DUAL-STATUS RETURN U.S. Nonresident Alien Income Tax Return LEE F DUT X. MN Foreign province/county

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1 DUAL-STATUS RETURN U.S. Nonresident Alien Income Tax Return OMB No For the year January 1-December 31, 2011, or other tax year Department of the Treasury Internal Revenue Service beginning, 2011, and ending, 20 Your first name and initial Last name Identifying number (see instructions) Form 1040NR Please print or type. LEE F DUT Present home address (number, street, and apt. no., or rural route). If you have a P.O. box, see instructions. Check if: Individual HYPO STREET City, town or post office, state, and ZIP code. If you have a foreign address, see instructions. Foreign country name MN Foreign province/county Estate or Trust Foreign postal code Filing Status Check only one box. 1 Single resident of Canada or Mexico or single U.S. national 2 Other single nonresident alien 3 Married resident of Canada or Mexico or married U.S. national If you checked box 3 or 4 above, enter the information below. (i) Spouse's first name and initial (ii) Spouse's last name Married resident of South Korea Other married nonresident alien Qualifying widow(er) with dependent child (see instructions) (iii) Spouse's identifying number Exemptions If more than four dependents, see instructions. Income Effectively Connected With U.S. Trade/ Business Attach Form(s) W-2, 1042-S, SSA-1042S, RRB-1042S, and 8288-A here. Also attach Form(s) 1099-R if tax was withheld. Enclose, but do not attach, any payment. Adjusted Gross Income 7 a Yourself. If someone can claim you as a dependent, do not check box 7a b Spouse. Check box 7b only if you checked box 3 or 4 above and your spouse did not Boxes checked on 7a and 7b have any U.S. gross income No. of children on c Dependents: (see instructions) (3) Dependent's (4) if qualifying (2) Dependent's relationship child for child tax 7c who: identifying number (1) First name Last name to you credit (see instr.) lived with you did not live with you due to divorce or separation Dependents on 7c not entered above d Total number of exemptions claimed 9b 10b 16a 16b Taxable amount (see instructions) 17a 17b Taxable amount (see instructions) Wages, salaries, tips, etc. Attach Form(s) W-2 9 a Taxable interest b Tax-exempt interest. Do not include on line 9a 10 a Ordinary dividends b Qualified dividends (see instructions) Taxable refunds, credits, or offsets of state and local income taxes (see instructions) Scholarship and fellowship grants. Attach Form(s) 1042-S or required statement (see instructions) Business income or (loss). Attach Schedule C or C-EZ (Form 1040) Capital gain or (loss). Attach Schedule D (Form 1040) if required. If not required, check here Other gains or (losses). Attach Form a IRA distributions 17 a Pensions and annuities Rental real estate, royalties, partnerships, trusts, etc. Attach Schedule E (Form 1040) Farm income or (loss). Attach Schedule F (Form 1040) Unemployment compensation Other income. List type and amount (see instructions) Total income exempt by a treaty from page 5, Schedule OI, Item L (1)(e) Combine the amounts in the far right column for lines 8 through 21. This is your total effectively connected income Educator expenses (see instructions) Health savings account deduction. Attach Form 8889 Moving expenses. Attach Form 3903 Deductible part of self-employment tax. Attach Schedule SE (Form 1040) Self-employed SEP, SIMPLE, and qualified plans Self-employed health insurance deduction (see instructions) Penalty on early withdrawal of savings Scholarship and fellowship grants excluded IRA deduction (see instructions) Student loan interest deduction (see instructions) 34 Domestic production activities deduction. Attach Form Add lines 24 through Subtract line 35 from line 23. This is your adjusted gross income 8 9a 10a b 17b Add numbers on lines above For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see instructions. Form 1040NR (2011) 1A

2 Form 1040NR (2011) Page 2 Tax and Credits FORM ,866. Other Taxes Payments Amount from line 36 (adjusted gross income) Itemized deductions from page 3, Schedule A, line 15 Subtract line 38 from line 37 Exemptions (see instructions) Taxable income. Subtract line 40 from line 39. If line 40 is more than line 39, enter -0- Tax (see instructions). Check if any tax is from: Alternative minimum tax (see instructions). Attach Form 6251 Add lines 42 and 43 a Form(s) 8814 b Form Foreign tax credit. Attach Form 1116 if required Credit for child and dependent care expenses. Attach Form 2441 Retirement savings contributions credit. Attach Form 8880 Child tax credit (see instructions) Residential energy credits. Attach Form Other credits from Form: a 3800 b 8801 c Add lines 45 through 50. These are your total credits FORM , Subtract line 51 from line 44. If line 51 is more than line 44, enter Tax on income not effectively connected with a U.S. trade or business from page 4, Schedule NEC, line Self-employment tax. Attach Schedule SE (Form 1040) 55 Unreported social security and Medicare tax from Form: a 4137 b Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required 57 Transportation tax (see instructions) 58 a Household employment taxes from Schedule H (Form 1040) b First-time homebuyer credit repayment from Form 5405 if required 59 Other taxes. Enter code(s) from instructions 60 Add lines 52 through 59. This is your total tax 61 Federal income tax withheld from: a Form(s) W-2 and a b Form(s) b c Form(s) 8288-A 61c d Form(s) 1042-S 61d estimated tax payments and amount applied from 2010 return Additional child tax credit. Attach Form Amount paid with request for extension to file (see instructions) Excess social security and tier 1 RRTA tax withheld (see instructions) Credit for federal tax paid on fuels. Attach Form Credits from Form: a 2439 b 8839 c 8801 d Credit for amount paid with Form 1040-C Add lines 61a through 68. These are your total payments If line 69 is more than line 60, subtract line 60 from line 69. This is the amount you overpaid 70 Refund 71 a Amount of line 70 you want refunded to you. If Form 8888 is attached, check here 71a Direct deposit? See b Routing number c Type: Checking Savings instructions. d Account number Amount You Owe Third Party Designee Sign Here Keep a copy of this return for your records. Paid Preparer e If you want your refund check mailed to an address outside the United States not shown on page 1, enter it here. Amount of line 70 you want applied to your 2012 estimated tax 72 Amount you owe. Subtract line 69 from line 60. For details on how to pay, see instructions 73 Yes. Complete below. Personal identification number (PIN) DILIPA N. MAIYA Estimated tax penalty (see instructions) 74 Do you want to allow another person to discuss this return with the IRS (see instructions)? Designee's Phone name no. Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Date Your occupation in the United States Print/Type preparer's name Preparer's signature PTIN Check if self-employed DILIPA N. MAIYA Firm's name Use Only Firm's EIN Firm's address Phone no. 1A a 58b , , ,640. 1, , ,657. FORM ,382. FORM , ,382. 1,725. 1,725. P No Form 104NR (2011)

