Lorton 179 ceducton
J Partor's share of will loss, und taste
BagInnisg
Profit
1.13469 9%
hiding
1.1346999%
19 Other dein/2k
W1
76.
•
Loss
1.4641288%
1.4641288%
Captor
1.4641288%
1.4641288% 14 SotelObymen: °emir oti(loss)
A
0.
K Partners share of Oates at year sixt
nem/come
°Wiled ncrrockros filarKing
Kerourse
$
1,315. II
4
135 488.
'See 8.2chel Stab-NM tor addbeall Mlormenbors
$
0.
2
A
k2
L Partners capital account snalysk
Beginning metal =cunt
Caodal cow:Moon kris; tris year
Carrel year IDC'eaS6 (deans.)
Winidrawats 8 distLtcns
smsweamtivamme _. ....... _____
$
$
50.000.8
$
—4.304.
SI
)
.......... $
45.696.
Tax bas's
El &AAP
ti Emotion 704(0 book
MI Other (mo air)
-in gait or loss?
II OM be parson contrib.'s, property soilt a butt
D
Yes
LX. No
'Ms% glad' sta•emern (see MO wrens)
Urn ....
-
-
. -
.
-
- — -
"
—
-
1141111
sparor
sic on
,
•
11360323 758241 21146.212
2011.03020 MIDWAY TRIAD, LLC
CONFIDENTIAL
5
21146_81
SDNY_GM_00032946
EFFA_00143559
EFTA01252650
SCHEDULE K-1
OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION
AMOUNT
76.
TOTAL TO SCHEDULE K-1, BOX 13, CODE W
76.
SCHEDULE K-1
DESCRIPTION
AMOUNT
TOTALS
INTEREST INCOME
-4,065.
4.
SCHEDULE K-1 INCOME SUBTOTAL
-4,061.
-76.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL
-76.
NET INCOME (LOSS) PER SCHEDULE K-1
-4,137.
WILLOW BROOK - SCH Ml, L2- INCOME ON SCH K, NOT
-34.
ON BOO
-132.
-1.
-167.
TOTAL TO SCHEDULE K-1, ITEM L
-4,304.
11360323 758241 21146.212
PARTNER NUMBER 5
2011.03020 MIDWAY TRIAD, LLC
21146_81
CONFIDENTIAL
SDNY_GM_00032947
EFTA_001143560
EFTA01252651
5
cr''te4rsre K-1(-am 10651 Felt
Tfu 1st Ideellffes the codes used on Schedule K-1 lor all mote's and provides summarized reporting islortnelao lor partners who me
FOCE 1040. For detailed rep odes and nalep la neniom , sea Ms separate Pennell listrotlione kr Se1e dole K-I ind lt e lestructoes
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11360323 758241 21146.212
I
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X
$4441181. 704X aarnect
Y 0.1w irannalion
2011.03020 MIDWAY TRIAD, LLO
CONFIDENTIAL
Par 10:0.' m40
•
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5
21146_B1
SDNY_GM_00032948
EFTA_00143561
EFTA01252652
5
'SCHEDULE
NJK-1
(Form NJ-1086)
2011
For Cater der Year 2011 or Fiscal Year Beginning
AUG 8 2011 end ending
DEC 31,2011 .
PARTNER'S SHARE OF INCOME
1019
PART I
General Information
eirenwie ss 4 4- F,Oow se.
lia
l
FernIP•Sja3N 000
a no
Pisitorfir. Y. Kara
Prowl Mani
27 HIGH TECH BOULEVARD
PrreMpli Slinc Mena
270 LAFAYETTE STREET, STITT 409
Cry
Stoe•
213 COO*
THOMASVILLE, NC 27360
Cily
State
ZP eta'.
NEW YORK, NY 10012
Wnet ripe o' only a ranner?
NP
Ente: Parbars nen:0033o ot
(see inettcbons)
;Noe
Data Pe•trer's Isterest is Partnorsing Nowt 0 9/ 0 5/ 201 1
(i) Moro decrease
(I') End of Year
r Trainer cn
Prolit Shang
1.1346999%
1.1346999%
Wan Doi
Yew
i OSS Mena
1.4641288%
1.4641288%
rr] Fbai :Clic',
IN riocktotoo
uvalomwoo
1.4641288%
1.4641288%
, 1 A•nereed 11JK-1
r n Masts Of CONCCreila Return
PART II
Income Information
Income CressifIconono
A. Total DIstrebdloo
NJ-1040 Filer.
Enter Amounts on
Line Stowe Below
B. Now Jersey
Suite Aliments
11-1040NR Flare
1. Partnershis Income (k6$)
-4.061..
a Net Qua ianrsecl laymen's
[
9. Partners 40100 Conttuton
4. 0iswint.lne Stare of Partwiehip
income (ta)
C.ito 1 Pus Lino 2 minus Ina)
-4.061.
Um 20, Page 2
Line22,Page 1
5. Pension.
Une 19, Pale 2
6. ast min (loss) from Es/mesa
oe Assets as a tissue of 2
OntolcMi40Mnni
Une 18, Page 2
Una it Page 1
PART III Partner's Information
'. Nrresident Pestrets Share of IN lax .
•
line 221, Page 1 C3T-100
line 14a, Page 1 (BT-1C03
ling 9,PNIT-100
tire 46, NJ-1040NR
Line 22,1U-T,I3CC
We 31a, NJ-1041
2. Pette's FEZ (eduction
2.
3. Partner's Metered Worishoo Tex CrecIJ .
... ....................
3.
PART IV Supplemental Information (Attach Schedule)
WWI
11360323 758241 21146.212
2011.03020 MIDWAY TRIAD, LLC
CONFIDENTIAL
21146_B1
SDNY_GM_00032949
EFTA_00143562
EFTA01252653
New York State Department of Taxation and Fnance
New York Partner's Schedule K-1
2011
Tax Low • Article 22 (Personal Income Tax)
Final K-1
For calimdar year 2011 or tax year beginning
08-08-2011 and ending
12-31-2011
Amended K-1
Partners: Berme completing your income tax return, see Form IT-204-IP I, Parents Instructions for Pam IT-21)4-IP (avagatm at www.tax.nnoir)
Partnership's Information (see Instructions)
Partnership's name (as shown on Form IT-204)
Partnership's FIN
A Mark snit In the box if saner appres to your entity
Publicly traded partnership
Portfolio investment partnership
B Tax arbiter registration number. It any
C fastness allocation percentage
IT-204-IP
5
Parineesinformaition(sreimwoom)
Partners name
Partners address
27 HIGH TECH BOULEVARD
Cdy
State
ZIP code
THOMASVILLE
NC
27360
o ThediMarma(pinwXkwinmaat-00
General partnerorLLC member-manager
X
LunitedpainerorotherLLCmember
E What Is the tax ?Prig status of the partner? wow. &IX% r • aporverwe Dm Oti.V )
LndNidual
Estate/trust
X
Partrwishp
F If the partner is a rldregorded entity a grantor list.
enter the tax ID of the entity or ncliyickial repotang the &erne a known
G Oki the partner sell Its ante-Jr/Cereal during the tax year?
G
Yes
No
X
H Partners tare of profit, look end capital
Beginning
Ending
1) Profit
Ht
1.1347 %
1.1347 %
2) Loss
it2
1.4641 %
1.4641 %
3) Captal
H3
1.4641 %
1.4641 %
I
Partners share of Nablides at the and of ma year
1) Nonrecourse
1,315.
2) Qualified nar000urse financing
12
135,488.
3) Recourse
13
J Partners capital account analysis
1) Bcghnlrg capital account
2) Capital contacted dump the year - cash
JQ
50,000.
3) Capital contributod during the year' property
J3
4) Current year increase (decrease)
J4
—4,304.
6) Withdrawals and distauthans cash
Js
6) Withdrawals and distributions • property
7) Ending capital account
J7
45,696.
