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s El GAAP U Book 0 Other (submit explanation) I.:Islet b h Ct. K Resident status (nark an Xi's. bases that pal 0 M'S fullyear resident '-- Yonkers full•year resident L_I NYC full•year resident 0 INS part-year resident _ Yonkers part•year resident 0 NYC parties! resident [2..l NYS nonresi
ents, and Credits North Carolina Cope Mount of Revenue or fiscal year beginning 11 13 12 and ending 12 31 12 rumen Hanle, Address, and ZIP Code BLUE CHIP CAPITAL LLC 27 HIGH TECH BLVD THOMASVILLE NC 27360 Federal =Is Partnershiel Name, Address, and ZIP Code MIDWAY CADENCE LLC 27O LAFAYETTE STREET SUITE 409
te bre° XI Tax baaie Q GMP El Book 0 Other Ombra exPianarion) K Resident status Imp* an X In f t i bone that apply) WS full-year resident 0 Yonkers ful•year resident P NYS part•yete resident 0 Yonkers part-year resident DC NYS nonresident 0 Yonkers nonresident L If the partner was includ
ses * Information About the Partner Net Inag-term carkl gain (lose) E Partners kis number F Parteer's name. address. city. state. and ZIP code BLUE CHIP CAPITAL LLC 2. 3 290. O General partner or I.LC member-manager 20 Other Information Limited partner or other Lig mentor °mastic partner El Foreign part
) CE Tax basis C GAAP Iji Book Other (submit expianaeore K Resident status (mark an x in all boxes that levy) C NYS fultyear resident I I Yonkers full-year resident =I NYS part-year resident L_I Yonkers part•year resident MI NYS nonresident El Yonkers nonresident L If the partner was i
-term capital gain (loss) I 90 Collectibles (28%) gain (loss) I 19 Distributions number F Partners I Lim e. address. city. state, and ZIP code BLUE CHIP CAPITAL LLC 329 SEABREEZE AVENUE PALM BEACH, FL 33480 9e Unrecaplured sec 1250 gain [ 20 Other information 10 Net section 1231 gain (lesS) 11 Other income
ox) al Tax basis El GASP n Book = Other (submit evrnenatfon) K Resident status (mark en X Psi? boxes that apt CI NYS full•yeer resident _I Yonkers full-year resident L.: NYC fueyear resident C NYS pert•year resident C Yonkers partysar resident C NYC parhyear resident DU NYS nonresident
meMs“mdCmdfts North Carolina Department of Revenue For calendar year or fleCal year beginning Partners I Partner's Warne, Address, and ZIP Code BLUE CHIP CAPITAL LLC 27 HIGH TECH BLVD THOMASVILLE NC 27360 THERE 11 13 12 and ending 12 31 12 Federal r Partnerehip's Name, Address. and ZIP Code MIDWAY CADENC
ing number ao Tax Owls C GAAP n Book CI Other !submit explanation) K Re/Mont status (marten Kin elf boxes Met C NYS full-yeer resident i_. Yonkers fulliyeer resident C NYC full-year resident C NYS port year resident C Yonkers pert-year resident 0 NYC partyear resident Er NYS nonresiden
rs Identifying number 20-3161309 09 Colectibkm 428%) pin (loss) VP Distributions , 9,392. F Partner's name. address, city, stile, and ZIP code BLUE CHIP CAPITAL LLC 27 HIGH TECH BOULEVARD THOMASVILLE, NC 27360 k Unrecaptured sec 1250 pain I 20 Other Information 10 Net section 1231 gain (loss) -54. it I:ent
box) LKJ Tex basis CI GAAP Book I= Other (submit explanation) K Resident status (mark an A' in arr boxes that mt e) 0 NYS fui-year resident Yonkers fullyear resident C NYC fullyear resident 0 NYS part-year resident C Yonkers part-year resident El NYC part-year resident M NYS nonresident
g 11 13 12 amending 12 31 12 Partnersidenti In Number Federal Partner's Name, Address, and ZIP Code Partnership's Name, Address, and ZIP Code BLUE CHIP CAPITAL LLC MIDWAY CADENCE LLC THERE ARE NO ADJUSTMENTS OR CREDITS FOR THIS PARTNER Partnership's Pro Rata Share Items All Partners 1. Share of partnerahlp
Cr Tax beets 0 GMP E l, Book L__J Otter (submit excianadcn) K Resident status (ma* in X in a' boxes that apply) I NYS ruttiest resident Li Yonkers full-year resident El NYC full/war resident L'71 NYS puttee, resident 0 Yorkers pert-year resident C WC pert-year resident [Xi NYS nonresid
ubbly traded prthershIP (PIP) ISIff Information About the Partner E Partners laentrylnp number F Partners name. address. cly, stab, and ZIP code BLUE CHIP CAPITAL LLC 27 HIGH TECH BOULEVARD THOMASVILLE, NC 27360 13 lip Omenl partner of LLC member-manager H Domestic partner C Foreign partner T1 What 1700 cf
) ICI Tax basis M GAAP 0 Book El Other (submit explanation) K Resident status (mark an Xin ea boxes that apply) 1=1 NYS full-year resident C Yonkers full-year resident C NYC ful:-year resident C NYS part-year resident C Yonkers pal-year resident C NYC oart-year resident NYS nonresident C
's LrJoitc.:y truirc, palnerstip (P- P• ik—Abornesktma E Partners inernfylna number 20-3161309 F Penners num address. city. Matt and 2IP code BLUE CHIP CAPITAL LLC 27 HIGH TECH BLVD. THOMASVILLE, NC 27380 O n General oarlfief r lC E Limited partneror otter LLC tnertbrr-rnanast neater H RI Domed: Penny
•year resident fl NYC full-year resident O NYS pallear resident I—J Yonkers pan-yew resident 0 NYC part•year resident DC NYS nonresident L 7 Yonkers nonresident L If the partner was included In a group return, enter the special NYS identlication number, If known • 118001121019 III IIII III 101
7 Check If this is a publicly traded partnership (PIP) NW Information About the Partner Liter F Partners name, address, city, state, and ZIP code BLUE CHIP CAPITAL LLC 27 HIGH TECH BOULEVARD THOMASVILLE, NC 27360 G t_J General partner or LLC IL limited partner or other LLC member-manager member N 0onestic pa
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