OMB No. 1545-1668

Tax year beginning , 2004

, 200__

Schedule K-1

(Form 8865)

Information About the Partnership

Partner’s Share of Income, Deductions,

Credits, etc.

Department of the Treasury

Internal Revenue Service

2004

and ending

or Part III

Part I

Part II

A Partnership’s employer identification number

B Partnership’s name, address, city, state, and ZIP code

Information About the Partner

C Partner’s identifying number

D Partner’s name, address, city, state, and ZIP code

E Partner’s share of profit, loss, capital, and deductions:

Beginning Ending

Profit %

Loss

Capital

F Partner’s capital account analysis:

Beginning capital account

Capital contributed during the year

Current year increase (decrease)

Withdrawals & distributions

Ending capital account

Tax basis GAAP Section 704(b) book

Other (explain)

%

% %

% %

$

$

$

$

$

( )

Final K-1 Amended K-1

Partner’s Share of Current Year Income,

Deductions, Credits, and Other Items

1 Ordinary business income (loss)

2 Net rental real estate income (loss)

15 Credits & credit recapture

4 Guaranteed payments

5 16 Foreign transactions

12 Section 179 deduction

18 Tax-exempt income and

nondeductible expenses

13 Other deductions

Cat. No. 28396B Schedule K-1 (Form 8865) 2004

 See back of form and separate instructions.

Interest income

6a Ordinary dividends

6b Qualified dividends

7 Royalties

8 Net short-term capital gain (loss)

9a Net long-term capital gain (loss)

9b Collectibles (28%) gain (loss)

10 Net section 1231 gain (loss)

11 Other income (loss)

14 Self-employment earnings (loss)

9c Unrecaptured section 1250 gain 17 Alternative minimum tax (AMT) items

19 Distributions

20 Other information

For Privacy Act and Paperwork Reduction Act Notice, see Instructions for Form 8865.

3 Other net rental income (loss)

Deductions % %

For IRS Use Only

*See attached statement for additional information.
Schedule K-1 (Form 8865) 2004 Page 2

This list identifies the codes used on Schedule K-1 for partners

and provides summarized reporting information for partners who

file Form 1040. For detailed reporting and filing information, see

the Partner’s Instructions for Schedule K-1 (Form 1065) and the

instructions for your income tax return.

Ordinary business income (loss). You must first determine whether the

income (loss) is passive or nonpassive. Then enter on your return as

follows:

Enter on

Passive loss See Partner’s Instr. (Form 1065)

Passive income Schedule E, line 28, column (g)

Nonpassive loss Schedule E, line 28, column (h)

Nonpassive income Schedule E, line 28, column (j)

Net rental real estate income (loss)

Other net rental income (loss)

Net income Schedule E, line 28, column (g)

Net loss See Partner’s Instr. (Form 1065)

Guaranteed payments Schedule E, line 28, column (j)

Interest income Form 1040, line 8a

6a. Form 1040, line 9a

6b. Form 1040, line 9b

Royalties Schedule E, line 4

Net short-term capital gain (loss) Schedule D, line 5, column (f)

Code

9a. Net long-term capital gain (loss) Schedule D, line 12, column (f)

9b. Collectibles (28%) gain (loss)

9c. Unrecaptured section 1250 gain See Partner’s Instr. (Form 1065)

28% Rate Gain Worksheet, line 4

(Schedule D Instructions)

Net section 1231 gain (loss)

Other income (loss)

Section 179 deduction

A Other portfolio income (loss)

B Involuntary conversions

Other deductions

C Sec. 1256 contracts & straddles Form 6781, line 1

D Mining exploration costs recapture

E Cancellation of debt

A Cash contributions (50%)

C Noncash contributions (50%)

E Capital gain property to a 50%

organization (30%)

B Cash contributions (30%)

D Noncash contributions (30%)

F Capital gain property (20%)

G Deductions—portfolio (2% floor)

H Deductions—portfolio (other)

I Investment interest expense

J Deductions—royalty income

Form 4952, line 1

K Section 59(e)(2) expenditures

Schedule E, line 18

L Amounts paid for medical insurance

Credits & credit recapture

A Net earnings (loss) from

self-employment Schedule SE, Section A or B

B Gross farming or fishing income See Partner’s Instr. (Form 1065)

C Gross non-farm income

A Low-income housing credit

(section 42(j)(5)) Form 8586, line 5

B Low-income housing credit (other)

