U.S. Income Tax Return for an S Corporation. 2 Cost of goods sold (attach Form 1125-A)...

Transcription

1 orm 110 U.. Income Tax Return for an orporation OM o o not file this form unless the corporation has filed or is attaching orm 55 to elect to be an corporation. Information about orm 110 and its separate instructions is at or calendar year 016 or tax year beginning, 016, ending, election effective date 016 epartment of the Treasury Internal Revenue ervice 1/01/015 usiness activity code number (see instrs) heck if chedule M- attached TYP OR PRIT mployer identification number uckeye onsulting, Inc. 015 ational hampions r uckeye, Z 856 ate incorporated Total assets (see instructions) 1/01/015 $ Is the corporation electing to be an corporation beginning with this tax year? H Yes o 1,000,000. If 'Yes,' attach orm 55 if not already filed () () inal return ame change ddress change (5) mended return election termination or revocation I nter the number of shareholders who were shareholders during any part of the tax year aution. Include only trade or business income and expenses on lines 1a through 1. ee the instructions for more information. 1 a ross receipts or sales a 1,00,000. b Returns and allowances b I c alance. ubtract line 1b from line 1a c 1,00,000. ost of goods sold (attach orm 115-) O M ross profit. ubtract line from line 1c ,00,000. et gain (loss) from orm 797, line 17 (attach orm 797) Other income (loss) (see instrs ' att statement) Total income (loss). dd lines through ,00, ompensation of officers (see instructions - attach orm 115-) , alaries and wages (less employment credits) , Repairs and maintenance , ad debts U 11 Rents ,000. T I 1 Taxes and licenses ,0. O 1 Interest , epreciation not claimed on orm 115- or elsewhere on return (attach orm 56) , epletion (o not deduct oil and gas depletion.) dvertising ,00. I Pension, profit-sharing, etc, plans mployee benefit programs ,700. T R 19 Other deductions (attach statement) ee tatement , Total deductions. dd lines 7 through ,00. 1 Ordinary business income (loss). ubtract line 0 from line ,800. a xcess net passive income or LIO recapture tax (see instructions) a T b Tax from chedule (orm 110) b c dd lines a and b (see instructions for additional taxes) c a 016 estimated tax payments and 015 overpayment credited to a b Tax deposited with orm b P c redit for federal tax paid on fuels (attach orm 16) c Y d dd lines a through c d M stimated tax penalty (see instructions). heck if orm 0 is attached mount owed. If line d is smaller than the total of lines c and, enter amount owed T 6 Overpayment. If line d is larger than the total of lines c and, enter amount overpaid nter amount from line 6 redited to 017 estimated tax Refunded 7 heck if: ign Here (1) () Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. eclaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. May the IR discuss this return with the preparer shown below (see instructions)? ignature of officer ate Title Yes o Print/Type preparer's name Paid Preparer Use Only Preparer's signature ate heck elf-prepared irm's name irm's address if PTI self-employed irm's I Phone no. or Paperwork Reduction ct otice, see separate instructions. P0105L 08/17/16 orm 110 (016)

