(and proxy tax under section 6033(e)) 2011 SEATTLE, WA

Transcription

1 Form Department of the Treasury Internal Revenue Service A For calendar year 211 or other tax year beginning, and ending 34 Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32, enter the smaller of zero or line LHA For Paperwork Reduction Act Notice, see instructions. Open to Public Inspection for 51(c)(3) Organizations Only DEmployer identification number (Employees trust, see instructions.) B Exempt under section Print BILL & MELINDA GATES FOUNDATION TRUST X 51( c )( 3 ) or E Unrelated business activity codes Number, street, and room or suite no. If a P.O. box, see instructions. (See instructions.) Type 48(e) 22(e) P.O. BOX 2335 C F Group exemption number (See instructions.) G Check organization type 51(c) corporation X 51(c) trust 41(a) trust Other trust H Describe the organization s primary unrelated business activity. SEE STATEMENT 1 I During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? ~~~~~~ If "Yes," enter the name and identifying number of the parent corporation. Yes X No J The books are in care of JENNIFER DEGER Telephone number Part I Unrelated Trade or Business Income (A) Income (B) Expenses (C) Net 1 a Gross receipts or sales b b c Less returns and allowances c Balance ~~~ 12 Other income (See instructions; attach schedule.) ~~~~~~~~~~~~ Total. Combine lines 3 through , Part II Deductions Not Taken Elsewhere (See instructions for limitations on deductions.) (Except for contributions, deductions must be directly connected with the unrelated business income.) OMB No T Exempt Organization Business Income Tax Return (and proxy tax under section 633(e)) 211 Check box if address changed Name of organization ( Check box if name changed and see instructions.) 48A 53(a) City or town, state, and ZIP code 529(a) SEATTLE, WA Book value of all assets at end of year Cost of goods sold (Schedule A, line 7) ~~~~~~~~~~~~~~~~~ Gross profit. Subtract line 2 from line 1c ~~~~~~~~~~~~~~~~ 4 a Capital gain net income (attach Schedule D) ~~~~~~~~~~~~~~~ Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797) ~~~~~~ Capital loss deduction for trusts ~~~~~~~~~~~~~~~~~~~~ Income (loss) from partnerships and S corporations (attach statement) ~~~ Rent income (Schedule C) ~~~~~~~~~~~~~~~~~~~~~~ Unrelated debt-financed income (Schedule E) ~~~~~~~~~~~~~~ Interest, annuities, royalties, and rents from controlled organizations (Sch. F)~ Investment income of a section 51(c)(7), (9), or (17) organization (Schedule G) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Exploited exempt activity income (Schedule I) ~~~~~~~~~~~~~~ Advertising income (Schedule J) ~~~~~~~~~~~~~~~~~~~~ Compensation of officers, directors, and trustees (Schedule K) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Salaries and wages ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Repairs and maintenance Bad debts ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Interest (attach schedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Taxes and licenses ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Charitable contributions (See instructions for limitation rules.) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Depreciation (attach Form 4562) Less depreciation claimed on Schedule A and elsewhere on return Depletion Contributions to deferred compensation plans ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Total deductions. Add lines 14 through 28 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13 ~~~~~~~~~~~~ 1c 2 3 4a 4b 4c ~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Employee benefit programs ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Excess exempt expenses (Schedule I) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Excess readership costs (Schedule J) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other deductions (attach schedule) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Net operating loss deduction (limited to the amount on line 3) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Unrelated business taxable income before specific deduction. Subtract line 31 from line 3 ~~~~~~~~~~~~~~~~~ Specific deduction (Generally $1,, but see instructions for exceptions.) ~~~~~~~~~~~~~~~~~~~~~~~~ 24, , ,12. STMT 2-25, a b ,.. Form 99-T (211)

