By The Numbers, Inc.

Error Report For By the Numbers, Inc.
:
o 1120 Warning:
Determine whether the IRS may discuss this return with the
preparer and select appropriate response box.
o 1120 Warning:
The amount entered as buildings and other depreciable

assets at the beginning of tax year on Sch L does not equal
the amount from Form 4562.
o 1120 Warning:
The amount entered as accumulated depreciation at the

beginning of tax year on Sch L does not equal the amount
from Form 4562.
o 1120 Warning:
The amount entered as Land (net of any amortization) at

the beginning of tax year on Sch L does not equal the
amount from Form 4562.
o 1120 Warning:
The amount entered as buildings and other depreciable

assets at the end of tax year on Sch L does not equal the
amount from Form 4562.
o 1120 Warning:
The amount entered as accumulated depreciation at the

end of tax year on Sch L does not equal the amount from
Form 4562.
o 1120 Warning:
The amount entered as Land (net of any amortization) at

the end of tax year on Sch L does not equal the amount
from Form 4562.
o 1120 Warning:
The end-of-year unappropriated retained earnings reported

on Sch L should equal the amount reported on Sch M-2.
o 1120 Error:
The box for a personal service corporation was not

checked.
o 1120 Warning:
The Corporation qualifies as a small corporation or is

otherwise exempt from the alternative minimum tax.
o 1120 Informational:
Either the Yes or the No box should be checked.
o Sch PH (1120) Warning:
If Line 6 is less than 60%, the corporation is not a PHC. Do

not file Schedule PHC.
IRS does not always require that a statement with details of

Part II and III be included with the return. To print this
statement select the 'See statement' box.
ACE adjustment does not apply to a regulated investment

company or a real estate investment trust.
Expired NOLs may have rolled over from the prior year
return. Please review and adjust the NOL Carryover
worksheet if applicable.
Override and Estimate Report For By the Numbers, Inc.:

o 1120 Override:
On Sheet 1 you entered a value of "22400"
o 1125-E Override:
On Sheet 1 you entered a value of "250000"
o Asset Entry Override:
On Sheet Input you entered a value of ""
Form
1120
Department of the Treasury

Internal Revenue Service
A Check if:
1a Consolidated return
(attach Form 851) . .
b Life/nonlife consolidated return . . . . .
2
Personal holding co.
(attach Sch. PH) . . .
3
Personal service corp.
(see instructions) . . .
For calendar year 2011 or tax year beginning

See separate instructions.
Deductions (See instructions for limitations on deductions.)

Tax, Refundable Credits,
and Payments
B Employer identification number
. . . . . . . . . . By
. . the
. . Numbers,
. . . . . Inc.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1111111
. . . . .
TYPE
Number, street, and room or suite no. If a P.O. box, see instructions.
C Date incorporated
. . . . OR
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Before
. . . .1900,
. . .see
. Options tab.
PRINT
1001 N. Main St.
8/8/2005
. . . . . . . . . . .City
. or
. town
. . . . . . . . . . . . . State
. . . . . . . . . . ZIP
. .code
. . . . . . D
. . Total
. . assets
. . . (see
. . instructions)
.
. . . . . . . . . . Los
. . Angeles
. . . . . . . . . . . . . . CA
. . . . . . . . . . 90012
. . . . . . . . $
. . . . . . . . . .
E Check if:
(1)
Initial return
(2)
Final return
(3)
Name change (4)
396,310
Address change
1a
b
c
d
e
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29a
b
c
30
31
32
Merchant card and third-party payments. For 2011, enter -0- . . . . . . . . . . . . 1a

. . . . . . . . . 0. . . . . . . . . . . . . . . .
Gross receipts or sales not reported on line 1a (see instructions) . . . . . . . . . . .1b. . . . . 530,000
. . . . . . . . . . . . . . . . . . . .
Total. Add lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . . . . . .1c. . . . . 530,000
. . . . . . . . . . . . . . . . . . . .
Returns and allowances plus any other adjustments (see instructions) . . . . . . . . 1d
. . . . . . . 3,000
. . . . . . . . . . . . . . . . . . .
Subtract line 1d from line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e. . . . . 527,000
. . . . . . . .
Cost of goods sold from Form 1125-A, line 8 (attach Form 1125-A) . . . . . . . . . . . . . . . . . . . . . .2 . . . . . . . . . . . . .
Gross profit. Subtract line 2 from line 1e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . 527,000
. . . . . . . .
Dividends (Schedule C, line 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 . . . . . . . . . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . . . . 3,000
. . . . . . .
Gross rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . . .
Gross royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. . . . . . . . . . . . .
Capital gain net income (attach Schedule D (Form 1120)) . . . . . . . . . . . . . . . . . . . . . . . . . 8. . . . . . . . . . . . .
Net gain or (loss) from Form 4797, Part II, line 17 (attach Form 4797) . . . . . . . . . . . . .. .. . .. . . . . . . . .. . 9 .. .. . . . . . .. .. . .. . . . . . .
Other income (see instructionsattach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
. . . . . . . . . . . . . .
Total income. Add lines 3 through 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
. . . . . 530,000
. . . . . . . .
Compensation of officers from Form 1125-E, line 4 (attach Form 1125-E) . . . . . . . . . . . . . . . . . . . 12. . . . . . . . . . . . .
Salaries and wages (less employment credits) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13. . . . . . 5,000
. . . . . . .
Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14. . . . . . 9,500
. . . . . . .
Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. . . . . . . . . . . . .
Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16. . . . . . 4,100
. . . . . . .
Taxes and licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
. . . . . . 50,470
. . . . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
. . . . . . 12,800
. . . . . . .
Charitable contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19. . . . . . 1,000
. . . . . . .
Depreciation from Form 4562 not claimed on Form 1125-A or elsewhere on return (attach Form 4562) . . . . . . . .20. . . . . 22,400
. . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
. . . . . . . . . . . . .
Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22. . . . . 19,300
. . . . . . . .
Pension, profit-sharing, etc., plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
. . . . . . 25,000
. . . . . . . .
Employee benefit programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
. . . . . . 16,900
. . . . . . .
Domestic production activities deduction (attach Form 8903) . . . . . . . . . . . . . . . . . . . . . . . . 25
. . . . . . . . . . . . .
Other deductions (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
. . . . . . 67,900
. . . . . . .
Total deductions. Add lines 12 through 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27. . . . . 234,370
. . . . . . . .
Taxable income before net operating loss deduction and special deductions. Subtract line 27 from line 11 . . . . . . 28
. . . . . 295,630
. . . . . . . .
Net operating loss deduction (see instructions) . . . . . . . . . . . . . . . . . 29a
. . . . . . . . . . . . . . . . . . . . . . . . . .
Special deductions (Schedule C, line 20) . . . . . . . . . . . . . . . . . . . .29b
. . . . . . . . . . . . . . . . . . . . . . . . .
Add lines 29a and 29b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29c
. . . . . . . . 0
. . . . .
Taxable income. Subtract line 29c from line 28 (see instructions) . . . . . . . . . . . .. . . . . . . . .. . .. .. . . . 30
. . . . .. . . 295,630
. . . . . . . .
Total tax (Schedule J, Part I, line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31. . . . . 103,471
. . . . . . . .
Total payments and refundable credits (Schedule J, Part II, line 21) . . . . . . . . . . . . . . . . . . . . . 32
. . . . . . . . .0 . . . . .
33
34
35
36
Estimated tax penalty (see instructions). Check if Form 2220 is attached

. . . . . . . . . . . . . . . . . . . . 33
. . . . . . . . . . . . .
Amount owed. If line 32 is smaller than the total of lines 31 and 33, enter amount owed . . . . . . . . . . . . . 34
. . . . . 103,471
. . . . . . . .
Overpayment. If line 32 is larger than the total of lines 31 and 33, enter amount overpaid . . . . . . . . . . . . .35. . . . . . . . 0. . . . .
Enter amount from line 35 you want:Credited to 2012 estimated tax
Refunded
0
36
Sign
Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct,
and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
11/29/2012
Signature of officer
Print/Type preparer's name
Paid
Preparer
Use Only
Date
Neda B. Ardekani
Title
Preparer's signature
Date
SELF-PREPARED RETURN
Firm's name
City
May the IRS discuss this return with

the preparer shown below (see
instructions)?
Yes
No
Check
if
self-employed
PTIN
Firm's EIN
Firm's address
For Paperwork Reduction Act Notice, see separate instructions.

(HTA)
, ending
Name
Schedule M-3 attached
Income
OMB No. 1545-0123
U.S. Corporation Income Tax Return
Phone no.
State
ZIP code
Form
1120 (2011)
Form 1120 (2011)
Schedule C
By the Numbers, Inc.
11-1111111
Dividends and Special Deductions (see instructions)
(a) Dividends
received
(b) %
Page
(c) Special deductions

(a) (b)
Dividends from less-than-20%-owned domestic corporations (other than

debt-financed stock) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
. . . . . . . . .
Dividends from 20%-or-more-owned domestic corporations (other than

. . . . . . . . . .
see
Dividends on debt-financed stock of domestic and foreign corporations . . . . . . . . . . . . . . . . . . instructions
. . . . . . . . . . . . . 0. . . .
Dividends on certain preferred stock of less-than-20%-owned public utilities . . . . . . . . . . . . . . . . . . 42

. . . . . . . . . . . .0 . . .
Dividends on certain preferred stock of 20%-or-more-owned public utilities . . . . . . . . . . . . . . . . . . .48. . . . . . . . . . . 0. . . .
Dividends from less-than-20%-owned foreign corporations and certain FSCs . . . . . . . . . . . . . . . . . .70. . . . . . . . . . . 0. . . .
Dividends from 20%-or-more-owned foreign corporations and certain FSCs . . . . . . . . . . . . . . . . . . 80

. . . . . . . . . . . .0 . . .
Dividends from wholly owned foreign subsidiaries . . . . . . . . . . . . . . . . . . . . . . . . . . . .100

. . . . . . . . . .
Total. Add lines 1 through 8. See instructions for limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0. . . .
10
Dividends from domestic corporations received by a small business investment

company operating under the Small Business Investment Act of 1958
. . . . . . . . . . . . . . . . . . . 100
. . . . . . . . . . . . 0. . . .
11
Dividends from affiliated group members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100

. . . . . . . . . . . .0 . . .
12
Dividends from certain FSCs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

. . . . . . . . . . .
13
Dividends from foreign corporations not included on lines 3, 6, 7, 8, 11, or 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
Income from controlled foreign corporations under subpart F (attach Form(s) 5471) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15
Foreign dividend gross-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
16
IC-DISC and former DISC dividends not included on lines 1, 2, or 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
Other dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
Deduction for dividends paid on certain preferred stock of public utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19
Total dividends. Add lines 1 through 17. Enter here and on page 1, line 4 . . . . . . . . . . . . . . . .0 . . . . . . . . . . . . . . . . . .
20
Total special deductions. Add lines 9, 10, 11, 12, and 18. Enter here and on page 1, line 29b . . . . . . . . . . . . . . . . . . . . . . 0. . . .
Form
1120 (2011)
Form 1120 (2011)
Schedule J
11-1111111
Page 3
Tax Computation and Payment (see instructions)
Part ITax Computation

1
Check if the corporation is a member of a controlled group (attach Schedule O (Form 1120)) . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income tax. Check if a qualified personal service corporation (see instructions) . . . . . .. . .. . . . . . . . .. .. . .. . . X. . . . . .2. . . . . 103,471
. . . . . . . . .
Alternative minimum tax (attach Form 4626) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . . . . . . . . . .
Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . . 103,471

. . . . . . . . .
5a Foreign tax credit (attach Form 1118) . . . . . . . . . . . . . . . . . . . . . . . 5a. . . . . . . . . . . . . . . . . . . . . . . . . .

b Credit from Form 8834, line 30 (attach Form 8834) . . . . . . . . .. . .. .. . . . . . . . . 5b
. . . . . . . . . . . . . . . . . . . . . . . . . .
c General business credit (attach Form 3800) . . . . . . . . . . . . . . . . . . . . . 5c. . . . . . . . . . . . . . . . . . . . . . . . . .
d Credit for prior year minimum tax (attach Form 8827) . . . . . . . . . . . . . . . . .5d. . . . . . . . . . . . . . . . . . . . . . . . . .
e Bond credits from Form 8912 . . . . . . . . . . . . . . . . . . . . . . . . . . .5e. . . . . . . . . . . . . . . . . . . . . . . . . .

