651112
Schedule K-1
(Form 1055)
Department of the Treasury
'.dagencutrynt20/2, atm 2012 ,
Final K•4 I I Amended K-1
it Partner's Share of Current Year Income,
0MB No.1545-0099
year bolinr
Internal Revenue Service Deductions, Credits, and Other items
oxiMg
1 Ordinary business income (loss) 16 Credits
Partner's Share of Income, Deductions,
Credits, etc. 0.
Is See separate instructi ons. 24wwwmflomailow
—13,669. 16 Foreign transactions
Information About the Partnership 3 Otter net rental income (loss)
A P • erldentratien number
B Partnership's name, address, city, state, and ZIP code
4 Guaranteed payments
-±
6 Interest income
MIDWAY ASHLEY CROSSING, LLC
270 LAFAYETTE STREET SUITE 409 Ba Ordinary dividends
NEW YORK, NY 10012 17 Atonally* min tax (AMT) Items
C IRS Center where partnership fled Mum 58 Ouskted dividends 2,024.
E-FILE —6.
7 loyalties
a L7 Check If this is a publicly traded partnership (PIP) 18 Tax-exempt Income and
8 tit short-term capital gain (loss) "L nondeductible
expenses
2.
NW Information About the Partner 9a Net longterm capital gain (less)
Liter
91) Collectibles (28%) gain (loss) 19 Olshtutione
F Partners name, address, city, state, and ZIP code 3,290.
9c Uinmeaptured sec 1250 gain
BLUE CHIP CAPITAL LLC 20 Other inforMation
10 Net section 1231 gain (loss)
27 HIGH TECH BOULEVARD
THOMASVILLE, NC 27360 —68.
11 Other income (loss)
G t_J General partner or LLC IL limited partner or other LLC
member-manager member
N 0onestic partner
11 What type of entkly is this pa rhter? PARTNERSHIP
C] Foreign partner
_r
12 Section 179 deduction
12 If this partner is a retirement plan (IRNSEPAreogiVe
tc.), dieck here
J Partners share of mit, loss. and caPMII
13 Other deductions
Be0inning BMW I9* STMT
Prat 1.3548951%1 1.3548951%
Lon 1.7482520%! 1.7482520%
aC ts' 1.7482520%) 1.7482520% 14 Self-employment earnings (loss)
K Partners share of kabllitieS at year end:
A 0.
Nomecourse
2,609.
Qualified nonrecourse financing
92,108. 'Sea triads te farad on 1informa on
Recourse
0.
L Partner's capital acCoollt allaVsb
:
Beginning repeal account
$ 47,413.
Capital contributed during the year
Current year increase (decrease)
11 8
$ —13,943.
Wadrawars & distribudons
k 3,2904
Ending capital account
$ 30,180.
r Tax basis GMP El Sedan 704(b)90k
Li Other (ersolaln)
M Did the partner contribote property with a built-In gain or
loss?
L— Yes Moo
It 'Yes'. attach statemer.t (sea Instructions)
Co; Ca-IS LHA For Paperwork Reduction Act Notice, see Instructions
for Form 1086. IFISGovirorm1085 Weenie (Form 1000) 2012
08320312 758241 21146.213 6
CON FILDIENT A tOSSING, LW 21146 Al
SDNY_GM_00033079
EFTA_00143692
EFTA01280219
MIDWAY ASHLEY CROSSING, LLC
SCHEDULE K-1 OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
ACCOUNTING FEES
15.
MISCELLANEOUS
4.
TOTAL TO SCHEDULE K-1, BOX 13, CODE W
19.
SCHEDULE K-1 ALTERNATIVE MINIMUM TAX, ADJUSTED
GAIN OR LOSS, BOX 17, CODE B
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
ORDINARY GAIN OR LOSS SEE FORM 6251 INSTRUCTIONS -6.
TOTAL TO SCHEDULE K-1, BOX 17, CODE B
-6.
SCHEDULE K-1 NONDEDUCTIBLE EXPENSES, BOX 18, CODE C
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
NONDEDUCTIBLE EXPENSES - SEE IRS SCH. K-1 INSTRUCTIONS
PASSTHROUGH
2.
TOTAL TO SCHEDULE K-1, BOX 18, CODE C
2.
SCHEDULE K-1 CURRENT YEAR INCREASES (DECREASES)
DESCRIPTION AMOUNT TOTALS
RENTAL REAL ESTATE INCOME (LOSS) -13,669.
SECTION 1231 GAIN (LOSS) -68.
SCHEDULE K-1 INCOME SUBTOTAL -13,737.
OTHER DEDUCTIONS -19.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL
-19.
NET INCOME (LOSS) PER SCHEDULE K-1 -13,756.
NONDEDUCTIBLE EXPENSES -2.
PARTNER NUMBER 6
08320312 758241 21146.213 CROSSING, LLC 21146_Al
CONEllbrNtrA SDNY_GM_00033080
EFTA_00143693
EFTA01280220
MIDWAY ASHLEY CROSSING, LLC
PREPAID RENTS - CY -198.
PREPAID RENTS - PY 13.
OTHER INCREASES OR DECREASES SUBTOTAL -187.
TOTAL TO SCHEDULE K-1, ITEM L -13,943.
PARTNER NUMBER 6
08320312 758241 21146.213,..ANciblE1/411gYfROSSING, LLC 21146 Al
SDNY_GM_00033081
EFTA_00143694
EFTA01280221
SONIC& K-1 (Flinn 1065) 2012
This list Identities the codes used on Schedule K-1 for all partners and provides • Page 2
Form 1040. For detailed repotting and thing Information, see summarized reporting Information lor partners who file
the separate Pannen Instructions for Schedule K-1 and the Instructions
for your Income tax return.
Cede Pegen
O-diroy o7sness roond era Cohen de Mee!~ le
iroodle (weal is • Wo.d 0000'd.
«ink'« rosate* end &ter or yn,r ree. :Co fd Ode. Cidde •
K Dhoblerc exam creel,
• Erocrordird 70f Dee neeirdd
Paco:. on edewurry etrolnynen1coca
Pooh** too M Cott Cot Irons eg mooch Ske the Peter's cor.itorns
Sen ne dtetlef • eadIC1010
~Ho IrEeno Sededule E. Ire 25 cc ern (go Whiter
None/too cis SEC.*DO E. Ire 28 coin! Di N Croak et• ~owe wool eteXiety
Noemove -tome Utedule E. ne 78, °Oro (2 old 1t*Derre teas
2. Detract/0o rerrO;ncorge (oes) • te Pitied* Vend:tee O Bea" wig OWN
• 03. OP nob hone toe) P C!re Credits
Net Income BOO. • E, Md2a, O Jrm (og It %Midi bireadbas
\ et Ode Se* Of direlsoli A Mr* Of medley ee
4. GoredOrd Pf/T4'11, ScheduleE. Ina 2$ OCiarne: PaCeaealM
C. Intro: Moro Fo-rn 1040, I rno ea B Goa Meer» bye SI some } Font 1110, Pet 1
es. CoIntry °Nerds Font 151.0, ilns as C Grose Horne ward et perloy
eb. Doted OV.Orde Form 1340, One Do
• hcolto Sena • E, Ono/
8 \et shc,!.!rrr, Cdeldf Cde Cc.* &hole • El, Mee Foredo wee dotelfe sourced at patient p erred
ate, ge I (ON SetedUes 0, to 12 U eetrOh'
Ob. Coiectles OW gel Neel 28% nee CM Waterer, ere 4 L ~got
Poo 1116, Per.
c• ledule13 Ins:meda) F Othre
Pe. UnnewLmc seabed 260 ge
See to Panner's keno-lore
W. NE octlen 1231 gage WO Deduclens alkeLtled and ecparJeew re panne' mw
See to onetetrallordoes CY ',doe: open»
11. Cas &mum glos) Frio 1114 Poll
on Olio Porn 1118, Poll
Code
A Cdher m1/1460 bonePOO See he Patmee • tetrads. Dec actors Woad ere moot!~ et ponentle 1.0
IOW Owes
B Irmelotary OfMelees Sea to Penns?, '.edr.stiCele Intone
C Sc 12s3 codecte roc es Fcm1678' line' I Pooh. category
ID Marko ~radon mete retaohre See PA> 535 J Ornot °Megan } For 1110. Peril
E Cenceánter c' MC: corn '040. no 21 or f.crri 932 < Orde
✓ Ors! wore does) See Pe Penroe dsbLotoo Catter.aberaeor
12. Snnol 179 corwwen See the Partners hetwankes L boy ham pao For 11, 6, news
Other deCu011One M Tote knew Sae decrad Few tilt Pole
N Medea-We In twee Bedded Oar Credit Ertl" 18. do 12
A Corn cow' ocdos ro3%) O Foreign OwOrg roe ~Ws
B Coe contitatices pou) Fenn $573
P ]IOabrtaa'ir,dpry,9exeusbn
c \onme cormarsprei roose O Chrenkmean trimmillor •
Fornsen
13 honors OCeMbutCns (30%) sae tlp Part-ote I nstamtiene
See be Ins:voters
E Caiole ddr property te e 5.)94
meeedeCedOOW 17. Altar salvo rehintern tax (Ain) ;Here
F Card on oniony 20%; A Pos1-19138orodalket Oustncrot
G Caw ed:bneel33/1) 9 Adjudge gale or OM
✓ See he Prods
14 nos:rent a- one expense corn 4952 Oro 1 C 3wWlon father !tan et dos) oboeens end
I De:Lorene - Mealy $03,To get ode. E, We 19 D Ca." Egooderea on home kn Inetwelkne
J Seceol 430.3/ alordfL Seethe Ponno's Instrootlem get I ~ors dedoctans Ern.MI
I1d
K Drethoenno porrelki (214 'cot) sclOwe A ire 23 • OtherAM• hems
L Deduontne - Carona lotto) Soled de 11. '1e28
Arroan pdd la Tomcat-rot incone end nondealaL woes
Todd& Moro Schoch A. . -nr of For '040. Ina 29
N Edocatand ~lame bernite A lexoerpt HOW none reoirC43. lino Cc
Bee he Pettier a of:oleos B Cenze tetaracenot none
O Dependent ore borers Form 2441, ere la Wee he Palnote nstrooder.
P PrenrodooLve doled express C Needed needle expense See It,. Pathos .re'rJet one
See he Partner's Insoteatlens
O Commettla rote taken dedocebn ie. DletrOutOre
kern MnronY real rate rota lies So Fenn b62 dOlvdene
A Use and maltetable seetrlace
▪ Noon* ere Roe See tie Partners leatAmtbre • Ystr coder alleged !cr oo:kei 737
S fieteettel en axone oedwrinr See ns Pretrets -00votene ) See be Panned* hele.clone
C OtWoropody
T Dernbalc proc.otan ecEdues
See cone 8903 Irdhogene 20 Other Infeenerne
Wormelem
J Ora fled redo:on ;whaled hai-ane A Inwetnent :roan, rani 4982. .'0 de
Fern SSW, lln7b
✓ Employes Fern W-7 ogee Dam 5903. One '7 B leveentided Otedetre03 Coen 4902. Hr.* 5
W Cnter dedurelo-s Son C Fun tax cred". ~Or Fenn 4135
PartnwIr totwoSone
• Ohellied onetrietaloi etendEen`a
Haw Der orb rel otehg See the Pat's a .nsletacree
14 Salt oWkorgen1earn I xis goon E Ran Melon own
%co If you hem a eactoi 179 deducdon or ary pryer kod F ~Ode ale* wane -outing
See the vat. Inf'oweerte
deducaens. see
Me ~ono rehactlme begot cemOrt ng When* SF. ~WOO« 44150 Ferri $611. got
G Drool" orlavolreow toeing
A Net eertip, Coo) Yon Schedule SE Sevtr Ace Credit end, Fen sty
stV-rep
B Gross lenig er merry Stone H Hoopoe or .nennnert COS'. Se* Porn 4266
See the coon's kedructlors I Ree4pla Of oriel derte
C Goo ron-!senIrate See the %tames hoodlum ach be carine+3 bereaves
.1 lociotack 'tweed complain
IS Codes long- oil ounneets See Fear 9697
< -oak- deck Wane! -lane Wooer
A LoOeineade betting «edit
netted So Eon" gated
1
Henke 420150 Fran pre 3008 L Ulapohon of piton. one
bull~ riodlon 1/9 Ow :Begone
B 1 ow-Incen•nolnindoc11:(oto)
81 Groapl,o ~SI Fig oeckecten
*OM on-not &deign. \' 1r Went «pree for coots:* mews
C Low-lreame hoo1na erode:mien
421159 groin post-200'7 :7401r9* O Socion 453(.Y0; ilernman
1r Settler 46.3.4k) Worrogar
O Lor "care Jansen eneget Fond See heNOW* ~not ons
O Seeger 12003» Wong«,
non port-21;07 be
Ti Intro' Mottle la weelacten
E On led -boo testico ooreireres See Panen4tt
~arrow
Field red sited Ireuctkrne
S CCF ronqualirOvelherewes
F °tor nine reel eratererodO
T 2.•Hotonlneweet.or • ne IOC ote
O Oein-^eedlOte.ta
U Arne-Anton of recerestclee cots
H +A betted ~del Ons odd For 1343, nne
' kernel end cielh ca0 &OM ruas
creed to ✓ Unfolded business Home node
Soft POMP.Innualors W Porno-Irma Or Or ,keel
rc:t
X Seakn'C8711rberMO
Y Odor One on
711222
01-C3-13
08320312 758241 21146.213
ce5Kirrn 6
Y Tr/XI:ROSSINC , LLC 21146_A1
SDNY_GM_00033082
EFTA_00143695
EFTA01280222
6
SCHEDULE STATE OF NEW JERSEY
' 1019
NJK-1
(Form NJ-1065) PARTNER'S SHARE OF INCOME
2012
For Calendar Year 2012, or Fiscal Year Beginning _ 2012 and ending
PART I General Information
Parhoss SS. r Email EA
Pmfremhirs Nelerai EIN
20-3161309 45-3131018/000
Panacea Kam Pahrokes Nemo
BLUE CHIP CAPITAL LLC MIDWAY ASHLEY CROSSING, LLC
MAEMime Pammist.p's Some/awn
27 HIGH TECH BOULEVARD 70 LAFAYETTE STREET SUITE 409
cl, as. ZP Gem City Stet za, C0Je
THOMASVILLE, NC 27360 EW YORK, NY 10012
What type of entity is partner i NP Enter Partner's percentage of:
(See instructions) Code (I) Before Decrease (I) End of Year
or Temanation
Data Partners interest in Partners,* began: 0 8 / 1 7 /2011 Profit Sharing 1.3548951 % 1.3548951 %
Mmh Ory Wm
Loss Sharing 1.7482520 % 1.7482520 %
in Final KIK-I Hedge Fund Capital Ownership 1.7482520 % 1.7482520 %
Amend d NJK-1 Member of C m os 4 Return
PART II Income Information
I 41.140411Pig
income Miele:anon A. Total Ditirlavtloo EnlorAmounto on 8. New Jersey
Source Amounts NJ-1040NR Filen
Line Shown Below
-1
1„Partnership Income gossi d.a en2 .iI
2. Net Guaranteed Payments
3. Partners 401 ) Contribution
4. Distributive Share of Partnership
Income (loss) Line 20. Page 2 i.,:le 22 P2ge 1
Une 1 plus Una 2 minus Una 3j —13,732.
1
5. Pension Line 19, Page 2
6. Net Gain (loss) from Disposition
of Assets as a Result ot a Line 1B,Page 2 Line is. Page 1
Complete Liouldelon
PART III Partner's Information
Line 10a, Page 1CST-100
tine 10a, Page 1 COT-700S
Line 8, PART-100
I. Nonresident Partner's Share of NJ Tax 1. Ilse 46, NJ-1040NR
Lhe 22 i.I-1080C
Line 31a, W-104I
2. Partners HEZ Deduction q,
vas'
3. Partners Sheltered IP/OrathOo Tax Creak
2ant.1
THIS FORM MAY BE REPRODUCED
12.Ch i
08320312 758241 21146.213 coNnuarvistALRossiNG, LLC 21146_A1
SDNY_GM_00013083
EFTA_00143696
EFTA01280223
MIDWAY ASHLEY CROSSING, LLC
45-3131018
NJ NJK-1 GIT-DEP PRO-RATA SHARE
DESCRIPTION AMOUNT TOTAL
FEDERAL DEPRECIATION 0.
NJ SECTION 179 DEDUCTION ALLOWABLE 0.
NJ DEPRECIATION ALLOWABLE 0.
SUBTOTAL 0.
NJ ADJUSTMENT TO FEDERAL 179 RECAPTURE INCOME 0.
NJ ADJUSTMENT TO FEDERAL GAIN (LOSS) ON
DISPOSITION OF ASSET(S) 0.
SUBTOTAL 0.
NEW JERSEY DEPRECIATION ADJUSTMENT
23.
PARTNER NUMBER 6
08320312 758241 21146.213 (::(!pqr21101E!1‘1-15f)5LROSSING, LLC 21146
Al
SDNY_GM 00033084
EFTA_00I 43697
EFTA01280224
New Ycrk State Department of Taxation and Finance
2012 New York Partner's Schedule K-1
Tax Law - Article 22 (Personal Income Tax)
IT-204-1P
6
Final K-1
For calendar year 2012 or tax year beginning 0 1 0 1 -2012 and encins 12-31-2012 Amended K-1
Partners: Before completing your Income tax return, see Form IT•2344P4, Partnera
Instructions for Form IT-204•IP (avalabk at www.tetuw.gov).
Partnership's Information (see instalcUons)
Partnership's name (as shovm on Fcrm IT•204)
Partnership's EN
MIDWAY ASHLEY CROSSING, LLC
45-3131018
A Mark an X in the box if either applies to your entity IT: PublIGy traded partnership L3 Portfolio Investment partnership
B Tax shelter registration number, If any
C Business allocation percentage
Partner's information (see hi/ructions)
Partners name
Partner's identifying number
BLUE CHIP CAPITAL LLC
Partner's address 20-3161309
27 HIGH TECH BOULEVARD
City State ZIP code
THOMASVILLE NC 27360
D The partner Is a hieli a, ark. s 000prn btu) 1: 1_ General partner or LLC mernbermanager X Limited partner or other LLC member
E What le the tax filing status of tne partner? ern el X ht,. &layoff
Ma box 'felon.) El Individual J Estats4rust al Partnership
F If the partner is a disregarded entity or grantor trust,
enter the tax 10 of the entity or individual reporting the income, If known
0 Did the partner sel its entire Interest during the tax year?
O Yes 0 No X
H Partner's share of profit, loss, and Capital Beginning Encino
1) Profit
Hi 1.3549 % 1.3549 %
2) Lose 142 1.7483 % 1.7483 V.
3) Capital H3 1.7483 % 1.7483 %
i Partners share of liabeties at the end of the year
1) Nonrecourse
It 2,609.
2) Qualified nonrecourse financing
12 92,108.
3) Recourse
13
J Partner's capital account analysis
1) Beginning capital account
J1 47,413.
2) Capital contributed during the year • cash
42
3) Capital contributed during the year - property
J3
4) Current year increase (decrease)
44 -13,943.
5) Withdrawais and cfistributIors - cash
a 3,290.
6) Withdrawals and distnbutions • property
,p;
7) Elding capital account
J7 30,180.
8) Method of accounting (mcvk an X in the appropliste box)
IX Tax basis L__I GASP 0 Book 0 Other (submitexp/anatIon)
K Resident status (mar* an X in as boxes that appl0
li NYS full-year resident U Yonkers ful•year resident fl NYC full-year resident
O NYS pallear resident
DC
I—J Yonkers pan-yew resident 0 NYC part•year resident
NYS nonresident L7 Yonkers nonresident
L If the partner was included In a group return, enter the special NYS
identlication number, If known
•
118001121019
IIIIIIIIII10111111
HI 1IIIIII111
CONFIDENTIAL SDNY_GM_00033085
EFTA_00143698
EFTA01280225
Page 2 of 4 IT-204-IP (2312)
M 1) Was Form I-1.266SE filed with the partnersh:p?
2) Was Form MTA.405-E Wed vAth the partnership?
M1 Yee E1 **El
N NYS estimated tax paid on behalf of partner (fromFormIT-2658)
M2 Yee 0 No C
Date Amount
1) Fest Instalment
2) Second Installment
142
3) Third installment
NI
4) Fourth Installment
N4
Total NYS estimated tax paid on behalf of partner (addInes NI through N4)
0 Estimated MCTMT paid on behalf of partner (from F0IMMTA-405) Date Amount
1) First Installment
01
2) Second installment
02
3) Third installment
03
4) Fourth installment 04
Total estimated MOTMT paid an behalf of mew; (addinn O1Utrough O4)
0
Partner's share of income, deductions, etc.
A - Partner's dishibutive share Items B - Federal Kel amount C - New York State amount
1 Ordinary business Income Goes) 1 1
2 Net rental real estate Income Oces) 2 —13,669. 2
3 Other net rental income (loss) 3 3
4 Guaranteed payments 4 4
5 Interest income 5 5
8 Ordinary dMdends 6 8
7 Royalties 7 7
8 Net ehort-term capital gan (loss) 8 8
9 Net long-tern capital pain (toss) 9 9
10 Net section 1231 gain Qom) 10 —68. 10
11 Other income Oces)Identify: 11 11
12 Section 179 deduction 12 12
13 Other deductions identify. SEE STATEMENT 13 19 . 13
14 Tax preference items for minimum tax 14 2,018. 14
kktntifr
15 Net earnings (loss) from self-employment 15 15
16 Tax-exempt Income and nondeductible expenses 16 2. 16
17 Distributions • cash and marketable securities 17 3,290. 17
18 Distributions • other property 18 18
19 Other items not Included above that are required to be
reported separately to partners . 19 19
Identity:
Partner's share of New York modifications (sse instructions)
20 New York State addtt ions
Number A - Total amount 8 - New York State allocated amount
20a EA- 16 133. 133.
2% EA-
20c EA-
20d EA-
20e EA-
201 EA-
21 Total addition modfIcationa (total of colUmn A, lines 20a
through 20f) 21 133.
118002121019
IIIIIIIII IIIIIIIIIIIIIIIIIIIIII 288602
11,19-'2
CONFIDENTIAL SDNY_GM_00033086
EFTA_(()143699
EFTA01280226
11-204-IP (2012) Pago 3 of 4
Partner's share of Now York modifications (continued)
22 New York State subtractions
Number A - Total amount - New York State allocated amount
22a ES- 21 110. 110.
22b ES-
22c ES-
22d ES-
22e ES-
22f ES-
23 Total subtraction modifications (total of COkintn A, lava 22a through 220
23 110.
