EFTA01280212.pdf

Internal Revenue Service
United States Department of the Treasury
This Product Contains Sensitive Taxpayer Data
Tax Return Transcript
Request Date: 10-20-2014
Response Date: 10-20-2014
Tracking Number:
SSN Provided:
Tax Period Ending: Dec. 31, 2012
The following items reflect the amount as shown on the return (PR). and the amount as adjusted (PC). if applicable. They do
not show subsequent activity on the account.
SSN:
SPOUSE SSN:
NAME(S) SHOWN ON RETURN:I
ADDRESS:
FILING STATUS: Single
FORM NUMBER: 1040
CYCLE POSTED: 2013430S
RECEIVED DATE: Oct.15, 2013
REMITTANCE: $0.00
EXEMPTION NUMBER: 1
DEPENDENT 1 NAME CTRL:
DEPENDENT 1 SSN:
DEPENDENT 2 NAME CTRL:
DEPENDENT 2 SSN:
DEPENDENT 3 NAME CTRL:
DEPENDENT 3 SSN:
DEPENDENT 4 NAME CTRL:
DEPENDENT 4 SSN:
IDENTITY THEFT PERSONAL ID NUMBER: 000000
PREPARER SSN: P00-44-4937
PREPARER EIN: 13-4008324
Income
WAGES, SALARIES, TIPS, ETC: $500,000.00
TAXABLE INTEREST INCOME: SCH B: $184,668.00
TAX-EXEMPT INTEREST: $104,201.00
ORDINARY DIVIDEND INCOME: SCH B: $113,633.00
QUALIFIED DIVIDENDS: $62,933.00
REFUNDS OF STATE/LOCAL TAXES: $0.00
ALIMONY RECEIVED: $0.00
BUSINESS INCOME OR LOSS (Schedule C): $0.00
BUSINESS INCOME OR LOSS: SCH C PER COMPUTER: $0.00
CAPITAL GAIN OR LOSS: (Schedule D): $33,319.00
CAPITAL GAINS OR LOSS: SCH D PER COMPUTER: $33,319.00
OTHER GAINS OR LOSSES (Form 4797): $0.00
TOTAL IRA DISTRIBUTIONS: $0.00
TAXABLE IRA DISTRIBUTIONS: $0.00
TOTAL PENSIONS AND ANNUIT:E1(:‘,I:::lI NFIDENTIAL $0.00
SDNY_GM_00033072
EFTA_00143685
EFTA01280212

TAXABLE PENSION/ANNUITY AMOUNT: $0.00
RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E): $-1,299,358.00
RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E) PER COMPUTER: 5-1,299,358.00
RENT/ROYALTY INCOME/LOSS PER COMPUTER: $1,846.00
ESTATE/TRUST INCOME/LOSS PER COMPUTER: $0.00
PARTNERSHIP/S-CORP INCOME/LOSS PER COMPUTER: $-1,301,204.00
FARM INCOME OR LOSS (Schedule P): $0.00
FARM INCOME OR LOSS (Schedule F) PER COMPUTER: $0.00
UNEMPLOYMENT COMPENSATION: $0.00
TOTAL SOCIAL SECURITY BENEFITS: $0.00
TAXABLE SOCIAL SECURITY BENEFITS: $0.00
TAXABLE SOCIAL SECURITY BENEFITS PER COMPUTER: $0.00
OTHER INCOME: $12,140.00
SCHEDULE EIC SE INCOME PER COMPUTER: $0.00
SCHEDULE EIC EARNED INCOME PER COMPUTER: $500,000.00
SCH EIC DISQUALIFIED INC COMPUTER: $436,787.00
TOTAL INCOME: S-455,598.00
TOTAL INCOME PER COMPUTER: 5-455,598.00
Adjustments to Income
EDUCATOR EXPENSES: $0.00
