OMB No. 1545-0172 Depreciation and Amortization

Form 4562 (Including Information on Listed Property)

Department of the Treasury

Internal Revenue Service

Attachment

 See separate instructions. Sequence No. 67

Name(s) shown on return Business or activity to which this form relates Identifying number

Election To Expense Certain Property Under Section 179

Note: If you have any listed property, complete Part V before you complete Part I.

1 Maximum amount. See page 2 of the instructions for a higher limit for certain businesses 1 $102,000

2 Total cost of section 179 property placed in service (see page 3 of the instructions) 2

3 Threshold cost of section 179 property before reduction in limitation 3 $410,000

4 Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0- 4

Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing

separately, see page 3 of the instructions

5

5

(a) Description of property (b) Cost (business use only) (c) Elected cost

6

7 Listed property. Enter the amount from line 29 7

8 Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7 8

9 Tentative deduction. Enter the smaller of line 5 or line 8 9

10 Carryover of disallowed deduction from line 13 of your 2003 Form 4562 10

11 Business income limitation. Enter the smaller of business income (not less than zero) or line 5 (see instructions) 11

12 Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11 12

13 Carryover of disallowed deduction to 2005. Add lines 9 and 10, less line 12  13

Note: Do not use Part II or Part III below for listed property. Instead, use Part V.

MACRS Depreciation (Do not include listed property.) (See page 5 of the instructions.)

(b) Month and

year placed in

service

(c) Basis for depreciation

(business/investment use

only—see instructions)

(d) Recovery

period (a) (e) Convention (f) Method (g) Depreciation deduction

Section B—Assets Placed in Service During 2004 Tax Year Using the General Depreciation System

19a 3-year property

b 5-year property

c 7-year property

d 10-year property

e 15-year property

f 20-year property

Residential rental 27.5 yrs. MM S/L

property

h

27.5 yrs. MM S/L

Nonresidential real MM S/L

property

i

MM S/L

Section C—Assets Placed in Service During 2004 Tax Year Using the Alternative Depreciation System

20a Class life S/L

b 12-year 12 yrs. S/L

c 40-year 40 yrs. MM S/L

Special Depreciation Allowance and Other Depreciation (Do not include listed property.)

17 MACRS deductions for assets placed in service in tax years beginning before 2004 17

15 Property subject to section 168(f)(1) election (see page 4 of the instructions) 15

16 Other depreciation (including ACRS) (see page 4 of the instructions) 16

Summary (see page 8 of the instructions)

21 Listed property. Enter amount from line 28 21

Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21.

Enter here and on the appropriate lines of your return. Partnerships and S corporations—see instr.

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22

23 For assets shown above and placed in service during the current year,

enter the portion of the basis attributable to section 263A costs 23

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 12906N Form 4562 (2004)

Part IV

Part I

Part II

Part III

 Attach to your tax return.

39 yrs.

Section A

18 If you are electing under section 168(i)(4) to group any assets placed in service during the tax year

into one or more general asset accounts, check here 

Classification of property

g 25-year property 25 yrs. S/L

Special depreciation allowance for qualified property (other than listed property) placed in service

during the tax year (see page 3 of the instructions)

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2004
Form 4562 (2004) Page 2

Listed Property (Include automobiles, certain other vehicles, cellular telephones, certain computers, and

property used for entertainment, recreation, or amusement.)

Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only

24a, 24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable.

Section A—Depreciation and Other Information (Caution: See page 9 of the instructions for limits for passenger automobiles.)

24a Do you have evidence to support the business/investment use claimed? Yes No 24b If “Yes,” is the evidence written? Yes No

(i)

Elected

section 179

cost

(h)

Depreciation

deduction

(g)

Method/

Convention

(f)

Recovery

period

(e)

Basis for depreciation

(business/investment

use only)

(d)

Cost or other

basis

(c)

Business/

investment use

percentage

(b)

Date placed in

service

(a)

Type of property (list

vehicles first)

26 Property used more than 50% in a qualified business use (see page 8 of the instructions):

%

%

%

27 Property used 50% or less in a qualified business use (see page 8 of the instructions):

% S/L –

% S/L –

% S/L –

28 Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 28

29 Add amounts in column (i), line 26. Enter here and on line 7, page 1 29

Section B—Information on Use of Vehicles

(f)

Vehicle 6

(e)

Vehicle 5

(d)

Vehicle 4

(c)

Vehicle 3

(b)

Vehicle 2

(a)

Vehicle 1

Total business/investment miles driven

during the year (do not include commuting

miles—See page 2 of the instructions)

30

31 Total commuting miles driven during the year

Total other personal (noncommuting)

miles driven

32

Total miles driven during the year.

Add lines 30 through 32

33

Was the vehicle available for personal Yes No Yes No Yes No Yes No Yes No Yes No

use during off-duty hours?

34

Was the vehicle used primarily by a

more than 5% owner or related person?

35

Is another vehicle available for personal

use?

36

Section C—Questions for Employers Who Provide Vehicles for Use by Their Employees

Yes No Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting,

by your employees?

37

Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees?

See page 10 of the instructions for vehicles used by corporate officers, directors, or 1% or more owners

38

39 Do you treat all use of vehicles by employees as personal use?

Do you provide more than five vehicles to your employees, obtain information from your employees about

the use of the vehicles, and retain the information received?

40

41 Do you meet the requirements concerning qualified automobile demonstration use? (See page 10 of the instructions.)

Note: If your answer to 37, 38, 39, 40, or 41 is “Yes,” do not complete Section B for the covered vehicles.

Amortization

(e)

Amortization

period or

percentage

(b)

Date amortization

begins

(c)

Amortizable

amount

(d)

Code

section

(f)

Amortization for

this year

(a)

Description of costs

42 Amortization of costs that begins during your 2004 tax year (see page 11 of the instructions):

43 Amortization of costs that began before your 2004 tax year 43

44 Total. Add amounts in column (f). See page 12 of the instructions for where to report 44

Complete this section for vehicles used by a sole proprietor, partner, or other “more than 5% owner,” or related person.

If you provided vehicles to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.

Part VI

Part V

Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are

not more than 5% owners or related persons (see page 10 of the instructions).

Form 4562 (2004)

Special depreciation allowance for qualified listed property placed in service during the tax

year and used more than 50% in a qualified business use (see page 8 of the instructions)

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