Form 8879-Eo - Irs E-File Signature Authorization For An Exempt Organization Sample - 2015 Page 37
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41CANCER SUPPORT COMMUNITY MONTANA
81-0542266
Form 4562 (2015)
Page
2
Part V
Listed Property
(Include automobiles, certain other vehicles, certain aircraft, certain computers, and property used for entertainment,
recreation, or amusement.)
For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete
24a, 24b, columns
Note:
only
(a) through (c) of Section A, all of Section B, and Section C if applicable.
Section A - Depreciation and Other Information (Caution:
See the instructions for limits for passenger automobiles.)
Do you have evidence to support the business/investment use claimed?
24a
Yes
No 24b
If "Yes," is the evidence written?
Yes
No
(b)
(c)
(e)
(i)
(f)
(g)
(h)
(a)
(d)
Date
Business/
Elected
Basis for depreciation
Recovery
Depreciation
Type of property
Method/
Cost or
placed in
investment
section 179
(business/investment
(list vehicles first)
period
deduction
Convention
other basis
use percentage
service
use only)
cost
Special depreciation allowance for qualified listed property placed in service during the tax year and
25
used more than 50% in a qualified business use•••••••••••••••••••••••••••••
25
Property used more than 50% in a qualified business use:
! !
26
! !
%
! !
%
%
! !
27
Property used 50% or less in a qualified business use:
! !
%
S/L -
! ! !
%
S/L -
%
S/L -
28
Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1 ~~~~~~~~~~~~
28
29
Add amounts in column (i), line 26. Enter here and on line 7, page 1 •••••••••••••••••••••••••••
29
Section B - Information on Use of Vehicles
Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles
to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.
(a)
(b)
(c)
(d)
(e)
(f)
Total business/investment miles driven during the
Vehicle
Vehicle
Vehicle
Vehicle
Vehicle
Vehicle
30
year (
include commuting miles)
do not
~~~~~~
31
Total commuting miles driven during the year ~
32
Total other personal (noncommuting) miles
driven~~~~~~~~~~~~~~~~~~~~~
33
Total miles driven during the year.
Add lines 30 through 32~~~~~~~~~~~~
34
Was the vehicle available for personal use
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
during off-duty hours? ~~~~~~~~~~~~
35
Was the vehicle used primarily by a more
than 5% owner or related person? ~~~~~~
36
Is another vehicle available for personal
use? •••••••••••••••••••••
Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees
Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who
are not
more than 5%
owners or related persons.
37
Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by your
Yes
No
employees?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
38
Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your
employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners ~~~~~~~~~~~~
39
Do you treat all use of vehicles by employees as personal use? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
40
Do you provide more than five vehicles to your employees, obtain information from your employees about
the use of the vehicles, and retain the information received? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
41
Do you meet the requirements concerning qualified automobile demonstration use? ~~~~~~~~~~~~~~~~~~~~~~~
Note:
If your answer to 37, 38, 39, 40, or 41 is "Yes," do not complete Section B for the covered vehicles.
Part VI
Amortization
(a)
(b)
(c)
(d)
(e)
(f)
Description of costs
Amortizable
Code
Amortization
Date amortization
Amortization
amount
section
for this year
begins
period or percentage
! !
Amortization of costs that begins during your 2015 tax year:
42
! !
43
43
Amortization of costs that began before your 2015 tax year ~~~~~~~~~~~~~~~~~~~~~~~~~~
44
44 Total.
Add amounts in column (f). See the instructions for where to report •••••••••••••••••••
Form
(2015)
4562
516252 12-28-15
38
13340919 792194 141677
2015.04020 CANCER SUPPORT COMMUNITY MO 141677_1
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