6
Total credits. Add lines 5a through 5e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . . 0. . . . . .
Subtract line 6 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. . . . . 103,471

. . . . . . . . .
Personal holding company tax (attach Schedule PH (Form 1120)) . . . . . . . . . . . . . . . . . . . . . . . . 8

. . . . . . . . . . . . . .
9a Recapture of investment credit (attach Form 4255) . . . . . . . . . . . . . . . . . . 9a

. . . . . . . . . . . . . . . . . . . . . . . . . .
b Recapture of low-income housing credit (attach Form 8611) . . . . . . . . . . . . . . 9b

. . . . . . . . . . . . . . . . . . . . . . . . . . .
c Interest due under the look-back methodcompleted long-term contracts (attach
Form 8697) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9c. . . . . . . . . . . . . . . . . . . . . . . . .
d Interest due under the look-back methodincome forecast method (attach Form
8866) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9d. . . . . . . . . . . . . . . . . . . . . . . .
e Alternative tax on qualifying shipping activities (attach Form 8902) . . . . . . . . . . . . 9e
. . . . . . . . . . . . . . . . . . . . . . . . . .
f Other (see instructionsattach schedule) . . . . . . . . . . . . . . . . . . . . . .9f. . . . . . . . . . . . . . . . . . . . . . . . . .

Total. Add lines 9a through 9f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. . . . . . . . 0. .
Total tax. Add lines 7, 8, and 10. Enter here and on page 1, line 31 . . . . . . . .. . . . . . . . .. . .. . . . . . . . .. .. . .. .11
. . . . . . . 103,471
. . . . . . . . .
10
11
Part IIPayments and Refundable Credits

12
2010 overpayment credited to 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

. . . . . . . . . . . . . .
13
14
2011 estimated tax payments . . . . . . . . . . . . . . . . . . . . . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . 13. . . . . . . . . . . . . .

2011 refund applied for on Form 4466 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
. . .( . . . . . . . . ). . .
15
Combine lines 12, 13, and 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. . . . . . . . 0. . . . . .
16
Tax deposited with Form 7004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

. . . . . . . . . . . . . .
17
Withholding (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17. . . . . . . . . . . . . .
18
Total payments. Add lines 15, 16, and 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

. . . . . . . . 0. . . . . .
Refundable credits from:
Form 2439 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19a
. . . . . . . . . . . . . . . . . . . . . . . . .
Form 4136 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. .. .. .19b
. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . . . . . . . . . .
Form 3800, line 17c and Form 8827, line 8c . . . . . . . . . . . . . . . . . . . . .19c
. . . . . . . . . . . . . . . . . . . . . . . . . .
Other (attach schedulesee instructions) . . . . . . . . . . . . . . . . . . . . . 19d
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Total credits. Add lines 19a through 19d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20. . . . . . . .0 . . . . .
Total payments and credits. Add lines 18 and 20. Enter here and on page 1, line 32 . . . . . . . . . . . . . . . 21
. . . . . . . . 0. . . . . .
19
a
b
c
d
20
21
Schedule K
Other Information (see instructions)
Check accounting method:
See the instructions and enter the:
X Cash
Accrual
Yes
Other (specify)
No
541990
actuarial
actuarial
a Business activity code no.

b Business activity
c Product or service
3
Is the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? . . . . . . . . . . . . . . . . . . . . . . . . X. . . .

If "Yes," enter name and EIN of the parent corporation
EIN
Name
At the end of the tax year:
a Did any foreign or domestic corporation, partnership (including any entity treated as a partnership), trust, or tax-exempt
organization own directly 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all classes of the
corporation's stock entitled to vote? If "Yes," complete Part I of Schedule G (Form 1120) (attach Schedule G) . . . . . . . . . . . . . . . . . X. . . .
b Did any individual or estate own directly 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all
classes of the corporation's stock entitled to vote? If "Yes," complete Part II of Schedule G (Form 1120) (attach Schedule G) . . . . . . . . . X. . . . . .
Form
1120 (2011)
Form 1120 (2011)
Schedule K
11-1111111
Page 4
Other Information continued (see instructions)

Yes
No
At the end of the tax year, did the corporation:
a Own directly 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all classes of stock entitled to vote of any
foreign or domestic corporation not included onForm 851, Affiliations Schedule? For rules of constructive ownership, see instructions.
If "Yes," complete (i) through (iv) below.
(ii) Employer
Identification Number
(if any)
(i) Name of Corporation
(iii) Country of
Incorporation
(iv) Percentage
Owned in Voting
Stock
b Own directly an interest of 20% or more, or own, directly or indirectly, an interest of 50% or more in any foreign or domestic partnership
(including an entity treated as a partnership) or in the beneficial interest of a trust? For rules of constructive ownership, see instructions . . . . . . . X. . . .
(ii) Employer
(if any)
(i) Name of Entity
(iii) Country of Organization
(iv) Maximum
Percentage Owned in
Profit, Loss, or Capital
During this tax year, did the corporation pay dividends (other than stock dividends and distributions in exchange for stock) in
excess of the corporation's current and accumulated earnings and profits? (See sections 301 and 316.) . . . . . . . . . . . . . . . . . . . X
. . . .
If "Yes," file Form 5452, Corporate Report of Nondividend Distributions.
If this is a consolidated return, answer here for the parent corporation and on Form 851 for each subsidiary.
At any time during the tax year, did one foreign person own, directly or indirectly, at least 25%(a)
of the total voting power of all
classes of the corporation's stock entitled to vote or(b) the total value of all classes of the corporation's stock? . . . . . . . . . . . . . . . . . X
. . . .
For rules of attribution, see section 318. If "Yes," enter:
(i) Percentage owned
and (ii) Owner's country
(c) The corporation may have to fileForm 5472, Information Return of a 25% Foreign-Owned U.S. Corporation or a Foreign
Corporation Engaged in a U.S. Trade or Business. Enter the number of Forms 5472 attached
8
Check this box if the corporation issued publicly offered debt instruments with original issue discount . . . . . . . . . . . . . . . . . . . . . . . . .
If checked, the corporation may have to fileForm 8281, Information Return for Publicly Offered Original Issue Discount Instruments.
Enter the amount of tax-exempt interest received or accrued during the tax year
$
3,000
2
10
Enter the number of shareholders at the end of the tax year (if 100 or fewer)
11
If the corporation has an NOL for the tax year and is electing to forego the carryback period, check here . . . . . . . . . . . . . . . . . . . . . . .
If the corporation is filing a consolidated return, the statement required by Regulations section 1.1502-21(b)(3) must be attached or
the election will not be valid.
12
Enter the available NOL carryover from prior tax years (do not reduce it by any deduction on line 29a.)
13
Are the corporation's total receipts (line 1c plus lines 4 through 10 on page 1) for the tax year
and its total assets at the end of the
tax year less than $250,000? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X. . . .
If "Yes," the corporation is not required to complete Schedules L, M-1, and M-2 on page 5. Instead, enter the total amount of cash
distributions and the book value of property distributions (other than cash) made during the tax year.
$
14
Is the corporation required to file Schedule UTP (Form 1120), Uncertain Tax Position Statement (see instructions)? . . . . . . . . . . . . . . . . . . .
If "Yes," complete and attach Schedule UTP.
15a Did the corporation make any payments in 2011 that would require it to file Form(s) 1099 (see instructions)? . . . . . . . . . . . . . . . . . .X . . . .
b If "Yes," did or will the corporation file all required Forms 1099? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Form
1120 (2011)
Form 1120 (2011)
Schedule L
Balance Sheets per Books

Assets
11-1111111
Beginning of tax year
(a)
(b)
Page 5
End of tax year

(c)
(d)
1
2a
b
3
4
5
6
7
8
9
10a
b
11a
b
12
13a
b
14
15
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23,220
. . . . . . . . . . . . . . . . . . 26,300
. . . . . . .
Trade notes and accounts receivable . . . . . . . . . . . . . .35,850
. . . . . . . . . . . . . . . . . .32,100
. . . . . . . . . . . . . . . .
Less allowance for bad debts . . . . . . . . . . . . (. . . . . . . .) . . . . . . 35,850
. . . . (. . . . . . . .) . . . . . . 32,100
. . . . . . .
Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
U.S. government obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tax-exempt securities (see instructions) . . . . . . . . . . . . . . . . . . . . . .75,000
. . . . . . . . . . . . . . . . . .75,000
. . . . . . .
Other current assets (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loans to shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mortgage and real estate loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other investments (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Buildings and other depreciable assets . . . . . . . . . . . . 295,600
. . . . . . . . . . . . . . . . . . 311,700
. . . . . . . . . . . . . . . . . .
Less accumulated depreciation . . . . . . . . . . . .( . . . . 63,500)
. . . . . . . . 232,100
. . . . . (. . . . . 85,900)
. . . . . . . . .225,800
. . . . . . . .
Depletable assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less accumulated depletion . . . . . . . . . . . . .( . . . . . . . ). . . . . . . . . 0 . .( . . . . . . . ). . . . . . . . . 0. . . . .
Land (net of any amortization) . . . . . . . . . . . . . . . . . . . . . . . . . 35,000
. . . . . . . . . . . . . . . . . . .35,000
. . . . . . .
Intangible assets (amortizable only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less accumulated amortization . . . . . . . . . . . (. . . . . . . . ) . . . . . . . . .0 . (. . . . . . . . ) . . . . . . . . .0 . . . . .
Other assets (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . .2,980
. . . . . . . . . . . . . . . . . . 2,110
. . . . . . .
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404,150
. . . . . . . . . . . . . . . . . . 396,310
. . . . . . . .
16
17
18
19
20
21
22
Accounts payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34,800

. . . . . . . . . . . . . . . . . . 35,596
. . . . . . . .
Mortgages, notes, bonds payable in less than 1 year
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other current liabilities (attach schedule) . . . . . . . . . . . . . . . . . . . . . . 9,350
. . . . . . . . . . . . . . . . . 18,250
. . . . . . . .
Loans from shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mortgages, notes, bonds payable in 1 year or more . . . . . . . . . . . . . . . . .114,000
. . . . . . . . . . . . . . . . . .108,600
. . . . . . . .
Other liabilities (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Capital stock: a Preferred stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b Common stock . . . . . . . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . .
Additional paid-in capital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Retained earningsAppropriated (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Retained earningsUnappropriated . . . . . . . . . . . . . . . . . . . . . . . 46,000
. . . . . . . . . . . . . . . . . . 33,864
. . . . . . . .
Adjustments to shareholders' equity (attach schedule)
Less cost of treasury stock . . . . . . . . . . . . . . . . . . . . . . ( . . . . . . . .) . . . . . . . . . . (. . . . . . . . ) . . . .
Total liabilities and shareholders' equity . . . . . . . . . . . . . . . . . . . . . 404,150
. . . . . . . . . . . . . . . . . . 396,310
. . . . . . . .
Liabilities and Shareholders' Equity
23
24
25
26
27
28
Schedule M-1
Reconciliation of Income (Loss) per Books With Income per Return

Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or moresee instructions
Net income (loss) per books . . . . . . . . . . . . . . . 299,496

. . . . . 7 . .Income
. . .recorded
. . . .on.books
. . this
. . year
. . not
. . . . . . . . . . . . . . .
Federal income tax per books . . . . . . . . . . . . . . . .-4,666
. . . . . included
. . . .on. this
. .return
. . (itemize):
. . . . . . . . . . . . . . . . . . . . .
Excess of capital losses over capital gains . . . . . . . . . . . . . . . . Tax-exempt
. . . . . interest
. . . . . $. . . . 3,000
. . . . . . . . . . . . . . . .
Income subject to tax not recorded on books
3,000
this year (itemize):
0 8 Deductions on this return not charged
5 Expenses recorded on books this year not
against book income this year (itemize):
deducted on this return (itemize):
a Depreciation . . . . .$ . . . . . . . . . . . . . . . . . . . .
a Depreciation . . . . . . . . $
. . . . . . . . . . . . . . . . . . b. .Charitable
. . . contributions
. . . . . . .$ . . . . . . . . . . . . . . . . . . .
b Charitable contributions . . . . $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c Travel and entertainment . . . .$ . . . . . 3,800
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2
3
4
0
3,800 9 Add lines 7 and 8 . . . . . . . . . . . . . . . . .3,000
. . . . . .
Add lines 1 through 5 . . . . . . . . . . . . . . . . . . 298,630
. . . . 10
. . Income
. . . (page
. . . 1,. line
. .28)line
. . . 6
. less
. . line
. .9 . . . . . 295,630
. . . . . . . .
Schedule M-2
1
2
3
Analysis of Unappropriated Retained Earnings per Books (Line 25, Schedule L)
Balance at beginning of year . . . . . . . . . . . . . . . .46,000

. . . .5 . Distributions:
. . . . . . . a. Cash
. . . . . . . . . . . . . . . . . . . . . . . . . . . 20,000
.. .. .. .. .. .. ..
. . . . . . . . . . . . . .b . Stock
. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .
Other increases (itemize):
c Property . . . . . . . . . . . . . . . . . .
6 Other decreases (itemize):
0 7 Add lines 5 and 6 . . . . . . . . . . . . . . . .20,000