EDUCATOR EXPENSES PER COMPUTER: $0.00
RESERVIST AND OTHER BUSINESS EXPENSE: $0.00
HEALTH SAVINGS ACCT DEDUCTION: $0.00
HEALTH SAVINGS ACCT DEDUCTION PER COMPTR: $0.00
MOVING EXPENSES: F3903: $0.00
SELF EMPLOYMENT TAX DEDUCTION: $0.00
SELF EMPLOYMENT TAX DEDUCTION PER COMPUTER: $0.00
KEOGH/SEP CONTRIBUTION DEDUCTION: $0.00
SELF-EMP HEALTH INS DEDUCTION: $0.00
EARLY WITHDRAWAL OP SAVINGS PENALTY: $0.00
ALIMONY PAID SSN:
ALIMONY PAID: $0.00
IRA DEDUCTION: $0.00
IRA DEDUCTION PER COMPUTER: $0.00
STUDENT LOAN INTEREST DEDUCTION: $0.00
STUDENT LOAN INTEREST DEDUCTION PER COMPUTER: $0.00
TUITION AND FEES DEDUCTION: $0.00
TUITION AND PEES DEDUCTION PER COMPUTER: $0.00
JURY DUTY PAY DEDUCTION: $0.00
DOMESTIC PRODUCTION ACTIVITIES DEDUCTION: 80.00
OTHER ADJUSTMENTS: $0.00
ARCHER MSA DEDUCTION: $0.00
ARCHER MSA DEDUCTION PER COMPUTER: $0.00
TOTAL ADJUSTMENTS: $0.00
TOTAL ADJUSTMENTS PER COMPUTER: $0.00
ADJUSTED GROSS INCOME: $-465,698.00
ADJUSTED GROSS INCOME PER COMPUTER: $-455,698.00
Tax and Credits
65-0R-OVER: NO
BLIND: NO
SPOUSE 65-OR-OVER: NO
SPOUSE BLIND: NO
STANDARD DEDUCTION PER COMPUTER: $0.00
ADDITIONAL STANDARD DEDUCTION PER COMPUTER: $0.00
TAX TABLE INCOME PER COMPUTER: $0.00
EXEMPT:ON AMOUNT PER COMPUTER: $3,800.00
TAXABLE INCOME: $0.00
TAXABLE INCOME PER COMPUTER: $0.00
TOTAL POSITIVE INCOME PER COMPUTER: $918,316.00
TENTATIVE TAX: $0.00
TENTATIVE TAX PER COMPUTER: $0.00
CONFIDENTIAL
SDNY_GM_00033073
EFTA_00143686
EFTA01280213

FORM 8814 ADDITIONAL TAX AMOUNT: $0.00
TAX ON INCOME LESS SOC SEC INCOME PER COMPUTER: $0.00
FORM 6251 ALTERNATIVE MINIMUM TAX: $0.00
FORM 6251 ALTERNATIVE M:N:MUM TAX PER COMPUTER: $0.00
FOREIGN TAX CREDIT: $0.00
FOREIGN TAX CREDIT PER COMPUTER: $0.00
FOREIGN INCOME EXCLUSION PER COMPUTER: $0.00
FOREIGN INCOME EXCLUSION TAX PER COMPUTER: $0.00
CH:LD 6, DEPENDENT CARE CREDIT: $0.00
CHILD 6 DEPENDENT CARE CREDIT PER COMPUTER: $0.00
CREDIT FOR ELDERLY AND DISABLED: $0.00
CREDIT FOR ELDERLY AND DISABLED PER COMPUTER: $0.00
EDUCATION CREDIT: $0.00
EDUCAT:0N CREDIT PER COMPUTER: $0.00
GROSS EDUCATION CREDIT PER COMPUTER: $0.00
RETIREMENT SAVINGS CNTRB CREDIT: $0.00
RETIREMENT SAVINGS CNTRB CREDIT PER COMPUTER: $0.00
PRIM RET SAV CNTRB: P8680 LN6A: $0.00
SEC RET SAV CNTRB: P8880 1246B: $0.00
TOTAL RET:REMENT SAVINGS CONTR:BUTION: P8880 CMPTR: $0.00
RESIDENTIAL ENERGY CREDIT: $0.00
RESIDENTIAL ENERGY CREDIT PER COMPUTER: $0.00
CHILD TAX CREDIT: $0.00
CHILD TAX CREDIT PER COMPUTER: $0.00