2 Form 99-T (211) BILL & MELINDA GATES FOUNDATION TRUST I Part III/ Tax Computation 35 Organizations Taxable as Corporations. See instructions for tax computation. Controlled group members (sections 1561 and 1563) check here ~ D See instructions and: a Enter your share of the $5,, $25,, and $9,925, taxable income brackets (in that order): (1) 1$ 1 (2) 1$ I (3) 1$ 1 b Enter organization's share ot (1) Additional 5% tax (not more than $11,75) I $ I (2) Additional 3% tax (not more than $1,) I $ I c Income tax on the amount on line Trusts Taxable at Trust Rates. See instructions for tax computation. Income tax on the amount on line 34 from: W Tax rate schedule or D Schedule (Form 141) Proxy tax. See instructions 38 Alternative minimum tax Total. Add lines 37 and 38 to line 35c or 36, whichever applies I Part IV I Tax and Payments 4a Foreign tax credit (corporations attach Form 1118; trusts attach Form 1116).... b Other credits (see instructions)... c General business credit Attach Form d Credit for prior year minimum tax (attach Form 881 or 8827)... e Total credits. Add lines 4a through 4d Subtract line 4e from line Other taxes. Check if from: CrF~;~ D F~;~ 861; [j Fo;~ 8697 t:~:ff~;~ ii86 6 D Othe; (att~~h ~~~:~~;e; 43 Total tax. Add lines 41 and a Payments: A 21 overpayment credited to a 1,. b 211 estimated tax payments.... c Tax deposited with Form d Foreign organizations: Tax paid or withheld at source (see instructions)... e Backup withholding (see instructions).... f Credit for small employer health insurance premiums (Attach Form 8941) f g Other credits and payments: D Form 2439 Form 4136 D Other Total ~ 44g Total payments. Add lines 44a through 44g 46 Estimated tax penalty (see instructions). Check if Form 222 is attached ~ Tax due. If line 45 is less than the total of lines 43 and 46, enter amount owed... ~ ~ ~ 48 Overpayment. If line 45 is larger than the total of lines 43 and 46, enter amount overpaid Enter the amount of line 48 you want Credited to 212 estimated tax ~ 1,.r Refunded I Part V I Statements Regarding Certain Activities and Other Information (see instructions) 1 At any time during the 211 calendar year, did the organization have an interest in or a signature or other authority over a financial account (bank, securities, or other) in a foreign country? If YES, the organization may have to file Form TO F , Report of Foreign Bank and 2 Financial Accounts. If YES, enter the name of the foreign country here ~ SEE STATEMENT 21 During the tax year, did the organization receive a distribution from, or was it the granto'~r o'rtf,ro"'rt"'ra"'ns""femrorvtr!o;-", a1f;n.or""el;n.gn;"1\"'rui<1s!r7i tf YES, see instructions for other forms the organization may have to fhe... "...,... _ Enter the amount of tax-exempt interest received or accrued during the tax year ~ $ 149, 886. Schedule A - Cost of Goods Sold. Enter method of inventory valuation ~ N / A 1 Inventory at beginning of year Inventory at end of year Purchases Cost of goods sold. Subtract line 6 3 Cost of labor... 3 from line 5. Enter here and in Part I, line a Additional section 263A costs... 4a 8 Do the rules of section 263A (with respect to b Other costs (attach schedule)... 4b property produced or acquired for resale) apply to 5 Total. Add lines 1 through 4b... 5 the organization? _... _. _... _ Sign Under penalties of perjury, I declare that I have exammed this return, Includmg accompanying schedules and statements, and to the best of my knowledge and belief, It IS true, correc~f preparer (other than taxpayer) IS based on all information of which pre parer has any knowledge 4a 4b 4c 4d 44b 44c 44d 44e 35c e Page 2 o. o. o. o. 1,. 1,. o. I.1" III May the IRS discuss this return with Here ~,/-y... ~... \ l15! \ ~ CHIEF FINANCIAL OFFICER the preparer shown below (see tilgnature 1 ottlcer uate \ iltle Instructions)? [!] Yes D No PrinVfype preparer's name Preparer's signature Date Check L if PTIN self- employed Paid JIi:I C,!1SCUJ1.1 1I-d2-/;{ Preparer JANE M. SEARING / POOOO565 Use Only 19 NE 4TH ~~ET, SUITE 17 Firm's address ~ BELLEVUE, WA 984 Phone no Firm's name ~ CLARK NUBER, P. sr I V Firm's EIN ~ Form 99-T (211) Yes x Yes No x No

3 Form 99-T (211) BILL & MELINDA GATES FOUNDATION TRUST Page Schedule C - Rent Income (From Real Property and Personal Property Leased With Real Property) (see instructions) 3 1. Description of property (1) (2) (3) (4) (1) (2) (3) (a) 2. From personal property (if the percentage of rent for personal property is more than 1% but not more than 5%) Rent received or accrued (b) From real and personal property (if the percentage of rent for personal property exceeds 5% or if the rent is based on profit or income) 3(a) Deductions directly connected with the income in columns 2(a) and 2(b) (attach schedule) (4) Total. Total. (c) Total income. Add totals of columns 2(a) and 2(b). Enter (b) Total deductions. Enter here and on page 1, here and on page 1, Part I, line 6, column (A). Part I, line 6, column (B). Schedule E - Unrelated Debt-Financed Income (see instructions) 3. Deductions directly connected with or allocable 2. Gross income from to debt-financed property 1. Description of debt-financed property or allocable to debtfinanced property (a) Straight line depreciation (b) Other deductions (attach schedule) (attach schedule) (1) (2) (3) (4) (1) (2) (3) (4) 4. Amount of average acquisition 5. Average adjusted basis 6. Column 4 divided 7. Gross income 8. Allocable deductions debt on or allocable to debt-financed of or allocable to by column 5 reportable (column (column 6 x total of columns property (attach schedule) debt-financed property 2 x column 6) 3(a) and 3(b)) (attach schedule) Enter here and on page 1, Part I, line 7, column (A). Enter here and on page 1, Part I, line 7, column (B). Totals ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~.. Total dividends-received deductions included in column 8. Schedule F - Interest, Annuities, Royalties, and Rents From Controlled Organizations (see instructions) Exempt Controlled Organizations 1. Name of controlled organization Part of column 4 that is 6. Deductions directly Employer identification Net unrelated income Total of specified included in the controlling connected with income number (loss) (see instructions) payments made organization s gross income in column 5 % % % % (1) (2) (3) (4) Nonexempt Controlled Organizations 7. Taxable Income 8. Net unrelated income (loss) 9. Total of specified payments 1. Part of column 9 that is included 11. Deductions directly connected (see instructions) made in the controlling organization s with income in column 1 gross income (1) (2) (3) (4) Totals J Add columns 5 and 1. Enter here and on page 1, Part I, line 8, column (A). Add columns 6 and 11. Enter here and on page 1, Part I, line 8, column (B)... Form 99-T (211)

