Exempt Organization Business Income Tax Return

Transcription

1 Form Department of the Treasury Internal Revenue Service A B For calendar year 2016 or other tax year beginning, and ending. OMB No Information about Form 0-T and its instructions is available at Open to Public Inspection for Do not enter SSN numbers on this form as it may be made public if your organization is a 501(c)(3). 501(c)(3) Organizations Only Employer identification number Name of organization ( Check box if name changed and see instructions.) D (Employees' trust, see instructions.) Exempt under section Print 501( c )( 3 ) or Number, street, and room or suite no. If a P.O. box, see instructions. Type 408(e) 220(e) P.O. BOX E Unrelated business activity codes (See instructions.) 408A 530(a) City or town, state or province, country, and ZIP or foreign postal code 52(a) SEATTLE, WA Book value of all assets C at end of year F Group exemption number (See instructions.) 40,38,252,180. G Check organization type 501(c) corporation X 501(c) trust 401(a) trust Other trust H Describe the organization's primary unrelated business activity. I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? ~~~~~~ Yes No If "Yes," enter the name and identifying number of the parent corporation. J The books are in care of JENNIFER DEGER Telephone number Part I Unrelated Trade or Business Income (A) Income (B) Expenses (C) Net b b c Less returns and allowances c Balance ~~~ 13 Total. Combine lines 3 through Part II Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions, deductions must be directly connected with the unrelated business income.) X 0-T Total deductions. Add lines 14 through 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or line Check box if address changed 1 a Gross receipts or sales Cost of goods sold (Schedule A, line 7) ~~~~~~~~~~~~~~~~~ Gross profit. Subtract line 2 from line 1c ~~~~~~~~~~~~~~~~ 4 a Capital gain net income (attach Schedule D) ~~~~~~~~~~~~~~~ Net gain (loss) (Form 477, Part II, line 17) (attach Form 477) ~~~~~~ Capital loss deduction for trusts ~~~~~~~~~~~~~~~~~~~~ Income (loss) from partnerships and S corporations (attach statement) ~~~ Rent income (Schedule C) ~~~~~~~~~~~~~~~~~~~~~~ Unrelated debt-financed income (Schedule E) ~~~~~~~~~~~~~~ Interest, annuities, royalties, and rents from controlled organizations (Sch. F)~ Investment income of a section 501(c)(7), (), or (17) organization (Schedule G) Exploited exempt activity income (Schedule I) ~~~~~~~~~~~~~~ Advertising income (Schedule J) ~~~~~~~~~~~~~~~~~~~~ Other income (See instructions; attach schedule) ~~~~~~~~~~~~ STATEMENT 20 Compensation of officers, directors, and trustees (Schedule K) Salaries and wages Repairs and maintenance Bad debts Interest (attach schedule) For Paperwork Reduction Act Notice, see instructions. 1c 2 3 4a 4b 4c ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Taxes and licenses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Charitable contributions (See instructions for limitation rules) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Depreciation (attach Form 4562) Less depreciation claimed on Schedule A and elsewhere on return Depletion Contributions to deferred compensation plans ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Employee benefit programs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Excess exempt expenses (Schedule I) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Excess readership costs (Schedule J) Other deductions (attach schedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated business taxable income before net operating loss deduction. Subtract line 2 from line 13 ~~~~~~~~~~~~ Net operating loss deduction (limited to the amount on line 30) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE STATEMENT 21 Unrelated business taxable income before specific deduction. Subtract line 31 from line 30 Specific deduction (Generally $1,000, but see line 33 instructions for exceptions) LHA Exempt Organization Business Income Tax Return (and proxy tax under section 6033(e)) BILL & MELINDA GATES FOUNDATION TRUST SEE STATEMENT 17 2,00. -2, a STMT 1 ~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~ b X 2,00. -2, ,543.,543. -,384. -,384. 1,000. -,384. Form 0-T (2016)