8) Method of accountteg (mark an X tote oppsopriite box)
Partners identityki number
X
Tax basis
OMP
Book
Other (attach OtokatION
I( Resident status (mum en X met' boxes met oppY)
NYS full-year resident
Yonkwshillwafleskient
NYC full-year resident
NYS part-year resident
Yonkers part-year resident
NYC part-year resident
X
NYS nonresident
Yonkers nonresident
L It the partner was tick-do:11n a group return enter the special NYS ideMilicaticd number. If Wenn
L
lt4651
12 011 •
Please file thle original scannable lore with the Tax Depadment.
CONFIDENTIAL
11019
'Narks
SDNY_GM_000329so
EFTA_00143563
EFTA01252654
Paget of 4
IT-204-IP (2011)
M 1) Was Form IT-28585 Ned with the partnerhIp?
2) Was Form MTA-436-E MS with the partnersNp?
N NYS marinated tax paid on ben* of partner (from Form M2658)
1) First Installment
NI
2) Second installment
N2
3) Third Installment
N3
4) Foath instalment
144
Total NYS estimated tax paid on behalf of partner (add Ines Nl through AN)
O Estimated MCTIAT paid on belief/ of partner (from Form MTA 405)
1) First instalment
O1
2) Second installment
O2
3) Third Installment
O3
4) Fourth hstalnant
O4
Total estimated MCTMT paid on behalf of partner (add hies Of through O4)
O
Partner's share of income, deductions, etc.
A • Partner's distributive share Items
e • Federal 51 amount
C - New York State amount
1 Ordinary business income (loss)
1.
1.
2 Net rental real estate income Foss)
2.
-4,065.
2.
3 Other net rental income Foss)
3.
3.
4 Guaranteed payments
4.
4.
6 Interest income
5.
4.
5.
6 Ordhary dividends
S.
0.
7 Royalties
7.
7.
8 Net short-term e.apital gen mass)
8.
8.
9 Net long-term capital gain (bee)
9.
9.
10 Net sectcn 1231 gain (loss)
10.
10.
11 Other income goes) clontify:
11.
11.
12 Section 170 deduction
12.
12.
13 OrnerdeductionslaWM50:
SEE STATEMENT
13.
76.
13.
14 Tax preference items for minimum Vex
14.
684.
14.
Identify:
15 Net earnings (loss) Porn seeemployment
75.
15.
16 Tax-exempt woo= and nondeductible expenses
16.
16.
17 Distributions - cash and marketable securities
17.
17.
18 Distributions -caw property
18.
18.
19 Other tams not included above that are required to be
reported separately to partners
identify:
SEE STATEMENT
19.
4.
19.
Date
Mt
Yes
No
St2
Yes
No
/mart
N
Date
Amount
Partner's share of New York modifications (see ktstructions)
20 New York State addrocns
Number
A - Total amount
B - New York State allocated amount
20a. E A-
200. E A-
20e. E A-
20d. E A-
20e. E A-
20f. E A-
21 Total add lien modifications (total of column A, Aims 20a through 20Q
27.
15052
•
Please file this original scannable form with the Tax Department.
III I
1182111019
CONFIDENTIAL
SDNY_GM_00032951
EFTA _00 I 43564
EFTA01252655
IT•204•IP ;2011}
Page 3 of 4
Partners share of New York modifications (continued)
22 New York State subtractions
Number
A • Total amount
22a. E S-
22b. E S•
22c. E S-
22d. E S.
22e. E S-
221. ES-
6- New York State allocated amount
23 Total subtraction medications (total of column A Aires 22a through 220
23.
24 Additions to federal Xeroxed deductions
Letter
Amount
24a.
24b.
24o.
24d.
24e.
241.
25 Total additions to federal itemized deekictions (add fines 249 through 240
25.
26 Subtractions from federal Itemized deductions
Letter
Amount
26a.
26b.
Mc.
28d.
280.
261.
27 Total eutitractiors from federal Itemized deductions fadd Cries 26e through 260
28 New York adjustments to tax preference items
Partner's other Information
29a. Partner's share of New York source gross Wont
29b. MC1D allocation percentage (see Instructions)
27.
28.
23a.
2£6.
4.
Partner's credit information
Part 1 - Pass-through credit bases and factors
redevelopment tax credit (Form IT-6I I or rr-6il.l)
A form tT•811
Et • corm 3-611.1
30 site preparation credit component
30.
so.
31 Tangier° property credit component
31.
31.
32 Onlite grandwater remediation credit component
32.
32.
1183111019
s?.)1,<•
Please file this original scannable form with the Tax Department.
CONFIDENTIAL
SDNY_GM_00032952
EFTA_00 I 43565
EFTA01252656
Pepe 4 of 4
IT-204-IP (2011)
Partner's credit information (continued)
EZ capital tax credit (Form rr-602)
33 Contributions of money to EZ community development prolects
33.
34 Recapture of credit for 'nvestments n certified EZ businesses
34.
95 Recapture of credit for centAuuta-is of money to EZ community development projects
35.
QEZE tax reduction credit (FamIT-604)
36 DUE employment increase factor
36.
37 OEZE zone allocation factor
37.
38 OEZE benelt period factor
36.
Excelsior Jobs prosaism tax credit (Form IT-607)
39 Excelsior fobs tax crack component
39.
40 Excelsior investment tax credit component
40.
41 Exoelskx research and development tax credit component
41.
42 Excelsior real property tax credit Component
42.
Farmers' school tax credit (Fpm IT-217)
43 Acres of quailed agricultural property
43.
44 Acres of qualified conservation property
44.
45 E6gble ached district property taxes paid
46 Acres of qualified agricultural property converted to nonqualified use
46.
Other pees-through credit bases and factors
Credit bases
Code
Amount
Coda
Amount
47a.
47d
47b.
470.
476
471.
Croat' factors
Code
Factor
Code
Factor
Code
Factor
47g.
471.
47k.
47h.
47j.
471•
Part 2 - Pass-through credits, addbacics and recaptures
48 Lorg•term care Murano° credit (Form IT-249)
48.
49 luvatmentcredit (acOding employment attentive credit end historic barn rahabRitation croak Form IT-212)49.
50 Research and development • investment Credit (Form 17-212)
50.
51 Other passthrcugh credits
Code
Amount
Code
Amount
51a.
51b.
811.
510.
51g.
S1d.
5111.
52 Addbacks ot Delta and recaptures
Code
Amount
Code
Amount
52a.
52d.
52b.
52e.
52c.
52f.
1245-11
Please file this original scannable farm with the Tax Department.
CONFIDENTIAL
p
1164111019
II III IIIIlIIIIII1111IIul
SDNY_GM_00032953
EFTA_00 143566
EFTA01252657
NY IT-204-IP
DESCRIPTION
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE K-1
AMOUNT
76.
0.
76.
0.
NY IT-204-IP
DESCRIPTION
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 19
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE K-1
AMOUNT
4.
0.
4.
0.
PARTNER NUMBER 5
CONFIDENTIAL
SDNY_GM_00032954
EFTA _00143567
EFTA01252658
NC K-1 (39)
.(0-403)
0M1PaiineesShamot
N.C. Income, Adjustments, and Credits
Kole Cara ea Deprhurt of Revenue
c41,11a, gar
rat fiscal year bepfinIrg
Putnit's leen5tying it mbe r
Partners llama, Address, and ZIP Code
27 HIGH TECH BOULEVARD
THOMASVILLE NC 27360
08 08 11 end suing
12 31 11
Federal Em !eye/ ID Nunber
Pulsemillia Nuns, Address, aid ZIP Coda
270 LAFAYETTE STREET SUIT 409
NEW YORK
NY 10012
Putnetiblp's Pio Rita Stele Herm
AilParton
1. Sfre of permemhp mcvMe (loss)
2. Maims io Inxima (ces)
a. Add:Ion kr bonus deprecation
b. Olher additionsto income (loss)
5. Ded gloms tom Dooms (lose)
a. Deduct:II far bonus Direction
b. Other deductons From PCOITIO (1058) STMT
L. a. Mara ottax 6400114r SmellRmlnesses That Pay
Untnuloren1 Insurance
b. Stare of otlwx tax credits
D Sham of ,ax withheld from flowage compensaeon
pam for pefsonal services perlormed it N.C.
