Error Report For Lori Corp: o 1120 Warning: This Corporation should file forms for Tax Year 2011.

o 1120 Error:

The Business activity code no. is not valid; must be between 111100 and 813000 OR if applicable, enter "Inactive".

o 1120 Warning:

Determine whether the IRS may discuss this return with the preparer and select appropriate response box.

o 1120 Warning:

The amount entered as buildings and other depreciable assets at the end of tax year on Sch L does not equal the amount from Form 4562.

o 1120 Warning:

The amount entered as accumulated depreciation at the end of tax year on Sch L does not equal the amount from Form 4562.

o 1120 Warning:

The end-of-year unappropriated retained earnings reported on Sch L should equal the amount reported on Sch M-2.

o 1120 Warning:

The Corporation qualifies as a small corporation or is otherwise exempt from the alternative minimum tax.

o 1120 Informational:

Either the Yes or the No box should be checked.

Override and Estimate Report For Lori Corp: o No results were found. Please review your return carefully.

2010 Tax Summary (1120)
Federal Information

Lori Corp

13-1928472

Total Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $700,000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... Total Deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . $430,900. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... Taxable Income (Loss) . . . . . . . . . . . . . . . . . . . . . . $227,100. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... Total Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $71,819. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... Overpayment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$28,181 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... Amount Applied . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Refund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$28,181 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...... Amount Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..

2010 Carryover Summary (1120)
Other Carryovers to 2011

Lori Corp

13-1928472

Regular AMT Form 1120: Charitable contributions carryover to 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $58,100

Filing Checklist for 2010 Tax Returns
To file your 2010 tax return(s), simply follow these instructions:

Federal - (Form 1120) 1. Sign and date your return.
An officer must sign and date the tax return.

2. Tax due/Overpayment
No tax is due. $28,181.00 will be refunded to you.

3. Mail the return.
Send the return and all accompanying attachments to the following address: Department of the Treasury Internal Revenue Service Center Cincinnati, OH 45999-0012 On or before the extended due date: As soon as possible

Using the United States Post Office certified mail service or another approved delivery service which provides a proof of mailing date, including DHL Express (DHL), Federal Express (FedEx), and United Parcel Service (UPS).

4. Keep a copy.
Print a second copy of the return for your records. We also recommend you print and retain the supporting schedules and all other documentation that is not sent in with your return.

Form

1120

U.S. Corporation Income Tax Return
For calendar year 2010 or tax year beginning 1/16/2011 See separate instructions.
Name

OMB No. 1545-0123

Department of the Treasury Internal Revenue Service A Check if: 1a Consolidated return (attach Form 851) . . b Life/nonlife consolidated return . . . . . 2 Personal holding co. (attach Sch. PH) . . . 3 Personal service corp. (see instructions) . . . 4 Schedule M-3 attached

, ending

1/16/2012
B Employer identification number

. . . . Use IRS . . Lori . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-1928472 . . . . . . Corp . . . . . label. Number, street, and room or suite no. If a P.O. box, see instructions. C Date incorporated . . . .Otherwise, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Before . . . see Options tab. . . . . . . . . 1900, . .

print or

4444 campbell ave.

1/16/2011

. . . . type. . . . . . . or town . . . . . . . . . . . State. . . . . . . . ZIP.code. . . . . D . Total assets (see instructions) . . City . . . . . . . . . . . . . . . . . . . . . . . . . . Chicago . . . . . . . . . . . . IL . . . . . . . . . 60618 . . . . . $ . . . . . . . . . 1,150,000 . . . . . . . . . E Check if:

Dr af t
Deductions (See instructions for limitations on deductions.) Income Tax, Refundable Credits, and Payments 30 31 32a b c e f g 33 34 35 36

1a 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

b Less returns and allowances c Bal 1c 900,000 Cost of goods sold (Schedule A, line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . 260,000. . . . . . . . Gross profit. Subtract line 2 from line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 . . . . .640,000 . . . . . . . . Dividends (Schedule C, line 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . 60,000. . . . . . . . Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . . . . . . . Gross rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . . . . . . . Gross royalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . . . . . . . . . . . . . Capital gain net income (attach Schedule D (Form 1120)) . . . . . . . . . . . . . . . . . . . . . . . . .8 . . . . . . . . . . . . . Net gain or (loss) from Form 4797, Part II, line 17 (attach Form 4797) . . . . . . . . . . .. .. . . . . . . . .. .. . . 9.. . . . . . . . . . .. .. . .. .. . . . Other income (see instructions—attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Total income. Add lines 3 through 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . . . . 700,000 . . . . . . . . . Compensation of officers (Schedule E, line 4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 . . . . 100,000 . . . . . . . . . Salaries and wages (less employment credits) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 . . . . .90,000 . . . . . . . . Repairs and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 . . . . . . . . . . . . . Bad debts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 . . . . . . . . . . . . . Rents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 . . . . 181,000 . . . . . . . . . Taxes and licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 . . . . . . . . . . . . . Charitable contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . .29,900. . . . . . . . Depreciation from Form 4562 not claimed on Schedule A or elsewhere on return (attach Form 4562) . . . . . . . 20 . . . . . . . . . . . . . . Depletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 . . . . . . . . . . . . . . Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 . . . . . . . . . . . . . Pension, profit-sharing, etc., plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23. . . . . . . . . . . . . Employee benefit programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 . . . . . . . . . . . . . Domestic production activities deduction (attach Form 8903) . . . . . . . . . . . . . . . . . . . . . . . 25 . . . . . . . . . . . . . Other deductions (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 . . . . . 30,000 . . . . . . . . Total deductions. Add lines 12 through 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 . . . . 430,900 . . . . . . . . . Taxable income before net operating loss deduction and special deductions. Subtract line 27 from line 11 . . . . . 28. . . . .269,100 . . . . . . . . . Less: a Net operating loss deduction (see instructions) . . . . . . . . . . . . 29a. . . . . . . . . . . . . . . . . . . . . . . . . b Special deductions (Schedule C, line 20) . . . . . . . . . . . . . . 29b . . . . . 42,000 . . 29c. . . . . 42,000 . . . . . . . . . . . . . Taxable income. Subtract line 29c from line 28 (see instructions) . . . . . . . . . . . . . . . . .. . . . . . . . 30 .. . . .. 227,100 . . . . . .. .. . . . . . Total tax (Schedule J, line 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31. . . . . 71,819. . . . . . . . 2009 overpayment credited to 2010 . . . . . . .32a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2010 estimated tax payments . . . . . . . . . .. . . . 32b. . . . 100,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2010 refund applied for on Form 4466 . . . . . .32c . .( . . . . . . .) . Bal . . 32d . . . . 100,000 . . . . . . . . . . . . . . . . d . . . . . . . Tax deposited with Form 7004 . . . . . . . . . . . . . . . . . . . . . . . 32e . . . . . . . . . . . . . . . . . . . . . . . . . Credits: (1) Form 2439 (2) Form 4136 32f 0 Refundable credits from Form 3800, line 19c, and Form 8827, line 8c . . . . . . . . 32g . . . . . . . . . . . . . . . . 100,000. . . . . . 32h . . . Gross receipts or sales