2 **************************** Other Information (see instructions) 1 heck accounting method: a b ccrual c ash Other (specify) orm 110 (016) chedule ee the instructions and enter the: a usiness activity ervice b Product or service... Yes Page o onsulting t any time during the tax year, was any shareholder of the corporation a disregarded entity, a trust, an estate, or a nominee or similar person? If "Yes," attach chedule -1, Information on ertain hareholders of an orporation t the end of the tax year, did the corporation: a Own directly 0 or more, or own, directly or indirectly, 50 or more of the total stock issued and outstanding of any foreign or domestic corporation? or rules of constructive ownership, see instructions. If 'Yes,' complete (i) through (v) below (ii) mployer (iii) ountry of (iv) Percentage (v) If Percentage in (iv) (i) ame of orporation Identification Incorporation of tock Owned is 100, nter the ate (if any) a Qualified umber (if any) ubchapter ubsidiary lection Was Made b Own directly an interest of 0 or more, or own, directly or indirectly, an interest of 50 or more in the profit, loss, or capital in any foreign or domestic partnership (including an entity treated as a partnership) or in the beneficial interest of a trust? or rules of constructive ownership, see instructions. If 'Yes,' complete (i) through (v) below (i) ame of ntity (ii) mployer Identification umber (if any) (iii) Type of ntity (v) Maximum Owned in Profit, Loss, or apital (iv) ountry of Organization 5 a t the end of the tax year, did the corporation have any outstanding shares of restricted stock? If 'Yes,' complete lines (i) and (ii) below. (i) Total shares of restricted stock (ii) Total shares of non-restricted stock b t the end of the tax year, did the corporation have any outstanding stock options, warrants, or similar instruments? If 'Yes,' complete lines (i) and (ii) below. (i) Total shares of stock outstanding at the end of the tax year (ii) Total shares of stock outstanding if all instruments were executed Has this corporation filed, or is it required to file, orm 8918, Material dvisor isclosure tatement, to provide information on any reportable transaction? heck this box if the corporation issued publicly offered debt instruments with original issue discount If checked, the corporation may have to file orm 881, Information Return for Publicly Offered Original Issue iscount Instruments. 8 If the corporation: (a) was a corporation before it elected to be an corporation or the corporation acquired an asset with a basis determined by reference to the basis of the asset (or the basis of any other property) in the hands of a corporation and (b) has net unrealized built-in gain in excess of the net recognized built-in gain from prior years, enter the net unrealized built-in gain reduced by net recognized built-in gain from prior years (see instructions) $ 9 nter the accumulated earnings and profits of the corporation at the end of the tax year $ oes the corporation satisfy both of the following conditions? a The corporation's total receipts (see instructions) for the tax year were less than $50, b The corporation's total assets at the end of the tax year were less than $50, If 'Yes,' the corporation is not required to complete chedules L and M uring the tax year, did the corporation have any non-shareholder debt that was canceled, was forgiven, or had the terms modified so as to reduce the principal amount of the debt? $ If 'Yes,' enter the amount of principal reduction 1 uring the tax year, was a qualified subchapter subsidiary election terminated or revoked? If 'Yes', see instructions a id the corporation make any payments in 016 that would require it to file orm(s) 1099? b If 'Yes,' did the corporation file or will it file required orms 1099? orm 110 (016) P011L 08/17/16

3 **************************** hareholders' Pro Rata hare Items orm 110 (016) chedule K Income (Loss) eductions redits oreign Transactions 1 Ordinary business income (loss) (page 1, line 1) et rental real estate income (loss) (attach orm 885) a Other gross rental income (loss) a b xpenses from other rental activities (attach statement) b c Other net rental income (loss). ubtract line b from line a c Interest income ividends: a Ordinary dividends a b Qualified dividends b 5, Royalties et short-term capital gain (loss) (attach chedule (orm 110)) a et long-term capital gain (loss) (attach chedule (orm 110)) a b ollectibles (8) gain (loss) b c Unrecaptured section 150 gain (attach statement) c 9 et section 11 gain (loss) (attach orm 797) Other income (loss) (see instructions) Type ection 179 deduction (attach orm 56) a haritable contributions ee tatement b Investment interest expense a 1 b c ection 59(e)() expenditures (1) Type () mount d Other deductions (see instructions).. Type 1 a Low-income housing credit (section (j)(5)) c () 1 d 1 a 1 b 1 c 1 d 1 e 1 f 1 g b Low-income housing credit (other) c Qualified rehabilitation expenditures (rental real estate) (attach orm 68, if applicable) d Other rental real estate credits (see instrs) Type e Other rental credits (see instrs) Type f iofuel producer credit (attach orm 678) g Other credits (see instructions) Type 1 a ame of country or U.. possession b ross income from all sources c ross income sourced at shareholder level b 1 c oreign gross income sourced at corporate level d Passive category e eneral category f Other (attach statement) d 1 e 1 f eductions allocated and apportioned at shareholder level g Interest expense h Other g 1 h eductions allocated and apportioned at corporate level to foreign source income i Passive category j eneral category k Other (attach statement) i 1 j 1 k Other information l Total foreign taxes (check one): m Reduction in taxes available for credit lternative Minimum Tax (MT) Items Items ffecting hareholder asis Page Total amount Paid ccrued (attach statement) n Other foreign tax information (attach statement) 15 a Post-1986 depreciation adjustment b djusted gain or loss c epletion (other than oil and gas) d Oil, gas, and geothermal properties ' gross income e Oil, gas, and geothermal properties ' deductions f Other MT items (attach statement) a Tax-exempt interest income b Other tax-exempt income c ondeductible expenses d istributions (attach stmt if required) (see instrs) e Repayment of loans from shareholders P01L 08/17/16 70,800. 1,000. 1,800. 5,000. 9,000. 5, l 1 m 15 a 15 b 15 c 15 d 15 e 15 f 16 a 16 b 16 c 16 d 16 e,170. 1,000. 8, ,000. orm 110 (016)

