Dear Valued Clients and Tax Advisors: We are very pleased to introduce a new tax reporting format. As always, a tax package will be mailed for each account as soon as the information is finalized. This will be as early as next week for some clients accounts. For those accounts which hold common trust funds, the new tax package will include information previously provided in K-1s for most of these funds. These tax packages will be mailed by the end of the first week of March, approximately two weeks earlier from prior years for those clients owning common trust fund units. Additionally, all tax packages will include fee and expense data which should eliminate the need to scroll through year-end statements for this information. To provide you an opportunity to become familiar with and ask any questions regarding the new 1099 package, we are pleased to provide you this sample. There is a considerable amount of information on page 2, so we encourage you to review it carefully. In particular, please note that all common trust fund income and expense information, with the exception of that information attributable to the Credit Opportunity Fund, is included in this package and listed on a fund by fund basis as Not Reported on 1099. This is the same information that will be reported to the IRS and should be used in preparation of your or your client s trust s income tax return. Because the reportable information for these common trust funds is included, K-1s will not be provided but will be available upon request shortly after April 15 th. Other Diversified Trust strategies for which K-1s do remain outstanding, however, will be listed on the Tax Information Statement included in the 1099 package along with an estimate of when those K-1s will be available. Many clients have historically provided accountants with annual statements to retrieve fee, expense and distribution information. All investment management and custody fees are summarized in the 1099 package under Other Deductions Subject to 2% Limitation. Other potentially deductible items are included under Deductions. Deductibility should be determined by the trust s 1041 preparer. Additionally, disbursements identified as distributions made to or on behalf of beneficiaries are summarized in the Tax Summary and are also listed individually. These items as well as those listed as Deductions should be reviewed carefully to ensure proper treatment on the trust s 1041. An additional item that may be helpful is the Computation of Expenses Allocable to Federal Tax Exempt Income which can be found toward the end of the package. All information referenced in this paragraph is provided as a courtesy only and is not reported to the IRS. While this 1099 package will be generated for the vast majority of our clients, there will be some exceptions. For any accounts that are custodied with Charles Schwab & Company, Schwab will continue to generate the requisite tax reporting. Additionally, beneficiaries of most irrevocable trusts of which Diversified Trust serves as trustee or co-trustee will also continue to receive beneficiary K-1s. Because of the earlier availability of tax information for those CPAs preparing the tax returns for those trusts, we would anticipate your receipt of those K-1s earlier than in prior years. We are excited about these improvements and the efficiencies they create. We welcome your questions and your comments and, as always, we value our relationship with you. DIVERSIFIED TRUST
S Page 1 of 24 From: DIVERSIFIED TRUST COMPANY, INC 6075 POPLAR AVENUE, SUITE 900 MEMPHIS, TN 38119 Contents Letter 2 Tax Summary 4 Combined Year-End 1099 Forms 6 Form 1099-B: Proceeds from Broker and Barter Exchange Transactions 7 Dividends and Interest Detail 10 Other Tax Information 17 Payments/Receipts Made on Behalf of Form 19 1099 Instructions for Recipient 22 Mail to: If a copy of the 1099 was sent to anyone other than the "Mail to" name and address, the name will be noted here.
- Page 2 of 24 We are pleased to provide you with this Tax Information Statement to assist you in the preparation of the Fiduciary Income Tax Returns for this trust. Please review this page carefully, as the information included with this 1099 package is much more extensive than the 1099s previously provided. Perhaps most importantly, DTC common trust fund ("CTF") income and expense items reported to the IRS on K-1s, other than those attributable to the DTC Credit Opportunity Fund, are reported to the trust herein as items "Not Reported on 1099". The first section in this package summarizes the information reported to the IRS via 1099 and adds to those amounts the items "Not Reported on 1099" to generate a total of all reportable items. The trust s 1099s and additional detail behind both the 1099s and items "Not Reported on 1099" follow. All amounts should be reported on the appropriate schedules of the trust s Fiduciary Income Tax Return and (if applicable) State Fiduciary Income Tax Return. The name of the 1099 Payer is shown at the top of each 1099 form, and CTF Payer information for each common trust fund is below. Because K-1 tax information is included herein, K-1s for these CTFs will not be provided but will be available upon request shortly after April 15th. No state income tax was paid from any CTF on behalf of its participants. Please note that international income and withholding items attributable to each CTF are presented as "VARIOUS". All foreign income should be treated as passive for foreign tax credit purposes. The percentage of common trust fund expenses attributable to foreign source income is for the International Equity CTF, for the Large Cap U.S. Equity CTF, and for the Small/Mid Cap U.S. Equity CTF. Per country detail for all international items is available by contacting Diversified Trust. Please note that income and expenses related to the DTC Credit Opportunity Fund and other partnerships will be reported to the trust on separate K-1(s) and will be mailed to you directly from each partnership. A list of
- Page 3 of 24 these partnerships (excluding certain family and private party partnerships) is included in the Tax Summary. Additionally, please note that sales of partnership units are reported on the 1099 as cost basis unknown. With the exception of the Credit Opportunity Fund, basis on these sales will need to be maintained based on the partnership K-1 information. Please consult the trust s tax advisor for proper reporting. The trust s Tax Summary also includes information regarding potentially deductible items. Investment Management or Custody Fees and Expenses are listed as "Other Deductions Subject to 2%Limitation," and other potentially deductible items are included under "Deductions". Deductibility should be determined by the trust s 1041 preparer. Payments identified as being made to or on behalf of beneficiaries are summarized in the Tax Summary and are also listed individually. These items as well as those listed as "Deductions" should be reviewed carefully to ensure proper treatment on the trust s 1041. Please forward this Tax Information Statement to the preparer of the trust s 1041. If you have any questions or need any additional information, please do not hesitate to contact us.