3 Form 1040NR (2011) Page 3 Schedule A - Itemized Deductions (see instructions) 07 Caution: If you made a gift and received a benefit in return, see instructions. Taxes You Paid 1 State and local income taxes 1 Gifts to U.S. Charities 2 Gifts by cash or check. If you made any gift of $250 or more, see instructions 2 3 Other than by cash or check. If you made any gift of $250 or more, see instructions. You must attach Form 8283 if the amount of your deduction is over $ Carryover from prior year 4 5 Add lines 2 through 4 5 Casualty and Theft Losses 6 Casualty or theft loss(es). Attach Form See instructions 6 Job Expenses and Certain Miscellaneous Deductions 7 Unreimbursed employee expenses - job travel, union dues, job education, etc. You must attach Form 2106 or Form 2106-EZ if required. See instructions 7 8 Tax preparation fees 8 9 Other expenses. See instructions for expenses to deduct here. List type and amount Other Miscellaneous Deductions 10 Add lines 7 through Enter the amount from Form 1040NR, line Multiply line 11 by 2% (.02) Subtract line 12 from line 10. If line 12 is more than line 10, enter Other - see instructions for expenses to deduct here. List type and amount 9 Total Itemized Deductions 15 Add the amounts in the far right column for lines 1 through 14. Also enter this amount on Form 1040NR, line Form 1040NR (2011) 1A

4 Schedule NEC - Tax on Income Not Effectively Connected With a U.S. Trade or Business (see instructions) Enter amount of income under the appropriate rate of tax (see instructions) Form 1040NR (2011) Page a b a b c a b Dividends paid by: U.S. corporations Foreign corporations Interest: Mortgage Paid by foreign corporations Other Nature of income Industrial royalties (patents, trademarks, etc.) Motion picture or T.V. copyright royalties Other royalties (copyrights, recording, publishing, etc.) Real property income and natural resources royalties Pensions and annuities Social security benefits Capital gain from line 18 below Gambling - Residents of Canada only. Enter net income in column (c). If zero or less, enter -0-. Winnings Losses Gambling winnings - Residents of countries other than Canada. Note. Losses not allowed Other (specify) Add lines 1a through 12 in columns (a) through (d) 1a 1b 2a 2b 2c c 11 (a) 10% (b) 15% (c) 30% Multiply line 13 by rate of tax at top of each column 14 Tax on income not effectively connected with a U.S. trade or business. Add columns (a) through (d) of line 14. Enter the total here and on Form 1040NR, line Enter only the capital gains and losses from property sales or exchanges that are from sources within the United States and not effectively connected with a U.S. business. Do not include a gain or loss on disposing of a U.S. real property interest; report these gains and losses on Schedule D (Form 1040). 16 Capital Gains and Losses From Sales or Exchanges of Property (a) Kind of property and description (b) Date (c) Date (if necessary, attach statement of acquired sold (d) Sales price descriptive details not shown below) (mo., day, yr.) (mo., day, yr.) (d) Other (specify) % % (f) LOSS (g) GAIN (e) Cost or other If (e) is more If (d) is more basis than (d), subtract (d) than (e), subtract (e) from (e) from (d) Report property sales or exchanges that are effectively 17 Add columns (f) and (g) of line ( ) connected with a U.S. business on Schedule D (Form 1040), Form 4797, or both. 18 Capital gain. Combine columns (f) and (g) of line 17. Enter the net gain here and on line 9 above (if a loss, enter -0-) 18 Form 1040NR (2011) 1A

