661117 
                                                                                           Final K-1           Amended K-1    OMB No. 1545-0092 
Schedule K-1                                                             Part III                    Beneficiary’s Share of Current Year Income,  
(Form 1041)                                                       2022                               Deductions, Credits, and Other Items 
Department of the Treasury           For calendar year 2022, or tax year 1                 Interest income                 11 Final year deductions
Internal Revenue Service 
     beginning              / /       ending                      / /    2a                Ordinary dividends

Beneficiary’s Share of Income, Deductions,                               2b                Qualified dividends
Credits, etc.                         See back of form and instructions. 
Part I  Information About the Estate or Trust                            3                 Net short-term capital gain
A    Estate’s or trust’s employer identification number 
                                                                         4a                Net long-term capital gain

B    Estate’s or trust’s name                                            4b                28% rate gain                   12 Alternative minimum tax adjustment

                                                                         4c                Unrecaptured section 1250 gain

                                                                         5                 Other portfolio and 
C    Fiduciary’s name, address, city, state, and ZIP code                                  nonbusiness income

                                                                         6                 Ordinary business income

                                                                         7                 Net rental real estate income
                                                                                                                           13 Credits and credit recapture
                                                                         8                 Other rental income

                                                                         9                 Directly apportioned deductions
D    Check if Form 1041-T was filed and enter the date it was filed 

                                                                                                                           14 Other information
E    Check if this is the final Form 1041 for the estate or trust 

Part II Information About the Beneficiary                                10                Estate tax deduction
F    Beneficiary’s identifying number

G    Beneficiary’s name, address, city, state, and ZIP code

                                                                         *See attached statement for additional information. 
                                                                         Note: A statement must be attached showing the 
                                                                         beneficiary’s share of income and directly apportioned 
                                                                         deductions from each business, rental real estate, and 
                                                                         other rental activity. 

H    Domestic beneficiary            Foreign beneficiary                  For IRS Use Only 
For Paperwork Reduction Act Notice, see the Instructions for Form 1041. www.irs.gov/Form1041               Cat. No. 11380D    Schedule K-1 (Form 1041) 2022

Schedule K-1 (Form 1041) 2022                                                                                                                                Page 2 
This list identifies the codes used on Schedule K-1 for beneficiaries and provides summarized reporting information for 
beneficiaries who file Form 1040 or 1040-SR. For detailed reporting and filing information, see the Instructions for Schedule 
K-1 (Form 1041) for a Beneficiary Filing Form 1040 or 1040-SR and the instructions for your income tax return. 

                                             Report on 
1.   Interest income                         Form 1040 or 1040-SR, line 2b            13. Credits and credit recapture 
2a. Ordinary dividends                       Form 1040 or 1040-SR, line 3b            Code                                        Report on 
2b. Qualified dividends                      Form 1040 or 1040-SR, line 3a            A Credit for estimated taxes                Form 1040 or 1040-SR, line 26
3.   Net short-term capital gain             Schedule D, line 5                       B Credit for backup withholding             Form 1040 or 1040-SR, line 25c
4a. Net long-term capital gain               Schedule D, line 12                      C Low-income housing credit 
4b. 28% rate gain                            28% Rate Gain Worksheet, line 4          D Rehabilitation credit and energy credit 
                                             (Schedule D Instructions)                E Other qualifying investment credit
4c. Unrecaptured section 1250 gain           Unrecaptured Section 1250 Gain           F  Work opportunity credit 
                                             Worksheet, line 11 (Schedule D           G Credit for small employer health 
                                             Instructions)                               insurance premiums
5.   Other portfolio and nonbusiness         Schedule E, line 33, column (f)          H Biofuel producer credit 
income                                                                                I Credit for increasing research activities 
6.   Ordinary business income                Schedule E, line 33, column (d)          J  Renewable electricity, refined coal, 
                                             or (f)                                      and Indian coal production credit 
7.   Net rental real estate income           Schedule E, line 33, column (d)          K Empowerment zone employment credit        See the beneficiary’s instructions 
                                             or (f)                                   L Indian employment credit 
8.   Other rental income                     Schedule E, line 33, column (d)          M Orphan drug credit 
                                             or (f)                                   N Credit for employer-provided child      
9.   Directly apportioned deductions                                                     care and facilities 
     Code                                                                             O Biodiesel and renewable diesel  fuels 
     A Depreciation                          Form 8582 or Schedule E, line               credit 
                                             33, column (c) or (e)                    P Credit to holders of tax credit bonds 
     B Depletion                             Form 8582 or Schedule E, line            Q Credit for employer differential wage 
                                             33, column (c) or (e)                       payments 
     C Amortization                          Form 8582 or Schedule E, line            R Recapture of credits 
                                             33, column (c) or (e)                    Z Other credits 
10. Estate tax deduction                     Schedule A, line 16                      14. Other information                     }
11. Final year deductions                                                             A Tax-exempt interest                       Form 1040 or 1040-SR, line 2a 
     A Excess deductions – Section 67(e)     Schedule 1 (Form 1040), line 24k         B Foreign taxes                             Schedule 3 (Form 1040), line 1 or 
       expenses                              (also see the beneficiary’s                                                          Schedule A, line 6 
                                             instructions)
     B Excess deductions – Non–miscellaneous See the beneficiary’s instructions       C Reserved for future use
     itemized deductions
     C Short-term capital loss carryover     Schedule D, line 5                       D Reserved for future use
                                             Schedule D, line 12; line 5 of the       E Net investment income                     Form 4952, line 4a 
     D Long-term capital loss carryover      wksht. for Sch. D, line 18; and  line 16 F Gross farm and fishing income             Schedule E, line 42 
                                             of the wksht. for Sch. D,  line 19 
     E Net operating loss carryover —        Schedule 1 (Form 1040), line 8a          G Foreign trading gross receipts            See the Instructions for  
       regular tax                                                                       (IRC 942(a))                             Form 8873 
     F Net operating loss carryover —        Form 6251, line 2f                       H Adjustment for section 1411 net           Form 8960, line 7 (also see the 
       minimum tax                                                                       investment income or deductions          beneficiary’s instructions)
12. Alternative minimum tax (AMT) items                                               I  Section 199A information                 See the beneficiary’s instructions 
     A Adjustment for minimum tax purposes   Form 6251, line 2j
                                                                                      Z Other information                         See the beneficiary’s instructions 
     B AMT adjustment attributable to  
       qualified dividends                                                            Note:  If you are a beneficiary who does not file a Form 1040 or 1040-SR, 
                                                                                      see instructions for the type of income tax return you are filing. 
     C AMT adjustment attributable to 
       net short-term capital gain 
     D AMT adjustment attributable to 
       net long-term capital gain 
                                             See the beneficiary’s 
     E AMT adjustment attributable to        instructions and the 
       unrecaptured section 1250 gain        Instructions for Form 6251 
     F  AMT adjustment attributable to 
       28% rate gain 
     G Accelerated depreciation 
     H Depletion 
      I  Amortization 
     J Exclusion items                   } 2023 Form 8801