X 900,000
(1)

Initial return

(2)

Final return

(3)

Name change

(4)

Address change

Estimated tax penalty (see instructions). Check if Form 2220 is attached . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Amount owed. If line 32h is smaller than the total of lines 31 and 33, enter amount owed . . . . . . . . . . . . 34 . . . . . . . 0 . . . . . . Overpayment. If line 32h is larger than the total of lines 31 and 33, enter amount overpaid . . . . . . . . . . . 35 . . . . . 28,181 . . . . . . . . . Enter amount from line 35 you want: Credited to 2011 estimated tax Refunded 36 28,181
May the IRS discuss this return with the preparer shown below (see instructions)? Yes No PTIN

Sign Here

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

8/18/2012

CFO Andrew Chia
Date

Signature of officer

Date

Title

Print/Type preparer's name

Preparer's signature

Paid Preparer's Use Only
(HTA)

SELF-PREPARED RETURN
Firm's name Firm's address City State

Check if self-employed Firm's EIN Phone no. ZIP code

For Paperwork Reduction Act Notice, see separate instructions.

Form

1120 (2010)

Form 1120 (2010)

Lori Corp

13-1928472

Page

2

Schedule A
1 2 3 4 5 6 7 8 9a

Cost of Goods Sold (see instructions)

Inventory at beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Purchases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . . . . 260,000. . . . . . . . . Cost of labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . . . . . . . Additional section 263A costs (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Other costs (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 . . . . . . . . . . . . . . . . . . . Total. Add lines 1 through 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. . . . . . . . . . 260,000. . . . . . . . . Inventory at end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 . . . . . . . . . . . . . . . . . . . Cost of goods sold. Subtract line 7 from line 6. Enter here and on page 1, line 2 . . . . . . . . . . . 8 . . . . . . . . . . 260,000. . . . . . . . . Check all methods used for valuing closing inventory: (i) X Cost (ii) (iii) Lower of cost or market Other (Specify method used and attach explanation.)

Dr af t
Schedule C Dividends and Special Deductions (see instructions)
(a) Dividends received (b) %

b Check if there was a writedown of subnormal goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Check if the LIFO inventory method was adopted this tax year for any goods (if checked, attach Form 970) . . . . . . . . . . . . . . . . . . . .

d If the LIFO inventory method was used for this tax year, enter percentage (or amounts) of closing inventory computed under LIFO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9d. . . . . . . . . . . . . . . . . . . . e If property is produced or acquired for resale, do the rules of section 263A apply to the corporation? . . . . . . . . . . Yes . . . . .No . . . . . . . . f Was there any change in determining quantities, cost, or valuations between opening and closing inventory? If "Yes," attach explanation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes . . . . X . No . . . . . . .
(c) Special deductions (a) x (b)

1 2

Dividends from less-than-20%-owned domestic corporations (other than

debt-financed stock) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60,000 . . 70. . . . . . . . 42,000 . . . . . Dividends from 20%-or-more-owned domestic corporations (other than

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

0 debt-financed stock) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80 . . . . . . . . . . Dividends on debt-financed stock of domestic and foreign corporations . . . . . . . . . . . . . . . . . .see instruct.. . . . . . . . . 0 . . . . . . . Dividends on certain preferred stock of less-than-20%-owned public utilities . . . . . . . . . . . . . . . . . 42. . . . . . . . . . . 0 . . . . Dividends on certain preferred stock of 20%-or-more-owned public utilities . . . . . . . . . . . . . . . . . . 48 . . . . . . . . . . 0 . . . . . Dividends from less-than-20%-owned foreign corporations and certain FSCs . . . . . . . . . . . . . . . . . 70 . . . . . . . . . . 0 . . . . . Dividends from 20%-or-more-owned foreign corporations and certain FSCs . . . . . . . . . . . . . . . . . 80 . . . . . . . . . . .0 . . . . Dividends from wholly owned foreign subsidiaries . . . . . . . . . . . . . . . . . . . . . . . . . . . 100. . . . . . . . . . 0 . Total. Add lines 1 through 8. See instructions for limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42,000 . . . . . . Dividends from domestic corporations received by a small business investment