. . . . . . .
Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . 345,496
. . . . . 8 . .Balance
. . . at. end
. .of.year
. .(line
. .4 less
. . line
. . 7). . . . . . .325,496
. . . . . . .
Form
1120 (2011)
Form
4626

Alternative Minimum TaxCorporations
OMB No. 1545-0175

Attach to the corporation's tax return.
Name
Employer identification number

11-1111111
Note: See the instructions to find out if the corporation is a small corporation exempt from the
alternative minimum tax (AMT) under section 55(e).
1
Taxable income or (loss) before net operating loss deduction . . . . . . . . . . . . . . . . . . .1 . . . . 295,630
. . . . . . .
2
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
3
Adjustments and preferences:

Depreciation of post-1986 property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
. . . . . . . . . . .
Amortization of certified pollution control facilities . . . . . . . . . . . . . . . . . . . . . . . .2b. . . . . . . . . . .
Amortization of mining exploration and development costs . . . . . . . . . . . . . . . . . . . . 2c. . . . . . . . . . .
Amortization of circulation expenditures (personal holding companies only) . . . . . . . . . . . . . 2d
. . . . . . . . . . . .
Adjusted gain or loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2e. . . . . . . . . . .
Long-term contracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f. . . . . . . . . . .
Merchant marine capital construction funds . . . . . . . . . . . . . . . . . . . . . . . . . .2g. . . . . . . . . . .
Section 833(b) deduction (Blue Cross, Blue Shield, and similar type organizations only) . . . . . . . . 2h
. . . . . . . . . . . .
Tax shelter farm activities (personal service corporations only) . . . . . . . . . . . . . . . . . . 2i
. . . . . . . . . . . .
Passive activities (closely held corporations and personal service corporations only) . . . . . . . . . . 2j. . . . . . . . . . .
Loss limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2k. . . . . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2l
. . . . . . . . . . .
Tax-exempt interest income from specified private activity bonds . . . . . . . . . . . . . . . . . 2m
. . . . . . . . . . . .
Intangible drilling costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2n. . . . . . . . . . .
Other adjustments and preferences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2o
. . . . . . . . . . .
Pre-adjustment alternative minimum taxable income (AMTI). Combine lines 1 through 2o . . . . . . . . 3. . . . 295,630
. . . . . . .
4
a
b
Adjusted current earnings (ACE) adjustment:

ACE from line 10 of the ACE worksheet in the instructions . . . . . . . . . . . 4a. . . . 298,630
. . . . . . . . . . . . . . . .
Subtract line 3 from line 4a. If line 3 exceeds line 4a, enter the difference as a
negative amount (see instructions) . . . . . . . . . . . . . . . . . . . . 4b
. . . . . .3,000
. . . . . . . . . . . . . .
Multiply line 4b by 75% (.75). Enter the result as a positive amount . . . . . . . 4c
. . . . . . 2,250
. . . . . . . . . . . . . .
Enter the excess, if any, of the corporation's total increases in AMTI from prior
year ACE adjustments over its total reductions in AMTI from prior year ACE
adjustments (see instructions). Note: You must enter an amount on line 4d
(even if line 4b is positive) . . . . . . . . . . . . . . . . . . . . . . . . 4d
. . . . . . . . . . . . . . . . . . . .
ACE adjustment.
If line 4b is zero or more, enter the amount from line 4c
. . . . . 4e. . . . . 2,250
. . . . . .
If line 4b is less than zero, enter the smaller of line 4c or line 4d as a negative amount
Combine lines 3 and 4e. If zero or less, stop here; the corporation does not owe any AMT . . . . . . . .5 . . . . 297,880
. . . . . . .
Alternative tax net operating loss deduction (see instructions) . . . . . . . . . . . . . . . . . . 6. . . . . . . 0. . . .
c
d
5
6
7
Alternative minimum taxable income. Subtract line 6 from line 5. If the corporation held a residual
interest in a REMIC, see instructions . . . . . . . . . . . . . . . . . . . . .. .. .. .. .. .. .. .. 7. . . . . . . . 297,880
.. .. .. .. .. .. ..
8
a
Exemption phase-out (if line 7 is $310,000 or more, skip lines 8a and 8b and enter -0- on line 8c):
Subtract $150,000 from line 7 (if completing this line for a member of a
controlled group, see instructions). If zero or less, enter -0- . . . . . . . . . . 8a
. . . . . 147,880
. . . . . . . . . . . . . . .
Multiply line 8a by 25% (.25) . . . . . . . . . . . . . . . . . . . . . . 8b
. . . . . .36,970
. . . . . . . . . . . . . .
Exemption. Subtract line 8b from $40,000 (if completing this line for a member of a controlled group,
see instructions). If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . 8c
. . . . . .3,030
. . . . .
Subtract line 8c from line 7. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . 9. . . . .294,850
. . . . . .
Multiply line 9 by 20% (.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10. . . . .58,970
. . . . . .
Alternative minimum tax foreign tax credit (AMTFTC) (see instructions) . . . . . . . . . . . . . . 11
. . . . . . . . . . . .
Tentative minimum tax. Subtract line 11 from line 10 . . . . . . . . . . . . . . .. .. .. .. .. .. .. ..12. . . . . . . . .58,970
.. .. .. .. .. ..
Regular tax liability before applying all credits except the foreign tax credit . . . . . . . . . . . . . .13. . . . 103,471
. . . . . . .
Alternative minimum tax. Subtract line 13 from line 12. If zero or less, enter -0-. Enter here and on
Form 1120, Schedule J, line 3, or the appropriate line of the corporation's income tax return . . . . . . 14
. . . . . . . 0. . . .
b
c
9
10
11
12
13
14
For Paperwork Reduction Act Notice, see the instructions.

(HTA)
Form
4626 (2011)
SCHEDULE G
(Form 1120)
Information on Certain Persons Owning the

Corporation's Voting Stock
(Rev. December 2011)

Employer identification number (EIN)
Name
Part I
11-1111111
Certain Entities Owning the Corporation's Voting Stock. (Form 1120, Schedule K, Question 4a).
Complete columns (i) through (v) below for any foreign or domestic corporation, partnership (including
any entity treated as a partnership), trust, or tax-exempt organization that owns directly 20% or more, or
owns, directly or indirectly, 50% or more of the total voting power of all classes of the corporation's
stock entitled to vote (see instructions).
(i) Name of Entity
Part II
OMB No.1545-0123
Attach to Form 1120.

See instructions on page 2.
(ii) Employer Identification

Number (if any)
(iii) Type of Entity
(iv) Country of Organization
(v) Percentage Owned in Voting Stock
Certain Individuals and Estates Owning the Corporation's Voting Stock. (Form 1120, Schedule K,
Question 4b). Complete columns (i) through (iv) below for any individual or estate that owns directly 20%
or more, or owns, directly or indirectly, 50% or more of the total voting power of all classes of the
corporation's stock entitled to vote (see instructions).
(i) Name of Individual or Estate
(ii) Identifying
Number (if any)
(iii) Country of
Citizenship (see
instructions)
(iv) Percentage Owned

in Voting Stock
Belinda Jackson
123-45-6789
United States
50.000%
Ahmad Sharma
987-65-4321
United States
50.000%
For Paperwork Reduction Act Notice,

see the Instructions for Form 1120.
(HTA)
Schedule G (Form 1120) (Rev. 12-2011)
SCHEDULE PH
(Form 1120)
U.S. Personal Holding Company (PHC) Tax

OMB No. 1545-0123
See separate instructions. Attach to tax return.

Name
Part I
Undistributed Personal Holding Company Income (see instructions)
Taxable income before net operating loss deduction and special deductions. Enter
amount from Form 1120, line 28 . . . . . . . . . . . . . . . . . . . . . . . . . 1. . . . . . . 295,630
. . . . . . .
2
Contributions deducted in figuring line 1. Enter amount from Form 1120, line 19 . . . . . . 2
. . . . . . . . . 1,000
. . . . .
3
Excess expenses and depreciation under section 545(b)(6). Enter amount from Part V,
line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . .
4
Total. Add lines 1 through 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . . . . 296,630
. . . . . . .
5
Federal and foreign income, war profits, and excess profits taxes not deducted in figuring
line 1 (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 . . . . . . . . . . . . . .
6
Contributions deductible under section 545(b)(2). See instructions for limitation . . . . . . .6 . . . . . . . . . . . . . .
7
Net operating loss for the preceding tax year deductible under section 545(b)(4) . . . . . . 7. . . . . . . . . . . . . .
8 a Net capital gain from Schedule D (Form 1120), line 13 . . . . .8a. . . . . . . . . . . . . . . . . . . . . . . . .
b Less: Income tax on this net capital gain (see section
545(b)(5)) (attach computation) . . . . . . . . . . . . . .8b. . . . . . . . 4,925
. . . 8c
. . . . . . . . .-4,925
. . . . . .
9
Deduction for dividends paid (other than dividends paid after the end of the tax year).
Enter amount from Part VI, line 5 . . . . . . . . . . . . . . . . . . . . . . . . . 9 . . . . . . . . . . . . . .
Additions
Deductions
11-1111111
10
Total. Add lines 5 through 9 . . . . . . . . . . . . . . . . . . . . . . . . . . .10. . . . . . . . -4,925

. . . . . .
11
12
Subtract line 10 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

. . . . . . . .301,555
. . . . . .
Dividends paid after the end of the tax year (other than deficiency dividends defined in
section 547(d)), but not more than the smaller of line 11 or 20% of Part VI, line 1 . . . . . . 12. . . . . . . . . . . . . .
Undistributed PHC income. Subtract line 12 from line 11. . . . . . . . . . . . . . . 13. . . . . . . 301,555
. . . . . . .
13
Note: If the information in Part II and Part IV is not submitted with the return, the limitation period for assessment and
collection of the PHC tax is any time within 6 years after the return is filed. See section 6501(f).
Part II
14
15 a
b
16
17
18 a
b
19 a
b
20
21
22
23
24
25
Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14. . . . . . . .20,000

. . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . .15a
. . . . . . . . .3,000
. . . . . . . . . . . . . . . . .
Less: Amounts excluded (attach schedule) . . . . . . . . . . .15b
. . . . . . . . . . . 15c
. . . . . . . . . 3,000
. . . . . .
Royalties (other than mineral, oil, gas, or copyright royalties) . . . . . . . . . . . . . . . .16. . . . . . . . . . . . . .
Annuities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. . . . . . . . . . . . . .
Rents . . . . . . . . . . . . . . . . . . . . . . . . . 18a
. . . . . . . . . 4,100
. . . . . . . . . . . . . . . . .
Less: Adjustments to rents (attach schedule) . . . . . . . . . .18b
. . . . . . . . . . . 18c
. . . . . . . . . 4,100
. . . . . .
Mineral, oil, and gas royalties . . . . . . . . . . . . . . . . 19a
. . . . . . . . . . . . . . . . . . . . . . . . . .
Less: Adjustments to mineral, oil, and gas royalties (attach
schedule) . . . . . . . . . . . . . . . . . . . . . . . . 19b
. . . . . . . . . . . 19c
. . . . . . . . . . . 0. . . .
Copyright royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
. . . . . . . . . . . . . .
Produced film rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21. . . . . . . . . . . . . .
Compensation received for use of corporation property by 25% or more shareholder . . . . . . 22
. . . . . . . . . . . . . .
Amounts received under personal service contracts and from their sale . . . . . . . . . . . 23
. . . . . . . . . . . . . . .
Amounts includible in taxable income from estates and trusts . . . . . . . . . . . . . . . 24
. . . . . . . . . . . . . . .
PHC income. Add lines 14 through 24 . . . . . . . . . . . . . . . . . . . . . . . . 25
. . . . . . . . 27,100
. . . . . .
Part III
26
Personal Holding Company Income (see instructions)
Tax on Undistributed Personal Holding Company Income
PHC tax. Multiply the amount on line 13 by the tax rate for undistributed PHC income (see
instructions). Enter the result here and on Schedule J, line 8, or on the proper line of the
appropriate tax return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
. . . . . . . . . . 0
. . . .
For Paperwork Reduction Act Notice, see the Instructions for Form 1120.
(HTA)
Schedule PH (Form 1120) (Rev. 12-2011)
Part IV
11-1111111
Page
Stock Ownership Requirement Under Section 542(a)(2)

Enter the names and addresses of the individuals who together owned, directly or indirectly, at any time
during the last half of the tax year, more than 50% in value of the outstanding stock of the corporation.
(a) Name
Highest percentage of shares

owned during last half of tax year
(b) Address
(c) Preferred
(d) Common
St
Zip
St
Zip
St
Zip
St
Zip
St
Zip
Add the amounts in columns (c) and (d) and enter the totals here . . . . . . . . . . . . . . . . . .% . . . . . %
. . . . .
Part V
Excess of Expenses and Depreciation Over Income From Property Not Allowable
Under Section 545(b)(6) (see instructions for Part I, line 3)
(a) Description of
property
(b) Date
acquired
(c) Cost or
other basis
(d) Depreciation
deduction
(e) Repairs,
insurance, and
other expenses
(section 162)
(attach schedule)
(f) Total of
columns (d)
and (e)
(g) Income from

rent or other
compensation
(h) Excess
(col. (f) less
col. (g))
Total excess of expenses and depreciation over rent or other compensation. Add the amounts in column
(h). Enter the total here and on Part I, line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0. . . .
Note: Attach a statement showing the names and addresses of persons from whom rent or other
compensation was received for the use of, or the right to use, each property.
Part VI
Deduction for Dividends Paid Under Sections 561 and 562
Taxable dividends paid. Do not include dividends considered as paid in the preceding tax
year under section 563 or deficiency dividends as defined in section 547 . . . . . . . . . . . 1 . . . . . . . . . . . . . .
Consent dividends. Attach Forms 972 and 973 . . . . . . . . . . . . . . . . . . . . . 2. . . . . . . . . . . . . .
Taxable distributions. Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . .0 . . . .
Dividend carryover from first and second preceding tax years. Attach computation . . . . . . . 4. . . . . . . . . . . . . .
Deduction for dividends paid. Add lines 3 and 4. Enter the total here and on Part I,
line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . . . . . . . . 0. . . . .
Form
1125-E
(December 2011)
Compensation of Officers
OMB No. 1545-2225
Attach to Form 1120, 1120-C, 1120-F, 1120-RIC.

