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FOR TAX YEAR 2019

CLEAN LIVING LLC

Knuff & Kunde CPAs

515 S Fitness Pl Ste 120

Eagle, ID 83616

(208)855-2578
Acknowledgement and General Information for 2019
Entities That File Returns Electronically
Name(s) as shown on return Employer Identification Number
CLEAN LIVING LLC **-***6043

Entity address

4821 E FREE CIR

IDAHO FALLS, ID 83401

Thank you for participating in IRS e-file.

1. X 2019 1120S income tax return for Federal was filed electronically.
The electronic filing services were provided by Knuff & Kunde CPAs .

06-11-2020
2. X
1120S income tax return was accepted on using a Personal Identification Number (PIN) as

an electronic signature. The entity entered a PIN or authorized the Electronic Return Originator (ERO) to enter or generate a PIN signature.
The submission ID assigned to this return is 8205192020163ys4vwap .

PLEASE DO NOT SEND A PAPER COPY OF ENTITY'S RETURN TO THE


IRS. IF YOU DO, IT WILL DELAY THE PROCESSING OF THE RETURN.

EF_ACK.LD
Acknowledgement and General Information for 2019
Entities That File Returns Electronically
Name(s) as shown on return Employer Identification Number
CLEAN LIVING LLC **-***6043

Entity address

4821 E FREE CIR

IDAHO FALLS, ID 83401

Thank you for participating in IRS e-file.

1. X 2019 7004 income tax return for Federal was filed electronically.
The electronic filing services were provided by Knuff & Kunde CPAs .

03-14-2020
2. X
7004 income tax return was accepted on using a Personal Identification Number (PIN) as

an electronic signature. The entity entered a PIN or authorized the Electronic Return Originator (ERO) to enter or generate a PIN signature.
The submission ID assigned to this return is 8205192020074fttj05y .

PLEASE DO NOT SEND A PAPER COPY OF ENTITY'S RETURN TO THE


IRS. IF YOU DO, IT WILL DELAY THE PROCESSING OF THE RETURN.

EF_ACK.LD
Form 1120-S U.S. Income Tax Return for an S Corporation OMB No. 1545-0123

Do not file this form unless the corporation has filed or


Department of the Treasury is attaching Form 2553 to elect to be an S corporation. 2019
Internal Revenue Service Go to www.irs.gov/Form1120S for instructions and the latest information.
For calendar year 2019 or tax year beginning , 2019, ending , 20
A S election effective date Name
D Employer identification number
CLEAN LIVING LLC
01-01-2018 TYPE 47-4726043
B Business activity code OR Number, street, and room or suite no. If a P.O. box, see instructions.
E Date incorporated
number (see instructions) PRINT 4821 E FREE CIR 01-01-2015
454390 City or town, state or province, country, and ZIP or foreign postal code
F Total assets (see instructions)
C Check if Sch. M-3 attached IDAHO FALLS ID 83401 $
G Is the corporation electing to be an S corporation beginning with this tax year? Yes X No If "Yes," attach Form 2553 if not already filed
H Check if: (1) Final return (2) Name change (3)Address change (4) Amended return (5)S election termination or revocation
I Enter the number of shareholders who were shareholders during any part of the tax year . . . . . . . . . . . . . . . . . . 2
J Check if corporation: (1) Aggregated activities for section 465 at-risk purposes (2) Grouped activities for section 469 passive activity purposes
Caution: Include only trade or business income and expenses on lines 1a through 21. See the instructions for more information.
1 a Gross receipts or sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a 80,119
b Returns and allowances . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b
c Balance. Subtract line 1b from line 1a ...................... . ...... ....... 1c 80,119
Incom

2 Cost of goods sold (attach Form 1125-A) . . . . . . . . . . . . . . . . . . . . . . 2 9,283


e

...... .......
3 Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . . . . . ...... ....... 3 70,836
4 Net gain (loss) from Form 4797, line 17 (attach Form 4797) . . . . . . . . . . . . . ...... ....... 4
5 Other income (loss) (see instructions - attach statement) . . . . . . . . . . . . . . ...... ....... 5
6 Total income (loss). Add lines 3 through 5 . . . . . . . . . . . . . . . . . . . . ...... ...... 6 70,836
7 Compensation of officers (see instructions - attach Form 1125-E) . . . . . . . . . . ...... ....... 7 4,150
8 Salaries and wages (less employment credits) . . . . . . . . . . . . . . . . . . . ...... ....... 8
limitation

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... .......
s)

9 Repairs and maintenance 9


10 Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... ....... 10
11 Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... ....... 11
for

12 Taxes and licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Wks. Tax/Lic 12 383


instruct
ions

13 Interest (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... ....... 13


14 Depreciation not claimed on Form 1125-A or elsewhere on return (attach Form 4562) ...... ....... 14
15 Depletion (Do not deduct oil and gas depletion.). . . . . . . . . . . . . . . . . ...... ....... 15
(see

16 Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... ....... 16


17 Pension, profit-sharing, etc., plans . . . . . . . . . . . . . . . . . . . . . . . . . ...... ....... 17
Deductio
ns

18 Employee benefit programs . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... ....... 18


19 Other deductions (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . .Statement...... .#2.. . 19 33,405
20 Total deductions. Add lines 7 through 19 ... . . . . . . . . . . . . . . . . . ...... ...... 20 37,938
21 Ordinary business income (loss). Subtract line 20 from line 6. . . . . . . . . . . ...... ....... 21 32,898
22 a Excess net passive income or LIFO recapture tax (see instructions) . . . . . . . . 22a
b Tax from Schedule D (Form 1120-S) . . . . . . . . . . . . . . . . . . . . . . . 22b
c Add lines 22a and 22b (see instructions for additional taxes) . . . . . . . . . . . . ...... ....... 22c
23 a 2019 estimated tax payments and 2018 overpayment credited to 2019 . . . . . . . 23a
Payment

b Tax deposited with Form 7004 . . . . . . . . . . . . . . . . . . . . . . . . . 23b


s

c Credit for federal tax paid on fuels (attach Form 4136) . . . . . . . . . . . . . . 23c
d Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23d
e Add lines 23a through 23d. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... .......
and

23e
24 Estimated tax penalty (see instructions). Check if Form 2220 is attached . . . . . . . ...... . . 24
25 Amount owed. If line 23e is smaller than the total of lines 22c and 24, enter amount owed .. . . . ....... 25
26 Overpayment. If line 23e is larger than the total of lines 22c and 24, enter amount overpaid ... . . ....... 26
27 Enter amount from line 26: Credited to 2020 estimated tax Refunded 27
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of May the IRS discuss this return
Sign my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which
preparer has any knowledge.
with the preparer shown below?

See instructions. X Yes No


Here REBECCA WARD 09-14-2020 PRESIDENT
Signature of officer Date Title

Print/Type preparer's name Preparer's signature Date Check if PTIN

Paid Kyle Kunde CPA Kyle Kunde CPA 09-14-2020 self-employed P01684117
Preparer Firm's name Knuff & Kunde CPAs Firm's EIN 87-0770286
Use Only Firm's address 515 S Fitness Pl Ste 120 Phone no.

