EFTA01280309.pdf

6 651112 Schedule K-1 2012 Final K-1 —1 Amended K-1 OMB No. 1545-0099 (Form 1066) For colorer •••2012 a bm In Partner's Share of Current Year Income, Department of the Treasury nling APRIL 24, 2012 S'ac Deductions, Credits, and Other Items internal Revenue Service ,„„ rc DECEMBER 31, 2012 1 Ordinary business Income (loss) 16 Crudes Partner's Share of Income, Deductions, 0. Credits, etc. le See separate Instructions. 2 Namavallatoterrmmotossi —7,445. 16 Foreign transactions 3 Other net rental Income (loss) pelt t Information About the Partnership A Partnership's employer WentiricatiOn number 4 Guaranteed payments PartnersNp's name, address, city, state. and ZIP code 5 Interest income 5. MIDWAY-CAROLINAS 2012 LLC Be Ordinary dividends 270 LAFAYETTE ST STE 409 17 Merman min tax (AMT) items NEW YORK, NY 10012 13b Qualified dividends A 1, 537 . C IRS Center where partnership fled return E—FILE 7 loyalties 18 Tax-exempt:roome and D n Chick il this is a publicly traded parinershp (PIP) 8 let short-term capital gain (Ion) nondeductible expenses 9a Net long-termcapital gate (loss) Part II Information About the Partner E Partners Identifying number fib Criectibles (28%) gain (loss) 19 Distribution: 2,173. F Partner's name. addrerst.cey, Vacant) DP code 9c Inrecaptured sec 1250 Gain 20 Other Information BLUE CHIP CAPITAL, LLC 10 Net section 1231 gain Goss) A 5. 27 HIGH TECH BLVD. THOMASVILLE, NC 27360 11 Other Mcome (bas) General partner Or LLC IL Limited partner or other LLC member-manager member H Domestk partner n Foreign partner VI What type of entity Is tins partner? PARTNERSHIP 12 Section 179 deduction 12 It this partner's a retirement ptan (IfWSEPMeogh/etc.), check here J Partners share of profit, loss, and capital: 13 Other deductions Beginning Ending PT* STMT Profit 0.8056130% 0.8056130% Loss 1.0395010% 1.0395010% Capital _ 1.0395010% 1.0395010% 14 SelFenuloyment earnings (loss) K Partners share 01labillbeS at year end: 0. Nonrecourse 2,429. Needed nonrecouree financing $ *See attached statement for additional in carnation. Recourse g 143,101. L Partners capital account analysis: Beginning caplet account Capital contributed during be year t 50,000. 8 Current year Increase (decrease) Withdrawals & distributions —7,479. 2,1734 g St Ending capital account $ 40,348. M Tax basis CJ GAP Section 704(b) book Other (explain) M Old the partner contribute property with a built-In gain or loss? Yet ai No It 'Yes'. attach statement (see instmctions) 01-03.13 WA For Paperwork Reduction Act Notice, tea InstnictIont ha Form 1066 IRS.govitorm1065 Schedule K-1 (Form 10851 2012 6 08020326 758241 21146.221 CONFIDENTtAt AS 2012 LLC 21146_G1 SDNY_GM_00033178 EFTA_00143791 EFTA01280309  MIDWAY-CAROLINAS 2012 LLC SCHEDULE K-1 OTHER DEDUCTIONS, BOX 13, CODE W DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT LEGAL 8. MAILING 1. TOTAL TO SCHEDULE K-1, BOX 13, CODE W 9. SCHEDULE K-1 CURRENT YEAR INCREASES (DECREASES) DESCRIPTION AMOUNT TOTALS RENTAL REAL ESTATE INCOME (LOSS) -7,445. INTEREST INCOME 5. SCHEDULE K-1 INCOME SUBTOTAL -7,440. OTHER DEDUCTIONS -9. SCHEDULE K-1 DEDUCTIONS SUBTOTAL -9. NET INCOME (LOSS) PER SCHEDULE K-1 -7,449. PREPAID RENTS CY- BRIGHTON -13. PREPAID RENTS CY- MEADOWS -17. OTHER INCREASES OR DECREASES SUBTOTAL -30. TOTAL TO