ADOPTION CREDIT: F8839: $0.00
ADOPTION CREDIT PER COMPUTER: $0.00
FORM 8839 REFUND ADOPT:ON CRED:T AMOUNT: $0.00
DC 1ST TIME HOMEBUYERS CREDIT: $0.00
DC 1ST TIME HOMEBUYERS CREDIT PER COMPUTER: $0.00
FORM 8396 MORTGAGE CERT:FICATE CREDIT: $0.00
FORM 8396 MORTGAGE CERTIFICATE CREDIT PER COMPUTER: $0.00
F3800, P8801 AND OTHER CREDIT AMOUNT: $0.00
FORM 3800 GENERAL BUSINESS CREDITS: $0.00
FORM 3800 GENERAL BUSINESS CREDITS PER COMPUTER: $0.00
PR:OR YR MIN TAX CREDIT: 98801: $0.00
PRIOR YR MIN TAX CREDIT: P8801 PER COMPUTER: $0.00
F8834 ELECTRIC VEHICLE CREDIT AMOUNT: $0.00
F8936 ELECTRIC MOTOR VEHICLE CREDIT AMOUNT: $0.00
F8910 ALTERNATIVE MOTOR VEHICLE CREDIT AMOUNT: $0.00
OTHER CREDITS: $0.00
TOTAL CREDITS: $0.00
TOTAL CREDITS PER COMPUTER: 80.00
INCOME TAX AFTER CREDITS PER COMPUTER: $0.00
Other Taxes
SE TAX: $0.00
SE TAX PER COMPUTER: $0.00
SOCIAL SECUR:TY AND MEDICARE TAX ON UNREPORTED TIPS: $0.00
SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS PER COMPUTER: $0.00
TAX ON QUALIFIED PLANS P5329 (PR): $0.00
TAX ON QUALIFIED PLANS P5329 PER COMPUTER: $0. 0 0
IRAP TAX PER COMPUTER: $0.00
TP TAX FIGURES (REDUCED BY IRAP) PER COMPUTER:
IMP TOTAL TAX (REDUCED BY IRAP) PER COMPUTER: $0.00
ADVANCED EARNED INCOME CREDIT: $0.00
RECOVERY REBATE CREDIT AMOUNT: $0.00
UNPAID PICA ON REPORTED TIPS: $0.00
OTHER TAXES: $0.00
RECAPTURE TAX: P8611: $0.00
HOUSEHOLD EMPLOYMENT TAXES: $0.00
HOUSEHOLD EMPLOYMENT TAXES PER COMPUTER: $0.00
RECAPTURE TAXES: $0.00
TOTAL ASSESSMENT PER COMPUTER: $0.00
CONFIDENTIAL
SDNY_GM_00033074
EF-EA_00143687
EFTA01280214

TOTAL TAX LIABILITY TP FIGURES: $0.00
TOTAL TAX LIABILITY TP FIGURES PER COMPUTER: $0.00
Payments
FEDERAL :NCOME TAX WITHHELD: $153,899.00
COBRA PREMIUM SUBSIDY: $0.00
ESTIMATED TAX PAYMENTS: $0.00
MAKING WORK PAY AND GOVT RET CREDIT: $0.00
MAKING WORK PAY AND GOVT RET CREDIT PER COMPUTER: 80.00
MAKING WORK PAY AND GOV'T RET CREDIT VERIFIED: $0.00
REFUNDABLE EDUCAT:ON CRED:T: $0.00
REFUNDABLE EDUCAT:ON CRED:T PER COMPUTER: $0.00
REFUNDABLE EDUCATION CRED:T VERIF:ED: $0.00
EARNED :NCOME CREDIT: $0.00
EARNED :NCOME CREDIT PER COMPUTER: $0.00
EARNED :NCOME CREDIT NONTAXABLE COMBAT PAY: $0.00
SCHEDULE M NONTAXABLE COMBAT PAY: $0.00
SCHEDULE 8812 NONTAXABLE COMBAT PAY: $0.00
EXCESS SOCIAL SECURITY & RRTA TAX WITHHELD: $0.00
SCHEDULE 8812 TOT SS/MEDICARE WITHHELD: $0.00
SCHEDULE 8812 ADD:TIONAL CHILD TAX CREDIT: $0.00
SCHEDULE 8812 ADD:TIONAL CHILD TAX CREDIT PER COMPUTER: $0.00