- Page 4 of 24 Tax Summary Listed below is a summarization of all items posted to your account. It includes items reported to the IRS on 1099 Forms INT, DIV, B and OID, items reported to the IRS by individual payers, and miscellaneous information you may need in the preparation of your federal and state income tax returns. INCOME Differences between amounts Reported on Combined 1099 and Total represent CTF information detailed in the following pages. Reported on Combined 1099 Domestic Dividends: Total for year $39,394.06 $55,593.51 Qualified $2,623.29 $18,822.74 Exempt Interest Dividends (not subject to Alt Min Tax): Non-taxable in Georgia $0.01 $0.01 Taxable in Georgia $17.26 $17.26 Exempt-interest Dividends (subject to Alt Min Tax): Taxable in Georgia $0.04 $0.04 Domestic Interest $0.00 $5.89 Short Term Gains and Losses: Common Trust Fund Gain/Loss (N/A) -$2,954.51 Other Short Term (Basis information reported to the IRS): Sales Price $157,500.00 $157,500.00 Cost or other basis $167,211.42 $167,211.42 Net gain/loss (N/A) -$9,711.42 Long Term Gains and Losses: Capital Gain Distributions: Capital gain distributions $10,061.89 $10,061.89 Common Trust Fund Gain/Loss (N/A) $51,791.54 Other Long Term (Basis information reported to the IRS): Sales Price $159,078.16 $159,078.16 Cost or other basis $142,791.24 $142,791.24 Market discount $0.00 $0.00 Net gain/loss (N/A) $16,286.92 Other Long Term (Basis information not reported to the IRS): Sales Price $263,907.97 $263,907.97 Cost or other basis (N/A) $228,697.15 Total
- Page 5 of 24 INCOME Reported on Combined 1099 Total Net gain/loss (N/A) $35,210.82 Other Income (N/A) $2,342.00 DEDUCTIONS Deductions will typically include fees, expenses, and state income taxes. See details in pages that follow. Gross Amount Allocated to Tax- Exempt Income Net Amount State Income Taxes $8,800.00 Agency Fees $26,800.00 $8.00 $26,792.00 Attorney, Accountant and Tax Preparer Fees $1,136.60 $0.00 $1,136.60 Other Deductions Subject to 2% Limitation $26,301.57 $7.85 $26,293.72 MISCELLANEOUS Reported on 1099 Total Nondividend Distributions $7,716.54 $7,716.54 Payments listed as being made on behalf of the trust Payments/Receipts Made on Behalf of represent payments to or for MARITAL TRUST a beneficiary. See Payments details in Receipts pages that follow. The following items from the account are presented to assist you in the preparation of your individual tax return. Transactions have been summarized under three general headings of, where applicable, Medical expenses, Taxes paid and Miscellaneous. They are intended to cover those items the account paid on your behalf during the tax year that you may want to consider for your individual tax return. We recommend that you check your statement of transactions for any corrections or additions. Miscellaneous $142,445.81 $0.00 OTHER INFORMATION Please review Other Information carefully. This section may include information specific to this taxpayer. Based on information provided by the client, disbursements from this trust have generally been classified as either trust expenses or beneficiary distributions. Deductible trust expenses, including state income taxes and state income tax estimates, are summarized above as Deductions. Distributions to or for beneficiaries are summarized as Payments/Receipts Made on Behalf of this trust. Such payments are detailed below. Because Federal income taxes and income tax estimates paid by the trust are neither deductions nor payments on behalf of a beneficiary, they are not reflected herein. Please contact Diversified Trust if any additional information is needed for proper completion of the trust s 1041. Note that because Federal income tax payments and estimates paid by the trust are neither deductions nor payments on behalf of a beneficiary, they are not listed in this document.
