On September 12, 2019 a
Exhibit,Appendix
was filed
involving a dispute between
4 C Woods Holdings, Llc,
and
The Assessor And The Assessment Review Commission Of Nassau County,
for Real Property - Tax Certiorari
in the District Court of Nassau County.
Preview
FILED: NASSAU COUNTY CLERK 10/31/2019 02:45 PM INDEX /NO. :-- /'-l
/ t- 405488/2019
NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 10/31/2019
14o4n1
vERlElcATloN
STATE OF )
SS:
COUNTY OF D^Jn )
tr Jp va'c-v-1c*.: {V1 being dulY sworn, says:
I am the of /--{ J"
name or )
fiitle or
Petitioner in the proceeding herein.
lhavereadtheannexedStatementsoftncomeandExpense'knowthecontents
and based on information and belief, I believe them to be true'
thereof
(Signature)
Sworn to me this M
day of 20JL
Alain Cueto
NOIARY PUBLIC
Notary Public W STA''E OF FLORIDA
Conrm# GGlB3001
Expires 21512A22
FILED: NASSAU COUNTY CLERK 10/31/2019 02:45 PM INDEX NO. 405488/2019
NYSCEF DOC.
SCHEDULE
NO. 3 '//D,2-M
RECEIVED NYSCEF: 10/31/2019
E Supplemental lncome and Loss OMB No. 1545-0074
(Form 1040) (From rental real estate, royalties, partnerships, S corporations,
Department of the Treasury ) Attactr
estates,
to Form 1040, 1O4NR, or Form 1041.
trusts, REMlCs, etc.)
2018
Attachment
Service
lnternal Revenue (99)
rl
Sequence No. I
Name(s) shown on return social security number
CHARLES G. MCCURDY & ALLISON MADDOX
Part ncome or m Note: lf you are in the business of renting personal
property, use
Schedule C or C-EZ lf are an individual, report farm rental income or loss from Form 21835 on page 2, line 40.
A Did you make any payments in 2018 that would require you to file Form(s) 1099? (see instructions) Yes No
'did or will
of each ztP
A DUCK
PRIVATE I}WESTMENT
c
1b Type of Property 2 For each rental real estate property listed Fair Rental Personal QJV
(from list below) above, repod the number of fair rental and Days Use Days
personal use days. Check the QJV box
1 only if you meet the requirements
to file as 365
6 joint venture. See instructions.
a qualified
B
Type of Property:
1 Single Family Residence 3 Vacation/Short-TermRental 5 Land 7 Self-Rental
2 6 8 Other
lncome: Properties: A B c
3 Rents received 3 126,000.
received 4 33.
Expenses
5 Advertising 5 10,730.
6 Auto and travel (see instructions) 6
7 Cleaning and maintenance .......... 7 4,803.
8 Commissions 8
I lnsurance 9
10 Legal and other professional
fees ... 10 33,365.
11 Management fees 11
12 Mortgage interest paid to banks, etc 't2
13 Other interest 13
14 Repairs 't4 46,740.
15 Supplies 15 2,965.
16 Taxes 16 L73,843.
17 Utilities 't7 16,911.
18 Depreciation expense or depletion 18 244,0L7 .
't9 other(list)> STMT 33 STMT 19 30,849. L8.
20 '19 ................
Total expenses. Add lines 5 through 20 564,223. l_8.
21 Subtract line 20 from line 3 (rents) and/or 4 (royalties).
lf result is a
(loss), see instructions to find out if you must file Form 6'198 21 -439 ,223. L5.
?2 Deductible rental real estate loss after limitation, if any, on
Form 8582 (see instructions) ............. . . 22 0.:
23a Total of all amounts reported on line 3 for all rental properties 23a 126,000.
b Total of all amounts reported on line 4 for all royalty properties 23b 33.
c Total of all amounts reported on line 12 for all properties ..... 23c
d Total of all amounts repoded on line 1 8 for all properties . ... 23d 244,0L7 .
e Total of all amounts reported on line 20 for all properties
..... 8e 564 ,24L.
24 lncome. Add positive amounts shown on line 21. Do not include any losses 24
25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here25
26 Total rental real estate and royalty income or (loss). Combine
lines 24 and 25. Enter the result here. lf Parts ll, ilt,
lV, and line 40 on page 2 do not apply to you, also enter this amount on Schedule 1 (Form 1040), line 1 7, or Form
1040NR, line 1 B. Otherwise, include this amount in the total on line 41 on
2 26 l_5.