Eagle ID 83616 (208)855-2578


For Paperwork Reduction Act Notice, see separate instructions. Form 1120-S (2019)
EEA
Form 1120-S (2019) CLEAN LIVING LLC 47-4726043 Page 2
Schedule B Other Information (see instructions)
1Check accounting method:a X Cash b Accrual Yes No
c Other (specify)
2 See the instructions and enter the:
a Business activity SALES b Product or service CLEANING SUPPLY
3 At any time during the tax year, was any shareholder of the corporation a disregarded entity, a trust, an estate, or a
nominee or similar person? If "Yes," attach Schedule B-1, Information on Certain Shareholders of an S Corporation . . . . . . . . . . X
4 At the end of the tax year, did the corporation:
a Own directly 20% or more, or own, directly or indirectly, 50% or more of the total stock issued and outstanding of
any foreign or domestic corporation? For rules of constructive ownership, see instructions. If "Yes," complete (i)
through (v)
below . . . . . . . . . . . . . . . . . . . ........ . . ........... .......... . . . ........ X
(i) Name of Corporation (ii) Employer (iii) Country of (iv) Percentage of (v) If Percentage in (iv) is 100%, Enter
Identification Incorporation Stock Owned the Date (if any) a Qualified Subchapter
Number (if any) S Subsidiary Election Was Made

Own directly an interest of 20% or more, or own, directly or indirectly, an interest of 50% or more in the profit, loss, or
capital in any foreign or domestic partnership (including an entity treated as a partnership) or in the beneficial interest of a
. . . . . . . . . . . . . . . . .trust?Forrulesofconstructiveownership,seeinstructions.If"Yes,"complete(i)through(v)below X
(i) Name of Entity (ii) Employer (iii) Type of Entity (iv) Country of (v) Maximum Percentage Owned
Identification Organization in Profit, Loss, or Capital
Number (if any)
5a

At the end of the tax year, did the corporation have any outstanding shares of restricted stock? . . . . . . . . . . . . . . . . . . . X
If "Yes," complete lines (i) and (ii) below.
(i) Total shares of restricted stock . . . . ........ . .......
(ii) Total shares of non-restricted stock . . ........ . .......
b At the end of the tax year, did the corporation have any outstanding stock options, warrants, or similar instruments? . ........ X
If "Yes," complete lines (i) and (ii) below.
(i) Total shares of stock outstanding at the end of the tax year . . ......
(ii) Total shares of stock outstanding if all instruments were executed . . . .
6 Has this corporation filed, or is it required to file, Form 8918, Material Advisor Disclosure Statement, to provide
information on any reportable transaction? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
7 Check this box if the corporation issued publicly offered debt instruments with original issue discount . . . . . . . . . . . . . .
If checked, the corporation may have to file Form 8281, Information Return for Publicly Offered Original Issue Discount
Instruments.
8 If the corporation: (a) was a C corporation before it elected to be an S corporation or the corporation acquired an asset with a basis
determined by reference to the basis of the asset (or the basis of any other property) in the hands of a C corporation and
(b) has net unrealized built-in gain in excess of the net recognized built-in gain from prior years, enter the net unrealized built-in
gain reduced by net recognized built-in gain from prior years. See instructions . . . . . . . . . . . $
9 Did the corporation have an election under section 163(j) for any real property trade or business or any farming business
in effect during the tax year? See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
10Does the corporation satisfy one or more of the following? See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
a The corporation owns a pass-through entity with current , or prior year carryover, excess business interest expense.
b The corporation's aggregate average annual gross receipts (determined under section 448(c)) for the 3 tax years
preceding the current tax year are more than $26 million and the corporation has business interest expense.
c The corporation is a tax shelter and the corporation has business interest
expense. If "Yes," complete and attach Form 8990.
11Does the corporation satisfy both of the following conditions?.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
a The corporation's total receipts (see instructions) for the tax year were less than $250,000.
b The corporation's total assets at the end of the tax year were less than $250,000. If
"Yes," the corporation is not required to complete Schedules L and M-1.
EEA Form 1120-S (2019)
Form 1120S (2019) CLEAN LIVING LLC 47-4726043 Page 3
Schedule B Other Information (see instructions) (continued) Yes No
12 During the tax year, did the corporation have any non-shareholder debt that was canceled, was forgiven, or had the
terms modified so as to reduce the principal amount of the debt? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
If "Yes," enter the amount of principal reduction . . . . . . . . . . . . . . . . . . . . . $
13 During the tax year, was a qualified subchapter S subsidiary election terminated or revoked? If "Yes," see instructions . . . . . . . X
14 a Did the corporation make any payments in 2019 that would require it to file Form(s) 1099? . . . . . . . . . . . . . . . . . . . . X
b If "Yes," did the corporation file or will it file required Form(s) 1099? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
15 Is the corporation attaching Form 8996 to certify as a Qualified Opportunity Fund? . . . . . . . . . . . . . . . . . . . . . . . . X
. . . . . . . . . . . . . . . . . . . . $
If "Yes," enter the amount from Form 8996, line 14
Schedule K Shareholders' Pro Rata Share Items Total amount
1 Ordinary business income (loss) (page 1, line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 32,898
2 Net rental real estate income (loss) (attach Form 8825) . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3a Other gross rental income (loss) . . . . . . . . . . . . . . . . . . . . . . . 3a
b Expenses from other rental activities (attach statement) . . . . . . . . . . . . 3b
c Other net rental income (loss). Subtract line 3b from line 3a . . . . . . . . . . . . . . . . . . . . . . . . 3c
4 Interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Dividends: a Ordinary dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5a
Income (Loss)

b Qualified dividends . . . . . . . . . . . . . . . . . . . . . . . 5b
6 Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
7 Net short-term capital gain (loss) (attach Schedule D (Form 1120-S)) . . . . . . . . . . . . . . . . . . . . 7
8a Net long-term capital gain (loss) (attach Schedule D (Form 1120-S)) . . . . . . . . . . . . . . . . . . . . . 8a
b Collectibles (28%) gain (loss) . . . . . . . . . . . . . . . . . . . . . . . . . 8b
c Unrecaptured section 1250 gain (attach statement) . . . . . . . . . . . . . . 8c
9 Net section 1231 gain (loss) (attach Form 4797) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
10 Other income (loss) (see instructions) . . . Type 10
11 Section 179 deduction (attach Form 4562). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Deductions

12a Charitable contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12a


b Investment interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12b
c Section 59(e)(2) expenditures (1) Type (2) Amount 12c(2)

d Other deductions (see instructions) . . . . Type 12d


13a Low-income housing credit (section 42(j)(5)). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13a
b Low-income housing credit (other) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13b
c Qualified rehabilitation expenditures (rental real estate) (attach Form 3468, if applicable) . . . . . . . . . . . 13c
Credits

d Other rental real estate credits (see instructions) . . . Type 13d


e Other rental credits (see instructions) . . . . . . . . Type 13e
f Biofuel producer credit (attach Form 6478) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13f
g Other credits (see instructions) . . . . . . . . . . . Type 13g
14a Name of country or U.S. possession
b Gross income from all sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14b
c Gross income sourced at shareholder level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14c
Foreign gross income sourced at corporate level
d Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14d
e Foreign branch category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14e
f Passive category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14f
g General category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14g
Foreign Transactions

h Other (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14h


Deductions allocated and apportioned at shareholder level
i Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14i
j Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14j
Deductions allocated and apportioned at corporate level to foreign source income
k Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14k
l Foreign branch category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14l
m Passive category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14m
n General category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14n
o Other (attach statement). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14o
Other information
p Total foreign taxes (check one): Paid Accrued . . . . . . . . . . . . . . . . . . . . . 14p
q Reduction in taxes available for credit (attach statement) . . . . . . . . . . . . . . . . . . . . . . . . . 14q
r Other foreign tax information (attach statement)
EEA
Form 1120-S (2019)
Form 1120-S (2019) CLEAN LIVING LLC 47-4726043 Page 4
Schedule K Shareholders' Pro Rata Share Items (continued) Total amount
15a . . . . . . . . . . . . . . . . . ........... . ..... 15a
Minimum

Post-1986 depreciation adjustment


Tax

e Oil, gas, and geothermal properties - deductions ........... ........... . .... . 15e
Alt ernative

b Adjusted gain or loss . . . . . . . . . . . . . . . . . . . . . . . . .......... . .... . 15b


.

c Depletion (other than oil and gas) . . . . . . . . . . . . . . . . . . .......... . ..... 15c


.

d Oil, gas, and geothermal properties - gross income . . . . . . . . . . ........... . ..... 15d

f Other AMT items (attach statement) . . . . . . . . . . . . . . . . . ........... . ..... 15f


16a Tax-exempt interest income 16a
Shareholde

Basis
r
ItemsAffecti ng

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


.

b . . . . . . . . . . . . . . . . . . . . . . .......... . .... . 16b


.