- Payer s Name and Address: DIVERSIFIED TRUST COMPANY, INC 6075 POPLAR AVENUE, SUITE 900 MEMPHIS, TN 38119 2014 Tax Information Statement Account Number: Recipient s Payer s Federal ID Number: Corrected Form 1099-DIV Dividends and Distributions OMB No. 1545-0110 1a Total ordinary dividends $39,394.06 1b Qualified dividends $2,623.29 2a Total capital gain distributions $10,061.89 2b Unrecaptured Section 1250 Gain 2c Section 1202 gain 2d Collectibles (28%) gain 3 Nondividend distributions $7,716.54 4 Federal income tax withheld 5 Investment expenses 6 Foreign tax paid 7 Foreign country or U.S. possession 8 Cash liquidation distributions 9 Non-cash liquidation distributions 10 Exempt-interest dividends $17.31 11 Specified private activity bond interest dividends $0.04 12 State GA 13 State identification number 14 State tax withheld 2nd TIN notice 2014 Combined Year-End 1099 Forms Recipient s Name and Address: 456 MAIN STREET ANYWHERE, USA 55555 Form 1099-INT Interest Income OMB No. 1545-0112 1 Interest income 2 Early withdrawal penalty 3 Interest on U.S. Savings Bonds and Treasury obligations 4 Federal income tax withheld 5 Investment expenses 6 Foreign tax paid 7 Foreign country or U.S. possession 8 Tax-exempt interest 9 Specified private activity bond interest 10 Market discount 11 Bond premium 12 Tax-exempt bond CUSIP no. 13 State 14 State identification number 15 State tax withheld Page 6 of 24 This page includes only those income items that are reported to the IRS via a 1099. Other items of income that are reported otherwise to the IRS are listed on the following pages as "Not Reported on Form 1099" and should be reported on the trust's income tax return. Summary of Form 1099-B Proceeds from Broker and Barter Exchange Transactions 1d Proceeds $580,486.13 1e Cost or other basis $310,002.66 1g Adjustments 4 Federal income tax withheld 8 Profit or (loss) realized in 2014 on closed contracts 9 Unrealized profit or (loss) on open contracts - 2013 10 Unrealized profit or (loss) on open contracts - 2014 11 Aggregate profit or (loss) on contracts Sales Price less commissions and option premiums from each sale transaction are reported individually to the IRS. Refer to the 1099-B section of this Tax Information Statement. Summary of Form 1099-OID Original Issue Discount 1 Original issue discount for 2014 2 Other periodic interest 3 Early withdrawal penalty 4 Federal income tax withheld 5 Market discount 6 Acquisition premium 8 Original issue discount on US Treasury obligations 9 Investment expenses Original Issue Discount Amounts are reported individually to the IRS. Refer to the 1099-OID section of this Tax Information Statement. This is important tax information and is being furnished to the Internal Revenue Service (except as indicated). If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported.
- Payer s Name and Address: DIVERSIFIED TRUST COMPANY, INC 6075 POPLAR AVENUE, SUITE 900 MEMPHIS, TN 38119 2014 Tax Information Statement Account Number: Recipient s Payer s Federal ID Number: Payer s State ID Number: State: GA Recipient s Name and Address: 456 MAIN STREET ANYWHERE, USA 55555 Page 7 of 24 Corrected 2nd TIN notice Reported to the IRS is proceeds less commissions and option premiums. Covered (Box 5 is not checked) Description of property (Box 1a) 2014 Form 1099-B: Proceeds from Broker and Barter Exchange Transactions OMB No. 1545-0715 The cost basis on certain assets is required to be reported to the IRS while cost on others is not. "Covered" indicates that cost basis is required to be reported. Federal State Cusip Date Sold Date Form 8949 Cost or Code Net Gain Income Tax Number or Disposed Acquired Checkbox Proceeds Other Basis if any Adjustments or Loss Tax Withheld Withheld (Box 1c) (Box 1b) (Box 1d) (Box 1e) (Box 1f) (Box 1g) (Box 4) (Box 16) Short Term Sales Reported on 1099-B 7504.817 ASTON/RIVER ROAD INDEPENDENT VALUE FUND CLASS I #266 00080Y579 12/30/2014 01/29/2014 A 77,900.00 85,479.86 0.00-7,579.86 0.00 0.00 2388.592 LEGG MASON BW GLOBAL OPPORTUNITIES BOND FUND CLASS I #2281 524686334 04/29/2014 04/29/2013 A 26,800.00 28,300.43 0.00-1,500.43 0.00 0.00 2521.246 LOOMIS SAYLES SENIOR FLOATING RATE AND FIXED INCOME FUND CL Y #2627 63872T554 04/29/2014 04/30/2013 A 26,700.00 26,851.27 0.00-151.27 0.00 0.00 2086.331 PIMCO INCOME FUND - INS #1821 72201F490 04/29/2014 04/30/2013 A 26,100.00 26,579.86 0.00-479.86 0.00 0.00 Total Short Term Sales Reported on 1099-B 157,500.00 167,211.42 0.00-9,711.42 0.00 0.00 Report on Form 8949, Part I, with Box A checked Long Term Sales Reported on 1099-B 4965.585 LOOMIS SAYLES SENIOR FLOATING RATE AND FIXED INCOME FUND CL Y #2627 63872T554 12/30/2014 04/30/2013 D 50,500.00 52,883.48 0.00-2,383.48 0.00 0.00 1258.687 OPPENHEIMER STEELPATH MLP SELECT 40 FUND CL Y 858268204 04/29/2014 09/28/2012 D 16,300.00 12,659.24 0.00 3,640.76 0.00 0.00 This is important tax information and is being furnished to the Internal Revenue Service (except as indicated). If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. The taxpayer is ultimately responsible for the accuracy of their own tax return.