2 Form 0-T (2016) Part Ill BILL & MELINDA GATES FOUNDATION TRUST Page 2 Tax Computation 35 Organizations Taxable as Corporations. See instructions for tax computation. a Controlled group members (sections 1561 and 1563) check here El See instructions and: Enter your share of the $50,000, $25,000, and $,25,000 taxable income brackets (in that order): (1) 1$ (2) (3)L b Enter organization's share of: (1) Additional 5% tax (not more than $11,750) Is I (2) Additional 3% tax (not more than $100,000) Is I c Income tax on the amount on line Trusts Taxable at Trust Rates. See instructions for tax computation. Income tax on the amount on line 34 from: Tax rate schedule or LIII Schedule D (Form 1041) 37 Proxy tax. See instructions 38 Alternative minimum tax 3 Tax on Non-Compliant Facility Income. See instructions 40 Total. Add lines 37, 38 and 3 to line 35c or 36, whichever applies... Part l ( Taxand Payments 41 a b C d e Credit for prior year minimum tax (attach Form 8801 or 8827) Total credits. Add lines 41a through 41d Subtract line 41e from line 40 Other taxes. Check if from: El Form 4255 El Form 8611 El Form 867 El Form 8866 El Other lattach schedule) 44 Total tax. Add lines 42 and a Payments: A 2015 overpayment credited to a b 2016 estimated tax payments o Tax deposited with Form c d Foreign organizations: Tax paid or withheld at source (see instructions).- 45d e Backup withholding (see instructions).- 45e Credit for small employer health insurance premiums (Attach Form 841).- 45f g Other credits and payments: El Form 243 Form 4136 El Other Total - 46 Total payments. Add lines 45a through 45g , Estimated tax penalty (see instructions). Check if Form 2220 is attached El Tax due. If line 46 is less than the total of lines 44 and 47, enter amount owed Overpayment. If line 46 is larger than the total of lines 44 and 47, enter amount overpaid a 4 100, Enter the amount of line 4 you want: Credited to 2017 estimated tax 100,000.1 Refunded I Part V I Statements Regarding Certain Activities and Other Information (see instructions) At any time during the 2016 calendar year, did the organization have an interest in or a signature or other authority - YesNo over a financial account (bank, securities, or other) in a foreign country? If YES, the organization may have to file FinCEN Form 114, Report of Foreign Bank and Financial Accounts. If YES, enter the name of the foreign country here.- SEE STATEMENT 22 x - 52 During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust?.- If YES, see instructions for other forms the organization may have to file. 53 Enter the amount of tax-exempt interest received or accrued during the tax year '$ - Under penaihes of perjury, declare that I have examined this return, including accompanying schedules and statements, and to the beat of my knowledge and belief, its true Si n correct, and corn. eclaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Paid Preparer Use Only Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116) Other credits (see instructions) General business credit. Attach Form 3800 it II 10/ CHIEF FINANCIAL OFFICER th:properershownb&ow(see r SigdFe of offider Dat V Title instructions)? [i Yes P1 No PrintlType preparer's name TOLENE G COX Firm's name DELOITTE TAX LLP Preparer's signature 25 FOURTH AVENUE, SUITE 3300 Firm's address SEATTLE, WA Date 4 a 41d 45b. 41b. 41c 11/07/17 100,000. Check LJ if self- employed Firm's EIN '- 35c e PTIN Phoneno Form 0(2016)

3 Form 0-T (2016) BILL & MELINDA GATES FOUNDATION TRUST Page 3 Schedule A - Cost of Goods Sold. Enter method of inventory valuation 1 Inventory at beginning of year ~~~ 1 6 Inventory at end of year ~~~~~~~~~~~~ 6 2 Purchases ~~~~~~~~~~~ 2 7 Cost of goods sold. Subtract line 6 3 Cost of labor~~~~~~~~~~~ 3 from line 5. Enter here and in Part I, 4 a Additional section 263A costs line 2 ~~~~~~~~~~~~~~~~~~~~ 7 (attach schedule) ~~~~~~~~ 4a 8 Do the rules of section 263A (with respect to b Other costs (attach schedule) ~~~ 4b property produced or acquired for resale) apply to 5 Total. Add lines 1 through 4b 5 the organization? Schedule C - Rent Income (From Real Property and Personal Property Leased With Real Property) (see instructions) 1. Description of property N/A Yes No (1) (2) (3) (4) (1) (2) (3) (4) Total (a) 2. From personal property (if the percentage of rent for personal property is more than 10% but not more than 50%) Rent received or accrued (b) From real and personal property (if the percentage of rent for personal property exceeds 50% or if the rent is based on profit or income) 0. Total 0. (c) Total income. Add totals of columns 2(a) and 2(b). Enter (b) Total deductions. Enter here and on page 1, here and on page 1, Part I, line 6, column (A) Part I, line 6, column (B) (see instructions) Schedule E - Unrelated Debt-Financed Income 1. Description of debt-financed property 2. Gross income from or allocable to debtfinanced property (a) 3. 3(a) Deductions directly connected with the income in columns 2(a) and 2(b) (attach schedule) Deductions directly connected with or allocable to debt-financed property Straight line depreciation (attach schedule) (b) Other deductions (attach schedule) (1) (2) (3) (4) 4. Amount of average acquisition 5. Average adjusted basis 6. Column 4 divided 7. Gross income 8. Allocable deductions debt on or allocable to debt-financed of or allocable to by column 5 reportable (column (column 6 x total of columns property (attach schedule) debt-financed property 2 x column 6) 3(a) and 3(b)) (attach schedule) (1) (2) (3) (4) Totals ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter here and on page 1, Part I, line 7, column (A). Total dividends-received deductions included in column 8 % % % % 0. Enter here and on page 1, Part I, line 7, column (B) Form 0-T (2016)

4 BILL & MELINDA GATES FOUNDATION TRUST Form 0-T (2016) Schedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations Exempt Controlled Organizations (see instructions) 1. Name of controlled organization 2. Employer 3. Net unrelated income 4. Total of specified 5. Part of column 4 that is 6. Deductions directly identification (loss) (see instructions) payments made included in the controlling connected with income number organization's gross income in column 5 Page 4 (1) (2) (3) (4) Nonexempt Controlled Organizations 7. Taxable Income 8. Net unrelated income (loss). Total of specified payments 10. Part of column that is included 11. Deductions directly connected (see instructions) made in the controlling organization's with income in column 10 gross income (1) (2) (3) (4) Totals J Schedule G - Investment Income of a Section 501(c)(7), (), or (17) Organization (see instructions) (1) (2) (3) (4) 1. Description of exploited activity 1. Description of income 2. Amount of income 2. Gross unrelated business income from trade or business Enter here and on page 1, Part I, line 10, col. (A). 3. Expenses directly connected with production of unrelated business income Enter here and on page 1, Part I, line 10, col. (B). Enter here and on page 1, Part I, line, column (A). Totals Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income (see instructions) (1) (2) (3) (4) 4. Net income (loss) from unrelated trade or business (column 2 minus column 3). If a gain, compute cols. 5 through 7. Totals Schedule J - Advertising Income (see instructions) Part I Income From Periodicals Reported on a Consolidated Basis Add columns 5 and 10. Enter here and on page 1, Part I, line 8, column (A). Add columns 6 and 11. Enter here and on page 1, Part I, line 8, column (B). 3. Deductions Total deductions directly connected 4. Set-asides 5. and set-asides (attach schedule) (attach schedule) (col. 3 plus col. 4) 5. Gross income from activity that 6. Expenses attributable to is not unrelated column 5 business income Enter here and on page 1, Part I, line, column (B) Excess exempt expenses (column 6 minus column 5, but not more than column 4). Enter here and on page 1, Part II, line Name of periodical 2. Gross Direct advertising 3. advertising costs income 4. Advertising gain or (loss) (col. 2 minus col. 3). If a gain, compute cols. 5 through Circulation 6. income Readership costs 7. Excess readership costs (column 6 minus column 5, but not more than column 4). (1) (2) (3) (4) Totals (carry to Part II, line (5)) Form 0-T (2016)

