£1040 Us individual income Tax Rute | 2014 ose ease ey eer iO he dye beg Bri er = [See separate instructions Your rs name ad a Tear our soca eur amber ll eee pauses sora SeCUT PIS ROMNEY ta ae mac i — Mircenme seen ice, state, Taw sgn ads, dso conplleopacs buon (ee BERGA) eet ane ne MA 02478 ——[Famign peau] rn soe ey Foret cane ne faint) Rar areas) ne eet USA J ES yeu [x] spain Filing Status * |_|Snae 4 [Tiss ot oanahad (oan eating pas) (eae ‘nstuctors) it 2 [arid fing jointy (event ony ene ha nce) the suing pen ht tt your gears, eae van enecr criyono 2 [_] Maries ting sepratay Ener spovees Sou cone ches tomate Bn — Soe and faloanehre, 5 [7] uativng wouter wih depose ED Exemptions 6 | Yourstf someone can claim you as a dependant, donot check boxéa sivee ] etaoneee ——b 1x] spouse =eeeetereees pote I Begun © Dependents: 2) Dependents ydereane [OLrowceran Sindh you oo stm | eels | ona, | 2 oma £0 an (eCieuctons) Sl] — Add mambers on Tota number of eager dined moa ie Income 7 Wages, salaes, io, ts Attaon Fama aeneaee Se Tenable inerestAtach SchesueBHreqined 210210222 2° DTITEIIT 3.012.775, Smee O Tetexamtinerst oo notinaudeontrooe 222) Law [3 395"| Watere A> 98, Ordinary didende. Aeon Sched reuted ttpescvcecesees [Qa] 3,649,567, woes" © Qualified dividends |, STM. 1. . Lee | 2,221) 956. rw, 10 Terabe refunes, cre, o oct fate and ical cots [10 | 352,905. a ‘Pha 450, 740) > oO 1 Aimonyrectied vse essen 12. Susneswzome asst She Ses G-ed ae SEQHETS 19. Captat gon creme) tach Sone rege rte Re ‘Feeinsuctons. 44 Other gains or (losses), ‘toch Fo 4797, 152 iRAdistibutens. [ Taxable amont || 163 Pensions and annuities | ° (16 Taxable amount [as | 6810176. Lm tae 17 Reval nm yates, Soren, Scapaaans He an , Sree 18 Feminconeor om) Also areas? a farmehes 49 Unamplomen conperecan BaSoneseee acer aaae Forviion. 208 soda enue [20a grange cent — 21 Obe nee Us gp andanont___SER_STAtEuENE 3 5. 22-coniete ana nt ie snes aunt Ts tdancaes BPE So 23 EeuaO ORME vere eens ee ES Geese 4 Cara taeus epeacteacniin eariy ste a Gross ‘fee-basis government officials. Attach Form 2106 or 2106-EZ [24 Income 25 Health savings account deduction. Attach Form 8889... 25 20° Movog pou Asch Fom i002 S 27nd par of empress Seaade oF 28. Setempoyd SEP. Sue me unre 2 20 Sel-ompoye esi nsusten dicen 20. Punayen ery wincowtofoaingn 310 Almony pdb Recs San Bie 1 acne eee ere 33. swcentcen mires don | ee 24. TutlonanetensatacnFomsoi7s 0S LDTLTTES 35 Sameera aces ceva. ntuohFom eis” “Lae —————| 36 Aides BONS ee vv vvve sevens sll oT ge 12.657, Sr cigs nea i dan acme) the FaEDE Hania, Py At ana Paper React med eo(OMB No. 1548-0074 Application for Automatic Extension of Time To File U.S. Individual Income Tax Return ram 4868 [rebral Revsrue Sanne ey ‘There are three ways to request an automatic extension of tine to file a U.S. individual Income tax return 1. You can file Form 4868 electronically by accessing IRS e-fle. Using your home computer or by using a tax professional who uses one 2. You can pay ail or part of your estimate of income tax due Using a creditor debit card or by using the Electronic Federal ‘TaxPayment System (EFTPS). 