20 Income Tax Return for Exempt Businesses under the Puerto Rico Incentives Programs Tourism Development

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1 P l a c e I n c o r p o r a t e d Form (II)DT Rev. 018 Liquidator: Reviewer: Field Audited by: / / R M N Taxpayer's Name Postal Address 20 GOVERNMENT OF PUERTO RICO DEPARTMENT OF THE TREASURY 20 Income Tax Return for Exempt Businesses under the Puerto Rico Incentives Programs Tourism Development TAXABLE YEAR BEGINNING ON, AND ENDING ON, Employer Identification Number Department of State Registry No. Serial Number AMENDED RETURN TAXABLE YEAR: 1 CALENDAR 2 FISCAL WEEKS Payment Stamp Industrial Code Municipal Code Zip Code Location of Principal Industry or Business - Number, Street and Country Type of Principal Industry or Business Address of the Contact Person Exempt business operates under: Change of Address: Yes No Extension of Time: Yes No Contrats with Governmental Entity: Yes No Merchant's Registration Number Telephone Number - Extension ( ) Incorporated Day / Month / Year Place Incorporated Receipt No. Amount: Type of Entity Act 52 of 1983 (Schedule L Incentives) Case No.: Act (Schedule L Incentives) Case No.: Act (Schedule L Incentives) Case No.: Act (Schedule Z Incentives) Case No.: Indicate if you are a member of a group of related entities Yes No Group number Part I Tax liability: a) Schedule L Incentives, Part II, line (1a) b) Schedule Z Incentives, Part II, line 5... (1b) c) Schedule P Incentives, Part II, line 19 (See instructions)... (1c) d) Total (Add lines 1(a) through 1(c))... Less: a) Tax withheld at source... (2a) b) Current year estimated tax payments... (2b) c) Excess from previous years not included on line 2(b)... (2c) d) Tax withheld on partners distributable share from partnerships or special partnerships (Form EC).. (2d) e) Amount paid with automatic extension of time or with original return... (2e) f) Tax withheld for professional services (Form 480.6B)... (2f) g) Tax withheld at source on eligible interest... (2g) h) Total payments (Add lines 2(a) through 2(g))... Balance of tax due (If line 1(d) is more than line 2(h), enter the difference here, otherwise, on line 5)... Tax... Interest... Surcharges... (d) Total (Add lines 3(a) through 3(c))... Addition to the Tax for Failure to Pay Estimated Tax (Schedule T Incentives, Part II, line 21)... Excess of tax withheld or paid (See instructions)... Amount paid with this return (Add lines 3(d) and 4 less line 5)... Amount overpaid to be credited to estimated tax for Contribution to the San Juan Bay Estuary Special Fund... Contribution to the Special Fund for the University of Puerto Rico... Amount to be refunded... OATH (a) (b) (c) We, the undersigned, president (or vice-president, or other principal officer) and treasurer (or assistant treasurer), or agent of the corporation for which this income tax return is made, each for himself declare under penalty of perjury, that this return (including schedules and statements attached) has been examined by us, and to the best of our knowledge and belief, is a true, correct, and complete return, made in good faith, pursuant to the Puerto Rico Internal Revenue Code of 2011, as amended, and the Regulations thereunder. President or vice-president's name Treasurer or assistant treasurer's name Agent's name SPECIALIST'S USE ONLY I declare under penalty of perjury that this return (including schedules and statements attached) has been examined by me, and to the best of my knowledge and belief is a true, correct, and complete return. The declaration of the person who prepares this return is with respect to the information received, and this information may be verified. Specialist's name (Print) Registration number 4P Firm's name (3a) (3b) (3c) President or vice-president's signature Treasurer or assistant treasurer's signature Agent's signature (1d) (2h) (3d) Self-employed specialist Specialist's signature Address Zip code NOTE TO TAXPAYER Indicate if you made payments for the preparation of your return: Yes No. If you answered "Yes", require the Specialist s signature and registration number. Retention Period: Ten years