4 **************************** hareholders' Pro Rata hare Items (continued) orm 110 (016) chedule K Other Information 17 a Investment income b Investment expenses c ividend distributions paid from accumulated earnings and profits d Other items and amounts (attach statement) Reconciliation 18 chedule L 6, a 17 b 17 c ee tatement Income/loss reconciliation. ombine the amounts on lines 1 through 10 in the far right column. rom the result, subtract the sum of the amounts on lines 11 through 1d and 1l eginning of tax year nd of tax year alance heets per ooks (a) (b) (c) ssets 1 ash a Trade notes and accounts receivable b Less allowance for bad debts Inventories U.. government obligations Tax-exempt securities (see instructions) Other current assets (attach stmt) Loans to shareholders Mortgage and real estate loans Other investments (attach statement).. ee t a uildings and other depreciable assets b Less accumulated depreciation a epletable assets b Less accumulated depletion Land (net of any amortization) a Intangible assets (amortizable only) b Less accumulated amortization Other assets (attach stmt) Total assets Liabilities and hareholders' quity 16 ccounts payable Mortgages, notes, bonds payable in less than 1 year Other current liabilities (attach stmt)... ee t Loans from shareholders Mortgages, notes, bonds payable in 1 year or more Other liabilities (attach statement) apital stock dditional paid-in capital Page Total amount 100,000. 6, , , ,000. (d) 160,05. 00,000. 0,000. 7,185., Retained earnings djustments to shareholders' equity (att stmt) Less cost of treasury stock Total liabilities and shareholders' equity ,000. 0, ,000.,00. 08/17/16, , , ,000., ,00. 1,000,000.,000. 6,00. 1,50. 10,700. 9, ,80.,000. 1,000. 0,000. 0,000.,70. 50, ,00. P01L,000. 0,95. 1,000,000. orm 110 (016)

5 **************************** chedule M-1 Reconciliation of Income (Loss) per ooks With Income (Loss) per Return orm 110 (016) Page 5 ote: The corporation may be required to file chedule M- (see instructions) 1 et income (loss) per books Income included on chedule K, lines 1,, c,, 5a, 6, 7, 8a, 9, and 10, not recorded on books this year (itemize): xpenses recorded on books this year not included on chedule K, lines 1 through 1, and 1l (itemize): 670, Income recorded on books this year not included on chedule K, lines 1 through 10 (itemize): a Tax-exempt interest. $ 1,000. tatement 7 $ $ ee tatement 6 a epreciation b Travel and entertainment.. 1,000. 5,000. 8, dd lines 5 and , Income (loss) (chedule K, ln 18). Ln less ln 7... chedule M- nalysis of ccumulated djustments ccount, Other djustments ccount, and hareholders' Undistributed Taxable Income Previously Taxed (see instructions) dd lines 1 through (a) ccumulated adjustments account , eductions included on chedule K, lines 1 through 1 and 1l, not charged against book income this year (itemize): a epreciation.... $ alance at beginning of tax year Ordinary income from page 1, line Other additions ee......tatement Loss from page 1, line Other reductions ee......tatement ombine lines 1 through istributions other than dividend distributions alance at end of tax year. ubtract line 7 from line P01L,70. 70,800. 7,800. ( 08/17/16 5,600.) 9,70. 00,000. 5,70. (b) Other adjustments account 11, ,000. (c) hareholders' undistributed taxable income previously taxed 1,000. 1,000. 1,000. orm 110 (016)

6 This page is intentionally left blank The arvs, LL Phoenix each, LL Training for usiness Professionals

7 orm 885 (Rev ecember 010) Rental Real state Income and xpenses of a Partnership or an orporation epartment of the Treasury Internal Revenue ervice ee instructions. ttach to orm 1065, orm 1065-, or orm 110. mployer identification number ame uckeye onsulting, Inc. 1 how the type and address of each property. or each rental real estate property listed, report the number of days rented at fair rental value and days with personal use. ee instructions. ee page to list additional properties. Physical address of each property ' street, city, state, ZIP code OM o Type ' nter code 1-8; see page for list 1111 ig Ten Ln uckeye, Z 856 air Rental ays Personal Use ays 66 Properties Rental Real state Income ross rents Rental Real state xpenses dvertising uto and travel leaning and maintenance ommissions Insurance Legal and other professional fees..... Interest Repairs Taxes Utilities Wages and salaries epreciation (see instructions) Other (list) ,000. 5,600. 1, Total expenses for each property. dd lines through ,000. Income or (Loss) from each property. 17 ubtract line 16 from line , a Total gross rents. dd gross rents from line, columns through H b Total expenses. dd total expenses from line 16, columns through H et gain (loss) from orm 797, Part II, line 17, from the disposition of property from rental real estate activities a et income (loss) from rental real estate activities from partnerships, estates, and trusts in which this partnership or corporation is a partner or beneficiary (from chedule K-1) b Identify below the partnerships, estates, or trusts from which net income (loss) is shown on line 0a. ttach a schedule if more space is needed: (1) ame () mployer identification number 18 a 18 b 7, , et rental estate income (loss). ombine lines 18a through 0a. nter the result here and on:? orm 1065 or 110: chedule K, line, or? orm 1065-: Part I, line or Paperwork Reduction ct otice, see the separate instructions. PZ0101L 19 0 a 1 0/09/11 1,000. orm 885 (1-010)

