E Check it (1) rita return 1a Gross receipts or sales b Retums and alowances 1b

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E Check it (1) rita return 1a Gross receipts or sales b Retums and alowances 1b Balance. Subtract line 1b from line 1a ic c 2 Cost of goods sold (attach Form 1125-A) 3 Gross proft. Subtract line 2 from line 1c . Dividends (Schedule C, line 1) 5 Interest 4 6 Gross rents 7 Gross royalties 8 Capital gain net income (attach Schedule D (Form 1120 1120) 9 Net gain or (loss) from Form 4797, Part Il, line 17 (attach Form 4797) 10 Other income (see instructions-attach statement) .. 11 12 Compensation of officers (see instructions-attach Form 1125-).. 13 Salaries and wages (less employment credits) 14 Repairs and maintenance 15 Bad debts 16 Rents 17 . Total income. Add lines 3 through 10 Taxes and licenses. 18 Interest 19 Charitable contributions 20 Depreciation from Form 4562 not claimed on Form 1125-A or elsewhere on return (attach Form 4562· 21 Depletion 22 Advertising 23 Pension, profit-sharing, etc., plans....-. . 24 Employee benefit programs 25 Domestic production activities deduction (attach Form 8903) 26 Other deductions (attach statement) . . Total deductions. Add lines 12 through 26 28 29a 27 Taxable income before net operating loss deduction and special deductions. Subtract line 27 from line 11 Net operating loss deduction (see instructions) b Special deductions (Schedule C, line 20) c 29a 29b Add lines 29a and 29b Taxable income. Subtract line 29c from line 28 (see instructions) 30 32 33 34 35 36 Total payments and refundable credits (Schedule J, Part II, line 21) Estimated tax penalty (see instructions). Check if Form 2220 is attached Amount owed. If line 32 is smaller than the total of lines 31 and 33, enter amount owed Overpayment. If line 32 is larger than the total of lines 31 and 33, enter amount overpaid Enter amount from line 35 you want Credited to 2016 estimated tax Under penaltios of porjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of m and complete. Dolaration of preparer lotherthanayer) is based on al iformation of which preparer has . . . on all information of which preparer has any knowledge. gn re Signature of officer Date Title Print/Type preparer's name Preparer's signature Date parer Only Firm's name Firm's Firm's address Phone

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