4 Form 99-T (211) BILL & MELINDA GATES FOUNDATION TRUST Schedule G - Investment Income of a Section 51(c)(7), (9), or (17) Organization (see instructions) (1) (2) (3) (4) 1. Description of exploited activity 1. Description of income 2. Amount of income 2. Gross unrelated business income from trade or business Enter here and on page 1, Part I, line 1, col. (A). 3. Expenses directly connected with production of unrelated business income Enter here and on page 1, Part I, line 1, col. (B). Enter here and on page 1, Part I, line 9, column (A). 4. Net income (loss) from unrelated trade or business (column 2 minus column 3). If a gain, compute cols. 5 through Deductions Total deductions directly connected 4. Set-asides 5. and set-asides (attach schedule) (attach schedule) (col. 3 plus col. 4) 5. Gross income 6. Expenses from activity that attributable to is not unrelated column 5 business income Enter here and on page 1, Part I, line 9, column (B). Totals.. Schedule I - Exploited Exempt Activity Income, Other Than Advertising Income (see instructions) (1) (2) (3) (4) Excess exempt expenses (column 6 minus column 5, but not more than column 4). Enter here and on page 1, Part II, line 26. Totals... Schedule J - Advertising Income (see instructions) Part I Income From Periodicals Reported on a Consolidated Basis Page 4 1. Name of periodical 2. Gross 3. Direct advertising advertising costs income 4. Advertising gain or (loss) (col. 2 minus col. 3). If a gain, compute cols. 5 through Circulation 6. Readership income costs 7. Excess readership costs (column 6 minus column 5, but not more than column 4). (1) (2) (3) (4) Totals (carry to Part II, line (5))... Part II Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part II, fill in columns 2 through 7 on a line-by-line basis.) (1) (2) (3) (4) (5) Name of periodical Totals from Part I 2. Gross 3. Direct advertising advertising costs income Enter here and on page 1, Part I, line 11, col. (A). Enter here and on page 1, Part I, line 11, col. (B). 4. Advertising gain or (loss) (col. 2 minus col. 3). If a gain, compute cols. 5 through Circulation 6. Readership income costs 7. Excess readership costs (column 6 minus column 5, but not more than column 4). Enter here and on page 1, Part II, line 27. Totals, Part II (lines 1-5)... Schedule K - Compensation of Officers, Directors, and Trustees (see instructions) 3. Percent of 4. Compensation attributable Title time devoted to 1. Name 2. to unrelated business business (1) (2) (3) (4) SEE STATEMENT 22 Total. Enter here and on page 1, Part II, line 14 % % % % 9. Form 99-T (211)

5 SCHEDULE D (Form 141) Department of the Treasury Internal Revenue Service Name of estate or trust Capital Gains and Losses Attach to Form 141, Form 5227, or Form 99-T. See the Instructions for Schedule D (Form 141) (also for Form 5227 or Form 99-T, if applicable). OMB No Employer identification number BILL & MELINDA GATES FOUNDATION TRUST Note: Form 5227 filers need to complete only Parts I and II. Part I Short-Term Capital Gains and Losses - Assets Held One Year or Less (a) Description of property (Example: 1 shares 7% preferred of "Z" Co.) (b) Date acquired (mo., day, yr.) (c) Date sold (mo., day, yr.) (d) Sales price (e) Cost or other basis (f) Gain or (loss) for the entire year Subtract (e) from (d) 1 a b Enter the short-term gain or (loss), if any, from Schedule D-1, line 1b ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 1b 2 Short-term capital gain or (loss) from Forms 4684, 6252, 6781, and 8824 ~~~~~~~~~~~~~~~~~~~~~~~~~ Net short-term gain or (loss). Combine lines 1a through 4 in column (f). Enter here and on line 13, 6 a Net short-term gain or (loss) from partnerships, S corporations, and other estates or trusts Short-term capital loss carryover. Enter the amount, if any, from line 9 of the 21 Capital Loss ~~~~~~~~~~~~~~~~~ Carryover Worksheet ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 4 ( ) column (3) on page 2 Part II Long-Term Capital Gains and Losses - Assets Held More Than One Year (a) Description of property (b) Date acquired (c) Date sold (d) Sales price (e) Cost or other (f) Gain or (loss) (Example: 1 shares 7% preferred of "Z" Co.) (mo., day, yr.) (mo., day, yr.) basis for the entire year Subtract (e) from (d) b Enter the long-term gain or (loss), if any, from Schedule D-1, line 6b ~~~~~~~~~~~~~~~~~~~~~~~~~~~ 6b 7 Long-term capital gain or (loss) from Forms 2439, 4684, 6252, 6781, and 8824 ~~~~~~~~~~~~~~~~~~~~~~ 7 8 Net long-term gain or (loss) from partnerships, S corporations, and other estates or trusts ~~~~~~~~~~~~~~~~~~ 8 1, Capital gain distributions ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Gain from Form 4797, Part I ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Long-term capital loss carryover. Enter the amount, if any, from line 14 of the 21 Capital Loss Carryover Worksheet ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 11 ( ) 12 Net long-term gain or (loss). Combine lines 6a through 11 in column (f). Enter here and on line 14a, column (3) on page LHA For Paperwork Reduction Act Notice, see the Instructions for Form 141. Schedule D (Form 141) ,39. 25,959.