24 Additions to fedeal itemized deductions
toner Amount
24a
24b
24c
24d
24e
24f
25 Total additions to federal itemized deductions (add Cries 24a through 240
26
28 Subtractions from federal itemized deductions
Letter Amount
26a
26b
26c
26d
26e
281
27 Total subtractions from federal itemized deductions (add Ones 26a through 26!)
27
28 New York adjustments to tax preference Item
28
Partner's other information
29a Partner's share of New York source gross income .
29e
29b MGM allocation percentage (see Instructions)
29b
Partner's credit information
Part 1 - Flow-through credit bases and factors
Brownfield redevelopment tax credit (Form IT-611 or IT-611.1)
A - Form IT-611 B - Form I7-611.1
30 Site preparation credit component 30 30
31 Tangibre property credit component 31 31
32 On-site groundwater remediatica credit component 82 32
118003121019
Gill 211891
11-19-12
CONFIDENTIAL SDNY_GM_00033087
EFTA_00143700
EFTA01280227
Page 4 of 4 IT-204-IP (2012)
Partner's credit information (continued)
EZ capital tax credit (Fenn IT-602)
33 Contributions of money to EZ community development projects 33
34 Recapture of credit for investments in certlfleo EZ butheeses 34
35 Recapture of credit for contributions of money to EZ community development projects 35
QEZE tax reduction credit (Form IT-604)
38 OEZE employment increase factor 36
37 QEZE zone elicitation factor 37
38 QEZE benefit period factor 36
Excelsior fobs program tax credit !Form 17-607)
39 Excelsior jobs tax credit component 30
40 Excelsior Investment tax credit component 40
41 Excelsior research and development tax credit component 41
42 Excelsior real property tax credit component 42
Fanners' school tax credit (Form IT-217)
43 Acres of qualified egricuitural property 43
44 Acres of qualified conservation property 44
45 Eligible school district properly taxes paid 4$
46 Acres of qualified agriculture/ properly converted to nonquaRlied use 46
Other flow-through credit bases and faotore
Credit bases
Code Amount Code Amount
47a 474
47b 47e
47c 471
Credit factors
Code Factor Code Factor Code Foolor
47g 47i 47k
47h 47j 471
Part 2 - now-through credits, addbacks and recaptures
48 Long-term care insurance credit (Form 1T-249) as
49 Investment credit (Including employment incentive credit and h(stork barn rehabiltadOn credit• Form/T-212)4g
50 Research and development - investment credit (Form?-212) 50
51 Other flovethrough credits
Code Amount Code Amount
51a 51e
51b 51f
51c 61g
Sid 51h
52 Addbacks of credits and recaptures
Code Amount Code Amount
52a 52d
62b 62e
52c 52f
118004121019
IIIOilIllIIIlFIIIIIIIIFIIII 288802
11-'9-12
CONFIDENTIAL SDNY_GM_Coo33088
EFTA 00143701
EFTA01280228
MIDWAY ASHLEY CROSSING, LLC 45-3131018
NY IT-204-IP OTHER DEDUCTIONS
AMOUNT FROM NEW YORK
FEDERAL STATE
DESCRIPTION SCHEDULE K-1 AMOUNT
ACCOUNTING FEES 15. O.
MISCELLANEOUS 4. 0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13 19. 0.
PARTNER NUMBER 6
CONFIDENTIAL SDNY_GM_00033089
EFTA ((1143702
EFTA01280229
NC k-1 (39). 2012 Partner's Share of
(D-403) N.C. Income, Adjustments, and Credits
10-I1-12 North Ca roina Department of Revenue
For calendar year or fiscal year beginning 01 01 12 and ending 12 31 12
Partner's (dent ying Number Federal Employer ID Number
203161309 453131018
Partners Name, Address, and ZIP Code Partnership's Name, Address, and ZIP Code
BLUE CHIP CAPITAL LLC MIDWAY ASHLEY CROSSING LLC
27 HIGH TECH BOULEVARD 270 LAFAYETTE STREET SUITE 409
THOMASVILLE NC 27360 NEW YORK NY 10012
Individuals Filing Form
Partnership's Pm Rata Share Rams Amount D-400 Enter Amount on:
All Partners
1. Share of partnership income (loss) -13737
2. Additions to Income (loss)
a. Addition for bonus depreciation 133 Page 2, Lhe 35
b. Other additions to inoorne (loss) 0 Page 2, Line 96
3. Deductions from income (loss)
a. Wooden for bonus depreciation STMT 110 Page 2, Lire 44e
b. Other deduction from income (loss) STMT 19 Page 2. Line 49
4. Share of tax credits 0 Form D-400TC
5. Share of tax verthheld from nomvage compensation
paid for personal services performed le N.C. 0 Page 2, Line 23
Nonresident Only
6. NonreskleN's share of N.C. taxable Income (loss) 0 Page 2. Una St
7. NonresIder.t's share of net tax paid by the manager
of the partnership 0 Page 2, Line 24c
"2-2n.12
CONFIDENTIAL SDNY_GM_00033090
EFTA_00143703
EFTA01280230
MIDWAY ASHLEY CROSSING, LLC
45-3131018
NC SCH K-1 DEDUCTIONS FROM FEDERAL TAXABLE INCOME
DESCRIPTION
AMOUNT
PROFESSIONAL FEES
15
MISCELLANEOUS EXPENSES
4
TOTAL TO SCHEDULE K-1, LINE 3B
19
NC SCH K-1 DEDUCTIONS FOR BONUS DEPRECIATION
DESCRIPTION
AMOUNT
ADJMNT FOR 1ST-YEAR DEPRECIATION ADDED BACK IN 2011
110.
TOTAL TO SCHEDULE K-1, LINE 3A
110.
PARTNER NUMBER 6
CONFIDENTIAL SDNY_GM_00033091
EFTA_00143704
EFTA01280231
STATE OF SOUTH CAROLINA
DEPARTMENT OF REVENUE SC1065 K-1
6 PARTNER'S SHARE OF SOUTH CAROLINA (Rev. 5/27/11)
INCOME, DEDUCTIONS, CREDITS, ETC. 3515
For calendar year 2012 or tax year beginning 0 1/01/12 and endno_ 12/31/12
Partners identifying number le 20-3161309 Perbtereblpie REN ► 45-3131018
Partners name, address ar.d ZIP code Partnership's name, address and ZIP code
BLUE CHIP CAPITAL LLC MIDWAY ASHLEY CROSSING, LLC
27 HIGH TECH BOULEVARD 270 LAFAYETTE STREET SUITE 409
THOMASVILLE, NC 27360 NEW YORK, NY 10012
Check If applicable' (1) Final K•1 Amended K1 (3) W Nonresident
(A) (B) CD)
Partners Share of Current Year Federal Plus or Minus Amount Not Amounts Alloceled
Income, Deductions, Credits, etc. kl Amounts SC Adjustments Allocated ("Apportioned to SC
or t.t Wed to SC
STMT
1 Ordinary business Income (ices) 1 1
2 Net rental real estate Income (Ices) —13,669. 30. —13 639.
3 Other net rental Income (loss) II
4 Guaranteed payments II e PI
B 5 Interest income I! II II
6 Dividends PI MN=
7 Royalties I I a
8 Net short.terrn capital gain (loss) PI PI
9 Net long-term capital gain (ices) Pale"
10 Net Section 1231 gain (loss) PI -68 1 10 —68.
11 Other Income (loss)
12 Section 179 deduction
13 Other deductions 19. 19.
SEE STATEMENT
14 Withholrino tax for nonresident partner 14
List applicable South Carolina two credits. (Attach an additional sheet If needed.)
15 16
1 16 to
17 17
18 18
19 Total South Carobs tax crenate 0 .
27701 SII-Ce-12
L 35151018 J
CONFIDENTIAL SDNY_GM_00033092
EFTA 00143705
EFTA01280232
MIDWAY ASHLEY CROSSING, LLC 45-3131018
SC SCHEDULE K-1 SCHEDULE K-1 ADJUSTMENTS
LINE NO. DESCRIPTION AMOUNT
LINE 2 ADDITIONS FOR BONUS DEPRECIATION 30.
TOTAL OF FORM SC1065, SCHEDULE K-1, COLUMN B 30.
SC SCHEDULE K-1 OTHER DEDUCTIONS
DESCRIPTION COL A COL B COL C COL D
OTHER DEDUCTIONS 19. 0. 0. 19.
COLUMN TOTAL 19. 0. 0. 19.
PARTNER NUMBER 6
CONFIDENTIAL SDNY_GM_00033093
EFTA_00I 43706
EFTA01280233
CONFIDENTIAL soxy_Gu_aansom
EFTA,I037.
EFTA01280234
5
651112
Schedule
(Form 1066)
Department of the Treasury
cot iudennt yoar 1Cl2 2012 L. Final
, K-1 E.: Amended K-1
;.pattilli Partner's Share of Current Year
OMB kb. 1545-009
Income,
rot oe‘Irnir,
internal Revenue Servtx Deductions, Credits, and Other Items
1 Ordinary business income (loss) 15 Credits
Partner's Share of Income, Deductions,
Credits, etc. 0.
lo.8as separate Instructions. 2 ot rental rah eaNt• tona(lose)
—5,205. 16 Foreign transit:none
Information About the Partnership 3 Other net rental income (loss)
A Partnership's employer kienbficaben number
45-1814195 4 Guaranteed paynr.ts
8 PartneMiltka name, addmssAnty. Mal& and ZIP code
MIDWAY -CAROLINAS LLC 5 truest Income
C/O MIDWAY INVESTORS
270 LAFAYETTE STREET STE 409 Ordinary dividends
NEW YORK, NY 10012 17 Alternative min tax (NAT) kerns
Ob Ouallled dividends 1 252.
C IRS Center where partne "hinged return
E-FILE 8* -21.
7 Royalties F*
D Q Check 11 this is a publicly traded partnership (rill)) 18 Tax-exampt Income and
8 Net short-term capital gain (loss) nondeductible expenses
1 .
nit 11 Information About the Partner 9a fir long-term Capital gain (loss)
E Partner's identifying number
20-3161309 9b Coilecttles (28%) gab, Coss) 19 TrIeMbutiors
F Partners name, address, city, state, and ZIP code 27,090.
9c Unrecaptured sec 1250 gab
BLUE CHIP CAPITAL. LLC 20 Other Intonation
27 HIGH TECH BOULEVARD 10 Net Wan 1231 gain (loss)
12.
THOMASVILLE, NC 27360 —185.
11 Otheancome (loss)
G General partner or LLC QC Limbed partner or other LLC
member-manager member
H Domestic partner Q Foreign partner
II What type of entity is tht partner? PARTNERSHIP
12 Section 179 deduction
12 if this partner is a retirement plan (IRAISEPrKeogNie
to.), check here
J Partner's share of profK, loss, and Cavite
19 Other deductions
Beginning Ending L*
Prof* 12.
1.3478261%1 1.3478261% W*
Loss STMT
1.7391304% 1.7391304%
captai 1.7391304% 1.7391304% 14 SelhemMOYment
K Partners share of Malt* at year end: °amines90m)
Nonrecourse 0.
2,844.
oualified nonrecourse financing 9 104,518. *Sea Mood statement for additional IlltOrMeOn
Recourse
$ O.
L Partners capital account analysis:
seafood capWaccount
42,061.
Capital contributed during the year
$
Current year increase (decrease)
Yhthdrawals 8 distributions
$ —5,531.
27,0904
I
Ending capital account
9,440.
CE Tax basis I. OAAP Section 704(b) book
0 Other (ercelain)
Ill Did the partner contrioute properly will a buk-In gain
or loss?
0 Yes IX No
If Yes', attach statement (see Instrmtions)
a co. re LHA For Paperwork Redaclion Aet Notice, see instructions for
Form 1080. iRSdovilorm1065 Schedule K-1 (Form 1066) 207E
15450311 758241 21146.210
CONFEIDENTIAL AS LLC C/0 blIsap ott ea s
EFTA_00143708
EFTA01280235
MIDWAY-CAROLINAS LLC C/O MIDWAY INVESTOR 45-1814195
SCHEDULE K-1 OTHER PORTFOLIO DEDUCTIONS, BOX 13, CODE L
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
PORTFOLIO AMORTIZATION SEE IRS SCH. K-1 INSTRUCTIONS 12.
TOTAL TO SCHEDULE K-1, BOX 13, CODE L 12.
SCHEDULE K-1 OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
INTEREST ON DEBT FINANCED ENTER ON APPLICABLE LINE OF
DISTRIBUTIONS YOUR RETURN 135.
MISCELLANEOUS 4.
PROFESSIONAL FEES 22.
TOTAL TO SCHEDULE K-1, BOX 13, CODE W 161.
SCHEDULE K-1 ALTERNATIVE MINIMUM TAX, ADJUSTED
GAIN OR LOSS, BOX 17, CODE B
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
ORDINARY GAIN OR LOSS SEE FORM 6251 INSTRUCTIONS -21.
TOTAL TO SCHEDULE K-1, BOX 17, CODE B -21.
SCHEDULE K-1 OTHER ALTERNATIVE MINIMUM TAX (AMT)
ITEMS, BOX 17, CODE F
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
ADJUSTED CURRENT EARNINGS SEE FORM 4626 ACE WORKSHEET
INSTRUCTIONS 12.
TOTAL TO SCHEDULE K-1, BOX 17, CODE F 12.
PARTNER NUMBER 5
15450311 758241 PPDENTIALAS LLC C/O MI 21146 91
21146.210CON SDNY_GM_00033096
EFTA_00 I 43709
EFTA01280236
MIDWAY-CAROLINAS LLC C/O MIDWAY INVESTOR 45-1814195
SCHEDULE K-1 NONDEDUCTIBLE EXPENSES, BOX 18, CODE C
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
NONDEDUCTIBLE EXPENSES - SEE IRS SCH. K-1 INSTRUCTIONS
PASSTHROUGH
1.
TOTAL TO SCHEDULE K-1, BOX 18, CODE C
1.
SCHEDULE K-1 CURRENT YEAR INCREASES (DECREASES)
DESCRIPTION AMOUNT TOTALS
RENTAL REAL ESTATE INCOME (LOSS) -5,205.
SECTION 1231 GAIN (LOSS) -165.
SCHEDULE K-1 INCOME SUBTOTAL -5,390.
PORTFOLIO DEDUCTIONS -12.
OTHER DEDUCTIONS -161.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL
-173.
NET INCOME (LOSS) PER SCHEDULE K-1 -5,563.
NONDEDUCTIBLE EXPENSES -1.
CHIMNEYS - PREPAID RENT - CY -36.
CHIMNEYS-PREPAID RENTS PY 19.
FORETSDALE - PREPAID RENTS CY -74.
FORETSDALE-PREPAID RENTS PY 124.
OTHER INCREASES OR DECREASES SUBTOTAL 32.
TOTAL TO SCHEDULE K-1, ITEM L -5,531.
PARTNER NUMBER 5
15450311 758241 21146.210
CONFIDENItAt LLC C/O MI 21146 91
SDNY_GM_00033097
EFTA_00 437 0
EFTA01280237
5
SoletureS-1 (ForrnIC65) 29'2 Papa 2
This list identirres the codex used on Schedule for all partners and provides sommarized reportIng Information lor partnere who Ille
Form 1040. For detalled reponIng and fliing Information, see the separate Partners Instructiont lor Scheture K•1 and the etstruclions
lor your Interne tax return.
CAtb esn
' assy erts leoorre par) %erm ul•thw ne iØe tes; 3 J Wen rienett ety rer
pa** ot nerteerve end enser yen.nrem es tellaire • Derter sees Cre31
_ Grpeevernert se sovne
Flest ei orierunktrente °Vert ree Ses 81e PerIncrs.W.st,s‘*iis
II Orten Ice seerne sete
Pren oas See the Pairer* inseriens Syler
Pese ve Sirs &nedre E 11.19 28 Sure 1m Creal1 ler1910yer *cola' wickiity
Noreats• b. ~ME em 29 Murre per Sid Mit ese tan
Nr es ni Sir ~ia E. Ona 28 Surr C o Beekup viserne
9 Apa 'ml SMSInerre(ter Sea te Patere Inntrer« P Oltee aren
3. ~ner renter Pose (eee)
Net :Ø &Seie E, Are 29 telen, ø l& FOrorr ~Ude,
Seise &e en ~9 InITLICCOM A Nenen or sart et US
4. GutranSe pet/7• 74 SetsJ • E, ka 29 orre Q; ~on
R Gres frose 'rom al esse } Es. I " 8. Part
6. Iren«Isne Form 1940, lira&
Familie" Ona Sa arip9 Irc031,11~ pliblee
• OrnIrery <Mana
C
Forn 1040, ku 90 evM
90 Cralerl Stemde
7. Royalls er40:4eE,Yed Eske grae Inxn•»na M pornettern
8. Nanna* torn tapre/ 901NS tlehects 0. ene • Pare ategrY
9a Nm bus trrue CeN191 gein ecule) 54.1.6a• 0. ene 12 E Genar treget/ fy Forn1' 18, Pert.
9b. Cksilacibk83 (29%; 9e9" 3e« 28% Fr. Gir Vielser, He 4 F Orer
Feehedule 0 Inestere1
ge wW.L.90 ~on 1260 9.1,1 Srie Vie ~a Inatrucdoes ~Snes tasse tid portteet et erter Sel
10. X«~ku 12719x1eter 8.94 Patrer• Irceuctbra O Inna:«pene Fan 1118, Pert I
11. Oter lesne Os: II ~ Fan 1118. Pert I
Cede %Pute en Soare tea sereonee et pannerse:: Ps re krige Geis
A OSP ponlolie no:miss Bere ts Paret.IS/0S« Ø lro
"v.:luntar/ corveralors 8•• Vi Parbal* IneScteare 93.341411
C Sec 1256 stare & seeren Feen (1781, ne I J Gana legery } ram 11113 Pr I
3 71år ieg exproreeor 0cepairs Sea kn. sa K Oter
E ~Atal ol død Ferm 1040, Sn 21 nr Fer. 982
- Otre res30,119 (13« See M Parteer ermer Oter neiser
L Total broen ros 3013 Fore 7116 Part II
12 See9er - 19ar11.Cer S. Ihe Prege I snertes M Tete Snøe Se, tese/ Feen 7116 Omn
13 Olher ducludons Redrefter Ir tare re ere br olla %stylta, ine12
O Feer ~N 0,0•4 rice973 Fern 6873
I
A Cent, rettare (50%)
P ~Mødd i riCeennee3Utal Fere 8973
• Caen ecnellnllos P0/4)
C Nonner carte bils ffl0313 • 0914ctiagn ensalkis Somme PenereMeistre
D norner rele *Ser 20%) Sn th ePeseslensens
E Gnette gele preprey te • 90% 17. Aterrernestelsm tem (AAMIterei
}
ergeSzet (30e9) A Per-19138 ~ei* on Sutrent
F Cinet gein preptry^ O Falluelad geiner len Si. te erhers
G CortrIbuiles (1X94) O Depleden lers sn on i gru) Insevotcate rc
H Inneber lertart =pers Feen eke, Ilne 1 lee Inelseene /er
D C4L ses. & greeeerre4 ses Semi
I Descekrna - royalty Insdne Sc1.90J • E. IMe 19
E ce øla. & ~flid dedurJona Fer 6261
J 9suilre 15~)etatur<atios 8.91,14, Ntedu Irwtnectcne F ~AMT Iberia
K %duellar, :officio CP% lbaae, SchedJ e A 8e23
Defuelrots »Se (Sal Schrina A IS 28 Tegiwienpl1~ «I neraauctION case«.
14 Ansees pele Sirs en reurence 541.611•Allerr1 ot Ferm 1040, frre 29 A Taue", lunn erm Fos 1040, IS»
N Educabored mais:~ ~Pi% Setrer Parteres k-tese:ny B Oter nor ~ript IrCOT, Sr the Parerra lesses
O %priori dr* benellea Felle 2447 as -2 C Hencledri:471•snee Sea tere Persia IneetralSe
P ~ecry* perto3«perm« Son te*Perterastesires
19 Deatibulas
• Orneeltele rerteltratlen denSen Sn Fart 8332 ~st an
from retel sinns SMS A Cash ere rrwketable turellte
R "es Se SI Se 9.moPreWtkstrucw.n B D aterrian *unett re sex 737 Ste en Patere Sterte,
3 ttebreetatIon eXperrie deductn Sea MPresh Irtelsratne O Oter ecry
✓ :;arele 3,00 JellOn ~Sn Sen Ferm 8036 wkxena 20 Oter Sinerree
etorrnotIon A i rotar! eser Forn 41152. le ta
J Orelleacl preselen sters Isne Ferm 8903, liren 9 InVostralt capereien Forn 4962, e6
✓ Fseyernr Forn W•2 sir* Fare 8303, Nila li • Wel tat cnert InbniNikm Forn 4138
W Otenteeduriene Seo ne/Pre« Ifbinet.016 D arter, rettrillb687 ~lures
(Ser Us stel ned eatate) Son Pro Pare litsin,c1Or.
e Bero rense ParlerlY Sea me Nyere ',st:Atten
14 3Senieleyrren: ~lege Foe6 F Reeers Of Isner. SeIng
Na Uyw huva sinn 179 titrert:n er cry perterlerod ~sis in realt terten 4243162 Forer 88' 1, ene i
Oie Parters Isracet, erre ørner eg sztio:kg•et • Resenro ot icnv•ecare eoric
• NM reernetp Spe tran Sdioe.ne SF AececnAortl selt tethr) Sur 88'1. lell
Rfl33.,r001hvestmer1ni; deo •orn 4266
sull•rtiorral I 8931.33» ortrofedits Sua 9.1PerInt :ncticeleas
13 Grus* hm", or eNr9 Isen ~Ne ~is Inetruelluen
C Gro» roa-Sir imot° Set IS Genro fotottas J Leeeteck - ccrneeted
1339 term coi39Cto S. Fot:1MP
76. ender K Ledets Irrer - Iss frost
~roe %e ruin 88199
A Ler-freon* Isteg ret1
L Orepentliee ei ser/ ell6
»Sen 420341lent ree-zooe
bk.:se sten 1/0 CitarrIs
• uovi-Irco-4 9/ %SMS C4 ~Gen 179 deduolcit
han pre-2008 bukenes rest sees try =este Festne*
C Lor frøs entesing eire Melen O Sects 4.6.7gig lebrelSr
42(85)3 9tentreet-20C7 Du icing. P ~n 4.63/Vd InforTM
D ~etse enurrts tnell134791 See ~re ~Uere o stette inerx P671771404
horr ecree2C07 Dell61831 R sn* 9,900194 pionceba 3.1. Part-aia
E Oeilhd nristilset CA axpenelturote '-tstructprs
Inntil ne««PM 8 CCF neser rad vaier rosa
9 Oter rest ner entre sale T Dedebee Siste • al end gui
G Olher reral nerts J Sorte/ete e! nelostatten øsb
H UndletrtnIe0 atal peSt selt toen 1043, line 31; Snek cox e ✓ ~Sec Uerer Irar. frose
I ACSOI ere eelMotte tiarar RIS Sie Ole Penere Inreeelores W Prester:4ot pair tas)
onil X SeclOn'OOPInid99,1":0
Y Olteretertnancn
21'2®
G1.03.11
5
15450311 758241 21146.2100ON FIDENTIALNAS LLC C/0 MI 2114691
SDNY_GM_00033098
EFTA_(() I 437 I I
EFTA01280238
Schedule of Activities
For caunOir yet 201a arta yew OK/Wm .2012, end irc
MIDWAY-CAROLINAS LLC
Mac C/o MIDWAY INVESTORS IA. Number. 45-1814195
Mn BLUE CHIP CAPITAL LLC
Aunty Nulty 107% COCO* Purity Toodul = DoK0pdan
Descd
ription 1 p.m's*
FORESTDALE APARTMENTS LLC
hm4
m044- 1 may- 404-
Ordinary business income (nes
Net rental real estate income Goss) -.3,197.