3. You can fle @ paper Form 4868, am It's Convenient, Safe, and Secure IRS e-fipis the IRS's electronic fing program. You can get an ‘utamatic extension of time to fle your tax return by fling Form 4868 electronical. You will receive an electronic acknowledgment ‘once you complete the transaction. Keep it with your records. Da ‘not send in Form 4884 if you file electronically, unless you are ‘making @ payment with a check or mony order (see page 3) Complete Form 4868 to use es a worksheet, ifyou think you may ‘owe tax when you fie your return, you wil need to estimate your total tax lability and subtract how much you have already pid (nes 4,5, and 6 below). ‘Several companies offer free e-fiing of Form 4868 through the Free File program. For more deta, 90 to IRS .gov and click on treet 2011 Efile Using Your Personal Computer or Through a Tax Professional Refer to your tax software package or tax preparer for ways to fle electronically. Be sure to have a copy of your 2010 tax elu - you will be asked to provide information from the return for texpayer verification. f you wish to make a payment, you can pay by ‘lectroni funds withdrawal or send your chack or money order to the address shown in the middle column under Where To Filo @ Paper Form 4868 (see page 4) Pay by Credit or Debit Card or EFTPS You can get an extension it you pay part oral of your estimate of income tax due by using a crecit or debit card. Your payment must be at least $1. You can also gat an extension witen you pay par or allof your estimate of income tax due using EFTPS. You can pay by hone or over the internet (see page 3). File a Paper Form 4868, If you wish to fle on paper instead of electronically, itn the Form 4888 below and mailitto the address shown on page 4 For information on using @ private delvery service, oe page 4 Note. Ifyou are a fiscal year taxpayer, you must fie a paper Form 4860, General Instructions Purpose of Form Use Form 4868 to apply for more months (4i*out of the ‘country” (defined on page 2) and a U.S ctizen or residons to fle Form 1080, 10408, 104082, 1040NR, i040NRAEZ, 1040. PR or 1040-85. Gift and genoration-skipping transfer (GST) tax return (Form 709), ‘An extension of time to fle your 2011 ealendar year income ax, return also extends the time to fle Form 709 for 2011, However, it does nol extend the time to pay any gift and GST tax you may ue for 2017, To make a payment of git and GST tax. soe Porm G302, you! do not pay the amount cue by the regular dub date for Form 708, you will owe interest and may also be charged psnaties, the donor died duting 2011, see the instructions for Forms 703 and 8892, Qualifying for the Extension To get the extra time you must ram 4868 Deparment ne rst internal RovanaSevee bo Identification 11 Your names) (600s ucons) WILLARD M ROMNEY ANN_D_ROMNEY ‘Aditess (sonarus) Appi To File U.S. Individu: BELMONT "2 Your soci securly number ation for Automatic Extension of Time ec 1. Property estimate your 2011 tax lablity using the information available to you. 2. Enter your foal tax ability on tine 4 of Form 4868, and 3. Fle Form 4868 by the regular due date of your rotun, Although you are not required to make a payment of the tax {You estimate as due, Form 4868 doos nat extend the tine fo bay faxes. I you do nt pay the amount due by tho, regular due date, you will owe intorest. You ray algo be charged ‘onalios. For more details, see Interest and Late Payment Snally {n page 2. Any romnitance you make with your appleaton fer ‘extension wil be treated as @ payment of tax ‘You do not have to explain why you are asking forthe extension \We will contact you only your request is deniod Do rat fle Form 4868 if you want the IRS fo figure your tax or you are under @ court order to file your return by ths Paulas coe date, REY ‘OWE No. 1648-0074 2011 fal Income Tax Return Individual Income Tax 4 Estimate of total tex sity for 2011 5 Total 2011 payments 6 Balance duo. Subiract fine § from line 4 (Gee instructions)... 