5 Form 1040NR (2011) Page 5 A B Schedule OI - Other Information (see instructions) Answer all questions Of what country or countries were you a citizen or national during the tax year? In what country did you claim residence for tax purposes during the tax year? C Have you ever applied to be a green card holder (lawful permanent resident) of the United States? Yes No D BRAZIL Were you ever: 1. A U.S. citizen? 2. A green card holder (lawful permanent resident) of the United States? If you answer "Yes" to (1) or (2), see Pub. 519, chapter 4, for expatriation rules that apply to you. US UNTIL 09/08/2011 Yes Yes No No E F If you had a visa on the last day of the tax year, enter your visa type. If you did not have a visa, enter your U.S. immigration status on the last day of the tax year. L-1 Have you ever changed your visa type (nonimmigrant status) or U.S. immigrant status? If you answered "Yes," indicate the date and nature of the change. N/A Yes No G List all dates you entered and left the United States during 2011 (see instructions). Note. If you are a resident of Canada or Mexico AND commute to work in the United States at frequent intervals, check the box for Canada or Mexico and skip to item H Canada Mexico Date entered United States mm/dd/yy Date departed United States mm/dd/yy Date entered United States mm/dd/yy Date departed United States mm/dd/yy 02/13/ /22/ /10/ /22/ /22/ /08/2011 H I J K L Give number of days (including vacation, nonworkdays, and partial days) you were present in the United States during: , 2010, and 2011 Did you file a U.S. income tax return for any prior year? Yes No If "Yes," give the latest year and form number you filed 2010 FORM 1040 Are you filing a return for a trust? Yes No If "Yes," did the trust have a U.S. or foreign owner under the grantor trust rules, make a distribution or loan to a U.S. person, or receive a contribution from a U.S. person? Yes No Did you receive total compensation of $250,000 or more during the tax year? If "Yes," did you use an alternative method to determine the source of this compensation? Income Exempt from Tax - If you are claiming exemption from income tax under a U.S. income tax treaty with a foreign country, complete (1) and (2) below. See Pub. 901 for more information on tax treaties. 1. Enter the name of the country, the applicable tax treaty article, the number of months in prior years you claimed the treaty benefit, and the amount of exempt income in the columns below. Attach Form 8833 if required (see instructions). (a) Country (b) Tax treaty article (c) Number of months claimed in prior tax years. Yes Yes No No (d) Amount of exempt income in current tax year N/A N/A (e) Total. Enter this amount on Form 1040NR, line 22. Do not enter it on line 8 or line Were you subject to tax in a foreign country on any of the income shown in 1(d) above? Yes No Form 1040NR (2011) 1A

6 Form 1040 Department of the Treasury - Internal Revenue Service (99) U.S. Individual Income Tax Return OMB No IRS Use Only - Do not write or staple in this space. For the year Jan. 1-Dec. 31, 2011, or other tax year beginning, 2011, ending, 20 See separate instructions. Your first name and initial Last name Your social security number LEE F DUT If a joint return, spouse's first name and initial Last name Spouse's social security number Home address (number and street). If you have a P.O. box, see instructions. Apt. no. Make sure the SSN(s) above and on line 6c are correct. HYPO STREET City, town or post office, state, and ZIP code. If you have a foreign address, also complete spaces below (see instructions). Presidential Election Campaign Foreign country name Foreign province/county Foreign postal code 1 Single 4 Filing Status 2 Married filing jointly (even if only one had income) Check here if you, or your spouse if filing jointly, want $3 to go to this fund. Checking a box below will not change your tax or refund. You Spouse Head of household (with qualifying person). (See instructions.) If the qualifying person is a child but not your dependent, enter this Check only one 3 Married filing separately. Enter spouse's SSN above child's name here. box. and full name here. FERNANDA DUT 5 Qualifying widow(er) with dependent child Boxes checked Exemptions 6a Yourself. If someone can claim you as a dependent, do not check box 6a on 6a and 6b No. of children b Spouse on 6c who: c Dependents: (4) if child under age 17 (2) Dependent's (3) Dependent's lived with you qualifying for child tax credit social security number relationship to you did not live with (1) First name Last name (see instructions) you due to divorce or separation (see instructions) If more than four dependents, see instructions and check here Income Attach Form(s) W-2 here. Also attach Forms W-2G and 1099-R if tax was withheld. If you did not get a W-2, see instructions. Enclose, but do not attach, any payment. Also, please use Form 1040-V. Adjusted Gross Income a mn Dependents on 6c not entered above Add numbers on d Total number of exemptions claimed lines above Wages, salaries, tips, etc. Attach Form(s) W-2 STMT 1 7 a Taxable interest. Attach Schedule B if required 8a b Tax-exempt interest. Do not include on line 8a 8b a Ordinary dividends. Attach Schedule B if required 9a b Qualified dividends 9b Taxable refunds, credits, or offsets of state and local income taxes STMT 2 10 Alimony received 11 Business income or (loss). Attach Schedule C or C-EZ 12 Capital gain or (loss). Attach Schedule D if required. If not required, check here 13 Other gains or (losses). Attach Form a IRA distributions 15a b Taxable amount 15b a Pensions and annuities 16a b Taxable amount 16b Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E 17 Farm income or (loss). Attach Schedule F 18 Unemployment compensation 19 a Social security benefits 20a b Taxable amount 20b Other income. List type and amount 21 Combine the amounts in the far right column for lines 7 through 21. This is your total income 22 Educator expenses 23 Certain business expenses of reservists, performing artists, and fee-basis government officials. Attach Form 2106 or 2106-EZ 24 Health savings account deduction. Attach Form Moving expenses. Attach Form Deductible part of self-employment tax. Attach Schedule SE 27 Self-employed SEP, SIMPLE, and qualified plans 28 Self-employed health insurance deduction 29 Penalty on early withdrawal of savings 30 Alimony paid b Recipient's SSN 31a IRA deduction 32 Student loan interest deduction 33 Tuition and fees. Attach Form Domestic production activities deduction. Attach Form Add lines 23 through Subtract line 36 from line 22. This is your adjusted gross income For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see separate instructions. Form 1040 (2011) 1A RS DUAL-STATUS STATEMENT NRA 1 96, , ,499.