Other net rental linen, (loss)
Interest income
Cividentis - Ordinary dividends '
- Ouali6e1 dividends
Royalties
Net short-term capital gain (loss)
Net longterm capita' gain (loss)
- Collecibles (28%) gain (loss)
- Unrecaptured Section 1250gain
Net section 1231 gain (loss) -181.
Other portfoio income
Section 125E contracts and straddles
Other income
Section 179 deduction
Chara bre contributions •
Portfolio deductions
Investment Interest expense
Section 59(e)(2) expend tures •
Other deductions 135.
Net ea mngs from self-employment
Gross farming or fishing Income
EtrNS nontarm Income
LIH credit • Section 420X5)partnerelips
• Other
Welled rehabilitation °VeldtsNS mated to metal reel estate
Other rental credits
Credits related to other rental activities
Recapture of LTH credit - Section 42(1)(5) partnerships
• Other
Other credits .
Post-1986 depreciation adjustment 713.
Adjusted gain or loss -20.
Portion of adjusted gairvloss allocable to short-term gainioss
Portion of adjusted galnAcss allocable to long-tern gahnoss
Porten of adjusted g&niloss allocable to section 1291 gain/loss
Depletion (other than oil and gas)
OiL gas and geothermal properties -gross income
Olt gas and geothermal properties - deductions
Other Afilif &errs
invesbnent Income
Investment extensile
20101
1101-12
5
15450311 758241 21146.210
CON.F1DEN:RAIL AS LLC C/O MI 21146 91
SDNY_GM_00-033099
EFTA_00143712
EFTA01280239
New Yak State Department of Taxation and Finance
2012 New York Partner's Schedule K-1
Tax Law - Article 22 (Personal Income Tax)
IT-204-IP
5
For calendar year 2012 or tax year beginning Final K-1
01-01 -2 0 12 and ending 12-31-2012
Partners: Before completing your income tax return, see Form IT-2 Amended K-1
044N, Partners Instructions for Fonn IT-204-1P (available at
Partnership's information (see Instructions) www.tax.ny.go v).
Partnership's name (as shown on Form IT-204)
Partnership's EN
MIDWAY-CAROLINAS LLC C/O MIDWAY INVESTOR
45-1814195
A Mark an Ar in the box if either applies to your entity
CI Publicly traded partnership LI Portfolio investment partnership
B Tax shelter registration number, if any
B
C Business allocation percentage
Ok
Partner's information (see Instructions)
Partners name
Partners Identlying ncnter
BLUE CHIP CAPITAL LLC
Pattner's address 20-3161309
27 HIGH TECH BOULEVARD
City
State ZIP code
THOMASVILLE NC 27360
D The partner Is a @en a sk, sirepreto etc C General partner or LLC mamba( manager Limited partner or other LLC member
E What is the tax filing statue of the partner? buns, X
in view:mores box, it MOWN E I I OrrIVICklei L EVateutrust rxl Partnership
F If the partner is a disregarded entity a grantor trust,
enter the tax ID of the entity or Individual reporting the Income, If
known
G Did the partner sell its entire interest during the tax yea/
Yes DI No
H Partner's share of profit. lose, and capital Beginning Ending
1) Profit
111 1.3478 % 1.3478 %
2) Loss
HR 1.7391 % 1.7391 %
3) Capital H3 1.7391 %
Partner's share of liabilities at the end ti the yet 1.7391 %
1) Ncnrecourse ..............
2) Qualified nonreccUree financing
ii 2,844.
3) Recourse
M 104,518.
' 13
J Partners capital account analysts
1) Beginning capital account
2) Capital contributed during the year • cash
J1 42,061.
J2
3) Capita) contributed dux igt the yea- property
J3
4) anent year increase (decrease)
5) Withdrawals and distributions • cash
J4 -5,531.
6) Withdrawals and distributions • property
A 27,090.
7) Ending capital account JO
8) Method of accounting (rnerfcen JIM the appropdate
J7 9,440.
box)
XI Tax taws ED ami, ED
Book :171 Other (submit explanation)
K Resent status (mark an X in .1 boxes that eppol
C NYS futyear resident LD Yonkers full-year resider.! 0 NYC Sutler resident
I J NYS pante& readent C Yonkers parttyear resident 0 NYC part-yew resident
DC NYS nonresident ... Yonkers nonresident
L If the partner was Included Ina group return, enter the special NYS
Identification number, Nknorm L
iluillvinilli21ii1iii1111o111 286561
11-10.P1
CONFIDENTIAL SDNY_GM_00033100
EFTA 00143713
EFTA01280240
Page 2 trf 4 1T-2O4-O1 (2012)
M 1) Was Form ITr2658-E fled with the partnership?
2) Was Form MTA4O5-E fled with the partnership? 1.41 Yea 0 .No a
N NYS estimated tax paid on behalf of partner (fromForm M2 Yes 0 No 0
IT-2868) Debt
1) First ir sta1ment Amount
Ni
2) Second Listallment
N2
3) Third instailment
N3
4) Fourth installment
114
Total NYS estimated tax paid cn behalf 04 partner (add/nes
NI through N4) N
O Estimated MCTMT paid cn behal of partner (from Form
MTA-405) Date Amount
1) First Installment
01
2) Second installment O2
3) Third Instalment
O9
4) Fourth instalment
04
Total estimated.MCTMT paid on behalf of partner (odd lines O1
through O4) 0
Partner's share of income, deductions, etc.
A - Partners distrioutNe share items B - Federal Kel amount C - Novi Yorn State amount
1 Ordinary business income (loss)
1 1
2 Net rental reel estate income Goes)
2 -5,205. 2
3 Other net rental income OM)
3 3
4 Guaranteed payments
4 4
5 Interest income
a 5
6 Ord'nery dividends
8 6
7 Royalties
7 7
8 Net shortterm capital gain pose)
8 8
9 Net long-term capital gain (loss)
9 9
10 Net section 1231 gain (loss)
10 —185. to
11 Other income (loss) Identify:
11 11
12 Section 179 deduction
12 12
13 Other deductions IdentifY: SEE STATEMENT 19 173. 13
14 "fax preference hems for minimum tut
14 1,243. 14
Identify(
15 Net earnings (ices) from matt-employment
18 15
18 Tax-exempt Income end nondeductible expenses
17 Distributions • cash and marketable securities
10 1- 16
17 ' 27,090. 17
18 Distnbutions - c4her property
18 18
19 Other items not included above that we required to
be
reported sepanatety to partnem
19 12 . 19
/donor SEE STATEMENT
Partner's share of New York mO8111)83OO119
(beektranithons)
2O New York State additions
Number A - Total amount B - New York Stale allocated amount
20a EA- 16 247. 247.
2Ob EA-
2Oc EA-
2Od EA-
2Oe EA-
2O1 EA-
21 Total addition modifications (total of column A lines
20a through 200 21 247.
118002121019
1111!11111111111111
1)1111111 28880
11.'9.12
CONFIDENTIAL SDNY_GM_OOO331O1
EFTA_00143714
EFTA01280241
IT-204-IP (2012,1 Page 3 of 4
Partner's share of New York modifications (centime<
22 New York State subtractions
Number A - Total amount B - New York State allocated amount
22a ES- 21 503. 503.
22b ES-
22c ES-
22d ES.
22e ES-
22f ES-
23 Total subtraction modifications (total of column A lines 22a through 221)
23 503.
24 Additions to federal Itemized deductions
Letter Amount
24a
24b
24c
24d
24e
24f
26 Total arldhlons to federal itemized deductions (addInes 24a through 244
25
26 Subtractions from federal Itemized deductions
Letter Amount
26a
26b
26o
26d
26e
26f
27 Total subtractions from federal itemized deductions (add*les 26a through 261)
27
28 New York adjustments to tax preference tams
28
Partner's other Information
29a Partners share of New York source gross income
29a
29b NICT0 allocation percentage (see Instructions)
29b
Partner's credit information
Part 1 - Flow-through credit bases and factors
Brownfield redevelopment tax credit (Form lT-677 or 1T-611.1)
A Form IT-611 B - Form IT-611.1
30 Site preparation credit ocrnponent 30 30
31 Tangible property credit component 31 31
32 Onsite groundwater remediatlor credit component .....
32
118003121019
IIIIIIIII10111111 Jill
1111111111 num
11 19-12
CONFIDENTIAL SDNY_GM 00033102
EFTA_00 1 437 15
EFTA01280242
Page 4 Of 4 IT-204-IP (2012)
Partner's credit inforination (continued)
EZ capital tax credal (Form IT-602)
33 Contributions of money to EZ community development pro:ects 33
34 Recapture of credt fora- vestments in certlfed EZ businesses 34
35 Recapture of credit for contributions of money to EZ community development protects 35
OEZE tax reduction credit (FormIT-604)
30 CEZE employment Increase factor . 38
37 OEZE zone allocation lector 37
38 OEZE benefit period factor 38
Excelsior robs program tax credit (Form IT-607)
39 Excelsior jobs tax credit component 30
40 Excelsior Investment tax creak component 40
41 Excelsior research and deve.opment tax credal component 41
42 Excelsim rea property tax credit component 42
Farmers' school tax credit (Form fT-217)
43 Acres of qualified agricultural property 43
44 Acres of qualified conservation property 44
45 Eligible school district property taxes paid 48
48 Acres of qualified agricultural property converted to nortqualieed use 46
Other flow-through credit bases and factors
Credit bases
Code Amount Code Amount
47a 47d
47b 47e
47c 471
Gracia factors
Code Factor Code Factor Code Factor
479 47i 47k
47h 47r 471
Part 2 - Flow-through credits, addbacks and recaptures
48 Long ten care insurance credit (Form IT-249) 48
49 Investment oredk (including employment Incentive credit andhistoric ban rehabifilation credit FormIT-212) 49
50 Research and development • Investment credit (Form IT-212) 80
51 Other flow through credits
Cods Amount Cods Amount
51a 51e
511
51c 51g
51d 51h
52 Addbacks of credits and recaptures
Code Amount Cods Amount
52a 52d
52b 52e
52o 52f
118004121019
p
285842
11-19-12
CONFIDENTIAL SDNY_GM_00033103
EFTA_00143716
EFTA01280243
MIDWAY-CAROLINAS LLC C/O MIDWAY INVESTOR 45-1814195
NY IT-204-IP OTHER DEDUCTIONS
AMOUNT FROM NEW YORK
FEDERAL STATE
DESCRIPTION SCHEDULE K-1 AMOUNT
DEDUCTIONS - PORTFOLIO (OTHER) 12. 0.
INTEREST ON DEBT FINANCED DISTRIBUTIONS 135. 0.
MISCELLANEOUS 4. 0.
PROFESSIONAL FEES 22. 0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13 173. 0.
NY IT-204-IP OTHER ITEMS REQUIRED TO BE REPORTED SEPARATELY
AMOUNT FROM NEW YORK
FEDERAL STATE
DESCRIPTION SCHEDULE K-1 AMOUNT
INVESTMENT EXPENSES 12. 0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 19 12. 0.
PARTNER NUMBER 5
CONFIDENTIAL SDNY_GM_00033104
EFTA_00143717
EFTA01280244
NC K-1 (39► 2012 Partner's Share of
(D-403) N.C. Income, Adjustments, and Credits
10.11.i2 North Carolina Department of Revenue
For calends• year Cr fiscal year basic ning 01 01 12 and ending 12 31 12
Partners Identifying Number Federal Employer ID Number
203161309 451814195
Partners Name, Address, and ZIP Code Partnership's Name, Address, and ZIP Code
MIDWAY-CAROLINAS LLC
BLUE CHIP CAPITAL LLC CO MIDWAY INVESTORS
27 HIGH TECH BOULEVARD 270 LAFAYETTE STREET STE 409
THOMASVILLE NC 27360 NEW YORK NY 10012
Individuals Piling Form
Partnership's Pro Rata Share Items Amount (1-400 Enter Amount on:
All Partners
1. Share of partnership Intorre (loss) -5390
2. Additions to Income (loss)
a. Addition for bons depredation 247 Page 2, Line 35
b. Other additions to home (loss) 0 Page 2, Line 36
3. Deductions 'roil Ircome (loss)
a. Deductkn fcr henna depreciation STMT 503 Page 2, Lite 44e
b. Other deduclons from Income (loss) STMT 34 Page 2, the 49
4. Snare of tax credits 0 Form D-40OTC
5. Snare of tax withheld from non wage compensation
paid for personal Services performed in N.C. 0 Page 2, Lite 23
Nonresidents Only
6. Nonresident's share of N.C. taxable !mane (loss) 0 Page 2, Line 51
7. Nonresident's snare of net tax paid by the manager
of the partnership 0 Page 2, Line 24c
269291
'2.20-12
CONFIDENTIAL SDNY_GM_00033105
EFTA_OO143718
EFTA01280245
MIDWAY-CAROLINAS LLC C/O MIDWAY INVESTOR 45-1814195
NC SCH K-1 DEDUCTIONS FROM FEDERAL TAXABLE INCOME
DESCRIPTION AMOUNT
PROFESSIONAL FEES 22
AMORTIZATION ORGANIZATION COSTS 12
TOTAL TO SCHEDULE K-1, LINE 3B 34
NC SCH K-1 DEDUCTIONS FOR BONUS DEPRECIATION
DESCRIPTION AMOUNT
ADJMNT FOR 1ST-YEAR DEPRECIATION ADDED BACK IN 2011 503.
TOTAL TO SCHEDULE K-1, LINE 3A 503.
PARTNER NUMBER 5
CONFIDENTIAL SDNY_GM_00033106
EFTA_00I 43719
EFTA01280246
r 1019 STATE OF SOUTH CAROLINA
DEPARTMENT OF FIEWNUE SC1065 K-1
5 PARTNER'S SHARE OF SOUTH CAROLINA (Rev. 5/27/11)
INCOME, DEDUCTIONS, CREDITS, ETC. 3515
For calendar year 2012 or tax year beginning 01/01/12 ard ending 12/31/12
Partners Identifying number 11, 20-3161309 Partnership's FEIN O. 45-1814195
Partners name, address end ZIP code Partnership's name. address and DP coda
MIDWAY-CAROLINAS LLC
BLUE CHIP CAPITAL LLC C/O MIDWAY INVESTORS
27 HIGH TECH BOULEVARD 270 LAFAYETTE STREET STE 409
THOMASVILLE, NC 27360 NEW YORK, NY 10012
Check if • (1) Fine! Kel Amended K 1 Nonresident
(0:9 (0) (C) (0)
Partner's Share of Current Year Federal Plus oc Minus Amounts Not Amounts Allocated
Income, Deductions, Credits, etc. Ic1 Amounts SC Adjustmems or Apportioned to SC
or ApAllocated
ocnione to SC
STMT
1 Ordinary business income (lose) 1 1 1
2 Net rental real estate income (loss) 2 -5,205. 2 86. 2 -3,197. 2 -1,922.
3 Other net rental Income aces 3'' 3 3 3
4 Guaranteed payments 4 4 4 4
i 5 Interest Income 6 5 5 5
$ 8 DivIdends 8 8 8 6
c
7 Royalties 7 7 7 7
8 Net skin-tem) capital gain (loss) 8 8 8 8
9 Net long-term capital gain (loss) 9 9 9 9
10 Net Section 1231 pale (loss) 10 -185.10 10 -185.10
11 Other ircome (loss) 11 11 11 11
,, 12 Section 179 deduction 12 12 12 12
S
13 Other deductions 13 173.13 13 154.13 19.
SEE STATEMENT
14 Withholding tax for nonresident partner 14 0.
Ust applicable South Carolina tax credts. (Attach an additional sheet if needed.)
15 15
- . ----- —
1
., 18 le
17 17
18 18
19 Total South Carona tax credits 19 0.
277t2i 0/4)242
L 35151018 J
CONFIDENTIAL SDNY_GM_00033107
EFTA_00143720
EFTA01280247
MIDWAY-CAROLINAS LLC C/O MIDWAY INVESTOR 45-1814195
SC SCHEDULE K-1 SCHEDULE K-1 ADJUSTMENTS
LINE NO. DESCRIPTION AMOUNT
ADJUSTMENT FOR BONUS DEPRECIATION 86.
LINE 2
86.
TOTAL OF FORM SC1065, SCHEDULE K-1, COLUMN B
SC SCHEDULE K-1 OTHER DEDUCTIONS
DESCRIPTION COL A COL B COL C COL D
173. O. 154. 19.
OTHER DEDUCTIONS
173. 0. 154. 19.
COLUMN TOTAL
PARTNER NUMBER 5
CONFIDENTIAL SDNY_GM_00033108
EFTA_00143721
EFTA01280248
CONFIDENTIAL SON,M,013.
EFTA,I03722
EFTA01280249
4
651112
Schedule K1
(Form 1065)
tor rearteryewarns max 2012 k
lnal K-I Amended K-1 OM No. I545-009
OC Partner's Share of Current Year Income,
Department of the Treasury yew enionnfrg Deductions, Credits, and Other Items
intern' Reverue Service
enwo 1 Ordinary business Income (loss) 15 Cradits
Partner's Sharo of Income, Deductions, O.
1
Credits, etc. P. See sepias Instuctione. 21,cmwme..t.ii.a.moree
—6,686. 15 Foreign transactions
ik Information About the Partnership 8 her net rental Income (loss)
A Partnership's employer identifkation number 4 Guaranteed payments
45-1534785
8 Partnership's name, address, c'ty, state, arid ZIP code interest Income
1.
MIDWAY MOUNTAINEER, LLC 54 Ordinary dividends
270 LAFAYETTE STREET, SUIT 409
17 A temative mm tax (AMT) items
NEW YORK NY 10012 a Clotted dividends -2.
C IRS Center where ;arboreta thed return
E-FILE
1$ Tax-exempt income and
0 0 Check it thls Is a publicly traded partnership (PIP) et short-term capital gain (loss)
l
Net long-term capital gain (bas)
11*
nondeductible Martha
5.
Pad II Information About the Partner
E Partner s identifying number 911 erllectithes (28%) gain (loss) 19 Distributions
20-3161309
A 7,059.
F Partners name, address, city, state, and ZIP ode Sc recaptured sec 12500th
28 COW Women
BLUE CHIP CAPITAL LLC 10 let settler 1231 gala (loss) 1.
27 HIGH TECH BOULEVARD
THOMASVILLE, NC 27360 11 Other Income (loss)
11 0 General partner or 1.1.0 Limited partner or other la
member-manager member
H Oornestic partner El Foreign partner
II What type of Godly b this canner? PARTNERSHIP 12 Section 179 deduction
12 this partner is a retirement plan (IEWSEP/Keogralt.), thick here - Cr
J Peepers share ci prat. Mss, and capital: 18 Other deductions
Beginning Email Cive 30.
Prom 2.3484848% 2.3484848%
Loss 3.0303030% 3.0303030%
Casket 3.0303030% 3.0303030% 14 Self-employment earnings (loss)
K Partners share of Kates at year end: O.
Nonrecourse 1,405.
Quailed nonrettursetinancing
Recocrse $ 0.
I. Partner's capkal account analysis:
Beet ring capital account 73,650.
Capital contributed clurthig the year $
rrer t year increase (decrease)
Withdrawals & distributicns
3,782.
7,0594
A
Ending capital account
Sl
70,373.
E2
S
LIC Tax basis U GARP Seaton 704(5) book
Other (explain)
M Old the partner contribute property wer a bull-in gain or loss?
I I Yes LL. No
If Yes'. attach statement (see instructions)
las
of sa u LHA For Paperwork Reduction Act Notice, see Instructions tar Form 1065. IRSgovarrn106.5 Schedule K-1 (Form 1065) 2012
16090315 758241 21146.209 CONFIDENTALEER, LLC
sarilbiAmato
4
EPTA_00143723
EFTA01280250
MIDWAY MOUNTAINEER, LLC 45-1534785
SCHEDULE K-1 OTHER PORTFOLIO DEDUCTIONS, BOX 13, CODE L
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
PORTFOLIO DEDUCTIONS FROM SEE IRS SCH. K-1 INSTRUCTIONS
PASSTHROUGH ENTITIES 30.
TOTAL TO SCHEDULE K-1, BOX 13, CODE L 30.
SCHEDULE K-1 OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
ACCOUNTING 27.
DUES & FEES 6.
TOTAL TO SCHEDULE K-1, BOX 13, CODE W 33.
SCHEDULE K-1 NONDEDUCTIBLE EXPENSES, BOX 18, CODE C
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
NONDEDUCTIBLE EXPENSES - SEE IRS SCH. K-1 INSTRUCTIONS
PASSTHROUGH 5.
TOTAL TO SCHEDULE K-1, BOX 18, CODE C 5.
SCHEDULE K-1 CURRENT YEAR INCREASES (DECREASES)
DESCRIPTION AMOUNT TOTALS
RENTAL REAL ESTATE INCOME (LOSS) -6,686.
INTEREST INCOME 1.
SCHEDULE K-1 INCOME SUBTOTAL -6,685.
PORTFOLIO DEDUCTIONS -30.
OTHER DEDUCTIONS -33.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL -63.
NET INCOME (LOSS) PER SCHEDULE K-1 -6,748.
PARTNER NUMBER 4
16090315 758241 21146.209 CON.F1 NTOIJALIEER, LLC
SDNWAI gO0V111
EFTA_00I 43724
EFTA01280251
MIDWAY, MOUNTAINEER, LLC 45-1534785
NONDEDUCTIBLE EXPENSES -5.
PREPAID RENTS CY -95.
STEP UP AMORTIZATION FROM PASS THROUGH 2,979.
STEP UP DEPRECIATION FROM PASS THROUGH 7,651.
OTHER INCREASES OR DECREASES SUBTOTAL 10,530.
TOTAL TO SCHEDULE K-1, ITEM L 3,782.