5 BILL & MELINDA GATES FOUNDATION TRUST 1. Name of periodical 2. Gross Direct advertising 3. advertising costs income 4. Advertising gain or (loss) (col. 2 minus col. 3). If a gain, compute cols. 5 through Circulation 6. income Form 0-T (2016) Part II Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in columns 2 through 7 on a line-by-line basis.) Readership costs Page 7. Excess readership costs (column 6 minus column 5, but not more than column 4). 5 (1) (2) (3) (4) Totals from Part I 1. Name Enter here and on page 1, Part I, line 11, col. (A). Enter here and on page 1, Part I, line 11, col. (B). Totals, Part II (lines 1-5) Schedule K - Compensation of Officers, Directors, and Trustees Title (see instructions) 3. Percent of 4. time devoted to business Enter here and on page 1, Part II, line 27. Compensation attributable to unrelated business 0. (1) (2) (3) (4) SEE STATEMENT 23 Total. Enter here and on page 1, Part II, line 14 % % % % 0. Form 0-T (2016)

6 SCHEDULE I (Form 1041) Department of the Treasury Internal Revenue Service Interest Taxes Attach to Form Information about Schedule I (Form 1041) and its separate instructions is at Miscellaneous itemized deductions (from Form 1041, line 15c) Refund of taxes Interest from specified private activity bonds exempt from the regular tax Qualified small business stock (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exercise of incentive stock options (excess of AMT income over regular tax income) Other estates and trusts (amount from Schedule K-1 (Form 1041), box 12, code A) ~~~~~~~~~~~~~~~~~~~~~ Electing large partnerships (amount from Schedule K-1 (Form 1065-B), box 6) ~~~~~~~~~~~~~~~~~~~~~~~ Disposition of property (difference between AMT and regular tax gain or loss) ~~~~~~~~~~~~~~~~~~~~~~~ Depreciation on assets placed in service after 186 (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~ Passive activities (difference between AMT and regular tax income or loss) ~~~~~~~~~~~~~~~~~~~~~~~~ Loss limitations (difference between AMT and regular tax income or loss) ~~~~~~~~~~~~~~~~~~~~~~~~~ Circulation costs (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Long-term contracts (difference between AMT and regular tax income) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Mining costs (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Research and experimental costs (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~~~~~~ Income from certain installment sales before January 1, 187 Intangible drilling costs preference ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other adjustments, including income-based related adjustments Alternative tax net operating loss deduction (See the instructions for the limitation that applies.) Adjusted alternative minimum taxable income. Combine lines 1 through 24 Note: Complete Part II below before going to line 26. Income distribution deduction from Part II, line 44 ~~~~~~~~~~~~~~~~~~~~~ Estate tax deduction (from Form 1041, line 1) Add lines 26 and 27 Estate's or trust's share of alternative minimum taxable income. Subtract line 28 from line 25 If line 2 is: $175,450 or more, enter the amount from line 2 on line 51 and go to line 52. Part II Income Distribution Deduction on a Minimum Tax Basis LHA $23,00 or less, stop here and enter -0- on Form 1041, Schedule G, line 1c. The estate or trust isn't liable for the alternative minimum tax. Over $23,00, but less than $175,450, go to line 45. Adjusted alternative minimum taxable income (see instructions) Alternative Minimum Tax - Estates and Trusts ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Adjusted tax-exempt interest (other than amounts included on line 8) ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total net gain from Schedule D (Form 1041), line 1, column (1). If a loss, enter -0- Capital gains for the tax year allocated to corpus and paid or permanently set aside for charitable purposes (from Form 1041, Schedule A, line 4) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Capital gains paid or permanently set aside for charitable purposes from gross income (see instructions) OMB No Name of estate or trust Employer identification number BILL & MELINDA GATES FOUNDATION TRUST Part I Estate's or Trust's Share of Alternative Minimum Taxable Income 1 Adjusted total income or (loss) (from Form 1041, line 17) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1 -,384. Capital gains computed on a minimum tax basis included on line 25 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 35 ( ) Capital losses computed on a minimum tax basis included on line 25. Enter as a positive amount ~~~~~~~~~~~~~~ 36 Distributable net alternative minimum taxable income (DNAMTI). Combine lines 30 through 36. If zero or less, enter -0- ~~~~~ 37 Income required to be distributed currently (from Form 1041, Schedule B, line ) ~~~~~~~~~~~~~~~~~~~~~ 38 Other amounts paid, credited, or otherwise required to be distributed (from Form 1041, Schedule B, line 10) ~~~~~~~~~~ 3 Total distributions. Add lines 38 and 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax-exempt income included on line 40 (other than amounts included on line 8) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Depletion (difference between regular tax and AMT) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Net operating loss deduction. Enter as a positive amount ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE STATEMENT 24 ~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ Tentative income distribution deduction on a minimum tax basis. Subtract line 41 from line 40 For Paperwork Reduction Act Notice, see the Instructions for Form Schedule I (Form 1041) (2016) N/A N/A N/A ( ) ( ) ( ) -,384. -,