6 Schedule D (Form 141) 211 BILL & MELINDA GATES FOUNDATION TRUST Page 2 Part III Summary of Parts I and II (1) Beneficiaries (2) Estate s (3) Total Caution: Read the instructions before completing this part. or trust s 13 Net short-term gain or (loss) ~~~~~~~~~~~~~~~~~~~~~~~~~ Net long-term gain or (loss): a Total for year ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14a 25, ,959. b Unrecaptured section 125 gain (see line 18 of the worksheet) ~~~~~~~~~~~ c 28% rate gain ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 14b 14c 15 Total net gain or (loss). Combine lines 13 and 14a ~~~~~~~~~~~~~ 15 25, ,946. Note: If line 15, column (3), is a net gain, enter the gain on Form 141, line 4 (or Form 99-T, Part I, line 4a). If lines 14a and 15, column (2), are net gains, go to Part V, and do not complete Part IV. If line 15, column (3), is a net loss, complete Part IV and the Capital Loss Carryover Worksheet, as necessary. Part IV Capital Loss Limitation 16 Enter here and enter as a (loss) on Form 141, line 4 (or Form 99-T, Part I, line 4c, if a trust), the smaller of: a The loss on line 15, column (3) or b $3, ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 16 ( ) Note: If the loss on line 15, column (3), is more than $3,, or if Form 141, page 1, line 22 (or Form 99-T, line 34), is a loss, complete the Capital Loss Carryover Worksheet in the instructions to figure your capital loss carryover. Part V Tax Computation Using Maximum Capital Gains Rates Form 141 filers. Complete this part only if both lines 14a and 15 in column (2) are gains, or an amount is entered in Part I or Part II and there is an entry on Form 141, line 2b(2), and Form 141, line 22, is more than zero. Caution: Skip this part and complete the Schedule D Tax Worksheet in the instructions if: Either line 14b, col. (2) or line 14c, col. (2) is more than zero, or Both Form 141, line 2b(1), and Form 4952, line 4g are more than zero. Form 99-T trusts. Complete this part only if both lines 14a and 15 are gains, or qualified dividends are included in income in Part I of Form 99-T, and Form 99-T, line 34, is more than zero. Skip this part and complete the Schedule D Tax Worksheet in the instructions if either line 14b, col. (2) or line 14c, col. (2) is more than zero Enter taxable income from Form 141, line 22 (or Form 99-T, line 34) Enter the smaller of line 14a or 15 in column (2) ~~~~~~~~ 17 but not less than zero ~~~~~~~~~~~~~~ Enter the estate s or trust s qualified dividends from Form 141, line 2b(2) (or enter the qualified dividends included in income in Part I of Form 99-T)~~~~~ Add lines 18 and 19 ~~~~~~~~~~~~~~~ If the estate or trust is filing Form 4952, enter the 2 amount from line 4g; otherwise, enter -- ~~~ Subtract line 21 from line 2. If zero or less, enter -- ~~~~~~~~~~~~~~~~ Subtract line 22 from line 17. If zero or less, enter -- ~~~~~~~~~~~~~~~~ Enter the smaller of the amount on line 17 or $2,3 ~~~~~~~~~~~~~~~~ Is the amount on line 23 equal to or more than the amount on line 24? Yes. Skip lines 25 and 26; go to line 27 and check the "No" box. No. Enter the amount from line 23 ~~~~~~~~~~~~~~~~~~~~~ Subtract line 25 from line 24 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Are the amounts on lines 22 and 26 the same? Yes. Skip lines 27 thru 3; go to line 31. No. Enter the smaller of line 17 or line 22 ~ Enter the amount from line 26 (If line 26 is blank, enter --)~~~~~~~~~~~~~~ Subtract line 28 from line 27 ~~~~~~~~~~~~~~~~~~~~~~~~~~~ Multiply line 29 by 15% (.15) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Figure the tax on the amount on line 23. Use the 211 Tax Rate Schedule for Estates and Trusts (see the Schedule G instructions in the instructions for Form 141) ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 3 and 31 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 33 Figure the tax on the amount on line 17. Use the 211 Tax Rate Schedule for Estates and Trusts (see the Schedule G instructions in the instructions for Form 141) ~~~~~~~~~~~~~~~~~~~~~~~~~~ 34 Tax on all taxable income. Enter the smaller of line 32 or line 33 here and on Form 141, Schedule G, line 1a (or Form 99-T, line 36) Schedule D (Form 141) 211

7 BILL & MELINDA GATES FOUNDATION TRUST }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 99-T DESCRIPTION OF ORGANIZATION S PRIMARY UNRELATED STATEMENT 19 BUSINESS ACTIVITY }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} THE PRIMARY UNRELATED BUSINESS ACTIVITY IS CONDUCTED WITHIN PASSIVE INVESTMENT PARTNERSHIPS IN WHICH THE BILL & MELINDA GATES FOUNDATION TRUST HOLDS AN INTEREST. TO FORM 99-T, PAGE 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 99-T INCOME (LOSS) FROM PARTNERSHIPS STATEMENT 2 }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} DESCRIPTION AMOUNT }}}}}}}}}}} }}}}}}}}}}}}}} ORDINARY LOSS - CSFB STRATEGIC PARTNERS II -46,122. ORDINARY LOSS - TOWER SQUARE CAPITAL PARTNERS III -9,36. ORDINARY LOSS - TOWER SQUARE CAPITAL PARTNERS III -8,931. ORDINARY INCOME - VITRUVIAN EXPLORATION LLC 33,249. NET RENTAL INCOME - CSFB STRATEGIC PARTNERS II 1,728. INTEREST INCOME - CSFB STRATEGIC PARTNERS II 6. DIVIDEND INCOME - CSFB STRATEGIC PARTNERS II 8. ROYALTIES - CSFB STRATEGIC PARTNERS II 6. OTHER INCOME - CSFB STRATEGIC PARTNERS II 732. OTHER DEDUCTIONS - CSFB STRATEGIC PARTNERS II -5,225. OTHER DEDUCTIONS - VITRUVIAN EXPLORATION LLC -17,2. INVESTMENT INTEREST EXPENSE- CSFB STRATEGIC PARTNERS II -11. }}}}}}}}}}}}}} TOTAL TO FORM 99-T, PAGE 1, LINE 5-357,12. ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 99-T NAME OF FOREIGN COUNTRY IN WHICH STATEMENT 21 ORGANIZATION HAS FINANCIAL INTEREST }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} NAME OF COUNTRY }}}}}}}}}}}}}}} ARGENTINA BRAZIL CHINA CZECH REPUBLIC DENMARK EGYPT GREECE INDIA JAPAN KOREA (SOUTH) MALAYSIA POLAND TAIWAN THAILAND STATEMENT(S) 19, 2, 21

