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SU0004405
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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SA-01-63
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SU0004405
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Entry Properties
Last modified
12/18/2019 11:07:57 AM
Creation date
12/5/2019 8:22:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0004405
PE
2632
FACILITY_NAME
SA-01-63
STREET_NUMBER
4124
Direction
N
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
ENTERED_DATE
5/19/2004 12:00:00 AM
SITE_LOCATION
4124 N WEST LN
RECEIVED_DATE
9/4/2001 12:00:00 AM
QC Status
Approved
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EHD - Public
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CALIFORNIA SCHEDULE <br /> NTF _ K-1 (568 ji <br /> YEARfillembe�'s Share of Income, <br /> Credits, etc- day year <br /> 2000 Deductions, ear 2wo,and ending month <br /> onth day y <br /> For Calendar year 2040 or fiscal ve LLCs FE 6 8-0 4 6 6 8 4 <br /> Member's identifying number P Code secretary of State til fa 1009100 <br /> d ZIP Q Code7 7 <br /> Member's name,address,state,and ZI LLC's name,address, <br /> Stlfte <br /> Stockton Deja Vu BoutigUe, LLC <br /> Hugh Griesbach8252 E Lansing Rd, <br /> 3000Sunrise Blvdp, 95'742• quite 2-3-5 <br /> Durand, MI 48429 <br /> Rancho Cordova, <br /> D Member's share of Liabilities: • S <br /> e of entity is this member? • Nonrecourse.• <br /> A What type uc • $ <br /> (1) Individual (5) General Partnership (8) h15EP Qualified nonrecourse finaming-- <br /> IRA1Koo9 ® $ <br /> (2) s Corporation (6) Limited Partnership 10 t r •.• ••••-••,,,. .. <br /> (14) �a%at o^ istratron number <br /> (3) EstatelTrust (7) LLP E Tax she}ter reg berrcly traded Partnership <br /> (g) C Corporation ful F (1) Check stere it this is a F <br /> • [] yes on 469(k)(2) -- -• • .... ... ..... .. . . .. <br /> End of year as defined in IRC Section ent partnership <br /> 8 is this member a foreign I) setore -•''-s e (2) Check here if this is an investment [-i <br /> i Before decrease � LJ <br /> C Enter member's () <br /> percentage(without or termination (R&4Ctions 17955 and 23044.7) -'''''' <br /> regard to special <br /> allocations)of 25 .0 C Check here if this is: • An amended Schedule K-1 (568) <br /> '/' • a (1) 11Afinal Schedule K-1 {55a}(� ❑ ❑Yes• ®No <br /> Profit sharing ..•.. % <br /> o/ His this member a nonresident of California? -..•.. ... <br /> Loss sharing .. . . . . % • <br /> Ownership of capital <br /> e) Capital account at end <br /> account (c ember's share of (d) Withdrativais and of year(combine column <br /> I Analysis of member's capitalons a throLi column d <br /> b Capita►contributed line 3,line 4,and tine 7 distributions <br /> (a) Capital account at ( ) during year Form 568.Schedule M-2 <br /> beginning of year ) • - <br /> • ( schedule on your Cardomia return- <br /> form from this sche e) California <br /> • edule K-1 (568)before entering d Total amounts wing <br /> b) Amounts from a California (d) Total sourceamounts <br /> Caution: Refer to Members inswctions for Sch <br /> a Distributive share' federal ScOhedule K-i adjustments coL(b)and Col.(0) <br /> and aedrts <br /> 65) <br /> 1 Ordinary income(loss)from trade <br /> or business activities•••• •.•.•''. 1' <br /> 2 Net income(loss) <br /> from rental real - <br /> estate activities .•••..•.•••'''• <br /> 3 Net incomo(loss)from other nntatactivstios _ 0 <br /> 4 Portfolio income(loss). I. <br /> Income a interest•---•--•-••---- <br /> (loss) D Dividends.......-. • <br /> 10. <br /> c Royalties................... <br /> ..••. <br /> d Net capital gain(loss)•....... . 111. <br /> • <br /> e ether porifofto income(loss)• , <br /> �-_ <br /> Attach schedule .•.••••.•.•.. <br /> 5 Guaranteed payments to members ► <br /> 6 Net gain (loss)under IRC Section • <br /> 123.1 (other than due to casualty D <br /> or theft- - -•-.. ....��schedule <br /> - <br /> 7 Other income(loss). <br /> 8 Charitable contributions.. .. ..••• <br /> g Fxensededuction for R&TC Sectionrecovery72i7•� <br /> property perry <br /> 17267.6,17268,and IRC <br /> Deduc- Section 179).Attach schedule----- <br /> tions <br /> -.•.tions 10 Deductions related to portfolio <br /> income.Attach schedule. .. •••••. <br /> t i Other deductions.Attach schedule <br /> p CA568K1 NTF3t959 <br /> K15 6 8 0 010 4 0 8 3 � Schedule K-t {568)2000 Side <br /> Partner 43 <br />
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