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n islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Dapergrsont of the 7renoury—Intomml gavcours Seneca For Privacy Act and Ptporviork Reduction Act Node. end InStruc rt'ona, sec Form 16-36S. FTC0015 EFTA00176026 2iNOT STAPLE OP FOLD • carded (S
SI O • MAG-PRM 97 O 1099-0 01 O 1099-R 98 O 100.0 75 O 049E OA O 6408-EfIn 72 O 6491-m5A Sr • 969 Return this entire page to the Internal Revenue Service. Photocopies ere not acceptable. Under penalties of penury, I dooltro that I have examined the return end accompanying docUmarda, end, to Ihn ban o1
the edcated insieuton We informal ow of this relarionshio whenyou opened this accost h this cast your 1u-a and smarties a* boated a LOS financial Seneca and rot the imedregbraer, and you nut make a copal of rip error or omission to both firms. • As detated in the account agreements, yw rust roily
u with an updated year-end valuation in January 2018 This 2017 yearend value of your IRA (or the updated value, if applicable) will be furnished to the Internal Revenue Service. December 29 value $57,676.64 Beneficiaries you've named for this account The beneficiaries listed below reflect the information in our records a
epenietly way cr guarantee the aCOSaCy or valday N any OM emotion vended by sources other than U3S Financial Drees es addle% although L6S inertial Seneca gerseralk updates this nIcematim as it is received, the fen does rot von* any entrances dna the information crcler "Coat base and "Ureealcod gad l
with an updated year-end valuation in January 2019 This 2018 year-end value of your IRA (or the updated value, if applicable) will be furnished to the Internal Revenue Service. December 31 value $58,125.23 Beneficiaries you've named for this account The benef iciaries listed below reflect the information in our records
n ei «oared bom thrd pains aid an «oozy t rol gunned wier Mil lends may eon WW1 could ilea yell complete 'Mama Ion wi beprovided open r•Cuellt . Seneca!». of deposit (CDs) (Os are MC nand up» $293.000 n pampa and Sound ntereat pos deponor and per ~Meg ',natant.. n aXtrd-inot with tfrt: nibs • ~o
with an updated year-end valuation in January 2015 This 2014 year-end value of your IRA (or the updated value, if applicable) will be furnished to the Internal Revenue Service. December 31 value $57,015.20 Beneficiaries you've named for this account The beneficiaries listed below reflect the information in our records a
sigaiag this Applicatia, I ackeowledge tat I are. Of will read all be various iloectavo •.ludie• bet sot limited to, the Cenral Tian Tor atoms ad Seneca. AgrACMCIII. PLIt ..ce es. sad Apitatlices. insadas Rist DiSCIOSyna. Sappleseetal Perm. ate it alt.:: TT Global Camay Moat *pavan, taiga c
ding, Of (b) it has not been notified that it is subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the Internal Revenue Service has notified it that the Depositor is no longer subject to backup withholding. (If the Depositor has in fact been notified by the IRS that it is sub
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