EFTA Document EFTA01280150

Schedule ft-1 (Form 1065) For (Swat DI convert of IN Tremary ON 0WIW0 Worn, Fiww Sena OM tv2 Partner's Share of Income, Credits, etc. • see 2012 yew 2(112, a Ilu , 20I3 N Final K-1 0 Amended K-i CND •.o. 1545-CC99 Current and Year Income, Other Items ak.r 139 Partner's Share of Deductions, Credits, 1 : Ordinary business income (loss) —72 16 Credits Deductions, separate instructions. 2 INK rectal red estate lame0ns) 3 Other net rental tricorns (loss) 16 Foreign transactions Partnership WM-Pt" Information About the 4 i Guaranteed payments A Partnership's employer identification number 26-3172589 5 Interest Income B Partnership% name, address, city, state, and ZIP code Level Management, LLC 19401 Old Jetton Road Cornelius, NC 28031 Gal Ordinary hi/stands 60 Qualified &viten& C IRS Center vinery partnership filed return Cincinnati, OH 7 Royalties D EiCheck if this is a publicly traded partnership (PT') 8 . sheritawt head gel (loss) Partner 9s, Net long-term capital gain (loss) 17 Alemelivemnimun to(NAT) lens iNkftli,11,, Information About the E Partner's identifying number 20-3161309 9b Co 'cobbles (28%) gain (loss) F Partner's name, address, city, state, and ZIP code Blue Chip Capital, LLC 27 High Tech Blvd. Thomasville, NC 27360 9c Untecapturod section 1250 gain 10 Net section 1231 gain (loss) 18 Tax-exemot income and nondeductible expenses 11 Other income (loss) G .0 General partner Of LLC 1. CU rnemberimanager iell Limited partner or other LLC member H 3 Domestic partner I I Foreign oartner It Vat Isle M entry is his patted (see nsli)En t attiko - 12 .1 this panrer is a retirement plar (IRA/SEP/Keogh/etc), check here (see instructions) J Partner's share of profit. loss, and capital Beginning Profit 25 00000 % bi t, ,---, U (see instructions): Ending 25 00000 % 19 Distributions 12 Section 179 deduction 13 1 Other deductions 20 Other information Loss 25 00000 % 25.00000 % Capital 25. 00000 % 25.00000 4 X Partner's share of liabilities at year end: Noreecouto Gushier; nonrecowse finanhng... Recourse $— ------ $ 41 - Self•employment earnings (loss) -72 ' - - $ L Partner's capital account analysis: Begriming capitai account Capital contributed during the year . Current year increase (decrease).. . ... Withdrawals and distributions Ending capital account N Tax basis OGAAP Other (explain) M Oid the partner contribute property with li ves EN0 It 'Ws. Mr USW Tam (w nentau) $ 947 'See attached statement for addit onal information. $ i 0R r : u E o r $ -72. $ $ 875 OSection 704(b) book a built-in gain or loss? BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065. Schedule K-1 (Form 106$) 2012 PTPA0312 01/02(13 CONFIDENTIAL SDNY_GM_00032832 EFTA 00143445 EFTA01280150 Schedule WI (Form 1065)2012 Blue Chip Capita:, LLC 26-3172589 Page 2 This list Identifies the codes used on Scher:Sale for all partners and provides summarized reporting information for ambers who file Form 1040. Fr denied reoorticg and filing intimation, see the separate Partners Instructions for Schedule Kl and the instructions for your Income tax return. 