Name
11-1111111
Note. Complete Form 1125-E only if total receipts are $500,000 or more. See instructions for definition of total receipts.
(a) Name of officer
Belinda Jackson
Ahmad Sharma
(b) Social security number
(c) Percent of
time devoted to
business
Percent of stock owned

(d) Common
(e) Preferred
(f) Amount of
compensation
123-45-6789
50.00%
50.00%
125,000
987-65-4321
50.00%
50.00%
125,000
Total compensation of officers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . 250,000

. . . . . . . .
Compensation of officers claimed on Form 1125-A or elsewhere on return . . . . . . . . . . 3. . . . . . .250,000

. . . . . . .
Subtract line 3 from line 2. Enter the result here and on Form 1120, page 1, line 12 or the
appropriate line of your tax return . . . . . . . . . . . . . . . . . . . . . . . . . . .4 . . . . . . . . .0 . . . .

(HTA)
Form 1125-E (12-2011)
11-1111111
Line 26 (1120) - Other Deductions
1 Dividends paid in cash on stock held by an employee stock ownership plan (see instructions) . . . . . 1. . . . . 20,000
. . . . . . . .
2 Travel, Meals and Entertainment
a Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
. . . . . .6,300
. . . . . . .
b Meals and entertainment, subject to 50% limit . . . . . . . . . . . . . . .2b. . . . . 7,600
. . . . . . . . . . . . . . .
c Meals and entertainment, subject to 80% limit (DOT) . . . . . . . . . . . . 2c. . . . . . . . . . . . . . . . . . . . .
d Less disallowed . . . . . . . . . . . . . . . . . . . . . . . . . . 2d
. . . . . .3,800
. . . . . . . . . . . . . . .
e Subtract line d from lines b and c . . . . . . . . . . . . . . . . . . . . . . . . . . . .2e. . . . . 3,800
. . . . . . .
3 Dues and subscriptions
3
4,900
4 Insurance
4
15,000
5 Legal and professional fees
5
12,500
6 Miscellaneous
6
3,000
7 Telephone
7
2,400
8 Total other deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 . . . . 67,900
. . . . . . . .
9 Total deductions less expenses for offsetting credits . . . . . . . . . . . . . . . . . . . . . . 9 . . . . .67,900
. . . . . . .
Line 14, Sch L (1120) - Other Assets
Beginning
End
1 Other Assets
1
2,980
2,110
2 Total other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . . . . 2,980
. . . . . . . . .2,110
. . . . . . .
Line 18, Sch L (1120) - Other Current Liabilities

Beginning
End
1 Other Current Liabilities
1
9,350
18,250
2 Total other current liabilities . . . . . . . . . . . . . . . . . . . . . . . 2. . . . . .9,350
. . . . . . . 18,250
. . . . . . . .
Line 8b (Sch PH (1120)) - Income Tax on Net Capital Gain

1
2
3
4
5
6
Taxable income from 1120, line 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 . . . . 295,630

. . . . . . . .
Net capital gain included in taxable income from Schedule D, line 13 . . . . . . . . . . . . . . . 2. . . . . . . 0. . . . . .
Taxable income excluding capital gain. Subtract line 2 from line 1 . . . . . . . . . . . . . . . . .3 . . . . 295,630
. . . . . . . .
Regular tax on line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . 103,471
. . . . . . . . .
Regular tax on line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . . . 98,546
. . . . . . . .
Tax attributable to capital gain. Subtract line 5 from line 4 . . . . . . . . . . . . . . . . . . . . 6 . . . . . 4,925
. . . . . . .
2011 CCH Small Firm Services. All rights reserved.
11-1111111
Line 5 (1120) - Interest Income
1 Other U.S. government obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. . . . . 3,000

. . . . . . . .
2 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . .3,000
. .
Line 13 (1120) - Salaries and Wages
1 Salaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. . . . . 5,000
. . . . . . . . . . . . . . . .
2 Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . . . . . . . . . . . . . . . . .
3
3
4 Total salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 . . . . .5,000
. . . . . . .
Salaries and wages reported elsewhere on return:
5 Amounts included in Cost of Goods Sold . . . . . . . . . . . . . . . . . . .5 . . . . . . .0 . . . . . . . . . . . . .
6 Elective contributions to a section 401(k) cash or deferred
arrangement, or amounts contributed under a salary reductions SEP
agreement or a SIMPLE IRA plan . . . . . . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . . . . . . . . . .
7 Total salaries and wages reported elsewhere on return . . . . . . . . . . . . . . . . . . . . . 7. . . . . . . 0. . . . . .
Less employment credits:
8 From Form 5884 - Work Opportunity Credit . . . . . . . . . . . . . . . . . 8. . . . . . . 0. . . . . . . . . . . . . .
9 From Form 8844 - Empowerment Zone Employment Credit . . . . . . . . . . . 9 . . . . . . . 0 . . . . . . . . . . . . .
10 From Form 8845 - Indian Employment Credit . . . . . . . . . . . . . . . . 10
. . . . . . . 0. . . . . . . . . . . . . .
11
11
12
12
13 Total employment credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
. . . . . . . 0. . . . . .
14 Reduction of expenses for other offsetting credits (see attached statement) . . . . . . . . . . . . .14. . . . . . .0 . . . . .
15 Total salaries and wages less employment credits and expense reductions . . . . . . . . . . . . . 15. . . . . 5,000
. . . . . . .
Line 17 (1120) - Taxes and Licenses

1
2
3
4
5
6
7
State income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . 2,250

. . . . . . .
Local property taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . . . . 21,500
. . . . . . . .
Payroll tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . 20,020
. . . . . . . .
other miscellaneous
4
1,700
Quarterly payments
5
5,000
Sub Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. . . . . 50,470
. . . . . . .
Total taxes and licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . . . . .50,470
. . . . . . .
Line 18 (1120) - Interest Expense

1 Business Loans
1
12,800
2 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . . . .12,800
. . . . . . .
11-1111111
Line 19 (1120) - Charitable Contributions

(A)
Amount
1
a
b
2
a
b
c
d
e
3
4
5
(B)
Adjustment
under Section
170(d)(2)(B)
(C)
Deduction
Allowed in
Current Year
(D)
Contribution
Carryover
Contribution for current year:

Direct contribution . . . . . . 1,000
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
From partnerships . . . . . . . . 0 . 1. . . . . . . 1,000
. . . . . . . . . . 0 . . . . . . 1,000
. . . . . . . . . . 0. . . . . .
Carryover from:
5th preceding period . . . . . . . . 2a
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
4th preceding period . . . . . . . . 2b
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
3rd preceding period . . . . . . . . 2c
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
2nd preceding period . . . . . . . .2d. . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . 0. . . . .
1st preceding period . . . . . . . . 2e
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
Totals . . . . . . . . . . . . . . 3. . . . . . . 1,000
. . . . . . . . . .0 . . . . . . 1,000
. . . . . . . . . . 0. . . . .
Carryover to expire next year due to 5 year limitation . . . . . . . . . . . . . . . . . . . . . .4 . . . . . . .0 . . . . .
Total contribution carryover to next year . . . . . . . . . . . . . . . . . . . . . . . . . . .5 . . . . . . .0 . . . . .
Computation of Section 179 Deduction for Estimated Charitable Contribution

6
7
8
9
10
Taxable Income computed without contribution deduction or Section 179 . . . . . . . . . . . . . .6 . . . . 319,030

. . . . . . . .
Section 179 deduction for purposes of contribution limitation . . . . . . . . . . . . . . . . . . .7 . . . . . . .0 . . . . .
Taxable income less Section 179 deduction. Subtract line 7 from line 6 . . . . . . . . . . . . . . .8 . . . . 319,030
. . . . . . . .
Maximum contribution limitation. Enter 10% of line 8 . . . . . . . . . . . . . . . . . . . . . . 9. . . . .31,903
. . . . . . .
Contribution deduction considering Section 179 limitation.
Smaller of line 3, col A minus lines 2a through 2e, col B or line 9 . . . . . . . . . . . . . . . . . 10
. . . . . .1,000
. . . . . . .
Computation of Actual Charitable Contribution

11
12
13
14
15
16
Actual Section 179 deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11. . . . . . .0 . . . . .

Taxable income less actual Section 179 deduction. Subtract line 11 from line 6 . . . . . . . . . . . 12
. . . . .319,030
. . . . . . . .
Net operating loss deductions limited by line 12 . . . . . . . . . . . . . . . . . . . . . . . . 13
. . . . . . . 0. . . . . .
Taxable income for purposes of contribution deduction. Subtract line 13 from line 12 . . . . . . . . . 14
. . . . .319,030
. . . . . . . .
Maximum contribution limitation. Enter 10% of line 14 . . . . . . . . . . . . . . . . . . . . . 15
. . . . . 31,903
. . . . . . . .
Actual contribution deduction. Smaller of line 3, col A minus lines 2a through 2e, col B or line 15 . . . . .16. . . . . 1,000
. . . . . . .
Computation of Qualified Conservation Property Contributions by Farmers and Ranchers

17 Carryover of 100% contribution from 2010 . . . . . . . . . . . . . . . . . . . .
18 Enter the amount of qualified conservation property contributions
Do not include any amount entered in line 1(A) above
Direct contribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
From partnerships . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
19 Net 100% contribution available for current year . . . . . . . . . . . . . . . . . .
20 Taxable income for purposes of 100% contribution deduction. Subtract line 16 from line 14 .
21 100% contribution deduction for current year. Enter the smaller of line 19 or line 20 . . . .
22 Carryover of 100% contribution to 2012. Subtract line 20 from line 19 . . . . . . . . .
. . . . . . 17
. . . . . . . . . . . . .
.
.
.
.
.
.
.
.
.
.
.
.
. .
. 0.
. .
. .
. .
. .
.
.
.
.
.
.
. .
. 18
.
.19.
.20.
.21.
.22.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. .
. 0.
. 0.
.0 .
.0 .
.0 .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. .
. .
.
.
.
.
Part I - Contribution carryover, NOL carryover, and Taxable income without contribution deduction
1 2011 taxable income without contributions deduction . . . . . . . . . . . . . . . . . . . . . . 1. . . . 319,030
. . . . . . . .
2 Contribution deduction available in 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . . . . 1,000
. . . . . . .
3 Prior year NOL carryover to 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 . . . . . . .0 . . . . .
Part II - Determination of 2011 contributions converted to NOL under Section 170(d)(2)(B)

1
2
3
4
Taxable Income computed without contribution deduction . . . . . . . . . . . . . . . . . . . . 1. . . . . . . 0. . . . . .