2 Form (II)DT Rev. 018 Tourism Development Incentives - Page 2 Exempt Business - Comparative Balance Sheet Beginning of the year Ending of the year Assets Total Total Part II Part III Cash on hand and banks... Accounts receivable... Less: Reserve for bad debts... Inventories... Other current assets... Notes receivable... Investments... Depreciable assets... Less: Reserve for depreciation... Loans receivable of stockholders or related entities Land... Other long-term assets... Total Assets... Liabilities and Net Worth Liabilities Accounts payable... Accrued expenses not paid... Other current liabilities... Long-term notes payable... Notes payable to stockholders or related entities Other long-term liabilities... Total Liabilities... Net Worth Capital stock (a) Preferred stock... (b) Common stock... Additional paid in capital... Retained earnings... Reserve... Total Net Worth... Total Liabilities and Net Worth... Net income (or loss) per books... Income tax per books... Excess of capital losses over capital gains... Taxable income not recorded on books this year (Itemize, use schedule if necessary) (a) $ (b) $ (c) $ (d) $ (e) $ (f) $ Total... Expenses recorded on books this year not claimed on this return (Itemize, use schedule if necessary) (a)meal and entertainment (portion not claimed) $ (b) Depreciation $ (c) Vessels, aircrafts and property located outside of P.R. $ (d) Expenses incurred or paid to stockholders, persons or related entities $ (e) $ (f) $ (g) $ (h) $ (i) $ (j) $ Total... Total (Add lines 1 through 5)... ( ( (20) (21a) (21b) ) ) ( ( ) ) (20) Reconciliation of Net Income (or Loss) per Books with Net Taxable Income (or Loss) per Return Retention Period: Ten years (21a) (21b) Income recorded on books this year not included on this return (Itemize, use schedule if necessary) (a) Exempt interest $ (b) $ (c) $ (d) $ (e) $ (f) $ (g) $ Total... Deductions on this tax return not charged against book income this year (Itemize, use schedule if necessary) (a) Depreciation (b) $ (c) $ (d) $ (e) $ (f) $ (g) $ (h) $ (i) $ Total... Total (Add lines 7 and 8)... Net taxable income (or loss) per return (Subtract line 9 from line 6)...

3 Form (II)DT Rev. 018 Part IV Part V Part VI Balance at beginning of year... Net income per books... Other increases (Itemize, use schedule if necessary) Total (Add lines 1, 2 and 3)... If a foreign corporation, indicate if the trade or business in Puerto Rico was held as a branch... If a branch, indicate the percent that represents the income from sources within Puerto Rico from the total income of the exempt business: % Did the exempt business keep any part of its records on a computerized system during this year?... The exempt business books are in care of: Name Address Telephone Indicate accounting method used for tax purposes: Cash Accrual Other (specify): Did the exempt business file the following documents? (a) (b) Informative Return (Forms 480.6A, 480.6B, 480.6C)... Withholding Statement (Form 499R-2/W-2PR)... If the gross income of the entity or controlled group exceeds $3,0,0, did you submit financial statements audited by a CPA licensed in Puerto Rico?... Number of employees during the year: (a) Exempt activity: (b) Other: Did the corporation claim expenses connected to the ownership, use, maintenance and depreciation of: (a) Vehicles?... (9a) (b) Vessels?... (9b) Was more than 80% of the total income derived from activities exclusively related to fishing or transportation of passengers or cargo or lease?... (9b1) (c) Aircrafts?... (9c) Was more than 80% of the total income derived from activities exclusively related to transportation of passengers or cargo or lease?... (9c1) (d) Residential property outside of Puerto Rico?... (9d) Was more than 80% of the total income derived from activities exclusively related to the lease of property to non related persons? (9d1) (e) Housing? (except business employees)... (9e) (f) Employees attending conventions outside of Puerto Rico or the United States?... (9f) Name of officer Analysis of Unappropriated Retained Earnings per Books Social security number Distributions: Questionnaire Tourism Development Incentives - Page 3 YES NO N/A YES NO N/A Have you been audited by the Federal Internal Revenue Service (IRS)?. Which years? 1 Did the exempt business distribute dividends other than stock dividends or distributions in liquidation in excess of the current and accumulated earnings during this year?... 1 Is the exempt business a partner in a partnership or special partnership? (If more than one, submit detail)... Name of the Partnership or Special Partnership Employer identification number 1 Did the corporation at the end of the taxable year own, directly or indirectly, 50% or more of the voting stocks of a corporation who is engaged in trade or business in Puerto Rico?... If Yes, attach a schedule showing: (a) name and employer identification number, (b) percentage owned, and (c) taxable income (or loss) before net operating loss and special deductions of the corporation for the taxable (6a) year (even when such taxable year does not coincide with the one of the (6b) corporation or partnership for which this return is filed). 1 Did any individual, partnership, corporation, estate or trust at the end of the taxable year own, directly or indirectly, 50% or more of the corporation's voting stocks? If Yes, attach a schedule showing the name and employer identification number. Enter the percentage owned: % 1 Enter the amount of exempt interest: 1 Does the exempt business have other exempt activities not covered under the Tourism Incentives Acts? (Attach schedule)... Under which act? 1 Have you made a timely election under: Section 5(b) Act No. 52 of 1983 Section 3(a)(D) Act Section 3(a)(D) Act Enter the total amount of charitable contributions to municipalities claimed during the taxable year: 1 Indicate if your books reflect premiums paid by unauthorized insurers Employer number assigned by the Department of Labor and Human Resources 2 Did the corporation claim expenses related to services provided by nonresidents of Puerto Rico? (Total $ ) (See inst.)... (21) (a) Did you pay the corresponding sales and use tax?... (21a) 2 Did the corporation claim depreciation expenses for tangible personal property acquired outside of Puerto Rico, for use in its operations not covered by a tax exemption decree?... (a) Did you pay the corresponding sales and use tax? (22a) 2 Did the corporation pay deemed dividend during the previous year? If Yes, indicate the amount $ Compensation to officers (c) Stocks... Other decreases (Use schedule if necessary) Total (Add lines 5 and 6)... Balance at end of year (Subtract line 7 from line 4)... Percentage of time devoted to business (a) Cash... (b) Property... Percentage of stocks owned Common Preferred Total compensation to officers... Retention Period: Ten years (5a) (5b) (5c) Compensation