7 Schedule I (Form 1041) (2016) Part II Income Distribution Deduction on a Minimum Tax Basis BILL & MELINDA GATES FOUNDATION TRUST N/A (continued) 43 Tentative income distribution deduction on a minimum tax basis. Subtract line 31 from line 37. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Income distribution deduction on a minimum tax basis. Enter the smaller of line 42 or line 43. Enter here and on line Part III Alternative Minimum Tax Exemption amount 45 $23,00.00 Enter the amount from line 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 46 Phase-out of exemption amount ~~~~~~~~~~~~~~~~~~~~~~~~~ 47 $7, Subtract line 47 from line 46. If zero or less, enter -0- ~~~~~~~~~~~~~~~~ 48 Multiply line 48 by 25% (0.25) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 4 from line 45. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 50 from line 46 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Go to Part IV of Schedule I to figure line 52 if the estate or trust has qualified dividends or has a gain on lines 18a and 1 of column (2) of Schedule D (Form 1041) (as refigured for the AMT, if necessary). Otherwise, if line 51 is - $186,300 or less, multiply line 51 by 26% (0.26). Over $186,300, multiply line 51 by 28% (0.28) and subtract $3,726 from the result ~~~~~~~~~~~~~~~~~~ Alternative minimum foreign tax credit (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tentative minimum tax. Subtract line 53 from line 52 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the tax from Form 1041, Schedule G, line 1a (minus any foreign tax credit from Schedule G, line 2a) ~~~~~~~~~ 56 Alternative minimum tax. Subtract line 55 from line 54. If zero or less, enter -0-. Enter here and on Form 1041, Schedule G, line 1c Part IV Line 52 Computation Using Maximum Capital Gains Rates Caution: If you didn't complete Part V of Schedule D (Form 1041), the Schedule D Tax Worksheet, or the Qualified Dividends Tax Worksheet in the Instructions for Form 1041, see the instructions before completing this part. Enter the amount from line 51 Enter the amount from Schedule D (Form 1041), line 26, line 13 of the Schedule D Tax Worksheet, or line 4 of the Qualified Dividends Tax Worksheet in the Instructions for Form 1041, whichever applies (as refigured for the AMT, if necessary) ~~~~~~~~ Enter the amount from Schedule D (Form 1041), line 18b, column (2) (as refigured for the AMT, if necessary). If you didn't complete Schedule D for the regular tax or the AMT, enter -0- ~~~~~~~~~~~~~~~~ If you didn't complete a Schedule D Tax Worksheet for the regular tax or the AMT, enter the amount from line 58. Otherwise, add lines 58 and 5 and enter the smaller of that result or the amount from line 10 of the Schedule D Tax Worksheet (as refigured for the AMT, if necessary) ~~~~~~~~~~~~~~~~~ Enter the smaller of line 57 or line 60 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 61 from line 57 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If line 62 is $186,300 or less, multiply line 62 by 26% (0.26). Otherwise, multiply line 62 by 28% (0.28) and subtract $3,726 from the result Maximum amount subject to the 0% rate ~~~~~~~~~~~~~~~~~~~~~ 64 $2, Enter the amount from line 27 of Schedule D (Form 1041), line 14 of the Schedule D Tax Worksheet, or line 5 of the Qualified Dividends Tax Worksheet in the Instructions for Form 1041, whichever applies (as figured for the regular tax). If you didn't complete Schedule D or either worksheet for the regular tax, enter the amount from Form 1041, line 22; if zero or less, enter -0- ~~~~~~~~~~~~~~~~~ Subtract line 65 from line 64. If zero or less, enter -0- ~~~~~~~~~~~~~~~ Enter the smaller of line 57 or line 58 ~~~~~~~~~~~~~~~~~~~~~~ Enter the smaller of line 66 or line 67. This amount is taxed at 0% ~~~~~~~~~~ 68 6 Subtract line 68 from line Schedule I (Form 1041) (2016) Page 2

8 Schedule I (Form 1041) (2016) Part IV Line 52 Computation Using Maximum Capital Gains Rates (continued) Maximum amount subject to rates below 20% ~~~~~~~~~~~~~~~~~~~ 70 $12, Enter the amount from line 66 ~~~~~~~~~~~~~~~~~~~~~~~~~ 71 Enter the amount from line 27 of Schedule D (Form 1041), line 18 of the Schedule D Tax Worksheet, or line 5 of the Qualified Dividends Tax Worksheet, whichever applies (as figured for the regular tax). If you didn't complete Schedule D or either worksheet for the regular tax, enter the amount from Form 1041, line 22; if zero or less, enter -0- ~~~~~~~~~~ 72 Add line 71 and line 72 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 73 from line 70. If zero or less, enter -0- ~~~~~~~~~~~~~~~~ Enter the smaller of line 6 or 74 ~~~~~~~~~~~~~~~~~~~~~~~~ 75 Multiply line 75 by 15% (0.15) Add lines 68 and 75 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 77 If lines 77 and 57 are the same, skip lines 78 through 82 and go to line 83. Otherwise, go to line 78. Subtract line 77 from line 67 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 78 Multiply line 78 by 20% (0.20) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If line 5 is zero or blank, skip lines 80 through 82 and go to line 83. Otherwise, go to line 80. Add lines 62, 77, and 78 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 80 Subtract line 80 from line 57 ~~~~~~~~~~~~~~~~~~~~~~~~~~ 81 Multiply line 81 by 25% (0.25) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 63, 76, 7, and 82 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If line 57 is $186,300 or less, multiply line 57 by 26% (0.26). Otherwise, multiply line 57 by 28% (0.28) and subtract $3,726 from the result ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the smaller of line 83 or line 84 here and on line 52 Page Schedule I (Form 1041) (2016)

