Name(s) shown on returnfield contains Charles and Lily Woods
Your social security numberfield contains 123-00-4567
Part I: Income or Loss From Rental Real Estate and Royalties Note. If you are in the business of renting personal property, use Schedule C or C-EZ (see instructions). If you are an individual, report farm rental income or loss from Form 4835 on page 2, line 40.:
1. Physical address of each property–street, city, state, zip:
Afield contains 6924 Country Road, Anytown, VA 22306
Type-from list belowfield contains 1
Bfield contains 6915 Country Road, Anytown, VA 22306
Type-from list belowfield contains 1
2. For each rental real estate property listed , report the number of days rented at fair rental value and days with personal use. See instructions.)
A
Fair Rental Daysfield contains 365
Personal Use Daysfield contains 0
B
Fair Rental Daysfield contains 365
Personal Use Daysfield contains 0
| Properties: A | Properties: B | |
|---|---|---|
| Income: 3a. Merchant card and third party payments. For 2011 enter -0- | -0- | -0- |
| Income: 3b. Payments not reported to you on line 3a | 25,000 | 8,300 |
| Income: 4. Totals not including amounts on line 3a that are not income | 25,000 | 8,300 |
| Expenses: 5. Advertising | 600 | 210 |
| Expenses: 7. Cleaning and Maintenance | 1,500 | 525 |
| Expenses: 8. Commissions | 1,200 | 420 |
| Expenses: 9. Insurance | 2,000 | 700 |
| Expenses: 10. Legal and other professional fees | 1,000 | 390 |
| Expenses: 12. Mortgage interest paid to banks, etcetera. (see page E-5) | 9,000 | 8,510 |
| Expenses: 14. Repairs | 700 | 245 |
| Expenses: 15. Supplies | 600 | 210 |
| Expenses: 16. Taxes | 2,000 | 700 |
| Expenses: 17. Utilities | 2,400 | 840 |
| Expenses: 18. Depreciation expense or depletion | 10,000 | 4,000 |
| 19. Other (list): Wages and salaries | 9,000 | 3,150 |
| 20. Total expenses. Add lines 5 through 19. | 40,000 | 19,900 |
| 21. Subtract line 20 from line 4. If result is a (loss), see the instructions to find out if you must file Form 6198/ | negative 15,000 | negative 11,600 |
| 22. Deductible rental real estate loss after limitation, if any, on Form 8582 (see instructions) | negative 6,155 | negative 3,546 |
23c. Total of all amounts reported on line 4 for all rental propertiesfield contains 33,300
23e. Total of all amounts reported on line 12 for all propertiesfield contains 17,510
23f. Total of all amounts reported on line 18 for all propertiesfield contains 14,000
23g. Total of all amounts reported on line 20 for all propertiesfield contains 59,900
25. Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses herefield contains negative 9,701
26. Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. If Parts II, III, IV, and line 40 on page 2 do not apply to you, also enter this amount on Form 1040, line 17, or Form 1040NR, line 18. Otherwise, include this amount in the total on line 41 on page 2field contains negative 9,701