8 orm 885 (1-010) 1 uckeye onsulting, Inc. Page how the type and address of each property. or each rental real estate property listed, report the number of days at fair rental value and days with personal use. ee instructions. Physical address of each property ' street, city, state, ZIP code Type ' nter code 1-8; see below for list air Rental ays Personal Use ays H Properties Rental Real state Income ross rents Rental Real state xpenses dvertising uto and travel leaning and maintenance ommissions Insurance Legal and other professional fees Interest Repairs Taxes Utilities Wages and salaries epreciation (see instructions) Other (list) H Total expenses for each property. dd lines through Income or (Loss) from each property. ubtract line 16 from line llowable odes for Type of Property 1 ' ingle amily Residence ' Multi-amily Residence ' Vacation or hort-term Rental ' ommercial 5 ' Land 6 ' Royalties 7 ' elf-rental 8 ' Other (include description with the code on orm 885 or on a separate statement) PZ010L 01/07/11 orm 885 (1-010)

9 HUL (orm 110) epartment of the Treasury Internal Revenue ervice OM o apital ains and Losses and uilt-in ains ttach to orm 110. Use orm 899 to list your transactions for lines 1b,,, 8b, 9, and 10. Information about chedule and its separate instructions is at ame mployer identification number uckeye onsulting, Inc. Part I hort-term apital ains and Losses ' ssets Held One Year or Less ee instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off the cents to whole dollars. (d) Proceeds (sales price) (e) ost (or other basis) (g) djustments to (h) ain or (loss). gain or loss from ubtract column (e) from orm(s) 899, Part I, column (d) and combine the line, column (g) result with column (g) 1a Totals for all short-term transactions reported on orm for which basis was reported to the IR and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on orm 899, leave this line blank and go to line 1b b Totals for all transactions reported on orm(s) 899 with ox checked Totals for all transactions reported on orm(s) 899 with ox checked Totals for all transactions reported on orm(s) 899 with ox checked hort-term capital gain from installment sales from orm 65, line 6 or hort-term capital gain or (loss) from like-kind exchanges from orm Tax on short-term capital gain included on line below et short-term capital gain or (loss). ombine lines 1a through 6 in column (h). nter here and on orm 110, chedule K, line 7 or Part II Long-Term apital ains and Losses ' ssets Held More Than One Year ee instructions for how to figure the amounts to enter on the lines below. This form may be easier to complete if you round off the cents to whole dollars. 8a Totals for all long-term transactions reported on orm for which basis was reported to the IR and for which you have no adjustments (see instructions). However, if you choose to report all these transactions on orm 899, leave this line blank and go to line 8b (d) Proceeds (sales price) (e) ost (or other basis) 19,000. (g) djustments to (h) ain or (loss). gain or loss from ubtract column (e) from orm(s) 899, Part II, column (d) and combine the line, column (g) result with column (g) 9,000. 8b Totals for all transactions reported on orm(s) 899 with ox checked Totals for all transactions reported on orm(s) 899 with ox checked Totals for all transactions reported on orm(s) 899 with ox checked Long-term capital gain from installment sales from orm 65, line 6 or Long-term capital gain or (loss) from like-kind exchanges from orm apital gain distributions (see instructions) Tax on long-term capital gain included on line below et long-term capital gain or (loss). ombine lines 8a through 1 in column (h). nter here and on orm 110, chedule K, line 8a or or Paperwork Reduction ct otice, see the Instructions for orm 110. P001L 08//16 9,000. chedule (orm 110) 016

10 uckeye onsulting, Inc. uilt-in ains Tax (ee instructions before completing this part.) chedule (orm 110) 016 Part III xcess of recognized built-in gains over recognized built-in losses (attach computation statement) Taxable income (attach computation statement) et recognized built-in gain. nter the smallest of line 16, line 17, or line 8 of chedule ection 17(b)() deduction ubtract line 19 from line 18. If zero or less, enter -0- here and on line nter 5 of line ection 17(b)() business credit and minimum tax credit carryforwards from corporation years Tax. ubtract line from line 1 (if zero or less, enter -0-). nter here and on orm 110, page 1, line b Page chedule (orm 110) 016 P001L 08//16