7 39a Check You were born before January 2, 1947, Blind. Total boxes if: Spouse was born before January 2, 1947, Blind. checked 39a b If your spouse itemizes on a separate return or you were a dual-status alien, check here 39b 40 Itemized deductions (from Schedule A) or your standard deduction (see left margin) Exemptions. Multiply $3,700 by the number on line 6d 43 Taxable income. Subtract line 42 from line 41. If line 42 is more than line 41, enter Tax (see instructions). Check if any from: a Form(s) 8814 b Form 4972 c 962 election 45 Alternative minimum tax (see instructions). Attach Form Add lines 44 and Foreign tax credit. Attach Form 1116 if required 1, Credit for child and dependent care expenses. Attach Form Education credits from Form 8863, line Retirement savings contributions credit. Attach Form Child tax credit (see instructions) Residential energy credits. Attach Form Other credits from Form: a 3800 b 8801 c Add lines 47 through 53. These are your total credits 55 Subtract line 54 from line 46. If line 54 is more than line 46, enter Self-employment tax. Attach Schedule SE 57 Unreported social security and Medicare tax from Form: a 4137 b Additional tax on IRAs, other qualified retirement plans, etc. Attach Form 5329 if required 59a Household employment taxes from Schedule H b First-time homebuyer credit repayment. Attach Form 5405 if required 60 Other taxes. Enter code(s) from instructions 61 Add lines 55 through 60. This is your total tax 62 Federal income tax withheld from Forms W-2 and , estimated tax payments and amount applied from 2010 return 63 64a Earned income credit (EIC) 64a b Nontaxable combat pay election 64b 65 Additional child tax credit. Attach Form American opportunity credit from Form 8863, line First-time homebuyer credit from Form 5405, line Amount paid with request for extension to file Excess social security and tier 1 RRTA tax withheld Credit for federal tax on fuels. Attach Form Add lines 62, 63, 64a, and 65 through 71. These are your total payments Form 1040 (2011) Page 2 Tax and Credits 38 Amount from line 37 (adjusted gross income) 38 Standard Deduction for - Subtract line 40 from line 38 People who check any box on line 39a or 39b or who can be claimed as a dependent, see instructions. All others: 47 Single or Married filing separately, $5,800 Married filing jointly or Qualifying widow(er), $11,600 Head of household, $8,500 Other Taxes Payments If you have a qualifying child, attach Schedule EIC. 71 Credits from Form: a 2439 b 8839 c 8801 d Refund 73 If line 72 is more than line 61, subtract line 61 from line 72. This is the amount you overpaid 73 74a Amount of line 73 you want refunded to you. If Form 8888 is attached, check here 74a Direct deposit? b Routing number c Type: Checking Savings See d Account number instructions. 75 Amount of line 73 you want applied to your 2012 estimated tax 75 Amount 76 Amount you owe. Subtract line 72 from line 61. For details on how to pay, see instructions 76 You Owe 77 Estimated tax penalty (see instructions) 77 Do you want to allow another person to discuss this return with the IRS (see instructions)? Yes. Complete below. No Third Party Designee's Phone Personal identification Designee name DILIPA N. MAIYA no number (PIN) Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Here Your signature Date Your occupation Daytime phone number Joint return? See instructions. If the IRS sent you an Identity Protection Keep a copy for Spouse's signature. If a joint return, both must sign. Date Spouse's occupation PIN, enter it here your records. (see inst.) Paid Preparer Use Only 1A ,499. STATEMENT ONLY Print/Type preparer's name Preparer's signature Date Check if PTIN DILIPA N. MAIYA self-employed Firm's name Firm's EIN Firm's address Phone no a 59b , ,566. 3, ,866. 1, ,382. P Form 1040 (2011)

8 SCHEDULE A (Form 1040) Itemized Deductions OMB No Department of the Treasury Attachment Attach to Form See Instructions for Schedule A (Form 1040). Internal Revenue Service (99) Sequence No. 07 Name(s) shown on Form 1040 Medical and Dental Expenses Taxes You Paid Caution. Do not include expenses reimbursed or paid by others. 1 Medical and dental expenses (see instructions) 1 2 Enter amount from Form 1040, line Multiply line 2 by 7.5% (.075) 3 4 Subtract line 3 from line 1. If line 3 is more than line 1, enter State and local (check only one box): a Income taxes, or STMT 3 5 4,933. b General sales taxes 6 Real estate taxes (see instructions) 6 7 Personal property taxes 7 8 Other taxes. List type and amount 9 Add lines 5 through 8 9 Interest 10 Home mortgage interest and points reported to you on Form 1098 You Paid 11 Home mortgage interest not reported to you on Form If paid to the person from whom you bought the home, see instructions and show that person's name, identifying no., and address 8 10 Your social security number LEE F DUT ,933. Note. Your mortgage interest deduction may be limited (see instructions). 12 Points not reported to you on Form See instructions for special rules 13 Mortgage insurance premiums (see instructions) Investment interest. Attach Form 4952 if required. (See instructions.) Add lines 10 through Gifts by cash or check. If you made any gift of $250 or more, see instructions 17 Other than by cash or check. If any gift of $250 or more, see instructions. You must attach Form 8283 if over $ Carryover from prior year 18 Gifts to Charity 16 If you made a gift and got a benefit for it, see instructions. Casualty and Theft Losses Job Expenses and Certain Miscellaneous Deductions Other Miscellaneous Deductions Total Itemized Deductions 19 Add lines 16 through Casualty or theft loss(es). Attach Form (See instructions.) Unreimbursed employee expenses - job travel, union dues, job education, etc. Attach Form 2106 or 2106-EZ if required. (See instructions.) Tax preparation fees Other expenses - investment, safe deposit box, etc. List type and amount Add lines 21 through Enter amount from Form , line , Multiply line 25 by 2% (.02) 26 1, Subtract line 26 from line 24. If line 26 is more than line 24, enter Other - from list in instructions. List type and amount Add the amounts in the far right column for lines 4 through 28. Also, enter this amount on Form 1040, line If you elect to itemize deductions even though they are less than your standard deduction, check here For Paperwork Reduction Act Notice, see Form 1040 instructions. Schedule A (Form 1040) ,933. 1A