Other tax-exempt income


c Nondeductible expenses . . . . . . . . . . . . . . . . . . . . . . . . . .Statement.... #16c....... . . 16c 228
d Distributions (attach statement if required) (see instructions) . . . . . . . . . . . . . . . . . . ..... 16d
e Repayment of loans from shareholders . . . . . . . . . . . . . . . ........... . ..... 16e
17 a Investment income .......... . .... . 17a
.

. . . . . . . . . . . . . . . . . . . . . . . .
Information

b Investment expenses 17b


Other

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


.

c Dividend distributions paid from accumulated earnings and profits . . . . . . . . . . . . . . . ..... 17c
d Other items and amounts (attach statement)
18Income (loss) reconciliation. Combine the amounts on lines 1 through 10 in the far right
Recon-
ciliatio

column. From the result, subtract the sum of the amounts on lines 11 through 12d and 14p . . . ..... 18 32,898
Schedule L Balance Sheets per Books Beginning of tax year End of tax year
Assets (a) (b) (c) (d)
1 . . .Cash ....................
2a . . . . . . . .Tradenotesandaccountsreceivable
b Less allowance for bad debts . . . . . . . . . . . . ( ) ( )
3 Inventories ....................
4 . . . . . . . . . . . .U.S.governmentobligations
5 . . . . . . .Tax-exemptsecurities(seeinstructions)
6 . . . . . . .Othercurrentassets(attachstatement)
7 . . . . . . . . . . . . . . .Loanstoshareholders
8 . . . . . . . . . . .Mortgageandrealestateloans
9 . . . . . . . .Otherinvestments(attachstatement)
10a . . . . . . .Buildingsandotherdepreciableassets
b Less accumulated depreciation . . . . . . . . . . . ( ) ( )
11a . . . . . . . . . . . . . . . . .Depletableassets
b Less accumulated depletion . . . . . . . . . . . . ( ) ( )
12 . . . . . . . . . . .Land(netofanyamortization)
13a . . . . . . . .Intangibleassets(amortizableonly)
b Less accumulated amortization . . . . . . . . . . ( ) ( )
14 . . . . . . . . . .Otherassets(attachstatement)
15 Total assets ....................
Liabilities and Shareholders' Equity
16 Accounts payable . . . . . . . . . . . . . . . . .
17 Mortgages, notes, bonds payable in less than 1 year
18 . . . . . .Othercurrentliabilities(attachstatement)
19 . . . . . . . . . . . . .Loansfromshareholders
20 Mortgages, notes, bonds payable in 1 year or more
21 . . . . . . . . .Otherliabilities(attachstatement)
22 Capital stock ...................
23 . . . . . . . . . . . . . .Additionalpaid-incapital
24 . . . . . . . . . . . . . . . . .Retainedearnings
25 Adjustments to shareholders' equity (attach statement)
26 . . . . . . . . . . . . .
Less cost of treasury stock ( ) ( )
27 . . . . . . .Totalliabilitiesandshareholders'equity
EEA Form 1120-S (2019)
Form 1120-S (2019) CLEAN LIVING LLC 47-4726043 Page 5
Schedule M-1 Reconciliation of Income (Loss) per Books With Income (Loss) per Return
Note: The corporation may be required to file Schedule M-3. See instructions.
1 Net income (loss) per books. . . . . . . . . 5 Income recorded on books this year not included
2 Income included on Schedule K, lines 1, 2, 3c, 4, on Schedule K, lines 1 through 10 (itemize):
5a, 6, 7, 8a, 9, and 10, not recorded on books this a Tax-exempt interest $
year (itemize):

3 Expenses recorded on books this year not 6 Deductions included on Schedule K,


included on Schedule K, lines 1 through 12 lines 1 through 12 and 14p , not charged
and 14p (itemize): against book income this year (itemize):
a Depreciation $ a Depreciation $
b Travel and entertainment $

. . . . . . . . . . . . .7Addlines5and6
4 . . . . . . . . . . . .Addlines1through3 8 Income (loss) (Schedule K, line 18). Subtract line 7 from line 4

Schedule M-2 Analysis of Accumulated Adjustments Account, Shareholders' Undistributed Taxable Income
Previously Taxed, Accumulated Earnings and Profits, and Other Adjustments Account
(see instructions)
(a) Accumulated (b) Shareholders' (c) Accumulated (d) Other adjustments
adjustments account undistributed taxable earnings and profits account
income previously taxed
1 Balance at beginning of tax year
........... 18,888
2 . . . . . . . . .Ordinaryincomefrompage1,line21 32,898
3 .Otheradditions ................ . .
4 . . . . . . . . . . . . . .Lossfrompage1,line21 )
5 Other reductions . . . . . . . . . . . . .....Statement.#30 ( 228 ) ( )
6 . . . . . . . . . . . . . .Combinelines1through5 51,558
7 Distributions
.....................
8 Balance at end of tax year. Subtract line 7 from
line 6 . . . . . . . . . . . . . . . . . . . . . . . . 51,558
EEA Form 1120-S
(2019)
Form
1125-A Cost of Goods Sold
(Rev. November 2018) Attach to Form 1120, 1120-C, 1120-F, 1120S, or 1065. OMB No. 1545-0123
Department of the Treasury
Internal Revenue Service Go to www.irs.gov/Form1125A for the latest information.
Name Employer identification number
CLEAN LIVING LLC 47-4726043
1 Inventory at beginning of year . . . . . ............................... 1
2 Purchases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 9,283
3 Cost of labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
4 Additional section 263A costs (attach schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5 Other costs (attach schedule) . . . . . ............................... 5
6 Total. Add lines 1 through 5 . . . . . ............................... 6 9,283
7 Inventory at end of year . . . . . . . . ............................... 7
8 Cost of goods sold. Subtract line 7 from line 6. Enter here and on Form 1120, page 1, line 2 or the
appropriate line of your tax return. See instructions. . . . . . . . . . . . . . . . . . . . . . . . . 8 9,283
9a Check all methods used for valuing closing inventory:
(i) Cost
(ii) Lower of cost or market
(iii) Other (Specify method used and attach explanation.)
b Check if there was a writedown of subnormal goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .........
c Check if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970) . . . . .........
d If the LIFO inventory method was used for this tax year, enter amount of closing inventory computed
under LIFO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9d
. . . . .
.

e If property is produced or acquired for resale, do the rules of section 263A apply to the entity? See instructions Yes No
f Was there any change in determining quantities, cost, or valuations between opening and closing inventory? If "Yes,"
attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No