8 BILL & MELINDA GATES FOUNDATION TRUST }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}} TURKEY UNITED KINGDOM ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ FORM 99-T SCHEDULE K - COMPENSATION OF OFFICERS, STATEMENT 22 DIRECTORS AND TRUSTEES }}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} NAME TITLE PERCENT COMPENSATION }}}} }}}}}}}}}}}}}}}}}} }}}}}}}}} }}}}}}}}}}}}}} WILLIAM H GATES, III TRUSTEE AND CEO.%. MELINDA FRENCH GATES TRUSTEE.%. RICHARD HENRIQUES CFO.%. KEITH TRAVERSE SECRETARY.%. MICHAEL LARSON LLC MANAGER.%. }}}}}}}}}}}}}} TOTAL TO FORM 99-T, SCHEDULE K ~~~~~~~~~~~~~~ STATEMENT(S) 21, 22

9 BILL & MELINDA GATES FOUNDATION TRUST EIN: CHARITABLE CONTRIBUTION CARRYFORWARD SCHEDULE FOR THE YEAR ENDED DECEMBER 31, 211 YEAR END CONTRIBUTIONS SUBJECT TO 5% LIMITATION CONTRIBUTIONS SUBJECT TO 3% LIMITATION AMOUNT UTILIZED 5% LIMITATION CARRYFORWARD 3% LIMITATION CARRYFORWARD 12/31/7-1,887,999,259 7,213-1,887,992,46 12/31/8-1,851,998, ,851,998,519 12/31/9 21 1,645,, ,645,, 12/31/1 1,136 1,875,, - 1,136 1,875,, 12/31/ ,97,, 333 * 151 1,97,, TOTAL 1,488 9,229,99,565 TOTAL CARRYFORWARD TO 12/31/212: $ 9,229,992,53 * PER REG 1.17A-1(d), A PORTION OF THE CONTRIBUTION DEDUCTION HAS BEEN DISALLOWED DUE TO THE NET OPERATING LOSS CARRYOVERS AND HAS BEEN ADDED TO THE NOL CARRYOVER AMOUNT. STATEMENT 23

10 BILL & MELINDA GATES FOUNDATION TRUST NET OPERATING LOSS CARRYFORWARD SCHEDULE ELECTION TO WAIVE CARRYBACK PERIOD FOR THE YEAR ENDED DECEMBER 31, 211 THE TAXPAYER ELECTS TO WAIVE THE ENTIRE NET OPERATING LOSS CARRYBACK PERIOD UNDER SECTION 172(B)(3) OF THE INTERNAL REVENUE CODE AND CARRYFORWARD THE LOSSES TO FUTURE YEARS. YEAR END AMOUNT GENERATED AMOUNT UTILIZED AMOUNT CARRYFORWARD 12/31/8 14, ,679 12/31/9 15,323-15,323 12/31/1 57,959-57,959 12/31/ * TOTAL 87, ,294 TOTAL NOL CARRYFORWARD TO 12/31/212: $ 87,294 * PER REG 1.17A-1(d), A PORTION OF THE CONTRIBUTION DEDUCTION HAS BEEN DISALLOWED DUE TO THE NET OPERATING LOSS CARRYOVERS. AN ADJUSTMENT WAS MADE TO 211 TO REFLECT THE PROPER TREATMENT UNDER THE REGULATION. STATEMENT 24

11 BILL & MELINDA GATES FOUNDATION TRUST PASSIVE ACTIVITY LOSS CARRYFORWARD FOR THE YEAR ENDED DECEMBER 31, 211 YEAR END AMOUNT GENERATED AMOUNT UTILIZED AS NOL DUE TO DISPOSITION AMOUNT UTILIZED AMOUNT CARRYFORWARD 12/31/9 191,561-37, ,818 12/31/11 333, ,332 TOTAL 524,893-37, ,15 TOTAL PASSIVE ACTIVITY LOSS CARRYFORWARD TO 12/31/212: $ 487,15 STATEMENT 25

