NJ NEW JERSEY 1040 DATA SHEET 1

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1 NJ NEW JERSEY 040 DATA SHEET GI GENERAL INFORMATION FILING DUE DATE (IF OTHER THAN STANDARD) 045 EXEMPTIONS FORCE TAX IF NOT REQUIRED TO FILE 6075 DOMESTIC PARTNER 6069 YES AUTHORIZE TO DISCUSS RETURN WITH PREPARER 690 YES BLIND OR DISABLED COUNTY / MUNICIPALITY CODE 6085 [4] 8 TAXPAYER 6003 YES SEND NJ TAX BOOKLET NEXT YEAR 603 YES SPOUSE 6004 YES FEDERAL EXTENSION ATTACHED 6042 YES 9 NUMBER OF QUALIFIED DEPENDENT CHILDREN 502 ONLINE FEDERAL EXTENSION CONFIRMATION # 6005 [5] 0 NUMBER OF OTHER DEPENDENTS 503 REQUESTED FED EXTENSION FOR PRESIDENTIAL DISASTER RELIEF 674 YES NUMBER OF DEPENDENTS ATTENDING COLLEGES 504 PRINT INSTRUCTION LETTER TO SEND TO CN YES RESIDENCY STATUS OVERRIDE VOUCHER PAYMENT AMOUNT 506 ADDRESS HAD CHANGED FROM LAST YEAR 6035 YES NAME CHANGE 6058 YES PREPARE NJ-040NR NONRESIDENT RETURN 603 YES CIVIL UNION FILERS (SEE HELPS) RESIDENT OF RECIPROCAL STATE (NONRESIDENTS ONLY) 6200 YES CIVIL UNION COUPLE FILING JOINT FOR NJ PURPOSES 6038 YES STATE OF RESIDENCE IF FILING NJ-040NR 6086 CIVIL UNION COUPLE FILING SEPARATE FOR NJ PURPOSES 6037 YES PART-YEAR RESIDENT OF NEW JERSEY 6022 YES CIVIL UNION PARTNERS FIRST NAME 6205 [5] PART- YEAR NEW JERSEY RESIDENT CIVIL UNION PARTNERS 6206 [20] 3 FROM: 6099 CIVIL UNION PARTNERS SSN 6207 TO: 605 NUMBER OF MONTHS AS A NJ RESIDENT 593 CONTRIBUTE $ TO GUBERNATORIAL ELECTION FUND GUBERNATORIAL ELECTIONS FUNDS TAXPAYER SPOUSE 6026 YES 6027 YES 2 FORM NJ- 040 RESIDENT INC TAX RETURN, PAGE 3 4 WAGES, SALARIES, TIPS, COMPENSATION, ETC TAXABLE INTEREST INCOME 509 TAX-EXEMPT INTEREST INCOME DIVIDENDS 50 7 NET PROFITS FROM BUSINESS 54 DESC OF PROP DATE PLACED IN SERVICE CY FEDERAL PART II - CALCULATION OF NJ FED BASIS FOR NJ SEC 79 DEDUCTION PY NJ FED METHOD PART III - CALCULATION OF ADJUSTMENT TO FEDERAL 79 RECAPTURE INCOME ASSET [27] DATE PLACED IN SERVICE PART IV - CALCULATION OF ADJUSTMENT TO FEDERAL GAIN OR LOSS ON DIPOSITION OF ASSET ASSET NJ WORKSHEET GIT DEP [27] DATE IN SERVICE DISPOSITION DATE LIFE/RATE NJ 79 RECAPTURE INCOME TOTAL NJ DEPREC ADJUSTMENTS NET GAINS OR INCOME FROM DISPOSITION OF PROPERTY PENSIONS AND IRA WITHDRAWALS DISTRIBUTIVE SHARE OF PARTNERSHIP INCOME NET PRO RATA SHARE OF S - CORP INCOME NET GAINS OR INCOME FROM RENTS, ROYALTIES, PATENTS, AND COPYRIGHTS GAMBLING WINNINGS ALIMONY & SEPARATE MAINTENANCE PAYMENTS RECEIVED 552 CONTINUED ON DATASHEET 2 NJ DEPR FEDERAL 79 RECAPTURE INC TOTAL FED DEPREC

2 NJ NEW JERSEY 040 DATA SHEET 2 3 FORM NJ- 040 RESIDENT INC TAX RETURN, PAGE 3 CONTINUED PRIZES AND AWARDS: ENTITY [25] AMOUNT DECEDENT NAME INCOME OF DECEDENT: [25] DECEDENT SSN [] AMOUNT NAME OF ESTATE OR TRUST INCOME FROM ESTATE AND TRUSTS: [25] AMOUNT 25 ORGANIZATION SCHOLARSHIPS AND FELLOWSHIPS: [25] ORGANIZATION ID [] AMOUNT RESIDENTIAL RENTAL VALUE OR ALLOWANCE PAID BY EMPLOYER: COMPANY NAME [25] COMPANY ID [] ALLOWANCE DESCRIPTION OTHER INCOME: [25] AMOUNT WORKSHEET D 27 