9 SCHEDULE D (Form 1041) Department of the Treasury Internal Revenue Service Name of estate or trust Capital Gains and Losses Attach to Form 1041, Form 5227, or Form 0-T. Use Form 84 to list your transactions for lines 1b, 2, 3, 8b, and 10. Information about Schedule D and its separate instructions is at OMB No Employer identification number BILL & MELINDA GATES FOUNDATION TRUST Note: Form 5227 filers need to complete only Parts I and II. Part I Short-Term Capital Gains and Losses - Assets Held One Year or Less See instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off cents to whole dollars. 1 a Totals for all short-term transactions reported on Form 10-B for 2 3 which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 84, leave this line blank and go to line 1b 1 b Totals for all transactions reported on Form(s) 84 with Box A checked Totals for all transactions reported on Form(s) 84 with Box B checked Totals for all transactions reported on Form(s) 84 with Box C checked (d) (e) (g) Cost (or other basis) Proceeds (sales price) Adjustments to gain or loss from Form(s) 84, Part I, line 2, column (g) (h) Gain or (loss) Subtract column (e) from column (d) and combine the result with column (g) 4 Short-term capital gain or (loss) from Forms 4684, 6252, 6781, and 8824 ~~~~~~~~~~~~~~~~~~~~~~~~~ Net short-term gain or (loss) from partnerships, S corporations, and other estates or trusts Short-term capital loss carryover. Enter the amount, if any, from line of the 2015 Capital Loss Carryover Worksheet ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6 ( ) Net short-term capital gain or (loss). Combine lines 1a through 6 in column (h). Enter here and on line 17, Box D checked Box E checked Box F checked ~~~~~~~~~~~~~~~~~ column (3) on page 2 Part II Long-Term Capital Gains and Losses - Assets Held More Than One Year See instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off cents to whole dollars. 8 a Totals for all long-term transactions reported on Form 10-B for which basis was reported to the IRS and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on Form 84, leave this line blank and go to line 8b 8 b Totals for all transactions reported on Form(s) 84 with Totals for all transactions reported on Form(s) 84 with Totals for all transactions reported on Form(s) 84 with (d) (e) (g) Cost (or other basis) Proceeds (sales price) 5 7 Adjustments to gain or loss from Form(s) 84, Part II, line 2, column (g) (h) Gain or (loss) Subtract column (e) from column (d) and combine the result with column (g) 11 Long-term capital gain or (loss) from Forms 243, 4684, 6252, 6781, and 8824 ~~~~~~~~~~~~~~~~~~~~~~ Net long-term gain or (loss) from partnerships, S corporations, and other estates or trusts ~~~~~~~~~~~~~~~~~~ Capital gain distributions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Gain from Form 477, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14 Long-term capital loss carryover. Enter the amount, if any, from line 14 of the 2015 Capital Loss Carryover Worksheet ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 15 ( ) Net long-term capital gain or (loss). Combine lines 8a through 15 in column (h). Enter here and on line 18a, column (3) on page ,032. 2, LHA For Paperwork Reduction Act Notice, see the Instructions for Form Schedule D (Form 1041) 2016