SCHEDULE 8812 ADD:T:ONAL CHILD TAX CREDIT VERIFIED: $0.00
AMOUNT PAID WITH FORM 4868: $0.00
FORM 2439 REGULATED INVESTMENT COMPANY CREDIT: $0.00
FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS: $0.00
FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS PER COMPUTER: $0.00
HEALTH COVERAGE TX CR: P8885: $0.00
FORM 8801 REFUNDABLE CREDIT FOR PRIOR YEAR MIN. TAX: $0.00
F:RST T:ME HOME BUYER CREDIT PER COMPUTER: $0.00
F:RST T:ME HOME BUYER CREDIT: $0.00
F:RST TIME HOME BUYER CREDIT VERIFIED: $0.00
PR:MARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT: $0.00
SECONDARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT: $0.00
F:RST TIME HOMEBUYER CREDIT REPAYMENT AMOUNT: $0.00
FORM 2555 COMBINED EARNED INCOME AMOUNT PER COMPUTER: $0.00
FORM 5405 TOTAL HOMEBUYERS CREDIT REPAYMENT PER COMPUTER: $0.00
SMALL EMPLOYER HEALTH :NSURANCE PER COMPUTER: $0.00
SMALL EMPLOYER HEALTH :NSURANCE PER COMPUTER (2S: $0.00
FORM 2439, 8801, and OTHER CREDIT TOTAL AMT: $0.00
TOTAL PAYMENTS: $153,899.00
TOTAL PAYMENTS PER COMPUTER: $153,899.00
Refund or Amount Owed
REFUND AMOUNT: 6-153,899.00
APPLIED TO NEXT YEAR'S ESTIMATED TAX: $0.00
ESTIMATED TAX PENALTY: $0.00
TAX ON :NCOME LESS STATE REFUND PER COMPUTER: $0.00
BAL DUE/OVER PYMT USING TP F:G PER COMPUTER: 6-153,899.00
BAL DUE/OVER PYMT USING COMPUTER FIGURES: $-153,899.00
FORM 8888 TOTAL REFUND PER COMPUTER: $0.00
Third Party Designee
THIRD PARTY DESIGNEE ID NUMBER: 44937
AUTHORIZATION INDICATOR: 1
TH:RD PARTY DESIGNEE NAME: DAV:D A VANEGMOND
Schedule A--Itemized Deductions
MEDICAL/DENTAL
MEDICAL AND DENTAL EXPENSES: $5,153.00
AG: PERCENTAGE LIMITATION PER COMPUTER:: $0.00
NET MED:CAL DEDUCTION: $5,153.00
NET MED:CAL DEDUCTION PER COMPUTER: $5,153.00
TAXES PAID CONFIDENTIAL
SDNY_GM_00033075
EFT/XJ*10143688
EFTA01280215

STATE AND LOCAL INCOME TAXES: $7,100.00
INCOME TAX OR GENERAL SALES TAX: Income Taxes
REAL ESTATE TAXES: $25,932.00
PERSONAL PROPERTY TAXES: $0.00
NEN MOTOR VEHICLE TAXES: $0.00
OTHER TAXES AMOUNT: $0.00
SCH A TAX DEDUCTIONS: $33,032.00
SCH A TAX PER COMPUTER: $33,032.00
INTEREST PAID
MORTGAGE INTEREST (FINANCIAL): $37,034.00
MORTGAGE INTEREST (INDIVIDUAL): $0.00
DEDUCTIBLE POINTS: $3,065.00
QUALIF:ED MORTGAGE INSURANCE PREMIUMS: $0.00
DEDUCTIBLE INVESTMENT INTEREST: $46,499.00
TOTAL INTEREST DEDUCTION: $86,598.00
TOTAL :NTEREST DEDUCTION PER COMPUTER: $86,598.00
CHARITABLE CONTRIBUTIONS