2... ‘Amount you are paying eee havucions) De ~ $3,226, 623 3 441 1 le winicidag terse erst eye ee] ‘3 Spouse's social security number | ae a Fam 4868 (2071), eyGOLDMAN SACHS HEOGE FUND PARTNERS H.LLC PARTNER SCHEDULE K-1 SUPPORTING SCHEDIRES R.ERADFORD MALT TTEE THE ANN O ROPESE GRAY ULF 80X15, CODE P OTHER eREDITS Us.wwTHHoLoING TAK TOTALOTHER CREDITS —— Page 5 of 22fun 100 G01) WILLARD M ROMNEY & ANN D ROMNEY Taxand 38 Avountfomanea7 adustesyon eon) Te. Credits ste oma ff lroenentan ere inar2” [Vans “os Spouse was bor before January2, 1947, [Jarind. J checked D394 It your spouse iemizes ona separate return o you were a dualstls ale, check hace 390 Itemized deductions (fom Schedule) or your standard deduction (see le margin) Subtract ne 40 fom tne 38. . Exemptions. Muitnly $3,700 by the Humber line 6, Ganges ‘Taxable income, Subtract line 42 trom ine 41.1 tine 42ia mee than ie ene Oe” ‘Tax (see instuctons). Chackitarytrom: a[_] Forms) 14 w{_] Form 4sr2_ el] $02 ee ‘Alternative minimum tx (see instructions). Alach Form 6254 Add ines 44 and 45... eee tes Foreign tax crest, attach Fem 1116 frequired Page 2 =| 20 | 13,696,951, Oj 4o| 4, 681,84. 41 | 9,015,109. 2 7.40) :..[43 1 9,007,709. ston + 4a [17 340, 83: 45 674,512 ioe Stag ‘Credit for child and dependent care expenses. Attach Form 2441 | | easier eaveton credits rom Form 880310823. ss ariadtang | 60 Retirement savings contibutions cre. Asch Fan 8680 ||” Heya Child tax cred (soe inatuctons), aout Residential every crit, tach fom So85) 12 2ST! ead ot 53. Other credits from Form: a[XJ3600 6[_Jesor e[_] _ zat" | 4 Add ines 47 trough 53. These are your total eedts =... Ts, [55 _Subtsct tno 64 from ln 45 ne 64 fe mere han ine 4, enero. Other 56 Sel-ompleymon tax tac Sehesule SE Taxes £7 pared soca sect rc adeowaxtomom: ac] aiar’ soso. 88 Adit tcon iho thr alfa tomate. at Ate a a8 eur 58 Houneotengoyenttneston Seiuetis 1 Feattine homebuyer ced payment Aachen ib reed 60" Oe tws Ent nat) tam reve 4A en 9 though 0 Thal yeura 598 m et | 1,935, 708. Payments 62 Feds! come tx tie ra Fors Wil Sn 108, 53, 2011 estimated tax payments ond amount api from 2070 return ae [sa Vsounevea “64a Eamed income cred (EC) .. ta SuME., [bNortaaie conta peyoecen |. [eau J Socistic| 68" aan nar reins Fon Bo 68 American opportuity cre trom Form 866,008, ||” Lee | 67 Firatime homebuyer crest rom Form $496, 10." | ||| | Ler {68 Amount paid with request for extension tole 68 NONE} 69. Excess soil secury ander 1RATAtarwihald, |||” |” | Lop TO. Credit fo fdera tox on fuels, Ata Form 4136 eee [10 71 Credits rom Form: a[_J2430 6[_]ees0 e[_Jaeat a[_Jeaes [71 72_Add ines 62,63, 646, end 65 through 71, These are your total payments... nae Plz] 3,434 Refund 73 Ile 72s mece than ine 61, subtract ine 61 fram ne 72. Thi the amount you overpaid 748 Amount of tne 79 you want refunded to you. Form 8866 is attached. chock hate Ovectdescsit? ® Routing number [ me type [_] Ci resem # Account umber TEE PT TT 75 _Amount of line 73 you want applied to your 2012 estimat * [rs 3, 498, 740. Amount 76 amount yeu owe. Solace 72 fomtne 83 For dts cn howto saohancaene 8 | 70 | YouOwe 17 sunaediocsonstyasnnbny cae