Net operating loss deductions. (NOL cannot exceed Part II, line 1) . . . . . . . . . . . . . . . . . 2 . . . . . . .0 . . . . .
Taxable income for purposes of contribution deduction. Subtract line 2 from line 1 . . . . . . . . . . .3 . . . . . . .0 . . . . .
Maximum contribution (10% of line 1 when NOL is not applied to taxable income computed without
contribution deductions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
. . . . . . . 0. . . . . .
5 Actual contribution deduction allowed. Enter line 16 above . . . . . . . . . . . . . . . . . . . .5 . . . . . . .0 . . . . .
6 Current year's Section 170(d)(2)(B) contribution deduction converted to NOL. Subtract line 5 from line 4
but do not enter more than the current year contribution less the actual contribution deduction . . . . . . 6 . . . . . . . 0 . . . . .
Part III - Determination of 2011 contribution carryover to next year under Section 170(d)(2)(B)
1
2
3
4
5
Contribution deduction available in 2011. Enter Part I, line 2 above . . . . . . . . . . . . . . . . .1 . . . . . 1,000

. . . . . . .
Contribution deducted for the tax year ending 2011. Enter line 16 above . . . . . . . . . . . . . . .2 . . . . .1,000
. . . . . . .
Current year's Section 170(d)(2)(B) contribution deduction converted to NOL. Enter Part II, line 6 above . . 3. . . . . . . 0 . . . . .
Carryover to expire next year due to 5 year limitation. Enter Column D, line 4 above . . . . . . . . . . 4 . . . . . . . 0 . . . . .
Total contribution carryover to next year. Subtract lines 2, 3, and 4 from line 1 . . . . . . . . . . . . 5. . . . . . . 0. . . . . .
11-1111111
Line 3, Sch J (1120) - Small Corporation Exempt from AMT Determination

Complete this worksheet to determine if the corporation qualifies as a small corporation exempt from the
alternative minimum tax.
Yes
No
X Is this tax year the corporation's first year in existence?
If "Yes", Stop here.
The corporation is exempt from AMT with no other qualification requirements.
X Did the corporation lose small corporation status in a prior year? If so, enter the change date:
Once a corporation loses its small corporation status, it cannot qualify in any subsequent tax year.
Tax Year
2005
2006
2007
2008
2009
2010
2011
Yes
or
N/A
X
Annualized
Gross Receipts
530,000
Prior Three
Year Average
0
0
0
0
0
0
0
Enter Gross Receipts for 2005.

No
Did the corporation have average annual gross receipts of $5 million or less for the FIRST
three-year period beginning after 1993 (for calendar year corps in existence on 1/1/1994
through 1996)?
Were the corporation's average gross receipts for EVERY three-year period beginning after
1994 and ending before its tax year beginning in 2011 $7.5 million or less? (For calendar
year corporations in existence on 1/1/1994, the three year periods are: 1995-1997, 1996-1998,
1997-1999, 1998-2000, 1999-2001, 2000-2002, 2001-2003, 2002-2004, 2003-2005, 2004-2006, 2005-2007,
2006-2008, 2007-2009, 2008-2010).
If the corporation had only one prior tax year, were the gross receipts for the prior tax
year $5 million or less, (or the corporation was established before 1994)?
Corporation qualifies as a small corporation or is otherwise exempt from the alternative minimum tax.
11-1111111
Sch L (1120) - Balance Sheets per Books

1
2a
2b
2c
3
4
5
6
7
8
9
10a
10b
10c
11a
11b
11c
12
13a
13b
13c
14
15
Assets
Beginning
Ending
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 . . . . 23,220
. . . . . . . . 26,300
. . . . . . . .
Trade notes and accounts receivable . . . . . . . . . . . . . . . . . . .2a. . . . .35,850
. . . . . . . .32,100
. . . . . . .
Less allowance for bad debts . . . . . . . . . . . . . . . . . . . . . .2b. . . . . . . . . . . . . . . . . . . . .
Net trade notes and accounts receivable . . . . . . . . . . . . . . . . . . 2c. . . . .35,850
. . . . . . . . 32,100
. . . . . . . .
Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . . . 0. . . . . . . . 0. . . . . .
U.S. government obligations . . . . . . . . . . . . . . . . . . . . . . 4. . . . . . . . . . . . . . . . . . . . .
Tax-exempt securities . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . .75,000
. . . . . . . .75,000
. . . . . . .
Other current assets . . . . . . . . . . . . . . . . . . . . . . . . . .6 . . . . . . 0
. . . . . . . . 0
. . . . . .
Loans to shareholders . . . . . . . . . . . . . . . . . . . . . . . . . 7. . . . . . . . . . . . . . . . . . . . .
Mortgage and real estate loans . . . . . . . . . . . . . . . . . . . . . 8. . . . . . . . . . . . . . . . . . . . .
Other investments . . . . . . . . . . . . . . . . . . . . . . . . . . 9. . . . . . . 0. . . . . . . . 0. . . . . .
Buildings and other depreciable assets . . . . . . . . . . . . . . . . . .10a
. . . . 295,600
. . . . . . . . 311,700
. . . . . . . . .
Less accumulated depreciation . . . . . . . . . . . . . . . . . . . . .10b
. . . . .-63,500
. . . . . . . .-85,900
. . . . . . . .
Net buildings and other depreciable assets . . . . . . . . . . . . . . . . 10c
. . . . . 232,100
. . . . . . . . 225,800
. . . . . . . .
Depletable assets . . . . . . . . . . . . . . . . . . . . . . . . . . 11a
. . . . . . . . . . . . . . . . . . . . .
Less accumulated depletion . . . . . . . . . . . . . . . . . . . . . . 11b
. . . . . . . . . . . . . . . . . . . . .
Net depletable assets . . . . . . . . . . . . . . . . . . . . . . . . .11c
. . . . . . . 0 . . . . . . . . 0. . . . . .
Land (net of any amortization) . . . . . . . . . . . . . . . . . . . . . 12
. . . . . 35,000
. . . . . . . . 35,000
. . . . . . . .
Intangible assets (amortizable only) . . . . . . . . . . . . . . . . . . . 13a
. . . . . . . 0
. . . . . . . . 0
. . . . . .
Less accumulated amortization . . . . . . . . . . . . . . . . . . . . .13b
. . . . . . . 0. . . . . . . . 0. . . . . .
Net intangible assets . . . . . . . . . . . . . . . . . . . . . . . . . 13c
. . . . . . . 0. . . . . . . . 0. . . . . .
Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
. . . . . .2,980
. . . . . . . . 2,110
. . . . . . .
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. . . . 404,150
. . . . . . . . 396,310
. . . . . . . .
16
17
18
19
20
21
22a
22b
22c
23
24
25
26
27
28
Accounts payable . . . . . . . . . . . . . . . . . . . . . . . . . . 16
. . . . . 34,800
. . . . . . . . 35,596
. . . . . . . .
Mortgages, notes, bonds payable in less than 1 year . . . . . . . . . . . . . 17
. . . . . . . . . . . . . . . . . . . . .
Other current liabilities . . . . . . . . . . . . . . . . . . . . . . . . 18
. . . . . . 9,350
. . . . . . . 18,250
. . . . . . . .
Loans from shareholders . . . . . . . . . . . . . . . . . . . . . . . 19
. . . . . . . . . . . . . . . . . . . . .
Mortgages, notes, bonds payable in 1 year or more . . . . . . . . . . . . . .20. . . . 114,000
. . . . . . . . 108,600
. . . . . . . .
Other liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . .21. . . . . . .0 . . . . . . . .0 . . . . .
Capital stock (preferred) . . . . . . . . . . . . . . . . . . . . . . . .22a
. . . . . . . . . . . . . . . . . . . . .
Capital stock (common) . . . . . . . . . . . . . . . . . . . . . . . .22b
. . . . 200,000
. . . . . . . . 200,000
. . . . . . . . .
Net Capital Stock . . . . . . . . . . . . . . . . . . . . . . . . . . .22c
. . . . 200,000
. . . . . . . . 200,000
. . . . . . . . .
Additional paid-in capital . . . . . . . . . . . . . . . . . . . . . . . .23. . . . . . . . . . . . . . . . . . . .
Retained earnings - appropriated . . . . . . . . . . . . . . . . . . . . 24
. . . . . . . 0
. . . . . . . . 0
. . . . . .
Retained earnings - unappropriated . . . . . . . . . . . . . . . . . . . 25
. . . . . 46,000
. . . . . . . . 33,864
. . . . . . . .
Adjustments to shareholders' equity . . . . . . . . . . . . . . . . . . . 26
. . . . . . . 0. . . . . . . . 0. . . . . .
Less cost of treasury stock . . . . . . . . . . . . . . . . . . . . . . . 27. . . . . . . . . . . . . . . . . . . . .
Total liabilities and shareholders' equity . . . . . . . . . . . . . . . . . .28. . . . 404,150
. . . . . . . . 396,310
. . . . . . . . .
Liabilities and Capital
End of year balance sheet out of balance by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . .
11-1111111
Line 2, Sch M-1 (1120) - Federal Income Tax per Books

1 Tax per books (Cash basis) . . . . . . . . . . . . . . . . . . . . . . . .1 . . . . -4,666
. . . . . . . . . . . . . . . .
2 Enter federal income tax per books. Enter on line 2, Schedule M-1 . . . . . . . . . . . . . . . . 2 . . . . . -4,666
. . . . . . .
Line 4a (4626) - Adjusted Current Earnings

1
2
a
b
c
3
a
b
c
d
e
f
4
a
b
c
d
e
f
5
a
b
c
d
e
f
6
7
8
9
10
Pre-adjustment AMTI. Enter the amount from line 3 of Form 4626 . . . . . . . . . . . . . . . . 1. . . . 295,630
. . . . . . . . .
ACE depreciation adjustment:
AMT depreciation . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
. . . . . . . 0. . . . . . . . . . . . . .
ACE depreciation:
(1) Post-1993 property . . . . . . . . . . . . . . . . 2b1
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(2) Post-1989, pre-1994 property . . . . . . . . . . . . 2b2
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(3) Pre-1990 MACRS property . . . . . . . . . . . . . 2b3
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(4) Pre-1990 original ACRS property . . . . . . . . . . . 2b4
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(5) Property described in sections 168(f)(1)
through (4) . . . . . . . . . . . . . . . . . . . .2b5
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(6) Other property . . . . . . . . . . . . . . . . . . 2b6
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(7) Total ACE depreciation. Add lines 2b(1) through 2b(6) . . . . . . . . . . .2b7
. . . . . . . 0. . . . . . . . . . . . . .
ACE depreciation adjustment. Subtract line 2b(7) from line 2a . . . . . . . . . . . . . . . . . .2c. . . . . . .0 . . . . .
Inclusion in ACE of items included in earnings and profits (E&P):
Tax-exempt interest income . . . . . . . . . . . . . . . . . . . . . . . 3a
. . . . . 3,000
. . . . . . . . . . . . . . . .
Death benefits from life insurance contracts . . . . . . . . . . . . . . . . . 3b. . . . . . . . . . . . . . . . . . . . .
All other distributions from life insurance contracts (including surrenders) . . . . . 3c
. . . . . . . . . . . . . . . . . . . . .
Inside buildup of undistributed income in life insurance contracts . . . . . . . . .3d. . . . . . . . . . . . . . . . . . . .
Other items (see Regulations sections 1.56(g)-1(c)(6)(iii) through (ix) for a
partial list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3e
. . . . . . . . . . . . . . . . . . . . .
Total increase to ACE from inclusion in ACE of items included in E&P. Add lines 3a through 3e . . . . .3f . . . . . 3,000
. . . . . . .
Disallowance of items not deductible from E&P:
Certain dividends received . . . . . . . . . . . . . . . . . . . . . . . .4a. . . . . . . . . . . . . . . . . . . .
Dividends paid on certain preferred stock of public utilities that are deductible
under section 247 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b
. . . . . . . . . . . . . . . . . . . . .
Dividends paid to an ESOP that are deductible under section 404(k) . . . . . . . 4c
. . . . . . . . . . . . . . . . . . . . .
Nonpatronage dividends that are paid and deductible under section
1382(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4d
. . . . . . . . . . . . . . . . . . . . .
Other items (see Regulations sections 1.56(g)-1(d)(3)(i) and (ii) for a
partial list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e
. . . . . . . . . . . . . . . . . . . . .
Total increase to ACE because of disallowance of items not deductible from E&P.
Add lines 4a through 4e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4f. . . . . . . 0 . . . . .
Other adjustments based on rules for figuring E&P:
Intangible drilling costs . . . . . . . . . . . . . . . . . . . . . . . . . 5a
. . . . . . . . . . . . . . . . . . . . .
Circulation expenditures . . . . . . . . . . . . . . . . . . . . . . . . 5b
. . . . . . . . . . . . . . . . . . . . .
Organizational expenditures . . . . . . . . . . . . . . . . . . . . . . . 5c. . . . . . . . . . . . . . . . . . . . .
LIFO inventory adjustments . . . . . . . . . . . . . . . . . . . . . . . 5d
. . . . . . . . . . . . . . . . . . . . .
Installments sales . . . . . . . . . . . . . . . . . . . . . . . . . . . 5e
. . . . . . . . . . . . . . . . . . . . .
Total other E&P adjustments. Combine lines 5a through 5e . . . . . . . . . . . . . . . . . . .5f . . . . . . .0 . . . . .
Disallowance of loss on exchange of debt pools . . . . . . . . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . .
Acquisition expenses of life insurance companies for qualified foreign contracts . . . . . . . . . . . 7. . . . . . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 . . . . . . . . . . . .
Basis adjustments in determining gain or loss from sale or exchange of pre-1994 property . . . . . . . 9 . . . . . . . . . . . .
Adjusted current earnings. Combine lines 1, 2c, 3f, 4f, and 5f through 9. Enter the result here
and on line 4a of Form 4626 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
. . . . 298,630
. . . . . . . . .
Form
1120

