% % Final Amended
1 Ordinary business income (loss) 1
10 Net Section 1231 gain (loss) 10
11 Other income (loss) 11
12 Charitable contributions 12
13 Section 179 expense deduction 13
14 Other deductions and losses 14
15 Qualified U S government interest deduction 15
16 State and local bond interest and dividend income 16
17 Income (loss) from non Nebraska sources (use only if you checked the LLC box above) 17
18 Community Development Assistance Act credit 18
19 Form 3800N credits (see instructions)
2 Net income (loss) from rental real estate activities 2
20 Contractor withholding (see instructions) 20
21 Nebraska income tax withheld (see instructions) 21
3 Net income (loss) from other rental activities 3
4 Guaranteed payments 4
5 Interest income 5
6 Dividend income 6
7 Royalties 7
8 Net short term capital gain (loss) 8
9 Net long term capital gain (loss) 9
a Employment and Investment Growth Act 19 a $
Apportionment Factor
b Nebraska Advantage Act 19 b $
Beginning 20 and Ending 20
c Nebraska Advantage Rural Development Act 19 c $
Check One:
d Nebraska Advantage Research and Development Act 19 d $
e New Markets Tax Credit 19 e $
Other (describe)
Partnership LLC
Partnership s Nebraska Nebraska Receipts Total Receipts Partner s Share of Income Percentage If applicable check the appropriate box:
Resident Individual Nonresident Individual Estate or Trust
Taxable Year of Organization
Total of 19a through 19e 19
8 691 2014
Check One: Nebraska ID Number Federal ID Number
City State Zip Code City State Zip Code
FORM 1065N
Legal Name
Name Doing Business As (dba) Name
Nebraska ID Number Federal ID Number Social Security Number Spouse s Social Security Number
Nebraska Schedule K 1N
Part A
Part B
Part C
Partner s Name and Mailing Address
Partner s Share of Credits
Partner s Share of Income and Deductions
Partner s Share of Income Deductions Modifications and Credits
Partner s Share of Modifications
Partnership s Name and Mailing Address
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
