Text extracted via OCR from the original document. May contain errors from the scanning process.
Etheduie H-1
2012
(Form 10135)
Dalmatia of the Team"
For cakeeler year 2012. or am
Internet Rivera &Moe
rust Nark,
6/29
2012
endng
12/31
20 12
Partner's Share of Income, Deductions,
Credits, etc.
10 ale beck of form and separate instructors
A
PartrerehIp'e employee klentlItelon nurrber
45-2096875
B
Partnertrilp's name. address, (Ay. date, and ZIP code
440 $ LASALLE STREET, 313TH FLOOR C/0 MORGAN STANLEY TAX
CHICAGO, IL 60805
C
IRS Center where partnership Med WWII
Ogden
D
K
Check ttl's
LrJoitc.:y truirc, palnerstip (P- P•
ik—Abornesktma
E
Partners inernfylna number
20-3161309
F
Penners num address. city. Matt and 2IP code
27 HIGH TECH BLVD.
THOMASVILLE, NC 27380
O n
General oarlfief r lC
E
Limited partneror otter LLC
tnertbrr-rnanast
neater
H
RI Domed: Penny
K
Foreign partner
It
Wier typa of eney 4 this camel (see /tabu:tons) LLC
12
the parts as e retkornant plan (IRNSED/Keephietc.), check :we
Partners share of v0:11. 10:03. aro capital (500 111541.1CeOn4
Beginning
Ending
Profit
0.000000 st
0.090473 %
-OSS
0.000000 la
0.090473 96
Ceded
0.000000 96
0.077681 96
K
Partnees Aare of 'chalks at year end:
Norerncurva .
1.155
Odle tad norrecctrso finalarn .
S
Recourse .
. .
.
$
L
Partrora carnal account analysis:
Bonin/ling capital ao:ount . .
NONE
Capital coninbuted (ken do year
S
33,811
Current year :,crease (decrease)
S
3,055
Windatwala 6 doetwors
I
DEIN cepa& acan.nt
$
36,888
El tax basis
Step
K
Seolket 704(b) book
LJ ClIct (*pitch)
II
Did ow partner contrituto property wta a built-in gen rte tes7
0
Yee
E
No
If 'ern: attach stator em (sue insbuctons)
4
66
a
°Stony beer is
ONO
Net metal real edam friconrs9oes)
Guaranteed PaYment1
Interest Income
286
Ord'oary dvIdends
813
OualRed O:donde
83
PoTatee
Net *holism cereal pin (loss)
(317)
Other net rental Means Pon)
Foreign trims/acne
16
C
D
651112
emli No.1645-0000
Credits
558
(3201
228
178
101
I
Be
Net englemi cent On (lone
17 Menthe rdelmum It MI) ems
(3)
i
CceectIbles (2896) gar floss)
(inmate:urea seeecn 1250 gain
10 Net sedan :231 gar pons)
11 011wricome floes)
12
_031)
Secdon179 deduction
13
011xr deductions
H
14
178
4.085
SellempsarnenteareMpt (Nes)
18
Tox.extropt memo and
nerdeduclIble avenue
TA
INIIIMaser0
20
A
Olhee InexmetIon
796
4,085
STMT
STMT
'See attached statement for additional infermat on
A
LL
For Papenvork Reduction Am Nebr., see Instructions for Form 1065.
IREWovifonn1016
Cat. Na 11304fl
Schedule K-I (Fonn 1065+ 2012
Partner # 316
CONFIDENTIAL
SDNY_GM 00033294
EFTA_00143907
EFTA01280333
---PAGE BREAK---
Scholia% K-1 (Form 1305)20'2
pe 2
This Est Wendt les the codes used on Schedule K-1 tot alt partners and provides summarized reporting information for partners who rile Form 1040.
For detailed reporting and filing Information, see the separate Partner's Instructions for Schedule K-1 and the Instructions for your income tax return.
I. Ordinary business Income (loss). Detcrmhe whether the income (um) es
Cede
hepee ;:e
passive cr roe-passimand ether on row return as taws.
J Wok oppertunity 01/2 00
Napo:Ion
K Cisabitid access <red ;
Pti33330 Was
See the Padres instrualona
L tropmennont cone and
Phone Moms
Schodue Eine 28. column (g)
wawa orrmun ty
Naripossree kiss
Scholu:e E. In. 28. column th)
°mat:rent ago,:
AkepO.Sedee krona
Senodulo E. Ins 28. ;Wen ID
• II Credt or rcesdn3 retearcr
See tho Autrice's :rt.:Lc:305
2. Net rented real estate Wane (loss)
See the Patter's inh'uctons
sot
3. Other net rental income (lose)
N Creen for era 'flyer social
Net income
Schedule E, Ins 28. ookran (g)
secu-rty end Mecham tax&i
Net to
See the Partners klrArlion
0 Semece vrthelateh9
4. Owned payments
Si3h0dUks F., Ire 28, column fit
P Other weditc
5. Interest income
FOrm 1040. line Se
18. Foreign transactions
Be. Ordinary divhesnele
Form 1040. the 9a
A Name of CoLrry Of U.S.
Ob. Qualified dividend,
;am 1040 line 90
7. Royalties
Schedule F, Ine
prztAsiOn
B Gmes 'icons horn all sources
Form 1118. Part I
8. Net snort-teen espial pin (heel
Schedule D. We 5
C Gross Mane sourced at
Be. Net long-term alpha geth Pea)
Schedule D. Ins 12
Farber kvel
90. Collectibles (28%) girth floss)
28% Rate Gain Worksheet One 4
Farrar vats Income sourced at partneship *NW
(Salida) D intbectlorst
D Pamir category
Sc. Unrecaptwod section 12509W
See the Panna's retro° Cons
E General category
Form 1118, Pei i
10. Net section 1231 gain (WO
Sac the Perry's Instructors
F °thee
11. Other income (loss)
OsoUctiownhooteed end apportbned at partner lava
Code
o
Interest overate
Form 11113, Part I
A Other portfolio 'moms cos.)