SCHEDULE K-1, ITEM L -7,479. PARTNER NUMBER 6 08020326 758241 21146.221 CONF1 tfribility 2012 LLC 21146 GI SDNY_GM_00033179 EFTA 00143792 EFTA01280310  6 Schedule K.1 (Form 10651 2012 Papa 2 This Its1 Identifies the codes used on Schedule K•1 for all partners and provides summarized reporting Information for partners who rile Form 1040. For detailed reporting and Sling Inlormetlon, see the separate Partners Instructions for Schedule K-1 and the Instructions lo t your Income lax return. Coot Rem. en • Denbo pas 'es, Ircome lose Demme mere/ tie axone >ex • I 4 Wont »mewl ty erellt pesiv or »omen nn et. , or pin • morn et Min» K Melee access r?ogit L Emmet-me IOW CM worm %oat on orrrour ty anciorlet over Ses Me Pe:nefs Irsnuaions M Omit Min:rani neural Pass ve des Soo 1M %Mere »Moto» Celt« Perm rare Schellule E, Ilne 28, co Jrni*: N Cant trenneysr »dal smutty Nor map ye cm Sew/OM& ilne a PO mire (1: ei Meecere »ea Net»se» noon» EalneOule E. II» 28, » J•re Q O Realm* etchre eng 2. Net term 7el set»home tom See Pm 'Mies »Met vs P OMceeb 3. Other ne rental Wale (MX Net occor• senora» F. IIon 28, oe Jnm 1& Fete traratectons Net ces Son he »trees »act cne A Nome et cony or 3. ne:47?e:.• Gammon payments &NO» E. IIM 28, co• Jinn() posinenon *meow Mom» eorn Ste» B Goon Noe*. 'men all so. tat %mill& PM I Denary c Men» Torn 'CM Mele C Ones incr., excel at petne: 0» Ba c vlOmOs Fern toe lire 9t. lave } Pelt» Schedule E Ilne 4 emir Lem Moon» sears at pantwonaltlp Mod Not mat-tenn»el» ceir Schedule D, linen D Pose»crap» NM 4M-ten »0 "Al OM 93»: sonetuts D, Ike 12 E Gems» »may Fenn111R Port I CoamtiMes (28%j min pot» 28% nit, Gain \\mashie Yu 4 F Cone .6ctreaue D immix* Unnemmed Neon 12M ern San toePare s nottelme De Jame Omen: mu imnelened el partner leve Net eel» • 23' 0•• »se See DePeres »Melon, G Mime :opera Form 1110, Pal I Other Morns Cces) H Peer Fonn 1118, PM I Coen Dec aCt101. allOcin< and egMelleg M partremblp Mal lo blip »are A Othor Pott'Cdo Mons (OM See mePrates nettelo-• «are • Mau May correr• Ste thePat»'. neMetlee I %Ivan aline" C Soc lea cortices &«MS» Fern 676 1, Ms t J Gera oreserc Form111& D Minn" **Mt m mete m'spx:x Zee R:t. 535 K Otte, E Corona:Imo( of» roan "CaO, lire 21 or Toren 062 r Corer moon...toe) Sse IntlPeres in•Inetlerill Cher Monomer L - ots amgn 'an »cl AVM ill& Pet I Selon 179 deduct on Ste DePirtle* Insotelon M t'ots »neon tees MM..» FornIll& PM CMor imanoncre N Reducten taxes ems» b• «ton Forn1110, Me 12 I A Can coo 011anma X31% LI Ere or tic ng gram »seta Forit4473 S Carl °entractes:m23m P EdnIterit.ilA Ire•Yr.0 «NUS« Fier 8873 C Nonnoten conolbuttre 6.396: O Other Mole I:errata:ma In•Pertnechtlnalniodcow • Noncom conMoutcre DOM: Ste MePaine* Ins:melon E Cent »In propene to see% 17. Ann** m Moen so We ten• 1 overnice 03%; F Greta gain procerti C Cra ogre ?ICON eo%) A Pot4.1006 Oenaletton eidlastmerl B Ap ate] »nor km Sabi Parretti C »Deter totter »an oa 3 gas) trtsMelore enci H Inestinntil Wen,. ox geese For &sea, anal the trebuctIcri> ta D Oil gas, 8 gerkidier• won WO« Ondiffbn5 roya ty 'room Sole»• E, lee 10 See the Partnes InerucCone C OI. al, & rirocirria culi.cinans Fas710261 J »men 6O(eXP: rtextel,MOS 0.nrAVT lems K °Minion peel.> c ex keel acticlUe L 0Muctiont: wet. t(ce«) Sam»s & linen 18, Tomcompt !nuns one TOMMUCCO» eMerste M Amu 1M >NCI In, Mon ea rearm »redo • A. line 1 er Tor I C40. 