PENSION EXCLUSION 548 WOULD TAXPAYER (AND SPOUSE IF MFJ) BE RECEIVING OR EVER BE ELIGIBLE TO RECEIVE SOCIAL SECURITY OR RR RETIREMENT 27 BENEFITS IF HAD PARTICIPATED IN EITHER PROGRAM 606 YES OTHER RETIREMENT INCOME EXCLUSION IF PART -YEAR RESIDENT, NUMBER OF MONTHS AS NEW JERSEY RESIDENT (WORKSHEET) 593 EXEMPTIONS (PART-YEAR ONLY) 5269 WORKSHEET E TOTAL NONREIMBURSED MEDICAL EXPENSES ADDITIONAL MEDICAL EXPENSES 55 SE HEALTH INSURANCE DEDUCTION 530 OVERRIDE WORKSHEET LIMITATION ALIMONY & SEPARATE MAINTENANCE PAYMENTS QUALIFIED CONSERVATION CONTRIBUTION HEALTH ENTERPRISE ZONE DEDUCTION 5099 TOTAL PROPERTY TAXES PAID HOMEOWNER AS OF OCTOBER, OF THE CURRENT YEAR 600 YES HOMEOWNER, BUT NOT AS OF OCTOBER, OF THE CURRENT YEAR 6065 YES c PROPERTY TAX DEDUCTION TAX CREDIT FOR INCOME TAXES PAID TO OTHER JURISDICTIONS (SCHEDULE A, LINE 5) 523 JURISDICTION CODE SHELTERED WORKSHOP TAX CREDIT USE TAX DUE ON OUT-OF-STATE PURCHASES PENALTY FOR UNDERPAYMENT OF ESTIMATED TAX 5084

3 NJ NEW JERSEY 040 DATA SHEET 3 4 FORM NJ- 040 RES INC TAX RTN, PG 4 47 TOTAL NEW JERSEY INCOME TAX WITHHELD 527 OTHER DESIGNATED CONTRIBUTION PROPERTY TAX CREDIT 5042 CODE NUMBER: 50 CU COUPLES: FED EIC AMOUNT RECEIVED AS JT FILERS Drug Ause Eduction Fund 5 EXCESS IN UNEMPLOYMENT INSURANCE WITHHELD Koren Veterns' Memoril Fund 52 EXCESS IN DISABILITY INSURANCE WITHHELD Orgn nd Tissue Donor Awreness 4 - NJ-Aids Services Fund 53 EXCESS IN FAMILY LEAVE WITHHELD Litercy Volunteers Americ - NJ Fund 6 - NJ Prostte Cncer Reserch Fund 57 APPLIED TO NEXT YEAR'S TAX NJ World Trde Center 58 ENDANGERED WILDLIFE FUND NJ Veterns Hven Progrm 59 CHILDREN'S TRUST FUND PREVENT CHILD ABUSE Community Food Pntry Fund 60 NJ VIETNAM VETERANS FUNDS Ct nd Dog Spy/Neuter Fund 609 DATE OF LATE PAYMENT U.S.S. NEW JERSEY EDUCATIONAL MUSEUM 5067 DATE OF LATE FILING BREAST CANCER FUND 5053 PENALTIES AND INTEREST: TAX DUE USED TO COMPUTE PENALTIES & INTEREST 5540 OVERRIDE INTEREST AND PENALTY CALCULATION 554 S NJ WORKSHEET F - PROPERTY TAX DEDUCTION / CREDIT HOMEOWNER AS OF OCTOBER, OF THE CURRENTY YEAR 600 YES SENIORS/BLIND/DISABLED PERSONS: ELIGIBLE HOMESTEAD REBATE6040 YES HOMEOWNER, BUT NOT AS OF OCTOBER, OF THE CURRENTY YR 6065 YES PROPERTY TAX PAID 525 TENANT DURING CURRENT YEAR 6002 YES RENT PAID 5253 RENTED DWELLING INCLUDES SEPARATE KITCHEN AND BATH 604 YES NOTE: IF BOTH PROPERTY TAX AND RENT WERE PAID, COMPLETE WORKSHEET F BELOW: (REQUIRED IF TENANT) F MARRIED / CU PARTNER FILING SEPARATE, SPOUSE'S OR CU PARTNER'S GROSS INCOME WORKSHEET F - MULTIPLE HOMEOWNERS/TENANTS IF ONE OR MORE OF THE FOLLOWING APPLY, COMPLETE THIS WORKSHEET; LIVED IN MORE THAN ONE QUALIFYING NJ RESIDENCE IN THE CURRENT YEAR; SHARED OWNERSHIP OF PRINCIPAL RESIDENCE DURING THE YEAR WITH SOMEONE OTHER THAN SPOUSE; PRINCIPAL RESIDENCE OWNED WAS A MULTIPLE UNIT OR ANYONE OTHER THAN SPOUSE OCCUPIED AND SHARED RENT FOR AN APARTMENT OR OTHER DWELLING UNIT STREET ADDRESS [26] CITY, STATE, ZIP PART I: HOMEOWNERS [26] # OF DAYS IN TAX YEAR IN THIS UNIT AS OWNER SHARE OF PROPERTY OWNED BY TXPAYER AND SPOUSE SHARE OF PROPERTY USED AS PRINCIPAL RESIDENCE TOTAL TAXES PAID ON THIS PROPERTY, LIMIT TO 7 ENTRIES PART II: TENANTS STREET ADDRESS CITY, STATE, ZIP [26] [26] # OF DAYS IN TAX YEAR AT RESIDENCE AS TENANT NO. TENANTS WHO SHARE RENT TOTAL RENT PAID BY TP & SP FOR RES THIS PRD, LIMIT TO 6 ENTRIES OPTIONAL OVERRIDE KEYFIELD ASSET MGR [ # ] MAX CHAR ADD-TO