See tie Partners instructions
H Other
Fawn 1116, Pan I
B Invo.cntary Cenotrekni3
See the Partner's instheollons
teatottons alorand and apporronsrl at parrmaNiNa fowl to I ordi0n source
G Sec. 1258 contracts A Meddles
Foment Ansi
Irksome
D Akre g experation costs recapture Sae Pub. 535
I
Pasch* Wain
E Cancelialkh of debt
Form 1040 lins21 or Forth 952
J Sew% category
} Form 1110 Pet I
F Other near* (loss)
See the Pe were Instructbra
K Cchcr
IL Section 179 deduction
See the Fanners instrueliona
Other idoematcn
13. Other %Mac-tons
L Total fo-eign taxes pelf
Fan 7116. Part II
A Cash contributions (50%)
M Total fordo taxes sewed
Form 1110 Pan II
B Criah oontrftvtona (37156)
N Sanaa' hiaas scalahle for wit Fain 111a. frio 12
C Noncesb corWtheshows (50%)
Cs Ftnegn Indira gross r0000301
Forth 8873
D Nonce* contributais 30%)
See the Fannor's
P existential) income outiusen
Fern 8573
E Capita' gran property te a 50%
Instructions
0
Other femur trahaetions
See the Piellerli instructens
rgnoelion (30%)
17. Alternative minimum tax (AMY) lams
F Gaps) gain warty (20%)
A lee;-•966 ospe: are walment
Cauributons (WO%)
B Adlalen gair
tes
See the .2arther's
N Westmont Interest expanse
Feet 4962. dre 1
C Depletion (other ten o: a pc:
insecctem and
I Deduotchs—royakylverne
Schoduas E. lino IS
I) 31. get & parral .grass norms
inshialors for
J Section 59;0(2) expandeltres
Soo the Partner's kirtructIons
E Cit gas. 8 polhathal—Cotlaticra
Few 0251
X Deductons — portfolio (P% float
Schedan A. Ins 23
F Other AMT awns
I. Deductions—podia° lethal
Schedule/kilns 28
18. Tax-exempt income and noadetkiedble expanses
M Amounts pith for theeicril henna, &WM A line I a Fpm 1040, lee 29
A Tex enema mewl thorns
Earn 1040.0th 8b
N Cdocationsi at:sista:a. benefits
Seethe Partnere Inehuctions
B Other tax-exernct tame
See the Partners instryclOna
O Depernent care betas
Earn 2441. Ine
C NOncleclUG50/1/2 WOTAN
Sae the Firtrers Insruclions
P Preprodialve period *morass
See tho Partner's Inalneakina
19. Distribuihns
O Cominrchl rthetailzetkin dixtuctica See Form Ele82 instralloa
A Cann and Tweetelo.
from rents. real cAtate eclWites
B Dembalen WWI 03 maim 737 ) See the Partner's kisteuctiais
R 'Tarawa and IRAs
See the Panneie thelrections
C Other (rowdy
S Pcfoeustation omens° 0000001
See the Parther's hstn.cCons
20. Other Informellon
T Conadc production act wtia
See Fenn 8903 nerucliens
A Irenstment Income
Form 4952. ikoo 4a
accretion
B ineesithert expanses
Forte 4952. Ike 5
U Guareso pmelecthn cralatias tarns Fehr 8903..11,'N
C Fue! tax credit informs:en
row 4136
V Empeoycr's Form W-2 sages
Forth 8903, line 17
D Ou1Nled rehabe :Mon expenditses See try Partner's Instructieh
W Other deckearons
See the Partners inesucticns
(Wow char.
reel estate)
14. Self-employmont earnings (loss)
E Bash of energy peporty
Soo the Farah 'flatmate:re
Note. B you hem a section 179 chantion any partner-land doduciana see d.o
F Marton, o' lac-'cone 170.1110a
Far:18V 1.Ithe 8
Pepsins Instructions berm cornakang &tad* SF.
credit ;warn 420(58
A KM eeinehs Coss) from
Schedule SE Section A or G
se linsolatmene
G Ancaptuce el her Worse housing Fern 8011. line 8
crto t @that)
B Gross toning or fishing hen
See the l'aetWe insbuctions
H Pet:Tars of twesentet Codlt
See Earn 4255
C 010%.5 non farm krone
See to Purther's Listhrficeis
I
Roceptuts of other credits
See the Partner', InsinclIons
15, Credits
A Low. meow housing credit
J Look. heck interact —candela:I
See Form 8097
tong-term contrails
(sateen 42(Ct5)) from pre 2058
tueolhos
K Look.oack Wesel —Eton. fore
See Form NM
mesiod
B '-ow-inoonie hazing credit
C
thew) keen pre-2008 bakhlp
.income rcuaill9 cadet
L Dispartions of property with
section 179 deduaittets
IA R3carni0016,0kon 179 dedittbn
(section 420(5)) from
N inaresi expense for corporate
post-2C07 buildhgs
re Low amore hewing cleat
loth's) from post-200]
headings
E tatted rthebtetaliat
expenaums (rental real (Mahe
Son the Palner's instmcdona
Patters
0
Sea tor 4530)(3) So:metro
P Seaton 453A(c) infomat on
0
Sootier 1260(b) information
hteln! 0103431/2 to procticher
wen:hums
See tho Partner's
instnactlons
F Cther rrtnbil reel 66 late a1/2103
OF committed whaleawah
0 Other -gnat credts
H Umfarbuted teats gars mat
Form 1040. bre
; check box a
T Murton 'Northwest—Weldon,
U ketie.2.00.1 ci 1/210r001130 Costs
I
Alcohol and entire* %dual fleas See the Partnor's instnactions
credit
V tented Wats taxable iroome
W Paton" anion gin Ocsr:
X Seam OM Worm:ton
Y Celia leformrton
Partner # 316
CONFIDENTIAL
SDNY_GM 00033295
EFTA_00143908
EFTA01280334
---PAGE BREAK---
45-2026675
INCOME(LOSS) FROM SCHEDULE K-1 BOXES 1.11
(73)
LESS: DEDUCTIONS FROM SCHEDULE K-1 BOXES 12, 13, 16L
160.1
4,263
TOTAL INCOME(LOSS) PER SCHEDULE K-1
;4.336)
7,332
59
3,055
BOX 5: INTEREST INCOME
265
TOTAL BOX 5 - INTEREST INCOME
265
BOX 6A: ORDINARY DIVIDENDS
53C
63
TOTAL BOX 13A - ORDINARY DIVIDENDS
6'3
BOX 1W. OTHER INCOME/(LOSS)
§988 INCOME/ILO-SS) FROM FLOW-THROUGH ENTITIES
107
(790)
52
TOTAL BOX 11F - OTHER INCOME/(LOSS)
(631)
BOX 13K: DEDUCTIONS-PORTFOLIO (2% FLOOR)
27
MANAGEMENT FEES
3.811
41
7
86
4
67
39
3
TOTAL BOX 13K - DEDUCTIONS-PORTFOLIO (2% FLOOR)
4,035
Partner S 316
CONFIDENTIAL
SDNY_GM_00033296
EFTA_00143909
EFTA01280335
---PAGE BREAK---
45-2096675
YOU ARE ALLOCATED INVESTMENT INCOME AND INVESTMENT EXPENSES ON BOX 20, CODES A AND B. PURSUANT TO IRC
SECTION 163(D). THE AMOUNTS REPORTED ON BOX 20A AND 20B REFLECT THE INFORMATION AS REPORTED TO THE FUND
WHEN PREPARING FORM 4952.