12 BILL & MELINDA GATES FOUNDATION TRUST ELECTION TO CARRYFORWARD UNUSED BUSINESS CREDITS FOR THE YEAR ENDED DECEMBER 31, 211 PURSUANT TO IRC SECTION 39(A), THE TAXPAYER HEREBY ELECTS UNDER 38(A), TO RELINQUISH THE ENTIRE CARRYBACK PERIOD SPECIFIED IN IRC SECTION 39(A) WITH RESPECT TO THE UNUSED BUSINESS CREDITS FOR THE YEAR ENDED DECEMBER 31, 211 AND TO CARRYFORWARD SUCH UNUSED BUSINESS CREDITS TO FUTURE YEARS. TYPE OF CREDIT 211 AMOUNT INCREASING RESEARCH ACTIVITIES CREDIT FROM FLOW THROUGH ENTITIES 1,176 OTHER CREDITS FROM FLOW THROUGH ENTITIES 889 TOTAL UNUSED BUSINESS CREDITS FOR 211: 2,65 YEAR END TYPE OF CREDIT AMOUNT GENERATED AMOUNT UTILIZED AMOUNT CARRYFORWARD 12/31/7 INCREASING RESEARCH ACTIVITIES CREDIT 1,811 1, WORK OPPORTUNITY CREDIT OTHER CREDITS /31/8 INCREASING RESEARCH ACTIVITIES CREDIT 1,55-1,55 WORK OPPORTUNITY CREDIT OTHER CREDITS /31/9 INCREASING RESEARCH ACTIVITIES CREDIT WORK OPPORTUNITY CREDIT OTHER CREDITS /31/1 INCREASING RESEARCH ACTIVITIES CREDIT /31/11 INCREASING RESEARCH ACTIVITIES CREDIT 1,176-1,176 OTHER CREDITS TOTAL 6,678 1,34 5,338 TOTAL BUSINESS CREDIT CARRYFORWARD TO 12/31/212: $ 5,338 STATEMENT 26

13 BILL & MELINDA GATES FOUNDATION TRUST EIN: PART 1, LINE 5, COLUMN (C) FOR THE YEAR ENDED DECEMBER 31, 211 ALLOWED LOSSES FROM PASSIVE ACTIVITIES ( SEE FORM 8582) $ (24,39) PORTFOLIO INCOME FROM CSFB STRATEGIC PARTNERS II, LP INTEREST 6 DIVIDENDS 8 OTHER PORTFOLIO INCOME 493 OTHER DEDUCTIONS (1,44) INVESTMENT INTEREST EXPENSE (11) (89) TOTAL ALLOWED INCOME / (LOSS) FROM PARTNERSHIPS AND S CORPORATIONS - PART 1, COLUMN (C) $ (25,28) STATEMENT 27

14 BILL & MELINDA GATES FOUNDATION TRUST EIN: FORM PART I: SALE OR EXCHANGES OF PROPERTY USED IN A TRADE OR BUSINESS AND INVOLUNTARY CONVERSIONS FROM OTHER THAN CASUALTY OR THEFTS FOR THE YEAR ENDED DECEMBER 31, 211 (A) DESCRIPTION OF PROPERTY (B) DATE ACQUIRED (C) DATE SOLD (D) GROSS SALES PRICE (E) DEPRECIATION ALLOWED (F) COST OR OTHER BASIS PLUS IMPROVEMENTS & EXPENSE OF SALE (G) GAIN/LOSS ALLOWED GAIN/LOSS CSFB STRATEGIC PARTNERS II, LP VARIOUS VARIOUS 24, ,39 24,39 VITRUVIAN EXPLORATION, LLC VARIOUS VARIOUS - - 1,6 (1,6) NONE ** PART I SEC GAIN AND LOSS 22,79 24,39 ** THE CURRENT YEAR LOSS FROM VITRUVIAN EXPLORATION, LLC IS NOT ALLOWED AS A DEDUCTION DURING THE CURRENT YEAR DUE TO PASSIVE ACTIVITY LOSS STATEMENT 28

15 Form 38 Department of the Treasury Internal Revenue Service (99) Name(s) shown on return General Business Credit See separate instructions. Attach to your tax return. Current Year Credit for Credits Not Allowed Against Tentative Minimum Tax (TMT) Part I (See instructions and complete Part(s) III before Parts I and II) 1 General business credit from line 2 of all Parts III with box A checked Passive activity credits from line 2 of all Parts III with box B checked 2 2,65 3 Enter the applicable passive activity credits allowed for 211 (see instructions) Carryforward of general business credit to 211. Enter the amount from line 2 of Part III with box C checked. See instructions for schedule to attach Carryback of general business credit from 212. Enter the amount from line 2 of Part III with box D checked (see instructions) Add lines 1, 3, 4, and Part II Allowable Credit 7 Regular tax before credits: Individuals. Enter the amount from Form 14, line 44, or Form 14NR, line 42. Corporations. Enter the amount from Form 112, Schedule J, Part I, line 2; or the applicable line of your return Estates and trusts. Enter the sum of the amounts from Form 141, Schedule G, lines 1a and 1b; or the amount from the applicable line of your return Alternative minimum tax: Individuals. Enter the amount from Form 6251, line Corporations. Enter the amount from Form 4626, line Estates and trusts. Enter the amount from Schedule I (Form 141), line 56.. Identifying number BILL & MELINDA GATES FOUNDATION TRUST OMB No Attachment Sequence No. 22 3,7 3,7 9 Add lines 7 and a Foreign tax credit a b Personal credits from Form 14 or 14NR (see instructions). 1b c Add lines 1a and 1b c 11 Net income tax. Subtract line 1c from line 9. If zero, skip lines 12 through 15 and enter -- on line 16a Net regular tax. Subtract line 1c from line 7. If zero or less, enter Enter 25% (.25) of the excess, if any, of line 12 over $25, (see instructions) Tentative minimum tax: Individuals. Enter the amount from Form 6251, line Corporations. Enter the amount from Form 4626, line Estates and trusts. Enter the amount from Schedule I (Form 141), line Enter the greater of line 13 or line a Subtract line 15 from line 11. If zero or less, enter a b For a corporation electing to accelerate the research credit, enter the bonus depreciation amount attributable to the research credit (see instructions) b c Add lines 16a and 16b c ISA 17a Enter the smaller of line 6 or line 16c a C corporations: See the line 17a instructions if there has been an ownership change, acquisition, or reorganization. b Enter the smaller of line 6 or line 16a. If you made an entry on line 16b, go to line 17c; otherwise, skip line 17c (see instructions) b c Subtract line 17b from line 17a. This is the refundable amount for a corporation electing to accelerate the research credit. Include this amount on Form 112, Schedule J, Part II, line 19c (or the applicable line of your return) c For Paperwork Reduction Act Notice, see separate instructions. Form 38 (211)