10 Schedule D (Form 1041) 2016 Part III Summary of Parts I and II 17 Net short-term gain or (loss) 18 Net long-term gain or (loss): a Total for year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ b Unrecaptured section 1250 gain (see line 18 of the wrksht.) ~~~~~~~~~~~~ c 28% rate gain ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ a 18b 18c (1) Beneficiaries' (2) Estate's (3) Total or trust's 1 Total net gain or (loss). Combine lines 17 and 18a ~~~~~~~~~~~~~ 1 Note: If line 1, column (3), is a net gain, enter the gain on Form 1041, line 4 (or Form 0-T, Part I, line 4a). If lines 18a and 1, column (2), are net gains, go to Part V, and don't complete Part IV. If line 1, column (3), is a net loss, complete Part IV and the Capital Loss Carryover Worksheet, as necessary. Part IV Capital Loss Limitation 20 Enter here and enter as a (loss) on Form 1041, line 4 (or Form 0-T, Part I, line 4c, if a trust), the smaller of: a The loss on line 1, column (3) or b $3,000 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 20 ( ) Note: If the loss on line 1, column (3), is more than $3,000, or if Form 1041, page 1, line 22 (or Form 0-T, line 34), is a loss, complete the Capital Loss Carryover Worksheet in the instructions to figure your capital loss carryover. Form 1041 filers. Complete this part only if both lines 18a and 1 in column (2) are gains, or an amount is entered in Part I or Part II and there is an entry on Form 1041, line 2b(2), and Form 1041, line 22, is more than zero. Caution: Skip this part and complete the Schedule D Tax Worksheet Form 0-T trusts. Complete this part only if both lines 18a and 1 are gains, or qualified dividends are included in income in Part I of Form 0-T, and Form 0-T, line 34, is more than zero. Skip this part and complete the Schedule D Tax Worksheet in the instructions if either line 18b, col. (2) or line 18c, col. (2) is more than zero Part V Caution: Read the instructions before completing this part. Either line 18b, col. (2) or line 18c, col. (2) is more than zero, or Both Form 1041, line 2b(1), and Form 452, line 4g are more than zero. Enter the smaller of line 18a or 1 in column (2) Enter the smaller of the amount on line 21 or $2,550 Enter the smaller of the amount on line 27 or line 28 Enter the smaller of line 21 or line 26 ~~~~~~~~~~~~~~~~~~~~~~~ Enter the smaller of line 21 or $12,400 ~~~~~~~~~~~~~~~~~~~~~~~~~ Enter taxable income from Form 1041, line 22 (or Form 0-T, line 34) but not less than zero ~~~~~~~~~~~~~~ Enter the estate's or trust's qualified dividends from Form 1041, line 2b(2) (or enter the qualified dividends included in income in Part I of Form 0-T)~~~~~ Add lines 22 and 23 ~~~~~~~~~~~~~~~ If the estate or trust is filing Form 452, enter the amount from line 4g; otherwise, enter -0- ~~~ Enter the smaller of line 32 or line 35 ~~~~~~~~~~~~~~~~~~~~~~~ Tax on all taxable income. Enter the smaller of line 43 or line 44 here and on Form 1041, Schedule in the instructions if: ~~~~~~~~ Subtract line 25 from line 24. If zero or less, enter -0- ~~~~~~~~~~~~~~~~ Subtract line 26 from line 21. If zero or less, enter -0- ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~ 30 Subtract line 2 from line 28. If zero or less, enter -0-. This amount is taxed at 0% Subtract line 30 from line 26 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ Add lines 27 and 30 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 34 from line 33. If zero or less, enter -0- Multiply line 36 by 15% (0.15) Enter the amount from line 31 ~~~~~~~~~~~~~~~~ Add lines 30 and 36 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 3 from line 38. If zero or less, enter -0- Multiply line 40 by 20% (0.20) BILL & MELINDA GATES FOUNDATION TRUST Tax Computation Using Maximum Capital Gains Rates ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~ Figure the tax on the amount on line 27. Use the 2016 Tax Rate Schedule for Estates and Trusts (see the Schedule G instructions in the instructions for Form 1041) Add lines 37, 41, and 42 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Figure the tax on the amount on line 21. Use the 2016 Tax Rate Schedule for Estates ~~~~~ and Trusts (see the Schedule G instructions in the instructions for Form 1041) ~~~~~ G, line 1a (or Form 0-T, line 36) Page 2 2,00. 2,00. 2,00. 2,00. Schedule D (Form 1041) 2016

11 Form Department of the Treasury Internal Revenue Service Name(s) shown on return Sales of Business Property (Also Involuntary Conversions and Recapture Amounts Under Sections 17 and 280F(b)(2)) Attach to your tax return. Information about Form 477 and its separate instructions is at (a) Description (b) Date acquired (c) Date sold (d) Gross sales of property (mo., day, yr.) (mo., day, yr.) price (e) Depreciation allowed or allowable since acquisition (f) Cost or other basis, plus improvements and expense of sale OMB No Attachment Sequence No. Identifying number 1 Enter the gross proceeds from sales or exchanges reported to you for 2016 on Form(s) 10-B or 10-S (or substitute statement) that you are including on line 2, 10, or 20 1 Part I Sales or Exchanges of Property Used in a Trade or Business and Involuntary Conversions From Other Than Casualty or Theft-Most Property Held More Than 1 Year (see instructions) Partnerships (except electing large partnerships) and S corporations. Report the gain or (loss) following the instructions for Form 1065, Schedule K, line 10, or Form 1120S, Schedule K, line. Skip lines 8,, 11, and 12 below. Individuals, partners, S corporation shareholders, and all others. If line 7 is zero or a loss, enter the amount from line 7 on line 11 below and skip lines 8 and. If line 7 is a gain and you didn't have any prior year section 1231 losses, or they were recaptured in an earlier year, enter the gain from line 7 as a long-term capital gain on the Schedule D filed with your return and skip lines 8,, 11, and 12 below. Part II BILL & MELINDA GATES FOUNDATION TRUST Gain, if any, from Form 4684, line 3~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Section 1231 gain from installment sales from Form 6252, line 26 or 37~~~~~~~~~~~~~~~~~~~~~~ Section 1231 gain or (loss) from like-kind exchanges from Form 8824 ~~~~~~~~~~~~~~~~~~~~~~~ Gain, if any, from line 32, from other than casualty or theft ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Combine lines 2 through 6. Enter the gain or (loss) here and on the appropriate line as follows: ~~~~~~~~~~ (g) Gain or (loss) Subtract (f) from the sum of (d) and (e) STRATEGIC PARTNERS II, LP - PASSIVE 2,10. TOWER SQUARE CAPITAL PARTNERS II, LP - PAL -77. Nonrecaptured net section 1231 losses from prior years. See instructions ~~~~~~~~~~~~~~~~~~~~ Subtract line 8 from line 7. If zero or less, enter -0-. If line is zero, enter the gain from line 7 on line 12 below. If line is more than zero, enter the amount from line 8 on line 12 below and enter the gain from line as a long-term capital gain on the Schedule D filed with your return. See instructions Ordinary Gains and Losses (see instructions) 27 2,032. 2, Ordinary gains and losses not included on lines 11 through 16 (include property held 1 year or less): a b LHA Loss, if any, from line 7 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11 ( ) Gain, if any, from line 7 or amount from line 8, if applicable ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 12 Gain, if any, from line 31~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Net gain or (loss) from Form 4684, lines 31 and 38a ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Ordinary gain from installment sales from Form 6252, line 25 or 36 ~~~~~~~~~~~~~~~~~~~~~~~~ Ordinary gain or (loss) from like-kind exchanges from Form 8824 ~~~~~~~~~~~~~~~~~~~~~~~~~ Combine lines 10 through 16 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ For all except individual returns, enter the amount from line 17 on the appropriate line of your return and skip lines a and b below. For individual returns, complete lines a and b below: If the loss on line 11 includes a loss from Form 4684, line 35, column (b)(ii), enter that part of the loss here. Enter the part of the loss from income-producing property on Schedule A (Form 1040), line 28, and the part of the loss from property used as an employee on Schedule A (Form 1040), line 23. Identify as from "Form 477, line 18a." See instructions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Redetermine the gain or (loss) on line 17 excluding the loss, if any, on line 18a. Enter here and on Form 1040, line 14 For Paperwork Reduction Act Notice, see separate instructions. Form 477 (2016) a 18b