PLEASE NOTE THAT EXCEPT FOR LINES 1, 2 AND 10, NONE OF THE DISTRIBUTIVE SHARE ITEMS REPORTED ON SCHEDULE
K-1 ARE CONSIDERED AS DERIVED FROM A PASSIVE ACTIVITY UNDER TREASURY REGULATION SECTION 1.469-1T(EX6).
THE K-1 HAS BEEN PREPARED ON THE BASIS OF A PARTNER WHO DOES NOT MATERIALLY PARTICIPATE IN THE
OPERATIONS OF THE PARTNERSHIP. THEREFORE. INTEREST EXPENSE HAS BEEN INCLUDED IN BOX 13. CODE H AS
INVESTMENT INTEREST EXPENSE AND IS NOT INCLUDED IN BOX 11, CODE F.
ITEM J: PARTNER'S SHARE OF PROFIT, LOSS AND CAPITAL
PARTNER PERCENTAGES REFLECTED ON ITEM J OF YOUR SCHEDULE K-1 ARE CALCULATED PURSUANT TO IRS
THAT AU. TAXABLE INCOME AND LOSS ITEMS REPORTED ON YOUR SCHEDULE K-1 ARE ALLOCATED CONSISTENT WITH
BOX 16, CODE A, B, C: GROSS INCOME FROM ALL SOURCES AND GROSS INCOME SOURCED AT PARTNER LEVEL
,
THE DETAIL FOR BOX IBA IS 'VARIOUS:' THE AMOUNTS REFLECTED ON LINE 166 AND 16C REFLECT THE INFORMATION
DO NOT NECESSARILY REFLECT THE "GROSS INCOME FROM ALL SOURCES" OR "GROSS INCOME SOURCED AT THE
PARTNER LEVEL" FOR THE FUND. CONSULT YOUR PERSONAL TAX ADVISOR REGARDING THE APPROPRIATE
BOX 16, CODE D, E, F: FOREIGN GROSS INCOME SOURCED AT PARTNERSHIP LEVEL
FOREIGN QUALIFIED DIVIDENDS ARE INCLUDED IN BOX 16, CODES 0. E, F (AS WELL AS IN BOX 1, BOXES 6A AND 68 AND
IN BOX 11, CODE F. IF APPLICABLE). PLEASE CONSULT YOUR TAX ADVISOR REGARDING WHETHER ADJUSTMENTS
SHOULD BE MADE TO THIS AMOUNT OR ANY OTHER AMOUNTS APPEARING IN BOX 16 FOR PURPOSES OF
CALCULATING YOUR FOREIGN TAX CREDITS ON FORM 1116.
BOX 16, CODE I, J, K: DEDUCTIONS ATTRIBUTABLE TO FOREIGN SOURCE INCOME
USING THE GROSS INCOME METHOD AND IS REFLECTED IN BOX 16, CODE I, J, K. THIS AMOUNT SHOULD BE CONSIDERED
BOX 20, CODE V: INFORMATION REGARDING UNRELATED BUSINESS TAXABLE INCOME:
BOX 20, CODE Y: OTHER INFORMATION
INCOME/ROSS) CEO!, AS DEFINED UNDER IRC SECTION 1446:
Partner # 316
CONFIDENTIAL
SDNY_GM_00033297
EFTA_00143910
EFTA01280336
---PAGE BREAK---
45-2096875
(3)
Partner # 316
CONFIDENTIAL
SDNY_GM_00033298
EFTA_00 I 43911
EFTA01280337
---PAGE BREAK---
LIVABLE YEAR Partner's Share of Income,
2012
Deductions, Credits, etc.
For calendar year 2012 or fiscal year beginning month
Psalters Identi In number 20-3161309
Partner's name, address, city, sate. and ZIP Code
27 HIGH TECH BLVD.
THOMASVILLE, NC 27380
•
K4 (565)
ar
r 1
and ending month
12
day
31
year _2012
Partnership's FEN 45-2098875
California Secrete of Stab file number
Partnership's name, address, 04 state, and ZIP Code
440 S LASALLE STREET, 39TH FLOOR C/0 MORGAN STANLEY TM
CHICAGO, IL 60605
A Is this partner a: • (1) 0 general partner, or (2) Lifl limited pants?
II What type of entity IS this partner? •
(1) 0 itlhAus
(6) C General Partnership
(9) 0 IRA/Keogh/SEP
(2) C $ Corporation
Oh C
Pnwsshlp
(10) 0 Exempt &variation
(3)0 ESthteallet
(7) C LIP
(11) 0 Disregartd Entity
(e) 0 c Corporation
(a) ib LLC
C Is this partner a foreign partner?