A Check if:
2
3

33
34
35
36
Sign
Here
. . . . . . . . . . By
. . the
. . Numbers,
. . . . . Inc.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1111111
. . . . .
TYPE
C Date incorporated
. . . . OR
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Before
. . . .1900,
. . .see
. Options tab.
PRINT
1001 N. Main St.
. . . . . . . . . . Los
. . Angeles
. . . . . . . . . . . . . . CA
. . . . . . . . . . 90012
. . . . . . . . $
. . . . . . . . . .
E Check if:
(1)
Initial return
(2)
Final return
(3)
Name change (4)
396,310
Address change
CO
PY

. . . . . . . . . 0. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
. . . . . . . 3,000
. . . . . . . . . . . . . . . . . . .
. . . . . . . .
. . . . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . . . . 3,000
. . . . . . .
Gross rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . . .
Gross royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. . . . . . . . . . . . .
. . . . . . . . . . . . . .
. . . . . 530,000
. . . . . . . .
. . . . . . .
. . . . . . .
Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. . . . . . . . . . . . .
Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16. . . . . . 4,100
. . . . . . .
. . . . . . 50,470
. . . . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
. . . . . . 12,800
. . . . . . .
. . . . . . .
. . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
. . . . . . . . . . . . .
Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22. . . . . 19,300
. . . . . . . .
. . . . . . 25,000
. . . . . . . .
. . . . . . 16,900
. . . . . . .
. . . . . . . . . . . . .
. . . . . . 67,900
. . . . . . .
. . . . . . . .
. . . . . 295,630
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
Add lines 29a and 29b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29c
. . . . . . . . 0
. . . . .
. . . . .. . . 295,630
. . . . . . . .
. . . . . . . .
. . . . . . . . .0 . . . . .
. . . . . . . . . . . . . . . . . . . . 33
. . . . . . . . . . . . .
. . . . . 103,471
. . . . . . . .
Refunded
0
36
11/29/2012
Paid
Preparer
Use Only
Date
Neda B. Ardekani
Title
Date
Firm's name
City

instructions)?
Yes
No
Check
if
self-employed
PTIN
Firm's EIN
Firm's address

(HTA)
8/8/2005
. . . . . . . . . . .City
. or
. town
. . . . . . . . . . . . . State
. . . . . . . . . . ZIP
. .code
. . . . . . D
. . Total
. . assets
. . . (see
. . instructions)
.
CL
IE
NT

and Payments
1a
b
c
d
e
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29a
b
c
30
31
32
, ending
Name
Income
OMB No. 1545-0123
Phone no.
State
ZIP code
Form
1120 (2011)
Form 1120 (2011)
Schedule C
11-1111111
(a) Dividends
received
(b) %
Page

(a) (b)

. . . . . . . . .

. . . . . . . . . .
see
. . . . . . . . . . . . . 0. . . .

. . . . . . . . . . . .0 . . .

. . . . . . . . . . . .0 . . .

. . . . . . . . . .
10
T
N
E
I
L
C

O
C
Y
P
. . . . . . . . . . . . . . . . . . . 100
. . . . . . . . . . . . 0. . . .
11

. . . . . . . . . . . .0 . . .
12

. . . . . . . . . . .
13
14
15
16
17
Other dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
19
20
Form
1120 (2011)
Form 1120 (2011)
Schedule J
11-1111111
Page 3

1
. . . . . . . . .
Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . . 103,471

. . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . .
CO
PY

6

. . . . . . . . .

. . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . .
Form 8697) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9c. . . . . . . . . . . . . . . . . . . . . . . . .
8866) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9d. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . 103,471
. . . . . . . . .
10
11

. . . . . . . . . . . . . .
13
14

. . .( . . . . . . . . ). . .
15
16

. . . . . . . . . . . . . .
17
18

. . . . . . . . 0. . . . . .
Form 2439 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19a
. . . . . . . . . . . . . . . . . . . . . . . . .
Form 4136 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. .. .. .19b
. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . 0. . . . . .
a
b
c
d
20
21
CL
I
19
EN
T
12
Schedule K
X Cash
Accrual
Yes
Other (specify)
No
541990
actuarial
actuarial

b Business activity
3

EIN
Name
Form
1120 (2011)
Form 1120 (2011)
Schedule K
11-1111111
Page 4

Yes
No
(ii) Employer
(if any)
(iii) Country of
Incorporation
CO
PY
(iv) Percentage
Owned in Voting
Stock
(ii) Employer
(if any)
CL
IE
NT
(i) Name of Entity
(iv) Maximum
Percentage Owned in
. . . .
. . . .
8
$
3,000
2
10
11
12
13
$
14
Form
1120 (2011)
Form 1120 (2011)
Schedule L

Assets
11-1111111
(a)
(b)
Page 5
End of tax year

(c)
(d)
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23,220
. . . . . . . . . . . . . . . . . . 26,300
. . . . . . .
. . . . . . . . . . . . . . . . . .32,100
. . . . . . . . . . . . . . . .
. . . . (. . . . . . . .) . . . . . . 32,100
. . . . . . .
Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .75,000
. . . . . . .
. . . . . . . . . . . . . . . . . . 311,700
. . . . . . . . . . . . . . . . . .
. . . . . . . . 232,100
. . . . . (. . . . . 85,900)
. . . . . . . . .225,800
. . . . . . . .
. . . . . . . . . . . . . . . . . . .35,000
. . . . . . .
. . . . . . . . . . . . . . . . . . 2,110
. . . . . . .
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404,150
. . . . . . . . . . . . . . . . . . 396,310
. . . . . . . .
16
17
18
19
20
21
22

. . . . . . . . . . . . . . . . . . 35,596
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 18,250
. . . . . . . .
. . . . . . . . . . . . . . . . . .108,600
. . . . . . . .
b Common stock . . . . . . . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . .
. . . . . . . . . . . . . . . . . . 33,864
. . . . . . . .
. . . . . . . . . . . . . . . . . . 396,310
. . . . . . . .
23
24
25
26
27
28
Schedule M-1
EN
T
CO
PY
1
2a
b
3
4
5
6
7
8
9
10a
b
11a
b
12
13a
b
14
15


. . . . . 7 . .Income
. . .recorded
. . . .on.books
. . this
. . year
. . not
. . . . . . . . . . . . . . .
. . . . . included
. . . .on. this
. .return
. . (itemize):
. . . . . . . . . . . . . . . . . . . . .
. . . . . interest
. . . . . $. . . . 3,000
. . . . . . . . . . . . . . . .
3,000
a Depreciation . . . . .$ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . b. .Charitable
. . . contributions
. . . . . . .$ . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CL
I
1
2
3
4
0
3,800 9 Add lines 7 and 8 . . . . . . . . . . . . . . . . .3,000
. . . . . .
. . . . 10
. . Income
. . . (page
. . . 1,. line
. .28)line
. . . 6
. less
. . line
. .9 . . . . . 295,630
. . . . . . . .
Schedule M-2
1
2
3

. . . . . . . a. Cash
. . . . . . . . . . . . . . . . . . . . . . . . . . . 20,000
.. .. .. .. .. .. ..
. . . . . . . . . . . . . .b . Stock
. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .
c Property . . . . . . . . . . . . . . . . . .
0 7 Add lines 5 and 6 . . . . . . . . . . . . . . . .20,000

. . . . . . .
Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . 345,496
. . . . . 8 . .Balance
. . . at. end
. .of.year
. .(line
. .4 less
. . line
. . 7). . . . . . .325,496
. . . . . . .
Form
1120 (2011)
Form
4626

OMB No. 1545-0175

Name

11-1111111
1
. . . . . . .

. . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2l
. . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . .
. . . . . . .
4
a
b

. . . . . . . . . . . . . . . .
. . . . . .3,000
. . . . . . . . . . . . . .
. . . . . . 2,250
. . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
ACE adjustment.
. . . . . 4e. . . . . 2,250
. . . . . .
. . . . . . .
5
6
CL
IE
NT
c
d
CO
PY
2
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
3
.. .. .. .. .. .. ..
8
a
. . . . . 147,880
. . . . . . . . . . . . . . .
. . . . . .36,970
. . . . . . . . . . . . . .
. . . . . .3,030
. . . . .
. . . . . .
Multiply line 9 by 20% (.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10. . . . .58,970
. . . . . .
. . . . . . . . . . . .
.. .. .. .. .. ..
. . . . . . .
. . . . . . . 0. . . .
b
c
9
10
11
12
13
14

(HTA)
Form
4626 (2011)
SCHEDULE G
(Form 1120)


Name

Number (if any)
CL
IE
NT
(i) Name of Entity
Part II
11-1111111
CO
PY
Part I
OMB No.1545-0123

(ii) Identifying
Number (if any)
(iii) Country of
Citizenship (see
instructions)

in Voting Stock
Belinda Jackson
123-45-6789
United States
50.000%
Ahmad Sharma
987-65-4321
United States
50.000%

(HTA)
SCHEDULE PH
(Form 1120)

OMB No. 1545-0123

Name
Part I
. . . . . . .
2
. . . . . . . . . 1,000
. . . . .
3
line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . .
4
. . . . . . .
5
6
7
. . . 8c
. . . . . . . . .-4,925
. . . . . .
9
CO
PY
Additions
10

. . . . . .
11
12

. . . . . . . .301,555
. . . . . .
. . . . . . .
13
CL
IE
NT
Deductions
11-1111111
Part II
14
15 a
b
16
17
18 a
b
19 a
b
20
21
22
23
24
25
Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14. . . . . . . .20,000

. . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . .15a
. . . . . . . . .3,000
. . . . . . . . . . . . . . . . .
. . . . . . . . . . . 15c
. . . . . . . . . 3,000
. . . . . .
Annuities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. . . . . . . . . . . . . .
Rents . . . . . . . . . . . . . . . . . . . . . . . . . 18a
. . . . . . . . . 4,100
. . . . . . . . . . . . . . . . .
. . . . . . . . . . . 18c
. . . . . . . . . 4,100
. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
schedule) . . . . . . . . . . . . . . . . . . . . . . . . 19b
. . . . . . . . . . . 19c
. . . . . . . . . . . 0. . . .
. . . . . . . . . . . . . .
. . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
. . . . . . . . 27,100
. . . . . .
Part III
26
. . . . . . . . . . 0
. . . .
(HTA)
Part IV
11-1111111
Page

(a) Name

(b) Address
(c) Preferred
(d) Common
St
Zip
St
Zip
St
Zip
St
Zip
. . . . .
Part V
(b) Date
acquired
(c) Cost or
other basis
(d) Depreciation
deduction
(e) Repairs,
insurance, and
other expenses
(section 162)
(attach schedule)
(f) Total of
columns (d)
and (e)
(g) Income from

rent or other
compensation
(h) Excess
(col. (f) less
col. (g))
CL
IE
NT
(a) Description of
property
Zip
CO
PY
St
Part VI
line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . . . . . . . . 0. . . . .
Form
1125-E
(December 2011)
OMB No. 1545-2225

Name
11-1111111
Belinda Jackson
Ahmad Sharma
(c) Percent of
time devoted to
business

(d) Common
123-45-6789
50.00%
987-65-4321
50.00%
(e) Preferred
50.00%
50.00%
NT
CO
P
CL
IE
(a) Name of officer
(f) Amount of
compensation
125,000
125,000

. . . . . . . .

. . . . . . .

(HTA)
Form 1125-E (12-2011)
11-1111111
. . . . . . . .
a Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
. . . . . .6,300
. . . . . . .
. . . . . . . . . . . . . . .
. . . . . .3,800
. . . . . . . . . . . . . . .
. . . . . . .
3
4,900
4 Insurance
4
15,000
5
12,500
6 Miscellaneous
6
3,000
7 Telephone
7
2,400
. . . . . . . .
. . . . . . .
T
N
E
I
L
C
Y
P
O
C
Beginning
End
1 Other Assets
1
2,980
2,110
. . . . . . . . .2,110
. . . . . . .
Beginning
End
1
9,350
18,250
. . . . . . . 18,250
. . . . . . . .

1
2
3
4
5
6

. . . . . . . .
. . . . . . . .
. . . . . . . . .
. . . . . . . .
. . . . . . .
11-1111111

. . . . . . . .
2 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . .3,000
. .
1 Salaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. . . . . 5,000
. . . . . . . . . . . . . . . .
2 Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . . . . . . . . . . . . . . . . .
3
3
. . . . . . .
. . . . . . . 0. . . . . . . . . . . . . .
11
11
12
12
. . . . . . . 0. . . . . .
. . . . . . .
I
L
T
N
E
Y
P
O
C

1
2
3
4
5
6
7
State income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . 2,250

. . . . . . .
. . . . . . . .
Payroll tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . 20,020
. . . . . . . .
other miscellaneous
4
1,700
Quarterly payments
5
5,000
Sub Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. . . . . 50,470
. . . . . . .
. . . . . . .

