2
651113
Schedule K-1 I I Final K-1 Li Amended K-1 OMB No. t545-0099
(Form 1065) Lit/ II la
F of caionery yea, 701 or tax Part III Partner's Share of Current Year Income,
Department of the Treasury yo.y co.l .ror, APRIL 1, 2013 Deductions, Credits, and Other Items
Internal Revenue Service memo DECEMBER 31, 2013 1 Ordinary business income (loss) 15 Credits
Partner's Share of Income, Deductions, I 0.
Credits, etc. I. See separate instructions. 2 NM revel Zeal aline worn° roes)
I 16 Foreign transactions
3 Other nel rental income (loss)
Part I Information About the Partnership
A Partnership's employer identification number 4 Guaranteed payments
I
B Partnership's name, address, city, state, and ZIP code 5 Interest income
I
INVESTMENT ENTITY PARTNERSHIP 6a Ordinary dividends
2030 1ST AVENUE, 3RD FLOOR I 17 Alternative min tax (AMT) items
SEATTLE, WA 98121 6b Qualified dividends
C IRS Center where partnership filed return I
E-FILE 7 Royalties
I 18 Tax-exempt income and
D 1 I Check if this is a publicly traded partnership (PTP) 8 Net short-term capital gain (loss) nondeductible expenses
9a Net long-term capital gain (loss)
Part II Information About the Partner
I
E Partners identifying number 9b Collectibles (28%) gain (loss) 19 Distributions
020-78-2154 I A 5,000,000.
F Partners name. address, city, state. and ZIP code 9c Unrecaptured sec 1250 gain
I. 20 Other information
DR. BORIS NIKOLIC 10 Net section 1231 gain (loss)
I
11 Other income (loss)
G n General partner or LLC 0 Limited partner or other LLC
member-manager member
H M Domestic partner 0 Foreign partner
11 What type of entity is this partner? INDIVIDUAL 12 Section 179 deduction
12 If this partner is a retirement plan (IRAJSERKeogh/etc.), check here LJ
J Partner's share of profit, loss, and capital: 13 Other deductions
Beginning Ending
Profit 0.0000000% VARIOUS%
Loss 0.0000000% 0.0000000%
Capital 0.0000000% 0 . 0 0 0 0 0 0 0% 14 Self-employment eamings (loss)
K Partners share of liabilities at year end: A I 0.
Nonrecourse $
Qualified nonrecourse financing $ 'See attached statement for additional information.
Recourse $ 0.
L Partners capital account analysis:
Beginning capital account $ 0. .a.
Capital contributed during the year $ 8
Current year increase (decrease) $ N
D
Withdrawals & distributions $( 5,000,00040 cr
Ending capital account $ -5,000,000. ,
0
u.
M Tax basis GAAP Section 704(b) book
Other (explain)
M Did the partner contribute property with a built-in gain or loss?
[. Yes LXJ No
If 'Yes', attach statement (see instructions)
1243-13 LHA For Paperwork Reduction Act Notice, see Instructions for Form 1065. IRS.govilorm1065 Schedule K-1 (Form 1085) 201
2
EFTA_R1_00373365
EFTA01926727
2
Schedule K-1 iFcar 10650 2013 Page 2
This list identifies the codes used on Schedule K-1 for all partners and provides summarized reporting information for partners who file
Form 1040. For detailed reporting and filing information, see the separate Partners Instructions for Schedule K•1 and the instructions
for your income tax return.
Gale PePOrt en
Ordinary b4.sness etcomelbseg Determine another the income doss, L Empowerment /Ono
I
passne et rorpassere and en:« on your return as knows. employment credit
• Credit la ireeasing research
Report on aetetel(Se See Ihe Petnnett nap( CtiOnS
N Great la employer social
Passe* loss See me Panner's Instructions Security sild Medicare times
Passer. Income SChearle E. line 28. column (9( O Backup withholding
Nonposshe loss Scheel/re E. lino 28. column (hi
P Other credits
Norpasswe income SChedule E. line 28. column Id
2. Net rental real estate income (loss) See MePartnas infatuctions 16 Farelen transactions
3. Other net rental income (bes) A Name of <arrvy Cr U.S
Net pl ane E, IMP 24. holunn (g) possession
NM loss See mePaul's Instruction. 8 CFOS, incase Stoll all sources } Form 1116. Pan I