11 chedule K-1 (orm 110) epartment of the Treasury Internal Revenue ervice inal K-1 Part III or calendar year 016, or tax year beginning ending, Information bout the orporation Interest income 900.,500. orporation's name, address, city, state, and ZIP code 5 b Qualified dividends 1 oreign transactions 15 lternative minimum tax (MT) items 1,085., Royalties 7 et short-term capital gain (loss) IR enter where corporation filed return Ogden, UT Part II 8 a et long-term capital gain (loss),500. Information bout the hareholder hareholder's identifying number hareholder's name, address, city, state, and ZIP code 8 b ollectibles (8) gain (loss) ******* 8 c Unrecaptured section 150 gain rchie chlister 1 Mirror Lake Rd uckeye, Z 856 6,000. Other net rental income (loss) 5 a Ordinary dividends uckeye onsulting, Inc. 015 ational hampions r uckeye, Z 856 redits et rental real estate income (loss) orporation's employer identification number Ordinary business income (loss) 1 5,00. OM o hareholder's hare of urrent Year Income, eductions, redits, and Other Items, hareholder's hare of Income, eductions, * redits, etc. ee page of form and separate instructions. Part I mended K-1 hareholder's percentage of stock ownership for tax year et section 11 gain (loss) Other income (loss) ection 179 deduction 16 Items affecting shareholder basis 500. Other deductions O R 1 1,500. 1,000. I R H ,000. U 17 O L Y Other information,00. K* TMT U* TMT *ee attached statement for additional information. or Paperwork Reduction ct otice, see Instructions for orm 110. hareholder 1 P01L 08//16 chedule K-1 (orm 110) 016

12 chedule K-1 (orm 110) 016 uckeye onsulting, Inc. Page This list identifies the codes used on chedule K-1 for all shareholders and provides summarized reporting information for shareholders who file orm 100. or detailed reporting and filing information, see the separate hareholder's Instructions for chedule K-1 and the instructions for your income tax return. ode Report on 1 Ordinary business income (loss). etermine whether the income (loss) is passive or nonpassive and enter on your return as follows: redit for employer social security and Report on ee the hareholder's Instructions Medicare taxes Passive loss Passive income chedule, line 8, column (g) onpassive loss chedule, line 8, column (h) onpassive income chedule, line 8, column (j) et rental real estate income (loss) ame of country or U.. possession et income chedule, line 8, column (g) et loss ross income sourced at shareholder level orm 100, line 9b chedule, line chedule, line 5 chedule, line 1 8 Rate ain Worksheet, line (chedule instructions) Other income (loss) ection 179 deduction orm 6781, line 1 ee Pub 55 Other deductions ash contributions (50) apital gain property to a 50 organization (0) H I J K L M apital gain property (0) O P Q R 1 orm 100, line 9a et section 11 gain (loss) 15 oncash contributions (50) ee the hareholder's Instructions ontributions (100) Investment interest expense eductions ' royalty income 16 orm 95, line 1 ' portfolio ( floor) eductions ' portfolio (other) chedule, line Preproductive period expenses ommercial revitalization deduction from rental real estate activities ee orm 858 instructions Reforestation expense deduction omestic production activities information ee orm 890 instructions Qualified production activities income orm 890, line 7b mployer's orm W- wages orm 890, line 17 Other deductions eductions chedule, line 8 redits Low-income housing credit (section (j)(5)) from pre-008 buildings Low-income housing credit (other) from pre-008 buildings Low-income housing credit (section (j)(5)) from post-007 buildings Low-income housing credit (other) from post-007 buildings Qualified rehabilitation expenditures (rental real estate) H I J K L M Other rental real estate credits ee the hareholder's Instructions Other rental credits Undistributed capital gains credit orm 100, line 7, box a iofuel producer credit Work opportunity credit isabled access credit ee the hareholder's Instructions mpowerment zone employment credit redit for increasing research activities ***************************************** ross income from all sources orm 1116, Part I lternative minimum tax (MT) items 17 Post-1986 depreciation adjustment djusted gain or loss ee the hareholder's Instructions and the Instructions for orm 651 epletion (other than oil & gas) ' gross income Oil, gas, & geothermal ' deductions Oil, gas, & geothermal Other MT items Items affecting shareholder basis chedule, line 19 ection 59(e)() expenditures Other credits oreign transactions ash contributions (0) oncash contributions (0) ackup withholding oreign gross income sourced at corporate level Passive category orm 1116, Part I eneral category Other eductions allocated and apportioned at shareholder level Interest expense orm 1116, Part I H Other orm 1116, Part I eductions allocated and apportioned at corporate level to foreign source income I Passive category orm 1116, Part I J eneral category K Other Other information orm 1116, Part II L Total foreign taxes paid M Total foreign taxes accrued orm 1116, Part II orm 1116, line 1 Reduction in taxes available for credit O oreign trading gross receipts orm 887 P xtraterritorial income exclusion orm 887 Q Other foreign transactions orm 100, line 8a Unrecaptured section 150 gain ode Other portfolio income (loss) Involuntary conversions ec. 156 contracts and straddles Mining exploration costs recapture Other income (loss) Other net rental income (loss) Interest income 5 a Ordinary dividends 5 b Qualified dividends 6 Royalties 7 et short-term capital gain (loss) 8 a et long-term capital gain (loss) 8 b ollectibles (8) gain (loss) 8c 9 10 O P Tax-exempt interest income orm 100, line 8b Other tax-exempt income ondeductible expenses ee the hareholder's Instructions istributions Repayment of loans from shareholders Other information Investment income orm 95, line a Investment expenses orm 95, line 5 Qualified rehabilitation expenditures (other than rental real estate) asis of energy property Recapture of low-income housing credit (section (j)(5)) orm 8611, line 8 Recapture of low-income housing credit (other) orm 8611, line 8 H I J K L M O P Q R T U V Recapture of investment credit ee orm 55 Recapture of other credits ' completed long-term contracts Look-back interest ' income forecast method Look-back interest ee orm 8697 ee orm 8866 ispositions of property with section 179 deductions Recapture of section 179 deduction ection 5(l)() information ection 5(c) information ection 160(b) information Interest allocable to production expenditures nonqualified withdrawals epletion information ee the hareholder's Instructions ' oil and gas Reserved ection 108(i) information et investment income Other information P01L 08//16 chedule K-1 (orm 110) 016