company operating under the Small Business Investment Act of 1958 . . . . . . . . . . . . . . . . . . .100 . . . . . . . . . . 0 . . . . . Dividends from affiliated group members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100. . . . . . . . . . .0 . . . . Dividends from certain FSCs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100 . . . . . . . . . . 0 . Dividends from foreign corporations not included on lines 3, 6, 7, 8, 11, or 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Income from controlled foreign corporations under subpart F (attach Form(s) 5471) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Foreign dividend gross-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IC-DISC and former DISC dividends not included on lines 1, 2, or 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other dividends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deduction for dividends paid on certain preferred stock of public utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total dividends. Add lines 1 through 17. Enter here and on page 1, line 4 . . . . . . . . . . . . 60,000 . . . . . . . . . . . . . . . . . . . . . Total special deductions. Add lines 9, 10, 11, 12, and 18. Enter here and on page 1, line 29b . . . . . . . . . . . . . . . . . . 42,000. . . . . . .

Schedule E

Compensation of Officers (see instructions for page 1, line 12)
(b) Social security number (c) Percent of time devoted to business

Note: Complete Schedule E only if total receipts (line 1a plus lines 4 through 10 on page 1) are $500,000 or more.
Percent of corporation stock owned

(a) Name of officer

(f) Amount of compensation

(d) Common

(e) Preferred

1 Hanz Shruber Stubb

2 3 4

100,000 0 0 0 0 Total compensation of officers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100,000 . . . . . . . Compensation of officers claimed on Schedule A and elsewhere on return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . Subtract line 3 from line 2. Enter the result here and on page 1, line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . 100,000 . . . . . . .
Form

332-16-4978

80.00% % % % %

% % % % %

% % % % %

1120 (2010)

Form 1120 (2010)

Lori Corp

13-1928472

Page

3

Schedule J
1 2 3 4 5a b c d e 6 7 8 9 10 1 2 a b c 3

Tax Computation (see instructions)

Check if the corporation is a member of a controlled group (attach Schedule O (Form 1120)) . . . . . . . . . . . . . . . . . . . . . . . . . .

Form 8866 Form 8902 Other (attach schedule) . . . . . . . . . . . . . . . . . . . . . 9 Total tax. Add lines 7 through 9. Enter here and on page 1, line 31 . . . . . . . . .. .. . . . . . . . .. .. . .. .. . . . . . . 10 . . . . . 71,819 . . . . . . . . .

Schedule K

Other Information (see instructions)

Yes No X Accrual Check accounting method: a Cash b c Other (specify) See the instructions and enter the: Business activity code no. 813400 Business activity Toilet Paper Product or service product Is the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group? . . . . . . . . . . . . . . . . . . . . . . . X . . . .

If "Yes," enter name and EIN of the parent corporation

4 At the end of the tax year: a Did any foreign or domestic corporation, partnership (including any entity treated as a partnership), trust, or tax-exempt organization own directly 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all classes of the corporation's stock entitled to vote? If "Yes," complete Part I of Schedule G (Form 1120) (attach Schedule G) . . . . . . . . . . . . . . . . X . . . . b Did any individual or estate own directly 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all classes of the corporation's stock entitled to vote? If "Yes," complete Part II of Schedule G (Form 1120) (attach Schedule G) . . . . . . . . . . X . . . . 5 At the end of the tax year, did the corporation: a Own directly 20% or more, or own, directly or indirectly, 50% or more of the total voting power of all classes of stock entitled to vote of any foreign or domestic corporation not included on Form 851, Affiliations Schedule? For rules of constructive ownership, see instructions . . . . . . X . . . . If "Yes," complete (i) through (iv).
(i) Name of Corporation (ii) Employer Identification Number (if any) (iii) Country of Incorporation (iv) Percentage Owned in Voting Stock

Dr

af t
EIN Name
Form

Income tax. Check if a qualified personal service corporation (see instructions) . . .. . . . . . . . . . .. .. . .. .. . . . . . . . .. ..2 . . . . . 71,819 . . . . . . . . Alternative minimum tax (attach Form 4626) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . . Add lines 2 and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 . . . . . 71,819 . . . . . . . . Foreign tax credit (attach Form 1118) . . . . . . . . . . . . . . . . . . . . . . 5a . . . . . . . . . . . . . . . . . . . . . . . . . . Credit from Form 8834, line 29 . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . 5b . . . . . . . . . . . . . . . . . . . . . . . General business credit (attach Form 3800) . . . . . . . . . . . . . . . . . . . . 5c . . . . . . . . . . . . . . . . . . . . . . . . . . Credit for prior year minimum tax (attach Form 8827) . . . . . . . . . . . . . . . . 5d . . . . . . . . . . . . . . . . . . . . . . . . . . Bond credits from Form 8912 . . . . . . . . . . . . . . . . . . . . . . . . . . 5e . . . . . . . . . . . . . . . . . . . . . . . . . . Total credits. Add lines 5a through 5e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 . . . . . . . 0 . . . . . . . Subtract line 6 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . . . . .71,819 . . . . . . . . . Personal holding company tax (attach Schedule PH (Form 1120)) . . . . . . . . . . . . . . . . . . . . . . . .8 . . . . . . . . . . . . . Other taxes. Check if from: Form 4255 Form 8611 Form 8697

1120 (2010)

Form 1120 (2010)

Lori Corp

13-1928472

Page Yes

4

Schedule K

Continued

b Own directly an interest of 20% or more, or own, directly or indirectly, an interest of 50% or more in any foreign or domestic partnership (including an entity treated as a partnership) or in the beneficial interest of a trust? For rules of constructive ownership, see instructions . . . . . . X . . . . If "Yes," complete (i) through (iv).
(i) Name of Entity (ii) Employer Identification Number (if any) (iii) Country of Organization (iv) Maximum Percentage Owned in Profit, Loss, or Capital

6

During this tax year, did the corporation pay dividends (other than stock dividends and distributions in exchange for stock) in excess of the corporation's current and accumulated earnings and profits? (See sections 301 and 316.) . . . . . . . . . . . . . . . . . . .X . . . If "Yes," file Form 5452, Corporate Report of Nondividend Distributions. If this is a consolidated return, answer here for the parent corporation and on Form 851 for each subsidiary.

