Taxpayer name
Taxpayer ID
Schedule A Properties Given Up and Received. See instructions.
Part I Properties Given Up. If you gave up more than three properties, attach additional copies of Schedule A.
Is property
Ownership
1
in
percentage
Property description
California?
Property address (if no street address, provide assessor's parcel number and county)/Description
Yes
A
_ _ _._ _%
City
State ZIP code
No
Property address (if no street address, provide assessor's parcel number and county)/Description
Yes
B
_ _ _._ _%
City
State ZIP code
No
Property address (if no street address, provide assessor's parcel number and county)/Description
Yes
C
_ _ _._ _%
City
State ZIP code
No
A
B
C
Properties given up:
2
Was this property acquired in a prior tax deferred
exchange?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
Yes
No
Yes
No
Yes
No
3
Consideration/Sales price . . . . . . . . . . . . . . . . . . . . . . . . . .
3
4
Selling expenses paid/incurred . . . . . . . . . . . . . . . . . . . . . .
4
5
Amount realized. Subtract line 4 from line 3 . . . . . . . . . . . .
5
6
California adjusted basis . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
7
Realized gain or (loss). Subtract line 6 from line 5 . . . . . . .
7
California source deferred gain. If all property given up was located in California, enter the amount from
8
Side 1, line 19, Deferred gain, adjusted for differences between federal and California law. If multiple properties
00
were given up and the properties were located both in and outside of California, see instructions. . . . . . . . . . . . .
8
Part II Properties Received. If you received more than three properties, attach additional copies of Schedule A.
Is property
Ownership
9
in
percentage
Property description
California?
Property address (if no street address, provide assessor's parcel number and county)/Description
Yes
D
_ _ _._ _%
City
State ZIP co
de
No
Property address (if no street address, provide assessor's parcel number and county)/Description
Yes
E
_ _ _._ _%
City
State ZIP co
de
No
Property address (if no street address, provide assessor's parcel number and county)/Description
Yes
F
_ _ _._ _%
City
State ZIP co
de
No
Part III Allocation of California Source Deferred Gain. See instructions.
D
E
F
Properties received:
10
Allocation of California source deferred gain to
properties received. If only one property was received,
enter the amount from Part I, line 8, in column D. If more
than one property was received, see instructions. . . . . . . .
10
11
Apportionment percentage for the taxable year of the exchange. See instructions . . . . . . . . . . . . . . . . . . . . . . . . .
11 __ _
_ __.__ __ __ __%
Side 2 FTB 3840
2015
C1
8422153