- Payer s Name and Address: DIVERSIFIED TRUST COMPANY, INC 6075 POPLAR AVENUE, SUITE 900 MEMPHIS, TN 38119 2014 Tax Information Statement Account Number: Recipient s Payer s Federal ID Number: Payer s State ID Number: State: GA Recipient s Name and Address: 456 MAIN STREET ANYWHERE, USA 55555 Page 8 of 24 Corrected 2nd TIN notice 2014 Form 1099-B: Proceeds from Broker and Barter Exchange Transactions Reported to the IRS is proceeds less commissions and option premiums. Covered (Box 5 is not checked) Description of property (Box 1a) OMB No. 1545-0715 Federal State Cusip Date Sold Date Form 8949 Cost or Code Net Gain Income Tax Number or Disposed Acquired Checkbox Proceeds Other Basis if any Adjustments or Loss Tax Withheld Withheld (Box 1c) (Box 1b) (Box 1d) (Box 1e) (Box 1f) (Box 1g) (Box 4) (Box 16) 3738.043 OPPENHEIMER STEELPATH MLP SELECT 40 FUND CL Y 858268204 09/29/2014 09/28/2012 D 50,800.00 37,595.37 0.00 13,204.63 0.00 0.00 1076.28 OPPENHEIMER STEELPATH MLP SELECT 40 FUND CL Y 858268204 12/30/2014 Various D 13,378.16 10,618.77 0.00 2,759.39 0.00 0.00 2278.994 PIMCO INCOME FUND - INS #1821 72201F490 12/30/2014 04/30/2013 D 28,100.00 29,034.38 0.00-934.38 0.00 0.00 Total Long Term Sales Reported on 1099-B 159,078.16 142,791.24 0.00 16,286.92 0.00 0.00 Report on Form 8949, Part II, with Box D checked This is important tax information and is being furnished to the Internal Revenue Service (except as indicated). If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. The taxpayer is ultimately responsible for the accuracy of their own tax return.
- Payer s Name and Address: DIVERSIFIED TRUST COMPANY, INC 6075 POPLAR AVENUE, SUITE 900 MEMPHIS, TN 38119 2014 Tax Information Statement Account Number: Recipient s Payer s Federal ID Number: Payer s State ID Number: State: Corrected GA 2nd TIN notice Recipient s Name and Address: 456 MAIN STREET ANYWHERE, USA 55555 Page 9 of 24 2014 Form 1099-B: Proceeds from Broker and Barter Exchange Transactions OMB No. 1545-0715 Reported to the IRS is proceeds less commissions and option premiums. For noncovered securities (Box 5 is checked) shown on this statement, cost basis information is not being reported to the IRS. Cost or Other Basis amounts shown with a "U" are unknown or unsubstantiated. Description of property (Box 1a) If basis is not required to be reported to the IRS, the asset is considered "noncovered" and only the proceeds from the sale are reported. Federal State CUSIP Date Sold Date Form 8949 Cost or Code Net Gain Income Tax Number or Disposed Acquired Checkbox Proceeds Other Basis if any Adjustments or Loss Tax Withheld Withheld (Box 1c) (Box 1b) (Box 1d) (Box 1e) (Box 1f) (Box 1g) (Box 4) (Box 16) Long Term Sales Reported on 1099-B 5440.01 DTC EQUITY OPPORTUNITY FUND COMMON CF1017890 Various 04/30/2014 E 72,500.01 61,981.88 0.00 10,518.13 0.00 0.00 4376.049 NATIXIS GATEWAY FUND CLASS Y #1986 367829884 01/29/2014 Various E 124,586.12 105,401.39 0.00 19,184.73 0.00 0.00 1401.596 OPPENHEIMER STEELPATH MLP SELECT 40 FUND CL Y 858268204 12/30/2014 10/29/2010 E 17,421.84 11,937.25 0.00 5,484.59 0.00 0.00 2713.568 PIMCO ALL ASSET FUND CLASS I #34 722005626 01/29/2014 06/17/2010 E 32,400.00 32,074.38 0.00 325.62 0.00 0.00 363.064 SMALL/MID CAP US EQUITY FUND CF1017791 04/30/2014 Various E 17,000.00 17,302.25 0.00-302.25 0.00 0.00 Total Long Term Sales Reported on 1099-B 263,907.97 228,697.15 0.00 35,210.82 0.00 0.00 Report on Form 8949, Part II, with Box E checked If the cost basis of the asset is unknown, a "U" will follow the amount reflected as basis. While cost reflected without a "U" on the noncovered securities schedule is not reported to the IRS, we believe the information to be accurate. This is important tax information and is being furnished to the Internal Revenue Service (except as indicated). If you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that it has not been reported. For noncovered securities shown on this statement, cost basis information is not being reported to the Internal Revenue Service. The taxpayer is ultimately responsible for the accuracy of their own tax return.