NaeresIdeats Oily
6. Nonte310errs Share of N.C. taxabb income (loss)
7. Nomesitlents Shy' of net tax pall by the manager
of toe craluvrehip
Moat
dNidoata Filing Form
0-400 Er eel Annul Os:
-4061
1324
Nil 3. tins 38
0
Page 3, Li% 40
0
Pape 3, in 48
76
Papa 4. Eno 52
0
Form 0-400C
0
Form 0-4001C
0
Pace 2. Line. IS
0
Pap 4, Lino 54
0
Page 2, Line 20c
'00201
CONFIDENTIAL
SDNY_GM_00032955
EF-ON_00I43568
EFTA01252659
NC SCH K-1
DESCRIPTION
TOTAL TO SCHEDULE K-1, LINE 3B
AMOUNT
76
76
PARTNER NUMBER 5
CONFIDENTIAL
SDNY_GM_00032956
EFTA_00143569
EFTA01252660
CONFIDENTIAL
SONV_G1,0069.57
EFTA,I03570
EFTA01252661
651111
SoItedul. K-1
2011
(Form 1085)
fa vt.prea. Nn 20". cctu
Depeameet of the Tanury
yew bureinp APRIL 21, 2011,
n FM. K--.
E
Amend«, K-1
Ofra No, Isescregg
Part III Partners Share of Current Year Income,
Deductions, Credits, and Other Items
Hemelseem.. &tyke
exenu DECEMBER 31 2011
tOrdhary business hcome (bus)
I
0,
15 Credits
Partner's Share of Income, Deductions,
Credits, etc.
I> See mums inviadoms,
2 Ns, ma ri«. enenema...0.4
I
—6.349.
15 Foreign Demotions
Part I
Information About the Partnership
St
9
et ne rem Income Dusa)
A ernershp's employs. idortitoillon nunber
4 Curia- leed payment
I
B PartnereNeS rime, settees. ter. slate, and ZIP :ode
270 LAFAYETTE STREET STE 409
NEW YORK, NY 10012
5 Interest iron.
I
6.
Ift OrdnarychMeres
I
17 A amaam rah tax (MT) Name
782.
.re
19 Goalie° clhroenck
I
C IRS Cenar Mime eyelash. lb. return
CINCINNATI. OH
8.
7 &tittles
I
D ILI Chick fr the is a publicly tided matentip (PIP)
18 TaxixemPlIlleeme
nondetuctiale
and
expensas
8 fee l torl-Men arnica n (bes)
i
Part II
Information About the Partner
Ila N long-Barn metal gain (loss)
I
E Parters 0enehleg Miner
96 COleetibitt (28%) ge:n (loss)
I
19 Dietebullons
it
1,357.
F Penn«. nano. adOren, dry, rare, and BP cos
27 HIGH TECH BOULEVARD
TSOMASVILLE, NC 27360
9e Immeapturode.e 1250 geM
I
20 alter .'ombol
A
6.
10 Nei sodion 1231 gain (Ins)
B
8.
11 Other -ncome (oss)
et I General owner or U.0
(xi try* pur beer or other I LC
member-nareger
member
H III Dameset pater
IL Foreign career
I What type or eery 15 fil patal?
PARTNERSHIP
12 Salon (79262x:son
J %Ines S`Ire Of pra loss, and went
Beglosis.
Min
B ore
1.3478261%1
1.3478261%
.--
18 Otte. neductIons
0
1
‹,
87.
Less
1.7391304%
1.7391304%
Caaell!
1.7391304%
1.7391304% MS.84-100)440dearKINB(X5)
A
0.
K i-tatneeS sham( Wedeln at mar °nit
ef °meows.
$
4.320.
Doabled nonrecouree iinancisii
S
78.414.
*See flinched stale-lent lei aidliWai InDn.
flexure.
$
0.
2.
8
2
8
I. ea rors alpha axon! waled.:
Begiini%cepta accoult
$
Capitt. ore trite. Duero Um year
$
50.000.
Wren:year Increase (decrease)
$
—6.582.!
Witte ab 8 estabutiens
SE
1.3574
Ending eagle account
$
42.061.
Tax basis
IJ GNP
C
Section 701(b) book
•
On« (explaln)
Al ex tre wffner co nebula e-operry wire. bull-.n gain et ass?
_
Yes.
IS_ No
II We. dare Stitaff Sit ;St' illsrUCtiOnSe
WS.
. . _
-
_
"
-
. — -
.
-
-
. ---
.....
.._. . ...— .............
of &pelvic
C 11C Oft
CO,I
.
5
13500322 758241 21146.210
2011.03020 MIDWAY-CAROLINAS LLC C/0 MI 21146_91
CONFIDENTIAL
SDNY_GM_000329SB
EFTA_0014357I
EFTA01252662
SCHEDULE K-1
OTHER PORTFOLIO DEDUCTIONS, BOX 13, CODE L
DESCRIPTION
AMOUNT
TOTAL TO SCHEDULE K-1,
SEE IRS SCH. K-1 INSTRUCTIONS
BOX 13, CODE L
8.
8.
SCHEDULE K-1
OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION
AMOUNT
TOTAL TO SCHEDULE K-1, BOX 13, CODE W
87.
87.
SCHEDULE K-1
ITEMS, BOX 17, CODE F
DESCRIPTION
AMOUNT
SEE FORM 4626 ACE WORKSHEET
INSTRUCTIONS
TOTAL TO SCHEDULE K-1, BOX 17, CODE F
8.
8.
SCHEDULE K-1
DESCRIPTION
AMOUNT
TOTALS
-6,349.
INTEREST INCOME
6.
SCHEDULE K-1 INCOME SUBTOTAL
-6,343.
-8.
-87.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL
-95.
NET INCOME (LOSS) PER SCHEDULE K-1
-6,438.
-124.
13500322 758241 21146.210
PARTNER NUMBER 5
2011.03020 MIDWAY-CAROLINAS LLC C/O MI 21146_91
CONFIDENTIAL
SDNY_GM_00032959
EFTA _00143572
EFTA01252663
45-1814195
-19.
-1.
-144.
TOTAL TO SCHEDULE K-1, ITEM L
-6,582.
PARTNER NUMBER 5
13500322 758241 21146.210
2011.03020 MIDWAY-CAROLINAS LLC C/O MI 21146_91
CONFIDENTIAL
SDNY_GM_00032960
EFTA _00143573
EFTA01252664
. 5
Szbegute 4-1 (Form IC€61 2)11
Fage 2
Tels Ist Identifies die codes end on &Affile K-1 for ail partners nid provl des ounimarized reporens information for pianers Mo file
. Form 1040. For dendled reparties sid filins Information, sse die separate Penn sr s Inelrubons fer Schelale K-1 and the Inslamli et
lor gour inoo me tex rature.
I
>dinars cars
norme Va
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vrettir te rentra/
te
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ire tra
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ficeparant rata
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I
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lon
d.
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▪
botterecern.
le
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la
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et. Oeta boa (291410sr kat
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11. 00« Narré »la
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(bue
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E
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G Ceerbenne(1.1071)
nverreet net« *rat«
I
DOCIJUICI• • royalty hart
J
Sale, tette apereleate
K
Delycrire • ver* c Ott lori
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II Ana ett 00 7a. Media, Murera
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O Daman
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proprallavie xnad pains
O Conatned ravi isba <barn
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Ft
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and FIA•
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*duce:.
T
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mouflon Pearta
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&paya% Fan W. 2 ben
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Sa TEP/nefs tan% ce
Schalele E. ro 26, caser KI
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E. Ire YB coin.
