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9 Gains and losses (attach separate Schedule D (Form 1120S) and/or Form 4797):
(a) Net short-term capital gain reduced by any net long-term capital loss.
(b) Net long-term capital gain reduced by any net short-term capital loss (if more than
$25,000, see instructions).

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City or town, State, and ZIP code

E Enter total assets from line

$

14. column D, Schedule L

IMPORTANT--All applicable lines and schedules must be filled in. If the lines on the schedules are not sufficient, see instruction N. 1 Gross receipts or gross sales

GROSS INCOME

Less: Returns and allowances

2 Less: Cost of goods sold (Schedule A) and/or operations (attach schedule)

3 Gross profit.

4 (a) Domestic dividends.

(b) Foreign dividends

5 Interest on obligations of the U.S. and U.S. instrumentalities

6 Other interest

7 Gross rents.

8 Gross royalties.

10 Other income (see instructions-attach schedule)
11
TOTAL income-Add lines 3 through 10

12 Compensation of officers (Schedule E).

13 Salaries and wages (not deducted elsewhere)

14 Repairs (see instructions)

15 Bad debts (Schedule F if reserve method is used)

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Under penalties of perjury, declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief it is Je, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which he has any knowledge.

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Schedule G Depreciation (See instruction 21). Note: If depreciation is computed by using the Class Life (ADR) Syster or the Guideline Class Life System, you must file Form 4832 (Class Life (ADR) System) or Form 5006 (Guideline Class Life Sys tem) with your return.

Check box(es) if you made an election this taxable year to use Class Life (ADR) System and/or

Guideline Class Life System. See Publication 53

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25,000.00

5 Totals

6 Less: Amount of depreciation claimed in Schedule A

7 Balance Enter here and on line 21, page 1

Schedule J Tax Computation (See instructions)

1 Taxable income (line 28, page 1).

2 (a) Enter 48% of line 1 (members of controlled groups, see instructions)

(b) Subtract $6,500 and enter difference

3 Net long-term capital gain reduced by net short-term capital loss (from line 9(b), page 1)

4 Subtract $25,000. (Statutory minimum.)

5 Balance (line 3 less line 4) (see instructions)

6 Enter 30% of line 5 (see instructions)

7 Income tax on capital gains (line 2 or line 6, whichever is lesser)--Enter here and on line 29, page 1

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Form 1120S (1974)

Schedule K Computation of Undistributed Taxable Income and Summary of Distributions and Other Items
Computation of Corporation's Undistributed Taxable Income

1 Taxable income (line 28, page 1).

2 Less: (a) Money distributed as dividends out of earnings and profits of the taxable year

(b) Tax imposed on certain capital gains (line 31, page 1)

3 Corporation's undistributed taxable income

Summary of Distributions and Other Items (attach additional sheets if necessary)

Page 3

(157)

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4 Actual dividend distributions taxable as ordinary income (Do not include amounts shown on line 6)

5 Actual dividend distributions taxable as long-term capital gains (after tax)⚫ .

6 Actual dividend distributions taxable as ordinary income and qualifying for dividend exclusion

7 Nondividend distributions

8 Undistributed taxable income-taxable as ordinary income or (loss).

9 Undistributed taxable income-taxable as long-term capital gain (after tax)*

Each shoreholder must be notified of his pro rata share of long-term capital gains that may qualify as subsection (d) gain. See section 1201(d). 10 Interest on investment indebtedness:

(a) investment interest expense.
(b) Net investment income or (loss).
(c) Excess expenses over rental income
attributable to net lease property.

(d) Excess of net long-term capital gains
over net short-term capital losses
attributable to investment property.

11 Items of tax preference:

(a) Accelerated depreciation on:

(1) Low-income rental housing
(2) Other real property.

(3) Personal property subject to a
net lease.

(b) Amortization of:

(1) Certified pollution control facili ties

(2) Railroad rolling stock.

(3) On-the-job training facilities.

(4) Child care facilities

(c) Reserves for losses on bad debts of financial institutions

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Additional Information Required

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Yes No No

(3) Employees' families at conventions or meetings? Yes (4) Employee or family vacations not reported on Form

W-2?

M Did you file all required Forms 1087, 1096, and 1099?. Yes

N Did the corporation, at any time during the taxable year, have any interest in or signature or other authority over a bank, securities, or other financial account in a foreign country? .C Yes C No

If "Yes," attach Form 4683. (For definitions, see Form 4683.)

O Answer only if (1) this is the first 1120S return filed since your election to be treated as a small business corporation and (2) the corporation was in existence for the taxable year prior to the election and had investment credit property: Was in agreement filed under section 1.47-4(b) of the regulations? Yes

No

Schedule K-1 Shareholder's Share of Undistributed Taxable Income, etc. (Complete a separate Schedule K-1 (Form 1120S) for each shareholder. Attach Copy A to Form 1120S. Give Copy B to the shareholder. Keep Copy C for your records.)

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