nnn ty] Third Party 990 WH! alow oar psc oasis hs oun wine RS we naan] Yoo Ganplae aon Tae MAT coy me en esignee SP DANIEL P,_PEHELEY 7 at BR, Hil Gras itcelita Gu Saeue SOMO aS RO OL Tie eee eae Te Vourigne et Pour oeeeton syne phone nanoar a — ‘ —FXECUTL VE Si pT sn : cmaces eT TTT) a cane ye imeags SS Doe. FS Veal alo Use Only ‘fttare_P PRI CEWATERE. oUSECOOPERS Lip J [renee Fov'sacies 125 HIGH STREET Phone ne. BOSTON, MA 02110‘SCHEDULE A 7 (Form 1040) Itemized Deductions No.1545-0074 2011 Derren Tea > auch to Frm 1040. >see nstetons or Schade Aer 1040) eee or Name(s) shown on Form 1040 ] Your goss ‘number WILLARD M ROMNEY ¢ ANN D ROMNEY : i auton. Dorlas een eins cay ano Medical age tn gonan aroma, Dental =? eeeaer Ta | ta 696, 951 | Expenses 3 Multpytne3by758 (01) 4 Subractine rom ine +f e's ine nine 3 4 NONE Taxes You § sists and ba check on one bo Paid 2 |X] Income taxes, or 5 » Teena sates tows Real ett tas (ne nracons) 6 214,728, 7 Persona poperytone, 7 146] 8 Other toes List ype ad aout S s 9 fading Stzcugh8 2 . 1,541,905 Interest 10° tone:orgnge nts ana pons pana toyoron For 1008 You Paid 11 sonemoroieinen steps oyu cn arn 8 Mga ‘01 ean fom whom o big te tore, na in sé show Oa pena ame dentin. end msaees B Note a trire "°° 42. Ponts nt reported to yen For 1058.6 Instrectons desucion may" forspecinuee sve ne mstactons | be limited ($88 43 Mortgage insurance premiums (see instructions), 43 sete 4 meinen ne. Atze Fam 4052 tepid es ste) [18] 904 THE 4 15 Addins 1Otwough ides se rees ne 1s 56,904, Gifts to 16 cits by cash or check. ryou maae ty if of $050 2 Charity ‘more, see instructions . , SEE, STATEMENT, 4 1,330,199, | ttyoumases 17 Ott than by cash e check. any gt of $250 or mare, gitandgats —__seoinstuetors. You must atlachFom 6263 over $500, | 17 920,573, | | ster 5 Eerie, 48. Cary fem pe yar serine 49 Addines 16 theugh 18 250,772, Tasuaty and Theft Losses 20_Casuaty oc thet losses) Ach Fe 4686 (See stucions) 20 Job Expenses 21” Uren! ample exeset [ob rs inn os] and Cea gaunt. teh Fam 2108 ws OEE # toe fe Miscetanests —inciucions) an, a Deductions 22 Tax preperstion fees pat 22 23. oer womens af apeat Bx Lik ose ono zs| 1,106,200 a bee ee [24 L. 106, 200. 28 eiiirese ne Las] "13, 696,951. 26 Muli ine 25 by 2% (02) 2 73,939, 21_Subtactine 26 tom tne 24 ns dois mare ant bd, ete weeder 2.261 Biker 26 Other ro st naruto tps andancane Wiscetaneus Deduction : 7 Total 8 Aad the mourn We Tar AGH Colm Tor Mes 4 Wag 8 Neo ie WNW Smt Htemized cn Form 1040, ine 40 GacosMionnaeancnnos 22 4,681, 842. Deductions 30 1 you slcttotemize debtors even teu heya te ha your tna desucon checkhee | For Paperwork Reduction Act Notice, soe Form 1040 fsiracions ee ‘Schedule A (Form 1040) 2044SCHEDULE B (Form 10608 or 1040) Interest and Ordinary Dividends 545.0074 2011 ee > tach to Form 10408 or 1040 > S00 Instructions on back oon SARA Sessaele 08 Fret) town ene Yeigseciteacriy number WLLLARD M ROMNEY § ANN D_ROMN; Part 1 List name of payer. If any interest is from a sellonfinanced mortgage and the | ‘Amount buyer used the property as a personal residence, see instructions on back and list this interest frst. Also, show that buyer's secial security number and address Interest (See instructions fon back and the Instructions for Form 10408, oF Form 1040, line Ba.) Note. i you received & For ‘099-INT, Form 1099-010, or substitute Statement from 8 brokerage frm, ist tre trm'e name as the payer andere the total interest 9 — the otal Imerest 2 Add tho amounts on line 7. , [2 301a, 775 frm 3. Bicludable interest on series EE and | US. savings bonds issued ‘after 1889, Atiach Form8815 .. 