12 Form 477 (2016) BILL & MELINDA GATES FOUNDATION TRUST Part III Gain From Disposition of Property Under Sections 1245, 1250, 1252, 1254, and 1255 (see instructions) Page 2 1 (a) Description of section 1245, 1250, 1252, 1254, or 1255 property: A B C D (b) Date acquired (mo., day, yr.) (c) Date sold (mo., day, yr.) These columns relate to the properties on lines 1A through 1D. Property A Property B Property C Property D Gross sales price ( Note: See line 1 before completing.) 20 Cost or other basis plus expense of sale If section 1245 property: ~~~~ Depreciation (or depletion) allowed or allowable ~ Adjusted basis. Subtract line 22 from line 21 ~~ Total gain. Subtract line 23 from line 20 a Depreciation allowed or allowable from line 22 ~ b Enter the smaller of line 24 or 25a 26 If section 1250 property: If straight line depreciation was used, enter -0- on line 26g, except for a corporation subject to section a 25b a Additional depreciation after 175. See instructions ~ b Applicable percentage multiplied by the smaller of line 24 or line 26a. See instructions ~~~~~ c Subtract line 26a from line 24. If residential rental property or line 24 isn't more than line 26a, skip lines 26d and 26e ~~~~~~~~~~~~~~~ d Additional depreciation after 16 and before 176 ~~ e Enter the smaller of line 26c or 26d ~~~~~~ 26a 26b 26c 26d 26e f g 27 a b Section 21 amount (corporations only) ~~~~ Add lines 26b, 26e, and 26f If section 1252 property: Skip this section if you didn't dispose of farmland or if this form is being completed for a partnership (other than an electing large partnership). Soil, water, and land clearing expenses ~~~~~ Line 27a multiplied by applicable percentage ~~~~~ c Enter the smaller of line 24 or 27b 28 If section 1254 property: a Intangible drilling and development costs, expenditures for development of mines and other natural deposits, mining exploration costs, and depletion. See instructions b Enter the smaller of line 24 or 28a 2 If section 1255 property: a Applicable percentage of payments excluded from income under section 126. See instructions b Enter the smaller of line 24 or 2a. See instructions Summary of Part III Gains. 26f 26g 27a 27b 27c 28a 28b 2a 2b Complete property columns A through D through line 2b before going to line Total gains for all properties. Add property columns A through D, line 24 ~~~~~~~~~~~~~~~~~~~~~ from other than casualty or theft on Form 477, line 6 32 Part IV Recapture Amounts Under Sections 17 and 280F(b)(2) When Business Use Drops to 50% or Less (see instructions) Add property columns A through D, lines 25b, 26g, 27c, 28b, and 2b. Enter here and on line 13 Section 17 expense deduction or depreciation allowable in prior years ~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~ Subtract line 31 from line 30. Enter the portion from casualty or theft on Form 4684, line 33. Enter the portion Recomputed depreciation. See instructions Recapture amount. Subtract line 34 from line 33. See the instructions for where to report (a) Section (b) Section 280F(b)(2) Form 477 (2016)

13 Form 5884 (Rev. December 2016) Department of the Treasury Internal Revenue Service Name(s) shown on return Work Opportunity Credit OMB No Attach to your tax return. Attachment Information about Form 5884 and its separate instructions is at Sequence No. 77 Identifying number BILL & MELINDA GATES FOUNDATION TRUST Enter on the applicable line below the total qualified first- or second-year wages paid or incurred during the tax year, and multiply by the percentage shown, for services of employees who are certified as members of a targeted group. a Qualified first-year wages of employees who worked for you at least 120 hours but fewer than 400 hours ~~~~~~~~~~~~~~~ $ x 25% (0.25) 1a b Qualified first-year wages of employees who worked for you at least 400 hours ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ $ x 40% (0.40) 1b c Qualified second-year wages of employees certified as long-term family assistance recipients ~~~~~~~~~~~~~~~~~~~~ $ x 50% (0.50) 1c 2 Add lines 1a, 1b, and 1c. See instructions for the adjustment you must make to salaries and wages ~~~~~ 2 3 Work opportunity credit from partnerships, S corporations, cooperatives, estates, and SEE STATEMENT 25 trusts (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 2 and 3. Cooperatives, estates, and trusts, go to line 5. Partnerships and S corporations, stop here and report this amount on Schedule K. All others, stop here and report this amount on Form 3800, Part III, line 4b ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ SEE STATEMENT Amount allocated to patrons of the cooperative or beneficiaries of the estate or trust (see instructions) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 5 6 Cooperatives, estates, and trusts, subtract line 5 from line 4. Report this amount on Form 3800, Part III, line 4b For Paperwork Reduction Act Notice, see separate instructions. 6 Form 5884 (Rev ) LHA

