Final K-1 Amended K-1 OMB No. 1545-1668

Schedule K-1 

(Form 8865)

Department of the Treasury 

Internal Revenue Service

2009

For calendar year 2009, or tax 

year beginning , 2009 

ending , 20 

Partner’s Share of Income, Deductions, 

Credits, etc. © See back of form and separate instructions.

Part I Information About the Partnership

A Partnership’s employer identification number

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

Part II 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: 

(see Partner’s Instr. (Form 1065))

Beginning Ending

Profit % %

Loss % %

Capital % %

Deductions % %

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)

For IRS Use Only 

Part III Partner’s Share of Current Year Income, 

Deductions, Credits, and Other Items

1 Ordinary business income (loss)

2 Net rental real estate income (loss)

3 Other net rental income (loss)

4 Guaranteed payments

5 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)

9c Unrecaptured section 1250 gain

10 Net section 1231 gain (loss)

11 Other income (loss)

12 Section 179 deduction

13 Other deductions

14 Self-employment earnings (loss)

15 Credits

16 Foreign transactions

17 Alternative minimum tax 

(AMT) items

18 Tax-exempt income and 

nondeductible expenses

19 Distributions

20 Other information

* See attached statement for additional information.

For Paperwork Reduction Act Notice, see Instructions for Form 8865. Cat. No. 28396B Schedule K-1 (Form 8865) 2009
Schedule K-1 (Form 8865) 2009 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.

1. Ordinary business income (loss). Determine whether the income (loss) is

passive or nonpassive and enter on your return as follows:

Report 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)

2. Net rental real estate income (loss) See Partner’s Instr. (Form 1065)

 3. Other net rental income (loss)

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

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

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

5. Interest income Form 1040, line 8a

6a. Ordinary dividends Form 1040, line 9a

6b. Qualified dividends Form 1040, line 9b

7. Royalties Schedule E, line 4

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

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

9b. Collectibles (28%) gain (loss) 28% Rate Gain Worksheet, line 4 

(Schedule D instructions)

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

10. Net section 1231 gain (loss) See Partner’s Instr. (Form 1065)

11. Other income (loss)

Code

A Other portfolio income (loss) See Partner’s Instr. (Form 1065)

B Involuntary conversions See Partner’s Instr. (Form 1065)

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

D Mining exploration costs recapture See Pub. 535

E Cancellation of debt Form 1040, line 21 or Form 982

F Other income (loss) See Partner’s Instr. (Form 1065)

12. Section 179 deduction See Partner’s Instr. (Form 1065)

13. Other deductions

A Cash contributions (50%) % See Partner’s Instr. (Form 1065)

B Cash contributions (30%)

C Noncash contributions (50%)

D Noncash contributions (30%)

E Capital gain property to a 50% 

organization (30%)

F Capital gain property (20%)

G Contributions (100%)

H Investment interest expense Form 4952, line 1

I Deductions—royalty income Schedule E, line 18

J Section 59(e)(2) expenditures See Partner’s Instr. (Form 1065)

K Deductions—portfolio (2% floor) Schedule A, line 23

L Deductions—portfolio (other) Schedule A, line 28

M Amounts paid for medical insurance Schedule A, line 1 or Form 1040, 

line 29

N Educational assistance benefits See Partner’s Instr. (Form 1065)

O Dependent care benefits Form 2441, line 14

P Preproductive period expenses See Partner’s Instr. (Form 1065)

Q Commercial revitalization deduction 

from rental real estate activities See Form 8582 instructions

R Pensions and IRAs See Partner’s Instr. (Form 1065)

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

T Domestic production activities 

information See Form 8903 instructions

U Qualified production activities income Form 8903, line 7

V Employer’s Form W-2 wages Form 8903, line 15

W Other deductions See Partner’s Instr. (Form 1065)

14. Self-employment earnings (loss)

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

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

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 See Partner’s Instr. (Form 1065)

15. Credits

A Low-income housing credit (section 

42(j)(5)) from pre-2008 buildings % See Partner’s Instr. (Form 1065) B Low-income housing credit 

(other) from pre-2008 buildings

C Low-income housing credit (section 

42(j)(5)) from post-2007 buildings Form 8586, line 11

D Low-income housing credit (other) 

from post-2007 buildings Form 8586, line 11

E Qualified rehabilitation 

expenditures (rental real estate) % See Partner’s Instr. (Form 1065) F Other rental real estate credit

G Other rental credits

 H Undistributed capital gains credit Form 1040, line 70; box a

Code Report on

I Alcohol and cellulosic biofuel fuels credit Form 6478, line 7

J Work opportunity credit Form 5884, line 3

K Disabled access credit See Partner’s Instr. (Form 1065)

L Empowerment zone and renewal 

community employment credit Form 8844, line 3

M Credit for increasing research activities See Partner’s Instr. (Form 1065)

N Credit for employer social security 

and Medicare taxes Form 8846, line 5

O Backup withholding Form 1040, line 61

P Other credits See Partner’s Instr. (Form 1065)

16. Foreign transactions

 A Name of country or U.S. 

possession % Form 1116, Part I B Gross income from all sources

C Gross income sourced at partner level

Foreign gross income sourced at partnership level

D Passive category % E General category Form 1116, Part I

F Other

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 category % J General category Form 1116, Part I

K Other

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)

17. 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

18. Tax-exempt income and nondeductible expenses

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

B Other tax-exempt income See Partner’s Instr. (Form 1065)

C Nondeductible expenses See Partner’s Instr. (Form 1065)

19. Distributions

A Cash and marketable securities % B See Partner’s Instr. (Form 1065)

C Other property

Distribution subject to section 737

20. Other information

A Investment income Form 4952, line 4a

B Investment expenses Form 4952, line 5

C Fuel tax credit information Form 4136

D Qualified rehabilitation expenditures 

(other than rental real estate) See Partner’s Instr. (Form 1065)

E Basis of energy property See Partner’s Instr. (Form 1065)

F Recapture of low-income housing 

credit (section 42(j)(5)) Form 8611, line 8

G Recapture of low-income housing 

credit (other) Form 8611, line 8

H Recapture of investment credit See Form 4255

I Recapture of other credits See Partner’s Instr. (Form 1065)

J Look-back interest—completed 

long-term contracts See Form 8697

K Look-back interest—income forecast 

method See Form 8866

L Dispositions of property with 

section 179 deductions % See Partner’s Instr. (Form 1065)

M Recapture of section 179 deduction

N Interest expense for corporate 

partners

O Section 453(l)(3) information

P Section 453A(c) information

Q Section 1260(b) information

R Interest allocable to production 

expenditures

S CCF nonqualified withdrawals

T Depletion Information—oil and gas

U Amortization of reforestation costs

V Unrelated business taxable income

W Precontribution gain (loss)

Y Other information

X Section 108(i) information