📄 Extracted Text (3,827 words)
Merrill Lynch T Page
Bank of America Corporation loft2
2012 TAX REPORTING STATEMENT
ORIGINAL 1099 01/26/2013
MR DANIEL M GROFF Table of Contents Page
Y K GROFF Summary Pages 3
Sale Proceeds and Gain/Loss Details 7
Dividend Income Activity 9
Interest Income Activity 10
Checking and Visa Summary 11
Merrill Lynch would like you to note the followin9 item(s) that may affect your tax return.
Please discuss these matters with your Tax Advisor prior to completing your return.
IMPORTANT ITEMS FOR YOUR ATTENTION
As a result of IRS legislation. all broker-dealers are required to report to the IRS the date of acquisition and cost basis on a sale of a "covered security." Legislation requires
reporting the gross proceeds of the sales of "covered" and "noncovered" securities and the adjusted cost basis for "covered securities." Any sale of a security that is considered a
"noncovered security" will be included with the adjusted cost basis but the adjusted basis will not be transmitted to the IRS.
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MR DANIEL M GROFF AND
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ORIGINAL 1099 01/26/2013
MR DANIEL M GROFF Your Financial Advisor 1000 Payer:
Y K GROFF/11M ML DIRECT Merrill Lynch, Pierce, Fenner & Smith Inc
P.O. BOX 1527 1800 Merrill Lynch Drive, MSC 0803
PENNINGTON, NJ 08534-4125 Pennington, NJ 08534.4129
Federal Identification Number 13.5674085
2012 TAX REPORTING STATEMENT
1099-DIV 2012 Dividends and Distributions (OMB NO. 1545-0110) 1099-INT 2012 Interest Income (OMB NO. 1545-0112)
Amount Amount
la Total Ordinary Dividends Sched. B. Line 5 8/or Form 1040 Line 9a 2.842.23 1 Interest Income Sched. B. Line 1 8/or Form 1040 Une 8a 33.73
lb Qualified Dividends Form 1040. Line 9b 2,835.18 2 Early Withdrawal Penalty Form 1040. Line 30 0.00
2a Total Capital Gain Distributions Schad. D. Line 13 or Form 1040 Line 13 0.00 3 Int. on U.S. Savings Bonds 8 Treas. Schedule B. Line 3 0.00
2b Unrecap. Sec. 1250 Gain Schedule D. Line 19 0.00 4 Federal Income Tax Withheld Form 1040, Line 62 0.00
2c Section 1202 Gain See Schad. 0 Instructions 0.00 5 Investment Expenses Sched. A. Line 23 (Amt. inc. in Line 1) 0.00
2d Collectibles (28%) Gain Schedule D. Line 18 0.00 6 Foreign Tax Paid Form 1116 8,/or Form 1040 Une 47 0.00
3 Nondividend Distributions See Publication 550 0.00 7 Foreign Country or U.S. Possession See Instructions
4 Federal Income Tax Withheld Form 1040, Line 62 0.00 8 Tax-Exempt Interest Form 1040. Line ea 0.00
5 Investment Expenses Sched. A. Line 23 (Amt. inc. in Line la) 0.00 9 Specified Private Activity Bond Interest See Instructions for Form 6251 0.00
6 Foreign Tax Paid Form 1116 8/or Form 1040 Line 47 20.82 10 Tax-Exempt Bond CUSIP Number See Instructions
7 Foreign Country or U.S. Possession See Instructions Various
8 Liquidation Distributions Cash See Instructions 0.00
9 Liquidation Distributions Non-Cash See Instructions 0.00
10 Exempt•Interest Dividends Form 1040. Line 8b 0.00
11 Spec. Private Activity Bond Int. Div. See Instructions for Form 6251 0.00
Summary of 2012 Original Issue Discount Items Summary of 2012 Sales Proceeds
Amount Amount
Original Issue Discount See Publication 1212 0.00 Sales Proceeds See Form 8949 39.574.27
OID on U.S. Treasury Obligations See Publication 1212 0.00 Federal Income Tax Withheld Form 1040, Line 62 0.00
Gross Proceeds from each of your 2012 securities trades are Individually reported to the IRS.