14 OMB No Credit for Increasing Research Activities Form 6765 Attach to your tax return Department of the Treasury Attachment Internal Revenue Service Information about Form 6765 and its separate instructions is at Sequence No. 81 Name(s) shown on return Identifying number BILL & MELINDA GATES FOUNDATION TRUST Section A - Regular Credit. Skip this section and go to Section B if you are electing or previously elected (and are not revoking) the alternative simplified credit Enter fixed-base percentage, but not more than 16% (0.16) ~~~~~~~~~~~~~ 10 % Enter the smaller of line 13 or line 14 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ statement that must be attached Section B - Alternative Simplified Credit. Skip this section if you are completing Section A Certain amounts paid or incurred to energy consortia Basic research payments to qualified organizations Qualified organization base period amount Subtract line 3 from line 2. If zero or less, enter -0- ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~ Wages for qualified services (do not include wages used in figuring the work opportunity credit) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Cost of supplies Rental or lease costs of computers ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the applicable percentage of contract research expenses ~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~ Total qualified research expenses. Add lines 5 through 8 ~~~~~~~~~~~~~~ Enter average annual gross receipts ~~~~~~~~~~~~~~~~~~~~~~~ Multiply line 11 by the percentage on line 10 ~~~~~~~~~~~~~~~~~~~ Subtract line 12 from line. If zero or less, enter -0- ~~~~~~~~~~~~~~~~ Multiply line by 50% (0.50) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 1, 4, and 15 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Are you electing the reduced credit under section 280C? Yes No If "Yes," multiply line 16 by 13% (0.13). If "No," multiply line 16 by 20% (0.20) and see the instructions for the statement that must be attached. Members of controlled groups or businesses under common control: see instructions for the Certain amounts paid or incurred to energy consortia Basic research payments to qualified organizations ~~~~~~~~~~~~~~~~ 1 Qualified organization base period amount ~~~~~~~~~~~~~~~~~~~~ 20 Subtract line 20 from line 1. If zero or less, enter -0- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 18 and 21 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Multiply line 22 by 20% (0.20) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Wages for qualified services (do not include wages used in figuring the work opportunity credit) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Cost of supplies ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Rental or lease costs of computers Enter the applicable percentage of contract research expenses Total qualified research expenses. Add lines 24 through 27 ~~~~~~~~~~~~~ Enter your total qualified research expenses for the prior 3 tax years. If you had no qualified research expenses in any one of those years, skip lines 30 and 31 ~~~~~~ Divide line 2 by 6.0 ~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 30 from line 28. If zero or less, enter -0- ~~~~~~~~~~~~~~~ Multiply line 31 by 14% (0.14). If you skipped lines 30 and 31, multiply line 28 by 6% (0.06) LHA For Paperwork Reduction Act Notice, see separate instructions. Form 6765 (2016)

15 Form 6765 (2016) Page 2 Section B - Alternative Simplified Credit (continued) Add lines 23 and 32 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Are you electing the reduced credit under section 280C? Yes No If "Yes," multiply line 33 by 65% (0.65). If "No," enter the amount from line 33 and see the line 17 instructions for the statement that must be attached. Members of controlled groups or businesses under common control: see instructions for the statement that must be attached Section C - Current Year Credit Enter the portion of the credit from Form 832, line 2, that is attributable to wages that were also used to figure the credit on line 17 or line 34 (whichever applies) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line 35 from line 17 or line 34 (whichever applies). If zero or less, enter -0- Credit for increasing research activities from partnerships, S corporations, estates, and trusts ~~~~~~~~~~~~~~~~~ STATEMENT 26 ~~~~~~~~~~~~~ Add lines 36 and 37 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Estates and trusts, go to line 3. Partnerships and S corporations not electing the payroll tax credit, stop here and report this amount on Schedule K. Partnerships and S corporations electing the payroll tax credit, complete Section D and report on Schedule K the amount on this line reduced by the amount on line 44. Eligible small businesses, stop here and report the credit on Form 3800, Part III, line 4i. See instructions for the definition of eligible small business. Filers other than eligible small businesses, stop here and report the credit on Form 3800, Part III, line 1c. Note: Qualified small business filers, other than partnerships and S corporations, electing the payroll tax credit must complete Form 3800 before completing Section D. Amount allocated to beneficiaries of the estate or trust ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Estates and trusts, subtract line 3 from line 38. For eligible small businesses, report the credit on Form 3800, Part III, line 4i. See instructions. For filers other than eligible small businesses, report the credit on Form 3800, Part III, line 1c Section D - Qualified Small Business Payroll Tax Election and Payroll Tax Credit. Skip this section if the payroll tax election does not apply. See instructions Check this box if you are a qualified small business electing the payroll tax credit. See instructions Enter the portion of line 36 elected as a payroll tax credit (do not enter more than $250,000). See instructions ~~~~~~ General business credit carryforward from the current year (see instructions). Partnerships and S corporations skip this line and go to line 44 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Partnerships and S corporations, enter the smaller of line 36 or line 42. All others, enter the smallest of line 36, line 42, or line 43. Enter here and on Form 874, line 5. Members of controlled groups or businesses under common control: see instructions for the statement that must be attached , Form 6765 (2016)