0... 0... eee eee ee 4 Subtract line 3 from tine 2. Enter the result here and on Form’ 10804, ‘or Fort 1040, tine Ba, sesseeeeeee b/s | 3,012,775, Note. Iline 4 is over $1,500, you must complete Parti Parti 5 Ustname of payer Ordinary Dividends (Soo instructons fon back ard the Inctructions for Form 10408, oF Form 140, line 9a.) Note. ifyou received a Form 4088-DIV or substitute Statement ftom a brokerage fem, ist the trm's ame as the payer ard enter the orcinary dividends shown ie amounts on line 8, Enlor the total here and on Form 1040, of Form: Sahat form 1040, tine 99 secsees bl 6] 3,649,567, Note I ine 6 ts over $1,500, you must complete Parti You must complet this par you (a) had over $1,500 of Tavable ilares or onary donde: RATS Part I foreign account o (e) received a distribution from, or were a grantor of, or atransferorto, aforeign trust. |¥eS| No Foreign 7a Atany time during 2011, di you have a nancial itorest in or signature auhorty over a nena Accounts 4000 (suchas a bark account, securiies account, or brokerage seco ected in a foragn | | ‘e county? Sevinstucons, sss ens re nd Coat “Yes,” are you required to file Form TD F 90-22.1 to report that financial interest or signature (See authority? See Form TD F 90-22.1 and its instructions for filing requirements and exceptions to IRetustenson those equrements es beveeeee B If you are required to fe Form TO F 90-22.4, enter ine name ofthe foreign’ county whore the figancil accovntis located Bn " a : During 2011, dd you rece @ daubuilon fim, ov were jou The erator of af Wendie foyign trust? "Ye," you may have tof Form 3520, Se ntuctons on back ae x Fy Paperwork Redon Act Note se oa x ret stone Scodie8 Porm 10shor ea a oS K-1 SOURCE: saseto 100 * TNGLUDES, 935,479. OF US TREAS OBLIGATION INT. FROM SCSCHEDULE C Profit or Loss From Business OMB No. 1848-9074 (ole Propitorstip) (Form 1040) | | serttosionensoeade Steet gw ommningomemene | DOT intemal Revenue Serer) Attach to Form 1040, 1040NR, or 141; partnerships generally must le Fo 1068 gesehment 99 WELLARD-M-ROMNEY CC ‘A Principat business or pression, indudlng POGUE Senos FaMTETORS) Emer cose rom nerucoons = » ‘© Bistress nae: Wo separate Gases nave, ave Ban Denpyeib mambo pos) AUTHOR/ SPEAKING FEES t © Busnes sess gnovdng elcome) - Frecnnirgmtos. (3) ah] acne) [] Omer main eo © id ou “materially parcpate inthe operation of ths business dung 20117 Ino eas nswcbon ta WH iyeu stares o acquired this bsnss cuir 2011.checthe . ss nnn bie you make any payments 2011 that would require yout fe Fon) 1098? (se nsbucone) jg 728." id yuo you fl eed Fes 10992. fe ene nee ree rnnenete EMT income ‘SEE STATEMENT @ _ ‘1a Merohet card and tite pany payments For20¥1, a0. vss ve ee [ta T Gross receipts or sales nt enlored on ne 1a (se instton) ae | 190, 350. © Income reports te yuan Form W2 if th "Sasa Empaye tok on {hat form was checked. Cauton. Soe ins. beore comping thisine, 4 Total gross recoipt. Ads tines ta through te ve s|__190, 350. 2 Returns and atowances pus any ther eustnents (oe isin) 3 Subtracting 2 tom ine fd. 4 Costet goods sold trem ine say, || | 5 Gross proft Subtacttine tom ines || TTT te & Other income, inctudng federal and stato gassine ol acer tend (ace iat) 2 7 ae Gioss income. Adsines Send eet eevee Lis EMM Expenses Enter expenses for business use of your home onlyen 8 Adwtising......... 