1120S U.S. Income Tax Return for an S Corporation Form 2012

1120S2012

U.S. Income Tax Return for an S Corporation

SignHere

PaidPreparerUse Only

Do not file this form unless the corporation has filed or is

attaching Form 2553 to elect to be an S corporation.

Information about Form 1120S and its separate instructions is at www.irs.gov/form1120s.

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For Paperwork Reduction Act Notice, see separate instructions.

OMB No. 1545-0130

For calendar year 2012 or tax year beginning , 2012, ending , 20

$

Is the corporation electing to be an S corporation beginning with this tax year? Yes No If "Yes," attach Form 2553 if not already filed

Check if: Final return Name change Address change Amended return S election termination or revocation

Enter the number of shareholders who were shareholders during any part of the tax year

Caution. Include only trade or business income and expenses on lines 1a through 21. See the instructions for more information.

Gross receipts or sales

Returns and allowances

Balance. Subtract line 1b from line 1a

Cost of goods sold (attach Form 1125-A)

Gross profit. Subtract line 2 from line 1c

Net gain (loss) from Form 4797, line 17 (attach Form 4797)

Other income (loss) (see instructions - attach statement)

Total income (loss). Add lines 3 through 5

Compensation of officers

Salaries and wages (less employment credits)

Repairs and maintenance

Bad debts

Rents

Taxes and licenses

InterestDepreciation not claimed on Form 1125-A or elsewhere on return (attach Form 4562)

Depletion (Do not deduct oil and gas depletion.)

Advertising

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e in

stru

ctio

ns

for

limita

tion

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Pension, profit-sharing, etc., plans

Employee benefit programs

Other deductions (attach statement)

Total deductions. Add lines 7 through 19

Ordinary business income (loss). Subtract line 20 from line 6

Excess net passive income or LIFO recapture tax (see instructions)

Tax from Schedule D (Form 1120S)

Add lines 22a and 22b (see instructions for additional taxes)

2012 estimated tax payments and 2011 overpayment credited to 2012

Tax deposited with Form 7004

Credit for federal tax paid on fuels (attach Form 4136)

Add lines 23a through 23c

Estimated tax penalty (see instructions). Check if Form 2220 is attached

Amount owed. If line 23d is smaller than the total of lines 22c and 24, enter amount owed

Overpayment. If line 23d is larger than the total of lines 22c and 24, enter amount overpaid

Enter amount from line 26 Credited to 2013 estimated tax

Form 1120S (2012)

Employer identification number

Form

Department of the Treasury

Internal Revenue Service

NameS election effective date

Number, street, and room or suite no. If a P.O. box, see instructions.Business activity code Date incorporatednumber (see instructions)

City or town, state, and ZIP code Total assets (see instructions)

Check if Sch. M-3attached

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

with the preparer shown belowall information of which preparer has any knowledge.

(see instructions)? Yes No

TitleSignature of officer Date

Print/Type preparer's name Date PTINPreparer's signature Check if

self-employed

Firm's name Firm's EIN

Firm's address Phone no.

EEA

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05-21-2007 ROBIN CENTER CHIROPRACTIC 26-0214535

4064 LAKELAND AVE NORTH 05-21-2007621339

ROBBINSDALE MN 55422 44,655X

1

429,904

429,904

429,904

429,90412,00074,1825,052

29,491ATT_STL 19,818

1,96915,366

17,575

Statement #2 165,242340,69589,209

XALEX CHERNYAVSKY PRESIDENT

Laurel St John CPA 03-13-2013 P00962456Abercrombie Accounting7582 Currell Blvd Ste 211Woodbury MN 55125 (651)739-2020

Schedule B Other Information1 a b Yes No

c

2

3

4

a

b

5 a

(i)

(ii)

b

(i)

(ii)

6

7

8

9

10

a

b

11

12

13 a

b

Form 1120S (2012)

(see instructions)

Check accounting method: Cash Accrual

Other (specify)

See the instructions and enter the:

a Business activity b Product or service

At any time during the tax year, was any shareholder of the corporation a disregarded entity, a trust, an estate, or a

nominee or similar person?

At the end of the tax year, did the corporation:

Own directly 20% or more, or own, directly or indirectly, 50% or more of the total stock issued and outstanding of any

foreign or domestic corporation? For rules of constructive ownership, see instructions. If "Yes," complete (i) through (v)

below

Own directly an interest of 20% or more, or own, directly or indirectly, an interest of 50% or more in the profit, loss, or

capital 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. If "Yes," complete (i) through (v) below

At the end of the tax year, did the corporation have any outstanding shares of restricted stock?

If "Yes," complete lines (i) and (ii) below.

Total shares of restricted stock

Total shares of non-restricted stock

At the end of the tax year, did the corporation have any outstanding stock options, warrants, or similar instruments?

If "Yes," complete lines (i) and (ii) below.

Total shares of stock outstanding at the end of the tax year

Total shares of stock outstanding if all instruments were executed

Has this corporation filed, or is it required to file, Form 8918, Material Advisor Disclosure Statement, to provide

information on any reportable transaction?

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.

If the corporation: (a) was a C corporation before it elected to be an S corporation or the corporation acquired an

asset with a basis determined by reference to the basis of the asset (or the basis of any other property) in

the hands of a C corporation and (b) has net unrealized built-in gain in excess of the net recognized built-in gain

from prior years, enter the net unrealized built-in gain reduced by net recognized built-in gain from prior years (see

instructions) $

Enter the accumulated earnings and profits of the corporation at the end of the tax year. $

Does the corporation satisfy both of the following conditions?

The corporation's total receipts (see instructions) for the tax year were less than $250,000

The corporation's total assets at the end of the tax year were less than $250,000

If "Yes," the corporation is not required to complete Schedules L and M-1.

During the tax year, did the corporation have any non-shareholder debt that was canceled, was forgiven, or had the

terms modified so as to reduce the principal amount of the debt?

If "Yes," enter the amount of principal reduction $

During the tax year, was a qualified subchapter S subsidiary election terminated or revoked? If "Yes," see instructions

Did the corporation make any payments in 2012 that would require it to file Form(s) 1099?

If "Yes," did the corporation file or will it file all required Forms 1099?

Form 1120S (2012)

(v)(ii) (iii) (iv)

(i)

(iv) (v)(i) (iii)

If Percentage in (iv) is 100%, Enter theEmployer Identification Number Country of Percentage of Stock

Name of Corporation Date (if any) a Qualified Subchapter S(if any) Incorporation Owned

Subsidiary Election Was Made

(ii) Employer Identification Number Country of Maximum Percentage Owned in Profit,Name of Entity Type of Entity

(if any) Organization Loss, or Capital

EEA

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ROBIN CENTER CHIROPRACTIC 26-0214535

X

SERVICES CHIROPRACTIC

X

X

X

Alt

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(AM

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Item

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inim

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Tax

Schedule K Shareholders' Pro Rata Share Items Total amount

11 1

2 2

3a 3a

b 3b

c 3c

4 4

5 5a

5b

6 6

7 7

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b 16b

c 16c

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d 16d

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Aff

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ing

Form 1120S (2012)

Ordinary business income (loss) (page 1, line 21)

Net rental real estate income (loss) (attach Form 8825)

Other gross rental income (loss)

Expenses from other rental activities (attach statement)