9 SCHEDULE B (Form 1040A or 1040) Department of the Treasury Internal Revenue Service (99) Name(s) shown on return Interest and Ordinary Dividends OMB No Attach to Form 1040A or See instructions on back. Attachment Sequence No. 08 Your social security number LEE F DUT Part I 1 List name of payer. If any interest is from a seller-financed mortgage and the Amount Interest buyer used the property as a personal residence, see instructions on back and list this interest first. Also, show that buyer's social security number and address (See instructions on back and the instructions for Form 1040A, or Form 1040, line 8a.) Note. If you received a Form 1099-INT, Form 1099-OID, or substitute statement from a brokerage firm, list the firm's name as the payer and enter the total interest 2 Add the amounts on line 1 shown on that 2 form. 3 Excludable interest on series EE and I U.S. savings bonds issued after Attach Form Subtract line 3 from line 2. Enter the result here and on Form 1040A, or Form 1040, line 8a 4 Note. If line 4 is over $1,500, you must complete Part III. Part II 5 List name of payer Ordinary Dividends (See instructions on back and the instructions for Form 1040A, or Form 1040, line 9a.) Note. If you received a Form 1099-DIV or substitute statement from a brokerage firm, list the firm's name as the payer and enter the ordinary 6 Add the amounts on line 5. Enter the total here and on Form 1040A, or Form dividends shown 1040, line 9a 6 on that form. Part III Foreign Accounts and Trusts (See instructions on back.) Note. If line 6 is over $1,500, you must complete Part III. You must complete this part if you (a) had over $1,500 of taxable interest or ordinary dividends; (b) had a foreign account; or (c) received a distribution from, or were a grantor of, or a transferor to, a foreign trust. 1 5 Amount 7a At any time during 2011, did you have a financial interest in or signature authority over a financial account (such as a bank account, securities account, or brokerage account) located a foreign country? See instructions If "Yes," are you required to file Form TD F to report that financial interest or signature authority? See Form TD F and its instructions for filing and exceptions to those requirements b If you are required to file Form TD F , enter the name of the foreign country where the financial account is located 8 During 2011, did you receive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If "Yes," you may have to file Form See instructions on back Yes No For Paperwork Reduction Act Notice, see your tax return instructions. Schedule B (Form 1040A or 1040) A

10 Income Compensation Dividends Interest Business income - Sch. C Short-term capital gains Long-term capital gains Ordinary gain - Form 4797 Pensions and annuities Partnerships/S corps / E & T Rents and royalties Farm income Section 911 Exclusions Miscellaneous income Other income HTKO U.S./Foreign Source Taxable Income Reconciliation Total U.S. Other Income 96, , , Passive Income Lump-sum Distributions Sec. 901(j) Income Re-sourced Treaty Inc. Excluded & Exempt Income: Section 911 Exclusions Section 119 meal exclusion Section 933 P.R. exclusion Other excluded income Gross income for allocation of deductions 96, , ,265. Less Excl. & Exempt Income: Section 911 Exclusions Section 119 meal exclusion Section 933 P.R. exclusion Other excluded income Special capital gain adjustment Total income - Form , , ,265. 1A

11 Expenses/Deductions Short-term capital loss Long-term capital loss Short-term capital loss c/o Long-term capital loss c/o Disallowed capital loss Business expenses Rent & royalty expenses U.S./Foreign Source Taxable Income Reconciliation Partnership/S corp/e & T Exp. Employee business exp.-pshp Farm expenses Ordinary loss (Form 4797) Miscellaneous deductions Other expenses Educator expenses Certain business expenses Health Savings account deduction Moving expenses Deductible part of SE tax Keogh/SEP deduction Self-employed Health Insurance Penalty on early withdrawal Alimony paid IRA deduction Student Loan Interest deduction Tuition and fees Domestic production activities HTKO Foreign housing cost deduction Other adjustments Total U.S. Other Income Passive Income Lump-sum Distributions Sec. 901(j) Income Re-sourced Treaty Inc. Adjusted gross income 96, , ,265. Itemized deductions: Directly allocable Ratably allocable Interest expense 4,933. 4, Losses from Foreign Sources Taxable income before personal exemptions 91, ,826. 9,740. 1A