Amounts of Original Issue Discount are individually reported to the IRS. Refer to the 2012 Refer to the 2012 Proceeds from Broker and Barter Exchange Transactions detail section of
Original Issue Discount detail section of this statement. this statement.
This is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty
or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported.
You may reach a Tax Representative at
Merrill Lynch, Pierce, Fenner & Smith Incorporated (MLPF&S) is a registered broker-dealer and wholly owned subsidiary of Bank of America Corporation
Member, Securities Investor Protection Corporation (SIPC)
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2012 TAX REPORTING STATEMENT
1099-MISC 2012 Miscellaneous Income (OMB NO. 1545-0115) Distributions and Charges
Amount Amount
2 Royalties Schedule E. Line 23b 0.00 Limited Partnership Income 0.00
3 Other Income Form 1040. Line 21 0.00 Non-Reportable Dividends and Interest 0.00
4 Federal Income Tax Withheld Form 1040, Line 62 0.00 Non-Reportable Tax-Exempt Interest 0.00
8 Sub. Payments in Lieu of Div. or Int. Form 1040. Line 21 0.00 Taxable Municipal Accrued Interest Paid 0.00
Non-Taxable Municipal Accrued Int. Paid 0.00
Other Accrued Interest Paid 0.00
Margin Interest 0.00
Fees 0.00
Non-Reportable Distribution Expenses 0.00
This is important tax information and Is being furnished to the Internal Revenue Service. If you
are required to file a return, a negligence penalty or other sanction may be imposed on you if
this income is taxable and the IRS determines that it has not been reported.
INSTRUCTIONS FOR RECIPIENT OF FORMS 1099 - READ CAREFULLY
The amounts listed on Forms 1099-DIV. 1099-INT. 1099-OID. 1099-MISC and 1099-B represent dividends. Foreign Tax Paid - You may be able to claim this foreign tax as a deduction or a credit on Form
interest. miscellaneous income, original issue discount and/or gross proceeds payments made or 1040. See your Form 1040 instructions.
credited to your account during the calendar year. Backup Withholding - Persons not furnishing their taxpayer identification number to the payer
become subject to backup withholding on certain payments at a rate of 28%. including dividends.
Real Estate Mortgage Investment Conduits (REMIC's) and other Collateralized Debt Obligations interest. and gross proceeds from dispositions of securities. See Form W-9. Request for Taxpayer
(CDO's) must report interest income or OID paid or accrued during the tax year to a regular interest Identification Number and Certification, for information on backup withholding.
holder. If you are a holder of a REM1C and/or CDO obligation. such interest income or OID will not be Include this amount on your income tax return as tax withheld.
reflected on the Form 1099-INT or 1099-OID appearing on this Tax Reporting Statement because this 1099-MISC - Miscellaneous Income (OMB No. 1545-0115)
information is unavailable to Merrill Lynch prior to publication. Such information will be sent to you Each royalty trust is required to provide their shareholders with detailed information regarding
separately for inclusion on your income tax return. items of trust income and deductions. Because the information reported to shareholders by the
If you are an investor in a limited partnership. information concerning your distributive share of the royalty trust includes the information we report to you on Form 1099-MISC. you should be careful
partnership's taxable income or loss (Form 1065. Schedule K-1) will not appear on the Tax Reporting not to report this income on your tax return twice.
Statement. Such information will be sent to you directly from the limited partnership. for inclusion on Line 1 - Shows the income received from rental property. Report on Schedule E (Form 1040).
your income tax return. Line 2 - Shows the royalty trust income paid to your account during the tax year. Report on
Schedule E (Form 1040).