2.8 18 Office expense ese insure), Car and truck oxenses (soe 48 Pension and prof sharng plans insite) vee 8 20. Ren ores se instructions 10 Commissins nates’ || |” | Tee Vehicles, machinery, and ecubment,, | 208 | 11 Contact abr (coe inatvcons) 11 | 8 Other businaee propery, fat (Deatasen ae eteeete a 21 Repairs and instance” 43° Depress’ sean 178] 122 Supplies (nt incised n Pa). expense deducton (oct Sacer fretied in "Party foe ceca inating) NL ay 24 —Trave, meas, and oneahmont 44 Employee benefit programs 2 Trawl. : (other than on tine 19), 14 Dede meals and 18 Insurance ther than eatin), | | [a5 entertainment (se insructons) 18 Interest 25 Utes ees Mortgage (pid to bans. etc). . {160 | 26 wages tess empoyment creda, otters. eee... [1b] “| 272 other expenses (om ine 48) 47__Legal and poessonlsenicas_|[ 47 b_ Reserved for future use 28 Tota expense before expanses fer business uss ohare Aas nes @ ugh 278 veasee 29 Tonttve proftar (oss). Subtactine28temine? snes nT 23 | 790, 350 30 ipenses for business usec your heme. Atach Ferm 8829, De net opr such exporsencseunece, 1)” ORB 31 Netproft or fess Subtract in 30 om ine 29 « IF prot, ete cn tt Form 1040, tin 12 (corm 10404, ine 12) end en Schedule SE, te 2 1 trates, you must go to tine 32 a 190, 350 32 Hfyouhave alos, check the box that descivs your investmetin his ati (se strc. 4 if you checked 32, eter the tes. on beth Form 404, tin 12, (or Ferm 1040NR, tne #8) and on Sched 8, ne 2 I you ontered an amount on nw fe, oee te Mewocrene ne eek 20 [Jarome sos sates and trusts, enter on Fxm 1064, tn 3. 320 [Ioemp onan * ityou checked 320, you must attach Form 6198. Your loss may be tinted $00 Your ax return nstuctons, ‘Schedule G (Form 1010) 2011scusiec (un 000" WILLARD M ROMNEY Sy 2 Gost of Goods Sold (S00 nstructons} 2 ene uaa + Cleon torr stconermatat ——« Jone th etre 34° Was there any change lo determining quantities, costs, or valuations between opering and lng inventor? Yes, attach exianation Bevsodsanebodeses Se elven [Xt ne 35 Inventory at beginning of yar. If ctterent rom last years closing inventory, stch explanation . Las 36 Purchases less cot of tems witherawn or persona se 37 Cost of lsber. Do net include any amounts pad to youre Pa 38 Materials and suppios | ae 39° Other costs a9 40° Aca tines 35 through 38, ee 41° Inventory t endo yee 4 42st of ond sold Subba Bo 4 rom ne 40, ead ened ee eee Lap Information on Your Vehicle. Complete this part only i you are claiming Gav Gv Al eossraos on Tho and are no quired to fle Form 4562 fr ths business, See the mstuctons Tor lne Te wna ont ros must fe Form 4562 ‘43 When is you pce your vehicle insane for business purposes? (menth, dy, yor) 44 Ofte total numberof miles you cove your vehicle during 2011, enor the nun of miles you used your whic fr « Bsheot Comming (eects) © Othe _ . 45 Was our vl avatar pron use ing yas? Cle Dn. 48 D0 you (or yur spose) ha ant aide eer NSIT eee eeeeeeeeeee, Cv Clne 478 Do you have evince sppa yeu CEN eee eee ecaeeeeece sees Cove (Ine ovens te evince water? : Cvs ne Other Expenses. List below business expenses nol ncudod on nes B78 ore 30 Tas ‘Schedule © Form 1040) 204% ‘48 Total ether expenses. Enter here don ine TaSCHEDULE C Profit or Loss From Business Form 104 (Sole Proprietorship) (Farm 1040) | » rorinormaion on schadule Candis anstone, otowmningovecteauce | 2011 ENUicTzerao| panne Form th, ean rts emomnpe recom nea te te suet og fa oop Tecate WILLARD ROMNEY In cb basa Ts Gada aa SOT GS OS Sem rer ton eto > Warns name Wasser baer rae ons Ha Terao Dao TT DIRECTOR'S FEE — eae ste reg aoe) F Accounting methos: (193) Cash (2) [—] Accrual (3) [_] Other lepociy we _ _ ‘© Did you ately partite inthe pean of his busines da 20419 Na evn Tonio 7 Dea Cae Ht ysateder ested tis bess dutglts chek tee eee . 