7

At any time during the tax year, did one foreign person own, directly or indirectly, at least 25% of (a) the total voting power of all classes of the corporation's stock entitled to vote or (b) the total value of all classes of the corporation's stock? . . . . . . . . . . . . . . . .X . . . . For rules of attribution, see section 318. If "Yes," enter: (i) Percentage owned and (ii) Owner's country (c) The corporation may have to file Form 5472, Information Return of a 25% Foreign-Owned U.S. Corporation or a Foreign Corporation Engaged in a U.S. Trade or Business. Enter the number of Forms 5472 attached

8 9 10 11

Check this box if the corporation issued publicly offered debt instruments with original issue discount . . . . . . . . . . . . . . . . . . . . . . . . If checked, the corporation may have to file Form 8281, Information Return for Publicly Offered Original Issue Discount Instruments. Enter the amount of tax-exempt interest received or accrued during the tax year Enter the number of shareholders at the end of the tax year (if 100 or fewer)

If the corporation has an NOL for the tax year and is electing to forego the carryback period, check here . . . . . . . . . . . . . . . . . . . . . . If the corporation is filing a consolidated return, the statement required by Regulations section 1.1502-21(b)(3) must be attached or the election will not be valid.

12 13

Enter the available NOL carryover from prior tax years (do not reduce it by any deduction on line 29a.)

Are the corporation's total receipts (line 1a plus lines 4 through 10 on page 1) for the tax year and its total assets at the end of the tax year less than $250,000? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X. . . . If "Yes," the corporation is not required to complete Schedules L, M-1, and M-2 on page 5. Instead, enter the total amount of cash distributions and the book value of property distributions (other than cash) made during the tax year. $

14

Is the corporation required to file Schedule UTP (Form 1120), Uncertain Tax Position Statement (see instructions)? . . . . . . . . . . . . . . . . . . If "Yes," complete and attach Schedule UTP.
Form

D

a r
$ $

t f

No

1120 (2010)

Form 1120 (2010)

Lori Corp

13-1928472
Beginning of tax year (a) (b) (c) End of tax year (d)

Page

5

Schedule L
1 2a b 3 4 5 6 7 8 9 10a b 11a b 12 13a b 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Balance Sheets per Books
Assets

Dr af t
Liabilities and Shareholders' Equity

Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 600,000 . . . . . . . . Trade notes and accounts receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 350,000 Less allowance for bad debts . . . . . . . . . . . . ( . . . . . . . . . . . . . . . . 0 . .( . . . . . . . ). . . . . . . . . . . . . ) 350,000 Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . U.S. government obligations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tax-exempt securities (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other current assets (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Loans to shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mortgage and real estate loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other investments (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Buildings and other depreciable assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250,000. . . . . . . . . . . . . . . . . Less accumulated depreciation . . . . . . . . . . . (. . . . . . . .) . . . . . . . . 0. . ( . . . . 50,000) . . . . . 200,000 . . . . . . . . . . . . Depletable assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less accumulated depletion . . . . . . . . . . . . ( . . . . . . . ) . . . . . . . . 0 . (. . . . . . . .) . . . . . . . . 0 . . . . . . . Land (net of any amortization) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Intangible assets (amortizable only) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Less accumulated amortization . . . . . . . . . . . (. . . . . . . .) . . . . . . . . 0. . ( . . . . . . . . . . . . . . . . 0. . . . . ) Other assets (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .0 . . . . . . . . . . . . . . . . . . . . . . 1,150,000

Accounts payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50,000 . . . . . . . Mortgages, notes, bonds payable in less than 1 year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other current liabilities (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Loans from shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mortgages, notes, bonds payable in 1 year or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other liabilities (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Capital stock: a Preferred stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Common stock . . . . . . . . . . . . . . . . . . . . . . . . . .0 . . . . . 300,000 . . . . . 300,000 . . . . . . . . . . . . Additional paid-in capital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Retained earnings—Appropriated (attach schedule) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .800,000 . . . . . . . . Retained earnings—Unappropriated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Adjustments to shareholders' equity (attach schedule) Less cost of treasury stock . . . . . . . . . . . . . . . . . . . . . .( . . . . . . . ) . . . . . . . . . .( . . . . . . . ). . . . . Total liabilities and shareholders' equity . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . .1,150,000 . . . . . . . .

Schedule M-1
1 2 3 4

Reconciliation of Income (Loss) per Books With Income per Return

Note: Schedule M-3 required instead of Schedule M-1 if total assets are $10 million or more—see instructions

Net income (loss) per books . . . . . . . . . . . . . . . 139,181 . 7 . Income recorded on books this .year .not . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Federal income tax per books . . . . . . . . . . . . . . . 71,819 . . .included on this return.(itemize): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Excess of capital losses over capital gains . . . . . . . . . . . . . . . .Tax-exempt .interest. . $ . . . . . . . . . . . . . . . . . . . . . . . . . . Income subject to tax not recorded on books 0 this year (itemize): 0 8 Deductions on this return not charged 5 Expenses recorded on books this year not against book income this year (itemize): deducted on this return (itemize): a Depreciation . . . . $ . . . . . . . . . . . . . . . . . . . . a Depreciation . . . . . . . . $ . . . . . . . . . . . . . . . . . b . Charitable.contributions . . $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . b Charitable contributions . . . . $ . . . . .58,100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c Travel and entertainment . . . $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6 1 2 3