1 Business Loans
1
12,800
2 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . . . .12,800
. . . . . . .
11-1111111

(A)
Amount
(C)
Deduction
Allowed in
Current Year
(D)
Contribution
Carryover

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . 0 . . . . . . 1,000
. . . . . . . . . . 0. . . . . .
Carryover from:
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
Totals . . . . . . . . . . . . . . 3. . . . . . . 1,000
. . . . . . . . . .0 . . . . . . 1,000
. . . . . . . . . . 0. . . . .
PY
1
a
b
2
a
b
c
d
e
3
4
5
(B)
Adjustment
under Section
170(d)(2)(B)

. . . . . . . .
. . . . . . . .
. . . . . . .
. . . . . .1,000
. . . . . . .

11
12
13
14
15
16
CO
6
7
8
9
10

. . . . .319,030
. . . . . . . .
. . . . . . . 0. . . . . .
. . . . .319,030
. . . . . . . .
. . . . . 31,903
. . . . . . . .
. . . . . . .
CL
IE
NT

. . . . . . 17
. . . . . . . . . . . . .
.
.
.
.
.
.
.
.
.
.
.
.
. .
. 0.
. .
. .
. .
. .
.
.
.
.
.
.
. .
. 18
.
.19.
.20.
.21.
.22.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. .
. 0.
. 0.
.0 .
.0 .
.0 .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. .
. .
.
.
.
.
. . . . . . . .
. . . . . . .

1
2
3
4

. . . . . . . 0. . . . . .
1
2
3
4
5

. . . . . . .
. . . . . . .
11-1111111

Yes
No
Y
P
O
C
Tax Year
2005
2006
2007
2008
2009
2010
2011
Yes
or
N/A
X
Annualized
Gross Receipts

T
N
E
I
L
530,000
No
Prior Three
Year Average
0
0
0
0
0
0
0
through 1996)?
1997-1999, 1998-2000, 1999-2001, 2000-2002, 2001-2003, 2002-2004, 2003-2005, 2004-2006, 2005-2007,
2006-2008, 2007-2009, 2008-2010).
11-1111111

1
2a
2b
2c
3
4
5
6
7
8
9
10a
10b
10c
11a
11b
11c
12
13a
13b
13c
14
15
Assets
Beginning
Ending
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 . . . . 23,220
. . . . . . . . 26,300
. . . . . . . .
. . . . . . . .32,100
. . . . . . .
. . . . . . . . 32,100
. . . . . . . .
Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . .75,000
. . . . . . .
. . . . . . . . 0
. . . . . .
. . . . 295,600
. . . . . . . . 311,700
. . . . . . . . .
. . . . .-63,500
. . . . . . . .-85,900
. . . . . . . .
. . . . . 232,100
. . . . . . . . 225,800
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . 0 . . . . . . . . 0. . . . . .
. . . . . 35,000
. . . . . . . . 35,000
. . . . . . . .
. . . . . . . 0
. . . . . . . . 0
. . . . . .
. . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . 0. . . . . . . . 0. . . . . .
Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
. . . . . .2,980
. . . . . . . . 2,110
. . . . . . .
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. . . . 404,150
. . . . . . . . 396,310
. . . . . . . .
16
17
18
19
20
21
22a
22b
22c
23
24
25
26
27
28
. . . . . 34,800
. . . . . . . . 35,596
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . 9,350
. . . . . . . 18,250
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . 108,600
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . 200,000
. . . . . . . . 200,000
. . . . . . . . .
. . . . 200,000
. . . . . . . . 200,000
. . . . . . . . .
. . . . . . . 0
. . . . . . . . 0
. . . . . .
. . . . . 46,000
. . . . . . . . 33,864
. . . . . . . .
. . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . 396,310
. . . . . . . . .
N
IE
L
C
Y
P
O
11-1111111

. . . . . . . . . . . . . . . .
. . . . . . .
f
4
a
b
c
d
e
f
5
a
b
c
d
e
f
6
7
8
9
10
CO
PY
c
3
a
b
c
d
e
. . . . . . . . .
. . . . . . . 0. . . . . . . . . . . . . .
ACE depreciation:
(1) Post-1993 property . . . . . . . . . . . . . . . . 2b1
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
through (4) . . . . . . . . . . . . . . . . . . . .2b5
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(6) Other property . . . . . . . . . . . . . . . . . . 2b6
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . 0. . . . . . . . . . . . . .
. . . . . 3,000
. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
partial list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3e
. . . . . . . . . . . . . . . . . . . . .
. . . . . . .
under section 247 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
1382(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4d
. . . . . . . . . . . . . . . . . . . . .
partial list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 . . . . . . . . . . . .
. . . . 298,630
. . . . . . . . .
CL
IE
NT
1
2
a
b
Form
1120

A Check if:
2
3


and Payments
. . . . . . . . . . By
. . the
. . Numbers,
. . . . . Inc.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1111111
. . . . .
TYPE
C Date incorporated
. . . . OR
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Before
. . . .1900,
. . .see
. Options tab.
PRINT
1001 N. Main St.
8/8/2005
. . . . . . . . . . .City
. or
. town
. . . . . . . . . . . . . State
. . . . . . . . . . ZIP
. .code
. . . . . . D
. . Total
. . assets
. . . (see
. . instructions)
.
. . . . . . . . . . Los
. . Angeles
. . . . . . . . . . . . . . CA
. . . . . . . . . . 90012
. . . . . . . . $
. . . . . . . . . .
E Check if:
(1)
Initial return
(2)
Final return
(3)
Name change (4)
396,310
Address change
1a
b
c
d
e
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29a
b
c
30
31
32

. . . . . . . . . 0. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
. . . . . . . 3,000
. . . . . . . . . . . . . . . . . . .
. . . . . . . .
. . . . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . . . . 3,000
. . . . . . .
Gross rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 . . . . . . . . . . . . .
Gross royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. . . . . . . . . . . . .
. . . . . . . . . . . . . .
. . . . . 530,000
. . . . . . . .
. . . . . . .
. . . . . . .
Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. . . . . . . . . . . . .
Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16. . . . . . 4,100
. . . . . . .
. . . . . . 50,470
. . . . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
. . . . . . 12,800
. . . . . . .
. . . . . . .
. . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
. . . . . . . . . . . . .
Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22. . . . . 19,300
. . . . . . . .
. . . . . . 25,000
. . . . . . . .
. . . . . . 16,900
. . . . . . .
. . . . . . . . . . . . .
. . . . . . 67,900
. . . . . . .
. . . . . . . .
. . . . . 295,630
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . .
Add lines 29a and 29b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29c
. . . . . . . . 0
. . . . .
. . . . .. . . 295,630
. . . . . . . .
. . . . . . . .
. . . . . . . . .0 . . . . .
33
34
35
36

. . . . . . . . . . . . . . . . . . . . 33
. . . . . . . . . . . . .
. . . . . 103,471
. . . . . . . .
Refunded
0
36
Sign
Here
11/29/2012
Paid
Preparer
Use Only
Date
Neda B. Ardekani
Title
Date
Firm's name
City

instructions)?
Yes
No
Check
if
self-employed
PTIN
Firm's EIN
Firm's address

(HTA)
, ending
Name
Income
OMB No. 1545-0123
Phone no.
State
ZIP code
Form
1120 (2011)
Form 1120 (2011)
Schedule C
11-1111111
(a) Dividends
received
(b) %
Page

(a) (b)

. . . . . . . . .

. . . . . . . . . .
see
. . . . . . . . . . . . . 0. . . .

. . . . . . . . . . . .0 . . .

. . . . . . . . . . . .0 . . .

. . . . . . . . . .
10

. . . . . . . . . . . . . . . . . . . 100
. . . . . . . . . . . . 0. . . .
11

. . . . . . . . . . . .0 . . .
12

. . . . . . . . . . .
13
14
15
16
17
Other dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
19
20
Form
1120 (2011)
Form 1120 (2011)
Schedule J
11-1111111
Page 3

1
. . . . . . . . .
Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . . 103,471

. . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . .

6

. . . . . . . . .

. . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . .
Form 8697) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9c. . . . . . . . . . . . . . . . . . . . . . . . .
8866) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9d. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . 103,471
. . . . . . . . .
10
11

12

. . . . . . . . . . . . . .
13
14

. . .( . . . . . . . . ). . .
15
16

. . . . . . . . . . . . . .
17
18

. . . . . . . . 0. . . . . .
Form 2439 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19a
. . . . . . . . . . . . . . . . . . . . . . . . .
Form 4136 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. .. .. .19b
. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . 0. . . . . .
19
a
b
c
d
20
21
Schedule K
X Cash
Accrual
Yes
Other (specify)
No
541990
actuarial
actuarial

b Business activity
3

EIN
Name
Form
1120 (2011)
Form 1120 (2011)
Schedule K
11-1111111
Page 4

Yes
No
(ii) Employer
(if any)
(iii) Country of
Incorporation
(iv) Percentage
Owned in Voting
Stock
(ii) Employer
(if any)
(i) Name of Entity
(iv) Maximum
Percentage Owned in
. . . .
. . . .
8
$
3,000
2
10
11
12
13
$
14
Form
1120 (2011)
Form 1120 (2011)
Schedule L

Assets
11-1111111
(a)
(b)
Page 5
End of tax year

(c)
(d)
1
2a
b
3
4
5
6
7
8
9
10a
b
11a
b
12
13a
b
14
15
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23,220
. . . . . . . . . . . . . . . . . . 26,300
. . . . . . .
. . . . . . . . . . . . . . . . . .32,100
. . . . . . . . . . . . . . . .
. . . . (. . . . . . . .) . . . . . . 32,100
. . . . . . .
Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . .75,000
. . . . . . .
. . . . . . . . . . . . . . . . . . 311,700
. . . . . . . . . . . . . . . . . .
. . . . . . . . 232,100
. . . . . (. . . . . 85,900)
. . . . . . . . .225,800
. . . . . . . .
. . . . . . . . . . . . . . . . . . .35,000
. . . . . . .
. . . . . . . . . . . . . . . . . . 2,110
. . . . . . .
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404,150
. . . . . . . . . . . . . . . . . . 396,310
. . . . . . . .
16
17
18
19
20
21
22

. . . . . . . . . . . . . . . . . . 35,596
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 18,250
. . . . . . . .
. . . . . . . . . . . . . . . . . .108,600
. . . . . . . .
b Common stock . . . . . . . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . . . 200,000
. . . . . . . .
. . . . . . . . . . . . . . . . . . 33,864
. . . . . . . .
. . . . . . . . . . . . . . . . . . 396,310
. . . . . . . .
23
24
25
26
27
28
Schedule M-1


. . . . . 7 . .Income
. . .recorded
. . . .on.books
. . this
. . year
. . not
. . . . . . . . . . . . . . .
. . . . . included
. . . .on. this
. .return
. . (itemize):
. . . . . . . . . . . . . . . . . . . . .
. . . . . interest
. . . . . $. . . . 3,000
. . . . . . . . . . . . . . . .
3,000
a Depreciation . . . . .$ . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . b. .Charitable
. . . contributions
. . . . . . .$ . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
2
3
4
0
3,800 9 Add lines 7 and 8 . . . . . . . . . . . . . . . . .3,000
. . . . . .
. . . . 10
. . Income
. . . (page
. . . 1,. line
. .28)line
. . . 6
. less
. . line
. .9 . . . . . 295,630
. . . . . . . .
Schedule M-2
1
2
3

. . . . . . . a. Cash
. . . . . . . . . . . . . . . . . . . . . . . . . . . 20,000
.. .. .. .. .. .. ..
. . . . . . . . . . . . . .b . Stock
. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .
c Property . . . . . . . . . . . . . . . . . .
0 7 Add lines 5 and 6 . . . . . . . . . . . . . . . .20,000

. . . . . . .
Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . 345,496
. . . . . 8 . .Balance
. . . at. end
. .of.year
. .(line
. .4 less
. . line
. . 7). . . . . . .325,496
. . . . . . .
Form
1120 (2011)
Form
4626

OMB No. 1545-0175

Name

11-1111111
1
. . . . . . .
2
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
3

. . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2l
. . . . . . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . .
. . . . . . .
4
a
b