CASH CONTRIBUTIONS: $0.00
OTHER THAN CASH: Form 8283: $0.00
CARRYOVER FROM PRIOR YEAR: $0.00
SCH A TOTAL CONTRIBUTIONS: $0.00
SCH A TOTAL CONTRIBUTIONS PER COMPUTER: $0.00
CASUALTY AND THEFT LOSS
CASUALTY OR THEFT LOSS: $0.00
JOBS AND MISCELLANEOUS
UNREIMBURSED EMPLOYEE EXPENSE AMOUNT: $0.00
TOTAL LIMITED MISC EXPENSES: $63,253.00
NET LIMITED MISC DEDUCTION: $63,253.00
NET LIMITED MISC DEDUCTION PER COMPUTER: $63,253.00
OTHER MISCELLANEOUS
OTHER THAN GAMBLING AMOUNT: $0.00
OTHER MISC DEDUCTIONS: $42.00
TOTAL ITEMIZED DEDUCTIONS
TOTAL ITEMIZED DEDUCTIONS: $188,078.00
TOTAL ITEMIZED DEDUCTIONS PER COMPUTER: $188,078.00
ELECT ITEMIZED DEDUCTION INDICATOR:
SCH A ITEMIZED PERCENTAGE PER COMPUTER: $0.00
Interest and Dividends
GROSS SCHEDULE B INTEREST: $184,668.00
TAXABLE INTEREST INCOME: $184,668.00
EXCLUDABLE SAVINGS FROM BOND INT: $0.00
GROSS SCHEDULE B DIVIDENDS: $113,633.00
DIVIDEND INCOME: $113,633.00
FOREIGN ACCOUNTS :ND: No
FOREIGN COUNTRY FINANCIAL INTEREST/SIGNATURE AUTHORITY: None
Schedule D--Capital Gains and Losses
SHORT TERM CAPITAL GAINS AND LOSSES
SHORT TERM BASIS SALE AMOUNT: $291,456.00
SHORT TERM BASIS COST AMOUNT: $295,100.00
SHORT TERM NO BASIS SALE AMOUNT: $0.00
SHORT TERM NO 1099E SALE AMOUNT: $0.00
NET SHORT-TERM GAIN/LOSS: $-9,581.00
LONG TERM CAPITAL GAINS AND LOSSES
LONG TERM BASIS SALE AMOUNT: $0.00
LONG TERM BASIS COST AMOUNT: $0.00
LONG TERM NO BASIS SALE AMOUNT: $553,433.00
CAPITAL GAIN DISTRIBUTIONS (PR): $9,923.00
NET LONG-TERM GAIN/LOSS: $42,900.00
CONFIDENTIAL
SONY_GM_00033076
EFTA_00143689
EFTA01280216

TAX COMPUTATION USING MAXIMUM CAPITAL GAINS RATES
284 RATE GAIN: $0.00
UNRECAPTURED SECT: 1250 GAIN: $0.00
SCH D 151 TAX CMPTR: $0.00
CAPITAL GAINS LESS INVEST INCOME PER COMPUTER: $33,319.00
CAP GAINS TENTATIVE AMT PER COMPUTER (1): $96,252.00
CAP GAINS TAX AMT PER COMPUTER (1): $0.00
CAP GAINS TENTATIVE AMT PER COMPUTER (2): $0.00
CAP GAINS TAX AM? PER COMPUTER (5): $0.00
CAP GAINS TAX AMT PER COMPUTER (6): $0.00
SCHEDULE D TAX PER COMPUTER: $0.00
Schedule S--Supplemental Income and Loss
INCOME OR LOSS PROM RENTAL REAL ESTATE AND ROYALTIES
SCHEDULE E FORM 1099 REQUIRED: No box checked
SCHEDULE E FORM 1099 FILED: Neither box checked
TOTAL RENTS RECEIVED: $0.00
TOTAL ROYALTIES RECEIVED: $1,846.00
TOTAL MORTGAGE INTEREST ALL PROPERTIES: $0.00
TOTAL DEPRECIATION OR DEPLETION FOR ALL PROPERTIES: $0.00
TOTAL EXPENSES FOR ALL PROPERTIES: $0.00
TOTAL RENTAL REAL ESTATE AND ROYALTY INCOME OR LOSS: $0.00