For Paperwork Reduction Act Notice, see instructions Form 1125-A (Rev. 11-2018)
EEA
671119
Final K-1 Amended K-1 OMB No. 1545-0123
Schedule K-1
2019 Part III
Shareholder's Share of Current Year Income,
(Form 1120-S) Deductions, Credits, and Other Items
Department of the Treasury For calendar year 2019, or tax year 1Ordinary business income (loss) 13 Credits
Internal Revenue Service
beginning 2019 ending
16,449
2 Net rental real estate income (loss)
3 Other net rental income (loss)
Shareholder's Share of Income, Deductions,
Credits, etc. See page 2 of form and separate instructions.
4 Interest income

Part I Information About the Corporation


5a Ordinary dividends
A Corporation's employer identification number

47-4726043 5b Qualified dividends 14 Foreign transactions


B Corporation's name, address, city, state, and ZIP code

CLEAN LIVING LLC


6 Royalties

4821 E FREE CIR


7 Net short-term capital gain (loss)

IDAHO FALLS ID 83401


8a Net long-term capital gain (loss)
C IRS Center where corporation filed return
8b Collectibles (28%) gain (loss)
OGDEN
8c Unrecaptured section 1250 gain
Part II Information About the Shareholder
D Shareholder's identifying number
518-25-3300
9 Net section 1231 gain (loss)
E Shareholder's name, address, city, state, and ZIP code
REBECCA WARD
10 Other income (loss) 15 Alternative minimum tax (AMT) items

4821 E FREE CIRCLE


IDAHO FALLS ID 83401

F Shareholder's percentage of stock


ownership for tax year. . . . . . . . . . 50.00000 %

11 Section 179 deduction 16 Items affecting shareholder basis

C* STMT
12 Other deductions
For IRS Use Only

17 Other information

V* STMT
18 More than one activity for at-risk purposes*

19 More than one activity for passive activity purposes*

* See attached statement for additional information.

For Paperwork Reduction Act Notice, see the Instructions for Form 1120-S. www.irs.gov/Form1120S Schedule K-1 (Form 1120-S) 2019

EEA
Schedule K-1 Supplemental Information 2019
Shareholder's name Shareholder's ID Number
REBECCA WARD 518-25-3300
Name of S Corporation S Corporation's EIN
CLEAN LIVING LLC 47-4726043
FORM 1120S SCHEDULE K-1 - LINE 16
CODE DESCRIPTION AMOUNT
C OTHER NONDEDUCTIBLE EXPENSES 114
MEALS 114__________
TOTAL 114
__________

1120SK_1.LD2
671119
Final K-1 Amended K-1 OMB No. 1545-0123
Schedule K-1
2019 Part III
Shareholder's Share of Current Year Income,
(Form 1120-S) Deductions, Credits, and Other Items
Department of the Treasury For calendar year 2019, or tax year 1Ordinary business income (loss) 13 Credits
Internal Revenue Service
beginning 2019 ending
16,449
2 Net rental real estate income (loss)
3 Other net rental income (loss)
Shareholder's Share of Income, Deductions,
Credits, etc. See page 2 of form and separate instructions.
4 Interest income

Part I Information About the Corporation


5a Ordinary dividends
A Corporation's employer identification number

47-4726043 5b Qualified dividends 14 Foreign transactions


B Corporation's name, address, city, state, and ZIP code

CLEAN LIVING LLC


6 Royalties

4821 E FREE CIR


7 Net short-term capital gain (loss)

IDAHO FALLS ID 83401


8a Net long-term capital gain (loss)
C IRS Center where corporation filed return
8b Collectibles (28%) gain (loss)
OGDEN
8c Unrecaptured section 1250 gain
Part II Information About the Shareholder
D Shareholder's identifying number
357-72-6788
9 Net section 1231 gain (loss)
E Shareholder's name, address, city, state, and ZIP code
KEVIN WARD
10 Other income (loss) 15 Alternative minimum tax (AMT) items

4821 E FREE CIRCLE


IDAHO FALLS ID 83401

F Shareholder's percentage of stock


ownership for tax year. . . . . . . . . . 50.00000 %

11 Section 179 deduction 16 Items affecting shareholder basis

C* STMT
12 Other deductions
For IRS Use Only

17 Other information

V* STMT
18 More than one activity for at-risk purposes*

19 More than one activity for passive activity purposes*

* See attached statement for additional information.

For Paperwork Reduction Act Notice, see the Instructions for Form 1120-S. www.irs.gov/Form1120S Schedule K-1 (Form 1120-S) 2019

EEA
Schedule K-1 Supplemental Information 2019
Shareholder's name Shareholder's ID Number
KEVIN WARD 357-72-6788
Name of S Corporation S Corporation's EIN
CLEAN LIVING LLC 47-4726043
FORM 1120S SCHEDULE K-1 - LINE 16
CODE DESCRIPTION AMOUNT
C OTHER NONDEDUCTIBLE EXPENSES 114
MEALS 114__________
TOTAL 114
__________

1120SK_1.LD2
Form 7004
(Rev. December 2018)
Application for Automatic Extension of Time To File Certain
Business Income Tax, Information, and Other Returns OMB No. 1545-0233

Department of the Treasury File a separate application for each return.


Internal Revenue Service Go to www.irs.gov/Form7004 for instructions and the latest information.
Name Identifying number

Print CLEAN LIVING LLC


47-4726043
or Number, street, and room or suite no. (If P.O. box, see instructions.)
Type 4821 E FREE CIR
City, town, state, and ZIP code (If a foreign address, enter city, province or state, and country (follow the country's practice for entering postal code).)
IDAHO FALLS ID 83401
Note: File request for extension by the due date of the return. See instructions before completing this form.
Part I Automatic Extension for Certain Business Income Tax, Information, and Other Returns. See instructions.
. . . . . . . . . . . . . . . . . . . . . . . .
1 Enter the form code for the return listed below that this application is for 2 5
Application Form Application Form
Is For: Code Is For: Code
Form 706-GS(D) 01 Form 1120-ND (section 4951 taxes) 20
Form 706-GS(T) 02 Form 1120-PC 21
Form 1041 (bankruptcy estate only) 03 Form 1120-POL 22
Form 1041 (estate other than a bankruptcy estate) 04 Form 1120-REIT 23
Form 1041 (trust) 05 Form 1120-RIC 24
Form 1041-N 06 Form 1120S 25
Form 1041-QFT 07 Form 1120-SF 26
Form 1042 08 Form 3520-A 27
Form 1065 09 Form 8612 28
Form 1066 11 Form 8613 29
Form 1120 12 Form 8725 30
Form 1120-C 34 Form 8804 31
Form 1120-F 15 Form 8831 32
Form 1120-FSC 16 Form 8876 33
Form 1120-H 17 Form 8924 35
Form 1120-L 18 Form 8928 36
Form 1120-ND 19
Part II All Filers Must Complete This Part
2 If the organization is a foreign corporation that does not have an office or place of business in the United States,
check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3 If the organization is a corporation and is the common parent of a group that intends to file a consolidated return,
check here . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If checked, attach a statement listing the name, address, and employer identification number (EIN) for each member
covered by this application.
4 If the organization is a corporation or partnership that qualifies under Regulations section 1.6081-5, check here . .
5a The application is for calendar year 20 19 , or tax year beginning , 20 , and ending , 20 .
b Short tax year. If this tax year is less than 12 months, check the reason: Initial return Final return
Change in accounting period Consolidated return to be filed Other (See instructions-attach explanation.)