4 NJ NEW JERSEY 040 DATA SHEET 4 NR NJ-040NR NR STATE NJ INCOME TAX, PG PREPARE FORM NJ-040NR NONRESIDENT RETURN 603 YES RESIDENT OF A RECIPROCAL STATE (NONRESIDENTS ONLY) 6200 YES STATE OF RESIDENCE WGS, SALARIES, TIPS, ETC INTEREST DIVIDENDS NET PROFIT FROM BUSN NET GAIN DISPOSITION NET GAIN RENTS, ETC NET GAMBLING WINNINGS PEN, ANNTY, < NJ EXCL 22 DISTR SH OF PTSHP INC 23 NET PRO RATA SHARE OF S-CORP INCOME 24 ALIMONY & SEP MAINT PMT RECD OTHER AMOUNT NATURE AND SOURCE 6052 EVERYWHERE NJ SOURCES PENSION EXCLUSION 548 OTHER RETIREMENT EXCLUSION 5225 NR3 NJ-040NR NR STATE NJ INCOME TAX, PG 3 PART I - NET GAINS OR INCOME FROM DISPOSITION OF PROPERTY NET GAINS OR INCOME FROM DISPOSITION OF PROPERTY KIND OF PROPERTY DATE [20] ACQUIRE [0] DATE SOLD [0] GR SALE PRICE [0] COST/ BASIS [0] [30] NR2 NJ-040NR NR STATE NJ INCOME TAX, PG 2 3 MEDICAL EXP AND MSA CONTRIBUTIONS 56 OVERRIDE WORKSHEET LIMITATION QUALIFIED CONSERVATION CONTRIBUTION HEALTHY ENTERPRISE ZONE DEDUCTION SHELTERED WORKSHOP TAX CREDIT PENALTY FOR UNDERPAYMENT OF ESTIMATED TAXES TOTAL NJ TAX WITHHELD PAYMENTS MADE IN CONNECTION WITH NJ REAL PROPERTY TAX PAID BY PARTNERSHIP 599 APPLIED TO NEXT YEAR'S TAX NJ ENDANGERED WILDLIFE FUND 537 c NJ CHILDREN'S TRUST FUND TO PREVENT CHILD ABUSE 538 d NJ VIETNAM VETERANS' MEMORIAL FUND 52 e NJ BREAST CANCER RESEARCH FUND 5053 f U.S.S.N.J. EDUCATIONAL MUSEUM FUND 5067 OTHER DESIGNATED CONTRIBUTION 5049 g CODE NUMBER: - Drug Ause Eduction Fund 2 - Koren Veterns' Memoril Fund 3 - Orgn nd Tissue Donor Awreness 4 - NJ-Aids Services Fund 5 - Litercy Volunteers Americ - NJ Fund 6 - NJ Prostte Cncer Reserch Fund 7 - NJ World Trde Center 8 - NJ Veterns Hven Progrm 609 INTEREST AND PENALTY DATE OF LATE PAYMENT 6345 DATE OF LATE FILING 6346 TAX DUE AMOUNT USED TO COMPUTE PENALTIES & INT 5540 OVERRIDE INTEREST AND PENALTY CACLULATION CAPITAL GAINS DISTRIBUTIONS OTHER NET GAINS NET GAINS/ INCOME FROM RENT, ROYALTIES, PATENTS, COPYRIGHTS KIND OF PROPERTY [25] NET RNT INC [0] NET INC RYLTY [0] NET INCOME [0] NET INC CPYRGT [0] PART III - ALLOCATION OF WAGE AND SALARY INCOME 63 WAGES, SALARIES, COLUMN A PART WHICH IS REQUIRED TO BE ALLOCATED TOTAL DAYS IN TAXABLE YEAR PART II - NET GAINS/INC FROM RENTS, ROYALTIES, COPYRIGHTS NON-WORKING DAYS (SUN, SAT, SICK, VACATION, ETC) 5228 [3] DAYS WORKED OUTSIDE NEW JERSEY 5229 PART IV - BUSINESS INCOME ALLOCATION ENTER LINE NUMBER AND AMOUNT OF EACH ITEM OF BUSINESS INCOME REPORTED IN COLUMN A OF PART WHICH IS REQUIRED TO BE ALLOCATED NRA MULTI # FROM LN # PART I AMOUNT PERCENTAGE [3] [3] NRA