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SCHEDULE E Supplemental Income and Loss OMB No.1545-0074 <br /> (Form 1040) 2012 <br /> (From rental real estate,royalties,partnerships,S corporations,estates,trusts,REMICs,etc.) <br /> ■ Attach to Form 1040,1040NR,or Form 1041. <br /> Department of the Treasury Attachment <br /> Internal Revenue Service (99) ■ Information about Schedule E and its separate instructions Is at www.irs.gov/rorm1040. Sequence No. 13 <br /> Name(s)shown on return <br /> <br /> Part I Income or Loss From Rental Real Estate and Royalties Note.If you are in the business of renting personal property,use <br /> 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. <br /> A Did you make any payments in 2012 that would require you to file Form(s)1099?(see instructions) ❑ Yes © No <br /> B If"Yes,"did you or will you file required Forms 1099? ❑ Yes D No <br /> 1a Physical address of each property(street,city,state,ZIP code) <br /> A 182 Depot Drive Verona,WI 53593 <br /> B 6610 Sun Valley Parkway Belleville,WI 53508 <br /> C <br /> 1 b Type of Property 2 Personal Use <br /> For each rental real estate property listed Fair Rental Days QJV <br /> (from list below) above,report the number of fair rental and Days <br /> A 1 personal use days.Check the QJV box A <br /> B 1 only if you meet the requirements to file as B ' <br /> a qualified joint venture.See instructions. <br /> C C <br /> Type of Property: <br /> 1 Single Family Residence 3 Vacation/Short-Term Rental 5 Land 7 Self-Rental <br /> 2 Multi-Family Residence 4 Commercial 6 Royalties 8 Other(describe) <br /> Income: I Properties: A B C <br /> 3 Rents received 3 7,968 16,460 <br /> 4 Royalties received 4 <br /> Expenses: <br /> 5 Advertising 5 <br /> 6 Auto and travel(see instructions) 6 37 <br /> 7 Cleaning and maintenance 7_ _ 214 <br /> 8 Commissions 8 <br /> 9 Insurance 9 1,625 <br /> 10 Legal and other professional fees 10 81 <br /> 11 Management fees 11 <br /> 12 Mortgage interest paid to banks,etc.(see instructions). . 12 4,891 <br /> 13 Other interest. . 13 <br /> 14 Repairs 14 124 6,388 <br /> 15 Supplies 15 2,522 <br /> 16 Taxes 16 <br /> 17 Utilities 17 1,901 <br /> 18 Depreciation expense or depletion 18 1,754 40,664 <br /> 19 Other(list) • See attached statement 19 4,270 <br /> 20 Total expenses.Add lines 5 through 19 20 6,769 57,702 <br /> 21 Subtract line 20 from line 3(rents)and/or 4(royalties).If <br /> result is a(loss),see instructions to find out if you must <br /> file Form 6198 21 1,199 -41,242 <br /> 22 Deductible rental real estate loss after limitation,if any, <br /> on Form 8582(see instructions) 22 ( 1,199 ) ( ) ) <br /> 23 a Total of all amounts reported on line 3 for all rental properties 23a 24,428 <br /> b Total of all amounts reported on line 4 for all royalty properties 23b 0 <br /> c Total of all amounts reported on line 12 for all properties 23c 4,891 A401, , <br /> d Total of all amounts reported on line 18 for all properties 23d 42,418 k <br /> e Total of all amounts reported on line 20 for all properties 23e 64,471F' <br /> 24 Income.Add positive amounts shown on line 21.Do not include any losses 24 1,199 <br /> 25 Losses.Add royalty losses from line 21 and rental real estate losses from line 22.Enter total losses here. . . 25 ( 1,199 ) <br /> 26 Total rental real estate and royalty income or(loss).Combine lines 24 and 25.Enter the result here. <br /> If Parts II,Ill,IV,and line 40 on page 2 do not apply to you,also enter this amount on Form 1040,line <br /> 17,or Form 1040NR,line 18.Otherwise,include this amount in the total on line 41 on page 2 26 0 <br /> For Paperwork Reduction Act Notice,see your tax return instructions. Schedule E(Form 1040)2012 <br /> HTA <br />