Line 3 - Generally. report this amount on the "Other Income line of Form 1040 and identify the
Nominees • If your federal Taxpayer Identification Number is shown on this form and includes amounts
payment. The amount shown may be payments you received as the beneficiary of a deceased
belonging to another person. you are considered a nominee recipient. You must file Form 1099-DIV.
employee. prizes. awards, taxable damages, or other taxable income. See Publication 525,
1099-INT. 1099.OID. 1099-MISC or 1099.8. as applicable, with the IRS. for each of the other owners to
Taxable and Nontaxable Income.
show their share of the income. and you must furnish a Form 1099-DIV. 1099-INT. 1099-OID. 1099-MISC
Line B - Shows substitute payments in lieu of dividends or tax-exempt interest received by your
or 1099-B to each owner. A husband or wife is not required to file a nominee return to show amounts
broker on your behalf after transfer of your securities for use in a short sale. Report on the
owned by the other. See the General Instructions for Certain Information Returns.
"Other Income line of Form 1040.
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MR DANIEL M GROFF AND
2012 TAX REPORTING STATEMENT
1099-DIV - DIVIDENDS AND DISTRIBUTIONS (OMB No. 1545-0110) Line 8 - Shows tax-exempt interest, paid to you during the calendar year by the payer. Report
Line la - Shows total ordinary dividends that are taxable. Include this amount on Line 9a of Form this amount on line 8b of Form 1040 or Form 1040A. This amount may be subject to backup
1040 or 1040A. Also report it on Schedule B (Form 1040A or 1040) if required. The amount shown withholding.
may be a distribution from an employee stock ownership plan (ESOP). Report it as a dividend on Line 9 - Shows tax-exempt interest subject to the alternative minimum tax. This amount is
your Form 1040/1040A but treat it as a plan distribution, not as investment income, for any other included on Line 8. See the Instructions for Form 6251, Alternative Minimum Tax • Individuals.
purpose.
Line lb - Shows the portion of the amount on Line to that may be eligible for the 15% or zero capital 1099-OID - ORIGINAL ISSUE DISCOUNT (OMB No. 1545-0117)
gains rates. See the Form 1040/1040A instructions for how to determine this amount. Report the Original Issue Discount (OID) is the excess of an obligation's stated redemption price at maturity
eligible amount on Line 9b, Form 1040 or 1040A. over its issue price (acquisition price for a stripped bond or coupon). OID is taxable as interest
Line 2a - Shows total capital gain distributions (long-term) from a regulated investment company or over the life of the obligation. If you are the holder of an OID obligation, generally you must
real estate investment trust. Report the amounts shown on line 2a on Schedule D (Form 1040), Une include an amount of OID in your gross income each year you hold the obligation. Obligations
13. But, if no amount is shown on Lines 2b-2d and your only capital gains and losses are capital gain that may have OID include a bond. debenture, note, certificate. or other evidence of indebtedness
distributions. you may be able to report the amounts as shown on Line 2a on Une 13 of Form 1040 having a term of more than t year. For example, the OID rules may apply to certificates of
(Line 10 of Form 1040A) rather than Schedule D. See the Form 1040 or 1040A instructions. deposit (CDs), time deposits. bonus savings plans, and other deposit arrangements. especially if
Line 2b - Shows the portion of the amount on Line 2a that is unrecaptured section 1250 gain from the payment of interest is deferred until maturity. In addition. the OID rules apply to Treasury
certain depreciable real property. Report this amount on the Unrecaptured Section 1250 Gain inflation-Indexed securities. See Publication 550, Investment Income and Expenses, for more
Worksheet Line 19 in the instructions for Schedule D (Form 1040). information.
Line 2c - Shows the portion of the amount on Une 2a that is Section 1202 gain from certain small Une 1 - Shows the OID on the obligation for the pan of the year you owned it. Report the entire
business stock that may be subject to a 50% exclusion. See the Schedule D (Form 1040) instructions. amount on Line 1 as interest income on your income tax return. However, depending on the type
Line 2d - Shows 28% rate gain from sales or exchanges of collectibles. If required, use this amount of debt instrument, the issue or acquisition date. and other factors (for example, if you paid
when completing the 28% Rate Gain Worksheet-Line 18 in the instructions for Schedule D (Form acquisition or bond premium or if the obligation is a stripped bond or coupon), you may have to
um). figure the correct amount of OID to report on your return. See Publication 1212, Guide to Original
Line 3 - This part of the distribution is nontaxable because it is a return of your cost (or other basis). Issue Discount Instruments, for details on how to figure the correct OID.