Se la Pende. reteestical
BentIvi•E Ira 33 oct..mn Im
Say te 951aea rental
Berwail•C lm Moere
W
Fem '040. lais
Ion '040. enfla
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(Sergel'Dherione
Sm la ont,
naucticro
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relerticra
Ste es Perharg Feut rera
Ste ro Potier.. herneteo-et
Sr Ka 036
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SaFePrnrtlnmaØs
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natualenp
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Sa •
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ner-o Pusey:Ion
erre 7441. 'T. 12
tha •TallaralEsinx}cre
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tto :errer te ranatre
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Faro INe3. rra ity
.ene aC3. ' re 17
Ste ro Puera haute tee
14.
arroi
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Mea Il you Irae saler 17,1 noierai r mye artreplevel dermes
m
ta Portera rAincter
aéra card•Ong Sate1a SE
A
Net *limbe Cala roe
reerherea
B Grue arma
, taro Insane
C trocs neerto heure
1S. exalta
A Loracare !baril den
»En la i C.X55 bis readt
Wba
•
Lealetoret Orant raft KT«
Iwo reitte$ tyd clef e
C LOS- Tan
POIMPE >tait Erectke
4.20%) for ear.20/7 V, SOT
C. Laie reen•FoanG Oatt Pr«
itte aoa1.2027 bul
C
Galba nOtattbartert bancha,
raid ro« estes;
F
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ana
•
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•
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I
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rd colt trie cita tel
dock
Sarre.> œ. Salir. A tx B
Sa St Mettre Paneton,
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13500322 758241 21146.210
Cole
J
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K ', baba axa* ante
L
Bettatryal
.
ene
eennenity OTterra
1 a le
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Ø1p
♦ Gel
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ad Velouta las
•
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o Otr enta
• Il %rate brisera
A ter
&mire
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300Stiœntlice
avote
C
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NAI
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▪
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▪
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Date- Ocre albriled and •ECOTIC000
erre lime
o
nierai deepmae
Faut 1114. owl I
H 02w
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ralettltencral garerait
rab
tallait adule*
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I
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K Oaer
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L
Tan:Mg tau pal
M Tete! lente liter mea,
N %duce= hW.* stabat b cade
O 'Colle t+elreeCtereCelfra
P
b ottant:api rasa areate
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A
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5
2011.03020 MIDWAY-CAROLINAS LLC C/O MI 21146_91
CONFIDENTIAL
SDNY_GM_00032961
EFTA_00143574
EFTA01252665
Schedule of Activities
;woud« nmer mrt it rajas **Wm APR 21 Y11. en; one.:
DEC 31 2011
Kama: C/O MIDWAY INVESTORS
For.
BLUE CHIP CAPIT
LLC
T
mevrry ',nos
Deecripben
1
't2h taxer N*
Parot
imilblp
of
Pads/
I
i°
Adity •
Ord•nary business Income (bee
Not rental real era ircne (loss)
Other eet tentai Income pots)
Interest inname
DiVdends - Cc dInary dhirbenos
-aalbed 6midends
—es
Net snort-term ca it& gain (loss)
Mt long•teryi capital gain (loss)
CollerbbIs (2815) gain (Iota)
• Umeantufed Sieben 1260 gain
Net »don 1231 gab (loss)
Ober pertloio income
Seen on 1256 contrasts and addicts
Otter bcom3
Section 179 deducilon
Crtriblfe contributions
Patio» ded.ietione
Investment interest expense
Pectic- 59(0)(2) expenditures
Other deductions
let earnbos from sell-emPlernelll
(idea farming or ilshirg noodle
Gross nonfarm Rome
LIN onadt - Senon 42()(5) partnerships
- Caber
Qualified rebate ration mdten3/11MS Mind brentetrol asos
Obis ism. credits
Credits related tool* ren0J ecliveires
Recapture of 1,14 credit -Seam 42(0(5) Palma
-Ober
OiYer c'edits
Post-1996deprecatior adjustment
Kopsted gait or loss
Parton ot adjusted galMoss albnole b shoe-term gilMcss
Pollen of adjusted galMoss closable b long-ben gaindoss
Portion of edited palndossallocabb b melon 1231 palniloss
Depletion (ile- 'ar Wand gas)
011, gas and rrectr.ixmai r mocks • cress eiome
Oil, pas e-d gal nr
proortss • deOactors
Met AMT items
Investment 'ncorne
Interment exconses
.70.-C1.11
ACPrite •
1
I ActiVay
- .197.
5.
368.
13500322 758241 21146.210
2011.03020 MIDWAY-CAROLINAS LLC C/O MI 21146_91
5
CONFIDENTIAL
SDNY_GM_00032962
EFTA 00143575
EFTA01252666
New York State Department of TaxatiCei and Finance
New York Partner's Schedule K-1
2011
IT-204-IP
• Tex Law - Artiste 22 personal Income Tax)
5
Final K-1
For calendar year 2011 or tax year bogInning
04-21-2011
and ending
12-31-2011
Amended K-1
Partners; Before completing your income tax return see Form I I -204-IP Partner's Instructions to, Purr; IT-204-1P ;:r. al sb'e at wewiesey.90.4.
Partnership's information (see instrctions)
Partnership's lame (as shown on Form IT-204)
Partnership's EN
A Mark an X n the box if tattler applies to your entity
Publicly traded pattnership
Portfolio investment partnership
a
Tax shelter registration number, d any
B
C Business allocation percentage
Paineesimfonneonfteepoancuw4
Partner's name
Partners address
27 HIGH TECH BOULEVARD
City
state
THOMASVILLE
NC
ZIP code
27360
Partner's Identifying nJm ben
D The partner is
in X Inne 3.174,7 a bo.(
General partner er LLC member•manager
X
Limited partner ur other ISC member
E
Whet is the tax filing status of the partner? aeoxerKir Ow aogopto a siox.-.)
Individual
Estate/trust
X
Partnership
F If the partner Is a disregarded entry or grantor trust,
enter the tax it) of the entity or hdlvidaal repatrg the income, a known
F
CI Did the partner so its entire Interest dollen the tax year?
CI
Yes
No
X
Partners share of profit, loss, anc capital
Beginning
Ending
1) Profit
HI
1.3478
%
1.3478
r.
2) Loss
142
1.7391 %
1.7391
3) Capital
H3
1.7391 %
1.7391
Partners share of labeller:a at the and of the yea
1) NonreCOurie
11
4,320.
2) Qualified nonrecourse financing
12
78,414.
3) Recourse
13
Partner's cap eel account anahrsIs
1) Beginning capital account
.J1
2) Cap tat contributed curing the yea -cash
J2
50,000.
3) Coptsl conthouted during the year -property
J3
4) Current year increase (decrease)
.14
-6,582.
6) Withdrawals and &Animations • cash
J5
1,357.
6) Withdrawals and cEstributions - property
J6
7) Ending capita! account
J7
42,061.
6) Method of accountng (rnto* an X in the approwiato box)
X
Tax basis
GMP
Book
Other (Basch oxplanatinn)
J
K Resident status (math an X k1 e boxes that appi/)
NYS fuelear resident
Yorkers Ioniser resident
NYC ful-year resident
NYS parbyear resident
`rankers part-year resident
NYC part-year reskient
X
NYS nonresident
Yonkers nonresident
L If the parse, was included In a group retim, enter the special NYS Identification number, r known
1181111019
Please file Ills original scannable form with the Tax Deportment
CONFIDENTIAL
SDNY_GM_00032963
EFTA_00143576
EFTA01252667
Page 2 of 4
IT-204-IP (2011)
M 1) Was Form 172868E tied with the partnership?
2) Was Fenn MTA405-E filed vAth the partnership?
N NYS estimated Utz paid on behalf of partner (horn Form 1T-2658)
1) First installment
NI
2) Second installment
N2
3) Thkd installment
N3
4) Fourth installment
N4
Total NYS estimated tax paid on behalf of partner (add Ines N7 through N4)
O Estimated MOTAT paid on behalf of partner (from Form PATA-405)
1) First katallmem
01
2) Second Installment
02
3) Iliad Installment
03
4) Fourth instalment
04
Total estimated MCTMT paid on behalf of partner (add Ines O1 through 04)
0
Partner's share of Income, deductions, etc.
A - Partner's distritutiye share items
I
Ordinary business income (loss)
1.
B - Federal K-1 amount
1.
0 • New York State amount
2 Net rental real estate income (loss)
2.
-6,349.
2.
3 Other net rental income Fees)
3.
a.