. . . . . . . . . . . . . . . .
. . . . . .3,000
. . . . . . . . . . . . . .
. . . . . . 2,250
. . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
ACE adjustment.
. . . . . 4e. . . . . 2,250
. . . . . .
. . . . . . .
c
d
5
6
7
.. .. .. .. .. .. ..
8
a
. . . . . 147,880
. . . . . . . . . . . . . . .
. . . . . .36,970
. . . . . . . . . . . . . .
. . . . . .3,030
. . . . .
. . . . . .
Multiply line 9 by 20% (.20) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10. . . . .58,970
. . . . . .
. . . . . . . . . . . .
.. .. .. .. .. ..
. . . . . . .
. . . . . . . 0. . . .
b
c
9
10
11
12
13
14

(HTA)
Form
4626 (2011)
SCHEDULE G
(Form 1120)


Name
Part I
11-1111111
(i) Name of Entity
Part II
OMB No.1545-0123


Number (if any)
(ii) Identifying
Number (if any)
(iii) Country of
Citizenship (see
instructions)

in Voting Stock
Belinda Jackson
123-45-6789
United States
50.000%
Ahmad Sharma
987-65-4321
United States
50.000%

(HTA)
SCHEDULE PH
(Form 1120)

OMB No. 1545-0123

Name
Part I
. . . . . . .
2
. . . . . . . . . 1,000
. . . . .
3
line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . .
4
. . . . . . .
5
6
7
. . . 8c
. . . . . . . . .-4,925
. . . . . .
9
Additions
Deductions
11-1111111
10

. . . . . .
11
12

. . . . . . . .301,555
. . . . . .
. . . . . . .
13
Part II
14
15 a
b
16
17
18 a
b
19 a
b
20
21
22
23
24
25
Dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14. . . . . . . .20,000

. . . . . .
Interest . . . . . . . . . . . . . . . . . . . . . . . . .15a
. . . . . . . . .3,000
. . . . . . . . . . . . . . . . .
. . . . . . . . . . . 15c
. . . . . . . . . 3,000
. . . . . .
Annuities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. . . . . . . . . . . . . .
Rents . . . . . . . . . . . . . . . . . . . . . . . . . 18a
. . . . . . . . . 4,100
. . . . . . . . . . . . . . . . .
. . . . . . . . . . . 18c
. . . . . . . . . 4,100
. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
schedule) . . . . . . . . . . . . . . . . . . . . . . . . 19b
. . . . . . . . . . . 19c
. . . . . . . . . . . 0. . . .
. . . . . . . . . . . . . .
. . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .
. . . . . . . . 27,100
. . . . . .
Part III
26
. . . . . . . . . . 0
. . . .
(HTA)
Part IV
11-1111111
Page

(a) Name

(b) Address
(c) Preferred
(d) Common
St
Zip
St
Zip
St
Zip
St
Zip
St
Zip
. . . . .
Part V
(a) Description of
property
(b) Date
acquired
(c) Cost or
other basis
(d) Depreciation
deduction
(e) Repairs,
insurance, and
other expenses
(section 162)
(attach schedule)
(f) Total of
columns (d)
and (e)
(g) Income from

rent or other
compensation
(h) Excess
(col. (f) less
col. (g))
Part VI
line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. . . . . . . . . . 0. . . . .
Form
1125-E
(December 2011)
OMB No. 1545-2225

Name
11-1111111
(a) Name of officer
Belinda Jackson
Ahmad Sharma
(c) Percent of
time devoted to
business

(d) Common
(e) Preferred
(f) Amount of
compensation
123-45-6789
50.00%
50.00%
125,000
987-65-4321
50.00%
50.00%
125,000

. . . . . . . .

. . . . . . .

(HTA)
Form 1125-E (12-2011)
11-1111111
. . . . . . . .
a Travel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a
. . . . . .6,300
. . . . . . .
. . . . . . . . . . . . . . .
. . . . . .3,800
. . . . . . . . . . . . . . .
. . . . . . .
3
4,900
4 Insurance
4
15,000
5
12,500
6 Miscellaneous
6
3,000
7 Telephone
7
2,400
. . . . . . . .
. . . . . . .
Beginning
End
1 Other Assets
1
2,980
2,110
. . . . . . . . .2,110
. . . . . . .

Beginning
End
1
9,350
18,250
. . . . . . . 18,250
. . . . . . . .

1
2
3
4
5
6

. . . . . . . .
. . . . . . . .
. . . . . . . . .
. . . . . . . .
. . . . . . .
11-1111111

. . . . . . . .
2 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . .3,000
. .
1 Salaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. . . . . 5,000
. . . . . . . . . . . . . . . .
2 Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . . . . . . . . . . . . . . . . .
3
3
. . . . . . .
. . . . . . . 0. . . . . . . . . . . . . .
11
11
12
12
. . . . . . . 0. . . . . .
. . . . . . .

1
2
3
4
5
6
7
State income tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . 2,250

. . . . . . .
. . . . . . . .
Payroll tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . 20,020
. . . . . . . .
other miscellaneous
4
1,700
Quarterly payments
5
5,000
Sub Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. . . . . 50,470
. . . . . . .
. . . . . . .

1 Business Loans
1
12,800
2 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . . . .12,800
. . . . . . .
11-1111111

(A)
Amount
1
a
b
2
a
b
c
d
e
3
4
5
(B)
Adjustment
under Section
170(d)(2)(B)
(C)
Deduction
Allowed in
Current Year
(D)
Contribution
Carryover

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . 0 . . . . . . 1,000
. . . . . . . . . . 0. . . . . .
Carryover from:
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . .
Totals . . . . . . . . . . . . . . 3. . . . . . . 1,000
. . . . . . . . . .0 . . . . . . 1,000
. . . . . . . . . . 0. . . . .

6
7
8
9
10

. . . . . . . .
. . . . . . . .
. . . . . . .
. . . . . .1,000
. . . . . . .

11
12
13
14
15
16

. . . . .319,030
. . . . . . . .
. . . . . . . 0. . . . . .
. . . . .319,030
. . . . . . . .
. . . . . 31,903
. . . . . . . .
. . . . . . .

. . . . . . 17
. . . . . . . . . . . . .
.
.
.
.
.
.
.
.
.
.
.
.
. .
. 0.
. .
. .
. .
. .
.
.
.
.
.
.
. .
. 18
.
.19.
.20.
.21.
.22.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. .
. 0.
. 0.
.0 .
.0 .
.0 .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
. .
. .
.
.
.
.
. . . . . . . .
. . . . . . .

1
2
3
4

. . . . . . . 0. . . . . .
1
2
3
4
5

. . . . . . .
. . . . . . .
11-1111111

Yes
No
Tax Year
2005
2006
2007
2008
2009
2010
2011
Yes
or
N/A
X
Annualized
Gross Receipts
530,000
Prior Three
Year Average
0
0
0
0
0
0
0

No
through 1996)?
1997-1999, 1998-2000, 1999-2001, 2000-2002, 2001-2003, 2002-2004, 2003-2005, 2004-2006, 2005-2007,
2006-2008, 2007-2009, 2008-2010).
11-1111111

1
2a
2b
2c
3
4
5
6
7
8
9
10a
10b
10c
11a
11b
11c
12
13a
13b
13c
14
15
Assets
Beginning
Ending
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 . . . . 23,220
. . . . . . . . 26,300
. . . . . . . .
. . . . . . . .32,100
. . . . . . .
. . . . . . . . 32,100
. . . . . . . .
Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . .75,000
. . . . . . .
. . . . . . . . 0
. . . . . .
. . . . 295,600
. . . . . . . . 311,700
. . . . . . . . .
. . . . .-63,500
. . . . . . . .-85,900
. . . . . . . .
. . . . . 232,100
. . . . . . . . 225,800
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . 0 . . . . . . . . 0. . . . . .
. . . . . 35,000
. . . . . . . . 35,000
. . . . . . . .
. . . . . . . 0
. . . . . . . . 0
. . . . . .
. . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . 0. . . . . . . . 0. . . . . .
Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
. . . . . .2,980
. . . . . . . . 2,110
. . . . . . .
Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. . . . 404,150
. . . . . . . . 396,310
. . . . . . . .
16
17
18
19
20
21
22a
22b
22c
23
24
25
26
27
28
. . . . . 34,800
. . . . . . . . 35,596
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . 9,350
. . . . . . . 18,250
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . 108,600
. . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . 200,000
. . . . . . . . 200,000
. . . . . . . . .
. . . . 200,000
. . . . . . . . 200,000
. . . . . . . . .
. . . . . . . 0
. . . . . . . . 0
. . . . . .
. . . . . 46,000
. . . . . . . . 33,864
. . . . . . . .
. . . . . . . 0. . . . . . . . 0. . . . . .
. . . . . . . . 396,310
. . . . . . . . .
11-1111111

. . . . . . . . . . . . . . . .
. . . . . . .

1
2
a
b
c
3
a
b
c
d
e
f
4
a
b
c
d
e
f
5
a
b
c
d
e
f
6
7
8
9
10
. . . . . . . . .
. . . . . . . 0. . . . . . . . . . . . . .
ACE depreciation:
(1) Post-1993 property . . . . . . . . . . . . . . . . 2b1
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
through (4) . . . . . . . . . . . . . . . . . . . .2b5
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(6) Other property . . . . . . . . . . . . . . . . . . 2b6
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . 0. . . . . . . . . . . . . .
. . . . . 3,000
. . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
partial list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3e
. . . . . . . . . . . . . . . . . . . . .
. . . . . . .
under section 247 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4b
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
1382(c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4d
. . . . . . . . . . . . . . . . . . . . .
partial list) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4e
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . .
Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 . . . . . . . . . . . .
. . . . 298,630
. . . . . . . . .

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Error Report For By the Numbers, Inc.

The amount entered as buildings and other depreciable

The amount entered as accumulated depreciation at the

The amount entered as Land (net of any amortization) at

The amount entered as buildings and other depreciable

The amount entered as accumulated depreciation at the

The amount entered as Land (net of any amortization) at

The end-of-year unappropriated retained earnings reported

The box for a personal service corporation was not

The Corporation qualifies as a small corporation or is

Either the Yes or the No box should be checked.

o Sch PH (1120) Warning:

If Line 6 is less than 60%, the corporation is not a PHC. Do

IRS does not always require that a statement with details of

ACE adjustment does not apply to a regulated investment

Override and Estimate Report For By the Numbers, Inc.:

On Sheet 1 you entered a value of "22400"

On Sheet 1 you entered a value of "250000"

o Asset Entry Override:

On Sheet Input you entered a value of ""

Department of the Treasury

For calendar year 2011 or tax year beginning

Deductions (See instructions for limitations on deductions.)

B Employer identification number

1001 N. Main St.

Name change (4)

Merchant card and third-party payments. For 2011, enter -0- . . . . . . . . . . . . 1a

Estimated tax penalty (see instructions). Check if Form 2220 is attached

May the IRS discuss this return with

For Paperwork Reduction Act Notice, see separate instructions.

Schedule M-3 attached

OMB No. 1545-0123

U.S. Corporation Income Tax Return

Form 1120 (2011)

By the Numbers, Inc.

Dividends and Special Deductions (see instructions)

(c) Special deductions

Dividends from less-than-20%-owned domestic corporations (other than

Dividends from 20%-or-more-owned domestic corporations (other than

Dividends on certain preferred stock of less-than-20%-owned public utilities . . . . . . . . . . . . . . . . . . 42

Dividends on certain preferred stock of 20%-or-more-owned public utilities . . . . . . . . . . . . . . . . . . .48. . . . . . . . . . . 0. . . .

Dividends from less-than-20%-owned foreign corporations and certain FSCs . . . . . . . . . . . . . . . . . .70. . . . . . . . . . . 0. . . .

Dividends from 20%-or-more-owned foreign corporations and certain FSCs . . . . . . . . . . . . . . . . . . 80

Dividends from wholly owned foreign subsidiaries . . . . . . . . . . . . . . . . . . . . . . . . . . . .100

Total. Add lines 1 through 8. See instructions for limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0. . . .

Dividends from domestic corporations received by a small business investment

Dividends from affiliated group members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100

Dividends from certain FSCs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

Dividends from foreign corporations not included on lines 3, 6, 7, 8, 11, or 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Foreign dividend gross-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

IC-DISC and former DISC dividends not included on lines 1, 2, or 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Deduction for dividends paid on certain preferred stock of public utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 1120 (2011)

By the Numbers, Inc.

Tax Computation and Payment (see instructions)

Part ITax Computation

Alternative minimum tax (attach Form 4626) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. . . . . . . . . . . . . .

Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . . 103,471

5a Foreign tax credit (attach Form 1118) . . . . . . . . . . . . . . . . . . . . . . . 5a. . . . . . . . . . . . . . . . . . . . . . . . . .

e Bond credits from Form 8912 . . . . . . . . . . . . . . . . . . . . . . . . . . .5e. . . . . . . . . . . . . . . . . . . . . . . . . .

Total credits. Add lines 5a through 5e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . . 0. . . . . .

Subtract line 6 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. . . . . 103,471