You must reduce your cost (or other basis) by this amount for figuring gain or loss when you sell Une 6 - Shows OID on a U.S. Treasury obligation for the part of the year you owned it. Report
your stock. But if you get back all your cost (or other basis), you must report future distributions as this amount as interest income on your federal income tax return, and see Publication 1212 to
capital gains. For more information, see Publication 550, investment Income and Expenses. figure any appropriate adjustments to this amount. This OID is exempt from state and local
Une 5 - My amount shown is your share of expenses of a nonpublicly offered regulated investment income taxes and is not included on Une 1.
company, generally a nonpublicly offered mutual fund. If you file Form 1040, you may deduct these
expenses on the "Other Expenses" line on Schedule A (Form 1040) subject to the 2% limit. This 1099-B - PROCEEDS FROM BROKER AND BARTER EXCHANGE TRANSACTIONS (OMB-1545-0715)
amount is included on Une 1a. Line la - Shows the trade date of the sale or exchange. For short sales, the date shown is the
Lines 8 and 9 - Shows cash and noncash liquidation distributions. date the security was delivered to close the short sale.
Line 10 - Shows exempt-interest dividends from a mutual fund or other regulated investment Line lb - This line may be blank if line 6a is populated or if the securities sold were acquired on
company. Include this amount on line 8b of Form 1040 as tax-exempt interest. a variety of dates. For short sales, the date shown is the date you acquired the security delivered
Line 11 - Shows exempt-interest dividends subject to the alternative minimum tax. This amount is to close the short sale.
included in Une 10. See the instructions for Form 6251. Line 2a - Shows the aggregate cash proceeds from transactions involving stocks, bonds, other
debt obligations,commodities, or forward contracts.
10994NT • INTEREST INCOME (OMB No. 15454)112) Une 3 - Shows the cost or other basis of securities sold. See the Schedule D (Form 1040)
Line 1 - Shows taxable interest paid to you during the calendar year by the payer. This does not instructions or Publication 550 for details about basis.
include interest shown on Line 3. If you receive a Form 1099•INT for interest paid on a tax-exempt Line 5 - Shows the amount of nondeductible loss in a wash sale transaction. For details on wash
obligation. see the instructions for your income tax return. sales, see the Schedule D (Form 1040) instructions and Publication 550.
Line 2 - Shows interest or principal forfeited because of early withdrawal of time savings. You may Line 6a • If populated. the securities sold were noncovered securities and lines lb, lc, 3, and 5
deduct this amount to figure your adjusted gross income on your income tax return. See the may be blank.
instructions for Form 1040 to see where to take this deduction. Une 6b -If populated. the basis on line 3 has been reported to the IRS.
Line 3 - Shows interest on U.S. Savings Bonds. Treasury bills, Treasury bonds. and Treasury notes.
This may or may not be all taxable. See Publication 550, Investment Income and Expenses. This
interest is exempt from state and local income taxes. This interest is not included on Une 1.
Line 5 - My amount shown Is your share of investment expenses of Unit Investment Trust or a
single•class REMIC. If you file Form 1040, you may deduct these expenses on the "Other Expenses"
line of Schedule A (Form 1040) subject to the 2% limit. This amount is included on Line 1.
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MR DANIEL M GROFF AND
2012 TAX REPORTING STATEMENT
The following sections are provided to facilitate your review and the preparation of your tax return.
The 2012 Proceeds from Broker and Barter Exchange Transactions section includes both sales of positions for "covered securities" and "noncovered securities". A covered security includes those
with a purchase date within the following timeline: Equities acquired on or after January 1. 2011 and Mutual Funds acquired on or after January 1, 2012. Legislation requires reporting the gross
proceeds of the sales of "covered" and "noncovered" securities and the adjusted cost basis for "covered securities". My sale of a security that is considered a "noncovered security" will still be
Included in this section with the adjusted cost basis (where available) but the adjusted basis will not be transmitted to the IRS.