NJ-NR-A GROSS INC TX BUS ALLOCATION SCH MULTIPLE TRADE NAME OF BUSINESS: TRADE ADDRESS: 607 TRADE ZIP CODE: (CITY AND STATE WILL BE ENTERED AUTOMATICALLY ON SCREEN) TRADE SSN/EIN 6073 TRADE FISCAL YEAR ENDING 6074 STREET ADDRESS [5] REAL PROPERTY OWNED REAL & TANGIBLE PROPERTY RENTED TANGIBLE PERSONAL PROP OWNED SECTION I - BUSINESS LOCATIONS DESCRIPTION OF CITY AND STATE [9] BUSINESS [20] SECTION 2 - AVERAGE VALUES SECTION 3 - BUSINESS ALLOCATION PERCENTAGE TOTAL RECEIPTS FROM ALL SALES, SERVICE, AND OTHER BUSINESS IN NEW JERSEY 5406 TOTAL RECEIPTS FROM SALES, SERVICE, AND OTHER BUSINESS ELSEWHERE 5407 WAGES, SALARIES, & OTHER PERSONAL COMPENSATION PD DURING YEAR IN NJ 5408 WAGES, SALARIES, & OTHER COMPENSATION PAID DURING THE YEAR EVERYWHERE 5409 OWN [45] [45] [45]

5 NJ NEW JERSEY 040 DATA SHEET 5 A MULTIPLE NOTE: SCHEDULE A - CREDIT FOR INCOME OR WAGE TAXES PAID TO OTHER JURISDICTIONS THE CREDIT FOR STATE INCOME TAXES PAID IS COMPUTED AUTOMATICALLY. IF THE AUTOMATE CREDIT (N0) BOX IS CHECKED, ALL STATE CREDIT INFORMATION MUST BE ENTERED MANUALLY. ENTER ONE STATE PER MULTIPLE FORM. AUTOMATE CREDIT INCOME TAXED BY OTHER JURISDICTION 6059 [5] AMOUNT 5 PROPERTY TAX PAID 9 INCOME OR WAGE TAX PAID TO OTHER JURISDICTIONS 6043 NO B SCHEDULE B - NET GAINS OR INCOME FROM DISPOSITION OF PROPERTY KIND OF PROPERTY AND DESCRIPTION DATE ACQUIRED DATE SOLD [20] DO NOT CARRY INFORMATION FROM FEDERAL SCHEDULE D 2 CAPITAL GAINS DISTRIBUTIONS 3 OTHER NET GAINS GROSS SALES PRICE COST / OTHER BASIS AS ADJUSTED & EXPENSE OF C SCHEDULE C - NET GAINS OR INCOME FORM RENTS, ROYALTIES, PATENTS AND COPYRIGHTS KIND OF PROPERTY [25] NET RENTAL INCOME (LOSS) NET INCOME FROM ROYALTIES NET INCOME FROM PATENTS NET INCOME FROM COPYRIGHTS DESC OF PROP DATE PLACED IN SERVICE CY FEDERAL NJ WORKSHEET GIT DEP PART II - CALCULATION OF NJ FED BASIS FOR NJ SEC 79 DEDUCTION PY NJ FED METHOD PART III - CALCULATION OF ADJUSTMENT TO FEDERAL 79 RECAPTURE INCOME ASSET [27] DATE PLACED IN SERVICE PART IV - CALCULATION OF ADJUSTMENT TO FEDERAL GAIN OR LOSS ON DIPOSITION OF ASSET LIFE/RATE NJ 79 RECAPTURE INCOME NJ DEPR FEDERAL 79 RECAPTURE INC ASSET [27] DATE IN SERVICE DISPOSITION DATE TOTAL NJ DEPREC TOTAL FED DEPREC

6 NJ NEW JERSEY 040 DATA SHEET 6 T24 EXCESS UNEMPLOYMENT & DISABILITY S24 EXCESS UNEMPLOYMENT & DISABILITY TAXPAYER SPOUSE c d e f FIRST SET SECOND SET FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN c d e f FIRST SET SECOND SET FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN FEIN PRIVATE PLAN g IF ADDITIONAL EMPLOYERS, ATTACH RIDER AND ENTER TOTAL DEDUCTIONS UNEMPLOYMENT INSURANCE DEDUCTED 5336 DISABILITY INSURANCE DEDUCTED 5337 FAMILY LEAVE INSURANCE DEDUCTED 5335 g IF ADDITIONAL EMPLOYERS, ATTACH RIDER AND ENTER TOTAL DEDUCTIONS UNEMPLOYMENT INSURANCE DEDUCTED 5368 DISABILITY INSURANCE DEDUCTED 5369 FAMILY LEAVE INSURANCE DEDUCTED 5370 X PREPARE FORM NJ-040X FILING STATUS ON ORIGINAL RETURN 33 = Single 2 = Mrried/CU couple fiing JT 3 = Mrried/CU