- Page 10 of 24 Qualified Dividends Qualified Domestic Dividends Dividends and Interest Detail Description Amount of dividend Reported on Form 1099-DIV ASTON/RIVER ROAD INDEPENDENT VALUE FUND CLASS I #266 535.16 FPA CRESCENT PORTFOLIO FUND CLASS I #134 490.90 PIMCO ALL ASSET FUND CLASS I #34 75.69 PIMCO INCOME FUND - INS #1821 2.25 THE RIVERNORTH CORE OPPORTUNITY FUND INV 1,248.52 WHITEBOX TACTICAL OPPORTUNITIES FUND - INS 270.77 Common trust fund items, where applicable, will be reflected as "Not Total Reported on Form 1099-DIV $2,623.29 Not Reported on Form 1099-DIV Reported on Form 1099" and will be DTC EQUITY OPPORTUNITY FUND COMMON 3,245.12 listed separately for each fund. INTERNATIONAL EQUITY FUND 7,690.31 LARGE CAP US EQUITY FUND 4,715.89 SMALL/MID CAP US EQUITY FUND 548.13 Total Not Reported on Form 1099-DIV $16,199.45 Total Qualified Domestic Dividends $18,822.74 Total Qualified Dividends included on 1099-DIV box 1a and 1b $2,623.29 Non-Qualified Dividends
- Page 11 of 24 Non-Qualified Domestic Dividends Description Amount of dividend Reported on Form 1099-DIV ASTON/RIVER ROAD INDEPENDENT VALUE FUND CLASS I #266 2,093.33 FPA CRESCENT PORTFOLIO FUND CLASS I #134 274.01 LEGG MASON BW GLOBAL OPPORTUNITIES BOND FUND CLASS I #2281 5,316.69 LOOMIS SAYLES SENIOR FLOATING RATE AND FIXED INCOME FUND CL Y #2627 14,469.58 PIMCO ALL ASSET FUND CLASS I #34 5,979.67 PIMCO INCOME FUND - INS #1821 7,495.72 PIMCO INCOME FUND - INS #1821 34.04 THE RIVERNORTH CORE OPPORTUNITY FUND INV 191.41 WHITEBOX TACTICAL OPPORTUNITIES FUND - INS 916.32 Total Reported on Form 1099-DIV $36,770.77 Total Non-Qualified Domestic Dividends $36,770.77 Total Non-Qualified Dividends included in Form 1099-DIV box 1a $36,770.77 Short-Term Common Trust Fund Gain/Loss Description Gains and losses attributable to sales of common trust fund units within the account, if any, will be reflected on a Form 1099-B that will be included in this package. The gains reflected to the left are pass-through gains from the common trust funds that historically have Amount of gain/loss Not Reported on Form 1099-DIV DTC EQUITY OPPORTUNITY FUND COMMON -719.16 been reported on K-1s. INTERNATIONAL EQUITY FUND -128.49
- Page 12 of 24 Short-Term Common Trust Fund Gain/Loss Description Amount of gain/loss LARGE CAP US EQUITY FUND 217.10 SMALL/MID CAP US EQUITY FUND -2,323.96 Total Not Reported on Form 1099-DIV -$2,954.51 Total Short-Term Common Trust Fund Gain/Loss -$2,954.51 Capital Gain Distributions Description Amount of dividend Reported on Form 1099-DIV ASTON/RIVER ROAD INDEPENDENT VALUE FUND CLASS I #266 4,337.64 FPA CRESCENT PORTFOLIO FUND CLASS I #134 2,714.23 LEGG MASON BW GLOBAL OPPORTUNITIES BOND FUND CLASS I #2281 269.09 PIMCO INCOME FUND - INS #1821 227.06 THE RIVERNORTH CORE OPPORTUNITY FUND INV 1,949.68 WHITEBOX TACTICAL OPPORTUNITIES FUND - INS 564.19 Total Reported on Form 1099-DIV $10,061.89 Total capital gain distributions $10,061.89
- Page 13 of 24 Long-Term Common Trust Fund Gain/Loss Description Gains and losses attributable to sales of common trust fund units within the account, if any, will be reflected on a Form 1099-B that will be included in this package. The gains reflected to the left are pass-through gains from the common trust funds that historically have Amount of gain/loss Not Reported on Form 1099-DIV DTC EQUITY OPPORTUNITY FUND COMMON 11,188.59 been reported on K-1s. INTERNATIONAL EQUITY FUND 15,003.67 LARGE CAP US EQUITY FUND 12,122.32 SMALL/MID CAP US EQUITY FUND 13,476.96 Total Not Reported on Form 1099-DIV $51,791.54 Total Long-Term Common Trust Fund Gain/Loss $51,791.54 Nondividend Distributions Description Amount of dividend Reported on Form 1099-DIV OPPENHEIMER STEELPATH MLP SELECT 40 FUND CL Y 7,716.54 Total Reported on Form 1099-DIV $7,716.54 Total Nondividend Distributions $7,716.54
- Page 14 of 24 Exempt interest dividends non-taxable in Georgia (not subject to Alt Min Tax) Investment Amount of Description expense dividend Reported on Form 1099-DIV Georgia FEDERATED TAX FREE INST TR #295 0.01 Total for Georgia $0.01 Total Reported on Form 1099-DIV box 10 $0.01 Totals $0.01 Exempt interest dividends taxable in Georgia (not subject to Alt Min Tax) Investment Amount of Description expense dividend Reported on Form 1099-DIV Various FIDELITY TAX EXEMPT MONEY MARKET #56 16.58 FEDERATED TAX FREE INST TR #295 0.67 Total for Various $17.25 Tennessee FEDERATED TAX FREE INST TR #295 0.01 Total for Tennessee $0.01 Total Reported on Form 1099-DIV box 10 $17.26