4 Guaranteed payments
4.
4.
S interest Wane
5.
6.
s.
It Ordinary dividends
8.
6.
7 Floyardes
7.
7.
8 Net shed-tem capital gain (Ices)
8.
a
9 Net longterm capital gain goes)
9.
9.
10 Net sentinel 1231 gain (ham
10.
10.
11 Other 'come (loss) Mondry:
11.
11.
12 Section 179 deduction
12.
12.
is Other deductions fdentffr
SEE STATEMENT
13.
95.
13.
14 Tax preference items for mhimum tax
14.
790 .
14.
Wen*:
15 Not earnings (Joss) from selfarr.pecryinem
It
15.
18 TaX&XeMpl Income and nondeductible expenses
I&
it
17 Distributions • cash and marketable securities
17.
1,357 .
17.
18 Distribution • other proper.).
is.
18.
19 Other itoms not 'eluded above that are required to be
ropcited separately to partners
19.
14 .
19.
Date
Mt
Yes
No
In
Yes
No
Amount
N
Date
Amount
owner
SEE STATEMENT
Partner's share of New York modifications um ustrucrkwu
20 Now Yak State ackhlichs
Number
A - Total amount
20a. E A-
200. E A-
20c. E A-
20d. E A-
20e. E A-
201. E A-
B - New York State allocated amount
21 Total addition nxxlMcations (tot& of column A W'es 70a through 200
21.
1782111019
lame
124«.11
Please Me this original scannable lawn with the Tax Departhient
CONFIDENTIAL
SDNY_GM_00032964
EFTA_00 143577
EFTA01252668
IT-204-IP (2011)
Pope 3 of 4
Partner's share of New York modifications (continued)
22 New York State subtraction,
Number
A - Total amount
B - New York State allocated amount
22a. C S-
22b. E s-
22c. E S.
22d. E S-
22e. E S-
22f. E S-
23 TOM subtraction mediate:ions (10W Of COlurnn A Noes 22a through 220
23.
24 Adosions to federal itemized Oath-0one
Lotter
Amount
24e
246.
24o.
24d.
24e.
241.
25 Total additions to federal bombed deductions (add Ones 24a through 240
25.
26 Subtractions from federal Itemized deductions
Lotter
Amount
26a.
260.
260.
NUL
26e.
20f.
27 TOtal subtractions from federal utilized deductions (add Aires 26a through 260
27.
28 New York adjustments to tax preference items
28.
Partner's other Information
2gra. Partners share of New York SOurCO gross ncome
29a.
6.
290. MCT0 allocation percentage (see mu:racoons)
296.
Partner's credit information
Part 1 - Pass-through credit bases and factors
Brownfield redevelopment tax credit (Form i7-617 or IT-611.7)
A FormIT.611
Form IT.611.1
30 Site ossparat0n credit co-rpm:ant
30.
30.
31 Taugtoleproprtycredloemponert
31.
31.
32 Waite groundwater fCMCMatiOn credit component
32.
32.
1183111019
is
1
R6C.
I2c4-1,1
Please the this original scannable form with the Tax Department
CONFIDENTIAL
SDNY_GM_00032965
EFTA_00 143578
EFTA01252669
Page 4 of 4
IT-204-IP (2011)
Partner's credit Information (continued)
EZ capital tax credit (Form IT-802)
33 Catteutions of money to E2 community development projects
33.
34 Recapture of credit for hveatmenta in certified a businesses
34.
35 Recapture of credit fa contributionsof matey to a community development projects
35.
OEZE tax reduction credit (Form IT-804)
35 OEZE employment Increase factor
36.
37 OEZE zone atocation factor
37
39 OEZE benefit period factor
38.
Excedirke jobs program tax credit (Form rri507)
39 Excelsior lobs tax aeon component
39.
40 Excedlor hvestment tax credit component
40.
41 Excelsior research and development tax credit component
41.
42 Excelsior real property tax credit component
42.
Fanners' school tax credit (Form IT-217)
43 Acres of citiaraied agricultural property
43.
44 Aaee of qualified consorvat on property
44.
45 Eligible school dstrict property taxes pad
45.
46 Axes of qualified agricultural property convened to ncnqualied use
46.
Other peas-through credit bases and factors
Credit bases
Code
Amount
Code
Amount
47a.
47d.
47b.
47e.
470.
47f.
Credit tatters
Code
Factor
Code
Factor
Code
Factor
47g.
471.
47k.
47h.
471.
47I.
Part 2 - Pass-through credits, addbacks and recaptures
48 Long.len-n care insurance credit (Form IT-249)
48.
49 evestment 7Cdit (including encloymtnt Incenthe credit and historic barn eshalantation credit: Form IT-212)49.
50 Research and development • Investment credit (Form CT-212)
50.
51 Other pasethrough Credits
Code
Amount
Code
Amount
51a.
51e.
511.
SM.
51g.
51d.
51h.
52 AdObacks of credits and recap heat
Code
Amount
52a.
52d.
Code
Amount
526
520.
52c.
521.
1184111019
MOM
teen
Please f de this original scannable form with the Tax Deparbnent.
CONFIDENTIAL
SDNY_GM_00032966
EFTA_00143579
EFTA01252670
NY IT-2C4-IP
DESCRIPTION
8.
0.
87.
0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13
95.
0.
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE K-1
AMOUNT
NY IT-204-IP
DESCRIPTION
6.
8.
0.
0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 19
14.
0.
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE K-1
AMOUNT
PARTNER NUMBER 5
CONFIDENTIAL
SDNY_GM_00032967
EFTA_00143580
EFTA01252671
NC K-1 (39)
pom
•
11.1)-11
2011 Partner's Share of
N.C. Income, Adjustments, and Credits
bort I:aro:at leper rant ct lawns,
rot arena' yuat
or fiscal hvar ha a nnY0
Partners Identifying Number
Parear's Name, Address, and ZIP Code
27 HIGH TECH BOULEVARD
THOMASVILLE NC 27360
04 21 11 amending
12 31 11
Federal Employer JO Number
Partnership's Name. Address, and LP Code
270 LAFAYETTE STREET STE 409
NEW YORK
NY 10012
Pitaserships Pro Rau Share Items
All Parlous
1. Share of canners hia income (loss;
2. Ade tors lo game (bas)
c. Addition Ice bonus dop•odatlon
c. Other actions to income (loss)
3. Dedsctiors from acorns loss)
a. eeductsn tor bonus &Fractal'?
b. Othet caductiors bow ammo (loss) STMT
4. a. Share of Tax Dale
Smal Buslnesees hat Fay
LC. linamployment Instance
b. Share cl other tax credits
5. SING of tax welshed from nonage compensate,
prod for personal serlais perch-ad in N.C.
Noir. sidenta Only
6. lionsidents share e Pit '.able income (zee)
7. Nonresident's sham of not lox paid by therm...agar
of the cartmrship
Amount
Individuals Filing Form
D-400 Ester Amorist n:
-6343
0
Page 3, Lire 38
0
Pace :cline 40
0
Page 3, ins 48
95
Page &Sins 52
0
Form 3433TC
0
Form D-433TC
0
Page 2, Line 19
0
Page 4, Lino 54
0
Page 2, LMe 20c
60201
1241, 1
CONFIDENTIAL
SDNY_GM_00032968
EFTA_00143581
EFTA01252672
NO SCH K-1
DESCRIPTION
AMOUNT
TOTAL TO SCHEDULE K-1, LINE 3B
87
8
PARTNER NUMBER 5
CONFIDENTIAL
95
SDNY_GM_00032969
EFTA _00143582
EFTA01252673
r
• 1019
5
PARTNER'S SHARE OF SOUTH CAROLINA
SC1385 K-1
(Rev. 5/27/11)
3515
For (attends, year 2011 a tax year beginning
fteafa's nt
nurnba
ldaa
Partners name, address and ZIP code
27 HIGH TECH BOULEVARD
THOMASVILLE, Nc 27360
04/2111
mamma dl Sk.
n__
PartniesNif's FEIN
►
Partnership's name, address and DP code
270 LAFAYETTE STREET STE 409
NEW YORK, NY 10012
Kit
Monreaident
Partner's Share of Current Veer
income Deduotions.Crecite. etc.