couple filing seprte 4 = Hed of household 5 = Qulifying widow(er) surviving CU prtner 500 ON ORIG RETN, $ DIDN'T GO TO GUBERNATORIAL FUND, BUT WILL NOW CONTRIBUTE TAXPAYER 6033 YES SPOUSE 6034 YES ORIG EXEMPT 6 REGULAR EXEMPTIONS AGE 65 OR OLDER EXEMPTIONS BLIND OR DISABLED EXEMPTIONS QUALIFIED DEPENDENT CHILDREN OTHER DEPENDENTS 5006 DEPENDENTS ATTENDING COLLEGE 5007 AMENDED INCOME TAX RETURN 6032 YES 32 QUALIFIED CONSERVATION CONTRIBUTION HEALTH ENTERPRISE ZONE 39 COMPLETE IF AMENDING INCOME FROM OTHER JURISDICTIONS 5035 INCOME FROM OTHER NJ SOURCES SHELTERED WORKSHOP TAX CREDIT USE TAX PENALTY FOR UNDERPAYMENT OF ESTIMATED TAX NEW JERSEY TAX WITHHOLDING PROPERTY TAX CREDIT NEW JERSEY ESTIMATED TAX PAYMENTS NJ EARNED INCOME TAX CREDIT EXCESS NEW JERSEY UI/WF/SWF WITHHELD 503 ORIGINAL AMTS 4 WAGES, SALARIES, TIPS, ETC EXCESS NJ DISABILITY INSURANCE WITHHELD TAXABLE INTEREST INCOME EXCESS NJ FAMILY LEAVE INSURANCE WITHHELD 576 TAX-EXEMPT INTEREST INCOME AMOUNT PAID WITH ORIGINAL RETURN DIVIDENDS REFUND ISSUED FROM ORIGINAL RETURN NET PROFIT FROM BUSINESS AMOUNT TO CREDIT TO NEXT YEAR TAX NET GAINS FROM DISPOSITION PENSIONS, ANNUITIES, AND IRA WITHDRAWALS NAME, SSN, AND ADDRESS IF DIFFERENT FROM ORIGINAL 6438 [65] 20 DISTRIBUTIVE SHARE OF PARTNERSHIP INCOME [65] 2 NET PRO RATA SHARE OF S CORP INCOME 507 EXPLANATION OF CHANGES 22 NET GAINS FROM RENTS, ROYALTIES, ETC NET GAMBLING WINNINGS [65] 24 ALIMONY RECEIVED OTHER INCOME [65] 27 PENSION EXCLUSION 505 OTHER RETIREMENT INCOME EXCLUSION [65] 29 EXEMPTIONS MEDICAL EXPENSES, MSA CONTRIBUTIONS [65] 3 ALIMONY PAYMENTS [65] c TAX TOTAL PROPERTY TAXES PAID PROPERTY TAX DEDUCTION CREDIT FOR TAXES PAID

7 NJ NEW JERSEY 040 DATA SHEET FORCE PRINTING OF FORM NJ-220 SUPPRESS PRINTING OF FORM NJ-220 QUALIFIED FARMER 4 PRIOR YEAR TAX PRIOR YEAR TAX OPTIONS 0 - Not pplicle, enter PY tx ove - No PY tx liility (whether or not return ws sed CY tx only) 2 - PY Rtn not filed/tx li unknown (penlty sed CY tx only) 3 - PY ws less thn 2 mo (penlty sed CY tx only) ESTIMATED TAX PAID AND TAX WITHHELD PER PERIOD 4/5/ /5/ /5/ 508 /5/ TOTAL INTEREST 5084 EXCEPTION II PRIOR YEAR NEW JERSEY GROSS INCOME NJ FORM NJ220 - UNDERPAYMENT OF ESTIMATED TAX 6029 YES EXCEPTION III 6062 YES PORTION OF NEW JERSEY GROSS INCOME ATTRIBUTABLE TO EACH PERIOD 609 YES --09 TO TO TO EXCEPTION IV PORTION OF NEW JERSEY GROSS TAXABLE INCOME APPLICABLE TO EACH PERION --09 TO TO TO PORTION OF CREDIT FOR TAXES PAID ATTRIBUTABLE TO EACH PERIOD --09 TO TO TO EF NJ FORM E-FILE SIGN AUTH DO NOT USE PIN PROGRAM 6236 PREPARE E-FILE OPT OUT REQUEST FORM 676 SUPPRESS NJ OPT-OUT FORM 6036 TAXPAYER OBJECTION 677 REASON 678 [70] 679 [70] YES YES YES EXT NJ FORM NJ EXTENSION APPL PREPARE NJ WITH FULL RETURN 6045 YES PREPARE NJ ONLY 6095 YES EXTENSION DATE TO: 6057 TOTAL ESTIMATED TAX LIABILITY NJ INCOME TAX WITHHELD OTHER TAX PAYMENTS EXTENSION PAYMENT 5064 JVA COPYRIGHT FORMS(SERVICESFORTAXPREPARERS.COM)