16 Form 38 (211) Page 2 Part II Allowable Credit (Continued) Note. If you are not required to report any amounts on lines 22 or 24 below, skip lines 18 through 25 and enter -- on line Multiply line 14 by 75% (.75) (see instructions) Enter the greater of line 13 or line Subtract line 19 from line 11. If zero or less, enter Subtract line 17b from line 2. If zero or less, enter Combine the amounts from line 3 of all Parts III with box A, C, or D checked Passive activity credit from line 3 of all Parts III with box B checked Enter the applicable passive activity credit allowed for 211 (see instructions) Add lines 22 and Empowerment zone and renewal community employment credit allowed. Enter the smaller of line 21 or line Subtract line 13 from line 11. If zero or less, enter Add lines 17b and Subtract line 28 from line 27. If zero or less, enter Enter the general business credit from line 5 of all Parts III with box A checked Enter the total eligible small business credit from line 6 of all Parts III with box E checked Passive activity credits from line 5 of all Parts III with box B checked and line 6 of all Parts III with box F checked Enter the applicable passive activity credits allowed for 211 (see instructions) Carryforward of business credit to 211. Enter the amount from line 5 of Part III with box C checked and line 6 of Part III with box G checked. See instructions for schedule to attach Carryback of business credit from 212. Enter the amount from line 5 of Part III with box D checked and line 6 of Part III with box H checked (see instructions) Add lines 3, 31, 33, 34, and Enter the smaller of line 29 or line Credit allowed for the current year. Add lines 28 and 37. Report the amount from line 38 (if smaller than the sum of Part I, line 6, and Part II, lines 25 and 36, see instructions) as indicated below or on the applicable line of your return: Individuals. Form 14, line 53, or Form 14NR, line Corporations. Form 112, Schedule J, Part I, line 5c Estates and trusts. Form 141, Schedule G, line 2b Form 38 (211)

17 BILL AND MELINDA GATES FOUNDATION TRUST Form 38 (211) Page 3 Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below. (see instructions) A General Business Credit From a Non-Passive Activity E Eligible Small Business Credit From a Non-Passive Activity B General Business Credit From a Passive Activity F Eligible Small Business Credit From a Passive Activity C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Eligible Small Business Credit Carrybacks I If you are filing more than one Part III with box A, B, E, or F checked, complete and attach first an additional Part III combining amounts from all Parts III with box A, B, E, or F checked. Check here if this is the consolidated Part III X (a) Description of credit (b) (c) If claiming the credit Note: On any line where the credit is from more than one source, a separate Part III is Enter the appropriate from a pass-through needed for each pass-through entity. entity, enter the EIN amount 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved for future use b c Increasing research activities (Form 6765) c ,176 d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (do not enter more than $5, in column (c) of Parts III with box A, B, E, or F checked, combined) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (do not enter more than $5 in column (c) of Parts III with box A, B, E, or F checked, combined).. 1j k Employer-provided child care facilities and services (Form 8882).... 1k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (Form 897) o p Energy efficient home (Form 898) p q Energy efficient appliance (Form 899) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling property (Form 8911) s t Reserved for future use t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (Form 8931) (do not enter more than $2 million in column (c) of Parts III with box A, B, E, or F checked, combined) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (Form 8834, Part I only) z aa New hire retention (Form 5884-B) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other zz 2 Add lines 1a through 1zz and enter here Enter the amount from Form a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Alcohol and cellulosic biofuel fuels (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Reserved for future use i j Reserved for future use j z Other z 5 Add lines 4a through 4z and enter here Add lines 2, 3, and MULTIPLE 889 2,65 2,65 Form 38 (211)

18 BILL AND MELINDA GATES FOUNDATION TRUST Form 38 (211) Page 3 Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below. (see instructions) A General Business Credit From a Non-Passive Activity E Eligible Small Business Credit From a Non-Passive Activity B X General Business Credit From a Passive Activity F Eligible Small Business Credit From a Passive Activity C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Eligible Small Business Credit Carrybacks I If you are filing more than one Part III with box A, B, E, or F checked, complete and attach first an additional Part III combining amounts from all Parts III with box A, B, E, or F checked. Check here if this is the consolidated Part III (a) Description of credit (b) (c) If claiming the credit Note: On any line where the credit is from more than one source, a separate Part III is Enter the appropriate from a pass-through needed for each pass-through entity. entity, enter the EIN amount 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved for future use b c Increasing research activities (Form 6765) c d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (do not enter more than $5, in column (c) of Parts III with box A, B, E, or F checked, combined) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (do not enter more than $5 in column (c) of Parts III with box A, B, E, or F checked, combined).. 1j k Employer-provided child care facilities and services (Form 8882).... 1k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (Form 897) o p Energy efficient home (Form 898) p q Energy efficient appliance (Form 899) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling property (Form 8911) s t Reserved for future use t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (Form 8931) (do not enter more than $2 million in column (c) of Parts III with box A, B, E, or F checked, combined) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (Form 8834, Part I only) z aa New hire retention (Form 5884-B) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other zz 2 Add lines 1a through 1zz and enter here Enter the amount from Form a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Alcohol and cellulosic biofuel fuels (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Reserved for future use i j Reserved for future use j z Other z 5 Add lines 4a through 4z and enter here Add lines 2, 3, and Form 38 (211)