PARTNER NUMBER 4
16090315 758241 21146.209
Fl LLC 21146 El
SDNY_GM_00033112
EFTA 00143725
EFTA01280252
4
Schedule K-: (Form I005) 2D:2 Page 2
This list Identifies the codes used on Schedule K-1 for all partners and provides summarized reporting Information for partners' ho tile
Form 1040. For detailed reporting and tiling information, see the separate Partners Instructions Ion Schedule l(-1 and the Instructions
for your income lax return.
C'wo
1. Octal, %class inGOWI coat DanninaInn to Inn :KW; J Wore nortunny credit
pawns or renews va and onern your fl m is 15 bvs. K Elbabeed ens beer
L Ernowbrent rob Ind newel
FIIPOn 01 Coney enployment creel t
51 Ono t let Ireton lo mama%
Passive ow S. the Pate.. teetwOcas
Pone !memo Seln. • E. Nes 28, earn ro: N Creel be employer von baby
NOW033 V0 8040.0E Iln•28. cobra 92 .rc Medlueer
MOIWINe/0 Income Inn • 2 Ilne28, =bre 0 o Backup Atroo
2. M: nn No into Hoene Ion) SW be Naga henna P Ono:nob
3 outer re, teens Inner Caen
het inn Bon • t lino 28, note Nell 141 Farolgn noon*
Nal ion Sae VsPones Inotactlara A %no* earn «US.
4 Guaranteed Gann Scans E, Illy 28. nab I POWS/Woe
Farr 1043, nib R ran roomIn NI bun } Fermi,* Peel
5 meet Irene
Fan IIM96 O Gas ben oxen m Peher
as °rainy charade
Fan 1040, Unit Ise
50 (boallbi ann.
7. /nits Sown E. Ilmo 4 FON121(POIN fICCIMINurec K intiertillp evd
I. Not tot torre apt: go (cob Bar o D.Pre 5 0 Pane cobweb
94 Net bibunre craprN Ca' Serb &mucus 0, S. E GIC44110rherf } Fenn Pell
Cla. Collect oars 128%; gse no) 2816 Rat. Gain Wen* les 4 F Cenv
(Bonk 0 belraWona)
9e Unrocapurod wen 1250 gib Soo ha Peron lestsieSSis Csoactlet stored arc sppcil Oft] K prom WM
*O. NM nen 1231 go -6 rob) Bw ttw Parton Inshau-Sans O 'Man Mine Farm 1118. Part I
1. Ohm- nate -es) H Ohm Fenn 1118. Pearl
COW Dnc..stlow a. cacaod orxl sppoiSared K 0•44WirCe WoW Sr lone bun
A On Bona IrecnuElow) See tee Panto Innotbrs horn
8 Invcrurtery oannolono SW. tw SSW* Unthaws I Penang canal
C Soo. :258 corn.. One co Faro 8781 Ml Ono. witegray Fon '111, Putt
O at beg axpleralloa Ctrs eweetils See Pon B35 K Otot
E Ca-celtraceta, &rot Forr10.10, w 21 °liana
F OlharInn* ( oe Sao he Pon t brim:tees Otler Ur tenni cm
L Teti beer ton pale Pow ilift Pon
12. Sene 179 &dna. Sae me Parinv's 'Saab • 7c-cl Emir ten accrued how 11tfl. Port I
13. Oi'e doonnea N RoducriCei IM Wad won • tram t En 11'4 Ito 12
O Fortin Nebo grew nob Farr 8873
I
A OW ante. oneNM)
teen nonteo4: one 1301(4 P EntlintfAil tan arcausen Fan. aRra
• boys SanucSaw See the aerrot • nornore
O Nolen *noun NOW
Non* contemns POW Soothe artery -sbucOon•
Cam:61 ca MOM, 10 650% 17 Nunn el -rum tea :tan ben
1
ovanIzaJoB(J616) A Put-'988 &ankle, aclan0tt
F Copt sae mm6..912210 Soo to Poirer's
B Adrusaret sec er
Cot orlon' GOON C ;win' (:411b Ste e tat Ireherbes 00
Inner: and oxpeeno Fan 4£42. !we 1 Car Wenders br
Sneau • F., lira 15 • OR oa & protean 9000 Ircone
0' 40.1.1.4>III• rewire ton E 04 Glaa. & plums - Sw-elloca Fan 8251
Senn 58822; oxen tin So• to Penmen lostankes F Cater MA1bee
K Deduct amr • polio ot% azen 5ceea le A 01022
L oxsuann. • pen C rote Sunk A rho BS It Tee many: heart era condonable boobs
Araunto Boo br trednel nine San Jo A antler Form 10740, Ono 29 A Image/mat newt tore Form 1240, be 8b
N Enacatorb omit ence Webb Soo to Panwe's loan:Ione Carer LleeeXele: Incur,* See he Parties Imbue:Ions
O Donn! rem beeratx ;orm 2441.11ra '2 C NOrCetkU.Ibler expenses Sec Ina Penn In
P Preprodacwo porn bean See no Panic's estsambra
19. DIshbutions
0 Caren el rennin an deluoton See Fern 56821estuotam
eon rent ma aralc art von A CaW awl larktratMe 'burn
R Persicns Are IRA, See he Parkin Insholons 8 Distriout on &ebb to sector 737 } Ow IM Prow. IrStoutt One
S Relertatathr nano dant an Sea he Pawn Henn C Ober properm
T Del-a8Se produeser acrthrlies See Far !NW Insluatbb 20. Mar Wanton
Intoenben A Wren. norre For 40 52. 1110 4+
Ora fled nun. elute, mccr,e neerows$, 'lb 7a B Inner lawns Far ab2. SW
V Erbroyera Fern W-2 ono econamni n17 O Gas lax fed: Inkenen Few 4136
w
Otter denrunow Sas the NOW's rnisbuCtCm. O ewe +Ow ex one Ally
:Oho, thon fental roe can) See he ate enr burctior •
• Bees aceau-y property rut ho Pert ere 'sutra:Sore
14. 8411-nowtort breirea keel F Hearn Of bee-Income 7ouslrg
Nob Ilyou In a won 179 CerlutSor Cs, Sly petter-tevel clecluvion sw moll nice 42225.1 cern sr 1. Ihe 8
IN) Partrwes InStuctcns Snot oxrploUns Schwa SE G Hearn el row-In Wee towline
A Vol nabs ben 'Mil SCriedL 0 St, UMW, A«0 cfecit :on•I Fenn tall. '508
soluaxmoyese H nacapteto or Inner( caret See Foto 4255
B CFAs twang Cc gist 19 Inn See to 3iIrroftilretwatIore I sxcapwre alatt. avails See to Pan's Irenrces
C Sites mn-larn income Sea 'rrtarli Ins:runny .1 ...v.,...tpack Flat ownpletscl
ong-terrn satiate See Fsw ma>
:8. Cmdta K nor beck Urban boons bent
A Low ben Mae19met wnloo We Fuer 8886
Infer 42015 tan pre-20111 sportown noun rem
wean motion 179 deduebn
8 Unworn@ "Oiling Ore 94104 14 144c•pl.n of beaker 179 be Jan
ton me-2n ouno Inter capon. br corporate person
C uweIncarta noun an Noon 0 Stela, 403=0 Ir berailan
427.0:1 kw owl-2007 WINN, 114clun M.3.697)Irtynt20:1
O LLY/NrtAtM2 lattiN credit :arm) Sea he Partin ben le
ns O Sectt :283>I1rbentIca
born pet:-2007 s...11dets Inn allocable b 2ICCIJaal Sea Be aarher's
F. areered ntiritatior centrum abort crow nu-Surs
}orta cod =my) S CCF relocated MIndetrwas
F Otte torte Ntrl blab urn* Dacron Irbonet - o and me
O Oter rob ta -ts .1 Arructust on gleafrestat.ol orate
H Lire atabJlod card (Ons &ode Form 1043 Ins 71; Wadi bane ✓rnseed arA vas enable Income
I Mcoh5
211282
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01.01-13
4
16090315 758241 21146.209 CON.F1 NT ObiktNEERs LLC 21146 El
SDNY_GM_OOO33113
EFTA_00143726
EFTA01280253
2012
New York State Depalment of Taxation and Finance
New York Partner's Schedule K-1 1T-204-IP
Tax Law - Article 22 (Personal Income Tax) 4
Final IC-I
For calendar year 2012 or tax year beginning 01-01-2012 and ending 12-31-2012 -- Amended Kr1
Partners: Before completing your Income tax return, see Form IT-204•IP-1, Partner's InstmctIons lei Form IT-204-IP (avalable at vnrnv.tax.ny.gov).
Partnership's information (see Instructions)
Partnership's name (as shown on Font IT-204) Partnership's EIN
MIDWAY MOUNTAINEER, LLC 45-1534785
A Mark an Asir the box if either applies to your entity Publicly traded partnership C Portfolio Investment partnership
B Tax Shelter reatration number, it ary B
C Busiress alocation percentage C
Partner's information (see instructions)
Par.rer's name Parmer's identifying number
BLUE CHIP CAPITAL LLC 20-3161309
Par.rer's address
27 HIGH TECH BOULEVARD
City State ZIP code
THOMASVILLE NC 27360
D The partner is a ran or X N n,. aoprepdn oax) General partner or LLC merrber-manager Limited partner or other LLC member
E What lathe tax fling status 0.l the partner? :flit Acpwratn Ø If Knew.) El Individual Estate/trust X Partnership
F If the partner is a disregarded entity or grantor trust,
enter the tax ID of the entity or Individual reporting the Income, If known
O Did the partner ea its entire interest during the tax year? G Yes __ No al
H Partner's share of profit, loss, and capital Beginning Encino
1; Profit Ht 2.3485 • 2.3485
2) Loss H2 3.0303 % 3.0303
3) Capital H3 3.0303 • 3.0303
I Partner's share of Ilabilitee at the end of the year
1) Nonrecourse H 1,405.
2) Otagfied nonnscourse thawing 12
3) Rama. I3
.1 Partner's capital account ennyss
1) Beginning capital °mount J1 73,650.
2) Capital contributed during the year • cash J2
3) Capital contributed during the year property J3
4) Ounent year Increase (decrease) J4 3,782.
5) Withdrawals and distributions - cash JS 7 , 059 .
6) Withdrawals and clstributens • property J6
7) Ending capital account J7 70,373.
8) Method of accounting (mark an Xin the apprspriate box)
Ix] Tax basis C ØP Book 1_1 Other (submit explanation)
K Resident etalue (mark an X in 2 boxes that apply)
C NYS lubyear resident C Yonkers full-yew resident C NYC fullyear reeldent
L._ NYS part-yea:resident D Yonkers part-year res:dent C NYC peat-year resident
MC WS nonresident C Yonkers nonresident
L It the partner was Inc.uded In a group return, enter the special NYS identification number, K known
118001121019
258%1
•-•e12
CONFIDENTIAL SDNY_GM_00033114
EFTA 00143727
EFTA01280254
Page 2 of 4 17-204-IP (2012)
M 1) Was Form IT-2658£ Ned with the partnersnlp? Ml Yes No
2) Wee Form MTA405•E Ned with the partnership? M2 Yes 17 No 0
N NYS estimated tax paid on behalf of partner (from Form IT-2858) Date Amount
1) Find Installment NI
2) Second Instalhent N2
3) Third Instalment NS
4) Fourth Installment IN4
Total NYS estimated tax paid on behalf of partner (add toes Ni through N4)
0 Estimated MOTM7 paid on behalf of panne, (fmm Form A4TA-405) Dab Amount
1) First ins'alhent 01
2) Second Installment 02
3) Third rstallment 03
4) Fourth Installment 04
Total estimated MCTMT pad cn behalf of partner (addInes O1 through O4) 0
Partner's share of income, deductions, etc.
A - Partner's cletributhe share Items 8 - Federal 147 amount C- New Yak State amount
1 Ordinary business IfICOM.6 Coss) 1 1
2 Net rental real estate income (loss) 2 -6, 686. 2
3 Other net rental Income (Ices) 3 3
4 Guaranteed payments 4 4
5 Interest Income a 1. 5
8 Ordinary dividends 6 8
7 Royalties 7 7
8 Net short-term capital gain (loss) 8 8
9 Net long-term capital gain Goes) 9 9
10 Net section 1231 gain (lose) 10 10
11 Other Income (loss)identIPT 11 11
12 Section 179 deduction 12 12
13 Other deductions Identif: SEE STATEMENT is 63. 13
14 Tax preference items for minimum tax 14 -2. 14
Identify:
16 Net earnings (loss) Iron sett-employment 16 15
18 Tax-exempt income and nondeductible expenses 16 5. 16
17 Distributions - cash and marketable securities . 17 7,059. 17
18 Distributims - other property 18 18
19 Otter items not Include° above that are required to be
reported separately to partners 19 31. 19
Identify: SEE STATEMENT
Partner's share of New York modifications (ees instructions)
20 Nev. York State tdcl
Number A - Total amount 8 - New York State allocated amount
20a EA- 16 92.
20b EA-
20c EA-
20d EA-
20o EA-
20f EA-
21 Total addition modifications dotal el colUrna A, fines 2Ca through 20f) . 92.
118002121019
III IIII
III I III III II I II
III III III III
aim
CONFIDENTIAL SDNY_GM_00033115
EFTA_00143728
EFTA01280255
IT-204-IP (2012) Page 3 of 4
Partner's share of New York modifications /continued)
22 New York State subtractions
Number A - Total amount B - New York State allocated amount
22a ES- 21 97 .
22b ES-
22c ES-
22d ES-
22e ES-
22f ES-
23 Total subtraction modifications (total of column A lines 22a through 226 23 97 .
24 Additions to federal itemtzed deductions
Letter Amount
24a
24b
24c
24d
24e
24f
25 Total additions to federal kemized deductions (add lines 24a through 240 26
28 Subtractions from federal ttenfzed deductions
Letter Amount
26a
26b
26e
26d
26e
26f
27 Total subtractions from federal itemized deductions (add lines 26a through 260 27
28 New York adjustments to tax preference items 28
Partner's other Information
29a Partners Sure of New York source gross income 29a
29b MCTD allocation percentage (seeinstructions) 29b
Partner's credit Information
Part 1 - Flow-through credit bases and factors
Brownfield redevelopment tax credit (Form IT-611 or 1T-6 t 1.1)
A - Form IT-611 B - Form IT-611.1
30 Site preparation credit component 30 30
31 Tangible property ore& component 31 31
32 On-site groundwater remediatIon credit component 32 32
11.10-.2
CONFIDENTIAL SDNY_GM_00033116
EFTA 00143729
EFTA01280256
Page 4 of 4 17-2044P 0012)
Partner's credit information (continued)
EZ capital tax credit (FAINT-602)
33 Contebutions of money to EZ community development projects 33
34 Recapture of credit for Investments in °rifled EZ businesses 34
36 Recapture of matt for oontributions re money to t1 community development orotects 35
CUE tax reduction credit (Form IT-604)
38 QEZE employment increase factor 38
37 QEZE zone stocation factor 37
38 QEZE benefit per cd factor 38
Excelsior jobs program tax crest (Form IT-607)
39 Excelsior lobe tax credit component 30
40 Excelsior Investment tax creclt component 40
41 Excelsior research, and development tax credit component 41
42 Excelsior teal property tax credit component 42
Farmers' school tax credit (Form IT-217)
43 Acres of quallied agricultural property 43
44 Acres of quailed conservation property 44
45 Engine school district property taxes paid 48
48 Acres cf qualified agrkult t.ral property converted to nonquakfled use 45
Other flow-through credit bases end factors
Credit bases
Code Amount Code Motet
470 47d
47b 47e
47c 471
Credt factors
Code Feotor Code Factor Code Factor
47g 471 47k
47h 473 471
Part 2 - Flow-through credits, addbacks and recaptures
48 Long-term care insurance credit (Form 1T-249) 48
49 Investment credit (including employment incentive crest end historic barn rehabilitation emS F019171T-212) 40
50 Research and development • investment credit (Fenn IT-212) 50
61 Other flow-through credits
Code Amount Code Amount
51a 51e
61b 511
51c 51g
51d 51h
52 Addbacks of credits and recaptures
Code Amount Code Amount
52a 52d
52b 62e
52c 521
118004121019
III IIII
III I IIII IIIIIIIIIII II
III III
MOM
11-19-12
CONFIDENTIAL SDNY_GM_00033117
EFTA_00143730
EFTA01280257
45-1534785
MIDWAY. MOUNTAINEER, LLC
NY IT-204-IP OTHER DEDUCTIONS
AMOUNT FROM NEW YORK
FEDERAL STATE
DESCRIPTION SCHEDULE K-1 AMOUNT
30. 0.
DEDUCTIONS - PORTFOLIO (OTHER)
27. 0.
ACCOUNTING
6. 0.
DUES & FEES
63. 0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13
NY IT-204-IP OTHER ITEMS REQUIRED TO BE REPORTED SEPARATELY
AMOUNT FROM NEW YORK
FEDERAL STATE
SCHEDULE K-1 AMOUNT
DESCRIPTION
1. 0.
INVESTMENT INCOME
30. 0.
INVESTMENT EXPENSES
31. 0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 19
PARTNER NUMBER 4
CONFIDENTIAL SDNY_GM_0003311B
EFTA_00143731
EFTA01280258
•
NC K-1 (39) 2012 Partner's Share of
(D-403) N.C. Income, Adjustments, and Credits
10-11.12 North Carolina Department of Revenue
01 01 12 amending 12 31 12
For calendar year or hut year begmning
Partner's Identifying Number Federal Employer ID Number
203161309 451534785
Partner's Name, Address, and ZIP Code Partnership's Name, Address, and ZIP Code
BLUE CHIP CAPITAL LLC MIDWAY MOUNTAINEER LLC
27 HIGH TECH BOULEVARD 270 LAFAYETTE STREET SUIT 409
NEW YORK NY 10012
THOMASVILLE NC 27360
Individuals Filing Form
Amount 0400 Enter Amount on:
Partnership's Pro Rata Share Items
All Partners
-6685
1. Snare of partnership Income (loss)
2. Additions to Income Doss)
92 Papa 2, DM, 35
a. AddRion for bonus depredation
0 Page 2, Line 36
b. Other additions to income (loss)
3. Deductions from Income (loss)
97 Page 2, :Me 44e
a. Deduction for bonus depredation STMT
33 Page 2, Line 49
b. Other deductions from income (lass) STMT
0 Form 0-400TC
4. Share of taxcredits
5. Share of tax withheld from nonwage comper.satiar
0 Par 2. Line 23
paid for personal services performed In N.C.
Nonresidents Only
0 Pace 2. Line 51
6. Nonresident's share of N.C. taxable income (oss)
7. Nonresident's store of net tax paid by the manager
0 Page 2, dm 24c
of the partnership
241091
CONFIDENTIAL SDNY_GM_00033119
EFTA_00143732
EFTA01280259
MIDWAY MOUNTAINEER, LLC 45-1534785
NC SCH K-1 DEDUCTIONS FROM FEDERAL TAXABLE INCOME
DESCRIPTION AMOUNT
6
DUES & FEES
27
ACCOUNTING
TOTAL TO SCHEDULE K-1, LINE 3B 33
NC SCH K-1 DEDUCTIONS FOR BONUS DEPRECIATION
DESCRIPTION AMOUNT
97.
ADJMNT FOR 1ST-YEAR DEPRECIATION ADDED BACK IN 2011
TOTAL TO SCHEDULE K-I, LINE 3A 97.
PARTNER NUMBER 4
CONFIDENTIAL SDNY_GM_00033120
EFTA_00143733
EFTA01280260
CONFIDENTIAL SONV_GN_OOMI 21
EFTA,103734
EFTA01280261
3
631112
Schedule K-1
(Ram 1066) Fermlividwrier2iraortex
2012 n Foal K-1 —I Amended K-1
AO;MP Partner's Share of Current Year Income,
CMS No 1545-009
Department of the Treasury yea- bectnn Deductions, Credits, and Other items
1 Ordinary business income (loss) 15 Credits
Internal Revenue Service "wine
Partner's Share of Income, Deductions,
► See separate Instructions. 2 Not mai red astute incomein*
0. 1
Credits, etc.
-27,051. 16 Foreign transactions
3 Other net rental income (loss)
Part I Information About the Partnership
A Partnership's employer Identification number 4 Guaranteed payments
27-3304656
Partnership's name, address, city, state, and ZIP code 6 Interest Income
MIDWAY PLANTATION LLC. Oa lathery dividends
270 LAFAYETTE ST. STE 409 17 Atemathre min tax (MT) Items
NEV.; YORK, NY 10012 6b QualKled dividends 2,529.
B* —14.
C IRS Center where partnership Sled return
E—FILE 7 Royalties
18 Tax-exempt income and
D Check it this is * publicly traded partnership (PTP) 8 let short-term capital gain (loss) nondeductible expenses
9a let long-term capital gain (loss)
Information About the Partner
E Partners Identifying number gs Collectibles (28%) gain (loss) 19 thstrkidons
9 392.
20-3161309
F Partner's name, address, city, state, and ZIP code 9c Unrecaptured sac 1250 geln
20 Other information
BLUE CHIP CAPITAL LLC 10 Net section 1231 gain (loss)
27 HIGH TECH BOULEVARD —54.
THOMASVILLE, NC 27360 11 Other Income (loss)
a 0 General partner or LLC DU Limited partner or other LLC
member-manage r member
H aid Domestic partner 0 Foreign partner
What bile of entity Is this partner? PARTNER SHIP 12 Section 179extudlos
2 it mks partner is a retirement plan (IFINSEPdthoghtetc.). check here
Partners share of croft loss, and caplet 13 Other deduction
Beginning Beim iW t STMT
Pratt 3.2978723% 4.255319 1%
Lon 4.2553191% 4.2553191%
Capita' 4.255319 1% 4.2553191% 14 Sell-employment earnings (loss)
0.
K Partner's Share of liabilities at year end:
Nonrecourse 5,485.
Cualified nonrecourse Financing 303,782 . had statement for addtionm information.
Recourse 0.
L Partners capital account analysis:
Beginning capital account $ 40,524.
Capital contributed during the year $
Current year Increase (decrease) $ —27,735.
witsdrawaissaistiessons SI 9,3924
Ending capital account S 3,397.
pp Tax basis 0 OAAP 0 Section 704(b) book
0 Other (explain)
PA Did the partnercontasse property with a built-In gain or loss?
C Yes LXJ No
N' es'. attach statement (see hist ruC0onsl
ti 1Lb Reduction Act Notice, see Bistro lions for Form 1055. I 6.0oWlornil 065 SchedtleK4 (Form 1066) 2012
e•th-la LHA For Paperwork 3
17540322 758241 21146.20C ONIFIDEN4-PIALTION LLC. 21146 41
SDNY_GM_00013122
EFTA_00143735
EFTA01280262
2'7 -3304656
MIDWAY PLANTATION LLC.
SCHEDULE K-1 OTHER DEDUCTIONS, BOX 13, CODE W
PARTNER FILING INSTRUCTIONS AMOUNT
DESCRIPTION
688.