04
Federal
K-1 Amounts
I/3)
Plus or Minus
SC Adembrients
IC)
I
Amounts Not
*located
a Apparticeed MSC
(0)
Amounn Allocated
a
to SC
I Ordinary business Income dose)
2 Net rer.tin real estate income Oess)
3 Other net rental income (loss)
4 Guaranteed payments
5 interest income
1
1
STMT
I
1
1
2
—6.349. 2
302. 2
-5.197. 2
-750.
3
3
3
3
4
4
4
4
5
6. 5
6
5. 5
1.
1
Dividends
8
a
a
8
I
6
7 Royalties
7
7
7
7
8 Net shortterm capital gain Nei) _
9 Net tongasrm capital gain Ooss)
10 Net Section 1231 gain (loss) ..... _
11 Other Wayne 4009)
8
a
8
8
0
9
a
:I
10
10
10
101
11
11
11
11
12 Section it 79 deduction
12
12
12
12
:8 13 Other deCILICI1Ofill
19
95.13
13
13
95.
STATEMENT
_agg
.
14 Withholdrataxfornommodentpartner .. . .
'it"'
14
0.
last applicable South Camino tax meas. (Attach an additional sheet a needed.)
15
15
t 16
18
.3
17
17
18
19 Total South Carolina tax, credrs
fra21 06-11.1i
L
35151018
CONFIDENTIAL
118
19
0.
J
SDNY_GM_00032970
EFTA_00 143583
EFTA01252674
SC• SCHEDULE K-1
SCHEDULE K-1 ADJUSTMENTS
LINE NO.
DESCRIPTION
AMOUNT
LINE 2
TOTAL OF FORM SC1065, SCHEDULE K-1, COLUMN B
402.
402.
DESCRIPTION
COL A
COL B
COL C
COL D
95.
0.
0.
95.
COLUMN TOTAL
95.
0.
0.
95.
aaalaii=•=7:MC
PARTNER NUMBER 5
CONFIDENTIAL
SDNY_GM_00032971
EFTA_00143584
EFTA01252675
CONFIDENTIAL
SON,GN,0320,
EFTA,103585
EFTA01252676
651111
Selinden K-1
2011
r - gestic-1
'j
Anrided <-1
c96i ith.1546-0009
(Form 1086)
forcsemayeeMr oxtagg
Deponent ist the -reasury
ve.,..Kthiva MARCH 30, 2011
Part III Partner's Share of Current Year Income,
Deductions, Credits, and Other Items
Interne' Revenue Sergio
fl* o DECEMBER 31, 2011
I Winery business mire (Ion)
[
0.
16 Credos
j
Partner's Share of Income, Deductions,
Credits, etc.
le See sonnets inflations.
2
lelUli r•ei ieilliOnGarn 0000
i
853.
-4,
is Ftev Smash:es
Part I
Information About the Partnership
3 Other nannies Income (ass)
A Parthershp's onazipir remit'
n lumber
41Iuaranteed payments
B 'artrthrstsis name, address, cly, slate, and Mode
6 'merest more
I
7.
270 LAFAYETTE STREET, SUIT 409
NEW YORK, NY 10012
es Ordnary dividends
I
17 Moat im min 2% (AMT) 'tens
—1,426.
Bb Qualified lividenes
_I
C IRS :;e-tb- mere mutest 1p feed -*turn
CINCINNATI, OH
7 Royabies
I
0 NI Check 6 Ms is a publdy traded corniershila (PIP)
18 Tax-exempt
nondeductlbee
income and
opens's
8.I shotgun metal gain (ass)
Part II
Information About the Partner
Is Net ion:elm capital gain Voss)
E Prthers Arryno aumisar
IN Galatibles (28%; pan (bss;
I
19 Disat.tos
A
2,500.
F Partra's name, address. city, state, and DO code
27 HIGH TECH BOULEVARD
THOMASVILLE, NC 27360
pc Unreoptrei sec '.25.1 pain
20 Other Arran
7.
10 Not section 1231 pat (icse)
I
_I
it Other tone (kiss)
I
6 t__) Genera:Fanner or LLC
----
renitad patty setter IA(;
memo-Meltivei
"amber
II lil Domes* mther
rl Forty partner
I What type 01 wiry is nes partner? PARTNERSHIP
12 Solbn172deducion
J Princessham of prob.WMInd capte.
Beginning
Eating
ball
2.3484848%
2.3484848%
U Other dedelbn$
Lass
I
3.0303030%]
3.0303030%
201%
3.0303030%
3.0303030% 14 Sellampbyrreni earninpe (bee)
A
0.
K Peres ONO ol Rabbles at year and:
lirlArscoterrol
S
1,898.
oueinesrureaisset rinsing
$
'Seem
strerront rat:100M. terns. n
WOMB
$
Q.
1
S
L Parthers capital annum analysis:
noncing capital annual
$
Capron contnbated during the year
$
75,000.!
Gummi yea' iraease(deveaSt)
S
1,150 e
Wthrfraebls & thrbidons
8(
2,500;1
Odin capita leccurt
S
ni§M.
uc Tax basis
Ili GAM)
CI Section 704(t) book
D
Other (bob n)
IA Did the earner mrhibute croperty is lb a Cu II-11 pall or bss?
MI yes
MK°
I' Yes', attach strewn (see rnsnuclors)
. - . ..
..
. . ..
1406.11
perm°
LIG
1
4
10120414 758241 21146.209
2011.03040 MIDWAY MOUNTAINEER, LLC
CONFIDENTIAL
21:46_131
SDNY_GM_00032973
EFTA_00143586
EFTA01252677
• MIDWAY MOUNTAINEER, LLC
SCHEDULE K-1
DESCRIPTION
AMOUNT
TOTALS
-4,853.
INTEREST INCOME
7.
SCHEDULE K-1 INCOME SUBTOTAL
-4,846.
NET INCOME (LOSS) PER SCHEDULE K-1
-4,846.
MEALS
-1.
-659.
1,986.
4,670.
5,996.
TOTAL TO SCHEDULE K-1, ITEM L
1,150.
10120414 758241 21146.209
PARTNER NUMBER 4
2011.03040 MIDWAY MOUNTAINEER, LLC
21146_El
CONFIDENTIAL
SDNY_GM_00032974
EFTA_00143587
EFTA01252678
fichedulaK-1 iron WWI 2`,:"
Ins list I dendfies the codes used on Sededule K-1 for ell pain ers and provides eummuized reponleg inlay &BOO fin partners wko file
Foam 1040. Foe dialled reporting and filing inlwmation, eee the separate Partners Instructions for Sodedule K-1 ad the instructions
lot your acorn', tax tetra.
PVC 2
t. Cea~y teals trnen
CoUrrIr• whet it Ti. freer • pa* •
nerdy a me None and art« al ye,/ telyn es boa
cat
Prams Moro
1kromidee ors
1470~e - T/re
2
Mel rtneil 'Al arob ben 3ate
3. Ctn. r•
1~4 keel
\el Re:~
Ka lees
4
0.4acial :Syron'
d
lam1w»
Ca
011dery eideoecla
ea. Ondlco *Made
•
Proydres
•
erren reciter
pm 1, 51.1
W
Val Rem
ap72101117(12a:
Lb
Ca necks ele141911/100117
Co
7.1nnompArea rolla 1100 Gon
C
*Olen '29' dd. 0 1•1
11 ~di Wane Cog
C—
A CB • *Mot e iron leak,
•
Ineeen cormeore
C Ric 1260 MSC,* e *MS,
D WOW we oadr ea* reond-c
e ~Ka
el *et
F Ceer Inane( eta
12. ~on •79 *palm
13. DS dieeuMns
A Ce* anieb.tor• 100951
B Oat centr44.4"4190%
C ~ma
onberods(44111:
trend ~Pawn
:37114:
e C1c14/ 00 ~414 1114 CAI
ow ~It» RCM I
F Copts gor Drapery Red
O Carelbuberts1111»:
71 imam
reercal orpe~
I
Denuecers .171e7Y 111.7ne
J tkolly 51(2)17.14~ ern
▪
Dedioeces • prre7eo :RA ere*
•
DadJeWIS • p7redeo 1~1
Id ~es
pi7J TO note nano
▪
eacefla Ruda:~ grebe
O D.aMMrsaroeesllM
•
erionlialmr *roe ~rm.