12 1116 Foreign Tax Credit OMB No Form (Individual, Estate, or Trust) Attach to Form 1040, 1040NR, 1041, or 990-T. Department of the Treasury Attachment Internal Revenue Service (99) See separate instructions. Sequence No. 19 Name Identifying number as shown on page 1 of your tax return Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. Check only one box on each Form Report all amounts in U.S. dollars except where specified in Part II below. a Passive category income c b General category income d Section 901(j) income Certain income re-sourced by treaty e Lump-sum distributions f Resident of (name of country) Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes to more than one foreign country or U.S. possession, use a separate column and line for each country or possession. Part I Taxable Income or Loss From Sources Outside the United States (for Category Checked Above) g Enter the name of the foreign country or U.S. possession 1a Gross income from sources within country shown above and of the type checked above (see instructions): b Check if line 1a is compensation for personal services as an employee, your total compensation from all sources is $250,000 or more, and you used an alternative basis to determine its source (see instructions) Deductions and losses (Caution: See instructions): 2 Expenses definitely related to the income on line 1a (attach statement) 3 Pro rata share of other deductions not definitely related: a Certain itemized deductions or standard deduction (see instructions) b Other deductions (attach statement) c Add lines 3a and 3b d Gross foreign source income (see instructions) e Gross income from all sources (see instructions) f Divide line 3d by line 3e (see instructions) g Multiply line 3c by line 3f 4 Pro rata share of interest expense (see instructions): Foreign Country or U.S. Possession A B C a Home mortgage interest (use worksheet page 14 of the instructions) b Other interest expense 5 Losses from foreign sources 6 Add lines 2, 3g, 4a, 4b, and Subtract line 6 from line 1a. Enter the result here and on line 15, page 2 Part II Country Foreign Taxes Paid or Accrued (see instructions) Credit is claimed for taxes (you must check one) (h) (i) Paid (j) Date paid or accrued Accrued In foreign currency Foreign taxes paid or accrued Taxes withheld at source on: (n) Other foreign taxes Taxes withheld at source on: (k) Dividends (l) Rents paid or (p) Rents and royalties accrued and royalties (q) Interest In U.S. dollars 1a 6 7 (r) Other foreign taxes paid or accrued Total (Add cols. A, B, and C.) (s) Total foreign taxes paid or accrued (add cols. (o) through (r)) A B C 8 Add lines A through C, column (s). Enter the total here and on line 9, page 2 8 For Paperwork Reduction Act Notice, see instructions. Form 1116 (2011) LEE F DUT 12/31/2011 BRAZIL BRAZIL 10,265. 4,933. 4, , , ,265. SEE SOURCING STATEMENT ,

13 Part III Figuring the Credit Form 1116 (2011) Page STMT 4 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I 9 Carryback or carryover (attach detailed computation) Add lines 9 and 10 Reduction in foreign taxes (see instructions) Taxes reclassified under high tax kickout (see instructions) ( ) 14 Combine lines 11, 12, and 13. This is the total amount of foreign taxes available for credit 15 Enter the amount from line 7. This is your taxable income or (loss) from sources outside the United States (before adjustments) for the category of income checked above Part I (see instructions) 15 Adjustments to line 15 (see instructions) 16 Combine the amounts on lines 15 and 16. This is your net foreign source taxable income. (If the result is zero or less, you have no foreign tax credit for the category of income you checked above Part I. Skip lines 18 through 22. However, if you are filing more than one Form 1116, you must complete line 20.) 17 Individuals: Enter the amount from Form 1040, line 41, or Form 1040NR, line 39. Estates and trusts: Enter your taxable income 18 without the deduction for your exemption Caution: If you figured your tax using the lower rates on qualified dividends or capital gains, see instructions. 19 Divide line 17 by line 18. If line 17 is more than line 18, enter "1" 20 Individuals: Enter the amount from Form 1040, line 44. If you are a nonresident alien, enter the amount from Form 1040NR, line 42. Estates and trusts: Enter the amount from Form 1041, Schedule G, line 1a, or the total of Form 990-T, lines 36 and 37 Caution: If you are completing line 20 for separate category e (lump-sum distributions), see instructions. 21 Multiply line 20 by line 19 (maximum amount of credit) 22 Enter the smaller of line 14 or line 21. If this is the only Form 1116 you are filing, skip lines 23 through 27 and enter this amount on line 28. Otherwise, complete the appropriate line in Part IV (see instructions) Part IV Summary of Credits From Separate Parts III (see instructions) ,814. 3,814. 9,740. 9, ,566. Credit for taxes on passive category income 23 Credit for taxes on general category income 24 Credit for taxes on certain income re-sourced by treaty 25 Credit for taxes on lump-sum distributions 26 Add lines 23 through 26 Enter the smaller of line 20 or line 27 Reduction of credit for international boycott operations. See instructions for line 12 Subtract line 29 from line 28. This is your foreign tax credit. Enter here and on Form 1040, line 47; Form 1040NR, line 45; Form 1041, Schedule G, line 2a; or Form 990-T, line 40a , ,983. Form 1116 (2011) , ,640. 1,983. 1,