0 58,100 9 Add lines 7 and 8 . . . . . . . . . . . . . . . . . . 0 . . . . . Add lines 1 through 5 . . . . . . . . . . . . . . . . . 269,100 .10. .Income (page 1, line 28)—line 6.less .line 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269,100

Schedule M-2

Analysis of Unappropriated Retained Earnings per Books (Line 25, Schedule L)

Balance at beginning of year . . . . . . . . . . . . . . . . . . . 5. . Distributions: . .a .Cash .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . . . . . . . Net income (loss) per books . . . . . . . . . . . . . . . 139,181. . . . . . . . . . b Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other increases (itemize): c Property . . . . . . . . . . . . . . . . . . 6 Other decreases (itemize):

4

0 7 Add lines 5 and 6 . . . . . . . . . . . . . . . . . .0 . . . . Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . 139,181 . 8 . Balance . . . of year (line 4 less. line 7) . . . . . . 139,181. . . . . . . . . . . at end . . . . . . . . . . . .
Form

1120 (2010)

SCHEDULE G (Form 1120)
Department of the Treasury Internal Revenue Service

Information on Certain Persons Owning the Corporation's Voting Stock
Attach to Form 1120. See instructions on page 2.

OMB No.1545-0123

Name

Employer identification number (EIN)

Lori Corp

13-1928472

Part I

Certain Entities Owning the Corporation's Voting Stock. (Form 1120, Schedule K, Question 4a). Complete columns (i) through (v) below for any foreign or domestic corporation, partnership (including any entity treated as a partnership), trust, or tax-exempt organization that owns directly 20% or more, or owns, directly or indirectly, 50% or more of the total voting power of all classes of the corporation's stock entitled to vote (see instructions).
(i) Name of Entity (ii) Employer Identification Number (if any) (iii) Type of Entity (iv) Country of Organization (v) Percentage Owned in Voting Stock

Part II

Dr
(i) Name of Individual or Estate

Certain Individuals and Estates Owning the Corporation's Voting Stock. (Form 1120, Schedule K, Question 4b). Complete columns (i) through (iv) below for any individual or estate that owns directly 20% or more, or owns, directly or indirectly, 50% or more of the total voting power of all classes of the corporation's stock entitled to vote (see instructions).
(ii) Identifying Number (if any) (iii) Country of Citizenship (see instructions) (iv) Percentage Owned in Voting Stock

For Paperwork Reduction Act Notice, see the Instructions for Form 1120.
(HTA)

aft

Schedule G (Form 1120) 2010

Lori Corp

13-1928472

Line 26 (1120) - Other Deductions
1 2 3 4 Telephone Utilities Total other deductions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Total deductions less expenses for offsetting credits . . . . . . . . . . . . . . . . . . . . . .

1 20,000 2 10,000 3 . . . . 30,000 . . . . . . . . . 4 . . . . 30,000 . . . . . . . . .

Line 24, Sch L (1120) - Appropriated Retained Earnings

Beginning End 1 1 800,000 2 Total appropriated retained earnings . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . 0 . . . . . 800,000. . . . . . . . .

© 2010 CCH Small Firm Services. All rights reserved.

Lori Corp

13-1928472

Line 13 (1120) - Salaries and Wages

1 Salaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 . . . . 90,000 . . . . . . . . . . . . . . . . 2 Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. . . . . . . . . . . . . . . . . . . . . 3 3 4 Total salaries and wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . . 90,000. . . . . . . . Salaries and wages reported elsewhere on return: 5 Amounts included in Cost of Goods Sold . . . . . . . . . . . . . . . . . . . 5 . . . . . . 0 . . . . . . . . . . . . . . . 6 Elective contributions to a section 401(k) cash or deferred arrangement, or amounts contributed under a salary reductions SEP agreement or a SIMPLE IRA plan . . . . . . . . . . . . . . . . . . . . . . 6. . . . . . . . . . . . . . . . . . . . . 7 Total salaries and wages reported elsewhere on return . . . . . . . . . . . . . . . . . . . . . . 7 . . . . . . . 0 . . . . . Less employment credits: 8 From Form 5884 - Work Opportunity Credit . . . . . . . . . . . . . . . . . .8 . . . . . . .0 . . . . . . . . . . . . . 9 From Form 8844 - Empowerment Zone Employment Credit . . . . . . . . . . . 9 . . . . . . 0 . . . . . . . . . . . . . . . 10 From Form 8845 - Indian Employment Credit . . . . . . . . . . . . . . . . .10 . . . . . . 0. . . . . . . . . . . . . . . 11 11 12 12 13 Total employment credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 . . . . . . 0. . . . . . . 14 Reduction of expenses for other offsetting credits (see attached statement) . . . . . . . . . . . . . 14 . . . . . . 0 . . . . . . . 15 Total salaries and wages less employment credits and expense reductions . . . . . . . . . . . . . 15 . . . . 90,000 . . . . . . . . .