1 oxéya1 make any gente 2011 ta woud ee yuo We Fas 187 (ene), os E]wo “os dd ou awl uo touted ams 097. enna ee res Pne ERM income SEE STATEMENT 9 a 12 echnt car and ir pay panama ForaOTh nO yyy Lit > Gross recats or sales ceed one ta(eeensnains) |... La 260. 350 Inn roped nyu on Fom Wi Stary Sn that torn was chet. Ceuton See ns. belo compitngthsine, ..... Lte Tu oes ob Pd Ja asin ea ee enema eee ace Rare an alowenes pl any bet ae (enone) ‘Le Subtactne 2 tom inetd al sselem=eze0ra00 Cost gous sos tromine 222 T TL TTTTIIIT ‘ Gross profit, Subtract line 4 from ine 3 ae Peer . vee ee ee PEL 260, 390, ‘ther come, cng eda and igo of liters winston) trate crme, i ines Sn SSSR AN ee VS Ree ea rele gOSo pS MT Expenses Enier expenses for business use of your home only on lina ages eee 18 Offs epee eee studs). [18 9 car ond wud opie jae 18 Pens andpeserngpine || [i = Insta) LB 20° Fentorler oe notin} 10 Commision cece’ 221)" Gal 1 Vatices, macinry.andenveent,.|208| 41 contac aber (cosa) [#4 othe business pepe 12 Deselons ss "Bae 21" Repaks and mahtones 12 Depreciation’ ana” eacton 479 | 22 Supptes (not neces Pai) ooponsa deduction (rot Ireluded In Part II) (soe 23° Taves andticenses Insbuctons) bee Eri | 24 Travel, meals, snd elerainment 14 Employee benefit programs a Tree! (other tran one 19)... . 44 bb Decuctote meas anc 15 Insurance other than heathy, | 45 entertainment (eee nsrvctons) 46 Interest: 25 utes . 7 3 Mortgage (pid to banks, ete) 26 Wogos (les employment reds} b ome... Boone errs 27a Other expanses (ramine 48), . 17 Legal ans potesionatsenices | [47 b_ Reserved fer future vse. 28 Total expenses bofos expenses for business vse cfhane Adalines 8 though 27a, 29° Testatve prof or (loss). Surat ine 28 fem fe 7 30° Expenses for business use of your hom Altach Form 6828. Oo not repr such expenses eaenhere 34 Net profit eos). Subtract in 20 from ine 29, « 12 profit, entr on both Ferm 1040, ine 12 or Form SO4QNR, line 13) and on Schedule SE, ne 2 \ It you entered en amount online to, se int. tates end rusts, enter on Form 4041, fine 3 1 tf ass, you must got ine 32. Lai|___260, 390. 32 Hfyounave aloss, check the box that describes your vestmantin his acy (so istucon). ‘Ifyou checked 82a, entrtho ss on both Form 1040, tine 12, fr Form {D40NR, line 13) and (on Schedule SE, line 2. I you entered an smount on tn te, see the instructions for line 3 320 [Janata Estates and tus, entr on Form 1041, line 3. 32 [Jeon manent «1 you checked 328, yeu must attach Form 6198. Your oss may etme che For Paperwork Reduction Act Notice, ee your ex return structions. ‘Schedule © (Form 1040) 207Scmédnc fom 401011 WELLARD M ROMNEY 2 fm - Gost of Goods Sold (ses instructions) 29 Mato Chom —— » C]rowerercosermetst —¢ [Jomeratach etnatey 34 Was there any change in determining quantities, cost, or valuations btwoen poring nd cosng inventan? "Yes, attach explanation. , Cres Ed no 35. Ioventory at boxinning of year. ferent trom last