Other net rental income (loss). Subtract line 3b from line 3a

Interest income

Dividends: a Ordinary dividends

b Qualified dividends

Royalties

Net short-term capital gain (loss) (attach Schedule D (Form 1120S))

Net long-term capital gain (loss) (attach Schedule D (Form 1120S))

Collectibles (28%) gain (loss)

Unrecaptured section 1250 gain (attach statement)

Net section 1231 gain (loss) (attach Form 4797)

Other income (loss) (see instructions) Type

Section 179 deduction (attach Form 4562)

Charitable contributions

Investment interest expense

Section 59(e)(2) expenditures Type Amount

Other deductions (see instructions) Type

Low-income housing credit (section 42(j)(5))

Low-income housing credit (other)

Qualified rehabilitation expenditures (rental real estate) (attach Form 3468)

Other rental real estate credits (see instructions) Type

Other rental credits (see instructions) Type

Alcohol and cellulosic biofuel fuels credit (attach Form 6478)

Other credits (see instructions) Type

Name of country or U.S. possession

Gross income from all sources

Gross income sourced at shareholder level

Foreign gross income sourced at corporate level

Passive category

General category

Other (attach statement)

Deductions allocated and apportioned at shareholder level

Interest expense

Other

Deductions allocated and apportioned at corporate level to foreign source income

Passive category

General category

Other (attach statement)

Other information

Total foreign taxes (check one): Paid Accrued

Reduction in taxes available for credit (attach statement)

Other foreign tax information (attach statement)

Post-1986 depreciation adjustment

Adjusted gain or loss

Depletion (other than oil and gas)

Oil, gas, and geothermal properties-gross income

Oil, gas, and geothermal properties-deductions

Other AMT items (attach statement)

Tax-exempt interest income

Other tax-exempt income

Nondeductible expenses

Distributions (attach statement if required) (see instructions)

Repayment of loans from shareholders

Form 1120S (2012)

12c(2)

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89,20927,504

2,168

(1,505)

3,830109,247

Schedule K

Schedule L

Total amount

17 a 17a

b 17b

c 17c

d

18

18

Balance Sheets per Books

Assets (a) (b) (c) (d)

1

2 a

b

3

4

5

6

7

8

9

10 a

b

11 a

b

12

13 a

b

14

15

Liabilities and Shareholders' Equity

16

17

18

19

20

21

22

23

24

25

26

27

Form 1120S (2012)

Shareholders' Pro Rata Share Items (continued)

Investment income

Investment expenses

Dividend distributions paid from accumulated earnings and profits

Other items and amounts (attach statement)

Income/loss reconciliation. Combine the amounts on lines 1 through 10 in the far right

column. From the result, subtract the sum of the amounts on lines 11 through 12d and 14I

Beginning of tax year End of tax year

Cash

Trade notes and accounts receivable

Less allowance for bad debts ( ) ( )

Inventories

U.S. government obligations

Tax-exempt securities (see instructions)

Other current assets (attach statement)

Loans to shareholders

Mortgage and real estate loans

Other investments (attach statement)

Buildings and other depreciable assets

Less accumulated depreciation ( ) ( )

Depletable assets

Less accumulated depletion ( ) ( )

Land (net of any amortization)

Intangible assets (amortizable only)

Less accumulated amortization ( ) ( )

Other assets (attach statement)

Total assets

Accounts payable

Other current liabilities (attach statement)

Loans from shareholders

Other liabilities (attach statement)

Capital stock

Additional paid-in capital

Retained earnings

Less cost of treasury stock ( ) ( )

Total liabilities and shareholders' equity

Form 1120S (2012)

Oth

erIn

form

atio

nR

eco

n-

cilia

tio

n

Mortgages, notes, bonds payable in less than 1 year

Mortgages, notes, bonds payable in 1 year or more

Adjustments to shareholders' equity (attach statement)

EEA

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114,545

(1,331) (2,094)

10,811 33,524

79,496 90,76173,002 6,494 77,536 13,225

15,974 44,655

Statement #22 15,843 Statement #22 22,785

0 21,739

31 31

100 100

15,974 44,655

Schedule M-1 Reconciliation of Income (Loss) per Books With Income (Loss) per Return

Schedule M-2

1 5

2

a

3 6

a a

b

7

4 8

Analysis of Accumulated Adjustments Account, Other Adjustments Account, and Shareholders'

1

2

3

4

5

6

7

8

Form 1120S (2012)

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

Tax-exempt interest $

Expenses recorded on books this year not Deductions included on Schedule K,

included on Schedule K, lines 1 through 12 and lines 1 through 12 and 14l , not charged

14l (itemize): against book income this year (itemize):

Depreciation $ Depreciation $

Travel and entertainment $

Add lines 5 and 6

Add lines 1 through 3

Undistributed Taxable Income Previously Taxed (see instructions)

(a) Accumulated (b) Other adjustments (c) Shareholders' undistributedadjustments account account taxable income previously taxed

Balance at beginning of tax year

Ordinary income from page 1, line 21

Other additions

Loss from page 1, line 21 ( )

Other reductions ( ) ( )

Combine lines 1 through 5

Distributions other than dividend distributions

Form 1120S (2012)

Income recorded on books this year not included

Income included on Schedule K, lines 1, 2, 3c, 4, on Schedule K, lines 1 through 10 (itemize):

5a, 6, 7, 8a, 9, and 10, not recorded on books this

year (itemize):

Income (loss) (Schedule K, line 18). Line 4 less line 7

Balance at end of tax year. Subtract line 7 from line 6

EEA

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110,715

3,830

3,830114,545 114,545

16389,209

Statement #29 27,504

Statement #30 5,998110,878109,247

1,631

Fo

r IR

S U

se O

nly

2012

671112

Shareholder's Share of Income, Deductions,Credits, etc.

Schedule K-1Part III(Form 1120S)

Part I Information About the Corporation

Part II Information About the Shareholder

Shareholder's Share of Current Year Income,

Deductions, Credits, and Other Items

%

* See attached statement for additional information.

1 13

2

3See page 2 of form and separate instructions.

4

A

5a

B

5b 14

6

7

C 8a

8b

8cD

9E

10 15

F

11 16

12

17

For Paperwork Reduction Act Notice, see Instructions for Form 1120S. Schedule K-1 (Form 1120S) 2012

Final K-1 Amended K-1 OMB No. 1545-0130

For calendar year 2012, or taxDepartment of the Treasury Ordinary business income (loss) Creditsyear beginning , 2012Internal Revenue Service

ending , 20

Net rental real estate income (loss)

Other net rental income (loss)

Interest income

Corporation's employer identification number

Ordinary dividends

Corporation's name, address, city, state, and ZIP code

Qualified dividends Foreign transactions

Royalties

Net short-term capital gain (loss)

IRS Center where corporation filed return Net long-term capital gain (loss)

Collectibles (28%) gain (loss)

Unrecaptured section 1250 gainShareholder's identifying number

Net section 1231 gain (loss)Shareholder's name, address, city, state, and ZIP code

Other income (loss) Alternative minimum tax (AMT) items

Shareholder's percentage of stockownership for tax year

Section 179 deduction Items affecting shareholder basis

Other deductions

Other information

IRS.gov/form1120S

EEA

. . . . . . . . . .