In calculating gain (loss), unless otherwise noted, it was assumed that the oldest position was liquidated first, and that you have made an election to amortize the premium paid on the purchase of
taxable bonds. Under the Cost Basis Reporting Regulations, brokers need not track wash sale activity for substantially identical securities, transactions across accounts, or between covered and
non-covered securities. However, you as a taxpayer still have to track and report wash sales as you have in the past which would include all of the aforementioned transaction types. Securities
distributed from a retirement account reflect the tax basis on the date of distribution. Other methods for calculating gain (loss) are available. The cost basis for most Original Issue Discount ("OID")
obligations includes the accretion of OID. For purposes of allocating original purchase price to the components of an equity unit consisting of a purchase contract and a debt security subject to a
remarketing event, we assumed that the fair market value of the debt security on purchase date was equal to its adjusted Issue price. The difference between your original cost and the amount
allocable to the debt component was allocated to the purchase contract. In making adjustments to the cost basis of the purchase contract, it was assumed that the unit holder included contract
adjustment payments in income when received.
1099-B 2012 PROCEEDS FROM BROKER & BARTER EXCHANGE TRANSACTIONS (OMB NO. 1545-0715)
Transaction lb. Date of la. Date of Sale 5. Wash Sale
le. Quantity Description Acquisition or Exchange 2a. Amount 3. Cost Basis Loss Disallowed Gain or (Loss) Remarks
SHORT TERM CAPITAL GAINS AND LOSSES - 1099-B Line lc.
COVERED TRANSACTIONS - 1099-B Line 6b. (cost basis reported to the IRS)
LULULEMON ATHLET1CA INC CUSIP Number 550021109
300.0000 Short Sale 01/25/12 12/09/11(S) 14,249.72 18,961.50 0.00 (4.711.78)
200.0000 Short Sale 01/25/12 12/09/11(S) 9,499.82 12,642.00 0.00 (3.142.18)
Security Subtotal 23,749.54 31,60150 0.00 (7,853.96)
SKECHERS U S A INC CL A CUSIP Number 830566105
500.0000 Short Sale 04/26/12 08/09/10(S) 15.824.73 8.377.50 0.00 7.447.23
Covered Short Term Capital Gains and Losses Subtotal 39,574.27 39,981.00 0.00 (406.73)
NET SHORT TERM CAPITAL GAINS AND LOSSES 39,574.27 39,981.00 0.00 (406.73)
TOTAL SALES PROCEEDS FOR CAPITAL GAINS AND LOSSES 39,574.27
TOTAL REPORTED SALES PROCEEDS 39,574.27
(S) Short Sale
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MR DANIEL M GROFF AND
2012 TAX REPORTING STATEMENT
2012 REALIZED CAPITAL GAIN AND LOSS SUMMARY
COVERED SHORT TERM NONCOVERED SHORT TERM COVERED LONG TERM NONCOVERED LONG TERM
GAINS/LOSSES GAINS/LOSSES GAINS/LOSSES GAINS/LOSSES
(406.73) 0.00 0.00 0.00
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MR DANIEL M GROFF AND
2012 TAX REPORTING STATEMENT
2012 DIVIDENDS AND QUALIFIED DIVIDEND DISTRIBUTIONS
Security Description Quantity Date Transaction Description Amount Qualified Dividend Remarks