19 BILL AND MELINDA GATES FOUNDATION TRUST Form 38 (211) Page 3 Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below. (see instructions) A General Business Credit From a Non-Passive Activity E Eligible Small Business Credit From a Non-Passive Activity B X General Business Credit From a Passive Activity F Eligible Small Business Credit From a Passive Activity C General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Eligible Small Business Credit Carrybacks I If you are filing more than one Part III with box A, B, E, or F checked, complete and attach first an additional Part III combining amounts from all Parts III with box A, B, E, or F checked. Check here if this is the consolidated Part III (a) Description of credit (b) (c) If claiming the credit Note: On any line where the credit is from more than one source, a separate Part III is Enter the appropriate from a pass-through needed for each pass-through entity. entity, enter the EIN amount 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved for future use b c Increasing research activities (Form 6765) c ,176 d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (do not enter more than $5, in column (c) of Parts III with box A, B, E, or F checked, combined) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (do not enter more than $5 in column (c) of Parts III with box A, B, E, or F checked, combined).. 1j k Employer-provided child care facilities and services (Form 8882).... 1k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (Form 897) o p Energy efficient home (Form 898) p q Energy efficient appliance (Form 899) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling property (Form 8911) s t Reserved for future use t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (Form 8931) (do not enter more than $2 million in column (c) of Parts III with box A, B, E, or F checked, combined) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (Form 8834, Part I only) z aa New hire retention (Form 5884-B) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other zz 2 Add lines 1a through 1zz and enter here Enter the amount from Form a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Alcohol and cellulosic biofuel fuels (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Reserved for future use i j Reserved for future use j z Other z 5 Add lines 4a through 4z and enter here Add lines 2, 3, and ,858 1,858 Form 38 (211)

20 BILL AND MELINDA GATES FOUNDATION TRUST Form 38 (211) Page 3 Part III General Business Credits or Eligible Small Business Credits (see instructions) Complete a separate Part III for each box checked below. (see instructions) A General Business Credit From a Non-Passive Activity E Eligible Small Business Credit From a Non-Passive Activity B General Business Credit From a Passive Activity F Eligible Small Business Credit From a Passive Activity C X General Business Credit Carryforwards G Eligible Small Business Credit Carryforwards D General Business Credit Carrybacks H Eligible Small Business Credit Carrybacks I If you are filing more than one Part III with box A, B, E, or F checked, complete and attach first an additional Part III combining amounts from all Parts III with box A, B, E, or F checked. Check here if this is the consolidated Part III (a) Description of credit (b) (c) If claiming the credit Note: On any line where the credit is from more than one source, a separate Part III is Enter the appropriate from a pass-through needed for each pass-through entity. entity, enter the EIN amount 1a Investment (Form 3468, Part II only) (attach Form 3468) a b Reserved for future use b c Increasing research activities (Form 6765) c MULTIPLE 2,965 d Low-income housing (Form 8586, Part I only) d e Disabled access (Form 8826) (do not enter more than $5, in column (c) of Parts III with box A, B, E, or F checked, combined) e f Renewable electricity, refined coal, and Indian coal production (Form 8835) 1f g Indian employment (Form 8845) g h Orphan drug (Form 882) h i New markets (Form 8874) i j Small employer pension plan startup costs (Form 8881) (do not enter more than $5 in column (c) of Parts III with box A, B, E, or F checked, combined).. 1j k Employer-provided child care facilities and services (Form 8882).... 1k l Biodiesel and renewable diesel fuels (attach Form 8864) l m Low sulfur diesel fuel production (Form 8896) m n Distilled spirits (Form 896) n o Nonconventional source fuel (Form 897) o p Energy efficient home (Form 898) p q Energy efficient appliance (Form 899) q r Alternative motor vehicle (Form 891) r s Alternative fuel vehicle refueling property (Form 8911) s t Reserved for future use t u Mine rescue team training (Form 8923) u v Agricultural chemicals security (Form 8931) (do not enter more than $2 million in column (c) of Parts III with box A, B, E, or F checked, combined) v w Employer differential wage payments (Form 8932) w x Carbon dioxide sequestration (Form 8933) x y Qualified plug-in electric drive motor vehicle (Form 8936) y z Qualified plug-in electric vehicle (Form 8834, Part I only) z aa New hire retention (Form 5884-B) aa bb General credits from an electing large partnership (Schedule K-1 (Form 165-B)) 1bb zz Other zz 2 Add lines 1a through 1zz and enter here Enter the amount from Form a Investment (Form 3468, Part III) (attach Form 3468) a b Work opportunity (Form 5884) b c Alcohol and cellulosic biofuel fuels (Form 6478) c d Low-income housing (Form 8586, Part II) d e Renewable electricity, refined coal, and Indian coal production (Form 8835) 4e f Employer social security and Medicare taxes paid on certain employee tips (Form 8846) f g Qualified railroad track maintenance (Form 89) g h Small employer health insurance premiums (Form 8941) h i Reserved for future use i j Reserved for future use j z Other z 5 Add lines 4a through 4z and enter here Add lines 2, 3, and MULTIPLE 42 3,7 MULTIPLE ,273 Form 38 (211)