8 NJ NEW JERSEY 040 DATA SHEET 8 PTK MULTIPLE TYPE OF ENTITY: PARTNERSHIP'S NAME 4 [35] PARTNERSHIP'S ADDRESS 42 [35] PARTNERSHIP'S ZIP CODE 43 [0] PARTNERSHIP'S CITY 420 [20] PARTNERSHIP'S STATE 42 PARTNER'S PERCENTAGE OF BEFORE DECREASE OR TERMINATION END OF YEAR PROFIT SHARING LOSS SHARING CAPITAL OWNERSHIP INCOME CLASSIFICATION TOTAL DISTRIB NJ SOURCE AMT PARTNERSHIP INCOME (LOSS) NET GUARANTEED PAYMENTS PARTNER'S 40(K) CONTRIBUTION PENSION 453 NET GAIN (LOSS) - DISPOSITION OF 6 ASSETS FROM COMPLETE LIQUIDATION 468 PART III - PARTNER'S INFORMATION SHARE OF NJ TAX NJ FORM NJ SCH NJK-, PARTNER SHARE SPOUSE'S K- 40 YES PRINT SCHEDULE NJK- 402 YES FISCAL YEAR BEGINNING 403 FISCAL YEAR ENDING 404 PARTNER'S SSN OR EIN RI=NJ Resident individul NRC=Nonresident individul RP=NJ resident prtnership NT=Nonresident trust NE=Nonresident estte FC=NON-NJ corportion HEDGE FUND 424 YES MEMBER OF COMPOSITE RETURN 425 YES PARTNERSHIP'S FEDERAL EIN 40 - PART II - INCOME INFORMATION 469 ESTIMATED TAX PAYMENTS ST QUARTER 426 2ND QUARTER 427 3RD QUARTER 428 4TH QUARTER 429 OTHER PARTNER'S HEZ DEDUCTION PARTNER'S SHELTERED WORKSHOP CREDIT 467 PART IV - SUPPLEMENTAL INFORMATION RESIDENT SUPPLEMENTAL INFORMATION DESCRIPTION PART I - GENERAL INFORMATION NR=Nonresident individul PI=Prt yer resident individul NP=Nonresident prtnership NPM=Nonresident prtnership RT=NJ resident trust RE=NJ resident estte RC=NJ corportion FCM=NON-NJ corportion EFC=Exempt foreign corp RO=NJ Resident other NO=Nonresident other NOM=Nonresident other 406 [3] DATE PARTNER'S INTEREST BEGAN 407 FINAL NJK- 408 YES AMENDED NJK- 409 YES [58] 465 AMOUNT SK NJ FORM CBT-00S - SCH NJK-, SHRHLDR SHARE MULTIPLE SPOUSE'S K- 40 YES PRINT SCHEDULE NJ-K- 402 YES FISCAL TAX YEAR BEGINNING 403 FISCAL TAX YEAR ENDING 404 S-CORPORATION FEIN S-CORPORATION NAME 406 [35] S-CORPORATION SECOND NAME 407 [35] S-CORPORATION ADDRESS 408 [35] S-CORPORATION ZIP CODE 409 S-CORPORATION CITY 40 [20] S-CORPORATION STATE 4 4 S INCOME/(LOSS) ALLOCATED TO NJ S INCOME/(LOSS) NOT ALLOCATED TO NJ 45 4 GAIN (LOSS) ON DISPOSITION OF ASSETS ALLOCATED TO NJ GAIN (LOSS) ON DISPOSITION OF ASSETS NOT ALLOC TO NJ TOTAL PAYMENTS MADE ON BEHALF OF SHAREHOLDER DISTRIBUTIONS ADDITIONS/ADJUSTMENTS DIVIDENDS RECEIVED FINAL NJ-K- 45 YES AMENDED NJ-K- 46 YES INDEBTEDNESS PART III - ACCUMULATED ADJUSTMENTS ACCOUNT NJ AAA NON-NJ AAA BEGINNING BALANCE INCOME/(LOSS) OTHER INCOME/(LOSS) OTHER DISTRIBUTIONS PART IV - NEW JERSEY EARNINGS AND PROFITS ACCOUNT BEGINNING BALANCE 48 INTEREST PAID TO SHAREHOLDER SHAREHOLDER'S HEZ DEDUCTION PART I SHAREHOLDER'S % OF STOCK OWNERSHIP FOR TAX YEAR PART II PART V FROM CORPORATION TO SHAREHOLDER FROM SHAREHOLDER TO CORPORATION 42 2 NON-RESIDENT SHAREHOLDER 43 YES 3 NON-CONSENTING SHAREHOLDER 44 YES ADDITIONAL LINE AVAILABLE ON INPUT SCREEN NON-RESIDENT SUPPLEMENTAL INFORMATION : DESCRIPTION [49] ALL SOURCES NJ SRCE AMTS ADDITIONAL LINE AVAILABLE ON INPUT SCREEN