0,7,20 A femempt»tree Mon» renn1C4C, Ina an N Eopenson anMince binette Soc thePence. Inennende • Gthe, tax•exempt Incene Sea Pre Pare Irrrxten O Dependeot aire »nee» For 2‘41, m12 Noideiduclible t•-•Tallaro $6* IN* Port:des Instr.otors C O Prom»men ported *pente anTo %mete Imowbons O Carnmentia motatOrloodaluellon Sec 'ern 6662 Instnetre 10. Dirra Dean Mr, •er up real et» colvitee A »an and :mows» seatIles 7 %Tibia ere Am BeeII»Plebe» Mermen 3 Dlembutbn sMet to seem 737 } See Me 5entrer's Inemelkos • nert.nraMi open» Oelatlim See thePan«. Ineratle» C Othr P•OPerl T lereer prePtior WI V ties Se* Fern 8933 neg.-IMO 20. Oelt Whence, *motor A levimerteent For 4962. ilne 45 ... (no lb& pm.elm met», 'morn Fare 8903 'am To 9 Mien& maxim Fom.. se area ✓ Drn eyes Foin W-2 ewes Tarn 3903 Me • 7 C F:e tax peel n'orrnmer For 4138 W Otweeouctbre See •tiePanne'. MstruoIlms D Outran retelnilltater en:malt:» Corn era, vital SC »We Soothe Pat»'» IrePtclone 14 Segmimployrreit tarungs dosai E Rana ot mew money See the Pares Inatuelene F gmeon of kanIncone teasing Nom II you reee • melon 170 cieduallot er try prerœlove leductlorta see coedit Ottel en 42ai3O Forte 861I. Ire 8 IleParera Intontetlore belme eormleMat Smoot» SE. C. %cep»n pi inalncorne boatting A »I witIrgs »es) borr Soo« Jlo SF, Seaton A of onallt tote) For 8611, loos eel ...ibwil 11 leceaure Y irxermmt crack See Fora .IMS 9 Ono» hen nai m %map Mome Ses te Peres Iretuolens I neopurn n . Om« evnelli See te Pertness Irsauelms C Omer nomlbrrn Poems See to Porycea iratNelces J _ook-cem lame cemplem0 onactonncotectop SeeFor 8M7 16. CrediN K Look•oecic Inborn; - Moms meant A trle.ire01110 Fouslrç credit menoct See rem. 8869 @man a2('(o)bom prc 2MS L DeposiSces el Mee/ IRMO» »eon 579 deduct» 8 Lormincone Cowart; creak lathe, M Raplare C' «Mai '79 :feu cn from me-2O36 tataIngs N Interest «pan» lor costa.» oartain C low•trr,,rx, loailry credit >eh ,' O »Mon 4.3.74A Mornatoo 00(,:: inn. cent 200: el Inn» P serer ,I53é4q naweton I/ LcvnInnarra »Joins Credit mneri See me Dann«, mt.:aces O 126O(bleraietol per-23C2 »Margo R Meer» • loantb• prcalMon See te Penes E Cutlet, enscilltatier mosnoltues imendlters Irene:it:nu Sr» M Mbre a ccr Nei:welded %etcseats F Ota meal and crate =di% T DefAelon Inter/314w - oi are gee O &taw» coellis U Ann:nation M wormer« cnes H Uteleibilsol eel» »Ins melt Tee 1O4O, heel 71; an» box • ✓ Unrstrion »Omen »Ms 'tome I Metro ono oe Mc* o WA» heala Sc. Pe %toes .Notn.cnons W Pareettaten grin e0.05I met X Scent, 13e, naprist» Y 0Msr rIparetler 211202 01-00-13 6 08020326 758241 21146.221C ON ENT/PALM 2012 LLC 21146 G1 SDNY_GM_00-(7133180 EFTA_00143793 EFTA01280311  New York State Department of Taxation and Finance 2012 New York Partner's Schedule K-1 IT-204-IP Tax Law - Article 22 (Personal Income Tax) 6 Final K-1 For calendar year 2012 or tax year beginning 04-24-2012 and encrmg 12-31-2012 Lj Amended K-1 Partners: Before completing your income tax return, see Form IT•204•IN, Partner's Instructions for Form IT-204-IP (availetae at vainv.tax.ny.gov). Partnership's Information (see instructions) Partnership's name (as shown on Font IT•204) Partnership's £IN MIDWAY-CAROLINAS 2012 LLC A Mark an X In the box if either applies