14 1116 ALTERNATIVE MINIMUM TA Foreign Tax Credit OMB No Form (Individual, Estate, or Trust) Attach to Form 1040, 1040NR, 1041, or 990-T. Department of the Treasury Attachment Internal Revenue Service (99) See separate instructions. Sequence No. 19 Name Identifying number as shown on page 1 of your tax return Use a separate Form 1116 for each category of income listed below. See Categories of Income in the instructions. Check only one box on each Form Report all amounts in U.S. dollars except where specified in Part II below. a Passive category income c b General category income d Section 901(j) income Certain income re-sourced by treaty e Lump-sum distributions f Resident of (name of country) Note: If you paid taxes to only one foreign country or U.S. possession, use column A in Part I and line A in Part II. If you paid taxes to more than one foreign country or U.S. possession, use a separate column and line for each country or possession. Part I Taxable Income or Loss From Sources Outside the United States (for Category Checked Above) g Enter the name of the foreign country or U.S. possession 1a Gross income from sources within country shown above and of the type checked above (see instructions): b Check if line 1a is compensation for personal services as an employee, your total compensation from all sources is $250,000 or more, and you used an alternative basis to determine its source (see instructions) Deductions and losses (Caution: See instructions): 2 Expenses definitely related to the income on line 1a (attach statement) 3 Pro rata share of other deductions not definitely related: a Certain itemized deductions or standard deduction (see instructions) b Other deductions (attach statement) c Add lines 3a and 3b d Gross foreign source income (see instructions) e Gross income from all sources (see instructions) f Divide line 3d by line 3e (see instructions) g Multiply line 3c by line 3f 4 Pro rata share of interest expense (see instructions): Foreign Country or U.S. Possession A B C a Home mortgage interest (use worksheet page 14 of the instructions) b Other interest expense 5 Losses from foreign sources 6 Add lines 2, 3g, 4a, 4b, and 5 7 Subtract line 6 from line 1a. Enter the result here and on line 15, page 2 Part II Country Foreign Taxes Paid or Accrued (see instructions) Credit is claimed for taxes (you must check one) (h) (i) Paid (j) Date paid or accrued Accrued In foreign currency Foreign taxes paid or accrued Taxes withheld at source on: (n) Other foreign taxes Taxes withheld at source on: (k) Dividends (l) Rents paid or (p) Rents and royalties accrued and royalties (q) Interest In U.S. dollars 1a 6 7 (r) Other foreign taxes paid or accrued Total (Add cols. A, B, and C.) (s) Total foreign taxes paid or accrued (add cols. (o) through (r)) A B C 8 Add lines A through C, column (s). Enter the total here and on line 9, page 2 8 For Paperwork Reduction Act Notice, see instructions. Form 1116 (2011) LEE F DUT 12/31/2011 BRAZIL BRAZIL 10, , , , ,

15 Part III ALTERNATIVE MINIMUM TA Figuring the Credit Form 1116 (2011) Page STMT 6 Enter the amount from line 8. These are your total foreign taxes paid or accrued for the category of income checked above Part I 9 Carryback or carryover (attach detailed computation) Add lines 9 and 10 Reduction in foreign taxes (see instructions) Taxes reclassified under high tax kickout (see instructions) ( ) 14 Combine lines 11, 12, and 13. This is the total amount of foreign taxes available for credit 15 Enter the amount from line 7. This is your taxable income or (loss) from sources outside the United States (before adjustments) for the category of income checked above Part I (see instructions) 15 Adjustments to line 15 (see instructions) 16 Combine the amounts on lines 15 and 16. This is your net foreign source taxable income. (If the result is zero or less, you have no foreign tax credit for the category of income you checked above Part I. Skip lines 18 through 22. However, if you are filing more than one Form 1116, you must complete line 20.) 17 Individuals: Enter the amount from Form 1040, line 41, or Form 1040NR, line 39. Estates and trusts: Enter your taxable income 18 without the deduction for your exemption Caution: If you figured your tax using the lower rates on qualified dividends or capital gains, see instructions. 19 Divide line 17 by line 18. If line 17 is more than line 18, enter "1" 20 Individuals: Enter the amount from Form 1040, line 44. If you are a nonresident alien, enter the amount from Form 1040NR, line 42. Estates and trusts: Enter the amount from Form 1041, Schedule G, line 1a, or the total of Form 990-T, lines 36 and 37 Caution: If you are completing line 20 for separate category e (lump-sum distributions), see instructions. 21 Multiply line 20 by line 19 (maximum amount of credit) 22 Enter the smaller of line 14 or line 21. If this is the only Form 1116 you are filing, skip lines 23 through 27 and enter this amount on line 28. Otherwise, complete the appropriate line in Part IV (see instructions) Part IV Summary of Credits From Separate Parts III (see instructions) ,865. 4, , , ,459. Credit for taxes on passive category income 23 Credit for taxes on general category income 24 Credit for taxes on certain income re-sourced by treaty 25 Credit for taxes on lump-sum distributions 26 Add lines 23 through 26 Enter the smaller of line 20 or line 27 Reduction of credit for international boycott operations. See instructions for line 12 Subtract line 29 from line 28. This is your foreign tax credit. Enter here and on Form 1040, line 47; Form 1040NR, line 45; Form 1041, Schedule G, line 2a; or Form 990-T, line 40a , ,787. Form 1116 (2011) , ,796. 1,787. 1,