Lori Corp

13-1928472

Line 19 (1120) - Charitable Contributions
(A) (B) Adjustment under Section 170(d)(2)(B) (C) Deduction Allowed in Current Year (D) Contribution Carryover

Amount 1 a b 2 a b c d e 3 4 5 6 7 8 9 10

Contribution for current year: Direct contribution . . . . . . 88,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . From partnerships . . . . . . . . 0. 1 . . . . . . 88,000. . . . . . . . 0 . . . . . 29,900 . . . . . . . . . . . . . . . . . . . . 58,100 Carryover from: 5th preceding period . . . . . . . . 2a . . . . . . . . . . . . . . . . . . . . . . . . .0 . . . . . . . . 0 . . . . . . 4th preceding period . . . . . . . . 2b . . . . . . . . . . . . . . . . . . . . . . . . .0 . . . . . . . . 0 . . . . . . 3rd preceding period . . . . . . . . 2c . . . . . . . . . . . . . . . . . . . . . . . . .0 . . . . . . . . 0 . . . . . . 2nd preceding period . . . . . . . . 2d . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . .0 . . . . . . . 1st preceding period . . . . . . . . 2e . . . . . . . . . . . . . . . . . . . . . . . . .0 . . . . . . . . 0 . . . . . . Totals . . . . . . . . . . . . . . 3 . . . . . .88,000 . . . . . . . . 0. . . . . . 29,900 . . . . . 58,100 . . . . . . . . . . . . . . Carryover to expire next year due to 5 year limitation . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . 0 . . . . . . . Total contribution carryover to next year . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . 58,100 . . . . . . . . .

Computation of Section 179 Deduction for Estimated Charitable Contribution

Taxable Income computed without contribution deduction or Section 179 . . . . . . . . . . . . . . 6 . . . . . . . . . . . . . 299,000 Section 179 deduction for purposes of contribution limitation . . . . . . . . . . . . . . . . . . . 7 . . . . . . 0 . . . . . . . Taxable income less Section 179 deduction. Subtract line 7 from line 6 . . . . . . . . . . . . . . . 8 . . . . . . . . . . . . . 299,000 Maximum contribution limitation. Enter 10% of line 8 . . . . . . . . . . . . . . . . . . . . . . .9 . . . . 29,900 . . . . . . . . Contribution deduction considering Section 179 limitation. Smaller of line 3, col A minus lines 2a through 2e, col B or line 9 . . . . . . . . . . . . . . . . . . 10 . . . . 29,900. . . . . . . . .

Computation of Actual Charitable Contribution
11 12 13 14 15 16

Actual Section 179 deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . . . . . . 0 . . . . . . . Taxable income less actual Section 179 deduction. Subtract line 11 from line 6 . . . . . . . . . . . . 12 . . . 299,000. . . . . . . . . . Net operating loss deductions limited by line 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . 13 Taxable income for purposes of contribution deduction. Subtract line 13 from line 12 . . . . . . . . . .14 . . . 299,000. . . . . . . . . Maximum contribution limitation. Enter 10% of line 14 . . . . . . . . . . . . . . . . . . . . . . 15 . . . . 29,900. . . . . . . . . Actual contribution deduction. Smaller of line 3, col A minus lines 2a through 2e, col B or line 15 . . . . . 16 . . . . 29,900 . . . . . . . . . . . . . . .17. . . . . . . . . . . .

Computation of Qualified Conservation Property Contributions by Farmers and Ranchers
17 Carryover of 100% contribution from 2009 . . . . . . . . . . . . . . . . . . . . . 18 Enter the amount of qualified conservation property contributions Do not include any amount entered in line 1(A) above Direct contribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . From partnerships . . . . . . . . . . . . . . . . .. .. . . . . . . . . . .. . . .. . . . . . . . . . 19 Net 100% contribution available for current year . . . . . . . . . . . . . . . . . . . 20 Taxable income for purposes of 100% contribution deduction. Subtract line 16 from line 14 . . 21 100% contribution deduction for current year. Enter the smaller of line 19 or line 20 . . . . . 22 Carryover of 100% contribution to 2011. Subtract line 20 from line 19 . . . . . . . . . .

. .. . . . .

. .. . . . .

. . . . . . . 0.. .. . . . . . . . 18 . . . 19 . . . . . . 20 . . . . . . 21 . . . . . . 22 . . .

. .. . . . .

. .. . . . .

. . . . . .

. . . . . . .
.. .. 0. . . . . . . . . ..

. . . .

.0 0 . . 0 . 0

. . . .

. . . .

. . . .

. . . .

. . . .

Part I - Contribution carryover, NOL carryover, and Taxable income without contribution deduction
1 2010 taxable income without contributions deduction . . . . . . . . . . . . . . . . . . . . . . .1 . . . . 299,000 . . . . . . . . 2 Contribution deduction available in 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 . . . . 88,000 . . . . . . . . 3 Prior year NOL carryover to 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . 0 . . . . . . .

Part II - Determination of 2010 contributions converted to NOL under Section 170(d)(2)(B)
1 2 3 4

Taxable Income computed without contribution deduction . . . . . . . . . . . . . . . . . . . . . 1 . . . . 299,000 . . . . . . . . Net operating loss deductions. (NOL cannot exceed Part II, line 1) . . . . . . . . . . . . . . . . . 2 . . . . . . 0 . . . . . . . Taxable income for purposes of contribution deduction. Subtract line 2 from line 1 . . . . . . . . . . . 3 . . . 299,000 . . . . . . . . . . Maximum contribution (10% of line 1 when NOL is not applied to taxable income computed without contribution deductions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. . . . . . . 0. . . . . . 5 Actual contribution deduction allowed. Enter line 16 above . . . . . . . . . . . . . . . . . . . . 5 . . . . 29,900 . . . . . . . . . 6 Current year's Section 170(d)(2)(B) contribution deduction converted to NOL. Subtract line 5 from line 4 but do not enter more than the current year contribution less the actual contribution deduction . . . . . . 6 . . . . . . . . . . . . . 0

Part III - Determination of 2010 contribution carryover to next year under Section 170(d)(2)(B)
1 2 3 4 5

Contribution deduction available in 2010. Enter Part I, line 2 above . . . . . . . . . . . . . . . . . 1 . . . . 88,000 . . . . . . . . . Contribution deducted for the tax year ending 2010. Enter line 16 above . . . . . . . . . . . . . . . 2. . . . . 29,900. . . . . . . . Current year's Section 170(d)(2)(B) contribution deduction converted to NOL. Enter Part II, line 6 above . . .3 . . . . . . .0 . . . . . Carryover to expire next year due to 5 year limitation. Enter Column D, line 4 above . . . . . . . . . . 4 . . . . . . 0 . . . . . . . Total contribution carryover to next year. Subtract lines 2, 3, and 4 from line 1 . . . . . . . . . . . . . 5 . . . . .58,100 . . . . . . .