to your entity E. Publicly traded partnership IT1 Portfolio investment partnership B Tax shelter rag stration number, If any 8 C Business allocation percentage C Partner's information (see instructions) Partner's name Partner's identifying number BLUE CHIP CAPITAL, LLC Partners address 27 HIGH TECH BLVD. City State ZIP code THOMASVILLE NC 27360 D The partner is a ;win on X ir he .prop et Do4 n General partner or LLC member-manager IM Limited partner or other LLC member E What is the tax fling status of the partner? ;gm( tri X b. me cotroprate bax. ifInowla C Individual Estate/trust LE Partnership F If the partner Is a disregarded entity or grantor trust, enter the tax ID of the entity or individual reporting the income, If known G Did the partner sell its entire interest during the tax year? G Yes El No 71 Beginning Ending H Partner's share of profit, loss, and capital 1) Profit H1 0.8056 % 0.8056 % 2) Loss H2 1.0395 % 1.0395 % 3) Capital H3 1.0395 % 1.0395 vo I Partner's share of liabilities at the end of the year 1) Ncurecourse 11 2,429. 2) Qualified nonrecourse financing 12 3) Recourse 13 143,101. J Partner's capital account shalysb 1) Beginning capital account J1 2) Capital contributed during the year • Cash J2 50,000. 3) Capital contributed during the year - property J3 4) Current year Increase (decrease) J4 —7,479. 5) Withdrawals and distributions • cash J5 2,173. 6) Withdrawals and datnbutions • property JO 7) EMing capital account a 40,348. 8) Method of accounting (mark en ill the 0pp:opiate box) ir Tax basis El CIAAP 0 Book El Other (submit explanation) K Resident statue (mark an A' In all boxes that apply) O NYS full-year resident C Yonkers full-year resident C NYC full-year resident El WS part•year resident n Yonkers part•year resident E NYC part-year resident M NYS nonresident C Yonkers nonresident L If the partner was Included in a group return, enter the special NYS Identification number, if known L 118001121019 HIE MSS, V-S-12 CONFIDENTIAL SDNY_GM_00033181 EFTA_00143794 EFTA01280312 Pepe 2 of 4 IT-204-IP (1012) M 1) Was Form IT•2658•'c Ned with the partnership? MI Yea Q No 2) Was Form MTA•406•E fled with the partnership? M2 Yes Q No N NYS estimated tax paid on behalf of partner Mom Formmass) Deto Amount 1) First Instalknent N1 2) Second Installment 3) Third installment PS3 4) Fourth Installment N4 Total NYS estimated tax paid on behalf of partner Odd Ales NI through N4) O Estimated RICTMT paid on behalf of partner (hornForm MTA-406) Date Amount 1) Fret installment O1 2) Second nstal!•ront 02 3) Third installment 03 4) Fourth Installment 04 Total estimated MOUNT paid en behalf of partner (add lines 01 through O4) Partner's share of Income, deductions, etc. A - Partner's distributive share Items - Federal K-1 afilount C - New York State amount 1 Ordinary business Income (loss) 1 1 2 Net rental real estate ircome (loss) 2 —7,445. 2 3 Other net rental income (loss) 3 3 4 Guaranteed payments 4 4 5 Interest income 6 5. 5 o Ordinary dividends 6 6 7 Royalties 7 7 8 Net short-tern capital gain (loss) 8 8 9 Net long-term capital gain (loss) 9 10 Net section 1231 gain hoes) 10 10 11 Other Income Goss) Identity: 11 11 12 Section 179 deduction 12 12 13 Other deductions Identify: SEE STATEMENT 13 9. 13 14 Tax preference Items for minimum tort 14 1,537. 