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Balance Shel and Anesew (Check Filing Status {Schedule B Rental Income Tax [TSehedule C Busines Income Tas i siinng income Tan in 1 Taxpayer Information T Taxpayers Name (Company Name or Name, Fabers Name, | 3 Tanjafesaciicaion wome ® Forks Vearende Grandes’ Name) a Regina Th Zona — Keto Tak Acunt Naier [Dawe ae Fe Worst [tebe Farms Asn Become ans | 5. Tax CB? 6 Talepne Namer 7 Famer Section? Busines A sd Capa Fnsrctions: Prior to competing this potion of th Balance Sheet ow x need a sompse the individual Annexes on the folowing tine pages Be sue and check your Hing ste at th ta thi orm + Raat Racial (ame Tou oa Aas rr 5 Re Ran es abe i Ce Tod To “0 ihe 7 efile ar Tol Fam eT ra Se + Tone Coa Ts Tal om Ame 2 3s Sa a Te Marae & ea Ta ae i 1 oe tana ate ED i TD alee Coa rear a OE [ie tcompetis Snvae neues taney foam 4 222 fierupkmken tea a fume B46 [icwanvace © 2 _ |56 [Oltice Equpmen and Fumie Speen sgh oan aroun = Ti [fee Dasa it eS, Co 5 ps fom sol Toa = 20 rae Asa ras Tot Fo fv Cbs 31 — | arnlaal acti als iow ee 8 Ca oF Na bk Valse Ace Gs Ce ow Ln Ea To Sir am Tou tea tae = Tout aust al ims eae 1 DD a eet Sth Pe = 27 Teas Ps aa | Vr Cao a Ae Stade ote ae A 3 oer Cat a sae a Po eT os on ils Ss pie Ma an er ai Too aT 32 Oba age Ten abo onal Taal fo An 2) Heat ais a in Tag al ET — — 5 36 aoe 37 Toa Col as 3 ag a eT : Hot and Cpt di an a ET a = a Teapaser tefrmation TTaspayers Name (Company or wid 2, Taxpayer ideuicavion Number” 1 Forine Vou Ended "Knnex Accounts Reverae Tio ne? Toa amano Li = - ‘Annex 2— Inventories (Applies fo Business Mining Ieoibs Only, Nt Rasa ROOT ae Beem Deseipon = Amount CSN Finish Proceed Prout z ST] Woreia Press" [Raw er 5 1 Reject By Produit and ie Rated ems — Spare Pars, Supplies, Packing aid oie Maras ‘ofa Lins ldough 6, (sr ToilArnount on Line 6 of Balance Shes es iz aoa: Toi nT Anon a ine Hoe Se ade Tal en Conic Sa ‘Annex 4~ Other lnestment “Annex $ Fixed Assets es ea un Total Line saa ae ‘A. Cost of Feu Assets (Tra 7 pes Sees eee Le Mao Vc ‘Schedule BEC — Businew/ Rental Tacome Tax Balnnce Shost annexes ] “Taxpayer Information [ TaRpATET NanleTCompaay oe TaATINAT | TanpayerFdencation ber | 3 For he Vent Edd ] Amex 6~ Intangible Ase ee Good Pate Usted Ta ‘Oe Tagibe Rs Tot of Lins | ough 5 cogil | Pret Lesstold Land Die Tange Rass Tot of Lins? Tough 1 Net Book Valu Lines 6 mins 1 nwen T— Other Assets “Total (ater Total amount on ie 25 of Balangs Shes) Annex 8— Loans payable in est than One Year Tensoreel iene Pate [Rane ots ae Wilding pi VAT Pabie — Tanove Ta Fable Exgee Tt Payable ded Tax SS [other Tae Pale To [Tol ne Tota cnt Te SRrRYor REVUES ge a ‘Schedule B& C Burinesal Rental Income Tae - Balance Shect Annexes | ¢ “Taxpayer Information T.Taspayer name (Company oF Tana) T Fortis Verrier “amex 1) Other Carron Cate “otal Estes Tot aout o ine 2 of Blane Sst acd Teal Fon Coiaton Seis ‘Annex 11 Loans Payable in Mae than 1 eae “Toil Ear Teal amount on Tine 30 of Balance Shot (nla Tol From Continston Shea Fused) | Annes 12. Other Long-Term Labi : Total Eater Tota wmnoual o ine 3 of Balance Shs (ntae Tol Fron Common Shaw 5) ‘Taxpayer Certification tet and eompite, unerstind that ay esrepreseaon i Panshable As pr tat Laws ad he Pes code

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