California Schedule K-1(568) - Member'S Share Of Income, Deductions, Credits, Etc. - 2004

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Member’s Share of Income,
YEAR
CALIFORNIA SCHEDULE
2004
Deductions, Credits, etc.
K-1 (568)
For calendar year 2004 or fiscal year beginning month _______ day _______ year 2004, and ending month _______ day _______ year _______
Member’s identifying number
LLC’s FEIN
Member’s name, address, state, and ZIP Code
Secretary of State file number
LLC’s name, address, state, and ZIP Code
¼
A What type of entity is this member?
D Member’s share of liabilities:
¼
Nonrecourse . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ _________________
(1)
Individual
(5)
General Partnership
(8)
LLC
¼
(2)
S Corporation
(6)
Limited Partnership
(9)
IRA/Keogh/SEP
Qualified nonrecourse financing . . . . . . . . . . . . .
$ _________________
(3)
Estate/Trust
(7)
LLP
(10)
Exempt Organization
¼
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ _________________
(4)
C Corporation
E Tax shelter registration number __________________________________
¼
B Is this member a foreign member? . . . . . . . . . . . . . . . . .
Yes
No
F (1) Check here if this is a publicly traded partnership
C Enter member’s
as defined in IRC Section 469(k)(2) . . . . . . . . . . . . . . . . . . . . . . . . . .
percentage (without
regard to special
(i) Before decrease
(ii) End of year
(2) Check here if this is an investment partnership
allocations) of:
or termination
(R&TC Sections 17955 and 23040.1) . . . . . . . . . . . . . . . . . . . . . . . . .
¼
.
.
¼
Profit sharing . . . . . . . . . . .
__ __ __
__ __ __ __%
__ __ __
__ __ __ __%
G Check here if this is:
¼
.
.
Loss sharing . . . . . . . . . . .
__ __ __
__ __ __ __%
__ __ __
__ __ __ __%
(1)
A final Schedule K-1 (568) (2)
An amended Schedule K-1 (568)
¼
.
.
¼
Ownership of capital . . . . .
__ __ __
__ __ __ __%
__ __ __
__ __ __ __%
H Is this member a nonresident of California? . . . . . . . . .
Yes
No
I
Analysis of member’s capital account:
(c)
(e)
(a)
(b)
(d)
Member’s share of
Capital account at end of year,
Capital account at
Capital contributed
Withdrawals and
line 3 , line 4, and line 7
combine column (a) through
beginning of year
during year
distributions
Form 568, Schedule M-2
column (d)
¼
¼
¼
(
) ¼
Caution: Refer to Member’s Instructions for Schedule K-1 (568) before entering information from this schedule on your California return.
(b)
(d)
(e)
(a)
(c)
Amounts from
Total amounts using
California
Distributive share items
California adjustments
federal Schedule K-1
California law. Combine
source amounts
(1065)
col. (b) and col. (c)
and credits
1 Ordinary income (loss) from trade or
¼
business activities . . . . . . . . . . . . . . . . . . . .
2 Net income (loss) from rental real
¼
estate activities . . . . . . . . . . . . . . . . . . . . . . .
3 Net income (loss) from other rental activities
4 Portfolio income (loss):
¼
a Interest . . . . . . . . . . . . . . . . . . . . . . . . . . .
¼
b Dividends . . . . . . . . . . . . . . . . . . . . . . . . .
¼
c Royalties . . . . . . . . . . . . . . . . . . . . . . . . . .
¼
d Net capital gain (loss) . . . . . . . . . . . . . . . .
e Other portfolio income (loss).
¼
Attach schedule . . . . . . . . . . . . . . . . . . . .
¼
5 Guaranteed payments to members . . . . . . .
6 Net gain (loss) under IRC Section 1231
¼
(other than due to casualty or theft) . . . . . .
¼
7 Other income (loss). Attach schedule . . . . .
8 Charitable contributions . . . . . . . . . . . . . . . .
9 Expense deduction for recovery property
(R&TC Sections 17267.2, 17267.6, 17268,
and IRC Section 179).
Attach schedule . . . . . . . . . . . . . . . . . . . . . .
10 Deductions related to portfolio income.
Attach schedule . . . . . . . . . . . . . . . . . . . . . .
11 Other deductions. Attach schedule . . . . . . .
K156804103
Schedule K-1 (568) 2004 Side 1

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