14 Identify: 15 Net earnings (loss) from self-employment 13 15 15 Tax-exempt income aid nondeductible expenses 10 16 17 Distributions • cash aid marketable :actuates . 17 2,173. 17 18 Distributions other property 18 18 19 Other rams not included above that are required t0 bs reported separately to partners 19 5. 19 idenfiry: SEE STATEMENT Partner's share of New York modifications (seeinstmcrions) 20 New York State additions Number A - Total amount 6 - New York Stale allocated amount 20a EA- 16 226. 20b EA- 20c EA- 20d EA- 20e EA- 201 EA- 21 Total addition modifications (total of cobmn A, fines 20a through 200 21 226. 118002121019 IIIIlIIIIIIIIIIIIIIIII1111 III III I 11-1912 CONFIDENTIAL SDNY_GM_00033162 EF1'A_00143795 EFTA01280313  IT-204-IP i2t)12i Page 3 of 4 Partner's share of New York modifications .'cor;:i 22 New York Slate suotractions Number A - Total amount B New York State allocated amount 22a ES- 22b ES- 22c ES- 22d ES- 22e ES- 22f ES- 23 Total subtraction moddications (total of column A, fnes 22a through 221) 23 24 Additions to federal Itemized deductions Letter Amount 24a 24b 24c 24d 24e 24f 25 Total additions to federal itemized deductions (add lines 24a through 24!) 25 28 SubtractIons from federal itemized deductions Letter Amount 28a 28b 26c 26d 28e 26f 27 Total subtractions from federal itemized deductions (add foes 26a through 266 27 28 New York adjustments to tax preference items 28 Partner's other information 29a Partner's share of New York source gross Income 29. 29b MOTO alocatlon percentage (see Instructions) 29b Partner's credit information Part 1 - Flow-through credit bases and factors Brownfield redevelopment tax credit (Form IT-6i7 or /T-617.1) A • Form 17411 B - Rpm IT-811.1 30 Site preparat on credit component 30 30 31 Tangible property credit component 31 31 32 On-site groundwater remedlation credit component 32 32 11800 3121019 211Setri 11.1912 CONFIDENTIAL SDNY_GM_000331,33 EFTA_00143796 EFTA01280314 Page 4 0(4 IT-2044P Q012) Partner's credit information (continued) EZ capital tax credit (Form !T-602) 33 Contributions of money to EZ community development protects 33 34 Recapture of credit for Investments in certified EZ businesses 34 35 Recapture of credit for oontributions of money to EZ community development projects 35 QEZE tax reduction credit (Form IT-604) 38 Cil2E employment ircrease factor 36 37 O¢E zone allocation factor 37 38 (DEM benefit period factor 38 Excelsior jobs program tax credit (Form IT-607) 39 Excelsior jobs tax credit component 39 40 Excelsior investment tax credit oomponent 40 41 Excelsior research and development tax credit component 41 42 Excelsior reed property tax credit component 42 Farmers' school tax credit (Form IT-217) 43 Acres of qualified agricultural property 43 44 Acres of qualified conservation property 44 45 Eligible school diMrict property taxes paid 46 46 Acres of qualified agricultural property converted to nonqualifid use 46 Other flow-through credit bases and factors Credit base,' Code Amount Cods Amount 47a 47d 47b 470 47c 471 Credlz factors Code Factor Code Factor Cods Fedor 47g 47i 47k 471t 47i 471 Pert 2 - Flow-through credits, addbacks and recaptures 48 Long-term care Insurance credit (Form IT-249) 48 49 Investment cleat (including employment incentive credit