RENT & ROYALTY INCOME: $1,846.00
RENT fi ROYALTY LOSSES: $0.00
REPAIRS EXPENSE COLUMN A: $0.00
REPAIRS EXPENSE COLUMN B: $0.00
REPAIRS EXPENSE COLUMN C: $0.00
INCOME OR LOSS PROM PARTNERSHIPS AND S CORPS
PRTSHP/CORP PASSIVE INCOME: $43.695.00
PRTSHP/CORP NONPASSIVE INCOME: $19,434.00
PRTSHP/CORP PASSIVE LOSS: $44,575.00
PRTSHP/CORP NONPASSIVE LOSS: $1,319,758.00
PARTNERSHIP INCOME: $63,129.00
PARTNERSHIP LOSS: $1,364,333.00
INCOME OR LOSS FROM ESTATES AND TRUSTS
ESTATE/TRUST PASSIVE INCOME: $0.00
ESTATE/TRUST PASSIVE LOSS: $0.00
ESTATE AND TRUST INCOME: $0.00
ESTATE AND TRUST LOSS: $0.00
PASSIVE LOSS NOT REPORTED ON P8582: 2
SCH K1 ES PAYMENT INDICATOR:
INCOME OR LOSS PROM REAL ESTATE MORTGAGE INVESTMENT CONDUITS
REAL ESTATE MORTGAGE INCOME/LOSS: $0.00
SUMMARY
NET FARM RENT INCOME/LOSS: $0.00
GROSS FARMING 6 FISHING INCOME: $0.00
Form 6251--Alternative Minimum Tax-Individuals
MEDICAL AND DENTAL: $0.00
CERTAIN HOME MORTGAGE INTEREST: $0.00
INVESTMENT INTEREST EXPENSE: $0.00
DEPLETION: $0.00
NET OPERATING LOSS DEDUCTION: $0.00
TAX EXMT INT FROM PRIV ACT BONDS: $3,205.00
QUALIFIED SMALL BUSINESS STOCK: $0.00
INCENTIVE STOCK OPTIONS: $0.00
ESTATE/TRUST BENEFICIARIES: $0.00
ELECTING LARGE PARTNERSHIPS: $0.00
ADJUSTED GAIN OR LOSS: $-7.00
DEPRECIATION OF PROPERTY: $-27,794.00
PASSIVE ACTIVITY LOSS: $7.00
CONFIDENTIAL
SDNY_GM_00033077
EFTA_00143690
EFTA01280217

LOSS LIMITATIONS: $0.00
CIRCULATION COSTS: $0.00
LONG TERM CONTRACTS: $0.00
MINING COSTS: $0.00
RESEARCH AND EXPERIMENTAL COSTS: $0.00
INSTALLMENT SALES INCOME: $0.00
INTANGIBLE DRILLING COSTS: $0.00
OTHER: $12.00
ALT TAX NET OPERATING LOSS: $0.00
ALT MINIMUM TAX FOREIGN TAX CR: $0.00
Form 4797--Sales of Business Property
REAL ESTATE PROCEEDS: F1099-B OR P1099-5: $0.00
TOTAL PROPERTY SALES GAIN OR LOSS: $880.00
NONRECAPTURED 1231 LOSS PRIOR YRS: $0.00
TOTAL SALES OF BUSINESS PROPERTY: $0.00
OTHER GAINS OR LOSSES (Form 4797): $0.00
GAIN ON SALE OP ANIMALS AMT: $0.00
Form 8863 - Education Credits (Hope and Lifetime Learning Credits)
PART III - ALLOWABLE EDUCATION CREDITS
GROSS EDUCATION CR PER COMPUTER: $0.00
TOTAL EDUCATION CREDIT AMOUNT: $0.00
TOTAL. EDUCATION CREDIT AMOUNT PER COMPUTER: $0.00
Form 4952 - Investment Interest Expense Deduction
:NVESTMENT PROP GA:N AMT: $32,439.00
INVESTMENT INCM ELECT AMT: $0.00
This Product Contains Sensitive Taxpayer Data
CONFIDENTIAL
SDNY_GM_00033078
EFTA_00143691
EFTA01280218