AMORTIZATION 9.
DUES & FEES 42.
PROFESSIONAL FEES
W 739.
TOTAL TO SCHEDULE K-1, BOX 13, CODE
SCHEDULE K-1 ALTERNATIVE MINIMUM TAX, ADJUSTED
GAIN OR LOSS, BOX 17, CODE B
PARTNER FILING INSTRUCTIONS AMOUNT
DESCRIPTION
-14.
SECTION 1231 GAIN OR LOSS SEE FORM 6251 INSTRUCTIONS
-14.
B
TOTAL TO SCHEDULE K-1, BOX 17, CODE
SCHEDULE K-1 CURRENT YEAR INCREASES (DECREASES)
AMOUNT TOTALS
DESCRIPTION
-27,051.
RENTAL REAL ESTATE INCOME (LOSS) -54.
SECTION 1231 GAIN (LOSS)
-27,105.
SCHEDULE K-1 INCOME SUBTOTAL
-739.
OTHER DEDUCTIONS
-739.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL
-27,844.
NET INCOME (LOSS) PER SCHEDULE K-1
-28.
PREPAID RENTS - CY 137.
PREPAID RENTS - PY
109.
OTHER INCREASES OR DECREASES SUBTOTAL
-27,735.
TOTAL TO SCHEDULE K-1, ITEM L
TNER NUBER 3
LLC.
IONPAR 2 146
17540322 758241 21146.20002NLEIDENTPIAL 1M
SDNMY_G _000334 1
23
EFTA_00143736
EFTA01280263
3
Schedule K-1 IForrn 10651 2012 • Page 2
This list Identifies the codes used on Schedule K-1 for all partners and provides summarized reporting Information for partners who rile
Form 1040. For detailed reporting and tiling information, see the separate Partners Instructions for Schedule K-I and the instructions
for your income tax return.
Code ~Oft nn
' Orene-, itnInetit ewe.,Beeil DeWen~her Ste non MO l• J Wait aPeatterheteedi
~eve al noncene end enter an yewfete fee kern K ~Knee nett
Entiernereint xole Inc Netted
Repo, : on owns- fie employment net See to Pen, * ireetxtnrs
to Oftenkr inneotng meek,
Pathan 544 eriPetra a Irstnictart elehátes
Per 'ome Selectee 5. lino 211. CO Jeri X Cneo.1 emecyer vent en et,
11~4 kee Schochl a lino 24 w Jon Tj arid Medan nee
Noneeeere lenei •riCllwl.0 é, Ire 28, note in 0 O Socket tetireklin9
2. Net tent MI Cane Iron ONO See ire area's Irene:lee P One areffie
a Other rig noted eiene01441
Net Inn 24•90•40 E. in 28. court CO 15 Fenian neffellons
See lie %hen instanter* A Nier. procurer or U.3
4. Ennierliee polymer's Schearlo E lire 2a. ~rt. 0 poseeeeke
B Co.. Ion toe all sconces } ;Jn I' le Part I
5. lent ineerne Torn 134C, lee 8a
goo, 101C, rir• 9a C Oren ran. oaten meat'«
OrIntry &Men
lb. Cluetred dinette Fein 1340 tiro 90
7. Floyett SciecJleir fine 4 Forcer gees none essOICI n: pen~hip eve.
& NM short-r malts pin (net Stench ro 0 Snob pasen ~gory
9a Net enttern Mate On« Schenk • lire 12 E Ginn creepy } Facr 1I'8, Pet
9t. E25144geir (bee 2131‘ Fete Gen Weekterit ime F Oter
Patient* 0 Inn-chore)
Sa Unreceptur0 neon 1250 pin See eieFsetnefet tenth:tons reducheire ercae ant isoperroi id at tanner eel
13 Net melon 1231 tea (ces) Ste tie Peetner's eeeuntore O Intern nine Fern • el& Pan 1
Ohir 'eon Ma) H Other con. 1118 Pet I
Cede owe-Iona 411~ aid ettltrt-cred ne Petreelle Iced tC hvgn ~Oa
A Other priloho Incon(aern) See Be auto?* Mnotctlana ixomB
j
B evolution cenvembins See I" Pawnee Innottlitee 1 Palenerr/9n
C See 1259 a"net16 Vienna Fenn Ent the 1 J Genre cenegoir ii Fats We, :eh I
O Mktg etplorliten con naps" 54, Pa. 635 f( Other
E Cenetednan el001 Fen 1040 line 21 orEen 982
F Othre knee 200 SemePaYmre..roAMdirs One Irbetaloh
I. Tool faelse tines Pad Fern 1110, het
'2. 5eolon 179 doeluetlen See the Partner* havens 1A To:01 01191BAca ac'-44TI Form '115, Art
13. Other deaecen N Reduetlen In Zees avasbn Ex cx t Fern '11E, ne 12
O Fever two hg greer wept. Tern 8873
I
A fah conteeuleas pC94)
P Extend:04.1'm~ endue'« Form 8573
B Caen centittrJore 430/41 See Vie Prner's traihnlone
O Other knees ternacters
O \ant cer e >Aire Et)
D Sar tone talons OC45) En Vie Punta Ineestkne
E Capital pen propeny to a 504 17 AtinetIve r* Turn tits (MT) Mr»
}
anniZ0000, 4 A int.19414 Mandator BEJSIPlent
F Caen Gain Wendy 0014: 3 Munn gain or bee Fine Ye %Imes
• CaTE-0400000151 C Depediet Biter etill oil 8 00 Innate» ere
H Irvestment 'tweet ten Fart 4062 line • 015 gee geonerre - Oreta inncre• Se Instructions M
I Dedtietere • royalty inn 5eredslie E Ike 19 F Ca, gm apo7arra • defied-ens Fenn S251
• ~Tan 69e42/elnecilturee See the Pertnerit MM *:lens F OlherAtfrlen
K Doe.iesore ^la C2SS Teal Ser•OLIer& Ike 23
L Dec titan* • oaten (eY0 Sonny& M 25 It Tie-sawn noon rod nendeinelitle«peen
M &mullein Mid tarpon cal *nascrco Schedtee A. lb» 1 or Few 10eD, ne 29 A ex-eadlelst beent hccere corm 100 Blei
'1 Caseation evenvr* bete Le See the nark. fl extime B Otne• tax-wendIran See 7e Potroes nieud.stne
O Upended an benches :ore 2e41, lee 12 C tkirdedrcro•ashenfee 50 74 Panera keiltekne
2 PrOteduCehe Oared ones Se es 'Wen Inflections
Dreetutkera
10.
Q Contested rwIttlentioo dedue3on ~Font t682 iratructen
torn an roe Mate ettivlin A Ceara awresszobabe
• IhenNeine ono IRAs Sea te P*7.0es inate.cLore • 2leeteten next to ~en 737 } Sen We ire« • Ina/Jabal
S Renernn etkPerbee ~MIDI See es knees Nientke• C Oteir newt!
T Dalwede: pion Jane nviteie Sec roan RCS Ineroneons 20. Ohl« 9-tenter
Irkerrenn A ItheoWnre irr.orti Form 4952, We 4a
U 040110 eedoctien aceNnie eon Fens. 893. Ire 73 tl fawner: eitoneas torn arke. Ire 5
✓ Sept.:Ire Fenn 44-2 •4•944 Foie ESA Vii C FLel tat CatIlt IrbertelcC Fore 4138
W Olher 00 echoes See eit Pedreis Irstructiene D alarm ~la, eatendit. Se
totter than tent* reel eon; Sen 7n Pirtreee Iret•int Ceti
E Bade °Inn? proPetY See te Pe•tnornb•litioriono
14. SWABIOleffilelt ern 10.0~
F ~pin rbeencome Intern
Wee II you here e settlel 179 elsoneon cr ary ~nor- ere ~tacos. see craft tane5on 421(5)) Fort8611,in
the ~We Intones before Cerratetn2 Sehodule O ~tare of low- nnOrie hat.fdry
«edit (peat) Feet Sell, tics 8
A Nal metro ;net hem acne.. SE Santee A or
- ROZZOtve al kennel:awl: See Torn 4256
eetneensio/Trat Fkoapt.h: ol other an% See Te Jscrer a Inv':~*
B Oren bring or IlatInei Boon See te Peen'. nnettfors
C One noels-in Interne See en Freer a nelrueleen J Look-hook Irtnet • toneetec
bug hen cemeeest Seie Form 8697
15. Own K Leokntit le tense Irene* krecnst
fretted See Ferri 6868
A LON-Incerne teeing credit
Beebe 47$01) fain P111-2COE L Dleptellithit of oieporly tee
since 179 eted.0one
tJMFP
B Lereincon nas os lone/ Irl Rectiotinte senton "79 cerkintio-
heel pre-2= toulltires N Ina,: expanse kw obi:crate eerttere
C Ln•Intrin -nee his not lent, O Set on 45300 ntinabon
/2054 h.r. pc41.23C7 e.doinhe P Sector 453A0 remain
O „Oes•trearre tIctaing ant: I (Cite° See he arrtne's Ineorttent O Settee '283(o) thrholnE
kit :-7.1•201/ toradires P newt blocttie in enter on See Ms Partners
E One.: rate) tear enrols-es ~fen het:A.1101e
flied Not testel 8 C:CF fer&icifted wiener's
F Ober metre in estate ante T Dopetior ir biltatintel • all and On
O One fenta theirs U Anortneter of reknit-don mite
14 Untie:41/nd &Iona Leine ~Oh Fein lea, line 71; Yin Pox • ✓ Unmated boatmen won socrie
I Akche anti nor Enna blend tin See the Panne?.Irsevenni • Pnrcaltitviice Gornto*/
en& X SaCeOn 1080 irkirnelitin
✓ OW Wort«on
2112(12
J1-01 13
3
17540322 758241 21146.20C O2N2Filj EPtig -PIATEION LLC. 21146 41
SDNY_GM_000U124
EFTA _00143737
EFTA01280264
2012
New Yak State Department of Taxation and Finance
New York Partner's Schedule K-1 IT-204-IP
Tax Law - Article 22 (Personal Income Tax) 3
- Final K-1
For calendar year 2012 or tax year beginning 01-01-2012 end ending 12-31-2012 Amended K-1
Partners: Before completing your income tax return, see Earn IT•2044134, Partner's Instructions for Fonn1T-204-IP (available at envw.tax.ny.gov).
Partnership's Information pse instructions)
Partnership's name (as shown on FormITI04) Partnership's EIN
MIDWAY PLANTATION LLC. 27-3304656
A Mark an X in the box If either applies to your entity C Publicly traded partnenitio O Portfolio Investment partnership
B Tax shelter registration number, Harry
C Business allocation percentage 46
Partner's information (see Listarcnons)
Partners name Partners identifying number
BLUE CHIP CAPITAL LLC 20-3161309
Partners address
27 HIGH TECH BOULEVARD
City State ZIP code
THOMASVILLE NC 27360
D The partner b a nen se X in re apprpodate bog, General partner or LLC member-manager 'XI United partner or other LLC member
E What Is the tax Piing status of the partner? owe., X ir tio eporcrate boA, it xrcreen) ED Individual Li . Estate/trust M Partnership
F If the partner Is a disregarded entity or grantor trust,
enter the tax ID of the entity a individual reporting the Income, If known F __
O Did the partner sell Its entire interest during the tax year? 0 Yee — No LXJ
Beginning Ending
H Partner's share of profit, loss, and capital
1) Profit N1 3.2979 % 4.2553
2) Loss H2 4.2553 % 4.2553
3) Capital 10 4.2553 % 4.2553
i Partners share of liabilities at the end of the year
1) Nonrecourse 11 5,485.
2) Qualified nonmcourse financing 12 303,782.
3) Recourse 13
J Partner's caplin account analysis
1) Beginning capital account J1 40,524.
2) Capital contributed during the year - cash J2
3) Capital contributed during the year • property .13
4) Cunard year increase (decrease) J4 -27,735.
5) Withdrawals and distributions • cash .15 9,392.
6) Withdrawals and distdbutions • property J6
7) Ending capital account J7 3,397.
8) Method of accounting (mai/can X In the eppropriete box)
M Tax basis GAAP OSock EJ Other (svbrrdt explanation)
K Resident status (mark an X In &boxes that apply*
CI NYS full•year resident Yonkers full-year resident U NYC ful-year realdent
C NYS part-yea- resident = Yonkers parbyear resident Ei NYC part-year resident
IT NYS norresident 17 Yonkers nonresident
L If the partner was included in a group return. enter the special NYS Identification number, If known L
muilifii2i111111111 212451
11-'9 12
CONFIDENTIAL SDNY_GM_00033125
EFTA_D0143738
EFTA01280265
Page 2 of 4 4T-204-IP 012) •
11 1) Wee Form IT-2868-E filed writ- the partnership? 151 Yea 0 No 0
2) Was Form MTA406E filed with the partnership? rA2 rod= No 0
N NYS estimated tax paid on behalf of partner (fromFonn IT-2658) Date Amount
1) First instalment NI
2) Second installment N2
3) Third Installment N3
4) Fourth Vistallinent 114
Total NYS estimated tax paid on behalf of partner (addInes N1 through N4)
O Estimated MOUNT paid on behalf of partner erOM FOM7MTA-405) Date Amount
1) First instalment 01
2) Second Installment 02
3) Third installment 03
4) Fourth installment 04
Total 'shouted MCTMT paid on behalf of partner (addMesa/ through 04) 0
Partner's share of Income, deductions, etc.
A - Partner's distrbutive share hems B - Federal K-1 amount C - New Yo-k Stale amount
1 Ordinary business income (loss) 1 1
2 Net rental real estate Income (loss) 2 —27,051. 2
3 Other net rental Income (loss) 3 3
4 Guaranteed payments 4 4
6 Interest income 5 5
6 Ordinary dividends 0 6
7 Royalties 7 7
8 Net shorttemi capital gain (loss) 8 8
9 Net lor.g-term capital gain (Ices) 9 9
10 Net section 1231 gain (toss) 10 —54. 10
11 Other income Ooss) Identify: 11 11
12 Section 179 deduction 12 12
13 Other deductions Identify: SEE STATEMENT 13 739. 13
14 Tax preference Items for minimum tax 14 2, 515. 14
identify:
15 Net eamk-igs (loss) from selfomployment 15 15
18 Tanxempt hoome and nondeductible expenses 10 16
17 Distributions - cash and marketable securttles 17 9,392. 17
18 Distributions • other property 18 18
19 Other Items not ircluded above that we required to be
reported separately to partners 19 19
identity:
Partner's share of New York modifications (seeinstructions)
20 New York State additions
Number A - Total amount B New York State allocated amount
20a EA- 16 484.
20b EA-
20c EA-
20d EA-
20e EA-
201 EA-
21 Total addition modifications (total of coiumn A. lines 20a through 200. 21 484.
IIIIIII 111421111IllIIII 288452
WW-12
CONFIDENTIAL SDNY_GM_00033126
EFTA_00143739
EFTA01280266
IT-204•IP (2012) • Page 3 al 4
Partner's share of New York modifications (continued)
22 New York State subtractions
Number A • Total amount B New York State &boated amount
22a ES-
22b ES-
22c ES-
22d ES-
22e ES-
221 ES-
23 Total subtraction modifications (total of col✓mn A knos 22a through 22f) 28
24 Additions to federal Itemized deductions
Letter Amount
24a
24b
24c
24d
24e
241
25 Total additions to federal Itemized deductions (add lines 24a through 240 26
26 Subtractions from (edema itemized deductions
Letter Amount
26a
26h
26c
2fid
26e
261
27 Total subtractions from federal itemized deductions (add Mee 26a Through 26f) 27
28 New York adjustments to tax preference items 20
Partner's other information
29a Partner's shale of New York source gross income 28.
29b MCTD allocation percentage (see instructions) 294
Partner's credit information
Part 1 - Flow-through credit bases and factors
Brownfield redevelopment tax credit (Form IT-611 or IT-671.1)
A - Fawn IT-611 Et - Form IT-611.1
30 Site preparation credit component 30 30
31 Tengble property credit con'pcner.t 31 31
32 On•site groundwater remediaticn credit component 92 32
11800 3121019
MUM
11.19-72
CONFIDENTIAL SDNY_GM_00033127
EFTA_00143740
EFTA01280267
Page 4 of 4 •IT-204•IP 12012)
Partner's credit Information (continued)
EZ capital tax credit (Form IT-602)
33 Contributions of money to EZ community development pro)ects 33
34 Recapture of credit for Investments In certified EZ businesses 34
36 Recapture of credit for contnbutions of money to EZ community development prorate 35
QEZE tax reduction credit (Form IT-604)
36 QEZE employment increase factor 35
37 QEZE bone allocation factor 37
38 QEZE benefit period factor 36
Excelsior Jobs program tax credit (Form 17.607)
39 Excelsior jobs lex credit component 30
40 Excelsior investment tax credit component 40
41 Excelsior research and development tax credit component 41
42 Excelsior real property tax credit component
Farmers' school tax credit (Form IT-217)
43 Acres of qualified agricultural property 43
44 Acres of qualified conservation property 44
45 Eligible school district property taxes paid 45
45 Acres of qualified agricultural property converted to r.onqualified use 46
Other flow-through credit bases and factors
Credit bases
Cods Amount Code Amount
47a 47d
47b 470
47c 471
Credit factors
Code Factor Code Factor Code Factor
47g 47i 47k
47h 471 471
Part 2 - Flow-through credits, addbacks and recaptures
48 Long-term care insurance credit (Form IT-249) ....... 48
49 Investment marl (Including employment Incentive credit and historic barn nattilltatIon credit FormIT-214 40
50 Research and development • investment credit (Form IT-212) 50
51 Other flow•through credits
Code Amount Code Amount
51. 51e
51f
51c 519
5141 51h
52 Addbacks of clerks and recaptures
Code Amount Code Amount
52e 52d
521) 52.
52c 521
118004121019
I111IIII IIIIIIIIIII fIIIll111
p 2aSSII2
11.1902
CONFIDENTIAL SDNY_GM_00033128
EF1'A_00143741
EFTA01280268
MIDWAY PLANTATION LLC. 27-3304656
NY IT-204-IP OTHER DEDUCTIONS
AMOUNT FROM NEW YORK
FEDERAL STATE
DESCRIPTION SCHEDULE K-1 AMOUNT
AMORTIZATION 688. 0.
9. 0.
DUES & FEES
42. 0.
PROFESSIONAL FEES
739. 0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13
PARTNER NUMBER 3
CONFIDENTIAL SDNY_GM_00033129
EFTA 00143742
EFTA01280269
NC k-1 (39) 2012 Partner's Share of
(D-403) N.C. Income, Adjustments, and Credits
10.11.12 North Carolina Department of Revenue
or fiscal year beginning 01 01 12 waving 12 31 12
For calendar year
Partner's Identifying Number Federal Employer ID Number
203161309 273304656
Partners Name, Address, and ZIP Code Partnership's Name, Address. and ZIP Code
BLUE CHIP CAPITAL LLC MIDWAY PLANTATION LLC
27 HIGH TECH BOULEVARD 270 LAFAYETTE ST STE 409
NEW YORK NY 10012
THOMASVILLE NC 27360
Individuals Filing Form
Amount D400 Enter Amount on:
Partnership's Pro Rats Share items
All Partners
1. Share of partnership Income (loss) -27105
2. Additions to income (loss)
484 Page 2, Line 95
a. Addition for bonus depreciation
0 Page 2, Line 36
b. Other additions to income (loss)
9. Deductions from Income (.oss)
25 Page 2, Line 44e
a. Deduction for bonus depreciation STMT
739 Page 2, Line 49
b. Other deductions from Income (loss) STMT
0 Form 0-400TC
4. Share of tax credits
5. Share of tax withheld horn nonwageompensallOn
0 Page 2, Line 29
paid for personal services performed In N.C.
Nonresidents Only
0 Page 2, Line 51
6. Nonresident's share of N.C. bauble Income (loss)
7. Nonresident's share of net tax pald by the manager
0 Page 2, Line 24c
of the partnership
2602e1
12-20-12
CONFIDENTIAL SDNY_GM_00033130
EFTA_00143743
EFTA01280270
27-3304656
MIDWAY PLANTATION LLC.
ME
NC SCH K-1 DEDUCTIONS FROM FEDERAL TAXABLE INCO
AMOUNT
DESCRIPTION
42
PROFESSIONAL FEES 688
AMORTIZATION 9
DUES & FEES
739
TOTAL TO SCHEDULE K-1, LINE 3B
NC SCH K-1 DEDUCTIONS FOR BONUS DEPRECIATION
AMOUNT
DESCRIPTION
D BACK IN 2010 2.
ADJMNT FOR 1ST-YEAR DEPRECIATION ADDE 23.
ECIA TION ADDE D BACK IN 2011
ADJMNT FOR 1ST-YEAR DEPR
25.
TOTAL TO SCHEDULE K-1, LINE 3A
PARTNER NUMBER 3
CONFIDENTIAL SDNY_GM_00033131
EFTA_00I 43744
EFTA01280271
CONFIDENTIAL SON,M,013.
EFTA,103705
EFTA01280272
5
651112
Schedule IM
(Form 1066) Fo-cgoe-aar yoo, 20' cv
2012 0 Final K-1
!Mild≥ Partner'
FT Amended H-1
s Share of Current
CMB No.1545-009
Year Income,
Department of the Treasury ye onir, ng Deductions, Credits, and Other Items
Intl:my:I Revd ma Service 1 Ordinary business bcolrA (loss) 15 Credits
Partner's Share of Income, Deductions, O.
Credits, etc. ► See separate instructions. 2 kiwwwirow mete Irani Neel
—14,807. 18 Foreign transactions
3 Other net rental !acorns (loss)
Information About the Partnership
A Partnership's employer Identification number 4 Gt:aranteed payments
45-2929589
B Partnership's name, address, cky, state, and ZIP code 5 In erest trams
MIDWAY TRIAD, LLC clinarydivilencis
270 LAFAYETTE STREET, SUIT 409
NEW YORK, NY 10012
T
lib Duelled dividends
17 Alternative min tax (Awl) Items
A 2,554.
C IRS Center0119re partnership Med return
E -FILE 7 Royalties
18 Tax-exempt Income and
D Check it Mis Isa publicly traded partnership (PT') 8 Niel short-term capital gain (loss) nondeductble expenses
9a Net long-tens capital gain (loss)
Part II Information About the Partner
E Padres identifying number 9b Correctible& (28%) gain (loss) 19 Distributions
20-3161309 7,510.