9 NJ NEW JERSEY 040 DATA SHEET 9 ES PRIOR YEAR OVERPAYMENT APPLIED PRIOR YEAR EXTENSION PAYMENT MADE IN CURRENT YEAR PRIOR YEAR ESTIMATED TAX PAID IN CURRENT YEAR PRIOR YEAR TAX PAID WITH RETURN AMOUNT PAID WITH EXTENSION - Refund ll overpyment 2- Apply ll overpyment 3- Apply to ll vouchers, refund lnce 4- Apply to st voucher, refund lnce ALLOCATION METHOD: - Consecutively 0- No estimted tx clcultion - Lesser of option 2 or option % of current yer txes 3-90% of next yer estimted tx IGNORE WITHHOLDINGS FOR NEXT YEAR ESTIMATED TAX NJ ESTIMATED TAX CURRENT YEAR ESTIMATED TAX PAYMENTS VOUCHER PAYMENT DATE ESTIMATED TAX CALCULATION ADJUSTMENTS TAXABLE INCOME INCREASE OR (-) DECREASE TAX INCREASE OR (-) DECREASE WITHHOLDINGS INCREASE OR (-) DECREASE 5363 THRESHOLD: - Prepre vouchers, if pplicle 2- Prepre if tx due > $,000 or mount entered 3- Prepre if tx due > $600 or mount entered 4- Prepre if tx due > $500 or mount entered 5- Prepre if tx due > $400 or mount entered 6- Prepre if tx due > $300 or mount entered 7- Prepre if tx due > $250 or mount entered ROUNDING - ONLY VOUCHER AMOUNTS WILL BE ROUNDED: - No rounding 2- Round voucher mount up to nerest 0 CHECK IF ONLY SPECIFIC VOUCHERS TO BE GENERATED PREPARE DATED REMINDER LETTERS SUPPRESS FIRST QUARTER REMINDER LETTER VOUCHER DATE VOUCHER DATE CURRENT YEAR ESTIMATED TAX WORKSHEET CURRENT YEAR OVERPAYMENT TO NEXT YEAR 2- Eqully 4-00% of next yer estimted tx 5-80% of next yer estimted tx 6-70% of next yer estimted tx 7- Lesser of option 2 or option 5 5- Apply to st nd 2nd vouchers, refund lnce 6- Apply to st, 2nd, nd 3rd vouchers, refund lnce 7- Apply mount entered NEXT YEAR ESTIMATED TAX NEXT YEAR VOUCHERS 8- Prepre if tx due > $246 or mount entered 9- Prepre if tx due > $200 or mount entered 0- Prepre if tx due > $50 or mount entered - Prepre if tx due > $00 or mount entered 2- Prepre if tx due > $50 or mount entered 3- Prepre lnk vouchers 4- Suppress vouchers 3- Round voucher mount up to nerest Round voucher mount up to nerest 000 OVERRIDES 8- Lesser of option 2 or option % of next yer estimted tx 0- Amount entered VOUCHER 6355 DUE DATE METHOD METHOD ESTIMATED TAX* OVERPAYMENT APPLIED AMOUNT YES 6353 METHOD AMOUNT AMOUNT AMOUNT THRESHOLD METHOD 6354 VOUCHER 3 VOUCHER YES 6359 YES AMT TO PRINT ON VOUCHER OPTIONAL OVERRIDE KEYFIELD ASSET MGR [ # ] MAX CHAR ADD-TO

10 NJ NEW JERSEY 040 DATA SHEET 0 PTR NJ - FORM PTR-, PROP TAX REIMBURSEMENT APPLICATION HOMEOWNER 6250 YES MOBILE HOMEOWNER 625 YES WAS OWNERSHIP OF PRINCIPAL RESIDENCE SHARED WITH MARITAL/CIVIL UNION STATUS ON DECEMBER 3, PRIOR YEAR: SINGLE 6253 MARRIED/CIVIL UNION COUPLE IF YES, INDICATE THE SHARE OF MARITAL/CIVIL UNION STATUS ON DECEMBER 3, CURRENT YEAR: THE OWNED PROPERTY SINGLE 6255 MARRIED/CIVIL UNION COUPLE DOES PRINCIPAL RES CONSIST ON DECEMBER 3, PRIOR YEAR, TAXPAYER OR SPOUSE/CU PARTNER WAS: 2 IF YES, INDICATE THE SHARE OF OR OLDER 6257 RECEIVING SS DISABILITY BENEFITS THE PROPERTY OCCUPIED ON DECEMBER 3, CURRENT YEAR, TAXPAYER OR SPOUSE/CU PARTNER WAS: TOTAL CURRENT YEAR PROPERTY TAXES DUE AND PAID 3 ON PRINCIPAL