671119
Final K-1 Amended K-1
OMB No. 1545-0123
Schedule K-1
(Form 1120-S)
2019
Department of the Treasury
Internal Revenue Service
For calendar year 2019, or tax year
beginning
/
/
/ /
ending
Shareholder’s Share of Income, Deductions,
Credits, etc.
See back of form and separate instructions.
Information About the Corporation
Part I
A Corporation’s employer identification number
B Corporation’s name, address, city, state, and ZIP code
C IRS Center where corporation filed return
Information About the Shareholder
Part II
D Shareholder’s identifying number
E Shareholder’s name, address, city, state, and ZIP code
F
Shareholder’s percentage of stock
ownership for tax year . . . . . . .
%
For IRS Use Only
Shareholder’s Share of Current Year Income,
Deductions, Credits, and Other Items
Part III
1
Ordinary business income (loss)
2
Net rental real estate income (loss)
3
Other net rental income (loss)
4
Interest income
5a
Ordinary dividends
5b
Qualified dividends
6
Royalties
7
Net short-term capital gain (loss)
8a
Net long-term capital gain (loss)
8b
Collectibles (28%) gain (loss)
8c
Unrecaptured section 1250 gain
9
Net section 1231 gain (loss)
10
Other income (loss)
11
Section 179 deduction
12
Other deductions
13
Credits
14 Foreign transactions
15
Alternative minimum tax (AMT) items
16 Items affecting shareholder basis
17
Other information
18
More than one activity for at-risk purposes*
19
More than one activity for passive activity purposes*
* See attached statement for additional information.
For Paperwork Reduction Act Notice, see the Instructions for Form 1120-S. www.irs.gov/Form1120S Cat. No. 11520D Schedule K-1 (Form 1120-S) 2019
2019
Schedule K-1 (Form 1120-S) 2019
Page 2
This list identifies the codes used on Schedule K-1 for all shareholders and provides summarized reporting information for shareholders who file Form 1040
or 1040-SR. For detailed reporting and filing information, see the separate Shareholder’s Instructions for Schedule K-1 and the instructions for your income
tax return.
1.
Ordinary business income (loss). Determine whether the income (loss) is
passive or nonpassive and enter on your return as follows:
Report on
Passive loss See the Shareholder’s Instructions
Passive income Schedule E, line 28, column (h)
Nonpassive loss See the Shareholder’s Instructions
Nonpassive income Schedule E, line 28, column (k)
2. Net rental real estate income (loss)
See the Shareholder’s Instructions
3. Other net rental income (loss)
Net income Schedule E, line 28, column (h)
Net loss See the Shareholder’s Instructions
4. Interest income Form 1040 or 1040-SR, line 2b
5a. Ordinary dividends Form 1040 or 1040-SR, line 3b
5b. Qualified dividends Form 1040 or 1040-SR, line 3a
6. Royalties Schedule E, line 4
7. Net short-term capital gain (loss) Schedule D, line 5
8a. Net long-term capital gain (loss) Schedule D, line 12
8b.