13 ************************* chedule K-1 (orm 110) 016 upplemental Information Page ox et Rental Real state Income (loss) Property Type and ddress ross Income et xpenses Type: - ommercial 1111 ig Ten Ln uckeye, Z 856 6,000. 0,000. $ Total $ et Income Passive onpass ec. 11 Total 6,000. Passive 6,000. ox 17 Other Information * escriptive Information U Line : IR 1 rental real estate $ 6,000. ox 17, ode K isposition of ssets with Prior ection 179 xpense sset escription urniture Tax Year(s) Passed Through ate cquired ate old ales Price ost or other basis plus expense of sale epreciation allowed or allowable ection 179 expense deduction previously reported ***************************************** PL101L 06/16/16 7/01/01 8//016 5,

14 016 hareholder's asis omputation orporation ame mployer I.. number uckeye onsulting, Inc. ame of hareholder hareholder's I.. number -- rchie chlister 1. TOK I T II O T YR IR: Ordinary income et income from rental activities et portfolio income et gain under ection Other income Tax-exempt interest income Other tax-exempt income et gain on disposition of ection 179 assets..... Oil and gas depletion in excess of basis OTHR IR: 1,5. R: 5,00. 6,000. 7, , ondeductible expenses Oil and gas depletion Ordinary loss et loss from rental activities et portfolio loss et loss under ection Other loss haritable contributions ection 179 expense deduction eductions related to portfolio income (loss) Other deductions Investment interest expense Total foreign taxes ection 59(e) expenses Prior year loss in excess of basis OTHR R: 1, Property distributions (including cash).... 1, TOTL IR: (add lines - 11). TOTL R (add lines 1-9). 00,000. 6, TOK I T O T YR. (Line 1 plus line 1 minus line 0) ,5... T I T II O T YR JUTMT TO T I: 0.. T I T O T YR (ombine Line and ) HRHOLR' TOTL I T O T YR (dd Line 1 and ) ,5. 71,800. PL01L 06/16/16

15 chedule K-1 (orm 110) epartment of the Treasury Internal Revenue ervice inal K-1 Part III or calendar year 016, or tax year beginning ending, Information bout the orporation Interest income 900.,500. orporation's name, address, city, state, and ZIP code 5 b Qualified dividends 1 oreign transactions 15 lternative minimum tax (MT) items 1,085., Royalties 7 et short-term capital gain (loss) IR enter where corporation filed return Ogden, UT Part II 8 a et long-term capital gain (loss),500. Information bout the hareholder hareholder's identifying number hareholder's name, address, city, state, and ZIP code 8 b ollectibles (8) gain (loss) *******YYYY 8 c Unrecaptured section 150 gain rutus uckeye 198 WW Ln uckeye, Z 856 6,000. Other net rental income (loss) 5 a Ordinary dividends uckeye onsulting, Inc. 015 ational hampions r uckeye, Z 856 redits et rental real estate income (loss) orporation's employer identification number Ordinary business income (loss) 1 5,00. OM o hareholder's hare of urrent Year Income, eductions, redits, and Other Items, hareholder's hare of Income, eductions, * redits, etc. ee page of form and separate instructions. Part I mended K-1 hareholder's percentage of stock ownership for tax year et section 11 gain (loss) Other income (loss) ection 179 deduction 16 Items affecting shareholder basis 500. Other deductions O R 1 1,500. 1,000. I R H ,000. U 17 O L Y Other information,00. K* TMT U* TMT *ee attached statement for additional information. or Paperwork Reduction ct otice, see Instructions for orm 110. hareholder P01L 08//16 chedule K-1 (orm 110) 016