• Li Yes PI No
0 Enter partners
percentage (without
regard to special
(I) Before decrease
(Ii) End of year
allocations) of:
or termination
Profit sharing
0,0 0 0 0%
Loss sharing
(Nmership ot capital
__11,22.1/1).%
•__p_.43 9 0 ea
E Partners share of liabilities:
NonrecOurse
• S
1.155
Oualiflad nonrecourse financing
•
Other
• S
F Reportable transaction or tax shelter registration
numoer(s)
0 (1) Check here if this is a publicly traded partnership
as defined in FC Section 469(k)(2)
(2) Check here if this H an Investment partnership
(R&TC Sect one 17955 and 23040.1)
0
H Check here if this IS: •
(1) IZ A final Schedule K-1 (565) (2)0 An amended Schedule K-1 (565)
I Is this partner a resident of California?
•CYes •IZNo
J
Analysis ofcrinera capital acoount Check the box •
Cl 0 Tax Basis (2) 2) GAAP (3 0 Section 704(b) Book (4 0 Other (explain)
l I
aid
(el
Capital aseesrt terulno Myer
Caplet cortibuied array=
Partners Owe ol tile Stine 4, and
Yelthdreats
disMbalions
CaPIal aularialf ad 0 PK
Ira 7, Form Mi. Soso* rh-2
contra oakum (ar throat. corium (d)
•
NONE •
33,811 •
3,055 • (
) •
36,868
Caution: Refer to Partner's instructions for Schedule K-1 565) before entering information from this schedule
your California return
(a)
C'Enbutive share bets
ule K-1
he
al Scd
Ar7:(1065
nbts) :ram
Califomiatifustments
Total amounts using
Cal ones
Caffein a Jew. Combine
source immune
laic
d)
col. f b) arid cal. (c)
arid credit'
1 Ordinary income (loss) from trade or
business actIliles
2 Net Income (loss) from rental real estate activities
3 Net Income toss) from other rental aaivhes
4 Guaranteoa payments to partners
S Interest Income
6 Dividends
7 Royalties
8 Nei short-term apt galr. toss)
9 Net long-term capital gain (less)
10 a Total gain under IOC Section In1
(Om( than due to casualty a. theft)
b Total loss under In Section 1231
(other than due to casualty or theft)
11 a Other portfolio Income (loss). Mich schedule
b Total other Income. Attach schedub
e Total other loss. Attach schedule
►
285
613
(317)
285 •
•
613 •
•
•
•
(317) •
(3)
(3) •
•
•
•
•
i.
For Privacy Notice, get form FIB 1131.
(631)
•
(631) •
7891123
r
Schedule K-1 (565) 2012 Side 1
Partner # 316
CONFIDENTIAL
SDNY_GM_00033299
EFTA 00143912
EFTA01280338
---PAGE BREAK---
•
3
g
a
Distdintiae sham Items
12 Expense deduction for recevery properly
(IPO SectIon 179 and ReiTC Sections 17267.2,
17267.6 and 17268)
13 a Charitable contitutors
b Investment Interest expense
a 1 Total expenditures to which an IFIC
Section 59(ei election may appy
2 Type al expenditures
d Deductions related to sonnet° income
a inn,•••ISAil#41AA6 1914.1“NkAA.116
15 a 'Wad withholding impels amount on
Form 5928 it sander year partnership)
b Low-Int:me housing credit
e Credit other than line 15b rated to rental
real estate activities
Creche related to other rental activities
e kenconsenting nonresident partners tax
paid by partnership
I Other credits — Mach required sctodules
cr statements
n Paw kohl, tnItin
17 a Depreciation adjust-rent on moiety placed
Insentroe alter '996
b Adjusted gain o' loss
o Depletion (eV in than el & gas)
d Goss Income from oil. pas, and
geothermal propert es
e Deductions alma to oil, gas, and
geothermal properties
I Other alternative minimum tax rte
2
. gi
lea Takexemptintemst income
s0
211 &
b Other tax-exempt Meanie
E 4,
9ligateSbatieeleerreee
S
19 a Distributions of mnnancash and
marketable securities)
h Disthotions of Droners other ten MOW
i
20 a Investment Income
796
7f15
I lnvestnent expenses
e Cher
(e)
Amounts from
federal Schedule K-1
(1065)
4,085
(0
Cellomeadatnents
3
DO
(a)
Total amounts using
California
California tee Combine
scrape amounts
ccl. (b; and cot. (C)
and credits
178
•
I
Side 2 Schedule K-1(565) 2012
—
I
7892123
Partner *316
CONFIDENTIAL
SDNY_GM_00033300
EFTA_001439I 3
EFTA01280339
---PAGE BREAK---
Other Partner Information
Table 1— Partner% share of nonbusiness income from Intangibles {source of Income Is dependent on residence or commercial domicile of the partners):
Interest
$
Sec. 1231 Gains/tense S
Capital GaInskosus S
Dividends
$
Royalties
S
Other
FOR USE BY PARTNERS ONLY — See instructions.
Table 2— Partners share c! distributive items.
A. Partners share of the partnership's business income. See instructions. $
B. Partners share of nonbusiness income from real and tangible personal property sourced or allocable to California.
Capital Gainstosses
$
Rents/Royaltlea
$
Sec. 1231 Gains/Losses S
Other
$
C. Partner% distributive share of the partnership's property, payroll, and sales:
California Sales —Doing Busiress Test S
Fasters
Total Alin and outside California
Total Ohio Carnage
Property Beginning
$
$
Ending
$
$
Annual rert maense
$
$
Payri
$
$
Sales
$
$
Tabl 3 —Partner's share of cost of goods sold, deductlees, and rental income.
Enter only amounts used tc determine income (loss) derived from and attributable to California sources. All amounts entered on this table are first multiplied by
the appropriate percentage in Item D (ii) end of year partners profit and loss sharing percentage on Side 1. See the partnership Schedule K-1 instructions for
information on how to obtain the amounts below.
1. Schedule K, Line 1, column (dl, Ordinary income (loss) trom trade or business activities:
a. Enter as a positive amount the cost of goods sold used to determine the amount on Schedule K Uno 1, column (d).
plus the total amounts on line la of Table 3 from all Schedule K-1s (565) this partnership received
b. Enter as a positive amount the total deductions used to determine the amount on Schedule K. Line 1. column (6), plus
the total amounts on line lb of Table 3 from all Schedule K-1s (565) this partnership received
2. Enter the total gross rents from line 18a of federal Form 8825 as adjusted for California law differences. plus the
total amounts on line 2 of Table 3 from all Schedule H-1s (565) this partnership received.