6 Tentative total tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 0

7 Total payments and credits. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 0

8 Balance due. Subtract line 7 from line 6. See instructions . . . . . . . . . . . . . . . . . . . . 8 0


For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Form 7004 (Rev. 12-2018)
EEA
Federal Supporting Statements 2019 PG01
Name(s) as shown on return Tax ID Number
CLEAN LIVING LLC 47-4726043
FORM 1120S - LINE 19 - OTHER DEDUCTIONS Statement #2
DESCRIPTION AMOUNT

EDUCATION AND TRAINING 369


INTERNET 1,260
LEGAL AND PROFESSIONAL 450
50% MEALS 228
OFFICE EXPENSE 9,475
OUTSIDE SERVICES/SUB CONTRACTORS 5,193
POSTAGE/SHIPPING 3,363
TELEPHONE 3,229
TRAVEL 7,994
MILEAGE REIMBURSEMENT 1,344
HOME OFFICE REIMBURSEMENT 500
TOTAL 33,405
______________

PG01
SCHEDULE K - LINE 16C - NONDEDUCTIBLE EXPENSES Statement #16c

DESCRIPTION AMOUNT
MEALS 228
TOTAL 228
______________

PG01
SCHEDULE M-2 - LINE 5 - OTHER REDUCTIONS Statement #30

DESCRIPTION AMOUNT
NONDEDUCTIBLE EXPENSES 228
TOTAL 228
______________

STATMENT.LD
1120S TAX RETURN COMPARISON 2019
2017 / 2018 / 2019

Name(s) as shown on return Identifying number


CLEAN LIVING LLC 47-4726043

2017 2018 2019 DIFFERENCE


Income FEDERAL FEDERAL FEDERAL BETWEEN 2018 & 2019
. . . . .Netreceipts 80,036 80,119 83
. . .Costofgoodssold 9,283 9,283
. . . . . .Grossprofit 80,036 70,836 (9,200)
.Netgain/lossfrom4797
. . . . . .Otherincome
. . . . .Totalincome 80,036 70,836 (9,200)
Deductions
. . . . . . . .Compensationofofficers 8,000 4,150 (3,850)
. . .Salariesandwages
. . . . . . . .Repairsandmaintenance
. . . . . . .Baddebts
. . . . . . . . .Rents
. . .Taxesandlicenses 383 383
. . . . . . . .Interest
. . . .Netdepreciation
. . . . . . . .Depletion
. . . . . .Advertising 168 (168)
.Pension,profit-sharing
. . .Employeebenefits
. . .Otherdeductions 52,690 33,405 (19,285)
. . . .Totaldeductions 60,858 37,938 (22,920)
Ordinary business income(loss) 19,178 32,898 13,720
Tax
. . . . . . .........Totaltax
Payments
. . . . . . . ...Estimatedtaxespaid
. . . . . . . .Totalpaymentsline23e
Results
. . . . . . . .....Amountowed
. . . . .Overpayment
. . .Appliedtoestimate
. . . . . . . .Refund

SCHEDULE K - Shareholder's Share Items


Income
Ordinary business income (loss) . . . . 19,178 32,898 13,720
Net rental real estate income (loss) . . .
Other net rental income (loss) . . . . .

Interest income . . . . . . . . . . . .
Ordinary dividends . . . . . . . . . . .
Qualified dividends . . . . . . . . . . .
Royalties . . . . . . . . . . . . . . . .

Net short-term capital gain (loss) . . . .

Net long-term capital gain (loss) . . . .

Collectibles (28%) gain (loss) . . . . .

Unrecaptured section 1250 gain . . . .

Net section 1231 gain (loss) . . . . . .

Other income (loss) . . . . . . . . . .

2017 2018 2019 DIFFERENCE

COMPARES.LD
1120S TAX RETURN COMPARISON 2019
2017 / 2018 / 2019
Page 2
Name(s) as shown on return Identifying number
CLEAN LIVING LLC 47-4726043

2017 2018 2019 DIFFERENCE


Deductions FEDERAL FEDERAL FEDERAL BETWEEN 2018 & 2019
. . . . . .Section179deduction. . .
. . . . . .Contributions...... . .
. . . .Investmentinterestexpense . .
Section 59(e)(2) expenditures . . . . .
. . . . . .Otherdeductions.... . .
Credits
Low-income housing credit (section 42(j)(5)) . .
Low-income housing credit (other) . . .
Qualified rehabilitation expenditures (rental real
estate)
. . . .Otherrentalrealestatecredits . .
. . . . . .Otherrentalcredits... . .
. . . .Creditforalcoholusedasfuel . .
. . . . . .Othercredits...... . .
Foreign Transactions
Gross income from all sources . . . . .
Gross income sourced at shareholder level . .
Foreign gross income sourced at corporate level

. . . . . .Passivecategory.... . .
. . . . . .Generalcategories... . .
. . . . . .Other.......... . .
Deductions allocated and apportioned at
shareholder level
Interest expense . . . . . .
. . . . . .Other.......... . .
Deductions allocated / apportioned at corp. level
to foreign source inc.
Passive category . . . . . .
. . . . . .Generalcategories... . .
. . . . . .Other.......... . .
Total foreign taxes paid or accrued . . .
Reduction in taxes available for credit . .
Alternative Minimum Tax (AMT) items
. .Post-1986depreciationadjustment . .
. . . . . .Adjustedgainorloss.. . .
. . . . . .Depletion........ . .
Oil, gas, and geothermal properties - gross income
Oil, gas, and geothermal properties - deductions

. . . . . .OtherAMTitems .... . .
Items Affecting Shareholder Basis
. . . . .Tax-exemptinterestincome . .
. . . . . .Othertax-exemptincome . .
. . . . . .Nondeductibleexpenses . . 290 228 (62)
. . . . . .Propertydistributions.. . .
Repayment of loans from shareholders .
Other information
. . . . . .Investmentincome... . .
. . . . . .Investmentexpenses.. . .
Dividend distributions paid from accum earnings
and profits
RESIDENT STATE
ID ID
. . . . . .Taxableincome..... . .
. . . . . .Totaltax........ . .
. . . . . .Overpayment...... . .
. . . . . .Balancedue...... . . 20 20
2017 2018 2019 DIFFERENCE
COMPARES.LD2
Don't Staple
1024
IDAHO Form 41S
S Corporation Income Tax Return
2019
State Tax Commission
Amended Return? Check the box. See For calendar year State use only
page 1 of instructions for reasons to 2019 or fiscal Mo Day Year Mo Day Year 1219
amend and enter number that applies.
year beginning ending
Business name State use only Federal Employer Identification Number (EIN)
CLEAN LIVING LLC CLEA 47 4726043
Current business mailing address
4821 E FREE CIR 454390
City State ZIP Code NAICS Code
IDAHO FALLS ID 83401
1. Is this a composite return? . . . . .......... ............................ Yes X No
2. If a federal audit was finalized this year, enter the latest year audited. . . . . . . . . . . . . Yes X No
3. Is this an inactive corporation or nameholder corporation? ............................
4. a. Were federal estimated tax payments required? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
b. Were estimated tax payments based on annualized amounts?. . . . . . . . . . . . . . . . . . . . . . . . Yes X No
5. Is this a final return? . . . . . . . .......... ............................. Yes X No
If yes, check the proper box below and enter the date the event occurred
Withdrawn from Idaho Dissolved Merged or reorganized Enter new EIN
6. Is this an electrical or telephone utility? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
7. Did the ownership change during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes X No
8. Enter the amount of investment tax credit earned this tax year . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Enter the amount of broadband equipment investment credit earned this tax year. . . . . . . . . . . . . . . .
10. Enter the amount of credit for Idaho research activities earned this tax year. . . . . . . . . . . . . . . . . . .
11. Reserved . . . . . . . . . . . . .......... .............................
12. Did you claim the property tax exemption for investment tax credit property acquired this tax year?. . . . . . . . Yes X No
Income
32,898
Don't Staple