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Line 32b (1120) - Tax Payments
1 2 3 4 5 6 7 8

Date Amount First quarter estimated tax payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . 25,000 . . . . . 1/30/2011 . . . . Second quarter estimated tax payment . . . . . . . . . . . . . . . . . . . . . . 4/30/2011 . . 2. . . . . 25,000. . . . . . . . . . . . Third quarter estimated tax payment . . . . . . . . . . . . . . . . . . . . . . . 8/30/2011 . . 3. . . . . 25,000. . . . . . . . . . . . Fourth quarter estimated tax payment . . . . . . . . . . . . . . . . . . . . . . 12/30/2011 . .4 . . . . 25,000 . . . . . . . . . . . . . Other payments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . . . . . . . Corporation's share of estimated tax payments credited to beneficiaries of a trust . . . . . . . . . . . . . . . . . . . . . . . . 6 0 Special estimated tax payments under IRC Sec. 847 . . . . . . . . . . . . . . . . . . . . . . .7 . . . . . . .0 . . . . . Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. . . . 100,000 . . .

Line 9, Sch C (1120) - Dividends-Received Deduction after Limitation

1a Amount from line 28, page 1, Form 1120, without any domestic production activities deduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a. . . . 269,100 . . . . . . . . . . . . . . . . . b Adjustment under section 1059 . . . . . . . . . . . . . . . . . . . . . . 1b . . . . . . . . . . . . . . . . . . . . . c Capital loss carryback to the tax year under section 1212(a)(1) . . . . . . . . . .1c . . . . . . . . . . . . . . . . . . . . . d Refigured line 28, page 1, Form 1120 amount. Add lines 1a through 1c . . . . . . . . . . . . . . 1d. . . . 269,100 . . . . . . . . . 2 Complete Schedule C, lines 10 through 12, column (c), and enter the total here . . . . . . . . . . . . 2 . . . . . . 0 . . . . . . . 3 Subtract line 2 from line 1d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . .269,100 . . . . . . . . . 4 Multiply line 3 by 80% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . .215,280 . . . . . . . . . 5a Add Schedule C, lines 2, 5, 7, and 8, column (c) . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . 5a b Enter the part of the deduction on Schedule C, line 3, column (c), that is attributable to dividends from 20%-or-more-owned corporations . . . . . . . . . . . . . . . 5b . . . . . . . . . . . . . . . . . . . . . c Add line 5a and line 5b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5c . . . . . . 0 . . . . . . 6 Enter the smaller of line 4 or 5c. If line 5c is greater than line 4, stop here; enter the amount from line 6 on line 9, column (c), and do not complete the rest of this worksheet . . . . . . . . . . . .6 . . . . . . .0 . . . . . 7a Enter the total amount of dividends from 20%-or-more-owned corporations that are included on Schedule C, lines 2, 5, 7, and 8, column (a) . . . . . . . . . . . . . . . . 7a . . . . . . 0 . . . . . . . . . . . . . . . b Enter the portion of dividends from 20%-or-more-owned corporations included on Schedule C, line 3, column (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b c Add line 7a and line 7b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7c . . . . . . 0 . . . . . . 8 Subtract line 7c from line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 . . . .269,100 . . . . . . . . . 9 Multiply line 8 by 70% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. . . . 188,370. . . . . . . . . 10 Subtract line 5c from the total of Schedule C, lines 1 through 8, column (c) . . . . . . . . . . . . . 10 . . . . 42,000 . . . . . . . . . 11 Enter the smaller of line 9 or line 10 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 . . . .42,000 . . . . . . . . 12 Dividends-received deduction after limitation (sec. 246(b)). Add lines 6 and 11. Enter the result here and on Schedule C, line 9, column (c) . . . . . . . . . . . . . . . . . . . . . . . 12 . . . . 42,000 . . . . . . . . .

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Line 3, Sch J (1120) - Small Corporation Exempt from AMT Determination
Complete this worksheet to determine if the corporation qualifies as a small corporation exempt from the alternative minimum tax. Yes No Is this tax year the corporation's first year in existence? X If "Yes", Stop here. The corporation is exempt from AMT with no other qualification requirements. Did the corporation lose small corporation status in a prior year? If so, enter the change date: If "Yes", Stop here. Once a corporation loses its small corporation status, it cannot qualify in any subsequent tax year. Annualized Gross Receipts Prior Three Year Average

Tax Year 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Yes or N/A

960,000

0 0 0 0 0 0 0 0 0 0 0 0 0 0

No Did the corporation have average annual gross receipts of $5 million or less for the FIRST three-year period beginning after 1993 (for calendar year corps in existence on 1/1/1994 through 1996)? Were the corporation's average gross receipts for EVERY three-year period beginning after 1994 and ending before its tax year beginning in 2010 $7.5 million or less? (For calendar year corporations in existence on 1/1/1994, the three year periods are: 1995-1997, 1996-1998, 1997-1999, 1998-2000, 1999-2001, 2000-2002, 2001-2003, 2002-2004, 2003-2005, 2004-2006, 2005-2007, 2006-2008, 2007-2009). If the corporation had only one prior tax year, were the gross receipts for the prior tax year $5 million or less, (or the corporation was established before 1994)?