O Cerneas nr.411.204.7 ~vat
(err W41 ree oats wetntle•
A Cm...2u re HA,
6 Rders~117.7 • Ranee ~IRO*
•
Doemerld ~Rion ~bee
Inernear
21 Oa lee prelecten *IV' co Roan
Enloyer o Fenn V/ .7 RAF»
ve (1114744elier•
Preen on
Sim 27e Fain*, Iretedrona
~le
C. toda eoi-refleg
Remo% F. 114 211. Pd.,, tl
Sclect • E ms2e. odder (1
Sate %teen Inerruellen
ScndaeE. Ire a
column fa)
51.711•Pannolnarxben
42:newle F. *DM ~Am 31
Ion 1340, to id
Fore 13410..iroll•
Forte ~O. Mae
SeneeL•R be 717
Scnimet • C, ~6
Sclic .4 e 14 C
2516 Nee 3ale ~one*
Inv 4
rearriem ~tan)
Ste M Paw
AMAactir•
SeMlwDaflsinFmelba
C44711wPrInn rented,
See thePari +en 7mr7~7.
Veen err In •
S..P.a,Ste
Feed 1010, In 21 a rem, 002
3••••Panws testa:ens
Se CS Prinne• hin‘clicr*
-} Sion Primed danctie•
For:1052,1m •
Soweee S. one,
Sat.* eta
7nenAle-A
deal* A re 271
*net*
A. • r•
9:44.4 A It • 1 ara1113a, In PP
Goo he ~wen bedeten
Fern 244 r. -ea
5144 Me erres in* zran9
Bee ran WIC rpn.<Caa
Ten ~Prate
hetbeekes
Soe tee earemL ISIOtedre
Fail OKA ManICMMA
doen PM In lb
gym 1,203 ha 17
Sae 44, Pan'. hatedois
te. Sen-ercianran: ~le*
17:7»)
ha Ilya dew a .ewer 179 &Mazer aa/7y anno-474 ~441tris. awe
no~
relit <dad cab. ecedderng Snodul• Ed.
A "deal -P147•411rorr
dialse..BS. Rata Au 71
ber ernoloriert
•
Oren %Inc et wag taant
Zee~ dartner's eeirJrace•
C Gress ler-~ infer*
da
darn, .
ramen
le.
Oorlile
A lee non haifl
c-ed•
baled 43110111rorn at42074
44~31
B lowelnernekarebeerwle *41
p4200$ Wray"
4
C .474-1Reorm howled 4aR112111011er
21/0111en e•17240712.111117*
IIIIr
Sa 11.067tern krelvalleas
1) _ea-dream p roseate net whirl
tan oefe-232/ AMMO.
•
Oiereetneelahrlicnepetwitteea
~Id
eetwel
F Orr roe* red ~No**
C Orr eat* =ace
14 ijnitierb21.21 oaddel pda atdt
I
~ha an, *Mao Mee* tee
Nye
111202
.404•1•
Fan 10411. In 71: en** Dan
SOO t‘e ~Ian bilnolbris
10120414 758241 21146.209
2011.03040
C<C4
RepAri.A
J Tbaaeca.Rtyaedt
K Diba.11.4144XII Grim I
L
tmcmwet Tel Una AM ~AA
Mart -Lty imp tierriAM MOM
LI GSM Ia IntAXAng march
@AN IM
N CA:it 'CC OrPhAV KAM MOMeor
Mid tht•I•An
O DtµDwtAddrO
P Ore urac1
4. Fordo ~act ea
A `drool eo.ley a Lit
Coca."
•
Ckai• ~stem
tiara*
C GM 'main. «CPO« Weir
Mee
Pon {p, seam 14on ~me at ear**
'en
~ra tabor/
F C~
)7 hen 1 1 id Pel l
D Puna celeorn
e o
0.0.4Mem W.Lmta and spenene r ern , kn.
1J 1440 eeponea
raw 1119
11 CC«
Form 1 I'd Pen
Dau.das e retrel end sopolene• earns` o MS to laorr taste
1-ccrne
~4
eceept4/
I< OP.
nrn 1110, 9411
J 0
I
Peal,. oilAJMY
OM*1 lerstrislil on
L /clal km 37 brae pad
M TOM tan+ UM iseamod
N Renctra to" ~Mt. •I a, treat
O ram,- AtiAng r303.00.1121.
P EXIImieer,IcAM .r CO-* acchMen
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CONFIDENTIAL
SDNY_GM_00032975
EFTA 00143588
EFTA01252679
New York State Department of Taxation end Remo
New York Partner's Schedule K-1
Tax Law - Article 22 (Personal Income Tax)
Final K-1
For calendar year 2011 or tax yes beginning
03-30-2011 end lasting
12-31-2011
Amended Kiit
Partners: Begat oorraang your income tax return, see Form IT7044P I. Partners Instructions for Fon; 17-204-IP (av amnia at WIVIVALILIty.901).
PadnemtWairdomuitionominstrucumo
Partnership's name (as shown on Form ff234)
A
Mark an X in the box if either applies to your entity
PubliCly traded Woven p
Portfolio Investment parthershp
B Tax shelter registration number, if any
B
C firmness allocasScn percentage
2011
IT-204-IP
4
Partnersnma EIN
ss
PannOr8iM00718tIODIseeimtruchWS)
Partner's name
Partnets address
27 HIGH TECH BOULEVARD
CRY
THOMASVILLE
D the partner is a r-rn ir X n e....esioaiier en.)
E Mat stile tax fling statue of the petna7 yreti
K in rarearessraistr. r r-orro
F
if the partner Is a disregarded eray or grantor trust,
enter the tax ID of the entity or Indteklual reverting the Income. V known
0
Did the partner sell its wire names: dang the tax year?
H Partner's share of profit, loss, and atonal
1) Profit
2) Loss
31 Capital
Partner's share of liabdities at tne end of the year
1) Komi:cone
2) Cuanned ncnrocouree ?rancho
3) Recourse
Patina s capital account analysis
1) Beginning capital account
2) Caeca' contrbuted dunng the year cash
3) Capkalcontritxrted du Mg the year -property
4) Current year increase (ceerease)
5) Withdrawals and distributions • cash
6) Withdrawals and distributkins • property
7) Ending capita; account
8) Method of accounting (mark an X In the appropriate box)
X
Tax basis
GAAP
Bock
State
NC
Z:P coce
27360
Partner's identifying number
General partner or LW memberthenaae,
X
United partner a other LW member
Inovidual
Estate/trust
X
Partnership
H1
H?
H3
F
Beginning
2.34615
3.0303
3.0303
Other (attach expianatotni
It
2
I3
Ji
.15
J6
J7
Yes
NO
X
Ending
%
2.3485 %
3.C303
%
3.0303
1,898.
75,000.
1,150.
2,500.
73,650.
K
Resident status (Math an X In al boxes that Awry)
NYS Milieu( resident
Yonkers fultyear resident
NYS part year resident
Yorkers pert year resident
X
NYS nonresident
Yonkers nonresident
L
If the partner was included n a group return, enter the special M'S IdertificaUon number. If known
NYC fullear resident
NYC part-year resident
1181111019
11, 80: I
.1
12.36 1
Please tile this original scannable corm with the Tax Department.
CONFIDENTIAL
SDNY_GM_00032976
EFTA_00143589
EFTA01252680
Page 2 of 4
IT•204•IP (2011)
M 1) Was Finn tT•266&E Sled Mtn the partners M7
2) Was Form MlAdOSE iced with the partnership?