- Page 15 of 24 Exempt interest dividends taxable in Georgia (not subject to Alt Min Tax) Investment Amount of Description expense dividend Totals $17.26 Exempt interest dividends taxable in Georgia (subject to Alt Min Tax) Description Amount of dividend Reported on Form 1099-DIV Various FEDERATED TAX FREE INST TR #295 0.04 Total for Various $0.04 Total Reported on Form 1099-DIV box 10 and 11 $0.04 Totals $0.04 Interest
- Page 16 of 24 Domestic Interest Amount of Amount of Amount of Description market discount bond premium interest Not Reported on Form 1099-INT DTC EQUITY OPPORTUNITY FUND COMMON 1.51 INTERNATIONAL EQUITY FUND 2.84 LARGE CAP US EQUITY FUND 0.85 SMALL/MID CAP US EQUITY FUND 0.69 Total Not Reported on Form 1099-INT $5.89 Total Domestic Interest $5.89
- Page 17 of 24 Other Income Other Tax Information Description Amount of income State Tax Refund - Principal 2,342.00 Total other income 2,342.00 Deductions Agency Fees Description Amount of expense Available for allocation to tax exempt income Trustee/Executor Fees-Income (allocable) 13,400.00 Trustee/Executor Fees-Principal (allocable) 13,400.00 Total available for allocation to tax exempt income 26,800.00 Total Agency Fees 26,800.00 Attorney, Accountant, and Tax preparer Fees This page will include information regarding fees and expenses deducted from this account and may include other items of tax significance paid on the trust's behalf directly from the account. Information regarding trust expenses is being provided as a courtesy and should not replace the tax preparer's reliance upon information provided by the client. Description Amount of expense Not available for allocation to tax exempt income Tax Preparation Fee (non-allocable) 1,136.60 Total not available for allocation to tax exempt income 1,136.60 Total Attorney, Accountant, and Tax preparer Fees 1,136.60
- Page 18 of 24 Other Deductions Subject to 2% Limitation Description Amount of expense Available for allocation to tax exempt income Investment Management Fees 26,284.70 Fees and expenses attributable to Total available for allocation to tax exempt income 26,284.70 Not available for allocation to tax exempt income common trust funds will be listed SMALL/MID CAP US EQUITY FUND 16.87 here. Historically this information has been provided on a K-1. Total not available for allocation to tax exempt income 16.87 Total Other Deductions Subject to 2% Limitation 26,301.57
- Page 19 of 24 Payments/Receipts Made on Behalf of The following transactions from the account are presented to assist you in the preparation of your individual tax return. Transactions are shown under three general headings of, where applicable, Medical Expenses, Taxes Paid and Miscellaneous. They are intended to cover those items the account paid on your behalf during the tax year that you may want to consider for your individual tax return. We recommend that you check your statement of transactions for any corrections or additions. Miscellaneous Date Description Payments Receipts Other Disbursements 01/24/2014 Other Disbursements CASH DISBURSEMENT INCOME DISTRIBUTION ACH-ING MONTHLY DISBURSEMENT TO 3,500.00 01/31/2014 Other Disbursements CASH DISBURSEMENT PRINCIPAL DISTRIBUTION TO SUSAN JONES FOR DOWN PAYMENT ON NEW HOME 02/24/2014 Other Disbursements CASH DISBURSEMENT INCOME DISTRIBUTION ACH-ING MONTHLY DISBURSEMENT TO 03/24/2014 Other Disbursements MAIN STREET BANK, ANYWHERE, USA MONTHLY DISBURSEMENT TO FBO 04/24/2014 Other Disbursements MAIN STREET BANK, ANYWHERE, USA MONTHLY DISBURSEMENT TO FBO 05/23/2014 Other Disbursements MAIN STREET BANK, ANYWHERE, USA MONTHLY DISBURSEMENT TO FBO 80,000.00 3,500.00 3,500.00 3,500.00 3,500.00
- Page 20 of 24 Date Description Payments Receipts 06/09/2014 Other Disbursements MAIN STREET BANK DISTRIBUTION OF RETAINED INCOME 07/31/2014 Other Disbursements MAIN STREET BANK MONTHLY INCOME DISTRIBUTION 08/29/2014 Other Disbursements MAIN STREET BANK MONTHLY INCOME DISTRIBUTION 09/30/2014 Other Disbursements MAIN STREET BANK MONTHLY INCOME DISTRIBUTION 10/31/2014 Other Disbursements MAIN STREET BANK MONTHLY INCOME DISTRIBUTION 11/28/2014 Other Disbursements MAIN STREET BANK MONTHLY INCOME DISTRIBUTION 12,000.00 8,941.23 5,849.82 4,699.26 4,428.85 2,765.15 12/31/2014 Other Disbursements 6,261.50 MAIN STREET BANK MONTHLY INCOME DISTRIBUTION Total Other Disbursements 142,445.81 0.00 Total Miscellaneous 142,445.81
- Page 21 of 24 Computation of Expenses Allocable to Federal Tax Exempt Income 1. Tax exempt income $17.31 2. Gross taxable income $57,941.40 3. Total income $57,958.71 4. Allocable expenses $53,084.70 Agency fees $26,800.00 Other deductions subject to 2% limitation $26,284.70 5. Expenses allocated to TEI (line 1/line 3 * line 4) $15.85 6. Expenses allocated to taxable income (line 4 - line 5) $53,068.85
