Form 1041N-K-1N Fillable Beneficiary's Share of Income, Deductions, Modifications, and Credits (1/2015)
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

1 Ordinary business income (loss) 1 10 Other deductions and losses 10 11 Qualified U S government interest deduction 11 12 State and local bond interest and dividend income 12 13 Community Development Assistance Act credit 13 14 Form 3800N credits (see instructions) 15 Angel investment tax credit 15 16 Nebraska income tax withheld (see instructions) 16 2 Net income (loss) from rental real estate activities 2 3 Net income (loss) from other rental activities 3 4 Interest income 4 5 Dividend income 5 6 Net short term capital gain (loss) 6 7 Net long term capital gain (loss) 7 8 Other income 8 9 Estate tax 9 a Employment and Investment Growth Act 14 a $ b Nebraska Advantage Act 14 b $ Beginning 20 and Ending 20 c Nebraska Advantage Rural Development Act 14 c $ d Nebraska Advantage Research and Development Act 14 d $ e New Markets Tax Credit 14 e $ Final Amended If applicable check the appropriate box: Check One: Other (describe) Resident Individual Nonresident Individual Estate or Trust Total of 14a through 14e 14 8 693 2014 Beneficiary s Name and Mailing Address Beneficiary s Share of Credits Beneficiary s Share of Income and Deductions Beneficiary s Share of Income Deductions Modifications and Credits Beneficiary s Share of Modifications City State Zip Code City State Zip Code Estate s or Trust s Name and Mailing Address Form 1041N Legal Name Name Doing Business As (dba) Name Nebraska ID Number Federal ID Number Nebraska ID Number Federal ID Number Nebraska Schedule K 1N Part A Part B Part C revenue nebraska gov 800 742 7474 (NE and IA) 402 471 5729 Schedule K 1N Street or Other Mailing Address Street or Other Mailing Address Taxable Year of Organization Social Security Number Spouse s Social Security Number