F Part:vies name, address, cty, state, and Z.P code 9c Unnscaptured sec 1250 gain
20 Other information
BLUE CHIP CAPITAL LLC 1D Net sectic411231 gain (loss) •
27 HIGH TECH BOULEVARD
THOMASVILLE, NC 27360 11 Other Moms (loss)
0-0 General partner or LLC LinSted partner or other LW
Member-manager member
DU Domestic partner Li Foreign partner
it What typo of entty es this partner? PARTNERSHIP 12 Section 179 deduction
2 If this partner Is a retirement plan (IRAISEPAterigh/etc ). check here
J Partner's share cl profit, loss, and capital: 19 Other deductions
Beginning Ending STMT
Profit 1.1346999% 1.1346999%
LOSS 1.4641288% 1.4641288%
Centel 1.4641288% 1.4641288% 14 Selkmployment eartinga (LOSS)
K Partner's share of inabilities at year end: 0.
Nonrecourse 3,652.
Ouallited nonrecou financing 135,488. • attached 51 for i, nal infirm
Recourse O.
L Putter's capital account analysis:
Beginning capita; account 45,696.
Capital contributed during the year
Current year Increase (decrease) $ —14,753.
7,5104
I
Withdrawals & distributions V
Ending capital account 23,433.
FL Tax basis Li GAAP ri Section 704(6) book
LJ Other (explain)
IA Did the partner contribute property with a bellt-n gain or loss?
Yes f ZJ No
if 'Yes'. attach statement (SAO instngfions)
01-03-13 LHA For Paperwork Reduction Act Notice, see intro Mons for Form 085. IRS.gowiform1065 Schedule K-1 (Form 1085) 2012
5
13060311 758241
21146.21C ON FloD ENTIALLc 21146B1
SDNY_GM_0063.3133
EFTA_00143746
EFTA01280273
MIDWAY TRIAD, LLC 45-2929589
SCHEDULE K-1 OTHER DEDUCTIONS, BOX 13, CODE W
DESCRIPTION PARTNER FILING INSTRUCTIONS AMOUNT
DUES & FEES 3.
PROFESSIONAL FEES 19.
TOTAL TO SCHEDULE K-1, BOX 13, CODE W 22.
SCHEDULE K-1 CURRENT YEAR INCREASES (DECREASES)
DESCRIPTION AMOUNT TOTALS
RENTAL REAL ESTATE INCOME (LOSS) -14,807.
SCHEDULE K-1 INCOME SUBTOTAL -14,807.
OTHER DEDUCTIONS - 22.
SCHEDULE K-1 DEDUCTIONS SUBTOTAL -22.
NET INCOME (LOSS) PER SCHEDULE K-1 -14,829.
MADISON - PREPAID RENTS - CY -66.
MADISON - PREPAID RENTS - PY 132.
WILLOW BROOK - PREPAID RENT CY -24.
WILLOW BROOK - PREPAID RENT PY 34.
OTHER INCREASES OR DECREASES SUBTOTAL 76.
TOTAL TO SCHEDULE K-1, ITEM L -14,753.
PARTNER NUMBER 5
13060311 758241 21146.21 CON 2 21146 B1
FI CDENT TIAL LLC SDNY_GM_00033134
EFTA _00143747
EFTA01280274
5
Page 2
Schedule K-1 iFerrn 1D651 2012
Information for partners who flue
This list Identifies the tones used on Schedule K-1 for all partners and provides summarized reporting
see the separate Partners Instructions for Schedule K-1 and the Instructions
Form 1040. For detailed reporting and Ming Information.
for your Income tax return. Cate -1e:ox
J ?Joie epputwity Mehl
'r bra was N.Off • (c t, Jaen, newtse.'ne 1Come eose)th
K Desk: Jo:cassaeot
perm. Cr unpnralve WC ear 01yes/cur/ et rotor.
L Ennewerwol zone end anon+
oomt..ety ernerynent oxC 1 See tit Putes Inv In.CUOv.
HWY. on :12 lents.% resew*
uctw..„8
SI Ctet
Panto lo ss See noPenwe Lrentetler
Pitatvo Wore Scred.. • E. One 28. Wont (qt N CHOW errobsw *We neatly
Nor Oteeteloee Seed. • E, 'x21 inure (5] end Mn Owe tree
Irrinstre nor° Scetaule E. M28. cosire O FladcupWVININling
2. 'ost tend yal as tat Inevro MN See tinPima's Inc/odor P Onrendts
3. One. -,et /err In n's SooN
IS. Prep, brescler•
Ne, Schelde F, Ilse 28. on air oe
powego
A tiend Of o
ernY 0/00,
Net loss Seel. ostler r1/1/212•4
4. clufrenind Serlecb Scharr E. line 28 cob. xn 8: } For 1118 coil
D Oesea borne !ion WI soma
f. atnt INGOT. Pr 1040 ens 8e
O Orr Incone soused et parne
Fore IOiQ Mr 9e
de 0 -0Nary dh cores leer
For 10(0."w 0u
OJe Stet CNC...CS
&Yalu* E. pan
Neer yry erred at prtnerehle swel
becer
com
cree
7 %tree
8. Set shorten ceoltr 9eb ea* ScINKIUle D. re 0 o
W. \at to-t ewm mot ail ( 0460
Schedule 0, re 12
WS Nee Cleln Worried, le 4
E GOMIS SSW } Fenn 1116 Pail
90. Greeter arm own (sos; F Ohs'
l*beer.D eatruclIns)
Sc Ur Warred *Kelm 1260 fie.1 Sr en ortrois I netellerne 0oluCtiOns eberen rid eaowirled C p•Nrie tel
O beret expense For 11'6, owlI
'C. NE act" 1231 Mt 3bee; See Out Paints Instructions
H 0-10/ NM, 11. 6, hest
'1. Oder Iron Pert)
Cede Didtacce War/ zed *mired et aertiereh.9 ltd i0 blip - 0001X11
A Other be/Volk noerre bor Sas thePadres Menuelfene Inns
B invelsnory corrosions Soo IS Penneee Iniefuefens I Porn roger
Form 67.51, MO I Omer celegor } Fe/in111S Pahl
C Sac. 1248 cornee} seranlee
O %tell erpcnitlen oc.S repeWee See Pub. 636 OW./
.K T
E Credos. Dryad Fore 1040, One 21 of Fere 982
Orr Abraders
F Chts/ %erre Pose) err Pertrefe relnieder Ern 1118, Per. II
to' OM
We the Peeler •►reueder M TCJI *Mr tnn 0,04. 3 Few 1111Piet I
12. SeCten 179 deduct's
N Reduces., In twee eVellabit Oen Fore 1116, line 12
13. Othersrlue-lant EvenIS/3
O Herr twin; pun WW40
I
A 040 Oot., oJtcee (COW P WOW° =ISM worn 08/3
8 Ce•P cotMot t 0054) See tie Pertnono trotrObes
O OTw'uMign seenSe0Sore
C NOTC4130 oatStuecela ROsfoi
• \crag onneut (3098 See Ole Partw's Inokuotwe
E Capita grin platy :et a 60% 17 Alterrno n -run SIX (A1.48 bens -I
A Art 1588 cepenerleneelurinn
I
oger sann (30%)
See re Pemens
F Capri gele ornery 9054) • &Eons/ ger cons
Iner.ctIone and
O ConnItsubsne (100%) G Deplete lotiV Own ON & poi
ram 4962 Pro I 2.4 Instrcerne bt
H Irretrrent inteteet ewer D 28, gr, & pothered woes rare
&radio E.14•19 Fern4261
I Deducier• /worn near F C4. WAS B tronerei dentbens
SW_on 5808; expnednee Seethe Faints Intrnollcrie F Other NJ/ Nee
K Dec Mon • percle ErA tat Schnicle A ene 23
Worn A, Nnen 18. Tax-rerrot were sew nonec arisio roe re
• Dec nitro • portbr (ant Fpm '040 Ire orb
Sandie* entice Rem 1044 sr 20 A Itotetewt weed 1, 03TO
• Arcurts celd kencecal'motor time Ise Pones hesuonsms
See en owner Metn.ct.Ons ▪ Otlerax-exernot Nana
• /odor eseirence born See In Peeler lnernikele
kyr Stet nee 12 o mmeinkvrve everted.
O ;opener care Leen.
P Preptoduvre cern.' evades See Ito Parser neteclons 19. Dltreolone
O Corrre•cr Fr taken/ deducien See Fon 8542 Iretnnecos A Can find Tatetebleoccuiths
from MOW ft-±3 *ebbs ecru O Diet tcn nJejet.:110 egnew 73/ } See to s Inetn-ctiors
R Pens one arc. Ift/o See the P5 We Inseam
O One poppy
• firarestatbs roper. deducde Sr the Perr i s Innsellens
Eterster plosixtke WNW* Sr For 8903 tetra:Ire 20. Ototenexcelter
A Inverren. Warr* torn 4952.''M 4e
lido ton Fern 4452 ns 5
U OJa (Pod waktike KW'S inoerre to- eV:02 to 7n ▪ 'everrsrc spent.
Fern WA We 17 C auras awn ber Mice Fern 4. 38
✓ ervoces Fenn r-2 Hero
W Ovwdeerdens Seetr.xtree andines • Ocalied nisChIrclon eoweit."es
(Mbar then festal fee! Wale) See to Pew', '687..erbne
e &eels Comm, preen. See to Pertia/A at, As
IA SottorloyreentrWrot F XI0000:1.19(.4 2Gte-In:nna fouirc
ate I:Action A2CIV F011. 86. 1, Ilne
NM yet ter a .ecton 178 crecacct co Cc" Per reNNIS SetJSONNe. eta
the Pieta s esertons tans Num eting Sonekule lF O Recicare of low. lochNI hcveng
cox:: MINN 00111491i, line 8
A Net earner 35es; her Sordule Si. Seam A 0/ H fter,eatule uPtIve4itTer: emir. se• Fe,, Cm
erfnemp oversee I FteCepture el otar credit, se. bePutt.. Imonetene
▪ Snous testing WOW% rotas See the Parser Instrudor •
J .004 auk ir.Wret - eS•rolet01
C Goons reinsertion/re Sr to Pertnen. Inerntors See Rem POB7
atteer crime/
▪ LOCk.bace Wars' -1044'00 '04,023,
15. Car. Is We (Wm 8.366
01W100
1
A Low retro 1noserg rent I. OleFoolkos of repot, ANN
Weir 428(56 tram pie.2608 soNicr • 79 cioNa:NeN
bdtellon M Ro ve erect° 1 /11 deduct's
n Low-Ircense /wringroll (other) N Wrest erzense ser ono/oft partneri
from pee-2X51:0!0'11P O Soren 453(028 Honer CA
O LoVhfroor Poring innt(rolen P &ace demo Werrion
421919, her peet-2W7 ws
See the Potreo rend one O Sedeco1241019 hkortrkei
Co Low-Ircennouteleg OWE @WO Ft Mares: a rase to plecucion erne Pertnies
ten peet-21X/7 btin nos eXpondltwee Inetrvetken
E Iled renberdos exprennes $ C..t nabcurtli tel veltrervali•
herr re wog T Dopricn infort en - el aid cos
▪ Othr err rsel Won credh U Arranyern of -doter*, *tab
O °trete , 0.033 ✓ Wrier hintiess tow* Inure
▪ Lwellettltnn owls ds owl t Corn 1013 Me 71, Ghee,: Ws I
Vi Frosittretar
Ann OIC'.10 fuels See le Pinner I/ebbs-tar
X Seeton 17.150 Informal oi
Wed' ✓ Otte irsonce:Jon
211262
C1-0013
5
21146 81
13060311 758241 21146.21CON2RDENTIALLEC
SDNY_GM_00033135
EFTA_00143748
EFTA01280275
5
STATE OF NEW JERSEY 1019
SCHEDULE'
NJK-1
(Form NJ-1065)
PARTNER'S SHARE OF INCOME
2012 For Calendar Year 2012, or Fiscal Year Beginning , 2012 and ending
PART I General Information
Pines SS / or Fan (IN ,,artnotsro • :Kra Bk
20-3161309 45-2929589/000
Potties Nemo Proranolp's Nano
rBLUE CHIP CAPITAL LLC IDWAY TRIAD, LLC
ohm/wan.. Petwon!rio StwetWoonso
27 HIGH TECH BOULEVARD 70 LAFAYETTE STREET SUIT 409
City etat coy
THOMASVILLE NC 27360 rPQs BW YORR, NY 10012 3" BP On
mat type of entity IS partner? NP Enter Partners percentage ot.
(0 Befoul Decrease (II) End of Year
(see instructions) Code
or Termination
08/05/2011 Prott Martin 1.1346999% 1.1346999%
Date Pa ((nen interest in Partnership began:
pamin ow 'Alt LOSS Sharing 1.4641288 % 1.4641288 %
RIM NJK-1 n Hedge Fund Cmitaltww00 --171341/118% 1.4641288%
Amended NJK-1 1 Member of Com ste Return
PART II Income Information
NJ-1040 Filers I B. New Jersey
A. Total Distribution Enter Amounts on NJ•1040KR Filers
Income Ciassifications Source Amounts
Line Shown Below
1 Pe tali Marne (loss) -14,669.
2. Net Guaranteed Pa merits
3. Partners 401(a) ContrroutIon
4. Distributive Share ol Partnership
Llne 20, Page 2 Line 22, Par 1
Income (loss) I I
(Lite 1 plus Line 2 minus Une$) —14,669.
.* ., ....
—
5. Pension Line 19, Page 2 I
6. NM Gain Doss) from Obposition
of Assets as a Result of a Line 18, Paget Une IC. Page 1
Comdata Liquidation
PART III Partners Information
Line 19a, Page 1 CBT-100
line 10a, Page 1 CBT-1006
Line 8, PART-100
1. Une 4E, NJ-1040NR
1. Nonresident. Partner's Share of NJ Tax
Lire 22, NJ-10800
Line P
3126J-1041
2. IMS6fri r U1.2—...
2. Partner's P.EZ Deduction Thtle41, YCL
7faS 'Pe.ts:
t •
3. Partners Sheltered Workshop Tax Credit .
ai
PART IV Supplemental Information (Attach Schedule)
I
THIS FORM MAY BE REPRODUCED
2switit
12-N-12
13060311 758241 21146.2100214F10 ENTAIL LLC 21146_S1
SONY_GPA_00033136
EF1'A_00143749
EFTA01280276
MIDWAY TRIAD, LLC 45-2929589
NJ NJK-1 GIT-DEP PRO-RATA SHARE
AMOUNT TOTAL
DESCRIPTION
FEDERAL DEPRECIATION O.
NJ SECTION 179 DEDUCTION ALLOWABLE O.
NJ DEPRECIATION ALLOWABLE O.
0.
SUBTOTAL
NJ ADJUSTMENT TO FEDERAL 179 RECAPTURE INCOME O.
NJ ADJUSTMENT TO FEDERAL GAIN (LOSS) ON
DISPOSITION OF ASSET(S) O.
0.
SUBTOTAL
160.
NEW JERSEY DEPRECIATION ADJUSTMENT
1h10_LIZARTNER NUMBER 5
21146 B1
13060311 758241 21146.21CON2FIDENT
SDNY_GM_00033137
EFTA_00143750
EFTA01280277
New York State Department of Taxation and Fhance
New York Partner's Schedule K-1
IT-204-IP
2012
Tax Law - Article 22 (Personal income Tax)
01-01-2012 and ending 12-31-20 12
E Final K-1
Amended K-1
5
For calendar year 2012 or tax year beginning www.tax.ny.go v).
Instrych`ons for Form IT-204-IP (available at
Partners: Before completing your income tax return, see Form IT•204•1P-I, Partners
Partnership's Information *soot/coons) Fartnership's EIN
Partnership's name (as shown on Form 1T-204)
45-2929589
MIDWAY TRIAD, LLC
i J Publicly traded prrtnerehlp C Portfolio Investment partnership
A Mark an X In the box If either applies to your entity
B
B Tax shaker registration number, t any
C %
C Business allocation percentage
Partner's Information (see Insbuctions) Partner's Identifying number
Partner's name
20-3161309
BLUE CHIP CAPITAL LLC
Partner's address
27 HIGH TECH BOULEVARD State DP code
City
THOMASVILLE NC 27360
General partner or LLC membehmanager al United partner or other LLC member
D The partner is a ruin, or A' it re =owl* box: Ei
ILI Individual Ei EstateArust FED Partnership
E What Is the tax filing status of the partner? tree, in X., ele woos,' to* .1lower
)
F if the partner lea disregarded entity or grantor trust,
F
enter the tax ID of the entity or Individual reporting the Income, If known _
G Yes _ No aCI
G Cid the partner sea its entire interest during the tax year?
Beginning Ending
H Partners share of profit, loss, and capital 1.1347
H1 1.1347 % %
1) Profit % 1.4641 %
H2 1.4641
2) Loss 1.4641 %
H3 1.4641 %
3) Capital
I Partner's share of EatAlines at the end of the yew 3,652.
I1
1) Nonrecourse 135,488.
12
2) Qualified nonreocurse financing
13
3) Recourse
J Partners capital a000unt analysis 45,696.
J1
1) Beginning capital account
J2
2) Capital contributed during the year • cash
J3
3) Capital contributed during the year • property -14,753.
J4
4) Current year Inoreaee (decrease) 7,510.
J5
5) Withckawals and cilstibulons - cash
J8
8) Wohdrowals and distributions - property 23,433.
J7
7) Ending capital account
8) Method of accounting (rnwk an Xi!? the appropriate box)
X Tex basis C GAAP 0 Book L J Other (submit avian/idea)
K Resident status (mark an X in WIboxes that apply)
C NYS full-year reskient Ll Yonkers full-yew resident El NYC fuillew resident
r i Yonkers pert-year resident C NYC pert-year resident
NYS parties: resident
M NYS nonresident t__J Yonkers nonresident
return, enter the special NYS Identification number, if known L
L If the partner was Included In a gaup
118001121019
IIIIIIIII H111IIIIIIIIIIIIIIIF
2Silfr.1
CONFIDENTIAL SDNY_GM_00033138
EPTA_D0I 4375 I
EFTA01280278
Page 2 o14 IT:204-IP (2012)
M1 Yes 0 No El
PA 1) Was Form IT-2858•E filed with the partnership? M2 Yes D No CI
2) Was Form MTA-405-E filed with the partnership? Date Amount
N NYS estimated tax paid on behalf of partner(hOmForm /T-2558)
RI
1) Rratinste/Iment
N2
2) Second Installment
Ira
3) Third Installment .
554
4) Fourth Installment
N4) N
Total NYS estimated tax paid on behalf of partner (add fines N1 through Amount
Form ref/A-405) Date
O Estimated MGTMT paid on behalf of partner (horn
01
1) First Installment
02
2) Second installment
O3
3) Third installment
04
4) Fourth Installment
04) O
Tote) estimated MCTMT paid on behalf of partner (add lines 07 through
Partner's share of income, deductions, to. B - Federal K-1 amount C - New Ycrk State amount
A - Fartner's distributive share items
1 1
1 Ordinary business Income (loss)
2 -14,807. 2
2 Net centre. real estate Income goes)
3 3
3 Other net rental Income toss) 4
4
4 Guaranteed payments
5 5
5 Interest Income
6 8
5 Ordinary dividends
7 7
7 Royalties
8 13
8 Net short-term capital gain (loss)
9 0
9 Net bag-temp capital gain Goss) 10
10 Nei section 1231 gain (loss) 10
11 11
11 Other Income floss) Idoolitr 12
12
12 Section 179 deduction 22 .
SEE STATEMENT 13 13
13 Other deductions identify: 14
14 2,554.
14 Tax preferer ce Items for minimum tax
identity:
16 15
15 Net earnings (loss) from selfemployment 18
18
18 Tax-exempt Income and nondeductible expenses 7,510. 17
17
17 Distributions • cash and marketable securities 18
18
18 Distributions -other property
19 Other items not Included above that we required to be
19 19
reported separately to partners
Identity:
tions,
Partner's share of New York modifications/seeinstruc
20 New York State additions
Number A - Total amount B - New York State allocated amount
425. 425.
20a EA- 16
20b EA-
20c EA-
20d EA-
20e EA-
201 EA-
425.
through 201)
21 Total addition modficatIons (rota, of column A lines 20a
11111i1111111111
18111i
III11 28118a2
11-19.12
CONFIDENTIAL SDNY_GM_00033139
EFTA 00143752
EFTA01280279
IT-204-IP (2012) Pees 3 of 4
Partner's share of New York modifications (continued)
22 New YorK State subtractons
Number A- Total amount B - New York State allocated amount
22a ES- 21 265. 265.
22b ES-
22o ES-
22d ES-
22e ES-
22f ES-
23 265.
23 Total subtractior. modifications (total of column A lines 22a through 22f)
24 Additions to federal itemized deductions
Letter Amount
24a
24b
24o
24d
24e
241
25
25 Total addhions to federal itemized deductions (add Ones 24a through 240
28 Subtractions from federal itemized decoctions
Letter Amount
26e
26b
28c
26d
26e
261
27
27 Total subtractions from federal itemized deductions (add lines 28a through 260
28
28 New York adjustments to lax pretererce items
Partner's other Information
29a
29a Partners share of New York source grosa income
29b °la
29b MCTD allocation percentage (see rastructrons)
Partner's credit Information
Part 1 - Flow-through credit bases and factors
Brownfield redevelopment tax credit (Form IT-,611 or IT-611.1)
A - Form IT-611 B - Form IT-611.1
30 30
30 Site preparation credit component
31 31
31 Tangible property credit component
32 32
32 On-sits groundwater remediation credit component
118003121019
(I Iii l1IIIIlill
nIIIIIII11111111
CONFIDENTIAL SDNY_GM_00033140
EF1'A_00143753
EFTA01280280
Rage 4 of 4 It:EGt-IFI (2014
Partner's credit Information (continued)
EZ capital tax credit (FormIT-602)
33 Oontributlans of money to EZ community development projects 88
34 Recapture of credit for Investments in certified EZ businesses 84
36 Recapture of credit for contributions of money to EZ community development projects 35
OEZE tax reduction credit (FormIT-604)
36 QEZE employment increase factor se
37 QEZE zone &location facto 37
38 QEZE benefit period factor 98
Excelsior jobs program tax credit (Form IT-607)
39 Excelsior jobs tax credit component 30
40 Excelsior nvestment tax credit component 40
41 Excelsior research and development tax credit component 41
42 Excelsior real properly tax credit component 42
Farmers' school tax credit (Form IT-217)
43 Acres of quarried agricultural property 48
44 Acres of qualified conservation property 44
45 Eligible school district proorty taxes paid 45
46 Acres of qualified agricultural property converted to nonquaifled use 46
Other flow-through credit bases and factors
Credit bases
Code Amount Cods Amount
47a 47d
47b 47e
47c 47f
Credit factors
Code Factor Code Factor Code Rioter
47g 471 47k
47h 47j 471
Part 2 - Flow-through credits, addbacks and recaptures
48 Longterm care Insurance credit (Form IT-249) 48
49 Investment credit (naiding employment incentive credit and Nato* bent rehabilitation credit; FormIT-212) 49
50 Research and development • investment credit (Form IT-212) 60
51 Other flowthrough credits
Code Amount Code Amount
51a 614
51h 611
51c 519
51d 611i
52 Addbacks of credits and recaptures
Code Amount Coda Amount
52a 52d
526
52c 52f
21IIIIII III
HI II11811111 28819072
11-19-12
CONFIDENTIAL SDNY_GM_00033141
EFTA (10143754
EFTA01280281
45-2929589
MIDWAY TRIAD, LLC
NY IT-204-IP OTHER DEDUCTIONS
AMOUNT FROM NEW YORK
FEDERAL STATE
SCHEDULE K-1 AMOUNT
DESCRIPTION
DUES & FEES 3. 0.
