California Schedule K-1 (100s) - Shareholder'S Share Of Income, Deductions, Credits, Etc. - 2012 Page 2

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(a)
(b)
(c)
(d)
(e)
Pro-rata share items
Amount from
California
Total amounts
California
federal Schedule K-1
adjustment
using California law
source amounts
(1120S)
Combine (b) and (c)
and credits
where applicable
15 a Depreciation adjustment on property placed in
service after 12/31/86 . . . . . . . . . . . . . . . . . . . . .
b Adjusted gain or loss . . . . . . . . . . . . . . . . . . . . .
c Depletion (other than oil and gas) . . . . . . . . . . . .
d 1 Gross income from oil, gas, and
geothermal properties . . . . . . . . . . . . . . . . . . .
2 Deductions allocable to oil, gas, and
geothermal properties . . . . . . . . . . . . . . . . . . .
e Other AMT items . Attach schedule . . . . . . . . . . .
16 a Tax-exempt interest income . . . . . . . . . . . . . . . .
b Other tax-exempt income . . . . . . . . . . . . . . . . . .
c Nondeductible expenses . . . . . . . . . . . . . . . . . . .
d Total property distributions (including cash)
other than dividends distribution reported
on line 17c . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e Repayment of loans from shareholders . . . . . . .
17 a Investment income . See instructions . . . . . . . . .
b Investment expenses . See instructions . . . . . . . .
c Total taxable dividend distribution paid from
accumulated earnings and profits .
See instructions . . . . . . . . . . . . . . . . . . . . . . . . .
d Other information . See instructions . . . . . . . . . .
18 a Type of income __________________________
b Name of state ___________________________
c Total gross income from sources outside
California . Attach schedule . . . . . . . . . . . . . . . . .
d Total applicable deductions and losses .
Attach schedule . . . . . . . . . . . . . . . . . . . . . . . . . .
e Total other state taxes . Check one:
 Paid
 Accrued . . . . . . . . . . . . . . . . . . . .
Table 1 — Each shareholder’s share of nonbusiness income from intangibles . See instructions .
Interest
$ _________________ Royalties
$ __________________
Dividends
$ __________________
1231 Gains/Losses $ _________________ Capital Gains/Losses $ __________________
Other
$ __________________
FOR USE BY SHAREHOLDERS ONLY. SEE INSTRUCTIONS.
Table 2 — Shareholder’s pro-rata share of business income and factors — See instructions .
A . Shareholder’s share of the S corporation’s business income $________________________________
B . Shareholder’s share of the nonbusiness income from real and tangible property sourced or allocable to California:
Capital Gains/Losses
$ _____________________________
Rents/Royalties $ _______________________________
1231 Gains/Losses
$ _____________________________
Other
$ _______________________________
C . Shareholder’s share of the S corporation’s property, payroll, and sales:
California Sales – Doing Business Test $____________________
Factors
Total within and outside California
Total within California
Property: Beginning
$
$
Ending
$
$
Annual Rent Expense
$
$
Payroll
$
$
Sales
$
$
Side 2 Schedule K-1 (100S) 2012
7872123

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