CORRECTED (if checked) BAYER'S name, street address. city or town, state or province, country. ZIP Applicable checkbox on Form 8949 TOMB No. 1545-0715 Proceeds From EXHIBITS 20XX arter Exchanged Form 1099-8 Sale of Bravo Stock orm 1099-B Sale of Alpha Stock Form 1099-DIV 813 Main Street Form 1099-B Transactions Form 1099-INT MEJ Tax Rate Schedules Schedule K-1 Do Nashville , Tennessee 37203 1a Description of property (Example: 100 sh. XYZ Co go shares, Bravo Corp. common Stold or dispose Scroll down to complete all parts of this task . March 1, Year April 15, Year 2 PAYER'S TIN RECIPIENT'S Patrick and Amanda Thompson, married filing jointly (MFJ) taxpayers, have Year 2 income from several sources. Tax documents for 1d Proceeds fe Cost or other basis Copy B "or the section 199A qualified business income (QBI) deduction . They have no other sour urces of income or adjustments to income in 22-XXXXXXX 708-XX-XXXX If Accrued market discount 1g Wash sale loss di For Recipient Year 2 and do not itemize deductions. The Year 2 standard deduction for married filing jointly taxpayers is $27 700 RECIPIENT'S name Short-term gain or loss 3 If checked, proceeds from Using the tax documents and individual tax rate schedules provided in the exhibit, calculate the amount of Patrick and Amanda's Long-term gain or loss Collectibles Year 2 federal taxable ment met investment income (NII) tax in the table below. Enter all amounts as positive values, using whole numbers. If the amount is zero, enter a zero (O) Amanda Thompson This is important tax security rmation and is 437 Laurel Lane Reported to IRS: If checked, loss is not allowed the IRS. If you are Year 2 taxable income City or town, state of province, country, and ZIP or foreign postal code Gross proceeds turn, a negligne a 2 Year 2 tax liability : Net proceeds Knoxville, Tennessee 37522 20is on closed curtains , Unrealized part 1219192618 sanction may be Long-term capital gain (LTCG) preferential tax Regular income tax TS1791A this income is xable and the IRS CUSIP number Fequirement Unrealized profit originof |11 Aggregate profit or (loss) determines that it Net investment income (NII) tax 14 State name Total Year 2 tax liability 15 State identifica 10. 16 State tax withheld $ reported 12 It checked, basis reported 13 Bartering $ BAYER'S pame, street address, city or town. s CORRECTED (if checked xbox on Form 8949 OMB No. 1545-0715 Capital Investments Inc. 20XX Broker and foreign postal code , and telephone , town . WineCORRECTED if checked Nashville Tennessee 37203 BaTransaction 1a Description of property (Example: 100 sh. 9 16 Qualified dividends .500 20XX Dividends and oration common stock Capital investments Inc. March 1, Year 2 November 15, Year 2 Nashville , Tennessee 37203 PAYER'S TIN RECIPIENT'S TIN 1d Proceeds a Total capital gain diatr. 25 m 1099-DIV le Cost of other basis Copy B 22- XXXXXXX 708-XX-XXXX 87,000 $ If Accrued market discount 1g Wash sale loss disallowed For Recipient PAYER'S TIN CIPIENT'S TIN 2c Section 1202 gain 2d Collectibles ( 28% ) gain For Recipient RECIPIENT'S name Short-term gain or loss I 3 If checked, proce 22-XXXXXXX 708-XX-XXXX Long-term gain or loss Amanda Themapcluding apt. Federal income tax withheld This is important tax "information and is security being furnished to sTran dadress Tincluding apt. no . ection 199A di the IRS . If you are 137 Laurel Lane Reported to IRS: I checkend loss is not alows required to file a aturn, a negligence yes proceeds Net proceeds penalty or other 8 Bois or closed contracts open contracts' 92/Size18 imanction may be city of town , state of province , country , and ZIP or foreign postal code Account number ( see instructions ) this income is distributions 10 CUSIP number TS1791A Knoxville, TN 37522 determines that it FATCA filing 11 Exempt -interes determines that it by 10 Unrealized profit 95 1817 of, 11 Aggregate profit of (loss ) has not been dividends State tax withheld reported 1 5 14 State identification 20XX CORRECTED (if checked) PAYER'S name foreign postal code, and telepho . state of province, country, ZIP 1a Total ordinary dividends OMB No. 1545-0110 20XX andme Partner's Share of Income, Deductions, 18,509 20XX Dividends an 16 Qualified dividends ation About the Parti Distributions Capital Investments Inc. 88-XXXXXXX 16 Schedule K J e atta 13 Main Street in Commercial Rentals lashville, Tennessee 37203 18,500 Form 1099-DIV 2a Total capital gain distrzb Unrecap. Sec. 1250 gain a East Thig, Street MFJ Tax Rate Schedules Copy B Finership fled return Kansas City, MO PAYER'S TIN RECIPIENT'S TIN For Recipient Part il Information About the Partner Regular Tax Rate Schedule (MFJ) 2c Section 1202 gain 2d Collectibles (28%) gain Partner's SON or TIN (Do "go5 x xchery Of Dividend eat Taxable Income Tax Liability 22.XXXXXXX 08.XX-XXXX Patrick Thompson 7 Royathies tax-exempt inter Over But Not Over sol $22,000 Of Amount Over Knoxville . TN 37922 RECIPIENT'S nan 19 Distribute $89 450 Limited partner or other LLC 150,000 $22,000 $2,200.00 + 12% $22,000 us is important tax $89,450 $190,750 cash distributions 22% $89,450 Amanda Thompson Section 198A dividend $190,750 $364,200 $190.750 S " What type of entity is this partner? Individual $364.200 580.00 + 2476 $462.500 Foreign tax paid untry or U.S. possession $693,750 $105,664.00 + 35% $462,500 are of proffe tors, and capital (see inislove Ending $693,750 $186 ,601.50 + 3 $693,75 City of town, state or province, country, and ZIP or foreign postal code Profit 30 * S posed on you if Cash liquidation distributions 10 Noncash liquidation distributions Check if dectesuse the due to sale or exchange of partner ship interest Partner's share of liabilities 12 Section 179 deduction Long-Term Capital Gain and Qualified Dividend Preferential Tax Rates (MFJ) Knoxville, TN 37522 not been reported. Taxable Income Tax Rate FATCA filing | 11 Exempt-interest dividends |12 Specified private activity 35,000 $ Over But Not Over Check this box if them K includes lability amounts Ber partnerships $89.250 $553 850 15% Account number (see instructions 3 State 14 State identification no. 15 State tax withheld 205,000 23 Mare them one active 167,008 -Soo attached statement for additional informal $553,850 209% 150,000 Net Investment Income (NII) Tax Rate: 3.8%