- Page 22 of 24 Recipient s identification number. For your protection, this form may show only the last four digits of your social security number (SSN), individual taxpayer identification number (ITIN), or adoption taxpayer identification number (ATIN). However, the issuer has reported your complete identification number to the IRS and, where applicable, to state and/or local governments. Account Number. May show an account or other unique number the payer assigned to distinguish your account. Box 1a. Shows total ordinary dividends that are taxable. Include this amount on line 9a of Form 1040 or 1040A. Also, report it on Schedule B (1040A or 1040), if required. Box 1b. Shows the portion of the amount in box 1a that may be eligible for reduced capital gains rates. See Form 1040/1040A instructions for how to determine this amount. Report the eligible amount on line 9b, Form 1040 or 1040A. The amount shown may be dividends a corporation paid directly to you as a participant (or beneficiary of a participant) in an employee stock ownership plan (ESOP). Report it as a dividend on your Form 1040/1040A but treat it as a plan distribution, not as investment income, for any other purpose. Box 2a. Shows total capital gain distributions from a regulated investment company or real estate investment trust. Report the amounts shown in box 2a on Schedule D (Form 1040), line 13. But, if no amount is shown in boxes 2c-2d and your only capital gains and losses are capital gain distributions, you may be able to report the amounts shown in box 2a on line 13 of Form 1040 (line 10 of Form 1040A) rather than Schedule D. See the Form 1040/1040A instructions. Box 2b. Shows the portion of the amount in box 2a that is unrecaptured section 1250 gain from certain depreciable real property. Report this amount on the Unrecaptured Section 1250 Gain Worksheet-Line 19 in the Schedule D instructions (Form 1040). Box 2c. Shows the portion of the amount in box 2a that is section 1202 gain from certain small business stock that may be subject to an exclusion. See the Schedule D (Form 1040) instructions. Dividends and Distributions - Form 1099-DIV Instructions for Recipient Box 2d. Shows 28% rate gain from sales or exchanges of collectibles. If required, use this amount when completing the 28% Rate Gain Worksheet-Line 18 in the instructions for Schedule D (Form 1040). Box 3. Shows the part of the distribution that is nontaxable because it is a return of your cost (or other basis). You must reduce your cost (or other basis) by this amount for figuring gain or loss when you sell your stock. But if you get back all your cost (or other basis), report future distributions as capital gains. See Pub. 550, Investment Income and Expenses. Box 4. Shows backup withholding. A payer must backup withhold on certain payments if you did not give your taxpayer identification number to the payer. See Form W-9, Request for Taxpayer Identification Number and Certification, for information on backup withholding. Include this amount on your income tax return as tax withheld. Box 5. Shows your share of expenses of a nonpublicly offered regulated investment company, generally a nonpublicly offered mutual fund. If you file Form 1040, you may deduct these expenses on the "Other expenses" line on Schedule A (Form 1040) subject to the 2% limit. This amount is included in box 1a. Box 6. Shows the foreign tax that you may be able to claim as a deduction or a credit on Form 1040. See the Form 1040 instructions. Box 7. This box should be left blank if a regulated investment company reported the foreign tax shown in box 6. Boxes 8 and 9. Shows cash and noncash liquidation distributions. Box 10. Shows exempt-interest dividends from a mutual fund or other regulated investment company paid to you during the calendar year. Include this amount on line 8b of Form 1040 or 1040A as tax-exempt interest. This amount may be subject to backup withholding. See box 4. Box 11. Shows exempt-interest dividends subject to the alternative minimum tax. This amount is included in box 10. See the Instructions for Form 6251. Boxes 12-14. State income tax withheld reporting boxes. Nominees. If this form includes amounts belonging to another person, you are considered a nominee recipient. You must file Form 1099-DIV (with a Form 1096) with the IRS for each of the other owners to show their share of the income, and you must furnish a Form 1099-DIV to each. A spouse is not required to file a nominee return to show amounts owned by the other spouse. See the 2014 General Instructions for Certain Information Returns. Future developments. For the latest information about the developments related to Form 1099-DIV and its instructions, such as legislation enacted after they were published, go to www.irs.gov/form1099div.