RESIDENCE OR OLDER 6259 RECEIVING SS DISABILITY BENEFITS TOTAL PRIOR YEAR PROPERTY TAXES DUE AND PAID 4 5 LIVED IN NJ CONTINUOUSLY SINCE BEFORE JANUARY, YES ON PRINCIPAL RESIDENCE 59 6 OWNED AND LIVED IN NJ HOME SINCE BEFORE JAN, YES ANYONE OTHR THAN SPOUSE/CU 6267 YES 6268 YES OF MORE THAN ONE UNIT 627 YES 6272 YES PRIOR YEAR TOTAL INCOME FDK NJ - SCH NJK-, BENEFICIARY'S SHARE NOTE: IF TAXPAYER WAS MARRIED OR IN A CIVIL UNION AS OF DECEMBER 3, PRIOR YEAR, INCOME MUST BE COMBINED WITH SPOUSE'S/CU PARTNER'S INCOME SOCIAL SECURITY BENEFITS 900 TOTAL PENSION INCOME 9002 c SALARIES AND WAGES 9003 d BONUSES, COMMISSIONS AND FEES 9004 e UNEMPLOYMENT BENEFITS 9005 f DISABILITY BENEFITS 9006 g INTEREST (TAXABLE AND EXEMPT) 9007 h DIVIDENDS 9008 i NET CAPITAL GAINS 9009 j NET RENTAL INCOME 900 k NET BUSINESS INCOME 90 l SUPPORT PAYMENTS 902 m INHERITANCES 903 n ROYALTIES 904 o GAMBLING AND LOTTERY WINNINGS 905 p REQUESTS AND DEATH BENEFITS 906 q ALL OTHER INCOME 907 CURRENT YEAR TOTAL INCOME MULTIPLE PART I - GENERAL INFORMATION SPOUSE'S K- 48 YES PRINT SCHEDULE NJK- 482 YES FISCAL YEAR BEGINNING 483 FISCAL YEAR ENDING 484 BENEFICIARY'S EIN (IF APPLICABLE) FINAL NJK- 438 YES AMENDED NJK- 439 YES MEMBER OF COMPOSITE RETURN 440 YES INDIVIDUAL 486 YES GRANTOR 488 YES ESTATE OR TRUST INFORMATION FEDERAL EIN NAME 49 [38] FIDUCIARY 492 [38] ADDRESS 493 [38] ZIP CODE 494 CITY 495 [20] STATE 496 RESIDENT NONRESIDENT NOTE: IF TAXPAYER WAS MARRIED OR IN A CIVIL UNION AS OF DECEMBER 3, CURRENT YR, INCOME MUST BE COMBINED WITH SPOUSE'S/CU PARTNER'S INCOME ESTATE OR TRUST INFORMATION 460 YES 463 YES SOCIAL SECURITY BENEFITS 9030 TRUST 46 YES 464 YES TOTAL PENSION INCOME 903 GRANTOR TRUST 462 YES 465 YES c SALARIES AND WAGES 9032 PART II - BENEFICIARY'S SHARE OF INCOME d BONUSES, COMMISSIONS AND FEES 9033 BENEFICIARY'S SHRE OF TOTAL DISTRIBUTION 450 e UNEMPLOYMENT BENEFITS 9034 BENEFICIARY'S SHARE OF NJ SOURCE INCOME 45 f DISABILITY BENEFITS 9035 TAX PAID BY PARTNERSHIPS 452 g INTEREST (TAXABLE AND EXEMPT) 9036 PART III - GRANTOR'S SHARE OF INCOME h DIVIDENDS 9037 EVERYWHERE NJ SOURCE i NET CAPITAL GAINS 9038 INTEREST j NET RENTAL INCOME 9039 NJ EXEMPT 402 k NET BUSINESS INCOME 9040 DIVIDENDS l SUPPORT PAYMENTS 904 NJ EXEMPT 404 m INHERITANCES 9042 NET PROFITS OR LOSS FROM BUSINESS n ROYALTIES 9043 NETS GAINS, INCOME OR LOSS FROM o GAMBLING AND LOTTERY WINNINGS 9044 DISPOSITION OF PROPERTY NETS GAINS, INCOME OR LOSS FROM p REQUESTS AND DEATH BENEFITS RENTS, ROYALTIES, PATENTS, COPYRIGHT 427 q ALL OTHER INCOME 9046 DISTRIBUTIVE SHARE OF PARTNERSHIP INCOME OR LOSS ADDRESS FOR REIMBURSEMENT CLAIM, IF DIFFERENT: NET PRO RATA SHARE OF S CORPORATION INCOME OR LOSS ADDRESS 6262 [3] MUNICIPALTY 6263 [23] OTHER INCOME HOMEOWNERS: BLOCK AND LOT NUMBERS OF THE RESIDENCE FOR WHICH THE PROPERTY TAX REIMBUTSEMENT IS BEING CLAIMED: 435 [23] TAX PAID BY PARTNERSHIP(S) ON BEHALF OF TRUST BLOCK 6264 [22] 43 LOT 6265 [22] QUALIFIER 6266 [] OVERRIDE KEYFIELD [ # ] MAX CHAR