year's lesing inventory, stash emloatin, Las 36 Purchases toss cost of tems wehoravn for persona use beef 87 Cost of labor. Do not include any amounts pido yours [2p eee 38 Materials and supplies |, [se a 38 Other costs 9 40. Add tines 38 through 39 ee 44° Ioventory at ond of year al axa goods sl Suter ne 40. Enter Merete donned ap ERIM ‘ntormation on Your Vehice. Comicis Hssov cnet eee Claiming car or tuck expenses on Tne and are not required to fle Form 4562 for this business. See the nstustons for lne Te tra set oe must file Form 4562 443. When oid you place your veicin sone for business purposes? (month day, yaar) De 44 ofthe total numberof miles you drove your vehicle during 2011, enter the numberof miles you used your whic foe 2 Bisiness _b Commuting (se instructens) © Other 45 Was your vohicte aval tor persons use ding of duty hows? . 448. Do,you (or your spouse) have another vehicle aval for personal se? 47 Do you have evidence to supe yur dedction?, , ‘Schedule G (Form 1040) 2071‘SCHEDULED Capital Gains and Losses 6 no 1545-0074 {Form 1040) | Attach to Form 1040 or Form 100 ex mac Seer 2011, ianeoose eon Tar Si ae MELLARD 16 ROMNEY 4 RN D RoMeY EIT short-term capital Gains and Losses - Assots Hold One Year or Less ‘Complete Form 8949 before completing ne 1, 2, or 3 {o) Sale pce tom | (conic ar vexs | acusinerisio | _aGamnor gous) This form may be easier to complete if you round off cents to |""™\Shamaiaye | "Gmaiemgelesss, | oem a fam omnec whole datas ‘ we ken) 11 Short-term totais from all Forms 8949 with box A checked Parti. pene neers fl J 2 Short-term totals from all Forms 8949 with box B | ___shecked in Parti ss wees i I 3° Shorttorm totals from all Forms 8849 with box & ___checkedin Parti ss eee an Ic 1 4 Short-term gain from Form 6252 and short-term gain or (loss) from Forms 4664, 6761, and 8824 5 Ret orem gan oF (oss) fom parmersige, S$ compraton, ets, and tnsis rm Schedule(s) Ke. 7 SEE. STATEMENT. 10. . © Shortterm capital oss carryover. Enter the amount, if any om line of yout Capital Lose Caryower Worksheet in the instructions, . . , wee ee etter eee LOM 7 Net short-term capital gain or (loss). Combine tines’ + ihrough 6 in ‘column (ti) jou have ‘any longterm capa gas or bates, got Par below. Oonuce got Pron te bak Lr} -r280906 Long-Term Capital Gains and Losses - Assets Held More Than One Year Sampo rom eewnotrecnatro tee a i8 Voawum | Qatccree | exmmee | oeneen RSET heer compte toured otenaie "Sten" | cig | Ramamie | pate @ Long-term totals from all Forms 8949 with box A checked in Part I, ieee 9 Longenm totals from all Forms 6949 with box B checked in Part a zi 410 Longeterm totais from all Forms 8849 with box checked n Part i peeeeeent ( 1 ‘11 Gain from Form 4797, Par i; long-term gain from Forms 2438 and 6252; and long-term gain or (oss) ] from Fors 4684, 8781, and 8824. : “stir ii 12 Not long-term gain or (oss) from partnerships, S corporations, estates, and trusts from Schedules) K-1 [42 | 9,033, 933. 13 Capital gain distributions. See the instructions SoM, 12, [13 39, 216. 14 Long-term capital loss carryover. Enter the amount, if any, ftom line 13 of your Capital Lose Carryover Worksheet in the instructions... . «at 7 18. Net fong-term capital gain or (loss). Combine lines @ through 14 In column aa “Then goto Par ti on the back ee 145 | 9,091, 082, For Paperwork Reduction Act Notice, see your tax return instruclions, ‘Schedule D (Form $040) 2017