N NYS estknated tax paid at behall of partner (from Form (7-2658)
1) First installment
NI
2, Second Instalment
ra
3) Ind installment
N3
4) Fourth entailment
144
Total NYS esrimeted tax redd or behalf of paten« (add Mee NI through Ne)
0
Estimated MCTMT paid on behalf of partner Morn Form MTA-405)
1) First installment
01
2) Second installment
02
3) Third Installment
03
4) Fourth installment
04
Total estimated MCTMT paid on behalf of partner (add Noes O1 through O4)
0
Partner's share of Income, deductions, etc.
A • 080513e5 distributive share Kerns
1 Ordinary business ino0me ('ae)
1.
B • Federal K1 fl
irt
1.
C • NOW vet* State amutmt
2 Net rental real estate income (loss)
2
-4,853.
2.
3 Other net rental income (loss)
3.
a
4 Guaranteed payments
4.
4.
6 Interest Income
6.
7 .
6.
6 Ordinary d)vdends
6.
6.
7 Floss/bee
7.
7.
8 Net shpt-term capital gaM (Ms)
s.
8.
9 Net long-term capital gar (l053)
9.
9.
10 Net Section 1231 gain doss)
to.
lo.
t 1 Other nestle (lon) Went*
71.
II.
12 &than 179 cieduCti0n
12.
12.
13 Other deductions Wan*:
It
IS.
14 Tax preference Item for minimum tax
14,
-1,426.
14.
Identify
15 Not earnings Goes) from seltempbyrnent
15.
15.
18 Tax-exempt Income and norbeductlbro expenses
18.
16.
17 Ontritxdiats - mtsh and marmtable securities
17.
2, 500.
17.
18 Disutbuti0ns - oUle property
18.
18.
19 Other Items not bonded above that are required to be
reported separately to cotters
lg.
7 .
19.
Identity:
SEE STATEMENT
Date
M1
Yes
No
at2
Yes
NO
Amount
N
Date
Amount
Partner's share of New York modifications (we instructions/
20 New Yak State additions
Number
A • Total amount
20s. E A-
206. E
20e. E
20d. E A•
20e. E A-
284. E 01.
B - Now Yo* State allocated amount
21 Total acknion modifications (tot& of cavars•t A *we 20e trough 200
21.
1181111019
Wane
os t
Please file this original scannable form with the tax Department.
CONFIDENTIAL
SDNY_GM_00032977
EFTA_001 43590
EFTA01252681
IT-204-IP (2011)
Page 3 0 4
Partners share of New York modifications fronsofis0
22 New York Stale subtractions
Number
A • Total amount
22a. E S-
22b. E S-
22c. E
22d. E Si
22.. E
22f. ES-
- Now York State allocated amount
23 Total subtraction modifications (total of column A tines 22a through 220
23.
24 Additions to federal Itemized deductions
Letter
Amount
24a.
24b.
24c.
24d.
240.
24f.
25 Total additions to federal Itemized deductions (add Wes 248 through 240
25.
ze suotracticeIS from federal Itemized deductions
Letter
Amount
26a
26b.
26c.
26d.
26c.
261.
27 Total subtractions from federal Itemized deductions (add Enos 268 Wrougn 261)
27.
28 New Yak ad)Lztments to tax palmate dans
28.
Partners other information
29o. Partner's snare of New Yon( SOUTC0 gross income
296. Mat) alkxabon percentage (sect instructions)
29e.
296.
Partner's credit information
Part 1 - Pass-through credit bases and factors
Brownfield redevelopment tax credit (Forint-PetI or IT-611.1)
A Form 174311
B • Form IT411.1
80 Ste preparation credit component
90.
30.
31 TalVrea property credit component
31.
31.
92 Coate groundwater res.tediabon crest component
32
32.
-651to
12.0s•ii
Please file this original scannable fain with the Tax Department.
CONFIDENTIAL
183111019
III' IIIIU!MNlllll9
SDNY_GM_00032978
EFTA_00143591
EFTA01252682
Page 4014
1T-204-111 (201, )
Partner's credit information (contkuree)
EZ capital tax credit (Font; 17-602)
33 Ccrenbutions of money to EZ community oevetoment projects
34 Recapture of credit for investments in cabbed EZ businesses
35 Recapture of credit for contnbutiona of money to
onowninity development projects
QEZE tax reduction credit (Form /r-604)
33
34.
35.
36 QEZE employment increase Samar
36.
37 QEZE zone aoCation factor
37.
38 0E2E benefit period factor
38.
&cake jobs program tax credit (Form 1T-607)
39 Excelsior jobs tax credit component
30
40 Excelsior hvestment tax credit conspcnent
40.
41 &pada researcn and doveropment tax credit component
41.
42 Excelsior real property tax credit component
42.
Femmes' school tax atilt (Form /2-217)
43 Acres of Qualified agricultural property
48.
44 Acres of unified conservation property
44.
45 Eligible school destrict property taxes paid
45.
46 Acres of quaffed agricultural property converted to nonquathed use
46.
Other pass-through credit bases and factors
Credit bases
Code
Amount
Code
Amount
Ca.
47d.
471s.
470.
47c.
47f.
Credit factors
Code
Factor
Code
Factor
Code
Factor
47g.
47L
47k.
47h.
471.
471.
Part 2 - Pass-through credits, addbacics and recaptures
4a Longterm care Insurance credit (Form 1T-249)
48.
49 investment reit (including emu/orient es:entry9 erode end Work barn rehabilitation credit RAT r7-212)49.
50 Research and development • investment credit (Form 1T-212)
50.
51 Other pasS•through credits
Code
Amount
Cods
Amount
Ste.
51e.
Sib.
Sic.
Sig.
51d.
51h.
52 Addoacks of mats aid recaptures
Code
Amount
Code
52a.
520.
52b.
52e.
52c.
521.
148802
Please file this original scannable form with the Tax Department.
Amount
CONFIDENTIAL
SDNY_GMJ)0032979
EFTA_0014359/
EFTA01252683
NY IT-204-IP
DESCRIPTION
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 19
AMOUNT FROM
NEW YORK
FEDERAL
STATE
SCHEDULE K-1
AMOUNT
7.
0.
7.
0.
PARTNER NUMBER 4
CONFIDENTIAL
SDNY_GM_00032980
EFTA_00 143593
EFTA01252684
NC K-1 (39)
(Dalm)
11.10-11
2011 Partner's Share of
N.C. Income, Adlustments, end Credits
Ko'th Carolina Cepa, trent o'
For calendar yea'
cc fast yoar teghlIng
Partite Ideally's Wombat
Parsers Name, Address, and NP Coda
27 HIGH TECH BOULEVARD
THOMASVILLE NC 27360
Patin ettliip's Pro Rata Share Items
All Parton
t
Sham V gerthersokr mama (css)
2. Addltions lc Yuma Coss)
a. AeiIIto for bonus depatolabon
0M-sr
iltomet;lossi
3. Ded.;etioss tool (come (loss)
a. DedoW.cn for boats derectabol
b. Other Oath:0mm !lora income (loss)
4. a. Stars of Tax WO for smilausr asses Mal Jay
N.G efierparneet fr:stranoe
C Sham °lathes tax crag*
5. Stare Cl tax w'hherg horn nonage co(c ersarlon
pat kr baronial sevints perlotmeo m
NoaraNdents Only
5. %cormorant's sPara c' N.G ramble ;roam luso)
7. Ncrossidr Fs stye ol net
Pa'd by :be rremeges
el :Ns pertnersblp
03 30 11
and credo°
12 31 11
Federal Employer ID Welber
Ps troterstIpl Name, Address, and ZIP Code
270 LAPAYETTE STREET SUIT 409
NEW YORK
NY 10012
Amount
11029'
—4846
484
0
0
0
0
0
0
0
0
Individuals Filing Form
D-400 Enter Aroma on:
Papa Line 38
Page 3, Line 40
Page 3, Una 46
Pap 4, Line 52
Foam 0-40010
Farr 0-400TC
Ng 2, Lino 4.9
Paw 4, Etna 54
uaGla 2. Una 200
CONFIDENTIAL
SDNY_GM_00032981
EFTA_00 143594
EFTA01252685