PROFESSIONAL FEES 19. 0.
22. 0.
TOTAL TO FORM IT-204-IP, PAGE 2, LINE 13
CONFIDENTIAL SDNY_GM_005
PARTNER NUMBER 033142
EFTA_00143755
EFTA01280282
NC K:1 (39}. 2012 Partner's Share of
(D-403) N.C. Income, Adjustments, and Credits
10.11.12 North Carolina Department of Revenue
For calendar year or fiscal year beer nine 01 01 12 and ending 12 31 12
Partner's IdeMilyIng Number Federal Employer ID Number
203161309 452929589
Partners Name, Address, and ZIP Code Partnership's Name, Address, and ZIP Code
BLUE CHIP CAPITAL LLC MIDWAY TRIAD LLC
27 HIGH TECH BOULEVARD 270 LAFAYETTE STREET SUIT 409
NEW YORK NY 10012
THOMASVILLE NC 27360
Individuals Filing Form
Amount 0-400 Enter Amount on:
Partnership's Pro Rata Share Items
All Partners
1. Share of partnership income (loss)
—14807
2. Additions to income (less)
425 Page 2, Line 95
a. Addition for bonus depreciation
0 Page 2, Line 36
b. Other Winans to hieome (105s)
3. Deductions from Income (loss)
265 Page 2, Line 441
a. Deduction for bonus depreciation STMT
22 Page 2, Line 49
b. Other deductions from income (loss) STMT
4. Share of tax credits
0 Form D-400TC
5. Share of tax withheld from nonwsge compensation
0 Page 2, line 23
paid for personal services performed in N.C.
Nonresidents Only
0 Page 2, Line 51
6. Nonresident's share of N.C. taxable income (loss)
7. Nonregdent'S share of net tax paid by the manager
0 Page 2, line 24c
of the partnership
12-20-12
CONFIDENTIAL SDNY_GM_00033143
EFTA_00143756
EFTA01280283
45-2929589
MIDWAY TRIAD, LLC
NC SCH K-1 DEDUCTIONS FROM FEDERAL TAXABLE INCOME
AMOUNT
DESCRIPTION
19
PROFESSIONAL FEES 3
DUES AND FEES
22
TOTAL TO SCHEDULE K-1, LINE 3B
NC SCH K-1 DEDUCTIONS FOR BONUS DEPRECIATION
AMOUNT
DESCRIPTION
2011 265.
D BACK IN
ADJMNT FOR 1ST-YEAR DEPRECIATION ADDE
265.
TOTAL TO SCHEDULE K-1, LINE 3A
PARTNER NUMBER 5
CONFIDENTIAL SDNY_GM_00033144
EFTA_00143757
EFTA01280284
ENBRIDGE ENERGY PARTNERS, L.P.
44AUTOAASO 3-OIGIt 334 77 PS3 776SIAA22-2-I
12315 2 AT 0.364
BLUE CHIP CAPITAL LLC
320 SEABREEZE AVENUE
PALM BEACH FL 33480.8132
Enclosed is your 2012 Schedule K-1 tax package. Please refer to the enclosed Individualized
Income Tax Reporting Package and Instructions for additional information. Also enclosed is the
complete Internal Revenue Service Instructions for Schedule K-1 for additional guidance.
In addition to the Schedule K-1, this tax reporting package includes your State Schedule (on the
reverse side of this page), your Sales Schedule (if applicable) and your Ownership Schedule.
Additional information may be found on our website at www.taxpackagesupport.com/enbridge. You
may request changes to information provided on the Schedule K-1 and have additional copies of
your K-1 printed.
If you would like to receive this information earlier and eliminate the need for mailing a paper K-1 in
the future, simply go to www.taxpackagesupport.comienbridge, register your e-mail address, and
choose the option to "Eliminate Paper K-1s". By choosing to eliminate paper K-1s, your tax
information will bypass the U.S. Postal Service and be delivered securely through the website. We
will notify you via email when the K-1s are available.
Supplemental Schedule K-1 Information is found below.
2012 SCHEDULE K-1 STATEMENT INFORMATION
K-1 CODE DESCRIPTION AMOUNT
131-1 Domestic Production Gross Receipts (DPGR) 51,253
1372 Non-Domestic Production Gross Receipts (non-DPGR) 49,848
1313 Cost of Goods Sold allocable to DPGR 38,435
1374 Cost of Goods Sold allocable to non-DPGR 31,565
13T5 Ex_aanses directly allocable to DPGR 10,869
1376 .enses directly allocable to non-DPGR 21,384
1317 Expenses indirectI llocable to DPGR 1,023
13T8 Expenses indirectly allocable to non-DPGR X041
13T9 Form W-2 Wages 0
20Y1. Gross Receipts 101,120
ITEMS TO NOTE - IRC Section 743(b) adjustments have been included in Box 1 if applicable
.w„.220,1,UAI4 CONFIDENTIAL cnmy am nIttt31`914""'
EFTA_00143758
EFTA01280285
2012 STATE SCHEDULE
ENBRIDGE ENERGY PARTNERS,L.P.
PARTNER NAME: BLUE CHIP CAPITAL LLC
ACCOUNT NUMBER: 141 0022295139
PARTNER FEDERAL ID/ENTITY: 20-3161309 / PARTNERSHIP
CUSTODIAN FEDERAL ID:
PARTNERSHIP FEDERAL ID: 39-1715850
TM SHELTER REGISTRATION NUMBER 92008000124
State Information
(oat,roundng and other Federal and Sate differences, totals may not agree to Federal totals)
CO a) .31 (4; (5) IIU a; Oh Cs,
ail s Net Whey ammo( Ha Sauton12314a er Sheen 1245 GO Poeta., Pia Stwl-Tar,' Pate° from* Imam IIVOS011an! Litre Allernalt. Menrrun Tie GvnRicatet aa's .nceme, Tax Adebick
Loa(-) Is 0 Cade Gin 0 teal(-) ciihrwesonAdratmeid
AL I -42 4 563
AR -23 2 307
FL -12 ¶ 156
GA -22 2 297
II. -212 20 2.813
IN -16 '1 209
KS -217 20 2,878
KY -1 0 12
LA -290 28 3,966
MI -250 23 3.310
MN -452 42 5.990
MO -47 4 617 1
MS -169 16 2.237 3
MT 0 0 I , 0 3 0
NC -7 0 I 1 se 0
ND -277 I 0 25 3.880 v 5
MY .3 0 I 0 41 0
OK -983 0 al 13,036 18
PA -15 0 0 1 193 0
SC 0 0 .1 0 3 0
TN -15 0 ! • 1 203 0
WI 432 0 I 31 seitte 5
WV -2 I 0 0 21 0
This schedule 51IMMEN120,1 your allocable stare of the Partnership's state tax items based on your unit ownership as reported on the Ownership Schedule. You need this Information to prepare your state
Income tax returns. Separate allocations and tax calculations were made for each lot of Partnership units. The sum of these calculations was accumulated to simplify your state tax reporting obligations.
These amounts are based on the information reflected on your Ownership Schedule. Each line represents your stare of income tax Items for certain states in which the Partnership had operations. Each
state Is Identified by a two-letter code shown to the far left hand column of this schedule. Differences between the sum of amounts in the state information and the federal information (found on Schedule
K-1) are due to rounding and variations between state Income tax laws. You may be required to file state Income tax returns in these states. Please refer to the attached Instructions for additional
discussion regarding your state income tax filing requirements.
The State Income Tax Addbedc is to provide EEP's investors with information necessary to accurately prepare their state income tax retum(s). Each state's filing requirements are unique, but there are
some states that require an addback of state income taxes. This column represents each investors apportionable share of the particular state's addback. For further queslions. please consult your tax
advisor or refer to the state websiteicontact information provided to you in your Individualized Instruction packet This information Is for state income tax returns only and should not be used in the
investor's federal Income tax return preparation.
Do not attach these schedules to your Fedora' or Slab Income Tax Returns. See tax Information instructions for notes and other information.
IMPACIS'IZPWA
EFTA01280286
011
2012 OWNERSHIP SCHEDULE
ENBRIDGE ENERGY PARTNERS, L.P.
PARTNER NAME: BLUE CHIP CAPITAL U -C
ACCOUNT NUMBER: 141 0022295139
PARTNER FEDERAL ID/ENTITY: 204161309 / PARTNERSHIP
CUSTODIAN FEDERAL ID:
PARTNERSHIP FEDERAL ID: 39-1715850
This schedule contains a summary of your unit ownership history from your original acquisition of Partnership units to December 31, 2012. This
Information came directly from tho transfer argent s records if you are a registered holder.
Ovmorship information for street name owners (who hold units in a brokerage norneme account) was provided from your brokers or nominee's records, if
tho broker or nominee provided the Information In accordance with Internal Revenue Code Section 6031(c). IRS regulations concerning partnerships
require brokers and nominees to inform the partnership directly of your unit activity so that the partnership may automatically furnish you with tax
Information.
If you held multiple lots of Partnership units, the ownership information has been accumulated for oath lot having a common federal lax identification
number and entity type, except for lots attributable to an individual retirement account (IRA), Keogh or similar type of account, which are reported in a
separate package. For IRA, Keogh. or Pension accounts, the federal tax Identification number of the custodian Is shown. You will receive a separate
indlvklualized Income Tax Reporting Package for each lot with a different tax Identification number. Dispositions of Partnership units have been treated
as If they relate to the Ids with the earliest acquisition date.
If your records do not agree with the information reported on this Ownership Schedule. then the amounts reported on the following schedules
may not be correct To correct this, you can make changes on our webaite at www.taxpackagesupportcontionbridge. You can also make the
necessary corrections directly onto this schedule, Including any necessary explanations, sign where indicated and mail before May 31, 2013 to:
Investor Relations
Enbridge Energy Partners, L.P.
PO Box 799080
Dallas, TX 75379
or you may contact our K-1 Call Center (provided by a third party on behalf of the Partnership) by phone at (800) 525-3999. by fax at (866) 554-3842.
The partnership will be filing a Schedule K-1 with the IRS based upon amounts reported In this Individual Income Tax Reporting Package. If you have
notified the Partnership of any necessary corrections prior to May 31, 2013, the corrected Information will be flied with the IRS. Any corrections made
altar this date may require you to fie Form 8082-Notice of Inconsistent Treatment or Administrative Adjustment Request (AAR) with your return.
You may find it necessary to extend your filing date for your personal lax return by filing Form 4868 - Application for Automatic Extension of Time to File
U.S. Individual Income Tax Return by April 15, 2013.
If the Ownership Schedule Is the only schedule containing Information (I.e. Schedule K-1 is blank), then your ownership history received from
the transfer agent, brokerage firm or nominee, Is Inaccurate or incomplete. Please contact the Partnership for instructions on how to proceed.
Transaction Description This Is the typo of transaction for the group of units involved. The "Desuiption• column provides explanations for the
abbreviations used in this column.
Transaction Date - This is the date on which the transaction occurred as reported to the Partnership by either the transfer agent (if you aro a registered
owner) or by your broker or nominee (if yew units are in street name).
Broker Code or Certificate Number - This column will indicate a broker I.D. It the transaction was reported to the Partnership from a broker or nominee.
This column wit also report a certificate number for transactions registered with the Partnership's registrar.
Units - This is the number of Partnership units associated with oath certificate or transaction less arty sales applied to that transaction.
Investor Tax Information (Schedule K-1) may be accessed through our wobsite at ihww.taxpackagesupporl.conVenbridge.
NOTE: THIS OWNERSHIP ACTIVITY SCHEDULE IS NOT PROOF OF OWNERSHIP NOR SHOULD IT BE
CONSTRUED AS PROOF OF OWNERSHIP IN ENBRIDGE ENERGY UNITS.
TRANSACTION
BROKER CODE OR
DESCRIPTION DATE CERTIFICATE NUMBER UNITS
ft C BUY 12-11-2009 141 3 920.0000
END OF YEAR UNITS 3,920.0000
If the Information reported on this schedule dons not accurately reflect your ownership history through December 31, 2012, please note any corrections
that need to be made. By signing this schedule, you authorize the Partnership to make the axtections indicated above.
rwwashe $4.
Signature
- C&INF parrot
EFTA_OO14376O
EFTA01280287
651112
0 Filet K-1 0 Amended K-1 OMB No. 1545-000
Schedule K-1
(Form 1065) Z.012 =gip; -P4,eilteatbitocatirstitzykaoticotk.t4:4
t;D
1 Ordinary business Income (Vett) 15 Crocks
Deportment of Lho 'Resets, For calendar year 2012, or lax
Internal Revenue SENVICO -7,624
yore beglmting , 2012
ending , 20 2 Net metal real oblate InCOSTIS (loss)
Partner's Share of Income, Deductions,
Credits, etc. See heck of fern and separate instructions. 3 Otter not rental inflow (loss) 15 Foreign transactions
Pan I . :information About the Partnership TS.:...e.V.4."-24.
A Partnerships on'plow- donut:taboo rOSOr 4 Guaremood payments
39-1715850
5 a-4°mM Income
B PerbeweNes name, address, oily, slate, and ZIP code
ENBRIDGE ENERGY PARTNERS L.P.
0 Ordinary dividends
1100 LOUISIANA
SUITE 3300
HOUSTON TX 77002 6b Qualified dividends
? Royalties
C IRS Center where partnership filed robin
Ogden, UT
s NQt thomenn capital gain foes)
El Check Ygds is a publicly poled partnership (PIP) -2
,Atsgtvottga as Net long-term capital gain Oat) ly Menthes rrornum (CM
E Penner's Identifying number
703
20.3161309 91) Collectibles (213%) gain doss)
F Penmen name, address, city. stab, and ZIP code
BLUE CHIP CAPITAL LLC tto Unrrocuptured braon 1250 gain
329 SEABREEZE AVENUE
PALM BEACH FL 33480 10 Net section /231 gain (loss) 1$ Tax-exempt MOM° and
nondeductible ewer s
11 Other Anne (loss)
COMAS partner or ILC r.1 binned partner or other MC
O
mernber-menector member
H Int DorsigsliC partner ❑ Foreign partner
19 Diseibutbms
II Whal two of entity Is tIi partner? (ewe insausenris) PARTNERSHIP_ 12 Section 179 deductko A 8,436
12 It this partner is a tenement plan (IFUVSEFIKeogliretc.), cheek here
(see instructiOns) ❑ 13 006t dediet0one
Partner's sham of profit. loss, and capital One instructions):
A' 16 20 alier n14444040
J
Beginning Ending
Profit 0 001557 % _CL021461 %
r STMT A 0
LOSS 0 001557 % _2001461 % V -7,623
Caplet DA/Q.1557 % 0.001461 % 14 iSellemploymonl comings 0004)
K Nineties snare of timblettes al year end: 101,120
Nonrecone
Qualified nnnrecourse financing $
'See attached statement for additional information.
Recourse
L Partners Caplet aocra.nt analysis-
Beginning capital recount $ . 73,021
Capital contributed during Ow W. $ 0
Oxford year Increase (derrease) . -7,678
Withdrawals a distributions. . . $ (8,436)
Ending capital account $ 56,907
CI Tex basis ❑ GAAP ❑ Section 701(b) clod 2
O Other (explain)
M Did the partner contribute property wkh a bult-in gain or loss?
❑ Yes El No
If 'Yes: attach statement ;Bee inStrIXSOnb)
For Paperwork Reduction Act Notice, see Instruct:lona for Farm 1055. IRS.govilorm1065 CaL No. 11394R Schedule K-1 (Paint 1065)2012
rpm.frwri v), 63, CONFIDENTIAL SONY GM 0001314B
EFTA_00143761
EFTA01280288
Schedule K-1 (Fonn l(1rs5) 2012 Page 2
This fist Identities the Codes used on Schedule K-1 tar all partners and proWdeS summarized reporting information for partners who fee Form 1040.
For detnited reporting and I fling Information, see the separate Partners Instructions for Schedule K-I and the instructions la your Income tax return.
I. Ordinary trimness income (loss). Deternene whetnev :he iris ne tins; is Code Report in
eassive a nonpaesiee and eider as your tsetse ad felons. J Work opportunity credit
1
Report on K Nimbler' auxes credit
Pareske toss See ile Partner's insirrectineu L Empowerment :one erne
Passko income Schedule E. line 28, column (g) renewal community
Nceptisalwe Mu Schedule E. tine 28, column (19 employment wedt
Nonpralw> income Schedule E, line 28, column () M Owe( for increasing research See the Partner's Ineelinbore
2. Net rental mul estate income poet) See the Partners Inatrartions activItice
3. Other net rental income (ties) N Creel lor ennioyer social
Net nrorne Schedule L. rte 28, column (e) mosey and Modioa-o Inxm
Net kiss See the Partners InteNclions O Res rap withholding
4. Guaranteed payments Schedule F. I rte 28, °Senn 9) P Other Credits
6. Interest income Form 1040, Inne 8a 18. Foreign tnnsections
On. Ordinary dividends Form 1040, neo 9a A Name of country or U.S.
Ob. Qualified dividends Fann 1040, hoe 90 possession
7. Royalties Schedule E, I no 4 B Grob income fram a I neuroses Form 1116, Pen I
0. Net abort-term capital gain (loss) Schedule D, Ile C Gross income entireed at
9e. Net long turn capital gain Foss) Schedule O Ina 12
Ob. Collectibles (28%) gain (loyal 28% Rate Oren Worksheet. leno 4 Foreign pews income sourced at pertnerehip love!
(ScheeMe Dirmertters) D Passive category
9c. Unrocapturod section 1260 gain See tho Parsers Instructions E Coved category learn 1118, Pert
10. Nat section 1231 gain (loss) See the Partners Inseuctions F Other
II. Other Income lions) Deductions ~aged and apportioned M minim load
Code O Interest expense Form 1118. Pert I
A Other pertioSe ,neons ((lose) See the Partners Instructions H Ohre Fenn 1118, Parti
B Involuntary tenvenblena See the Partners :emotions Otextions °Notated mw upteortemort at portmexhip level le foreign SOUrCe
C Soc. 1256 contracts 8 shaddlee Fain 6181, he income
D Minna expk.ration costs ramptre See Pub. MIS I Passive category
E Canerdiation el debt ' Form 1040. One 21 or Form 982 J ~one cateuen I Form 1116, Pest I
F Other income 0334 See be Paitnees inettuctions K °leer
12. Section 179 deduction See the Partner's Instructions Other Informedion
13. Olher deductions L Fold foreign lama NMI Fornt 1118, Prat II
A Cosh contributions (50%) OA Total foreign taxes accrue" Form 1116, Pert II
B Cush contritaitions :33%) N Reduction in tang; avaibdie for credit Form 1116, line 12
C Noncash winerthatnes (SC%) O Fenian sliding enema roceipte Forte 8873
• NeneaSe coreribibm130%) Seethe Partner° P ExIsarenNeel Yxart axe baron Forn 8873
E Capital an (roped>, to a 50% Instructions Q Oboe foreign transactions See the ~nets Inelnxalwes
organization p" 17. Alternative minamem tax (AMR Items
F Capital gain (needy 23%) A Peet 1988 depertiaber wijustmag
a Contributions (100%) B Adjusted gain a less Soo the Partners
ernmetment Intemat expense Fenn 4952, hoe 1 C Depletion NO her then a & spot iodinate% end
I Deductions -royalty income Schedule F, Ilre tal D 011, gm 8 wahertnerrirces raceme the Instructions Sar
J Suction 59(0(2) expenditures See the Porter's instructkert E (..9, gm, LK geothertrolecioductices Form 5251
K Deductions-portfolio 2% lban Schedule A, l le 73 F Other AMT items
L Deductions - portfolio :mbar) Schedule &Sao 28 It Tax-exempt Income end nondeductible expanses
M Amounts paid for moo cal low/anon Sdnue Aline 1 or Pam 1040. the 29 A Tax-exempt 990'0° Income Rem 1040. line 8o
N Educational assiatance benetts See the Partner's Instructions B Other tax-excerpt income Son tho Pertnar's instruction,
o Dependent are benefits Form 2441, roe 12 C Nondeductible expenses Se. the Planners Inebec &we
P Preprcductive poeiod expense.; See the Partner's hdeuctions 19. Distributions
O Commercial reveal:alien deduction See Fame 8582 Instruct cos A Cash and ~Ratable %Cut*
item rental real estate activities B Okstation subiter to :echo, 137 I See the Partner's Instructions
Fl Pensions and IRAs See the Pariner's Instructions C Cenv property
S Reforestation expense deduction See the Partner's Instructions 20. Other nfonnetion
T rioter-Mac prodirt:Ien ~lie, Sees Forte 89«.1Instructions A Investment income Form 4%2, line 'a
information B Investment expense" fterm 4952, lone 5
U Ormmod production ectrvitina nedine Fenn 8(1C3. lire 7o C Fuel tax credit inforeration Kenn 4136
✓ °Moyers Forth W-2 waged Form 8903, line 17 D Qua alert refugeeMier Green:Stu:es See the Penner's iremucticns
W Other deductions Soo the Partner's Instructions (other than rental reel estate)
14. &rieemployment earnings floss) E Po* of energy property See the Partnee's isstructions
F Recapture of low-income haeurcj Form 8811, lined
Noted/you bum a section 179 deduction or any petineclevei neeloctIong 500 the
Partner's instmcletos beforo completing Schedule SE credit (section 44,(5);
A NW etsnings (on) kan Schedule SE. Section A or B G 'recapture of Inv-intala housing I orm 8611, line 8
sell-empieyment credit (other)
• Ortes farming or fisNrer bourne See the Penner's Instructions H Aix:epee° ol innutment credit See Form 4256
C Gross non-fann income See the Panners Instructiore I ~lure el other credl:s See the Partner's instructors
IS. Credits J Look-back Merest—ownple:ed See Form 8697
A Low-income housing credit long-tarn contracts
K Leek-back intermit —Income formes: See Form 8866
(seclion 42(8;56 kin, pre-2008
~Pod
hairdnas L Dispositions al property with
B Low-income homey credit
(*thee, truce pro 2408 bulidinge ~Non 179 deductions
M Rempureof medal ITO deckstce
• low income rousing credit
(section 424(5)1 from N Interest expense for corporate
peel 2007 builoings Soo the Partner's Inseimaions partners
O Section 4530(3) irtormation
O Low-income 'outing crod4
P Section 4:33A(c) Inionnegion
(other) Irene peat-2C07 See the Portner's
balding* a Section 126069 information
R Interest :allocable to prodacbor irestmctions
E Queened rehMeltistein
expenditures (genta' reel (elate) expenditures
F Other rented reel estate credits S CCF nonquelified withdrawals
Other rented credits T Depebon information —ell ann. pes
H Undistributed capital gains credit Forte 1040, lino 71: creek box a U Arecetizatice of relecestation costs
I Alcohol and ceilulesic hief.eni foe" Soo tho Partner's Instructions ✓ Unrelated business taxable inotens
credit W Priecontrbution gah (on;
X Benton 108411Vereneturt
Y Olhly *gamut°
iii54.411111 meur CONFIDENTIAL SONY nmb ilfletla1411/
EFTA_00143762
EFTA01280289
BOARDWALK
'000
PIPELINE PARTNERS°
I./a:Mini-DIGIT 33480 28 PS5 775L2A826-8-1
4142 2 AV 0.360
BLUE CHIP CAPITAL LLC
329 SEABREEZE AVENUE
PALM BEACH FL 33480-6132
February 28, 2013
Dear Unitholder:
Enclosed is your Boardwalk Pipeline Partners, LP tax package for 2012. This package
contains important information that you will need to prepare your federal and state
Income tax returns for 2012 - please do not discard.