13. Ordinary income (loss). Form 1120S, page 1 . . . . . . . . . . . . . . . . . . . . . . ........... 13


14. Net income (loss) from rental real estate activities. Form 1120S, Schedule K . . . . . . . ........... 14
15. Net income (loss) from other rental activities. Form 1120S, Schedule K . . . . . . . . . ........... 15
16. Portfolio income (loss). Form 1120S, Schedule K . . . . . . . . . . . . . . . . . . . . ........... 16
17. Other items. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 17
18. Net distributable income. Add lines 13 through 17 . . . . . . . . . . . . . . . . . . . . ........... 18 32,898
Additions
19. Interest and dividends not taxable under Internal Revenue Code. . . . . . . . . . . . ........... 19
20. State, municipal and local taxes measured by net income. Include a schedule . . . . . . .......... 20
21. Bonus depreciation. Include a schedule . . . . . . . . . . . . . . . . . . . . . . . . . .......... 21
22. Other additions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 22
23. Add lines 18 through 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 23 32,898
Subtractions
24. Interest from Idaho municipal securities . . . . . . . . . . . . . . . . . . . . . 24
25. Interest on U.S. government obligations. Include a schedule . . . . . . . . . . . 25
26. Interest and other expenses related to lines 24 and 25 . . . . . . . . . . . . . . 26
27. Add lines 24 and 25, then subtract line 26 . . . . . . . . . . . . . . . . . . . . . . . . ........... 27 0
28. Technological equipment donation . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 28
29. Allocated income. Include a schedule . . . . . . . . . . . . . . . . . . . . . . 29
30. Interest and other expenses related to line 29. Include a schedule . . . . . . . . 30
31. Subtract line 30 from line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 31 0
32. Bonus depreciation. Include a schedule . . . . . . . . . . . . . . . . . . . . . . . . . ........... 32
33. Other subtractions. See instructions . . . . . . . . . . . . . . . . . . . . . . . . . . ........... 33
34. Total subtractions. Add lines 27, 28, 31, 32 and 33 . . . . . . . . . . . . . . . . . . . ........... 34
35. Net business income subject to apportionment. Subtract line 34 from line 23 . . . . . . . ........... 35 32,898
Continue to page 2
MAIL TO: Idaho State Tax Commission, PO Box 56, Boise ID 83756-0056
Include a complete copy of your federal Form 1120S.
EFO00028 05-21-2019 Page 1 of 2
01923018
IDAHO State Tax Commission Form 41S 2019 (continued)

36. Net business income subject to apportionment. Enter the amount from line 35 . . . . . . . . . ........ 36 32,898
37. Corporations with all activity in Idaho enter 100%. Multistate/multinational corporations
complete and include Form 42; enter the apportionment factor from Form 42, Part I, line 21 . . . ....... . 100.0000
. .
37 %
38. Net business income apportioned to Idaho. Multiply line 36 by the percent on line 37 . . . . . . ....... .
. .
38 32,898
Income allocated to Idaho. See instructions. . . . . . . . ............ .... . . ....... .
. .
39. 39
40. S corporation income from Form PTE-12, Column b. Include Form PTE-12. . . . . . . . . . . . . . . . . . .
. .
40 32,898
S corporation income from Form PTE-12, Column e. Include Form PTE-12. . . . . . . . . . . . . . . . . . .
. .
41. 41
42. . . . . . . . . .Incomereportedonentity'scompositereturnfromFormPTE-12,Columnc.IncludeFormPTE-12 42
. . . ....... .
. .
43. Idaho income tax from Form PTE-12, Column d. (6.925% of line 42.) Include Form PTE-12 43
Credits
44. Credit for contributions to Idaho educational entities . . . . . . . . . . . . . . . . . 44
45. . . . . . . . . . . .CreditforcontributionstoIdahoyouthandrehabilitationfacilities 45
46. Total business income tax credits from Form 44, Part I, line 9.
Include Form 44 . . . . . . . . . . . . . . . . . . . . ............ . . 46
. . . . . . .Totalcredits.Addlines44through46 . . . ............ .... . . ....... .
. .
47. 47
48. Subtract line 47 from line 43. If line 47 is greater than line 43, enter zero . . . . . . . . . . . . . . . . . . .
. .
48 0
Other Taxes 20
49. Minimum tax. See instructions if the S corporation owes federal tax . . . . . . . . . . . . . . . . . . . . . . .
49
50. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Permanentbuildingfundtax.Seeinstructions . .
50
51. Total tax from recapture of income tax credits from Form 44, Part II, line 6. Include Form 44 . . ....... . . .
51
52. Fuels tax due. Include Form 75 . . . . . . . . . . . . . ............ .... . . ....... . . .
52
53. . . . . . . . . . ....... . . .
53
.Sales/usetaxdueonuntaxedpurchases(online,mailorder,andother)
54. . . . . . . . .Taxfromrecaptureofqualifiedinvestmentexemption(QIE).IncludeForm49E ....... . . .
54
R
55. Total tax. Add lines 48 through 54 . . . . . . . . . . . ............ .... . . ....... . . .
55 20
56. Underpayment interest. Include Form 41ESR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
56
57. Donation to Opportunity Scholarship Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
57
58. Add lines 55 through 57 . . . . . . . . . . . . . . . . ............ .... . . ....... . . .
58 20
Payments and Other Credits
59. Estimated tax payments. If made under other EINs, provide EINs, amounts and rollforwards . . ....... . . .
59
60. Special fuels tax refund Gasoline tax refund Include Form 75 60
.
61. Tax Reimbursement Incentive credit. Include certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
62. Total payments and other credits. Add lines 59 through 61 . . . . . . . . . . . . . . . . . . . . . . . . . . . .
62
Refund or Payment Due 20
63. Tax due. If line 58 is more than line 62, subtract line 62 from line 58 . . . . . . . . . . . . . . . . . . . . . . .
63
64. Penalty Interest from the due date Enter total 64

65. Total Due. Add lines 63 and 64 . . . . . . . . . . .. . ............ ............. 65 20

. . . . . . . . . . . . . . . . . . .
. .
66. Overpayment. If line 58 is less than line 62, subtract line 58 from line 62 66

67. Refund. Amount of line 66 you want refunded to you . . . . . . . . . . . . . . . . . . . . . . . . . . . 67


68. Estimated Tax. Amount you want credited to your 2020 estimated tax.
. . . . . . . . . . . . . . ............ .... . . ....... .
. .
Subtract line 67 from line 66 68
Amended Return Only. Complete this section to determine your tax due or refund.
69. Total due (line 65) or overpayment (line 66) on this return . . . . . . . . . . . . . . . . . . . . . . . . . . 69 . .

70. Refund from original return plus additional refunds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 .


.

71. Tax paid with original return plus additional tax paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
71 .
72. Amended tax due or refund. Add lines 69 and 70, then subtract line 71 . . . . . . . . . . . . . . . . . . . . .
72 .
Within 180 days of receiving this return, the Idaho State Tax Commission may discuss this return with the paid preparer identified below.
X Under penalties of perjury, I declare that to the best of my knowledge and belief this return is true, correct and complete. See instructions.
Signature of officer Date
Sign 09-14-2020
Here Title Phone number
PRESIDENT
Paid preparer's signature Preparer's EIN, SSN or PTIN 01923218
P01684117
Address Phone number
515 S Fitness Pl Ste 120
Eagle, ID 83616 208-855-2578
EFO00028 05-21-2019 Page 2 of 2
Form ID-VP - Instructions 2019
IDAHO Income Tax Voucher Payment
State Tax Commission

Only use this voucher when sending a payment without a return.

