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the corporation is ultimately not qualified to make a section 444 election. Part III Income beneficiary's name and address Social security number Qualified Subchapter S Trust (QSST) Election Under Section 1361(d)(2)* Trust's name and address Employer identification number Date on which stock of the corporation was trans
ormation Name (see instructions) Nautilus, Inc. Type or Print *nstructions.) A Employer Identification number B Date incorporated 11/22/2011 C State of incorporation St. Thomas, VI 00802 VI D Check he applicable box(es) if the corporation. after applying for the EIN shown in A above, changed it
the corporation is ultimately not qualified to make a section 444 election. Part III Income beneficiary's name and address Social security number Qualified Subchapter S Trust (QSST) Election Under Section 1361(d)(2)* Trust's name and address Employer identification number Date on which stock of the corporation was trans
Name (see instructions) Maple, Inc. A Employer Identification number Type ns.t B oat or Print 11/22/2011 City or town. state. and ZIP code C State of incorporation St. Thomas, VI 00802 VI D Check the applicable box(es) if the corporation. after applying for the EIN shown in A above, changed i
the corporation is ultimately not qualified to make a section 444 election. Part III Income beneficiary's name and address Social security number Qualified Subchapter S Trust (QSST) Election Under Section 1361(d)(2)* Trust's name and address Employer identification number Date on which stock of the corporation was trans
g with reference to the month of ► If box (2) or (4) is checked, complete Part II A Em to r Identification number B Date incorporated 11/22/2011 C State of incorporation VI changed its K name or K address ► 11 / 22 / 2011 usually enter the 0 If more than 100 shareholders are listed for item J
the corporation is ultimately not qualified to make a section 444 election. Part III Income beneficiary's name and address Social security number Qualified Subchapter S Trust (QSST) Election Under Section 1361(d)(2)* Trust's name and address Employer identification number Date on which stock of the corporation was trans
Type I Number street, and room or stile no or Print box see instructions.) A B Date incorporated 11/22/2011 City or town. state. and ZIP code C State of incorporation St. Thomas, VI 00802 VI D Check he applicable box(es) if the corporation. after applying for the EIN shown in A above, changed it
Entities connected to both Qualified Subchapter S Trust and C State