89,209

27,504

26-0214535

ROBIN CENTER CHIROPRACTIC

4064 LAKELAND AVE NORTH

ROBBINSDALE MN 55422

E-FILE

560-61-4710

ALEX CHERNYAVSKY

7650 28TH ST SE A (1,505)BUFFALO MN 55313

100.00000

2,168 C 3,830

D 109,247

This list identifies the codes used on Schedule K-1 for all shareholders and provides summarized reporting information for shareholders whofile Form 1040. For detailed reporting and filing information, see the separate Shareholder's Instructions for Schedule K-1 and theinstructions for your income tax return.

Page 2

1. Ordinary business income (loss). M

N

OP

14. Foreign transactions

A2. Net rental real estate income (loss)

3. Other net rental income (loss) B

C

4. Interest income

D5a. Ordinary dividendsE

5b. Qualified dividends F

6. Royalties

G7. Net short-term capital gain (loss)H

8a. Net long-term capital gain (loss)

8b. Collectibles (28%) gain (loss)

IJ8c. Unrecaptured section 1250 gainK

9. Net section 1231 gain (loss)

10. Other income (loss) LMNA

BOCPDQE

15. Alternative minimum tax (AMT) items11. Section 179 deduction

A12. Other deductions B

A CB DC ED FE

16. Items affecting shareholder basis

AFBGCHDIEJ

KL 17. Other informationM

AN

BC

OP

DE

Q

R FS

G13. Credits H

A I

B J

C K

D L

E MN

F O

G PHI Q

RJ SK

L T

U

N

Schedule K-1 (Form 1120S) 2012

Code Report on

Determine whether the income (loss) is Credit for increasing researchpassive or nonpassive and enter on your return as follows: activities

Credit for employer socialReport onSee the Shareholder's Instructionssecurity and Medicare taxesPassive loss See the Shareholder's Instructions

Backup withholdingPassive income Schedule E, line 28, column (g)Other creditsNonpassive loss Schedule E, line 28, column (h)

Nonpassive income Schedule E, line 28, column (j)

Name of country or U.S.See the Shareholder's InstructionspossessionGross income from all sources Form 1116, Part I

Net income Schedule E, line 28, column (g) Gross income sourced atNet loss See the Shareholder's Instructions shareholder level

Form 1040, line 8a Foreign gross income sourced at corporate level

Passive categoryForm 1040, line 9aGeneral category Form 1116, Part I

Form 1040, line 9b Other

Schedule E, line 4 Deductions allocated and apportioned at shareholder level

Interest expense Form 1116, Part ISchedule D, line 5Other Form 1116, Part I

Schedule D, line 12Deductions allocated and apportioned at corporate level to foreign source

28% Rate Gain Worksheet, line 4 income

(Schedule D instructions) Passive category

General categorySee the Shareholder's Instructions Form 1116, Part IOther

See the Shareholder's InstructionsOther information

Total foreign taxes paid Form 1116, Part II

Total foreign taxes accruedCode Form 1116, Part IIReduction in taxes available forOther portfolio income (loss) See the Shareholder's Instructionscredit Form 1116, line 12Involuntary conversions See the Shareholder's InstructionsForeign trading gross receipts Form 8873Sec. 1256 contracts & straddles Form 6781, line 1Extraterritorial income exclusion Form 8873Mining exploration costs recapture See Pub. 535Other foreign transactions See the Shareholder's InstructionsOther income (loss) See the Shareholder's Instructions

See the Shareholder's InstructionsPost-1986 depreciation adjustment

See theAdjusted gain or loss

Shareholder'sCash contributions (50%) Depletion (other than oil & gas)Instructions andCash contributions (30%) Oil, gas, & geothermal - gross incomethe Instructions forNoncash contributions (50%) Oil, gas, & geothermal - deductions

See the Shareholder's Form 6251Noncash contributions (30%) Other AMT itemsInstructionsCapital gain property to a 50%

organization (30%)Tax-exempt interest income Form 1040, line 8bCapital gain property (20%)Other tax-exempt incomeContributions (100%)Nondeductible expensesInvestment interest expense Form 4952, line 1

See the Shareholder'sDistributionsDeductions - royalty income Schedule E, line 19InstructionsRepayment of loans fromSection 59(e)(2) expenditures See the Shareholder's Instructions

shareholdersDeductions - portfolio (2% floor) Schedule A, line 23Deductions - portfolio (other) Schedule A, line 28Preproductive period expenses See the Shareholder's Instructions

Investment income Form 4952, line 4aCommercial revitalization deduction

Investment expenses Form 4952, line 5from rental real estate activities See Form 8582 instructions

Qualified rehabilitation expendituresReforestation expense deduction See the Shareholder's Instructions

(other than rental real estate) See the Shareholder's InstructionsDomestic production activities

Basis of energy property See the Shareholder's Instructionsinformation See Form 8903 instructions

Recapture of low-income housingQualified production activities income Form 8903, line 7b credit (section 42(j)(5)) Form 8611, line 8Employer's Form W-2 wages Form 8903, line 17 Recapture of low-income housingOther deductions See the Shareholder's Instructions credit (other) Form 8611, line 8

Recapture of investment credit See Form 4255

Recapture of other credits See the Shareholder's InstructionsLow-income housing credit (section Look-back interest - completed42(j)(5)) from pre-2008 buildings long-term contracts See Form 8697Low-income housing credit (other) from Look-back interest - income forecastpre-2008 buildings method See Form 8866Low-income housing credit (section Dispositions of property with

See the Shareholder's42(j)(5)) from post-2007 buildings section 179 deductions

InstructionsLow-income housing credit (other) Recapture of section 179from post-2007 buildings deductionQualified rehabilitation expenditures Section 453(I)(3) information(rental real estate) Section 453A(c) informationOther rental real estate credits Section 1260(b) informationOther rental credits Interest allocable to production

See the Shareholder'sUndistributed capital gains credit Form 1040, line 71, box a expenditures

InstructionsAlcohol and cellulosic biofuel fuels CCF nonqualified withdrawalscredit Depletion information - oil and gasWork opportunity credit Amortization of reforestationSee the Shareholder's Disabled access credit Instructions costsEmpowerment zone and renewal Section 108(i) informationcommunity employment credit Other information

EEA

Line 17 Line 19 Line 20a Line 21Description Type

Income/Loss 4797 Pass-thru Net

Totals

8825 K-1 Rental Real Estate Activity 2012

EIN/SSN

K1_8825~.LD

Shareholder/Partner Name Ownership percentage

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ALEX CHERNYAVSKY 100 560-61-4710

4064 LAKELAND AVE NROBBINSDALE MN 55422 4 COMMERCIAL 27,504

27,504 27,504

Depreciation and Amortization45622012(Including Information on Listed Property)

179

Part I Election To Expense Certain Property Under Section 179

Part II Special Depreciation Allowance and Other Depreciation

Part III MACRS Depreciation

Part IV Summary

See separate instructions. Attach to your tax return.

1 1

2 2

3 3

4 4

5

5

6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14

14

15 15

16 16

Section A

17 17

18

Section B - Assets Placed in Service During 2012 Tax Year Using the General Depreciation System

19a

b

c

d

e

f

g

h

i

Section C - Assets Placed in Service During 2012 Tax Year Using the Alternative Depreciation System

20a

b

c

21 21

22

22

23

23


OMB No. 1545-0172Form

AttachmentSequence No.