4 Schedule L Incentives Rev. 018 Taxpayer's Name PARTIALLY EXEMPT INCOME UNDER ACT 52 OF 1983, ACT OR ACT To be filed with Form (II)DT Taxable year beginning on, and ending on, Case Number 20 Employer Identification Number Type of Business Partially exempt income under: Act 52 of 1983 Act Act Effective period for income: Part I Begins: Ends: Net Income Subject to Tax Number of jobs directly related with tourism development: Current: Required: Net operating income (or loss) for the year (Part IV, line 45)... Net operating loss deduction for the preceding year (See instructions. Submit detail)... Net operating income (or loss) from eligible tourism activities subject to the computation (Subtract line 2 from line 1)... Exempt amount: % of line 3 (See instructions)... Net income subject to tax (Subtract line 4 from line 3) ( Act )... Part II Computation of Tax Net income subject to normal tax (Same as Part I, line 5) Less: Surtax net income deduction (Check here if comes from Form AS 2651 )... Net income subject to surtax Normal tax (Multiply line 1 by 22%) Surtax (See instructions) Total tax (Add lines 4 and 5) Alternative Tax Capital Gains and Preferential Rates (Schedule D1 Corporation, line 9) (Does not apply to Act 52 of 1983)... Tax Determined (Line 6 or 7, whichever is smaller)... Recapture of credit claimed in excess (Schedule B Incentives, Part I, line 3) Tax credits (Schedule B Incentives, Part II, line 29).... Tax liability (Subtract line 10 from the sum of lines 8 and Transfer to Form (II)DT, Part I, line 1(a)).... Part III Gross Profit on Sales or Production and Other Income (Exclude income from casino operations) Net sales of goods or products (See instructions)... Less: Cost of goods sold or direct costs of production Inventory at the beginning of the year 1 "C" 2 "C" or "MV"... Purchase of materials or merchandise... Direct wages... Other direct costs (From Part V, line 12)... Cost of goods available for sale (Add lines 2 through 5)... Less: Inventory at the end of the year 1 "C" 2 "C" or "MV"... Total cost of goods sold or direct costs of production (Subtract line 7 from line 6)... Gross profit (or loss) on sale of goods or products (Subtract line 8 from line 1)... Capital assets gains (Does not apply to operations under Act 52 of 198 Submit Schedule D Corporation)... Net gain (or loss) from the sale or exchange of property other than capital assets (Does not apply to operations under Act 52 of 198 Submit Schedule D Corporation)... Interests... Rent... Other income (Submit detail)... Total income (Add lines 9 through 14)... Retention Period: Ten years