1 Ordinary huskiest bonne "W. Dele—n. *ether Ina 'we" 1055) 5 ~be Code Report on Cr ~ewe are etr or your rater as Styes Report an J Wert coPertinfiy creole Patine loss Sea te rese.r.WOrn K Danai ?WM crab Pawn run Plebes ne Noneassms meon. Schedel: E. lino 74. oak-.r Scrod le E. lea a firkin' (1') Scfictkeee E. ' no a Ch3rh I) Øe ide d cerreasny wee L Empowerment erriderseltbode L See re randers M fade let notteing 'ebb& whiten restarbent 2 Net natal reel eØ Income gets) 3 Ober net rental beano cooed See re »ratters Irateficonl N Credit SY sØ We. lea eng "ban boos 0 ~UP ell~e5 It team Scerdle E. :ire 25. coin-. (g) P °poi croon tie: ins See be »44ttere lebrrnes 16 'mil« transactions 4 Guarenteed paymenle Seeable E. :Ire 28. colorer (I) A Name ci party a V.S. aoSS°931an 5 Interest bled% Ferry INC. abets B GIG« born ironn a I sources F 'on 1116,,arl I 6a Ordinary dividends Fan '040. Ina 9a C Ores tame two% a: canner tere, 6 b gurgled "bends ECM ICAC. c,a ge Foreign gross income sourced et partners/lip level 7 Royalties SchneJe E. sea D Pan ra :Wiry 8 Net theerlenet cbatall gain goes) Schackile D. It» 5 E csirirat ernriry corm »an I 9 a N« len¢Mrm cop" gain goes) Stock D. ale 12 F F. 9 b ColleedWn (2811) tarn (bee) C thwerefieurerd auction 1250 gain 10 11•I salon 1231 gain doss) 11 Oh« Income Bus« 28% Robe Gtr ~Wet TIM 4 (Seed" D front*" See de Panpipe!. Interwar* Sea the Partners ~AC" Deductions allocated and appereoned arpertner level G htesesl °keen* form 1116, Par! . H Clef ram 1116. Pan i Deductions allocated and apportioned at partnership level to foreign source diCOM0 Code I »abbe oaten A Ober teddobr Income :tas) See re Paring's ireb.ettel r— Far 1116. Patti J General ainapin K otter B reTurfiWy contemns See tie Prbeis 'eankclers C Section '256 ortbot and treacles ram6fu.lne' Otlar information D 14 -du era 01K or ccell retarkee Sae PID 535 L "Val kvecr SoteS cad Prot/II II IS, Pel II E Conerleite «dent roan 1043. ne 21 or Farr 992 M 'ob 'cretn tares "bee Fro 1115, Fan II F caw incur., ;big) See re Payers III/VPKIC/%5 N RNattam h/ *Sae ere b# le ceedl Fore /116. ene 12 12 snarl in &auction 500 g,. POstneff .runetnee 0 geeejn YacinG eons receipt; Farm 8873 13 Other deduction& P EØ91/1”/III eacii."Ke Fate 8873 A Cabs cong>bbons (5") Q on, brew YLIMIPILNIIII See be Parrett :nsiketicel B Cat> balrbtions (3010 17 Attemelve nenImLen let (AIM hems C N.-ix/Jab ea bid:lions (5") D Nolan a» keutons (Kb) E Cagnal era n Proneeb le a 5C% obsoe zaten (30%) F Cape& Bat peepety CB% G coarabutces 00094 H levearen: eneanset °bens* For, ..— See re Isabres IrerraceceS 4952, line I 18 A »ost '966 ~dada-) aoydrbet B masted oat. cr ase C 'Scathe- (o'er rare al 4, uns) , See de Parboil »ebb:Lions ard D c.. ga. A atnettenral gibs be untktbcort lot E Cer, fibs. 4 Øreral deabetbat Form Cal F 07e. AMY Sews Taxeonompl Interne and nonefeaucebb expenses I Deducbool — royally flare ScreedJes 5, ate 19 A Tax -99390: ftert. 9939.1 Form 1043, Ihe .1 Sieber 5nbe)(2) excenekres See the bonnets Instr-ct cat B One lax-exempt intone See trePIIIrrel nsYLabm K Deduanrs - pvtlt he (21) der) Sdeedis A. lire 23 C Notbeerate ereenses See de Partners bgb~S osip,n," — comb (alle() Save a A. Ide PS 19 met:neutrons M tbrobnb pod icr -,.tiul ~wee N r dixoteral rentinoe tee It 0 Deperient care :en,* P Preprouidno Devon ?lawmen Q Cannetrai tofitalkeb: SNUG on bon, rents real ~In activeres ~mile A Ina 1 or Fern IØ. Lie 29 See the Porters "excites Fan 2441. Lee '.2 See che Price" ',bobble See Fan "12 :bauble% 20 A each and 9999tabio eery". B tdorrobeo bbee:1 lo umiton 737 k See 1' 8 'jabs" C Other pfeeerly rnseblines Ober intormatIon A irnarerrent tØ Fern 49Q lib 4e B ~end °brims Ben 4952. the 5 R NeserS erC IRAs See Ile Parberb nstsubd-os C ba "di Yoruba Ben 4136 19erfleellen ewense T Obretac red-chcr eNvb nforrxen U (,lubin% prosublan actnntles loco" V E-mløe'ehsnWlrages Sire fie Probere See F e n n 8933 l-tni9 PCT. 8303. 