Note: If you have any listed property, complete Part V before you complete Part I.

Maximum amount (see instructions)

Total cost of section 179 property placed in service (see instructions)

Threshold cost of section 179 property before reduction in limitation (see instructions)

Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0-

Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing

separately, see instructions

Listed property. Enter the amount from line 29

Total elected cost of section 179 property. Add amounts in column (c), lines 6 and 7

Tentative deduction. Enter the smaller of line 5 or line 8

Carryover of disallowed deduction from line 13 of your 2011 Form 4562

Business income limitation. Enter the smaller of business income (not less than zero) or line 5

Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11

Carryover of disallowed deduction to 2013. Add lines 9 and 10, less line 12

Note: Do not use Part II or Part III below for listed property. Instead, use Part V.

(Do not include listed property.) (See instructions.)

Special depreciation allowance for qualified property (other than listed property) placed in service

during the tax year (see instructions)

Property subject to section 168(f)(1) election

Other depreciation (including ACRS)

(Do not include listed property.) (See instructions.)

MACRS deductions for assets placed in service in tax years beginning before 2012

If you are electing to group any assets placed in service during the tax year into one or more general

asset accounts, check here

3-year property

5-year property

7-year property

10-year property

15-year property

20-year property

25-year property 25 yrs. S/L

Residential rental 27.5 yrs. MM S/L

property 27.5 yrs. MM S/L

Nonresidential real 39 yrs. MM S/L

property MM S/L

Class life S/L

12-year 12 yrs. S/L

40-year 40 yrs. MM S/L

(See instructions.)

Listed property. Enter amount from line 28

Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21. Enter

here and on the appropriate lines of your return. Partnerships and S corporations - see instructions

For assets shown above and placed in service during the current year, enter the

portion of the basis attributable to section 263A costs

Form 4562 (2012)

Identifying number

(a) (b) (c)

(b) (c)(d)

(a) (e) (f) (g)

Department of the TreasuryInternal Revenue Service (99)

Name(s) shown on return Business or activity to which this form relates

Description of property Cost (business use only) Elected cost

(see instructions)

Month and year Basis for depreciationRecoveryplaced in (business/investment useClassification of property Convention Method Depreciation deductionperiodservice only-see instructions)

EEA

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ROBIN CENTER CHIROPRACTIC FORM 1120S 26-0214535

500,00024,265

2,000,0000

500,000

COMPUTER 869 869MASSAGE CHAIRS 1,299 1,299

2,1682,168

128,7132,168

11,049

3,765

11,048 5 MQ 200 DB 552

15,366

Part V Listed Property

Part VI Amortization

24a Yes No Yes No

25

25

26

27

28 28

29 29

Section B - Information on Use of Vehicles

30

31

32

33

34 Yes No Yes No Yes No Yes No Yes No Yes No

35

36

Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees

37 Yes No

38

39

40

41

42

43 43

44 44

Form 4562 (2012) Page 2

(Include automobiles, certain other vehicles, certain computers, and property used for

entertainment, recreation, or amusement.)

Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a,24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable.

Section A - Depreciation and Other Information (Caution: See the instructions for limits for passenger automobiles.)

24b If "Yes," is the evidence written?

Special depreciation allowance for qualified listed property placed in service during

the tax year and used more than 50% in a qualified business use (see instructions)

Property used more than 50% in a qualified business use:

%

%

%

Property used 50% or less in a qualified business use:

% S/L-

% S/L-

% S/L-

Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1

Add amounts in column (i), line 26. Enter here and on line 7, page 1

Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles

to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.

Total business/investment miles driven during

the year (do not include commuting miles)

Total commuting miles driven during the year

Total other personal (noncommuting)

miles driven

Total miles driven during the year. Add

lines 30 through 32

Was the vehicle available for personal

use during off-duty hours?

Was the vehicle used primarily by a more

than 5% owner or related person?

Is another vehicle available for personal use?

Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not

more than 5% owners or related persons (see instructions).

Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by

your employees?

Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your

employees? See the instructions for vehicles used by corporate officers, directors, or 1% or more owners

Do you treat all use of vehicles by employees as personal use?

Do you provide more than five vehicles to your employees, obtain information from your employees about the

use of the vehicles, and retain the information received?

Do you meet the requirements concerning qualified automobile demonstration use? (See instructions.)

Note: If your answer to 37, 38, 39, 40, or 41 is "Yes," do not complete Section B for the covered vehicles.

Amortization of costs that begins during your 2012 tax year (see instructions):

Amortization of costs that began before your 2012 tax year

Total. Add amounts in column (f). See the instructions for where to report

Form 4562 (2012)

(c) (e) (i)(a) (b) (d) (f) (g) (h)

(a) (b) (c) (d) (e) (f)

(e)(b) (c) (d) (f)(a)

Do you have evidence to support the business/investment use claimed?

Business/ Basis for depreciationType of property (list Date placed Cost or other basis Recovery Method/ Depreciation Elected section 179

investment use (business/investmentvehicles first) in service period Convention deduction cost

percentage use only)

Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4 Vehicle 5 Vehicle 6

AmortizationDate amortization Amortizable amount Code section Amortization for this year

period orDescription of costs beginspercentage

EEA

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VAN 20080630 100 13,000 13,000

Sales of Business Property47972012(Also Involuntary Conversions and Recapture Amounts

Under Sections 179 and 280F(b)(2))

27

Part I Sales or Exchanges of Property Used in a Trade or Business and Involuntary Conversions From Other

Part II

Than Casualty or Theft - Most Property Held More Than 1 Year (see instructions)

Ordinary Gains and Losses (see instructions)

Attach to your tax return.Information about Form 4797 and its separate instructions is at www.irs.gov/form4797.

1

1

2

3 3

4 4

5 5

6 6

7 7

8 8

9

9

10

11 11

12 12

13 13

14 14

15 15

16 16

17 17

18

a

18a

b 18b


Form

Enter the gross proceeds from sales or exchanges reported to you for 2012 on Form(s) 1099-B or 1099-S (or

substitute statement) that you are including on line 2, 10, or 20 (see instructions)

Gain, if any, from Form 4684, line 39

Section 1231 gain from installment sales from Form 6252, line 26 or 37

Section 1231 gain or (loss) from like-kind exchanges from Form 8824

Gain, if any, from line 32, from other than casualty or theft

Combine lines 2 through 6. Enter the gain or (loss) here and on the appropriate line as follows:

Partnerships (except electing large partnerships) and S corporations. Report the gain or (loss) following theinstructions for Form 1065, Schedule K, line 10, or Form 1120S, Schedule K, line 9. Skip lines 8, 9, 11, and 12 below.

Individuals, partners, S corporation shareholders, and all others. If line 7 is zero or a loss, enter the amount fromline 7 on line 11 below and skip lines 8 and 9. If line 7 is a gain and you did not have any prior year section 1231losses, or they were recaptured in an earlier year, enter the gain from line 7 as a long-term capital gain on theSchedule D filed with your return and skip lines 8, 9, 11, and 12 below.

