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tion of the transmission, (b)the reason for any delay in processing the return or refund, and (c) the date of any refund. If applicable, I authorize the U.S. Treasury and its designated Financial Agent to initiate an ACH electronic funds withdrawal (direct debit) entry to the financial institution account indicate
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Income (Loss) Rental Real Estate Inc. (Loss) Other Rental Income (Loss) Passive Activity Loss C/0 MIT Passive Activity Loss G/0 Interest US Treasury Bond Interest Dividends Royalties Shan-Tam Groom Daln1Loss) Net Long. orm coot. Gain Mos.) Gisafalt(141d Payment,' 10 Partner TP 3 3 A
ained UNITED KINGDOM, POUND (b) Foreign currency exchange rate used to convert to U.S. dollars (c) Source of exchange rate used if not from U.S. Treasury Department's Bureau of the Fiscal Service LHA For Paperwork Reduction Act Notice, see the separate instructions. Form 8938 (2015) S2332 I 11-05-15 65 EFTA0
partment of the Treastoy Attachment Pe Attach to Form 1040. 14arnelS) Shown On roan 1040 Sequame No. ut internal Revenue Service BM) ow SOMA **Corey number Itemized Deductions 2015 GMT SLAINE MAXWELL Medical Caution: Do not include expenses reimbursed or paid by others. and 1 Medical and de
he Farth 490. fee tar reP1ithri9 information It Is the padre of ties to file the typical* lei reporting forms with the US interns' Revenue Semce aid PR Treasury Department and in such form, accurately ELS12fy <linden* ardor interest as tar exempt or treat* income. Neese comsat your inclvdual tax preParer. December 20
ni coon" or norm% rte./It (.9. 'ruled parowthos and prvaeplaments) that are nor regisiered iodic the Stones Act of 1933. and • fealtiescomm. to 9. Corey. 'Wang* and prekus tied contact &LIN tutees commas and COmmerli *Men Conrad, The WC protection rid to aPpolarairral protecton do not m69 to thee
Farts 493, for lac reporting information it is the practice of UBS to file the arckettie lac repotting forms with the US Interfa Revenue Sehice and PR treasury Department and in such loans accurately dasafy (linden:8 andror interest as tar ererrpt or lamb* exam neat consult your indvaue tan preparer. August 2016 (3)
tcy *theme.) Dividend ReiWdebibanit Program (DRIP) The peke reflected is an average vice You may obtan the actual price from yos rootlet Advisor. Corey vulvae tares are purchased under Dia; &Mal shaves wil be veld ad the cash wit be &soothed h your account The dviderd retwestrnere price squirted b
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