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armontmd and SaMco Tax . HST CO Comb Ontec Sala Ito • MI 43) Retened 44) WI Return 145) Crede C
002 10:18 AA 13617101 000 Transparlation Charge D6.02ure Fod Surcharge ResIdermial Oeltvery Rectrienl PETER SCHLEICHKORN CORPORATE EXPRESS BRADFORD PLACE MELYILLE NY 11747 US 13.10 -2.10 0.28 1.35 Total Transportatie', Charges CONFIDENTIAL USD 12.63 SDNY_GM_00340321 EFTA_00213016 EFTA
nce Ceherwee. enter .0- I )0arre closed all or Ito. Day Yr 10 11 a Enter the short-term portion of
Global Intermediary Identification Number (GIIN) (Optional) 9 NELSON STREET 9 City or town, province or state. and country Oncluding postal code) BRADFORD BD1 5AN UNITED KINGDOM 1 Type of account M Deposit 0 Custodial Account number or other designation 3 Check all that apply a O Account opene
015I 35 EFTA00026323 Form 4797 Deparbrienl a Ito Troosmy Internal ROvOnue Service NamerS}Sn0wn o
ccount is maintained. Number. street. and room or suite no. 9 NELSON STREET 9 City or town. province or state, and country (including postal code) BRADFORD BD1 5AN UNITED KINGDOM 1 Type of account LXJ Deposit LJ Custodial number or other designation 3 Check all that apply a LJ Account opened during
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