In the tax package, Boardwalk Pipeline Partners, LP is providing the following documents to
you:
I. Schedule K-1, (Form 1065)
2. Schedule K-1, Additional Information
3. State Income Schedule
4. Ownership Schedule
5. Sales Schedule (if Applicable)
6. Individualized Income Tax Reporting Package Instructions
7. Graphic Guide of Federal Tax Forms
8. Pariner's Instructions for Schedule K-1, Form 1065
Please carefully review the information on your Ownership Schedule. If the information is
inaccurate, please contact us as explained on the form. We will issue a corrected Schedule
K-1, Slate Schedule, Ownership Schedule, and Sales Schedule, if applicable, as soon as
possible.
The enclosed general instructions and graphic guide are provided for your general guidance,
and are not intended to be, nor should they be construed as tax advice. The tax information in
this package, as reflected on the schedules provided, is based on existing federal and state tax
laws and regulations as interpreted by the General Partner. Before completing any tax filing,
we recommend that you consult with your tax advisor.
If you should have any questions regarding this tax package, please call toll free (866)
867-5085 or logon to our tax package support webslte at
www.taxpackagesupport.com/boardwalk.
Sincerely,
Boardwalk Pipeline Partners,a
..IMAWOKICAPI4 ONFIDENTIAL SIDNV.‘614.00033150
EFTA_00143763
EFTA01280290
651112
CI Final K-1 Ei Amended K- I
Schedule K-1
(Form 1065) 2012 1 6~
‘`‘
:1;;
NIT%Si.4;141Warrn11,:Yetar Income, -
. Other Items
Dope:intent of the Treasury 1 Ordinary business income (lossi 15 Credits
For calendar year 2012. or lax
Internal Revenue Service s beginnng -3,686
, 20:2
ending .20 2 Not rental rote estate Income (loss)
Partner's Share of Income, Deductions,
Credits, etc. is- so* back of form and separate instructions. 3 Olhor not rental Income (loss) 16 Foreign transactions
r-Zrflaiffisiatiaw- 4P16191W1tv841)~ 4 Gunnies(' payments
A Penner-Mt:is employer idernfication number
20-3265614
B Palma* a Mme, address. city, state and ZIP code 5 Intranet income
BOARDWALK PIPELINE PARTNERS, LP 10
9 GREENWAY PLAZA, SUITE 2800 Is Ordinary Olvleenes
HOUSTON, TX 77048
80 Quelified aivioende
7 Royalties
C IRS Center where purtnen4hip 0 ed return
Ogden, UT
Not shod-Sum capital gatt (loss)
Cneck dials Is a pubic& traded partnership (PIP)
Part II .4 k, lebiS900~811~84ftlikei..V".1rfesit*Sital Sa Nut long.tett capital gain (lees) 0 17A AaeWs we're's( la‹(AMNees
-12
E Partners identifying number
20-3161309 9b Collectibles (28%) gain (loss)
F Partners name. address, city. state, and ZIP code
BLUE CHIP CAPITAL LLC 9c Unreceptured section 1250 gen
329 SEABREE7_E AVENUE
PALM BEACH FL 33480 10 Net section 1231 gain (less) 18 Tax-exempt Income and
nondeductible toperises
11 Oat« inoune (loss) C 19
0 ❑ General partner or LLC r.--A limited peter or tit's' LIS
member-manager =1' 1 member
H Doinesic Partner p Foreign earner
19 Distelbutions
Il What type or entry e ms partner? (sots instruchcns) PARTNERSHIP 12 Ølion 179 °eduction A 7.446
12 If this mainly Is a retirement plan (IRA/SEP/Keogh:etc.). chock hero r
(sac Instructions) LJ 13 Other deductions
J Partners share of wont loss, and capital (see .meterrettens):
A! 9 211 Other Infcralc9
Beginning Ending
STMT A 10
Profit 0.001727 % 0,001487 %
Loss 0 001727 % 0.001487 V t -3,685
Capital _0,00172_7 % 0.001487 % 14 Self oencroymeri earnings (bee)
K Partners share of ilaWnes al year ene: r r --- • -• • . -
19,327
• -• -•
Nonrecourac 52,076
Qualified nerirecourse financing $
Recourse
'See attached statement for additional information.
t. Partners capital account analysts:
Beginning capital accourt 73,639
Capital corttoled during tie year. $ 0
Current year inuuaso (decrease). $ -3,704
$ (7.446)
Withdrawals & cistrIbutiOns. . .
Ending capital account 62,489 å
El Tax basis Q GAAP ❑ Section 704(b) book
El Other iexploln) Outside Tax Bees
LL
PA idi the Partner COirtriblitu property with a built.in gain or loss?
rD—
LJ Yet [3 No
If 'Vas,* attach statement (see Heber:lions)
or Paperwork Reduction Act Nods», see Instructions for Form 1065. IRS.g olorm i065 Cut No. 11394R Schedule K-1 (Form 1005)21)12
CONFIDENTIAL SDNY_GM_00033151
EFTA_00143764
EFTA01280291
2012 OWNERSHIP SCHEDULE
BOARDWALK PIPELINE PARTNERS, LP
PARTNER NAME: BLUE CHIP CAPITAL LLC
ACCOUNT NUMBER: 141 0022488551
PARTNER FEDERAL IDIENTITY: 20-3161309 I PARTNERSHIP
CUSTODIAN FEDERAL ID:
PARTNERSHIP FEDERAL ID: 20.3265614
"IWsZnedulickitalls Your history of owneranip of Boardwalk Pitman° Partners, LP units ffecugh 2612. The enclosed tax package reflects yew ewnershio it unitsreeslernd WAr
the pennant*. and units hate In a broker exeunt if such Information was provided by Iho broke.' on your Wool. ft your words do not 80/430 with the transactions shown. the
enamel lax information may be :ncomple:e. In such an event. you may request changes (I) on the InZernet. (2) by mail or (3) by p'ro'ud. To request (naves oy mar, disks
make corrections on this schedule find write any needed explanations on the schedule. Sign the statement below and submit toe corrected schedule before May 31.2013 to:
Boardwalt Pipeline Partners. LP
Tax Package Supped
P.O. Box 799060
Colas, TX 75379-9030
Phone: 1.866-867-5085
werw.mxpackagosupporLuorn/hcardwalt
Upon reorapt a revised K-I wit be forwarded to Pe eodress on your Schadthe K-1. This schedule does not have to be returned unless changes have been mace.
It is important that you submit corrections to the partnership by May 31. 2013. Corrections submitted to the partnership Our May 31. 2013. may 11140 in a requirement to
include Fonn 8082 - Notice of Inoonseamt Trealmont or Admnistrative Adjustment Request (AAR) to your re:um. Corrections whinnies siker May 31, 2013. will not be rehectec
in thu partnership's ox return filed WM the In:ernal Revak+, Service. The Partnership Me, Its fedora: lax return MU! the Ogden. UT IRS Servico Conics.
NOTE: RECEIPT OF THIS SCHEDULE IS NOT PROOF OF OWNERSHIP
TRANSACTION
BROKER OR
DESCRIPTION DATE CERTIFICATE NUMBER UNITS
AC BUY 12-10-2009 141 3.500.0000
END OF YEAR UNITS 3.500.0000
SEE TAX INSTRUCTIONS FOR ADDITIONAL INFORMATION
ACKNOWLEDGEMENT FOR CORRECTIONS ONLY
The infommtion reported on thls schedule. as corrected, accurately and completely presents my ownership history through 12131112.
By signing this schedule, I authorize the Partnership to make the corrections as indicated above to my Schedule K-1.
CD NFIDENT IL
Spada
IIIONMAJO.,4142A.
SDNY_GM_00033152
EFTA_00143765
EFTA01280292
651112
L Fins K.1 -1•="'Icti,i.,;', K-1
(Form -465) Fre CtiC•163, eV 2012, es ,r.< Millet be drralti0n;i: 416;ediCslualincalinher Items
I:Swirled ol re Treasury mu *se envie • zoI2 1 Ordinary business Income Coss) 15 Cretin)
Inieno. hew nom Sonto OrKina -72.
2 fist renal reel ere trans (lost)
Partner's Share of Income, Deductions,
Credits, etc. . See separate Instructions, 3 Other net rental income (loss) 10 Foreign tmnsactions
Information About the Partnership 4 Guaranteed payments
A Partnership's employer identification number
26-3172589 5 Interest Income
B Partnership's name, address, dty, stab). and ZIP code
Level Management, LLC 6a Ordinary dividends
19401 Old Jetton Road
Cornelius, NC 28031 6b qualified thydends
C FtS Center where partnemrilp filed return 7 Royalties
Cincinnati, OH
8 Notshottamn cadtal Diadem)
D ['Check if this Is a publicly traded partnorshiP (PiP)
9* Net longterm capital gain (loss) 17 Altrymtne retort cm (AYR lbsrs
ROW Information About the Partner
E Partrer's Identifying number 9b Collectibles (28%) gain (loss)
20-3161309
F Partners name, address, city, stale, and ZIP coca 9c Unrecaptured section 1250 gain
Blue Chip Capital, LLC
27 High Tech Blvd. 10 Net section 1231 gain 009S) 81 Tax-exempt income. and
norsiodustle expensas
Thomasville, NC 27360
11 Other income (loss)
O gl General partner or LI.0 'Limited pi:finer of other
LLA nomber-manager • JI.I.0 member
H gDomestic partner OForeign partner
11 Vat broadest, is trib ostler? Mes instr)ihs tp eruni c
19 Distributions
12 If this partner is a retirement plan OFtAISEPAteoghletc), ,--i
check here (see instructions) U 12 Section 179 deduction
.1 Partnees share of profit, loss, and Capital (see insimelions):
Beginning Ending 18 Other deductions
Profit 25.00000 8 25.00000 Ar _ . 20 OTher information
Loss 25 00000 8 25.000 0 t
Capital 25,00000 % 25.00000 %.,-
K Partner's shwa of liabilities at year end:
Nonrecourse * —/14 Self-employment earrings (loss)
Qualified nonrecourse finning $
A —72.
Recourse $
1. Partners capital account analysis:
Beginning capital account $ 947 *See attached statement for additional Information.
Capital contributed during the year $ r
Current year increase (decrease) 9 —72. °
Yethdrawals and distributions $ i
Ending capital account $ 875. 1st
K 'a basis DGAAP I Section 7040)) book u
Other (explain) 1
IA Did the partner contribute property with a bullbin gain or loss? o
II
Dyes g)N° ly.
II Yes alltch slOteonal Oa traltxtlor.$)
Schedule K-1 (Form 1005) 2012
BAA For Paperwork Reduction Act Notice, see Instructions for Form 1065.
PTPA:412 Ta02113
CONFIDENTIAL SDNY_GM_00033153
EF1'A_00143766
EFTA01280293
Stifedula H-1 (Form 1065) 2012 Blue Chip Capital, LLC 26- 3172589 Par 2
TN: inst Identifies tie coon used on Schedule K-I for '11 partners and gram eurenartted reporting information for miners ate file Faro 1140. For detailed MCOrt1110
and Ming Informatics'', see rho separate Partes Inert Wort for Schage K-1 eid thenstrsellone for your Income tru return.
1 Ordinary bunion I/KammU(4» Otttunna vemenr !to income (lau) 3 assivo c od e Report on
ranpeterse en0 einY on yew' reltrn a *Okra.
Report an J was uppertnlp twit
Penh% 515) Set tbe Po'e't bi*.tb't K Daaled >cOnss cant
%n+" mane ficnodok E, tro N. ether 41 L 5,54111•61, acne end ~all mane*
eltekiPII7' Sae re WNW'S
%rams VI hi: '<nettle L. In 29, colcrur ) M Creel: f7f Inc~ nlItertti act teen Ine~ortz
Morpout4e kutten !Moak E. Ire ES. mAnn
N Creeit eracieder KAM ~My at
2 NM revile rod estate Menem doss) to. to Portions Itttats Merl:ne .Yren
3 Other not rent& Inoone Goss) O Bacup wat«an.
Ne1 in“'" Stacdols E, coRonn tg) P one crcdit;
Ne; tan See tie 'WOW'S IrtgrItOn5 16 Yongontreneection•
4 Guitentad prpnente Schedule E, toe 28. edliann Q) A ewe a mulry a0Messbn
5 Icemen Income Fenn 104C. in. Se B Coco Irk", kon ail saute, Form 11' 5. Pa( I
6 a Onto'ry dIAlloner Firm 104C, ene 90 C Gras tveran touted el ceilnet 7~1
b CluellInd &Mende Run, Mo 95 Foreign gross income sourced at pannership level
7 Royellms 44+14e E, MA 4 D ~Iva eahconc
8 Net Mort-lens cestal gin (Mee) Schedule 0, be 5 E amoral cowry Form ;;15, %AI
9 a Na ongdmm embei tgen One) Selena C. em :2 F 0ut
9 b censuses (WM n 111(l0,6) a% Rehr GM,- Vrodshool. Pre Deductions allocated and apportioned a. paroler level
4 (Schedule 0 Ingncticcul
G Intones! «mase Fenn 1116, Peril
n Cm:reaps/me maim 1260 P 111 Res tie Pa-rors Inehmaces
H Olt Fan 1116, Pod,
10 hot ~don ten gal dent Seer Om PerMON :mecum/am
Deductions allocated and apportioned at partnership Mn! to
11 Otnebeolum0ces) foreign source Income
Code %salve meget
A Ofher »Moen rIterne (,ea.) See to Partiets inflections J Orval øa204 } NM, III6,Pan I
B Inattntery conmenns ten It* Pernere hulatheos K ern
C
Suellen 125644We= end Mrad,Ues ram 0/11, hne 1 Other information
D kiln; suplenlien coon %%PO% !"•• Puz 53.5 L Total *Sign has ps'e hem 111E. Part II
E Coacollaller 0'6e: %ITN ICAO. ; m 21 a ram 9N N Total forden Imes acumen Fenn 1116. Pan 11
F ova- kØ (I544) Soo Ix Patton !mtmellms N Fax44.41In :arm ~Age la ~It Fan 1115, 8th 12
12 secure 179 emluden seg Portnere 'istrmiden O Fore44 ewers von recedes Font 8873
13 ON«doenctkane P hi:a Warne nelota Fern 8873
A Cmh cm "Mutant X44) Q Demean tr Senseeklare Ste no Pe'tne?e Pgrunlone
B Cis!. ccuviwtani t3" 17 Allernethm mIremun lox (Mn) Memo
C tercenh rentetolinns (BC%) A irus.ISS6 decreclentnathatraent
1_.
5•4 Fe Part's',
D trondal: ruchlb.Ants (Clt) Instnerlme B Arend celn or lest
$e* On i3:9.1.9.7. •:.
E cam 9ein ~rirb a tre,"% C Depelkei (42 Ar cd cm)
INIACliont ad
elgan ally. (3Pta) D Or, On a smotherral — 'ass bØ ro le airmSone let
F Cede& tub wort/ (77%)
E 0 1. 77.7. a pinhead — J•eatinie Fenn 6231
O Ccontotatt ("41:11) F e1w Ar sea
H InmeerrnulAtuma; expmee Font 4952, One I 18 Tsocientre :memo end nonemluelbe axataM
I Dedte4CM — myely inccom SChOd eee E. Sr r9 A Tie.enernpt ialumet ireon• refe tom. awn
J Sed« 59(0)41 eaperdtne1 tee ha Prim."' Ina...cores B Cow Issarlept hose See M Patten inischos
K Newham — sateen (214 OW) A. Wig 21 C lbrrtwgaalesausa Svc to Pam«s irelmedane
DeOLCI.Ond — 9ccif&e ('-‘11~1 Schedule A leg, a 19 Ontributbne
713nedia A. nt. I or
1
• Arosti red ss reee , A Cam 44 nub:4MM tecuteo
Farr '0'4 1111.1 29
severe
N t cluutan esMetenen smelt See no Parinere turnskam
BDh719,..-bon se heel b fACIOn 737 — See the Dense.
lealresluds
O D9q:enden1 we tenet Forts 2441. k» II
C q79' ennn”ly
20 One intoned«
P Pm:manta pw.i.xl rgorua tee Be Po, trees 1metctora
A Pm:gm« noxne Fan 4962, Ste 4e
Q LailintreSI codachar 'Torn Fan 4952. rem 5
wiping ontan ',bbs toe Fenn 8543 :mince ens B
headmen* spines
R PentionsaNimm See lie Penmen Intent:done C Fuel lat oc<15 ;tram Font 4136
• Fielmechrtial eymne asionim See the Porkers Into -tabu, D °need relaelue/cn expeneties (Wet
tron wad mel eslake) Swine ParIne.'s Intent-inn
T »reek ctoit441 eGtivtlin 144 Fun 6933 hestebys
E Sege 4 mangy gem* 3ee ate Patties leek. dems
U :).ane proctotma actin,. Lace* Fern e9C3, lire lb
F ~pare el selncome mud% rain (maim Fenn h'e8
✓ Enpoyent Ran vr.2 vaunt Fein. 8903, lb e 17 430(5))
W 0lnerdidoclant 53. ha PaMiere I tenndons G aoseaurecr Ictutrcone Sucre teat lored Form 5611. Ink B
14 Sell.enirgermil‘ramlnea (105e) 14 Fbne~e d Invegnienl dent sea Fern 4255
klolt n'yOu here a sadden 179 <, :cf..:6en or ivy Null«4~1dentWil. see te I noceahre nthmerec Sot eta Prefneis I itutrico 5
Parma's LINN.Y.kos DN'te ornoteUrg .?ttinvio SE. J 1.0Cluba:'<at ui s— coatted
3chulun SE. Static A a R sresen Sno Firm 86O7
A No: 04t77100•41 /on rar erralennont
B GoestorvepleL^ainØ Bed the Fogner's lastreelam K fz uffietrismyzrze — sneer:
Sou ram 8166
C limm rtn.taern Iacono Sc. Cm EntInet's Item:liens
L Oke~oru al monody *Rh
15 CIntEt11 seelion 179 decluenro
A Low.ileome haisirg 0•111(.7.ecton 429)95); — R•Cal.fe of cactee 179 runs:ton
Lem me-7004 I/Mina N meant summit lor oncemba patinas
B Loma:acre will tra=ll (4711141.°111 • 5dcbon 4530(3) enernalun
lard24:11 td) ne,
CLon b e Idlt (action 47(ix5)) P mum Ware inwrinba
pool-2007 Wpm,.
oor Q SUSS 1260(1) rneenoten
D lconirenrat Fuzing teol (tahe) 1ran S% 8n PattileS SCO Vie Ponre's
4061-200? hailtlfrua 7arstAlion rt Irlerett albeit.% to twolucilto spomalkies Inks:Ss
E 0ualikd ogleKtellan expenditaS erne S CEP neleverree volltuorole
teal silk) T åppeNrklrrNtale—eiendom
F Canr twat los slate cf,7b U Nowtrobs d tokenism cost.
G am Isis' cods ✓ I.Incitated bights lanke khans
H Unalidinded capital gelt. antra Stun IOW. me ?I; ched, Ø * W ~Salon gan (1.45.1
Flatel ral mei« blohni Nile mode See Ste ?Moen Irelndllont X Seelkyi 103() nkrmwa
Y Oh« inkummkn
PTP40312 OV02/13 Seleedrae K-1(Frem 1(165) 2012
CONFIDENTIAL SDNY_GM_00033154
EFTA_00143767
EFTA01280294
NC K-1 (50) 2012 Partner's Share of
()-403) N.C. Income, Adjustments, and Credits
10-11.t2 North Carolino Department o' Revenue
For ca.:ender year 2012 o fiscal year beginning and end n6
Federal Employer ID Number
Partner's Identifying Number
203161309 263172589
Partner's Name, Address, and Zip Code Partnership's Name, Address, and Zip Code
BLUE CHIP CAPITAL LLC LEVEL MANAGEMENT LLC
27 HIGH TECH BLVD. 19401 OLD JETTON ROAD
THOMASVILLE NC 27360 CORNELIUS NC 28031
Individuals Filing Form
Partnership's Pro Rita Share Items Amount DADE Enter Amount on:
All Partners
1 Share of partnership intara Coss) -72
2 Additions to income (loss) Page 2, Line 35
a Addition ler bor.us depreciation
51 Page 2, Line 36
b Other actions to Vairie(icas) SSE SLIPP :NITO
3 Deductions troll', income (loss) Page 2, Line 44e
a Ooducion for bonus depreciation 0
Page 2, Line 49
b Ott deist= from Irma (bat)
0 Forrr 0-400W
4 Share of tax credits
5 Share of tax witriteld from nonwago compensation Page 2, Line 23
paid for personal services performed hi V.C. 0
Nonresidents Only Page 2, Line 51
6 Nonresident's share of N.C. taxable income (loss) 0
7 Nonresident's share of net tax pad by the manager
0 Page 2, Line. 24e
of :he partnership
SEE SLPPI.F.VENTAL INFORMATION
sciimom M4Dra
CONFIDENTIAL SDNY_GM_0003.3155
EFIA_00143768
EFTA01280295
26-3172589 1
Level Management, LIS
FORM D-403, SCHEME NC K•103tUE CHIP CAPITAL LLC)
SUPPLEMENTAL INFORMATION
LINE 2 - OTHER ADDITIONS TO FEDERAL INCOME:
STATE TAXES DEDUCTED ON US RETURN 51
TOTAL 51
CONFIDENTIAL SDNY_GM_00033156
EFTA_00143769
EFTA01280296