4. GJaranteed payments Schedule E. line 28. column (p C CFOs,: income uveta at panne?
5. Interest income Fan 1040. kne Fa level
6a Ordinary ravidends Form 1040. kne
Foteiga aces income sourced at partnership level
6b Oak?", casedends Fare 1040. kne %
Sand» E. line 4 O Passivecategory
Royalties
Sena* D. line 5 E General category Form 1116. Pert I
8 Not shon• tam Capital 9on 00S8 )
Schedule D. lire 12 F Other
Sia Net lorepterm capital pen doss)
9b Gollectbles (28%1 pen (Ices) 28% Rate Gan Workshed. lino 4 Deductions anocauati and npoonioned a: parirde level
(SCheckee D Instructions) G Interns: expense Form 1116, Pan I
9c Uhrecaptured section 1250 garn See Me Pertnas Instructions H Other Form 1118. Pad I
10 Not section 1231 gain (loss) See the Partners Instructions
11 Other ethane (lo« Deductions allocated and apportioned at partner:nip level to foreign soiree
Code income
A Other patklio income Ikea, See me Partner's Instructions Passive category
J General category } Form 1116. Pan I
B Invoker:ay coma-Hens See the Paten's InSboCtions
C Sic +293 contracts & sandel« gam 6781. lane I K Onso
O Mirkng expkwelion ants recapture See Pup. 535 Other blame:bp
E Cancellation of debt Form 1040. V. 21 a Fain 982 L Total Iceman taxer. pad Foie 1118 Pan II
F Ora income (loss) See me Partner's Instructions Al Total lama, •axes :Castel Fenn 1116. Pan II
N Reduction in take, ~edible la credit Fenn 1116. lino 12
12 Section 179 deduction See tre Pains a. Instruchans
O Facer trading qv,* receipts Form 8873
13 OM« deductions P E Hoderitaire anon fltelbeSee Fare 8873
I
A Cash Conanbutians (50%) O Other laeignsansactions See Me Partners Inzetchons
B Caen contributions ISO%)
C Noncash contribution 150%)
17 Aherne:No minimum tax (AND)Minn
▪ Norma, contributions I30%) See me Par:~ instruct
I
Capital gain property toa 50% A Post.1986 depreciation adiastment
E See the Pastnees
organ:Eno <30%I 8 Adjusted germ a lose
F Capital gain property I2016) C Depletion (other den oil 6 gas) instromlens and
D OIL gen. a geothermal . cross income the Instructions la
G Ccreitmhons (100%)
11 investmen1 Meant expense Form 4952. kne 1 E OF. gas. 8 geothermal deductions Form 6251
I Deductions - royalty income Schedule E, lire It) F Other AMT neon
J Section 59(6X2)Oxpen08weS See re Para' c Instructions
I8 Tax-exempt income and nondeductible expenses
K Deductions pellet% WM 1100e1 Senedue A. lire 13
A Tax-exempt interest income Fan 1040. lire 80
L Deductions pergola> (anal Soneduld A. line 28
8 Other tax-exempt mare See the PartnaM Instructions
M Amounts paid la melCal insurance Sonatina A. Ire 1 or Form 1040. line 29
C NondecluChble expeneeti See the PeetneeM Inset/lions
N Educational awn:once ~dim See tre Pea's Instructions
O Dependent axe bench% Form 2441. line 12 19 DISIttibUlleltil
P PmerOd.iCtrre Pa"' expenses See tne Pewees Instructions A Gash and marketable securities
O Commerce, revitaluation &diction See Form 8582 Instructions 8 OntrioutiOn Subieet lo Section 737 } See the Partners instructions
Iran rental real estate se:miles C entw VeentY
R Pensions and IRAs See tee Praia. instructions
20 Other intonation
S Relay tats expense deduction See re Pareets Instructions
A Investment income Fain 4952 lire la
1 Domosoc adduction %Wotan See Form 8%3 Instructions
interredeon B Investment mimeses Form 4952. line 5
C Fuel tea credit information Form 4136
U °waned production activities ,Ø,r ° Form 8903. line lb
D °dad"? rehabilitation expendnures
✓ Employer's F am 19.2 wages Form 8903, kne I?
lot nor than rental real estate) Soo the PannorM Instnatboes
W Ore deductions See tne Perire'S Instructions
E Bausa energy property See the Partnees Inseuctone
F Rematture of knv•income housing
14 Sell.emplonmeni earnings dose) rea: !ectice, 41(.115» Fam 8611. lint 8
G Recapture oil/eV/SFr-OTC amusing
Note II you have a %Oaten 179 ~action a any pertna-level deductions. set
credit :omen. Form 8611. line 8
the Partner's Instructions they, compiteng Schedule SE
H Recapture of investment credo See Form 4255
A Net earnings doss) from Schedule SE. Section A or 8 I RPFPP:ve of olle Penis See the Partners eneuctions
tett-ment J Look -bade interest completed
8 Gross Irene a fishing income See Me POMWM InStrucUOnS long-lamr contracts See Form 8697
C Grose non•tarn income See me Prior's Instructions K Look -beta interest . roane ferecasa
method See fan 8866
15 Credits L Onposilions ot property eim
A Low-income hooting tattletl section 179 deductions
(section 421a(5))erom prin 1008 SI Recapture of section 179 deduction
buildings N Internet expense la coda" partners
B Low-income housing credo 0 Section 453(1a3)nlamation
loemfleorn pre 2008 baking% P Section 453Afel Ireamation
G Low-income 'rcueing Credit (section 0 Section 12603,/ information
42(858 Can post -7037 buildings R keenest allocable 10 °reduction See the Patna 's
D Low-income nousing credit (other) Ste Me Partner's Influences
*samara. tee Instructions
from posl.2037 Wlldngs 5 CCF non:melded withdrawals
E Ouoirliod rehabilitation expondatu•ø T Depletion ink:inseam . cd and gas
areal real estate) U Amortization or rebrestolion ants
F Otar rental real ~ate craw.; V Unrelated business taxable income
G OM« rental creak. W PreoonvIcsann gain (loss)
11 Undistributed capital gains an" Form 1040. kne 71: check bon e X Section 108w information
I Eleoluel producer credit Y Net investment income
J Work oppalunly creed See me Paten's Instructions Z Other information
K Disabled access neon
311262
12.03.13
2
EFTA_R1_00373366
EFTA01926728