You can pay in one of two ways:


Pay securely online through our Taxpayer Access Point (TAP) at tax.idaho.gov/quickpay
Visit tax.idaho.gov/epay for more information about other electronic payments.
By mail
Complete the voucher below by entering:
• Your name, address and Social Security number (SSN) or EIN
• Spouse's name and SSN, if joint individual return
• The tax type of your return
• The filing period of your return
• Individuals: Enter 1219
• Businesses: Enter your fiscal year ending date using the two-
digit abbreviations for month and year
Example: September 2019 is entered as 0919
• The amount you're paying by check or money order
Make your check or money order payable to the Idaho State Tax Commission. Don't staple
your check to your voucher or send a check stub.
Mail your voucher and payment to the address on the voucher.
If the full amount of your tax due isn't received or postmarked on or before the due date of your
return, we'll charge you penalty and interest on the balance of the tax due.

Contact us:
In the Boise area: (208) 334-7660 | Toll free: (800) 972-7660
Hearing impaired (TDD) (800) 377-3529
tax.idaho.gov/contact
CUT HERE

1024 Mail to:


IDAHO Form ID-VP 2019 Idaho State Tax Commission
State Tax Commission Income Tax Voucher Payment PO Box 83784
Boise ID 83707-3784
Name as shown on your individual or business return Social Security number or EIN

CLEAN LIVING LLC 47-4726043


Spouse's name, if a joint individual return Spouse's Social Security number

Tax type Filing period Tran code Amount paid with voucher
Individual (01) 1219 95 $ 20
X Business (05)
Current mailing address
4821 E FREE CIR
City State ZIP Code
IDAHO FALLS ID 83401
EFO00316 11-26-2019

474726043 000000000 CLEA 05 1219 A 95 9


Form ID K-1 - Schedule
IDAHO Partner’s, Shareholder’s or Beneficiary’s
1024

2019
State Tax Commission
Share of Idaho Adjustments, Credits, etc.
For tax year Mo Day Year Mo Day Year
beginning 01-01-2019 ending 12-31-2019 Final K-1 Amended K-1

Part I - Pass-through Entity (PTE) Information


Partnership X S Corporation Estate Resident Trust Nonresident Trust Qualified Investment Partnership

PTE EIN PTE name


47-4726043 CLEAN LIVING LLC
PTE current address City State ZIP Code
4821 E FREE CIR IDAHO FALLS ID 83401
Part II - Owner information
General Partner Limited Partner X Shareholder Beneficiary Other LLC Member Disregarded Entity
Owner's SSN/EIN Owner’s name
518-25-3300 REBECCA WARD
Owner's current address City State ZIP Code
4821 E FREE CIRCLE IDAHO FALLS ID 83401
PTE filing code: Nonresident Owner Agreement (A) Composite (C) Not Required (N)
X Idaho Resident Individual (R) Pass-through Withholding (W)
Owners should refer to the ID K-1 instructions to determine if they have an Idaho filing requirement.
Beneficiary’s percentage of distributive share %
Owner’s share of profit and loss/stock ownership: Beginning50.0000 % Ending 50.0000 %

Part III - Pass-through Owner’s Share of Idaho Apportionment Factor Items


Total Idaho
1. Real and tangible personal property: Beginning . . . . . 1
Partnerships and Corporations

2. Real and tangible personal property: Ending . . . . . . . 2


3. Capitalized rent expense . . . . . . . . . . . . . . . . . 3
4. Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5. Payroll . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6. Idaho apportionment factor . . . . . . . . . . . . . . . . . .................. 6 %

Part IV - Idaho Distributable Income Column A Column B


Federal Income Federal Idaho Apportioned
7. Ordinary income (loss) . . . . . . . . . . . . . . . . . . 7 16,449 16,449
8. Net rental real estate income (loss) . . . . . . . . . . . . 8
9. Interest income . . . . . . . . . . . . . . . . . . . . . . 9
10. Ordinary dividends . . . . . . . . . . . . . . . . . . . . . 10
11. Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12. Net short-term capital gain (loss) . . . . . . . . . . . . . 12
13. Net long-term capital gain (loss) . . . . . . . . . . . . . 13
14. Other income (loss). Include schedule . . . . . . . . . . 14
15. Section 179 deduction . . . . . . . . . . . . . . . . . . . 15
16. Guaranteed payments subject to Idaho apportionment factor. . . 16
17. Charitable contributions . . . . . . . . . . . . . . . . . . 17
18. Trust/Estate income . . . . . . . . . . . . . . . . . . . . 18
19. Subtotal, federal income . . . . . . . . . . . . . . . . . 19 16,449 16,449
EFO00201 09-27-2019 Page 1 of 3
IDAHO State Tax Commission Form ID K-1 - Schedule 2019 (continued)
1024

47-4726043 518-25-3300
Idaho Additions Column A Column B
Total Gross Owner's Share Idaho Apportioned Amount
20. State, municipal and local taxes . . . . . . . . . . . . . . 20
21. Interest and dividends not taxable under
Internal Revenue Code (IRC) . . . . . . . . . . . . . . . . 21
22. Bonus depreciation addition . . . . . . . . . . . . . . . . . 22
23. Other Idaho additions. Include schedule . . . . . . . . . . 23
Idaho Subtractions Column A Column B
Total Gross Owner's Share Idaho Apportioned Amount
24. Interest from Idaho municipal securities included in
line 21, net expenses. . . . . . . . . . . . . . . . . . . . . 24
25. Interest on U.S. government obligations, net expenses . . 25
26. Idaho technological equipment donation . . . . . . . . . . 26
27. Bonus depreciation deduction . . . . . . . . . . . . . . . . 27

28. Other Idaho subtractions and descriptions . . . . . . . . . 28


29. Subtotal net business income. . . . . . . . . . . . . . . 29 16,449 16,449
Allocated Income Column A Column B
Total Gross Owner's Share Idaho Amount
30. Guaranteed payments sourced as compensation to Idaho 30
31. Guaranteed payments sourced as compensation
to another state . . . . . . . . . . . . . . . . . . . . . . . 31
32. Other allocated income. Include schedule . . . . . . . . . 32
33. Total allocated income . . . . . . . . . . . . . . . . . . . 33
34. Idaho distributable income . . . . . . . . . . . . . . . . 34 16,449 16,449
Part V - Composite Filing and Pass-through Withholding Idaho Amount

35. Owner's income reported on the entity's composite return. . . ................ 35


. . . . . . . . . . . . . . . . . . .36.Multiplyline35by6.925% . . ................ 36
37. Share of Idaho credits claimed on behalf of the owner . . . .. ................ 37
. . . . . . . . . . . . .38.Taxpaidbytheentityonbehalfoftheowneroncompositereturn 38
39. Tax withheld by the entity on behalf of the owner . . . . .. ................ 39
Part VI - Pass-through Informational Items

40. Capital gain (loss) eligible for the Idaho capital gains deduction:
b. Date acquired c. Date sold d.Distributive share
a. Description of property and Idaho location:
(mm/dd/yyyy) (mm/dd/yyyy) of gain or (loss)

Federal Idaho

41. Interest expense offset total income . . . . . . . . . . . 41


EFO00201 09-27-2019 Page 2 of 3
Form ID K-1 - Schedule
IDAHO Partner’s, Shareholder’s or Beneficiary’s
1024

