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eg 3,010, | elaine Teese S Donors Te t nm Fe Gis 2 Ziel s+ 20 00,0 OLR = lease eae] RECTO AVENUE SREY 4 DPA Cutey, 2 ADP Code 4D S Restore Recess cas ae aT arom | To Cass NS Tremere 75u- 193 ighenfward.sakalam@aee | ton ES an een ocean teed SS Doren Taye ertaaen NEE tay DALE Sui WSF x S ¢ o = SE hele PEST Pariit= Computation of Taz TU Tea NG Subeao Tan Poe im Lo 1S Aepicsti Deron Taxae 6. 0% 18 Toa! Oxers A 130 GOOD Ties a Oey ATA Payrrrts fy rer ts Ourrg be Caer Voor 1B Forogy Dover's Tax ad Senctb era Sain TP TO NED i “ATC Tax Pon Pevoxs) Fed Rear fh san Arendt Ream | {7D Taal Tax esPayres rains 8 7 18 TaxPayabin| Operon r laa nO) Pras 9A Sarre 198 rere 196 Gorerarse 190 Tal Porsies Sir hrs AO I 2OTOTAL AMOUNT PAYABLEAOversynert) Szraftn nd) ere) I 2.0) 3 G00 le TF rn dp Pa red 8 are oe oe SSSR RSD wen ETFS TTS ‘etn rare nen a be po msn td fae be por coen pe dopa eames Fee TTR SSS et pes Pte Renae es ea er ar Ferrers ‘Sad TSS es GLekwwaed aLeovewDrs SO at EET are Ope aad Rear waaTTT GRA BETS TS PORTIS TPS PRR SW TT neat SeaaToe ates | [seared [titesrrenn acorn Part I= Detalls of Payment Details of Payment | “sqaee™ | __Number Date aaucarrenn “Amount Fi Cesvewk Debt Mere) | 22Chex { 23 Tax Debit Nero 7 Chen Ge ee peprii tiie Nadie Valen Waa Res Fa Sn SBA EGET BIR Form No. 1800 anor 2018 ENC) Pose Donor’s Tax Return Deel] ii F Donor's Name Mort £,2:214,41410,0,0, 0,041 CDW EN PALS Gib ENN WALRiPy [LBS Part iv=Compu jon of Tax 25 Personal Poparies anPervcowan 11 14811 00,0] +01 26 Real Proper Fem Pat craig 111 1311101 0.0.0] +10.0) 27 Teal Gin this Retum fam athe sSanze) 11 47101 00,0 | +10} ess Decco By Peper preity Ppp ppg iy fet a PP tr fyi fel Pp i fe et siti iia fusi tii |33 Tote! Deductions Allowed (Sum afters 22 i 32) pitpitpii ett 54 Tot Net Grins tim reas am) 11 1 1710101 00:01 «10.01 [35 Add: Total Prior Net Gifts During the Calendar Year (tem 26 Retum Previa) Fed witin Pa year) Pippi posi tel 4 6 eal Net Gs arto on 11 hap apol-lod a7 tess Beene Gt 111 12)5,0;0,0,0/.|0,0) [38 Total Net Gits Subject to Tax (tem 36 Lees tom 37) pi OOO! Pan ~Scheduies chedule A= Deseipion of Donated Parag (Aedes Tasasagy Schedule A Dosen aaa PST aE T-cAsh — 10. 4.00 Stott odsc00- a E fe o tre {oo FAX DECLARATION.) TOTRPRGWERT [-ELASERCATION OG LIPR_cny Z “Schedule B = Continuation ofthe Description of Donated Real Property 'AREA | _ FAIR MARKET VALUE (FMM) PER TD FV PER BI ZONAL VALUE) 059m: 155.00 310,000. FAR MARKET VALUE 310,000, "TOTAL (Ta Pot fom T pitescnta Rapaor GR Condrvon Poplar CL Goer GL Goveonant at R gear TTT ‘Re Resseds!Contomewsn CCConmar)Gersomiium PSPaning Sit GPGowem|Pupce Paris 210,000 ‘ApD-Are Pry Davomect (eeu we eu. Bia Farm nr 1800 | Donor’ Ss alex Return aire tan nneen onpeemmicnn tml ——___| saa jawee | Fo Om G.g.0.0.1.1.com] Donee's Taxpayer [oe AS Boe SSAct: Tot Pree Net Gis Darra te Cotrxie Yew faew Nat Ram Arwen) Peni yh S6Teal NAGS Srv eS S7 Less Exp GA 7 i 58 Tot Net Ges Subect iD Tax aoe We ons) | sped “4. 13k. ooleio: oO ee 1512.010.0.0/+/ 0.0} 12,5,0,0 00.00) Panv = Schedules ‘Schedule A — Description of Donated Personal Propery iach actors cin TROT PARTEUARS. Cast howe 0.0) TREES 30,000

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