16 Form 6251 Department of the Treasury Internal Revenue Service (99) Name(s) shown on Form 1040 or Form 1040NR Alternative Minimum Tax - Individuals See separate instructions. Attach to Form 1040 or Form 1040NR. OMB No Attachment Sequence No. 32 Your social security number LEE F DUT Part I Alternative Minimum Taxable Income (See instructions for how to complete each line.) zero or less, enter -0-2 Taxes from Schedule A (Form 1040), line 9 3 Enter the home mortgage interest adjustment, if any, from line 6 of the worksheet in the instructions for this line 4 Miscellaneous deductions from Schedule A (Form 1040), line Tax refund from Form 1040, line 10 or line 21 7 ( ) Investment interest expense (difference between regular tax and AMT) 8 Depletion (difference between regular tax and AMT) 9 Net operating loss deduction from Form 1040, line 21. Enter as a positive amount 10 Alternative tax net operating loss deduction 11 ) ( Interest from specified private activity bonds exempt from the regular tax 12 Qualified small business stock (7% of gain excluded under section 1202) 13 Exercise of incentive stock options (excess of AMT income over regular tax income) 14 Estates and trusts (amount from Schedule K-1 (Form 1041), box 12, code A) 15 Electing large partnerships (amount from Schedule K-1 (Form 1065-B), box 6) 16 Disposition of property (difference between AMT and regular tax gain or loss) 17 Depreciation on assets placed in service after 1986 (difference between regular tax and AMT) 18 Passive activities (difference between AMT and regular tax income or loss) 19 Loss limitations (difference between AMT and regular tax income or loss) 20 Circulation costs (difference between regular tax and AMT) 21 Long-term contracts (difference between AMT and regular tax income) 22 Mining costs (difference between regular tax and AMT) 23 Research and experimental costs (difference between regular tax and AMT) 24 Income from certain installment sales before January 1, ( ) Intangible drilling costs preference 26 Other adjustments, including income-based related adjustments 27 1 If filing Schedule A (Form 1040), enter the amount from Form 1040, line 41 and go to line 2. Otherwise, enter the amount from Form 1040, line 38, and go to line 7. (If less than zero, enter as a negative amount.) 1 2 Medical and dental. Enter the smaller of Schedule A (Form 1040), line 4, or 2.5% (.025) of Form 1040, line 38. If Skip this line. It is reserved for future use Alternative minimum taxable income. Combine lines 1 through 27. (If married filing separately and line 28 is more than $223,900, see instructions.) Part II Alternative Minimum Tax (AMT) 29 Exemption. (If you were under age 24 at the end of 2011, see instructions.) IF your filing status is... AND line 28 is not over... THEN enter on line Single or head of household $112,500 $48,450 Married filing jointly or qualifying widow(er) 150,000 74,450 Married filing separately 75,000 37,225 If line 28 is over the amount shown above for your filing status, see instructions Subtract line 29 from line 28. If more than zero, go to line 31. If zero or less, enter -0- here and on lines 31, 33, and 35, and go to line If you are filing Form 2555 or 2555-EZ, see instructions for the amount to enter. If you reported capital gain distributions directly on Form 1040, line 13; you reported qualified dividends on Form 1040, line 9b; or you had a gain on both lines 15 and 16 of Schedule D (Form 1040) (as refigured for the AMT, if necessary), complete Part III on the back and enter the amount from line 54 here. All others: If line 30 is $175,000 or less ($87,500 or less if married filing separately), multiply line 30 by 26% (.26). Otherwise, multiply line 30 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result. 32 Alternative minimum tax foreign tax credit (see instructions) Tentative minimum tax. Subtract line 32 from line Tax from Form 1040, line 44 (minus any tax from Form 4972 and any foreign tax credit from Form 1040, line 47). If you used Schedule J to figure your tax, the amount from line 44 of Form 1040 must be refigured without using Schedule J (see instructions) AMT. Subtract line 34 from line 33. If zero or less, enter -0-. Enter here and on Form 1040, line 45 For Paperwork Reduction Act Notice, see your tax return instructions. Form 6251 (2011) ,566. 4, ,459. STMT 8 31, , ,796. 1, , ,

17 Form 6251 (2011) Page 2 Part III Tax Computation Using Maximum Capital Gains Rates Complete Part III only if you are required to do so by line 31 or by the Foreign Earned Income Tax Worksheet in the instructions Enter the amount from Form 6251, line 30. If you are filing Form 2555 or 2555-EZ, enter the amount from line 3 of the worksheet in the instructions for this line 37 Enter the amount from line 6 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 13 of the Schedule D Tax Worksheet in the instructions for Schedule D (Form 1040), whichever applies (as refigured for the AMT, if necessary) (see instructions). If you are filing Form 2555 or 2555-EZ, see instructions for the amount to enter Enter the amount from Schedule D (Form 1040), line 19 (as refigured for the AMT, if necessary) (see instructions). If you are filing Form 2555 or 2555-EZ, see instructions for the amount to enter If you did not complete a Schedule D Tax Worksheet for the regular tax or the AMT, enter the amount from line 37. Otherwise, add lines 37 and 38, 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). If you are filing Form 2555 or 2555-EZ, see instructions for the amount to enter Enter the smaller of line 36 or line Subtract line 40 from line If line 41 is $175,000 or less ($87,500 or less if married filing separately), multiply line 41 by 26% (.26). Otherwise, multiply line 41 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result Enter: $69,000 if married filing jointly or qualifying widow(er), $34,500 if single or married filing separately, or $46,250 if head of household. 43 Enter the amount from line 7 of the Qualified Dividends and Capital Gain Tax Worksheet in the instructions for Form 1040, line 44, or the amount from line 14 of the Schedule D Tax Worksheet in the instructions for Schedule D (Form 1040), whichever applies (as figured for the regular tax). If you did not complete either worksheet for the regular tax, enter Subtract line 44 from line 43. If zero or less, enter Enter the smaller of line 36 or line Enter the smaller of line 45 or line Subtract line 47 from line Multiply line 48 by 15% (.15) If line 38 is zero or blank, skip lines 50 and 51 and go to line 52. Otherwise, go to line Subtract line 46 from line Multiply line 50 by 25% (.25) Add lines 42, 49, and If line 36 is $175,000 or less ($87,500 or less if married filing separately), multiply line 36 by 26% (.26). Otherwise, multiply line 36 by 28% (.28) and subtract $3,500 ($1,750 if married filing separately) from the result Enter the smaller of line 52 or line 53 here and on line 31. If you are filing Form 2555 or 2555-EZ, do not enter this amount on line 31. Instead, enter it on line 4 of the worksheet in the instructions for line Form 6251 (2011)