2019
State Tax Commission
Share of Idaho Adjustments, Credits, etc.
For tax year Mo Day Year Mo Day Year
beginning 01-01-2019 ending 12-31-2019 Final K-1 Amended K-1

Part I - Pass-through Entity (PTE) Information


Partnership X S Corporation Estate Resident Trust Nonresident Trust Qualified Investment Partnership

PTE EIN PTE name


47-4726043 CLEAN LIVING LLC
PTE current address City State ZIP Code
4821 E FREE CIR IDAHO FALLS ID 83401
Part II - Owner information
General Partner Limited Partner X Shareholder Beneficiary Other LLC Member Disregarded Entity
Owner's SSN/EIN Owner’s name
357-72-6788 KEVIN WARD
Owner's current address City State ZIP Code
4821 E FREE CIRCLE IDAHO FALLS ID 83401
PTE filing code: Nonresident Owner Agreement (A) Composite (C) Not Required (N)
X Idaho Resident Individual (R) Pass-through Withholding (W)
Owners should refer to the ID K-1 instructions to determine if they have an Idaho filing requirement.
Beneficiary’s percentage of distributive share %
Owner’s share of profit and loss/stock ownership: Beginning50.0000 % Ending 50.0000 %

Part III - Pass-through Owner’s Share of Idaho Apportionment Factor Items


Total Idaho
1. Real and tangible personal property: Beginning . . . . . 1
Partnerships and Corporations

2. Real and tangible personal property: Ending . . . . . . . 2


3. Capitalized rent expense . . . . . . . . . . . . . . . . . 3
4. Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5. Payroll . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6. Idaho apportionment factor . . . . . . . . . . . . . . . . . .................. 6 %

Part IV - Idaho Distributable Income Column A Column B


Federal Income Federal Idaho Apportioned
7. Ordinary income (loss) . . . . . . . . . . . . . . . . . . 7 16,449 16,449
8. Net rental real estate income (loss) . . . . . . . . . . . . 8
9. Interest income . . . . . . . . . . . . . . . . . . . . . . 9
10. Ordinary dividends . . . . . . . . . . . . . . . . . . . . . 10
11. Royalties . . . . . . . . . . . . . . . . . . . . . . . . . . 11
12. Net short-term capital gain (loss) . . . . . . . . . . . . . 12
13. Net long-term capital gain (loss) . . . . . . . . . . . . . 13
14. Other income (loss). Include schedule . . . . . . . . . . 14
15. Section 179 deduction . . . . . . . . . . . . . . . . . . . 15
16. Guaranteed payments subject to Idaho apportionment factor. . . 16
17. Charitable contributions . . . . . . . . . . . . . . . . . . 17
18. Trust/Estate income . . . . . . . . . . . . . . . . . . . . 18
19. Subtotal, federal income . . . . . . . . . . . . . . . . . 19 16,449 16,449
EFO00201 09-27-2019 Page 1 of 3
IDAHO State Tax Commission Form ID K-1 - Schedule 2019 (continued)
1024

47-4726043 357-72-6788
Idaho Additions Column A Column B
Total Gross Owner's Share Idaho Apportioned Amount
20. State, municipal and local taxes . . . . . . . . . . . . . . 20
21. Interest and dividends not taxable under
Internal Revenue Code (IRC) . . . . . . . . . . . . . . . . 21
22. Bonus depreciation addition . . . . . . . . . . . . . . . . . 22
23. Other Idaho additions. Include schedule . . . . . . . . . . 23
Idaho Subtractions Column A Column B
Total Gross Owner's Share Idaho Apportioned Amount
24. Interest from Idaho municipal securities included in
line 21, net expenses. . . . . . . . . . . . . . . . . . . . . 24
25. Interest on U.S. government obligations, net expenses . . 25
26. Idaho technological equipment donation . . . . . . . . . . 26
27. Bonus depreciation deduction . . . . . . . . . . . . . . . . 27

28. Other Idaho subtractions and descriptions . . . . . . . . . 28


29. Subtotal net business income. . . . . . . . . . . . . . . 29 16,449 16,449
Allocated Income Column A Column B
Total Gross Owner's Share Idaho Amount
30. Guaranteed payments sourced as compensation to Idaho 30
31. Guaranteed payments sourced as compensation
to another state . . . . . . . . . . . . . . . . . . . . . . . 31
32. Other allocated income. Include schedule . . . . . . . . . 32
33. Total allocated income . . . . . . . . . . . . . . . . . . . 33
34. Idaho distributable income . . . . . . . . . . . . . . . . 34 16,449 16,449
Part V - Composite Filing and Pass-through Withholding Idaho Amount

35. Owner's income reported on the entity's composite return. . . ................ 35


. . . . . . . . . . . . . . . . . . .36.Multiplyline35by6.925% . . ................ 36
37. Share of Idaho credits claimed on behalf of the owner . . . .. ................ 37
. . . . . . . . . . . . .38.Taxpaidbytheentityonbehalfoftheowneroncompositereturn 38
39. Tax withheld by the entity on behalf of the owner . . . . .. ................ 39
Part VI - Pass-through Informational Items

40. Capital gain (loss) eligible for the Idaho capital gains deduction:
b. Date acquired c. Date sold d.Distributive share
a. Description of property and Idaho location:
(mm/dd/yyyy) (mm/dd/yyyy) of gain or (loss)

Federal Idaho

41. Interest expense offset total income . . . . . . . . . . . 41


EFO00201 09-27-2019 Page 2 of 3
Form PTE-12
IDAHO Schedule of Pass-through Owners 1024
State Tax Commission
(Required with Forms 41S, 65 or 66)
Pass-through entity (PTE) name PTE EIN PTE tax year beginning PTE tax year ending
CLEAN LIVING LLC 47-4726043 01-01-2019 12-31-2019
Contact name Contact phone number Contact email address

Other Composite Withholding


(a) (b) (c) (d) (e) (f)
EIN or Idaho Idaho Income Idaho Income
Owner's Name Social Security Owner's Address Filing Distributable Distributable Tax Paid Distributable Tax Withheld
(one owner per line) Number City, State and ZIP Code Code Income Income by Entity Income by Entity
4821 E FREE CIRCLE
IDAHO FALLS
REBECCA WARD 518-25-3300 ID 83401 R 16,449
4821 E FREE CIRCLE
IDAHO FALLS
KEVIN WARD 357-72-6788 ID 83401 R 16,449

Total Columns (b), (c), (d), (e) and (f)


If you have more than one schedule, enter the total amounts on the last page only. 32,898
Page 1 of 1
EFO00241 12-04-2019
IDEF_ACK Acknowledgement and General Information for 2019
Taxpayers Who File Returns Electronically
Name(s) as shown on return Identification Number
CLEAN LIVING LLC **-***6043

Address

4821 E FREE CIR


IDAHO FALLS, ID 83401

Thank you for participating in IRS e-file.

1. X Your 2019 state income tax return for ID41S was filed electronically.
The electronic filing services were provided by Knuff & Kunde CPAs .

2. X Your return was accepted on 06-12-2020using a Personal Identification Number (PIN) as your electronic
signature. You entered a PIN or authorized the Electronic Return Originator (ERO) to enter or generate a PIN
for you.
The submission ID assigned to this return is 8205192020163n5gfnat .

PLEASE DO NOT SEND A PAPER COPY OF THE TAX RETURN TO THE


STATE. IF YOU DO, IT WILL DELAY THE PROCESSING OF THE RETURN.

IDEF_ACK.LD

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