Corporation qualifies as a small corporation or is otherwise exempt from the alternative minimum tax.

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Sch L (1120) - Balance Sheets per Books
1 2a 2b 2c 3 4 5 6 7 8 9 10a 10b 10c 11a 11b 11c 12 13a 13b 13c 14 15 16 17 18 19 20 21 22a 22b 22c 23 24 25 26 27 28

Assets Beginning Ending Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. . . . . . . 0. . . . . 600,000 . . . . . . . . . Trade notes and accounts receivable . . . . . . . . . . . . . . . . . . . 2a . . . . . . 0 . . . . . 350,000 . . . . . . . . . . Less allowance for bad debts . . . . . . . . . . . . . . . . . . . . . . 2b . . . . . . . . . . . . . . . . . . . . . Net trade notes and accounts receivable . . . . . . . . . . . . . . . . . . 2c . . . . . . .0 . . . . . 350,000 . . . . . . . . . Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 . . . . . . . 0 . . . . . . . . 0 . . . . . . U.S. government obligations . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . Tax-exempt securities . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . . . . . . . . . . . . . . . Other current assets . . . . . . . . . . . . . . . . . . . . . . . . . . 6. . . . . . . 0. . . . . . . . 0. . . . . . Loans to shareholders . . . . . . . . . . . . . . . . . . . . . . . . . .7 . . . . . . . . . . . . . . . . . . . . . Mortgage and real estate loans . . . . . . . . . . . . . . . . . . . . . .8 . . . . . . . . . . . . . . . . . . . . . Other investments . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 . . . . . . . 0 . . . . . . . . 0. . . . . . Buildings and other depreciable assets . . . . . . . . . . . . . . . . . . 10a . . . . . .0 . . . . . 250,000 . . . . . . . . . . . Less accumulated depreciation . . . . . . . . . . . . . . . . . . . . . 10b . . . . . . 0 . . . . . .50,000 . . . . . . . . . . Net buildings and other depreciable assets . . . . . . . . . . . . . . . . .10c . . . . . . 0 . . . . . . . . . . . . . . . 200,000 Depletable assets . . . . . . . . . . . . . . . . . . . . . . . . . . 11a . . . . . . . . . . . . . . . . . . . . . . Less accumulated depletion . . . . . . . . . . . . . . . . . . . . . . 11b . . . . . . . . . . . . . . . . . . . . . . Net depletable assets . . . . . . . . . . . . . . . . . . . . . . . . . 11c. . . . . . . . . . . . . . .0 . . . . . . 0 Land (net of any amortization) . . . . . . . . . . . . . . . . . . . . . . 12 . . . . . . 0 . . . . . . . 0 . . . . . . . . Intangible assets (amortizable only) . . . . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . . . . 0. . . . . . 13a Less accumulated amortization . . . . . . . . . . . . . . . . . . . . . 13b . . . . . . 0 . . . . . . . . 0 . . . . . . . . Net intangible assets . . . . . . . . . . . . . . . . . . . . . . . . . 13c . . . . . . 0 . . . . . . . . 0 . . . . . . . . Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 . . . . . . 0. . . . . . . . 0 . . . . . . . Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 . . . . . . 0 . . . . 1,150,000 . . . . . . . . . . . Liabilities and Capital

Accounts payable . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 . . . . . . . . . . . . 50,000 . . . . . . . . . Mortgages, notes, bonds payable in less than 1 year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Other current liabilities . . . . . . . . . . . . . . . . . . . . . . . . . 18 . . . . . . 0 . . . . . . . 0 . . . . . . . . Loans from shareholders . . . . . . . . . . . . . . . . . . . . . . . . 19 . . . . . . . . . . . . . . . . . . . . . Mortgages, notes, bonds payable in 1 year or more . . . . . . . . . . . . . . 20 . . . . . . . . . . . . . . . . . . . . . Other liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 . . . . . . 0 . . . . . . . 0 . . . . . . . . Capital stock (preferred) . . . . . . . . . . . . . . . . . . . . . . . . 22a. . . . . . . . . . . . . . . . . . . . . Capital stock (common) . . . . . . . . . . . . . . . . . . . . . . . . 22b . . . . . .0 . . . . . 300,000 . . . . . . . . . . . Net Capital Stock . . . . . . . . . . . . . . . . . . . . . . . . . . . 22c . . . . . .0 . . . . . 300,000 . . . . . . . . . . . Additional paid-in capital . . . . . . . . . . . . . . . . . . . . . . . . 23 . . . . . . . . . . . . . . . . . . . . . Retained earnings - appropriated . . . . . . . . . . . . . . . . . . . . .24 . . . . . . 0. . . . . 800,000. . . . . . . . . . Retained earnings - unappropriated . . . . . . . . . . . . . . . . . . . .25 . . . . . . . . . . . . . . 0. . . . . . . Adjustments to shareholders' equity . . . . . . . . . . . . . . . . . . . .26 . . . . . . 0. . . . . . . . 0. . . . . . . Less cost of treasury stock . . . . . . . . . . . . . . . . . . . . . . . 27 . . . . . . . . . . . . . . . . . . . . . Total liabilities and shareholders' equity . . . . . . . . . . . . . . . . . . 28 . . . . . . . . . . . 1,150,000 . . . . . . 0 . . . .

End of year balance sheet out of balance by . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0. . . . . .

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Line 2, Sch M-1 (1120) - Federal Income Tax per Books
1 Tax per books (Accrual basis) . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . 71,819 . . . . . . . . . . . . . . . . . 2 Enter federal income tax per books. Enter on line 2, Schedule M-1 . . . . . . . . . . . . . . . . . . . . . 71,819 . . . . . 2 . . .