7^9 lb renn 8903. IM 17 O Ckfirbed refiaboutem (ochre fibre ~1 bid estate) See be Partners nartetotra E Babb of or wpm*, Ste be Partners terneeters F ‘lactptor • 1,699 et". %aid) onset becton F 42(1)(5)) ern 5611. Ire a W Oder derdfirbers Sots the varma': !retnall^n G R9011:11,* of ibolroemelb~C red I(onda) Fon 66'1. be 14 Sellemployment «rings Qom) H Beene.* cl inestehre Crete See rans 4255 Nob, :firm rare a 'abbe /79 ~nee any ~~...sel et «lute's. ste Ste r'ann e M.n.ttan NAY* (^Ming Sorbet* SE I Rico fits* it ode ebb b See No Panne?, Iblf tercet A rui WrBX/3 C919 .Ten 999999eynert Ube& • 5E. Stk...xn A or !I J lael,4»elt Fic=c)d— Øreled enerleent See :am 8697 B Sross foritire of fitning Name C Gen NIX9fitir MINN, 15 Credit* See re Parbeit I nststkres See re Penner s ibbedszes ok K yr itirx tires, ircorr. «ail WM Sae norm 8866 L D ~an of :wiry aktn 179 dre-caele A Lon-intone »see ono, urban 420)(5)) hob ere-2Wt B Low-frame +.1.15in2 att (ota) 'an ere .2£09 bullets RecarLee ed secten 179 ~roe N .nerst ear". roc Wont, Prim, O Saber 4531)(3) ederrate, C Lem earns noun% 9691 batten 42(0(5)) ace, tos1.23C7 D Loefiareare robing cosedt MVO °an Ø1J37 'adopt E *Baled heheb91I9D0.14lapertit991 (reetel selniob) See Me Pieter e Inmates P sector awa(e) gleenatinn Q Serer 730(b) .moteialion R lane, Mobs" fie reeve« erected:set 0:77 nonebilled veladranh I Deepalsw Werrialficte — oa and On e See the Partre Inaba". F Oder eerie reed ester.° redb U Atonvolicr of tleetlefen ceele G Crher reeler 9999 V :knew« bubseu rasa" ncorre H Vat/at/hired capital gars at" 4~ and catec brake, hers credit ram 1C40, be 71, check box a See ntt 'Mn.'."Inc ons W Peecentobbtre Cal (na) X Serb," 103(,) beyrrayon Y Ober °donation ~eV 01872.fi, 3 SØØ e Kl(Form 1065) 2012 CONFIDENTIAL SONY_Gfut 00032833 EFTA_00 I43446 EFTA01280151 NC K-1 (50) (D-403) 10.11.12 2012 Partner's Share of N.C. Income, Adjustments, and Credits North Carolina Department of Revenue For calendar yea 2012 or fiscal year beginning Partner's Identifying Number 203161309 Partner's Name, Address, and ZIp Code BLUE CHIP CAPITAL LLC 27 HIGH TECH BLVD. THOMASVILLE NC 27360 Partnership's Pro Rata Share Items All Partners 1 Share of oadrership income (loss) 2 Additions to income (loss) a Addition for bonus depreciation b Oft &Mots to tome (oss) SEE SUPP INFO 3 Deductions from Marne (oss) a Deduction for bonus depreciation b Oiler deluders from iocone 0050 4 Share of tax credits 5 Share of tax wittheid from nonwage compensation paid for cyclonal 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 SUPPLEMENTAL INFORMA—ION and end n7 Federal Employer ID Number 263172589 Partnership's Name, Address, and Zip Code LEVEL MANAGEMENT LLC 19401 OLD JETTON ROAD CORNELIUS NC 28031 Amount —72 51 0 0 0 0 0 Individuals Filing Form D-400 Enter Amount on: Page 2, lire 35 Page Z Line 36 Page 2, Line 44e Page 2, Lire 49 Form D-400TC Page 2, Line 23 Page 2, Line 51 Page 2, line 24c nccaeder 01/10/I3 CONFIDENTIAL SDNY_GM_00032834 EFTA 00143447 EFTA01280152 Level Management. LLC 26-3172589 =ORM Dd403, SCI-EDWE NC K•1(BLLE CHIP CAPITAL LLC) SUPPLEMENTAL INFORMATION LINE 2 - OTHER ADDITIONS TO FEDERAL INCOME: STATE TAXES DEDUCTED ON CS RETURN 51 TOTAL 51 CONFIDENTIAL SONY_GM_00032835 EFTA_00143448 EFTA01280153