3. Enter the gross income (loss) from other rental activities from Schedule K, Une 3a. column (d), plus the total amounts
on line 3 of Table 3 from all Schedule K-Is (565) this partnership received
7893123
r
Schedule K-1 (565) 2012 Side
Partner # 318
CONFIDENTIAL
SDNY_GM_00033301
EFFA_00143914
EFTA01280340
---PAGE BREAK---
IT-65 2012 Schedule IN K-1
Stale Form &alai (R12/5.12)
Indiana Department of Raven Le
Partner's Share of Indiana Adjusted Gross Income, Deductions, Modifications, and Credits
Tax Year Beginning
C8
. 29 , 2012 and Ending
12
31
I 2012
Name of Partnership
Distributions - Provide IN K-1 to each partner. Enclose IN K-1 with IT-85 return. For information on the
acceptable electronic date file format, visit the Deoartmenrs webs?* at vmw.in.govidor/3772.htm Pro rate
amounts for lines 1 through 28 of any nonresident partner must be multiplied by the Indiana apportionment
oe-cent, if applicable, from IT-85, line 4.
Part 1 - Partner's Identification Section
(a) If Partner Is an Individual (please print dearly)
Last Name:
First Name:
al
a2
a3
(b) It Partner Is an Other Entity (please print clearly)
Name:
b.j BLUE CHIP CAPITAL Lie
b2
(c) Partner's State of Residence or Commercial 0tankile
c1
(d) Indiana Tax YVIthheici for Nonresident Partner (on W14-113)
(e) Partner's Federal Pro Rate Percentage
(0 Partner's Tax as Computed on IT-65COMP Column G
Federal identification Number
45-2096875
Social Security Number.
Federal Identification Number
20-3161309
FL
0, 0//581 %
CO
Part 2 - Distributive Share Amount (use apportioned figures for nonresident partners)
1. Ordinary business income (loss)
2. Net rental real estate income (loss)
3. Other net rental income (loss)
4. Guaranteed payments
5. Interest income
6. Ordinary *Mends
7. Royalties
8. Net short-term capital gain (loss)
9. Net long-term capital gain (loss)
10. Net IRC Section 1231 gain (loes)
11. Other income (loss)
12.IRC Section 179 expense deduction
13e. Portion of expenses related to Investment portfolio income, Including investment interest
expense and other (federal nonitemized) deductions
13b.Other information from line 20 of federal K-1 related to investment interest and expenses
not listed elsewhere
14.Tolal pro ram distributions (Add lines 1 through 11: subtract lines 12, 13a. and 13b
when applicable.)
CO
CO
CO
00
00
00
00
00
00
00
30
00
00
00
13612(11594
Continued on next page lie
Partner # 316
CONFIDENTIAL
SDNY_GM_00033302
EFTA_001439 I 5
EFTA01280341
---PAGE BREAK---
IT-65
2012 Schedule IN K-1
Page 2
Part 3 - State Modifications Add or subtract the following. Designate the distributive share
amount of each mcdif cation for Indiana adjusted gross income from line 2 on the front of
Form IT-65. For non•esldonts. apply apportioned figures. (Use a min.us sign to denote
negative amounts.)
15. State income taxes deducted
00
16. Net bonus depreciaton allowance
00
17. Excess IRC Section 179 deduction
00
18. interest on U.S. obigations
00
19. Addback/ Deduction
Code:
00
2C.Addback/ Deduction
Code: __
00
21. Addback/ Deduction
Code:
00
22. Addback/ Deduction
Code:
00
_ _
23. Addback/ Deduction
Code: _
00
24 Addback/ Deduction
Code:
_ _
00
25 Addback/ Deduction
Code: _
.
00
__
26 Addback/ Deduction
Code:
00
27. Total distributive share of modificaticns (add Inn 15 through 26 and carry total to Column B
on Schedule IT-65COMP)
00
Part 4 - Pro Rata Share of Indiana Pass•through Tax Credits from Partnership
28 Enter the name of the tax credit program, its three-digit ID code, and the doler amount of the
partner's distributive share for each a towable credit
Name of Credit:
ID Code.
a
b
c
00
e
1
00
9
h
I
00
29. Total pass-through credits (add lines 28c, 28f, and 281)
00
1111111
11111111111111111111111111
13812121594
III
Partner # 316
CONFIDENTIAL
SDNY_GM_00033303
EFTA_00143916
EFTA01280342
---PAGE BREAK---
SCHEDULE
NJK-1
(Form NJ-1065)
2012
PARTNER'S SHARE OF INCOME
For Calendar Year 2012, or Fiscal Year Beginning
Arm 29 , 2012 and ending
December 31 , 20 12
PART I
General Information
Pc-ma's SS e
Faded EIN
20-3181309
Patinae New
Seed Andre
27 HIGH TECH BLVD.
City
Staie
Zip Cede
I Do
Slate
Zip Ckoz
THOMASVILLE
NC
27380
CHICAGO
IL
60605
Partieriters Fetterd flN
45-2096075
Sertiodad's Name
Perteaddre Sweet Piedra!
440 S LASALLE STREET, 39TH FLOOR C/0 MORGAN STANLEY'
What type of entity is parole (too immune%)
NP
Code
Dale Patina's Inured in Pennant:in began:
6
29
2012
Wadi
Day
Yaw
0 Final NJK-1
CI Hedge Fund
0 Amended NJK-1
K Member of Composite Return -
Eder Partner's percentage or
(I) Before Decrease
or 1 cimination
(ti) End of Year
Profit Sludrig
0.000000 %
0.090473 %
I ass Sidling
0.000000 %
0.090473 %
Capital. O....Lusby
0.000000 %
0.077581 %
PART II
laconic Information
Income CiasslEastions
A. 'Fetal Distribution
I. Parmership Income (loss)
(4,336)
2. Net Guaranteed Payments
Pannees 401(k) Contribution
4. Distribudve Share of Partnership
Income (loss)
(Line I plus Line 2 minus Line 3)
NJ-104U filers
I
Enter Amounts on
line Shown Below
(4,336)
Line 20, Page 2
5. Pension
Line 19, Page 2
6. Net Gain (loss) from Disposition
of Assets as a Result of a
Complete Liquidation
PART
B. New Jersey Source
KI-1040NR Filers
Amounts
Line 22, Page I
Line 18, Page 2
Line I8, Page I
Partner's Information
I. Nonresident Partner's Share of NJ Tax
2. Partner's IIEZ Deduction
2.