5 Rev. 018 Schedule L Incentives - Page 2 Part IV Deductions and Net Operating Income Compensation to officers (Complete Part VI of the return)... Salaries, commissions and bonuses to employees... Commissions to businesses... Social security tax (FICA)... Unemployment tax... State Insurance Fund premiums... Medical or hospitalization insurance... Insurance... Interests... Rent... Property tax: (a) Personal (b) Real... Other taxes, patents and licenses (Submit detail)... Losses from fire, storms, theft or other casualties... Automobile expenses (Mileage ) (See instructions)... Other motor vehicle expenses (See instructions)... Meal and entertainment expenses (Total ) (See instructions)... Travel expenses... Professional services... Contributions to pension or other qualified plans (See instructions. Submit Form AS 6041)... Depreciation and amortization (See instructions. Submit Schedule E)... Bad debts (See instructions. Submit detail)... Charitable contributions... Repairs... Royalties... Management fees... Expenses incurred or paid for services received from persons not engaged in trade or business in Puerto Rico... Expenses incurred or paid for qualified disaster assistance payments to employees (See instructions)... Other deductions (See instructions. Submit detail)... Total deductions (Add lines 16 through 43)... Net operating income (or loss) for the year (Subtract line 44 from line 1 Enter here and in Part I, line 1)... (20) (21) (27) (28) (29) (30) (31) (32) (33) (34) (35) (36) (37) (38) (39) (40) (41) (42) (43) (44) (45) Part V Other Direct Costs Salaries, wages and bonuses... Social security tax (FICA)... Unemployment tax... State Insurance Fund premiums... Medical or hospitalization insurance... Other insurance... Excise taxes / Use taxes... Retention Period: Ten years Repairs... Utilities... Depreciation(Submit Schedule E)... 1 Other expenses (Submit detail)... 1 Total other direct costs (Add lines 1 through 1 Transfer to Part III, line 5)...

6 Schedule Z Incentives Rev. 018 INCOME TAX FOR EXEMPT BUSINESSES UNDER ACT To be filed with Form (II)DT 20 Taxpayer s Name Taxable year beginning on, and ending on, Employer Identification Number Type of Business Case Number Part I Net Income Subject to Tax Net operating income (or loss) for the year (Part IV, line 35) Net operating loss deduction for the preceding year (See instructions. Submit detail)..... Net operating income (or loss) (Subtract line 2 from line 1) ( Act ).... Part II Computation of Tax Fixed income tax rate 25% 15% 10% 8%... Total tax (Multiply line 3 by the fixed income tax rate on line Enter here and transfer to Form (II)DT, Part I, line 1(b)) Part III Gross Profit on Sales and Other Income Net sales of goods or products (See instructions)... Interests... Rent... Other income (Submit detail)... Total income (Add lines 1 through 4)... Part IV Deductions and Net Operating Income Compensation to officers (Complete Part VI of the return)... Salaries, commissions and bonuses to employees... Commissions to businesses... Social security tax (FICA)... Unemployment tax... State Insurance Fund premiums... Medical or hospitalization insurance Insurance.... Interests Rent Property tax: (a) Personal (b) Real... Other taxes, patents and licenses (Submit detail)... Losses from fire, storms, theft or other casualties Automobile expenses (Mileage ) (See instructions)... Other motor vehicle expenses (See instructions)... Meal and entertainment expenses (Total ) (See instructions)... Travel expenses Professional services Contributions to pension or other qualified plans (See instructions. Submit Form AS 6041)... Depreciation and amortization (See instructions. Submit Schedule E) Bad debts (See instructions. Submit detail) Charitable contributions Repairs Royalties... Management fees... Expenses incurred or paid for services received from persons not engaged in trade or business in Puerto Rico... Expenses incurred or paid for qualified disaster assistance payments to employess (See instructions)... Other deductions (See instructions. Submit detail)... Total deductions (Add lines 6 through 33)... Net operating income (or loss) for the year (Subtract line 34 from line Enter here and in Part I, line 1)... Retention Period: Ten years (20) (21) (27) (28) (29) (30) (31) (32) (33) (34) (35) %

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