end hIstonc bar rehabilitation crook Form1T-212) 40 SO Research and development - Investment credit (Form IT-212) 60 61 Other flow-through credits Code Amount Code Amount 61a 51e 51t. 511 510 51g 51d 51h 52 Addbacim of credte and recaptures Code Amount Cods Amount 52a 62d 52b 52e 52c 521 118004121019 III IIIIIIIIIIIIII IIIIIIIIIIIIII CONFIDENTIAL SDNY_GM_00033184 EFTA_00143797 EFTA01280315  MIDWAY-CAROLINAS 2012 LLC NY IT-204-IP OTHER DEDUCTIONS AMOUNT FROM NEW YORK FEDERAL STATE DESCRIPTION SCHEDULE K-1 AMOUNT LEGAL 8. 0. MAILING 1. 0. TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13 9. 0. NY IT-204-IP OTHER ITEMS REQUIRED TO BE REPORTED SEPARATELY AMOUNT FROM NEW YORK FEDERAL STATE DESCRIPTION SCHEDULE K-1 AMOUNT INVESTMENT INCOME 5. 0. TOTAL TO FORM IT-204-IP, PAGE 2, LINE 19 5. 0. PARTNER NUMBER 6 CONFIDENTIAL SDNY_GM_00033i85 EFTA_00143798 EFTA01280316  NC K-1. (39) 2012 Partner's Share of (D-403) N.C. Income, Adjustments, and Credits 10.11.12 North Carolina Department of Revenu► For calendar year or fiscal year beginning 04 24 12 and ending 12 31 12 Partner's (dent I Number Federal Em r ID Number Partners Name, Address, and ZIP Carle Partnership's Name, Address, and ZIP Cede BLUE CHIP CAPITAL LLC MIDWAY-CAROLINAS 2012 LLC 27 HIGH TECH BLVD 270 LAFAYETTE ST STE 409 THOMASVILLE NC 27360 NEW YORK NY 10012 Individuals Filing Form Partnership's Pro Rata Share items Amount 0-400 Enter Amount on: All Partners 1. Share of partnership Income (loss) -7440 2 Additions to income (loss) a. Addition for bonus depredation 226 Page 2. Line 95 b. Other additions to Income (loss) 0 Page 2, Une 36 3. Deductions from income (loss) a. Deduction for bonus deprecation 0 Page 2. Line 44e b. Other deductions from Income (loss) 0 Page 2, Line 49 4. Share of tax credits 0 Form 0.400T0 5. Share of tax werheld horn nonwage compensation paid for personal services performed in N.C. 0 Page 2. Line 23 lioncesIdents GeV 6. No nresklent's share of N.C. taxable lucerne (loss) 0 Page 2, Une 51 7. Nonresident's share of let lax paid by the manager of the partnership 0 Page 2, Une 24c 289291 12.28.17 CONFIDENTIAL SDNY_GM_00033186 EFTA_00I 43799 EFTA01280317  Forcalendaryeer 2012 STATE OF SOUTH CAROLINA DEPARTMENT OF REVENUE PARTNER'S SHARE OF SOUTH CAROLINA INCOME, DEDUCTIONS, CREDITS, ETC. ar b Inning 04/24/12 (Rev. 5/27/11) and ending 12 31/12 3515 Jsclossi 1 Partner's Ident number OP ParbenshIp's FEIN Partners name, address and ZIP code Partnership's name, address and ZIP code BLUE CHIP CAPITAL, LLC MIDWAY-CAROLINAS 2012 LLC 27 HIGH TECH BLVD. 270 LAFAYETTE ST STE 409 THOMASVILLE, NC 27360 ,NEW YORK, NY 10012 Check If applicable: (1) 1 Final IC1 (21 — Amended K•1 (3) Lai Nonresident Partner's Share of Current Year (Al (3) Amounts Not a Amounts Allocated Federal Plus or Minus Income, Deductions, Credits, etc. Ic1 Amounts SC Adjustments Allocated or Apportioned to SC or Apportioned to SC STMT 1 Ordinary business income (loss) ,,, 1 1 2 Net rectal real estate income (loss) -7,445. 2 193. 2 -3,685. 2 -3,567. 3 Other net rental income (toes) 3 3 3 4 Guaranteed payments 4 4 4 5 Interest Income 5. 5 5 5. 5 6 Dividends 6 8 8 8 7 Royalties 7 7 7 7 8 Net short-term capital gain (loss) 8 8 8 -1 9 Net long-term capital gain (loss) 9 9 9 10 Net Section 1231 gain (loss) 10 10 10