3. Partner's Sheltered Workshop Tax Credit
3.
PART IV
Supplemental Information (Attach Schedule)
Line 19a. Pogo 1 Or" l°°
Line los, Pogo I CIIT-I00.5
Lieu S. PART-RIO
Line 46, N1-024(0a
Line 22, XX IOSOC
Lea 31., NJ-1041
Partner g 316
CONFIDENTIAL
SDNY_GM_00033304
EFTA_0014391 7
EFTA01280343
---PAGE BREAK---
f
äp
For calendar year 2012 or tax year beginning I
8/29
12
New York State Department of —axation erd Finance
New York Partner's Schedule K-1
Tax Law— Article 22 (Personal Income Tax)
intending I
12/31/12
11-204-IP
Final K-1
O Amended K-1
Partners: Et, re completing your income tax retain, see Fan IT-204-IP-I, Panthets Instructions for Farm IT-204-1P (available at vnvw.tax.ny.govj
Partnership's information (see instructions)
Partnership's name (es shown on Form IT-204)
A Mark an X In the box if either applies to your entity 0
Publicly traded partnership
Partnership's EIN
45-2096875
ICI Portfolio investment partnership
B Tax sheer registration number, if any
B
C Business allocation percentage
C
0,0000 %
Partner's Information (see instructions)
Partners name
BLUE CHIP CAPITAL I1C
Partner *address
27 HIGH TECH BLVD.
City
THOMASVILLE
D The partner is a rain en X in sae atarwsretca) I= General partner or LLC men' oer-manager
Lim :ed partner or other LLC rrember
E
F
What is the tax filing status of the partner? (,varrenXnt e swoon& toz, Moan.;
tf the partner is a disregarded entity or grantor trust,
enter the tax ID of the entity or individual reporting the income, if known
C
Maki dual l= Estate/trust
IM Partnership
G Did the partner sell its entire interest during the tax year?
G Yes CI
No CI
H Partner's share of profit, loss, and capital
espsrning
Ending
1) Profit
2) Loss
H1
0.0000
0.0905%1
H2
1
0.0000 %
0.0905 %
3) Capital
H3
0.0000 %
0.0776%
I
Partner's share of liabilities at the end of the year
1) Nonrecourse
11
1,155
2) Qualified nonrecourse financing
12
3) Recourse
13
J Partner's capital account analysis
1) Beginning capital account
J1
NONE
2) Capital contributed during the year —cash
J2
3) Capital contributed during the year — property
J9
4) Current year increase (decrease)
J4
3,056
5) Withdrawals and distributions —cash
J5
Withdrawals and cistibutiena —property
7) Ending capital account
.17
3,055
8) Method of accounting (mark ana the approanala box)
ICI Tax basis
M
GAAP
0
Book El Other (submit explanation)
K Resident status (mark an Xin ea boxes that apply)
1=1 NYS full-year resident
C
Yonkers full-year resident
C
NYC ful:-year resident
C
NYS part-year resident
C
Yonkers pal-year resident
C
NYC oart-year resident
NYS nonresident
C
Yonkers nonresident
L If the partner was incuced n a group return, enter the special NYS identification number, if known
L
Slate
NC
Z P code
27360
Partners identifying number
20-3181309
118001120094
III
Partner S 316
CONFIDENTIAL
SDNY_DM_00033305
EFTA_00143918
EFTA01280344
---PAGE BREAK---
Page 2 of 4 IT-204-IP (2012)
NI 1) Was Form IT-2658-E filed with the partnership?
M1 Yes O
No CI
2) Was Form MTA-405-E Ned with the partnership?
M2 Yes CI
No Ci
N NYS estimated tax paid on behalf of partner (from Pam IT-2668)
1) First installment
NI
2) Second installment
N2
3) Third installment
N3
4) Fourth installment
114
Total NYS estimated tax paid on behalf of partner (adding Nt through N4)
Deb
Amount
N
O Estimated MCTMT paid on behalf of partner (horn Form MT -40$
1) First installment
O1
2) Second installment
O2
3) Third installment
O3
4) Fourth installment
O4
Total estimated MCTMT paid on behalf of partner Madam Of Mrough CM)
O
Dab
Partner's share of income, deductions, etc.