- Page 23 of 24 Brokers and barter exchanges must report proceeds from (and in some cases, basis for) transactions to you and the IRS on Form 1099-B. Reporting is also required when your broker knows or has reason to know that a corporation in which you own stock has had a reportable change in control or capital structure. You may be required to recognize gain from the receipt of cash, stock, or other property that was exchanged for the corporation s stock. If your broker reported this type of transaction to you, the corporation is identified in the box 1a. Recipient s identification number. For your protection, this form may show only the last four digits of your social security number (SSN), individual taxpayer identification number (ITIN), or adoption taxpayer identification number (ATIN). However, the issuer has reported your complete identification number to the IRS and, where applicable, to state and/or local governments. Account Number. May show an account or other unique number the payer assigned to distinguish your account. CUSIP number. Shows the CUSIP (Committee on Uniform Security Identification Procedures) number or other applicable identifying number. Applicable check box on Form 8949. Indicates where to report this transaction on Form 8949 and Schedule D, and which check box is applicable. See the instructions for your Schedule D and/or Form 8949. Box 1a. Shows a brief description of the item or service for which amounts are being reported. For regulated futures contracts and forward contracts, "RFC" or other appropriate description may be shown. For Section 1256 option contracts, "Section 1256 option" or other appropriate description may be shown. For a corporation that had a reportable change in control or capital structure, this box may show the class of stock as C (common), P (preferred), or O (other). Box 1c. Shows the trade date of the sale or exchange. For short sales, the date shown is the date the security was delivered to close the short sale. For aggregate reporting in boxes 8 through 11, no entry will be present. Proceeds from Broker and Barter Exchange Transactions - Form 1099-B Instructions for Recipient Box 1d. Shows the cash proceeds, reduced by any commissions or transfer taxes related to the sale, for transactions involving stocks, debt, commodities, forward contracts, non-section 1256 option contracts, or securities futures contracts. May show the proceeds from the disposition of your interest(s) in a widely held fixed investment trust. May also show aggregate amount of cash and the fair market value of any stock or other property received in a reportable change in control or capital structure arising from the corporate transfer of property to a foreign corporation. Losses on forward contracts or non-section 1256 option contracts are shown in parentheses. This box does not include proceeds from regulated futures contracts or Section 1256 option contracts. Report this amount on Form 8949 or on Schedule D (whichever is applicable) as explained in the instructions for Schedule D. Box 1e. Shows the cost or other basis of securities sold. If the securities were acquired through the exercise of a non-compensatory option granted or acquired on or after January 1, 2014, the basis has been adjusted to reflect your option premium. If the securities were acquired through the exercise of a non-compensatory option granted or acquired before January 1, 2014, your broker is permitted, but not required, to adjust the basis to reflect your option premium. If the securities were acquired through the exercise of a compensatory option, the basis has not been adjusted to include any amount related to the option that was reported to you on a Form W-2. If box 5 is checked, box 1e may be blank. See the Instructions for Form 8949, Instructions for Schedule D, or Pub. 550 for details. Box 1f. Shows W for wash sale, C for collectibles, or D for market discount. Box 1g. Shows the amount of nondeductible loss in a wash sale transaction or the amount of accrued market discount. For details on wash sales and market discount, see Schedule D (Form 1040) instructions and Pub. 550. Box 3. If checked, the basis in box 1e has been reported to the IRS and one of the check boxes in box 2 must be checked. If box 3 is checked on Form(s) 1099-B and NO adjustment is required, see instructions for your Schedule D as you may be able to report your transaction directly on Schedule D. Box 4. Shows backup withholding. Generally, a payer must backup withhold if you did not furnish your taxpayer identification number to the payer. See Form W-9 for information on backup withholding. Include this amount on your income tax return as tax withheld. Box 5. If checked, the securities sold were noncovered securities and boxes 1b, 1e, and 2 may be blank. Generally, a noncovered security means: stock purchased before 2011, stock in most mutual funds purchased before 2012, stock purchased in or transferred to a dividend reinvestment plan before 2012, debt acquired before 2014, options granted or acquired before 2014, and securities futures contracts entered into before 2014. Box 6. If the exercise of a non-compensatory option resulted in a sale of a security, indicates whether the amount in box 1d was adjusted for premium.
E Page 24 of 24 Box 7. If checked, you cannot take a loss on your tax return based on gross proceeds from a reportable change in control or capital structure reported in box 1d. See the Form 8949 and Schedule D instructions. The broker should advise you of any losses on a separate statement. Regulated Futures Contracts, Foreign Currency Contracts, and Section 1256 Option Contracts (Boxes 8 Through 11): Box 8. Shows the profit or (loss) realized on regulated futures, foreign currency, or Section 1256 option contracts closed during 2014. Box 9. Shows any year-end adjustment to the profit or (loss) shown in box 8 due to open contracts on December 31, 2013. Box 10. Shows the unrealized profit or (loss) on open contracts held in your account on December 31, 2014. These are considered closed out as of that date. This will become an adjustment reported as unrealized profit or (loss) on open contracts-12/31/2014 in 2015. Box 11. Boxes 8, 9, and 10 are all used to figure the aggregate profit or (loss) on regulated futures, foreign currency, or Section 1256 option contracts for the year. Include this amount on your 2014 Form 6781. Box 13. Shows the cash you received, the fair market value of any property or services you received, and the fair market value of any trade credits or scrip credited to your account by a barter exchange. See Pub. 525. Boxes 14-16. Shows state(s)/local income tax information. Future developments. For the latest information about any developments related to Form 1099-B and its instructions, such as legislation enacted after they were published, go to www.irs.gov/form1099b. Proceeds from Broker and Barter Exchange Transactions - Form 1099-B Instructions for Recipient continued