16 chedule K-1 (orm 110) 016 uckeye onsulting, Inc. Page This list identifies the codes used on chedule K-1 for all shareholders and provides summarized reporting information for shareholders who file orm 100. or detailed reporting and filing information, see the separate hareholder's Instructions for chedule K-1 and the instructions for your income tax return. ode Report on 1 Ordinary business income (loss). etermine whether the income (loss) is passive or nonpassive and enter on your return as follows: redit for employer social security and Report on ee the hareholder's Instructions Medicare taxes Passive loss Passive income chedule, line 8, column (g) onpassive loss chedule, line 8, column (h) onpassive income chedule, line 8, column (j) et rental real estate income (loss) ame of country or U.. possession et income chedule, line 8, column (g) et loss ross income sourced at shareholder level orm 100, line 9b chedule, line chedule, line 5 chedule, line 1 8 Rate ain Worksheet, line (chedule instructions) Other income (loss) ection 179 deduction orm 6781, line 1 ee Pub 55 Other deductions ash contributions (50) apital gain property to a 50 organization (0) H I J K L M apital gain property (0) O P Q R 1 orm 100, line 9a et section 11 gain (loss) 15 oncash contributions (50) ee the hareholder's Instructions ontributions (100) Investment interest expense eductions ' royalty income 16 orm 95, line 1 ' portfolio ( floor) eductions ' portfolio (other) chedule, line Preproductive period expenses ommercial revitalization deduction from rental real estate activities ee orm 858 instructions Reforestation expense deduction omestic production activities information ee orm 890 instructions Qualified production activities income orm 890, line 7b mployer's orm W- wages orm 890, line 17 Other deductions eductions chedule, line 8 redits Low-income housing credit (section (j)(5)) from pre-008 buildings Low-income housing credit (other) from pre-008 buildings Low-income housing credit (section (j)(5)) from post-007 buildings Low-income housing credit (other) from post-007 buildings Qualified rehabilitation expenditures (rental real estate) H I J K L M Other rental real estate credits ee the hareholder's Instructions Other rental credits Undistributed capital gains credit orm 100, line 7, box a iofuel producer credit Work opportunity credit isabled access credit ee the hareholder's Instructions mpowerment zone employment credit redit for increasing research activities ***************************************YYYY ross income from all sources orm 1116, Part I lternative minimum tax (MT) items 17 Post-1986 depreciation adjustment djusted gain or loss ee the hareholder's Instructions and the Instructions for orm 651 epletion (other than oil & gas) ' gross income Oil, gas, & geothermal ' deductions Oil, gas, & geothermal Other MT items Items affecting shareholder basis chedule, line 19 ection 59(e)() expenditures Other credits oreign transactions ash contributions (0) oncash contributions (0) ackup withholding oreign gross income sourced at corporate level Passive category orm 1116, Part I eneral category Other eductions allocated and apportioned at shareholder level Interest expense orm 1116, Part I H Other orm 1116, Part I eductions allocated and apportioned at corporate level to foreign source income I Passive category orm 1116, Part I J eneral category K Other Other information orm 1116, Part II L Total foreign taxes paid M Total foreign taxes accrued orm 1116, Part II orm 1116, line 1 Reduction in taxes available for credit O oreign trading gross receipts orm 887 P xtraterritorial income exclusion orm 887 Q Other foreign transactions orm 100, line 8a Unrecaptured section 150 gain ode Other portfolio income (loss) Involuntary conversions ec. 156 contracts and straddles Mining exploration costs recapture Other income (loss) Other net rental income (loss) Interest income 5 a Ordinary dividends 5 b Qualified dividends 6 Royalties 7 et short-term capital gain (loss) 8 a et long-term capital gain (loss) 8 b ollectibles (8) gain (loss) 8c 9 10 O P Tax-exempt interest income orm 100, line 8b Other tax-exempt income ondeductible expenses ee the hareholder's Instructions istributions Repayment of loans from shareholders Other information Investment income orm 95, line a Investment expenses orm 95, line 5 Qualified rehabilitation expenditures (other than rental real estate) asis of energy property Recapture of low-income housing credit (section (j)(5)) orm 8611, line 8 Recapture of low-income housing credit (other) orm 8611, line 8 H I J K L M O P Q R T U V Recapture of investment credit ee orm 55 Recapture of other credits ' completed long-term contracts Look-back interest ' income forecast method Look-back interest ee orm 8697 ee orm 8866 ispositions of property with section 179 deductions Recapture of section 179 deduction ection 5(l)() information ection 5(c) information ection 160(b) information Interest allocable to production expenditures nonqualified withdrawals epletion information ee the hareholder's Instructions ' oil and gas Reserved ection 108(i) information et investment income Other information P01L 08//16 chedule K-1 (orm 110) 016