A - Partner's distributive share items
1 Ordinary business income goes)
2 Net rental real estate Income (loss)
3 Other net rental income (loss)
4 Guaranteed payments
6 Interest Income
6 Ordinary dividends
7 Royalties
8 Net short-tent capital gain goes)
9 Net long-term capital gain (loss)
10 Net section 1231 gain (loss)
11 Other income (loss) [den
12 Section 179 deduction
13 Other deductions Pent*
14 Tex preference Items for minknum tax
I Weary:
15 Net earnings (loss) from self-employment
16 Tax-exempt income and nondeductible expenses
17 Distributions - cash and marketable securities
18 Distributions - other property
19 Other items not included above that are required to be
reported separately to partners
Identify
- Federal K-1 amount
I
C - New York State amount
19
4880
1
2
3
4
6
6
6
10
11
12
13
14
16
18
17
18
19
Partner's share of New York modifications (see instructions)
20 New "ink State additions
Numbir
A- Total amount
- New Tort SO% allocated amount
20a
EA —
20b EA-
20c EA-
20d
EA—
20e
EA —
20f
EA —
21 Total addition modifications (:oral of column A lines 20e through 200
116032120354
21
Partner it 316
CONFIDENTIAL
SDNY_GM_00033306
EFTA_001439 I 9
EFTA01280345
---PAGE BREAK---
17-204-IP (2012) Page 3 of 4
Partner's share of New York modifications (continued)
22 New York State subtractions
Numbs*
A-701.1 amount
22a
22b
22c
22d
22e
221
ES
ES-
ES
ES-
-
ES -
ES -
B — Naw York Stars a [located amount
23
otal subtraction modifications (Mel of column A. lines 22e through 22O
24 Additions to federal itemized deductions
Uttar
Amount
24a
24b
240
24d
24e
24f
26 Total additions to federal itemized dechicticns (esd lines 24e through 240
26 Subtractions from federal itemized ceduclions
Loiter
Amount
26a
26b
26e
26d
26e
281
27 Total subtractions from federal item zec deductions (add lines 28a through 260
28 New York adjustments to tax preference items
23
26
281
Partner's other information
29a Partner's share of New York source gross income
29b MCTD a lecadon percentage (see instruchons)
I 2 Lis
29b
0.0000 %
Partner's credit information
Part 1 - Flow-through credit bases and factors
Brownfield redevelopment tax credit (Pam 17-0110?-011.1)
30 Ste preparation credit component
31 Tangible property credit compcaent
32 on-site groundwater remediation credit component
III III III I II 111111
III III 11111
II II
A -Pala IT411
30
31
32
- Fonn IT411.1
30
31
32
Partner* 316
CONFIDENTIAL
SDNY_GM_00033307
EFFA_00143920
EFTA01280346
---PAGE BREAK---
. •
Page 4 of 4 IT-204-IP (2012)
Partners credit Information (Continued)
EZ capital tax credit (Fenn IT-002)
33 Contributions of money to E2 community development projects
33
34 Recapture of credit for investments in certified EZ businesses
34
35 Recapture of credit for contributions of money to EZ community development projects
36
QEZE tax reduction credit (Form IT.604)
36 QEZE employment increase factor
36
37 QEZE zone allocation factor
37
38 QEZE benefit period factor
38
Excelsior jobs program tax credit (Form IT-807)
39 Excelsior ;olds tax credit component
39
40 Excelsior Investment tax credit component
40
41 Excelsior research and development tax credit component
41
42 Excelsior real property tax credit component
42
Farmers' school tax credit (Form ff.217)
43 Acres of qualified agricultural property
43
44 Acres of qualified conservation property
44
45 Eligible school district property taxes paid
45
46 Acres of quallied agricultural property converted to nonquared use
46
Other flow-through credit bases and factors
Cred t rases
Code
Amount
47a
47b
47c
Credit factors
cane
47h
Factor
J
471_1
47
47d
1
47e
47f
Code
0
Factor
Part 2 — Flow- hrough credits, addbacks and recaptures
48 Long-term care irsurance credit (Form IT-249)
49 Investment credit (including employment Incontive
50 Research and development — investment credit
51 Other flow-through credits
Code
Amount
treat
(Form
and historic
/7-212)
ham tehobilitation
Code
credt Pam IT-212).
Arent
48
49
50
514
51e
511
81c
51b
a
51h
514
52 Addbacks of credits and recaptures
Code
Amount
Cede
Amor
52a
52d
62b
62•
52c
62f
47k
471
Cede
Factor
11111111iTi°11111111111111111
Partner # 316
CONFIDENTIAL
SDNY_GM_00033308
EFTA_0014392 I
EFTA01280347
---PAGE BREAK---
2012 Oregon Partner's Share of income, Deductions, Credits, etc.
Far catenate '6.92012er tat
yearteruss
era andna
6/29/2012
12/3112012
g
=nal K-1
E Amended K-1
It trawl type of coley Is this perinea
LLC
B Partnerships name address and ZIP cede
12 reels padre( Ma reerenterd pan ORAISEPS900999t9 ). Shea 98e9
440 S LASALLE STREET, 39TH FLOOR C/O MORGAN STANLEY
TAX
CHICAGO, IL 60605
Part II
E Pertain identitfl flat
F Partnees name. address end ZIP code
27 HIGH TECH BLVD.
THOMASVILLE, NC 27360
20.3161309
0 n
Gwent partner rile
rmrnee•meneger
Reeidert
z
Umited perner mortar 1.1.0
mentor
Ncri•Reeldert
CRAIN
'eters share c4 wort loss end ambit
Beginning
Ending
'refit
toes
0.000000% I
0.000000%
0.090473%
0.090473%
0.000000%
0.077581%
K Parmer's share o Ilablites at year rd'.
Nonrecouse
Guar had nonrecourse ?Wrong
ReeOunte
L Par Ws =pied accoult Malls
Illaghttng espial a=cint
Capita corelbuted dtx erg the yew
Current year trews (decrease)
Wahareners S. detrbutions
it
Endrig came account
1.155
NONE
33,811
3.055
38.866
Part III
Line Om on Federal K-1
Faders'
State
Adjustment •
Adjusted
Federal
State '"
Granary business income (oss)._
2
Net rental seal &stabs WWI° NW
3
Other net rearm Income Close)
4
Guam-coed pay-rers
•
leterest income
Be
Ordinary *Mends
. — .
.
—
—
.
7
a
Net slat-term caplet grin (beat)._
9a
Net keg-term capital gall ;Ion)
•
—
—
.
to
Net sestbn i231gar (Ica)
.
.
11
Oner *no:me (ces)
13A-G [Alameda oontreudcne
— •
. .
.
.
•
•
13144,W OthetcleductiCel
IS
Cretin ere* leearlul)
161
Folagn tans paid
. 44.0 ..
.
0.404*
1614
Fattish taxes waned
17
Altamaha rattan biz (MAT) keine
18A-B TaX9tteelpths:C010
•
.
.••
113C
Nenclectwbele apemen 4•••••••
••••.
.
.
••••....I.
•• •
••••••••
•
19
Diebtotra
Oregon taxes altered by Parbusratp
Outor Nonn000n:
285
613
265
613
(317)
(3)
(317)
(3)
(631)
(631)
4.283
4263
Partner # 316
• State Adjustment This column represents the adjustments between federal and stale tax law.
" Adjusted Federal: For residents of this slate, this column should be used to report your stele taxable rooms.
• State ror rv, rowients Of th s stetelhis totem should be used to report your state taxable Inxme.
