Schedum for John Parsons If required, round amount to the nearest dollar Note: Box 16: Conectoreported the expenses and Corport tributions to a form owo Box in Code Aed to report investment in Code to See the income news to report Section 195 W-2 wages from the trade Schedule K-1 (Form 1120-5) 2019 571119 Final K-1 Amended 1 OM 1545-01 Part II Shareholder's Share of Current Te Income Deductions, Credits, and other items 1 Ordinary business income 13 Credits Doss) Department of the Treasury Internal Revenue Service beginning / For calendar year 2019, or tax year ending 2 Net rental real estate Income (los) Shareholder's Share of Income, Deductions, Credits, etc. See page 2 of form and separate instructions Part I Information About the Corporation A Corporation's employer identification number 11-1111120 3 Other net rental income (loss) 4 Interest income 5a Ordinary dividends B Corporation's name, address, city, state, and ZIP code Premium, Inc. 1005 16th Street Cut and Shoot, TX 77303 5b Qualified dividends 14 Foreign transactions 6 Royalties CIRS Center where corporation filed return e-file Part II Information About the Shareholder 7 Net short-term capital gain (loss) D Shareholder's identifying number 123-45-6781 8a Net long-term capital gain (loss) E Shareholder's name, address, city, state, and ZIP code John Parsons 5607 20th Street Cut and Shoot, TX 77303 Bb Collectibles (28%) gain (loss) 8c Unrecaptured section 1250 gain + Shareholder's percentage of stock ownership for tax year 9 Net section 1231 gain (loss) 10 Other income (loss) 15 Alternative minimum tas AMT tems Schedum for John Parsons If required, round amount to the nearest dollar Note: Box 16: Conectoreported the expenses and Corport tributions to a form owo Box in Code Aed to report investment in Code to See the income news to report Section 195 W-2 wages from the trade Schedule K-1 (Form 1120-5) 2019 571119 Final K-1 Amended 1 OM 1545-01 Part II Shareholder's Share of Current Te Income Deductions, Credits, and other items 1 Ordinary business income 13 Credits Doss) Department of the Treasury Internal Revenue Service beginning / For calendar year 2019, or tax year ending 2 Net rental real estate Income (los) Shareholder's Share of Income, Deductions, Credits, etc. See page 2 of form and separate instructions Part I Information About the Corporation A Corporation's employer identification number 11-1111120 3 Other net rental income (loss) 4 Interest income 5a Ordinary dividends B Corporation's name, address, city, state, and ZIP code Premium, Inc. 1005 16th Street Cut and Shoot, TX 77303 5b Qualified dividends 14 Foreign transactions 6 Royalties CIRS Center where corporation filed return e-file Part II Information About the Shareholder 7 Net short-term capital gain (loss) D Shareholder's identifying number 123-45-6781 8a Net long-term capital gain (loss) E Shareholder's name, address, city, state, and ZIP code John Parsons 5607 20th Street Cut and Shoot, TX 77303 Bb Collectibles (28%) gain (loss) 8c Unrecaptured section 1250 gain + Shareholder's percentage of stock ownership for tax year 9 Net section 1231 gain (loss) 10 Other income (loss) 15 Alternative minimum tas AMT tems