LHA For Paperwork Reduction Act Notice, see the separateinstructions, Schedule E (Form 1O4O) 2018
821491 10-'t8-18
27
Document Filed Date
October 31, 2019
Case Filing Date
September 12, 2019
Category
Real Property - Tax Certiorari
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FILED: NASSAU COUNTY CLERK 10/31/2019 02:45 PM INDEX /NO. :-- /'-l / t- 405488/2019 NYSCEF DOC. NO. 3 RECEIVED NYSCEF: 10/31/2019 14o4n1 vERlElcATloN STATE OF ) SS: COUNTY OF D^Jn ) tr Jp va'c-v-1c*.: {V1 being dulY sworn, says: I am the of /--{ J" name or ) fiitle or Petitioner in the proceeding herein. lhavereadtheannexedStatementsoftncomeandExpense'knowthecontents and based on information and belief, I believe them to be true' thereof (Signature) Sworn to me this M day of 20JL Alain Cueto NOIARY PUBLIC Notary Public W STA''E OF FLORIDA Conrm# GGlB3001 Expires 21512A22 FILED: NASSAU COUNTY CLERK 10/31/2019 02:45 PM INDEX NO. 405488/2019 NYSCEF DOC. SCHEDULE NO. 3 '//D,2-M RECEIVED NYSCEF: 10/31/2019 E Supplemental lncome and Loss OMB No. 1545-0074 (Form 1040) (From rental real estate, royalties, partnerships, S corporations, Department of the Treasury ) Attactr estates, to Form 1040, 1O4NR, or Form 1041. trusts, REMlCs, etc.) 2018 Attachment Service lnternal Revenue (99) rl Sequence No. I Name(s) shown on return social security number CHARLES G. MCCURDY & ALLISON MADDOX Part ncome or m Note: lf you are in the business of renting personal property, use Schedule C or C-EZ lf are an individual, report farm rental income or loss from Form 21835 on page 2, line 40. A Did you make any payments in 2018 that would require you to file Form(s) 1099? (see instructions) Yes No 'did or will of each ztP A DUCK PRIVATE I}WESTMENT c 1b Type of Property 2 For each rental real estate property listed Fair Rental Personal QJV (from list below) above, repod the number of fair rental and Days Use Days personal use days. Check the QJV box 1 only if you meet the requirements to file as 365 6 joint venture. See instructions. a qualified B Type of Property: 1 Single Family Residence 3 Vacation/Short-TermRental 5 Land 7 Self-Rental 2 6 8 Other lncome: Properties: A B c 3 Rents received 3 126,000. received 4 33. Expenses 5 Advertising 5 10,730. 6 Auto and travel (see instructions) 6 7 Cleaning and maintenance .......... 7 4,803. 8 Commissions 8 I lnsurance 9 10 Legal and other professional fees ... 10 33,365. 11 Management fees 11 12 Mortgage interest paid to banks, etc 't2 13 Other interest 13 14 Repairs 't4 46,740. 15 Supplies 15 2,965. 16 Taxes 16 L73,843. 17 Utilities 't7 16,911. 18 Depreciation expense or depletion 18 244,0L7 . 't9 other(list)> STMT 33 STMT 19 30,849. L8. 20 '19 ................ Total expenses. Add lines 5 through 20 564,223. l_8. 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties). lf result is a (loss), see instructions to find out if you must file Form 6'198 21 -439 ,223. L5. ?2 Deductible rental real estate loss after limitation, if any, on Form 8582 (see instructions) ............. . . 22 0.: 23a Total of all amounts reported on line 3 for all rental properties 23a 126,000. b Total of all amounts reported on line 4 for all royalty properties 23b 33. c Total of all amounts reported on line 12 for all properties ..... 23c d Total of all amounts repoded on line 1 8 for all properties . ... 23d 244,0L7 . e Total of all amounts reported on line 20 for all properties ..... 8e 564 ,24L. 24 lncome. Add positive amounts shown on line 21. Do not include any losses 24 25 Losses. Add royalty losses from line 21 and rental real estate losses from line 22. Enter total losses here25 26 Total rental real estate and royalty income or (loss). Combine lines 24 and 25. Enter the result here. lf Parts ll, ilt, lV, and line 40 on page 2 do not apply to you, also enter this amount on Schedule 1 (Form 1040), line 1 7, or Form 1040NR, line 1 B. Otherwise, include this amount in the total on line 41 on 2 26 l_5. LHA For Paperwork Reduction Act Notice, see the separateinstructions, Schedule E (Form 1O4O) 2018 821491 10-'t8-18 27