Collectibles (28%) gain (loss)
28% Rate Gain Worksheet, line 4
(Schedule D instructions)
8c. Unrecaptured section 1250 gain See the Shareholder’s Instructions
9. Net section 1231 gain (loss) See the Shareholder’s Instructions
10. Other income (loss)
Code
A Other portfolio income (loss) See the Shareholder’s Instructions
B Involuntary conversions See the Shareholder’s Instructions
C Sec. 1256 contracts & straddles Form 6781, line 1
D Mining exploration costs recapture See Pub. 535
E
Reserved for future use
F Section 965(a) inclusion
G
Income under subpart F (other
than inclusions under sections
951A and 965)
H Other income (loss)
}
See the Shareholder’s Instructions
11. Section 179 deduction See the Shareholder’s Instructions
12. Other deductions
A Cash contributions (60%)
B Cash contributions (30%)
C Noncash contributions (50%)
D Noncash contributions (30%)
E
Capital gain property to a 50%
organization (30%)
F Capital gain property (20%)
G Contributions (100%)
}
See the Shareholder’s Instructions
H Investment interest expense Form 4952, line 1
I Deductions—royalty income Schedule E, line 19
J Section 59(e)(2) expenditures See the Shareholder’s Instructions
K Section 965(c) deduction See the Shareholder’s Instructions
L Deductions—portfolio (other) Schedule A, line 16
M Preproductive period expenses See the Shareholder’s Instructions
N
Commercial revitalization deduction
from rental real estate activities See Form 8582 instructions
O Reforestation expense deduction See the Shareholder’s Instructions
P through R
Reserved for future use
S Other deductions See the Shareholder’s Instructions
13. Credits
A
Low-income housing credit (section
42(j)(5)) from pre-2008 buildings
B
Low-income housing credit (other)
from pre-2008 buildings
C
Low-income housing credit (section
42(j)(5)) from post-2007 buildings
D
Low-income housing credit (other)
from post-2007 buildings
E
Qualified rehabilitation expenditures
(rental real estate)
F Other rental real estate credits
G Other rental credits
}
See the Shareholder’s
Instructions
H
Undistributed capital gains credit
Schedule 3 (Form 1040 or 1040-SR), line
13, box a
I Biofuel producer credit
J
Work opportunity credit
K Disabled access credit
L
Empowerment zone employment credit
M
Credit for increasing research
activities
}
See the Shareholder’s
Instructions
Code
Report on
N
Credit for employer social
security and Medicare taxes
O Backup withholding
P Other credits
}
See the Shareholder’s Instructions
14.
Foreign transactions
A
Name of country or U.S.
possession
B Gross income from all sources
C
Gross income sourced at
shareholder level
}
Form 1116, Part I
Foreign gross income sourced at corporate level
D Reserved for future use
E Foreign branch category
F Passive category
G General category
H Other
}
Form 1116, Part I
Deductions allocated and apportioned at shareholder level
I Interest expense Form 1116, Part I
J Other Form 1116, Part I
Deductions allocated and apportioned at corporate level to foreign source
income
K Reserved for future use
L Foreign branch category
M Passive category
N General category
O Other
}
Form 1116, Part I
Other information
P Total foreign taxes paid Form 1116, Part II
Q Total foreign taxes accrued Form 1116, Part II
R
Reduction in taxes available for
credit Form 1116, line 12
S
Foreign trading gross receipts
Form 8873
T
Extraterritorial income exclusion
Form 8873
U Section 965 information See the Shareholder’s Instructions
V Other foreign transactions See the Shareholder’s Instructions
15. Alternative minimum tax (AMT) items
A
Post-1986 depreciation adjustment
B Adjusted gain or loss
C Depletion (other than oil & gas)
D
Oil, gas, & geothermal—gross income
E
Oil, gas, & geothermal—deductions
F Other AMT items
}
See the Shareholder’s Instructions
and the Instructions for Form 6251
16. Items affecting shareholder basis
A
Tax-exempt interest income Form 1040 or 1040-SR, line 2a
B Other tax-exempt income
C Nondeductible expenses
D Distributions
E
Repayment of loans from
shareholders
See the Shareholder’s Instructions
}
17. Other information
A Investment income Form 4952, line 4a
B Investment expenses Form 4952, line 5
C
Qualified rehabilitation expenditures
(other than rental real estate) See the Shareholder’s Instructions
D Basis of energy property See the Shareholder’s Instructions
E
Recapture of low-income housing
credit (section 42(j)(5)) Form 8611, line 8
F
Recapture of low-income housing
credit (other) Form 8611, line 8
G Recapture of investment credit See Form 4255
H Recapture of other credits See the Shareholder’s Instructions
I
Look-back interest—completed
long-term contracts See Form 8697
J
Look-back interest—income
forecast method See Form 8866
K
Dispositions of property with
section 179 deductions
L
Recapture of section 179 deduction
M through U
V Section 199A information
}
See the Shareholder’s Instructions
W through Z
AA Excess taxable income
AB
Excess business interest income
AC Other information
}
See the Shareholder’s Instructions
Reserved for future use