Nonrecaptured net section 1231 losses from prior years (see instructions)

Subtract line 8 from line 7. If zero or less, enter -0-. If line 9 is zero, enter the gain from line 7 on line 12 below. If line

9 is more than zero, enter the amount from line 8 on line 12 below and enter the gain from line 9 as a long-term

capital gain on the Schedule D filed with your return (see instructions)

Ordinary gains and losses not included on lines 11 through 16 (include property held 1 year or less):

Loss, if any, from line 7 ( )

Gain, if any, from line 7 or amount from line 8, if applicable

Gain, if any, from line 31

Net gain or (loss) from Form 4684, lines 31 and 38a

Ordinary gain from installment sales from Form 6252, line 25 or 36

Ordinary gain or (loss) from like-kind exchanges from Form 8824

Combine lines 10 through 16

For all except individual returns, enter the amount from line 17 on the appropriate line of your return and skip lines a

and b below. For individual returns, complete lines a and b below:

If the loss on line 11 includes a loss from Form 4684, line 35, column (b)(ii), enter that part of the loss here. Enter the part

of the loss from income-producing property on Schedule A (Form 1040), line 28, and the part of the loss from property

used as an employee on Schedule A (Form 1040), line 23. Identify as from "Form 4797, line 18a." See instructions

Redetermine the gain or (loss) on line 17 excluding the loss, if any, on line 18a. Enter here and on Form 1040, line 14

Form 4797 (2012)

Identifying number

(e) (f)(a) (b) (c) (d) (g) Gain or (loss)

OMB No. 1545-0184

Department of the Treasury AttachmentInternal Revenue Service (99) Sequence No.

Name(s) shown on return

Depreciation Cost or otherDescription Date acquired Date sold Gross allowed or basis, plus

allowable since improvements and Subtract (f) from theof property sales price(yr., mo., day) (yr., mo., day)acquisition expense of sale sum of (d) and (e)

EEA

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. . . . .


VAN 2008063020121108 13,000 13,000

A

B

C

D

A B C D

8825 Rental Real Estate Income and Expenses of aPartnership or an S Corporation

Properties

( )

See instructions.Attach to Form 1065, Form 1065-B, or Form 1120S.

1

Rental Real Estate Income

2 2

Rental Real Estate Expenses

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 14

15

15

16

16

17

17

18 a 18a

b 18b

19

19

20 a

20a

b

21 21

For Paperwork Reduction Act Notice, see instructions.

OMB No. 1545-1186

Show the type and address of each property. For each rental real estate property listed, report the number of days rented at fair

rental value and days with personal use. See instructions. See page 2 to list additional properties.

Physical address of each property - street, city, Type - Enter code 1-8;Fair Rental Days Personal Use Days

state, ZIP code see page 2 for list

Gross rents

Advertising

Auto and travel

Cleaning and maintenance

Commissions

Insurance

Legal and other professional fees

Interest

Repairs

Taxes

Utilities

Wages and salaries

Depreciation (see instructions)

Other (list)

Total expenses for each property.


Income or (Loss) from each

property. Subtract line 16 from line 2

Total gross rents. Add gross rents from line 2, columns A through H

Total expenses. Add total expenses from line 16, columns A through H

Net gain (loss) from Form 4797, Part II, line 17, from the disposition of property from rental real

estate activities

Net income (loss) from rental real estate activities from partnerships, estates, and trusts in which

this partnership or S corporation is a partner or beneficiary (from Schedule K-1)

Identify below the partnerships, estates, or trusts from which net income (loss) is shown on line 20a.

Attach a schedule if more space is needed:

(1) Name (2) Employer identification number

Net rental estate income (loss). Combine lines 18a through 20a. Enter the result here and on:

Form 1065 or 1120S: Schedule K, line 2, or

Form 1065-B: Part I, line 4

Form 8825 (12-2010)

Employer identification number

Form

(Rev. December 2010)

Department of the Treasury

Internal Revenue Service

Name

EEA

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4064 LAKELAND AVE NROBBINSDALE MN 55422

4COMMERCIAL

365

27,504

27,50427,504

27,504

2012Taxes and Licenses Attachment

Taxes and Licenses Form 1120S Page 1, Line 12

1 1

2 2

3 3

4 4

5 5

6 6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 14

Note: This information does not transmit to the IRS with e-filed returns.

Including with a paper filed return is optional.

State income taxes

State franchise taxes

City income taxes

City franchise taxes

Local property taxes

Intangible property taxes

Payroll taxes

Less: credit from Form 8846

Foreign taxes paid

Occupancy taxes

Other miscellaneous taxes

Built in gains tax allocated to ordinary income

Licenses

Total to Form 1120S, Page 1, Line 12

S CORPORATION NAME EIN

ATT_STL.LD


10,848

8,970

19,818

Federal Supporting Statements 2012Name(s) as shown on return FEIN

STATMENT.LD

FORM 1120S LINE 19

PG01


Statement #2

DESCRIPTION AMOUNTACCOUNTING 7,508AUTOMOBILE AND TRUCK EXPENSE 6,532BANK CHARGES 1,792DUES AND SUBSCRIPTIONS 373EDUCATION AND TRAINING 1,541EQUIPMENT RENTAL/LEASE 16,828INSURANCE 6,14850% MEALS AND ENTERTAINMENT 3,831OFFICE EXPENSE 9,245OUTSIDE SERVICES/SUB CONTRACTORS 29,928POSTAGE/SHIPPING 1,175SUPPLIES 11,554TELEPHONE 6,417TRAVEL 968UNIFORMS 2,809UTILITIES 7,428BILLING SERVICE 50,803CREDIT CARD FEES 291STORAGE EXPENSE 71______________

____________________________TOTAL 165,242

STM22PG01

FORM 1120S, SCHEDULE L, LINE 18 OTHER CURRENT LIABILITIES

DESCRIPTION BEG OF YEAR END OF YEARUS BANK CC 3199 10,834 14,434AMEX CC 71008 1,930 6,840FEDERAL PAYROLL TAX 2,152 1,058STATE PAYROLL TAX 357 219MN CARE TAX 570 234___________ ___________

TOTAL 15,843 22,785___________ ______________________ ___________

Federal Supporting Statements 2012Name(s) as shown on return FEIN

STATMENT.LD

SCHEDULE M-2 LINE 3

PG01


Statement #29

DESCRIPTION AMOUNTNET RENTAL REAL ESTATE INCOME 27,504______________

____________________________TOTAL 27,504

SCHEDULE M-2 LINE 5PG01

Statement #30

DESCRIPTION AMOUNTALLOWED SECTION 179 EXPENSE 2,168NONDEDUCTIBLE EXPENSES 3,830______________

____________________________TOTAL 5,998

S Corporation Return 2012MINNESOTA REVENUE

2012 M8

ID 1121

Print

or

Type

Round amounts to nearest whole dollar1

1

2 2

33

44

Tax 5 56and

6Credits

7 7

88

9 910

10

1111

12 12

13 13

1414

15 15

16 16

17 17

18 18

19Refund

or 19

Amount 20

Due 20

21 21

22 22

23

Signa-tures

Include a complete copy of federal Form 1120S, Schedules K and K-1, and other federal schedules

Tax year beginning , 2012, ending

Name of corporation Federal ID number Minnesota tax ID

Current street address Check if new address Former name, if changed since 2011 return:

City State Zip code Number of enclosed Number ofSchedules KS: shareholders:

