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ements of the Practitioner PIN method and Pub. 1345, Handbook for Authorized IRS e-file Providers of Individual Income Tax Returns. ERO's signature Ito. DAVID WEISS CPA, PLLC Date ► 719995 11-10.17 ERO Must Retain This Form - See Instructions Don't Submit This Form to the IRS Unless Requested To
I AV 0.-Vn9 Fiale Change — SOCIAL SECURITY NUMBER Business name BUSNESS CODE NUMBER AS PER FEDER/a HE TLHN SWIM'S address (number and street) Mitres* Caange — City and Sae ZIP coos I Cckinv? In n0 VS/ ESTATES ANO TRUSTS ONLY. ENTER EMPLOYER IDENTIFICATION NUMBER Business Telephone Runt. Ta
and 67 through 73. These are your total payments Ito 74 547,000. Refund 75 If line 74 is more than
I AV 0.-Vn9 Fiale Change — SOCIAL SECURITY NUMBER Business name BUSNESS CODE NUMBER AS PER FEDER/a HE TLHN SWIM'S address (number and street) Mitres* Caange — City and Sae ZIP coos I Cckinv? In n0 VS/ ESTATES ANO TRUSTS ONLY. ENTER EMPLOYER IDENTIFICATION NUMBER Business Telephone Runt. Ta
a pattailr (rum' fund lanais ShirOt Nil X II. I Ito - We and ar *Are and recehe retteeng aid ormths
w value but held awayfroml8SFinaioi Savion (my anal (leash aIBS Bat (i)ca;h at LOS AG Stanford amide Id) nitrate acetels. Widely 'Adobe wee Irk ad Mitres of mutual latch ante soh shares ate to owed dray is the nine a the a0annt hallo on the boob ad records of the ;pliable Moor a male agent/ • Caton
a pattailr (rum' fund lanais ShirOt Nil X II. I Ito - We and ar *Are and recehe retteeng aid ormths
w value but held awayfroml8SFinaioi Savion (my anal (leash aIBS Bat (i)ca;h at LOS AG Stanford amide Id) nitrate acetels. Widely 'Adobe wee hot ad Mitres of mutual latch ante soh shares ate to owed dray is the nine a the a0annt hallo on the boob ad records of the ;pliable Moor a male agent/ • Caton
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