C Qualified rehabilitation expenditures

(rental real estate)

D Qualified rehabilitation expenditures

(other than rental real estate)

E Basis of energy property

F Qualified timber property

G Other rental real estate credits

H Other rental credits

I Undistributed capital gains credit

J Work opportunity credit

K Welfare-to-work credit

L Disabled access credit

M Empowerment zone and renewal

community employment credit Form 8844, line 3

N New York Liberty Zone business

employee credit

O New markets credit

See Partner’s Instr. (Form 1065)

Foreign transactions

A Name of country or U.S.

possession Form 1116, Part I

B Gross income from all sources Form 1116, Part I

C Gross income sourced at partner

level Form 1116, Part I

Foreign gross income sourced at partnership level

D Passive Form 1116, Part l

E Listed categories Form 1116, Part I

F General limitation Form 1116, Part I

Deductions allocated and apportioned at partner level

G Interest expense Form 1116, Part I

H Other Form 1116, Part I

Deductions allocated and apportioned at partnership level

to foreign source income

I Passive Form 1116, Part I

J Listed categories Form 1116, Part I

Other information

L Total foreign taxes paid Form 1116, Part II

M Total foreign taxes accrued Form 1116, Part II

N Reduction in taxes available for

credit Form 1116, line 12

O Foreign trading gross receipts Form 8873

P Extraterritorial income exclusion Form 8873

Q Other foreign transactions See Partner’s Instr. (Form 1065)

Alternative minimum tax (AMT) items

A Post-1986 depreciation adjustment

See Partner’s Instr.

(Form 1065) and the

Instructions for

Form 6251

B Adjusted gain or loss

C Depletion (other than oil & gas)

D Oil, gas, & geothermal—gross income

E Oil, gas, & geothermal—deductions

F Other AMT items

Other information

D Look-back interest—completed

long-term contracts

E Look-back interest—income forecast

method

P Unrelated business taxable income

H Special basis adjustments

F Dispositions of property with

section 179 deductions

I Section 453(l)(3) information

Code Enter on

Ordinary dividends

Qualified dividends

F Other income (loss)

See Pub. 535

Form 1040, line 21 or Form 982

O Preproductive period expenses

P Commercial revitalization deduction

from rental real estate activities

Q Penalty on early withdrawal of

savings

R Pensions and IRAs

T Other deductions

Form 1040, line 33

See Form 8582 Instructions

Schedule A, line 1 or Form 1040,

line 31

Schedule A, line 15

Schedule A, line 15

Schedule A, line 16

Schedule A, line 16

Schedule A, line 16

Schedule A, line 16

Schedule A, line 22

Schedule A, line 27

Self-employment earnings (loss)

Form 8586, line 5

Form 3468, line 1

Form 3468, line 1

Form 3468, line 2

Form 3468, line 3

See Partner’s Instr. (Form 1065)

Credit for employer social security

and Medicare taxes

Backup withholding

Recapture of low-income housing

credit (section 42(j)(5))

Recapture of low-income housing

credit (other)

Recapture of investment credit

Other credits

Recapture of other credits

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Form 4255

Form 8611, line 8

Form 8611, line 8

Form 1040, line 63

Form 8846, line 5

Form 8884, line 3

Form 8861, line 3

Form 5884, line 3

Form 1040, line 69, box a

Form 8826, line 7

Form 8874, line 2

V

T

S

R

Q

P

U

K General limitation Form 1116, Part I

Tax-exempt income and nondeductible expenses

A Tax-exempt interest income Form 1040, line 8b

B Other tax-exempt income

C Nondeductible expenses

A Cash and marketable securities

B Other property

Distributions

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form1065)

J Section 453A(c) information

C Fuel tax credit information

M CCF nonqualified withdrawals

K Section 1260(b) information

L Interest allocable to production

expenditures

A Investment income

B Investment expenses

N Information needed to figure

depletion—oil and gas

O Amortization of reforestation costs

Q Other information



M Educational assistance benefits

N Dependent care benefits Form 2441, line 12

Note: If you have a section 179 deduction or any partner-level deductions, see

the Partner’s Instr. (Form 1065) before completing Schedule SE.

G Recapture of section 179 deduction

Form 4952, line 4a

Form 4952, line 5

Form 4136

Form 8697

Form 8866

See Partner’s Instr.

(Form 1065) 

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See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

See Partner’s Instr. (Form 1065)

S Reforestation expense deduction See Partner’s Instr. (Form 1065)