S corporation taxes (place an X in all that apply):

federal Schedule D taxes passive income

LIFO recapture (enclose computation)

Minimum fee from M8A, line 21 (see M8A instructions, pg. 9) (enclose M8A)

Composite income tax for nonresident shareholders (enclose Schedules KS)

Minnesota income tax withheld for nonresident shareholders.(enclose Forms AWC)If you received Form AWC from a shareholder, check box:

Add lines 1 through 4Employer Transit Pass Credit not passed through to shareholders,

limited to the sum of lines 1 and 2 above (enclose Schedule ETP)

Subtract line 6 from line 5

Minnesota Nongame Wildlife Fund donation (see instructions, pg. 4).This will reduce your refund or increase your tax

Add lines 7 and 8

Enterprise Zone Credit not passed throughto shareholders (enclose Schedule EPC)

Job Opportunity Building Zone Jobs Credit not passedthrough to shareholders (enclose Schedule JOBZ)

Credit for tuberculosis testing on cattle (see instructions, pg. 5)

Estimated tax and/or extension payments made for 2012


Tax due. If line 9 is more than line 14, subtract line 14 from line 9

Penalty (see instructions, pg. 5)

Interest (see instructions, pg. 5)

Additional charge for underpayment of estimated tax (attach Schedule EST)

AMOUNT DUE. If you entered an amount on line 15, add lines 15 through 18.

Payment method: Electronic (see inst., pg. 2), or Check (attach Form PV40)Overpayment. If line 14 is more than the sum of lines

9 and 18, subtract line 9 and line 18 from line 14

Amount of line 20 to be credited to your 2013 estimated tax

REFUND. Subtract line 21 from line 20

To have your refund direct deposited, enter the following. Otherwise, you will receive a check.

Account type: Routing number Account number (use an account not assoc. with any foreign banks)

Checking Savings

Mail to: Minnesota S Corporation Income Tax, Mail Station 1770, St. Paul, MN 55145-1770

Place an X in

all that apply:Initial Composite Financial Qualified Subchapter Qualified business partici- Out of business (see

return income tax institution S Subsidiary pating in a JOBZ zone instructions, pg. 4)

Signature of officer Date Daytime phone I authorize the MN Dept. ofRevenue to discuss this taxreturn with the person below.

This email address belongs to:Print name of officer Email address for correspondence, if desiredEmployee Paid preparer Other

Paid preparer's signature Date Daytime phone Preparer's PTIN

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01-01-2012 12-31-2012

ROBIN CENTER CHIROPRACTIC 26-0214535 8919549

4064 LAKELAND AVE NORTH

ROBBINSDALE MN 55422 1 1

0

100

100

100

100

0

10000

0

100X

0

00

X03-13-2013 763-746-1244

ALEX CHERNYAVSKY

03-13-2013 651-739-2020 P00962456

2012 M8AApportionment and Minimum Fee 2012

ID 1121

MINNESOTA REVENUE

B B B

A

Place an X in the box if you conduct all activity

in Minnesota, and enter 1.00000 on line 18.

1 1

2

2

3

3

44

5 5

6

6

7

7

8 8

9 9

1010

11

11

12 12

13 13

14

14

1515

1616

171718 APPORTIONMENT FACTOR

18

1919

2020

2121

Add line 21 amounts and enter on Form M8, line 2.

If the amount Enter this amount If the amount Enter this amount

on line 20 is: on line 21: on line 20 is: on line 21:

S corporation nameIf you're a qualified business participating in a JOBZ FEINzone in Minnesota and all your property and payroll Minnesota tax IDare within the zone, you are exempt from the mini-mum fee. Enter zero on line 21 below and on line 2of Form M8.

Average inventory

Average tangible property

(at original cost)

Average land owned/used

(at original cost)

Financial institutions only: averageintangible property (see inst., pg. 8)

Capitalized rents (gross rents x 8)

Total property (add lines 1 - 5;

if Col. A is zero, see inst., pg. 7)

Minnesota property factor (divide each

line 6B amount by line 6A; carry to five decimal places)

Property factor weight 0.035 0.035 0.035

Weighted ratio for PROPERTY (multiply line 7 by line 8)

Payroll/officer's compensation(if Col. A is zero, see inst., pg. 7)

Minnesota payroll factor (divide each


Payroll factor weight 0.035 0.035 0.035

Weighted ratio for PAYROLL (multiply line 11 by line 12)

Sales or receipts (if a financialinstitution or if Col. A is zero,see inst., pg. 7)

Minnesota sales factor (divide each


Sales factor weight 0.93 0.93 0.93

Weighted ratio for SALES (multiply line 15 by line 16)

(Add lines 9, 13 and 17 in each column OR if you conduct all

activity in Minnesota, enter 1.00000 on line 18)

Minimum fee calculation (read instructions, pg. 9)

Adjustments (see instructions, pg. 9)

Add lines 6, 10, 14 and 19

Minimum fee (see table below)

less than $500,000 $0 $5,000,000 to $9,999,999 $1,000

$500,000 to $999,999 $100 $10,000,000 to $19,999,999 $2,000

$1,000,000 to $4,999,999 $300 $20,000,000 or more $5,000

1 2 3

Total In andOutside Minnesota In Minnesota In Minnesota In Minnesota

Property

Ratio

Payroll

Ratio

Sales

Ratio

Apportion-

ment/

Minimum

Fee

QSSS designated filer

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X

ROBIN CENT26-02145358919549

0 0

85129 85129

0 0

00

370552 370552

455681 455681

1.00000

0.03500

86182 86182

1.00000

0.03500

457408 457408

1.00000

0.93000

1.00000

0

999271

100

MINNESOTA REVENUE

Shareholder's Share of Income, Credits and Modifications 2012

MNKS_SUM

Modifications to Federal Taxable Income

1 1

2 2

3

3

4

4

5 5

6

6

A 7l

7l8 8

sh 9a

9re 10 10ho 11 11l

12 12de 13 13rs 14 14

15 15

16 16

Relating to Alternative Minimum Tax

17 17

18 18

19 19

20 20

Minnesota Portion of Amounts From Federal Schedule K-1 (1120S)

21 21

22

N 22o 23n

23re 24 24s

25 25id 26 26e

27 27nt 28 28

29 29s

30ha 30r

31 31eh 32 32o

Composite Income Tax or Nonresident Withholdingld 33 33e 34r

34s35

35

Calculate lines 1-17 the same for all resident and nonresident shareholders. Calculate

lines 18-32 for nonresident shareholders only. Round amounts to the nearest whole dollar.

