Statement A-QBI Pass-through Entity Reporting

\begin{tabular}{|c|c|c|c|}
\hline
\multicolumn{2}{|l|}{Partnership's name: George Corporation} & \multicolumn{2}{|c|}{Partnership's EIN: 94-8888888} \\
\hline
Partner's name: Brianna Tabor & \multicolumn{3}{|c|}{Partner's identifying number: 444-11-5555} \\
\hline
\multirow[b]{2}{*}{Partner's share of:} & Trade or Business 1 & Trade or Business 2 & Trade or Business 3 \\
\hline
& \begin{tabular}{l}
PTP \\
Aggregated \\
SSTB
\end{tabular}
& \begin{tabular}{l}
PTP \\
Aggregated \\
SSTB
\end{tabular}
& \begin{tabular}{l}
PTP \\
Aggregated \\
SSTB
\end{tabular} \\
\hline
\multicolumn{4}{|c|}{QBI or qualified PTP items subject to partner-specific determinations:} \\
\hline
Ordinary business income (loss) . . . . . . . . . . . . & & & \\
\hline
Rental income (loss) . . . . . . . . . . . . . . . . . . . . & & & \\
\hline
Royalty income (loss) . . . . . . . . . . . . . . . . . . & & & \\
\hline
Section 1231 gain (loss) . . . . . . . . . . . . . . . . & & & \\
\hline
Other income (loss) . . . . . . . . . . . . . . . . . . . . & & & \\
\hline
Section 179 deduction . . . . . . . . . . . . . . . . . . . & & & \\
\hline
\end{tabular}