DISNEY (WALT) CO COM STK 2000 01/18/12 Dividend 1.200.00 1.200.00
2000 12/28/12 Dividend 1,500.00 1.500.00
Security Subtotal 2,700.00 2,700.00
MERCK AND CO INC SHS 4 01/09/12 Dividend 1.68 1.68
4 04/09/12 Dividend 1.68 1.68
4 07/09/12 Dividend 1.68 1.68
4 10/05/12 Dividend 1.68 1.68
Security Subtotal 6.72 6.72
TEMPLETON DEVELOPING 09/12/12 Dividend 2.64 2.64
MARKETS TRUST CL A 12/28/12 Foreign Dividend 132.87 125.82
12/28/12 Foreign Tax (20.82) 0.00
Security Subtotal 114.69 128.46
TOTAL DIVIDEND ACTIVITY 2,821.41 2,835.18
TOTAL ORDINARY DIVIDENDS 1A 1099-DIVJ 2,842.23
TOTAL QUALIFIED DIVIDENDS LINE 1B 1099-DIV 2,835.18
TOTAL FEDERAL INCOME TAX ITHHELD (INCL DED IN LINE 4 1099-DIV) 0.00
TOTAL FOREIGN TAX PAID (INCLUDED IN LINE 6 1099-DIV) (20.82)
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MR DANIEL M GROFF AND
2012 TAX REPORTING STATEMENT
2012 INTEREST INCOME
Security Description Quantity Date Transaction Description Amount Remarks
INTEREST
MERRILL LYNCH DIRECT 01/31/12 Bank Interest 4.81
02/29/12 Bank Interest 4.26
03/30/12 Bank Interest 4.40
04/30/12 Bank Interest 4.54
05/31/12 Bank Interest 4.47
06/29/12 Bank Interest 4.19
07/31/12 Bank Interest 4.16
08/31/12 Bank Interest 0.89
09/28/12 Bank Interest 0.80
10/31/12 Bank Interest 0.95
11/30/12 Bank Interest 0.26
Security Subtotal 33.73
TOTAL INTEREST ACTIVITY 33.73
TOTAL INTEREST (LINE 1 1099-INT) 33.73
TOTAL FEDERAL INCOME TAX WITHHELD (INCLUDED IN LINE 4 1099-INT) 0.00
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MR DANIEL M GROFF AND
2012 TAX REPORTING STATEMENT
THE VISA SIGNATURE SUMMARY STATEMENT TRACKS ALL OF YOUR CARD TRANSACTIONS BY DATE AND MERCHANT CATEGORY, KEEPS YOUR CHECKS ORGANIZED NUMERICALLY AND EVEN
PROVIDES A MONTH-BY-MONTH ANALYSIS OF ALL YOUR CARD AND CHECKING EXPENSES. THIS INFORMATION IS FOR PERSONAL REVIEW AND IS NOT REPORTED TO THE IRS. THIS ANNUAL
SUMMARY STATEMENT CAN HELP YOU. YOUR ACCOUNTANT OR YOUR TAX ADVISOR WITH YOUR FINANCIAL PLANNING AND YOUR TAX PREPARATION.
2012 CHECKS WRITTEN/BILL PAYMENTS
Check Number Date Written Date Cleared Payee Amount Client Workspace
0496 11/08 11/09 LESLEY GROFF 105.424.00
TOTAL CHECKS WRITTEN/BILL PAYMENTS ACTIVITY 105,424.00
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MR DANIEL M GROFF AND
2012 TAX REPORTING STATEMENT
EXPENSES BY MONTH
JAN FEB MAR APR MAY JUN 2012 SUBTOTAL
Lodging
Restaurants
Car Rental
Air Lines/Travel Agents
Entertainment/Recreation
Service Stations
Healthcare
Education
Merchandise
Cash Advances
ATM Cash Withdrawals
Other/Unclassified
VISA Credit
Total Net Charges:
Total Checking:
Total Expenses:
EXPENSES BY MONTH
JUL AUG SEP OCT NOV DEC 2012 SUBTOTAL
Lodging
Restaurants
Car Rental
Air Lines/Travel Agents
Entertainment/Recreation
Service Stations
Healthcare
Education
Merchandise
Cash Advances
ATM Cash Withdrawals
Other/Unclassified
VISA Credit
Total Net Charges:
Total Checking: 105,424.00 105,424.00
Total Expenses: 105,424.00 105,424.00
14. END OF STATEMENT -
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