17 ************************* chedule K-1 (orm 110) 016 upplemental Information Page ox et Rental Real state Income (loss) Property Type and ddress ross Income et xpenses Type: - ommercial 1111 ig Ten Ln uckeye, Z 856 6,000. 0,000. $ Total $ et Income Passive onpass ec. 11 Total 6,000. Passive 6,000. ox 17 Other Information * escriptive Information U Line : IR 1 rental real estate $ 6,000. ox 17, ode K isposition of ssets with Prior ection 179 xpense sset escription urniture Tax Year(s) Passed Through ate cquired ate old ales Price ost or other basis plus expense of sale epreciation allowed or allowable ection 179 expense deduction previously reported ***************************************YYYY PL101L 06/16/16 7/01/01 8//016 5,

18 016 hareholder's asis omputation orporation ame mployer I.. number uckeye onsulting, Inc. ame of hareholder hareholder's I.. number YYY-YY-YYYY rutus uckeye 1. TOK I T II O T YR IR: Ordinary income et income from rental activities et portfolio income et gain under ection Other income Tax-exempt interest income Other tax-exempt income et gain on disposition of ection 179 assets..... Oil and gas depletion in excess of basis OTHR IR: 1,5. R: 5,00. 6,000. 7, , ondeductible expenses Oil and gas depletion Ordinary loss et loss from rental activities et portfolio loss et loss under ection Other loss haritable contributions ection 179 expense deduction eductions related to portfolio income (loss) Other deductions Investment interest expense Total foreign taxes ection 59(e) expenses Prior year loss in excess of basis OTHR R: 1, Property distributions (including cash).... 1, TOTL IR: (add lines - 11). TOTL R (add lines 1-9). 00,000. 6, TOK I T O T YR. (Line 1 plus line 1 minus line 0) ,5... T I T II O T YR JUTMT TO T I: 0.. T I T O T YR (ombine Line and ) HRHOLR' TOTL I T O T YR (dd Line 1 and ) ,5. 71,800. PL01L 06/16/16

19 orm 115- (Rev October 016) epartment of the Treasury Internal Revenue ervice ompensation of Officers OM o ttach to orm 110, 110-, 110-, 110-RIT, 110-RI, or 110. Information about orm 115- and its separate instructions is at ame mployer identification number uckeye onsulting, Inc. ote: omplete orm 115- only if total receipts are $500,000 or more. ee instructions for definition of total receipts. 1 (a) ame of officer (b) ocial security number (c) Percent of time devoted to business Percent of stock owned (d) ommon (e) Preferred (f) mount of compensation rchie chlister ******* ,000. rutus uckeye ******* ,000. Total compensation of officers ompensation of officers claimed on orm 115- or elsewhere on return ,000. ubtract line from line. nter the result here and on orm 110, page 1, line 1 or the appropriate 00,000. line of your tax return or Paperwork Reduction ct otice, see separate instructions. orm 115- (Rev ) P101L 08/18/16

20 This page is intentionally left blank The arvs, LL Phoenix each, LL Training for usiness Professionals

21 016 ederal tatements Page 1 uckeye onsulting, Inc. tatement 1 orm 110, Line 19 Other eductions mortization $ uto and Truck xpense ank harges ues and ubscriptions Insurance Janitorial Legal and Professional Meals & entertainment deductible Meals and ntertainment xpense Miscellaneous Office xpense Postage Printing Professional development Telephone Travel Utilities Total $ 00. 1,500. 1,800. 1,00. 10,100. 7, , ,000. 1, ,000.,500.,900. 1,900.,00. 1,000. 9,500. 1,610. tatement orm 110, chedule K, Line 1a haritable ontributions ash ontributions - 50 Limitation $ Total $ 5,000. 5,000. tatement orm 110, chedule K, Line 17d Other Items and mounts isposition of ssets with Prior ection 179 xpense sset escription urniture Tax Year(s) Passed Through ate cquired ate old ales Price ost or other basis plus expense of sale epreciation allowed or allowable ection 179 expense deduction previously reported /01/01 8//016 0, ,000. tatement orm 110, chedule L, Line 9 Other Investments eginning, Inc OU Tax-ree onds $ $ 0,000. nding 0. 0,000.