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ral Tax ID number is: TIN#: ( Company mailing address is: 57 Royce Road Newton MA 02459 I understand that this certification may be disclosed to the Internal Revenue Service by the transferee and that any false statement I have made herein could be punished by fine, imprisonment, or both. Under penalties of perjury, I
M_00012710 EFTA_00123353 EFTA01268619 LAW H HUDKINS LAWLLe Attorneys • Jacqueline M. linekins • Bengmin f Percy • Lowe N. lornyiello (met ( Goering Rekord G Aneenon. • Moine Nitro • ',einem., to NM. in NH & MA • Ailminal to Prania, Vr & MA Pteme 1. Mama • Mnitted to Pranne in MA & HI /Wan
. The company Federal Tax ID number is: TIN#: Company mailing address is: Newton MA 02459 I understand that this certification may be disclosed to the Internal Revenue Service by the transferee and that any false statement I have made herein could be punished by fine, imprisonment, or both. Under penalties of perjury, I
Attorneys H LAW HUDKINS LAW • lecqselise M. Hudkins • Martha I. Priiie • Beceomin E. Percy Remo T. &roue • burn M. hone& Oar P Wm. Emily I Goering • Condke O'Ner Piked G. Anderson' Greg kaki' Compliance Agreement and Privacy Policy Compliance Agreement • Adnuulm Pradiet n Nil & MA • Asir
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
IC. See the important information about your statement at the end of this docunent for details about those balances. Hddng UBS BANK USA CEP ACCT Goering balance Closing tulaxe on Dec 1 (t) on Dec 21 (I) • ',nee per shin on Dec 31 CD Average rate Your Pi sandal Advisor: SCOTT STACKMANLYLE CAS
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