CONFIDENTIAL
SDNY_GM_00033309
EFTA_D0 I 43922
EFTA01280348
---PAGE BREAK---
1207210053
PA SCHEDULE RK-1
SSN
ROSIZIOnt Schodulo of UntoIdo
Partne 'Beneficiary Pass Throng I
IMMO. Loss and Creeds
PA•10SPA65 RK-1 ,:05-12; OA) 2012
Lott Name
Spouse sSSN
If jointly bald
FEIN 203181309
a First Line of Address
ferry
of Address
or Post Office
I THOMASVILLE
27 HIGH TECH BLVD.
Sunk Piro) Name
Phone Number
Name of Owner Receiving RK-I (if other than an individual)
I
Amended Schedule co
Mad o
Sharcheirkes stock owoershim
%
Beneficiary's yeast distribution:
%
Planes's percentage of:
Profit sharing 00008 %
Loss sharing 0009!..%
Ownership of capital: _ qcope %
Name of Entity Issuing RK-1
f
Orr or Post Mee
rhe 7. P Code
IL 160605
FEIN
Revenue ID
452096875
CHICAGO
Entity: (Pill le one oval only)
o
Estaxamst
O
PAS Corp
O
Piscal Year
Shon Year
06/29/12
Bern
12/31/12
dm Partnership
0
Lit-.
NOTE: Amounts from this schedule must be reported on the appropriate PA Tie Return.
I PA-Tasabk Business Income (Loss) from Operations
2 Interest Income
3 Dividend Income
Ir• loss, fall in the on].
tam
4 Nd Gain (Lots) from the Sale, Exchange or Disposkket of Property
5 Nd Iwo (Loss) from Rents, Royalties, Puenu and Copyright:
6 Income of/from Estates or Trusts
If a 1014, MI in the oval.
—
if a loss, fill in the OVAL
.0
7 Gambling and Lottery Winnings (Loss)
s
8 Resident Credit. Submit statement
1
9 Total Other Credits. Submit statement
10 Distributiorut of Casb. Marketable Securities, and Property - nnt including guaranteed payments .
11 Guaranteed Payments for Capital or Other Services
12 All Other Guaranteed Payments for Services Rendered
13 Guaranteed Payments to the Retired Partner
> 14 Distributions Rom PA Aommulated Adjustments Account .. .. If liqvidathig. El in the oval
A
15 Distributions of Cash. Marketable Securities, and Property
16 Nontaxable income (loss) or nondeductible expenses required to
calculate owner's basis. Submit statement.
17 Owner's Share of 1/IC Section 179 allowed according to PA rules
IS Owner's Share of Straight-Line Depreciation
19 Partner's Share of Nourecourse Liabilities at year-end
20 Panacea Share of Recourse Liabilities at year-end
1
L,
1207210053
If a loss, fill in the cmd.
bad
1
2
3
4
5
6
if a loss, MI In the oval.
o
7
8
9
10
11
12
13
r=t
14
15
O
16
17
IS
19
20
Ovmor.
0
0
0
0
0
Individual
PAS Cap.
All Other Corp.
Estastifrust
Partnership
LLC
Mans
Patina-.
o
Gemmel Panne:
or LL.0 Member
• Manager
SI Limited Punter
or Other LLC
Member
1,155
1207210053
Partner # 316
CONFIDENTIAL
SDNY_GM_00033310
EFTA_00143923
EFTA01280349
---PAGE BREAK---
1207310051
PA SCHEDULE NRK-1
tionresicent Schodtho of SNreholder
ParTherliereliclary Pass Trough
Ineorna. Loss and Credits
PA-20/14/ACS fiRK1
2 1: 2012
2
L
a
ISSN
ISFrollitled
s SSN
y held
FEIN 203161309
First Line of Address
27 HIGH TECH BLVD.
Second Line of Address
Suffix First Name
El
Phone Number
Name of Owner Receiving NRK-1 (if other than an individual)
City or Post ()thee
THOMASVILLE
(a
ZIP Code
127360
Amended Schedule O
Final 0
Shateho:dets stock ownership:
%
Beneficiary's )en-end distribution:
St
Paso's percentage on
Froth sharing: St22599i
Inn &haring: _Ina%
Chsterstip of capital: JODI%
Name of Entity Issuing NRIC-1
City or Post Office
State
ZIP Code
CHICAGO
RUN
452096875
0
60605
Revenue ID
katuy: On In one oval only)
o
13statoTnut
o
PAS Cap
O
Fiscal Year
a
Short Year
06/29112
Begin
12/31/12
gn i
NOTE: Amotmts Goa this schedule must be reported on the appropriate PA Tax Return.
1 PA-Taxable Business Income (Loss) from Operations
If a loss, NI in
oval. 0
2 Net Gain (Loss) from the Sale, Exchange or Disposition of Property If is loss, 511 in the oval. o
2
3 Net Income (Loss) from Rents, Royalties, Patents and Copyrights
If a loss, fill in the oval. v=s 3
4 Income of/from Estates or Trusts
4
ti
Partnenitp
o
LLC
S Gambling and Lottery Winnings (Loss)
II a loss, EU in the oval. o
6 PA Nonresident Tax Withheld
7 Total Other Credits. Submit statement
S
6
7
S Distributions of Cash, Marketable Securities, and Property not including guaranteed payments
8
al
9 Outusimeed Payments for Capital or Other Services
9
k
10 All Other Guaranteed Payments for Services Rendered (PA-Apportioned Amount Only)
10
11 Guaranteed Payments to the Roiled Partner
11
>
12 Distributions from PA Accumulated Adjustments Account
If Hqukletlag, MI in We oval. 0
12
13 Distributions of Cash, Marketable Securities, and Property
13
;
14 Notattabk income OOSS) or nondeductibk expenses required to
If a loss, fill in the ovaL o
14
1
1
calculate owna's economic investment. Submit statement.
15 Owner's Share of IRC Section 179 allowed according to PA rules
15
16 Owner's Share of Straight-Line Depreciation
16
17 Partner's Share of Noorecourse Liabilities at year-end
17
18 Partner's Share of Recourse Liabilities at year-end
18
1207310051
Owner:
ci
Individual
O
PASO:up.
o
All Othar Corp.
O
Ertaicartut
O
Partnership
-
LLC
0
Rump
Partner.
o
General Partner
or LLC Member
• Manager
-
LamitedParuter
or Other LLC
Mot
1,155
1207310051
Ni I 0
Partner*316
CONFIDENTIAL
SDNY_GM_00033311
EFTA_00143924
EFTA01280350