Interest income from non-Minnesota state and municipal bonds

State income tax deducted in arriving at ordinary or net rental income

Expenses deducted that are attributable to income not taxed by Minne-

sota (other than interest or mutual fund dividends from U.S. bonds)

If the S corporation elected section 179 expensing, enter the share-

holder's flow-through section 179 expensing for Minnesota purposes

100% of shareholder's pro rata share of federal bonus depreciation

Federal tax-exempt subsidies paid to employers for providing

prescription drug coverage for their retirees

Fines, fees and penalties deducted federally

as a trade or business expense

Addition due to federal changes not adopted by Minnesota

Interest from U.S. government bond obligations, minus any expenses

deducted on the federal return that are attributable to this income

JOBZ business and investment income exemptions

Subtraction due to federal changes not adopted by Minnesota

Employer transit pass credit

Enterprise zone credit

Credit for increasing research activities

Credit for historic structure rehabilitation & NPS project number:

Jobs credit for participating in a JOBZ zone

Intangible drilling costs

Gross income from oil, gas and geothermal properties

Deductions allocable to oil, gas and geothermal properties

Depletion

Minnesota source gross income

Ordinary Minnesota source income (loss)

from trade or business activities

Income (loss) from Minnesota rental real estate

and other Minnesota rental activities

Interest income

Ordinary dividends

Royalties

Net Minnesota short-term capital gain (loss)

Net Minnesota long-term capital gain (loss)

Section 1231 Minnesota net gain (loss)

Other Minnesota income (loss). (Describe type of income

or include separate sheet: )

Section 179 expense deduction apportionable to Minnesota ( )

S Corporation's MN apportionment factor (line 18 of M8A)

Minnesota source distributive income

Minnesota composite income tax paid by S corporation. If the

shareholder elected composite income tax

Minnesota income tax withheld for nonresident shareholder

not electing to file composite income tax. If the shareholder

completed and signed a Form AWC

1121

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11049

2012Minnesota KS Worksheet

Line 5(Keep for your records)

If you chose on your federal return the special depreciation allowance for certain qualified property, your shareholders must add back 80

percent of the bonus depreciation to Minnesota.

Follow the steps below to determine the shareholder's share of the amount that is required to be added back to Minnesota:

1 Add line 14 and line 25 of your federal Form 4562

2 Total of any bonus depreciation amounts passed through to the S corporation as a partner of a

partnership (from line 8 of Schedule KPC)

3 Add steps 1 and 2

4 Multiply step 3 by the shareholder's percentage of stock ownership

Enter the result from step 4 on line 5 of the shareholder's Schedule KS.

Shareholder's Name SSN

EIN

MNKS_BON.LD

Name of Corporation

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. . . . . . . . . . . . . . . . . . . . .

ALEX CHERNYAVSKY 560-61-4710


11049

11049

11049

45622012

Minnesota

Depreciation and AmortizationFor your records only. Do Not Mail to Minnesota.

Part I Election To Expense Certain Tangible Property Under Section 179

Part II Special Depreciation Allowance and Other Depreciation

Part III MACRS Depreciation

Part IV

Summary

1 1

2 2

3 3

4 4

5

5

6

7 7

8 8

9 9

10 10

11 11

12 12

13 13

14 Not allowed for

14 MINNESOTA purposes

15 15

16 16

Section A

17 17

18

Section B - Assets Placed in Service During 2012 Tax Year Using the General Depreciation System

19a

b

c

d

e

f

g

h

i

Section C - Assets Placed in Service During 2012 Tax Year Using the Alternative Depreciation System

20a

b

c

21 21

22

22

23

23

Form(Including Information on Listed Property)

(Rev. 11/05)

See separate instructions.

Note: If you have any listed property, complete Part V before you complete Part I.

Maximum amount. See IRS instructions for a higher limit for certain businesses

Total cost of IRC Section 179 property placed in service (see IRS instructions)

Threshold cost of IRC Section 179 property before reduction in limitation

Reduction in limitation. Subtract line 3 from line 2. If zero or less, enter -0-

Dollar limitation for tax year. Subtract line 4 from line 1. If zero or less, enter -0-. If married filing

separately, see IRS instructions

Listed property. Enter the amount from line 29.

Total elected cost of IRC Section 179 property. Add amounts in column (c), lines 6 and 7

Tentative deduction. Enter the smaller of line 5 or line 8

Carryover of disallowed deduction from line 13 of your 2011 Form 4562

Business income limitation. Enter the smaller of business income (not less than zero) or line 5

IRC Section 179 expense deduction. Add lines 9 and 10, but do not enter more than line 11

Carryover of disallowed deduction to 2013. Add lines 9 and 10, less line 12

Note: Do not use Part II or Part III below for listed property. Instead, use Part V.

(Do not include listed property.)

Special depreciation allowance for qualified property (other than listed property) placed in

service during the tax year

Property subject to IRC Section 168(f)(1) election

Other depreciation (including ACRS)

(Do not include listed property.)

MACRS deductions for assets placed in service in tax years beginning before 2012

If you are electing under IRC Section 168(i)(4) to group any assets placed in service during

the tax year into one or more general asset accounts, check here

3-year property

5-year property

7-year property

10-year property

15-year property

20-year property

25-year property 25 yrs. S/L

Residential rental 27.5 yrs. MM S/L

property 27.5 yrs. MM S/L

Nonresidential real 39 yrs. MM S/L

property MM S/L

Class life S/L

12-year 12 yrs. S/L

40-year 40 yrs. MM S/L

Listed property. Enter amount from line 28

Total. Add amounts from line 12, lines 14 through 17, lines 19 and 20 in column (g), and line 21

Enter here and on the appropriate lines of your return

For assets shown above and placed in service during the current year, enter the

portion of the basis attributable to IRC Section 263A costs

(a) (b) (c) (d) (e) (f)

Note: Minnesota does not allow any additional depreciation benefits provided by I.R.C. Section

168(k) and 1400L.

Name(s) shown on return Business or activity to which this form relates Identification number

(a) Description of property (b) Cost (business use only) (c) Elected cost

Classification of property Month and Basis for depreciation Recovery Convention Method (g) Depreciation deductionyear placed in (business/investment use period

service only-see instructions)

. . . . . . . . . . . . . .

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. . . . . . . . . . .

ROBIN CENTER CHIROPRACTIC FORM 1120S 26-0214535

2500024265

2000000

25000

COMPUTER 869 869MASSAGE CHAIRS 1299 1299

21682168

250002168

1770

22097 5 MQ 200 DB 1105

2875

For your records only. Do not Mail to Minnesota.Part V Listed Property

Part VI Amortization

24a Yes No Yes No

25

25

26

27

28 28

29 29

Section B - Information on Use of Vehicles

30

31

32

33

34 Yes No Yes No Yes No Yes No Yes No Yes No

35

36

Section C - Questions for Employers Who Provide Vehicles for Use by Their Employees

Yes No

37

38

39

40

41

42

43 43

44 44

Form 4562 (2012) Page 2

(Include automobiles, certain other vehicles, cellular telephones, certain computers, and

property used for entertainment, recreation, or amusement.)

Note: For any vehicle for which you are using the standard mileage rate or deducting lease expense, complete only 24a,24b, columns (a) through (c) of Section A, all of Section B, and Section C if applicable.

Section A - Depreciation and Other Information (Caution: See IRS instructions for limits for passenger automobiles.)

24b If "Yes," is the evidence written?

Special depreciation allowance for qualified listed property placed in service during the tax

year and used more than 50% in a qualified business use:

Property used more than 50% in a qualified business use:

%

%

%

Property used 50% or less in a qualified business use:

% S/L-

% S/L-

% S/L-

Add amounts in column (h), lines 25 through 27. Enter here and on line 21, page 1

Add amounts in column (i), line 26. Enter here and on line 7, page 1

Complete this section for vehicles used by a sole proprietor, partner, or other "more than 5% owner," or related person. If you provided vehicles

to your employees, first answer the questions in Section C to see if you meet an exception to completing this section for those vehicles.

