Form Nyc-2.1 - Investment And Other Exempt Income And Investment Capital Page 3
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NAME
EIN
Form NYC-2.1 - 2017
Page 3
SCHEDULE D - Total investment and other exempt income and excess interest deductions attributable
1
Total investment and other exempt income (add Schedule B, line 28 and Schedule C, line 23; enter
here and on Form NYC-2 or NYC-2A, Schedule B, line 25).........................................................................1
Total excess interest deductions attributable to gross investment income, investment capital, and gross other exempt
2
income (add Schedule C, line 22, and either Schedule B, line 21 (if the safe harbor election is not made) or Schedule
B, line 25 (if the safe harbor election is made); enter here and on NYC-2 or NYC-2A, Schedule B, line 27) ................. 2
SCHEDULE E - Investment capital (see instructions)
Part 1 - Investment capital that generates income claimed not taxable by New York City under the U. S. Constitution
Description of asset (identify each asset, and enter number of shares (if applicable) and date acquired here; for each asset complete columns D through H on the corresponding
lines below; enter only directly owned assets in items A through G)
Item
A
B
C
D
E
F
G
H
Description of asset
Number of shares
Date
Number of shares
Date
Average
Liabilities
Net
attributable
average FMV
acquired, if applicable
acquired
sold, if applicable
sold
FMV reported
A
B
C
D
E
F
Total from additional sheet(s)
1.
Total columns F, G and H; enter here and on Form NYC-2 or NYC-2A, Schedule D, line 1 ..............................1.
Part 2 - Investment capital - stocks actually held more than one year
Description of investment (identify each investment, and enter number of shares and date acquired here; for each investment complete columns D through H on the corre-
sponding lines below; enter only directly owned investments in items A through G)
Item
A
B
C
D
E
F
G
H
Number of
Date
Number of
Date
Average
Liabilities
Net
Name/CUSIP/CINS/lot number
shares acquired
acquired
shares sold
sold
FMV reported
attributable
average FMV
A
B
C
D
E
F
Total from additional sheet(s)
2.
Total columns F, G and H; enter here and on Form NYC-2 or NYC-2A, Schedule D, line 2 ..............................2.
Part 3 - Investment capital - stocks presumed held more than one year
Description of investment (identify each investment, and enter number of shares and date acquired here; for each investment complete columns D through H on the corre-
sponding lines below; enter only directly owned investments in items A through G)
Item
A
B
C
D
E
F
G
H
Name/CUSIP/CINS/lot number
Number of
Date
Number of
Date
Average
Liabilities
Net
attributable
average FMV
shares acquired
acquired
shares sold
sold
FMV reported
A
B
C
D
E
F
Total from additional sheet(s)
3.
Total columns F, G and H; enter here and on Form NYC-2 or NYC-2A, Schedule D, line 3 ..............................3.
Part 4 - Total Investment capital
4.
Total of all investment capital (add lines 1, 2 and 3 in columns F, G and H) ......................................................4.
31531791
31531791
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