Total business/investment miles driven

during the year (do not include commuting

miles

Total commuting miles driven during the year

Total other personal (noncommuting)

miles driven

Total miles driven during the year.


Was the vehicle available for personal use

during off-duty hours?

Was the vehicle used primarily by a more

than 5% owner or related person?

Is another vehicle available for personal

use?

Answer these questions to determine if you meet an exception to completing Section B for vehicles used by employees who are not more than

5% owners or related persons.

Do you maintain a written policy statement that prohibits all personal use of vehicles, including commuting, by

your employees?

Do you maintain a written policy statement that prohibits personal use of vehicles, except commuting, by your employees?

See IRS instructions for vehicles used by corporate officers, directors, or 1% or more owners

Do you treat all use of vehicles by employees as personal use?

Do you provide more than five vehicles to your employees, obtain information from your employees about the

use of the vehicles, and retain the information received?

Do you meet the requirements concerning qualified automobile demonstration use?

Note: If your answer to 37, 38, 39, 40, or 41 is "Yes," do not complete Section B for the covered vehicles.

Amortization of costs that begins during your 2012 tax year:

Amortization of costs that began before your 2012 tax year

Total. Add amounts in column (f)

(a) (b) (c) (d) (e) (f) (g) (h) (i)

Not Allowed for

Minnesota Purposes

(a) (b) (c) (d) (e) (f)

(a) (b) (c) (d) (e) (f)AmortizationDescription of costs Date amortization Amortizable Code Amortization for

period orbegins amount section this yearpercentage

Do you have evidence to support the business/investment use claimed?

Business/Type of property (list Date placed in Cost or other Basis for depreciation Recovery Method/ Depreciation Electedinvestmentvehicles first) service basis (business/investment period Convention deduction section 179

useuse only) costpercentage

Vehicle 1 Vehicle 2 Vehicle 3 Vehicle 4 Vehicle 5 Vehicle 6

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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VAN 20080630100 13000 13000 5 200DBHY

MINNESOTA REVENUE

Shareholder's Share of Income, Credits and Modifications 2012

ID 1121

2012 KS

Amended KS:

Print

or

Type

Form M1 filers,

Modifications to Federal Taxable Income include on:

1 1

2 2

3

3

4

4

5 5

6

6Al 7l

7sh 8 8ar

9eh 9ol 10 10de

11 11rs

12 12

13 13

14 14

15

15

16 16

Relating to Alternative Minimum Tax

1717

1818

1919

20 20

S corporation: Complete and provide Schedule KS to each nonresident shareholder and Minnesota shareholder who has

adjustments to income.

Individual Estate Shareholder's percentage ofEntity of shareholderTrust Exempt Organization stock ownership for tax year: %(place an X in one box):

Calculate lines 1-20 the same for all resident and nonresident shareholders. Calculate

lines 21-35 for nonresident shareholders only. Round amounts to the nearest whole dollar.

Interest income from non-Minnesota state and municipal bonds M1M, line 4

State income tax deducted in arriving at ordinary or net rental income M1M, line 8Expenses deducted that are attributable to income not taxed by Minne-

sota (other than interest or mutual fund dividends from U.S. bonds) M1M, line 10If the S corporation elected section 179 expensing, enter the share-

holder's flow-through section 179 expensing for Minnesota purposes M1M, see line 7 inst.

100% of shareholder's pro rata share of federal bonus depreciation M1M, see line 6 inst.Federal tax-exempt subsidies paid to employers for providing

prescription drug coverage for their retirees M1M, line 11Fines, fees and penalties deducted federally

as a trade or business expense M1M, line 12

Addition due to federal changes not adopted by Minnesota M1M, line 16

Interest from U.S. government bond obligations, minus any expensesdeducted on the federal return that are attributable to this income M1M, line 18

JOBZ business and investment income exemptions M1M, line 32

Subtraction due to federal changes not adopted by Minnesota M1M, line 37

Employer Transit Pass Credit M1C, line 4

Enterprise Zone Credit M1B, line 6

Credit for increasing research activities M1B, line 1

Credit for historic structure rehabilita-

tion and enter NPS project number: M1B, line 3

Jobs Credit for participating in a JOBZ zone M1B, line 4

Intangible drilling costs Lines 17-20 are usedto compute M1MT,

Gross income from oil, gas and geothermal propertieslines 6 and 7. See

Deductions allocable to oil, gas and geothermal properties M1MT instructions fordetails.

Depletion

Continued next page

, 2012 and endingTax year beginningS corporation's federal ID number S corporation's Minnesota tax IDShareholder's federal ID or Social Security number

S corporation's name JOBZ ID number, if anyShareholder's name

AddressAddress

State Zip code City State Zip codeCity

. . . . . . . . . . .

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560-61-4710 260214535 8919549

ALEX CHERNYAVSKY ROBIN CENTER CHIROP

4064 LAKELAND AVE NORTH7650 28TH ST SE

BUFFALO MN 55313 ROBBINSDALE MN 55422X

100.00

11049

MINNESOTA REVENUE

ID 1121

2012 KS P2

Shareholder's Share of Income, Credits and Modifications 2012 (continued)

Minnesota Portion of Amounts From Federal Schedule K-1 (1120S)

21 21

22

22

23

23No 24 24nr

25 25es

26 26id

27e 27nt

28 28

S29 29h

a 30r

30eho 31 31ld 32 32er

Composite Income Tax or Nonresident Withholdings

33 33

3434

35

35

S corporations: Include this schedule and copies of federal Schedules K and K-1 when you file your Form M8.

Shareholders: Include this schedule when you file your Minnesota Form M1.

Minnesota source gross income information (see inst.)Ordinary Minnesota source income (loss)

from trade or business activities M1NR, line 6, col BIncome (loss) from Minnesota rental real estate

and other Minnesota rental activities M1NR, line 6, col B

Interest income M1NR, line 2, col B

Ordinary dividends M1NR, line 2, col B

Royalties M1NR, line 6, col B

Net Minnesota short-term capital gain (loss)M1NR, line 4, col B

Net Minnesota long-term capital gain (loss) M1NR, line 4, col B

Section 1231 Minnesota net gain (loss) M1NR, line 4 or 8, col BOther Minnesota income (loss). (Describe type of income

or include separate sheet: ) M1NR, line 8, col B

Section 179 expense deduction apportionable to Minnesota M1NR inst, line 6, col B

S corporation's Minnesota apportionment factor (line 18 of M8A) information only

If an amount is on line 35below, include line 33 onM1W, line 7, col. B.Minnesota source distributive income (see instructions)

Minnesota composite income tax paid by S corporation. If theshareholder elected composite income tax, mark an X in this box: composite income taxMinnesota income tax withheld for nonresident shareholdernot electing to file composite income tax. If the shareholder

completed and signed a Form AWC, mark an X in this box: M1W, line 7, col C

Shareholder's name Shareholder's Social Security number

S corporation's name S corporation's federal ID number S corporation's Minnesota ID number

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ALEX CHERNYAVSKY 560-61-4710

ROBIN CENTER CHIROPRACTIC 26-0214535 8919549

1120S U.S. Income Tax Return for an S Corporation Form 2012

Documents

Transcript of 1120S U.S. Income Tax Return for an S Corporation Form 2012