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axpayer lientilianion Number and Ceitfication. for information on backup wthholdng. Include this amount on your inocene tax return as tax withheld. Box 5. Shows your share of *menses of a nonsubncle offered regulated investment company, generally a nonputricly offered mutual Itmd If you fib Form 1040,
to a 50% exclusion and certain empowerment Ione business sock that may be subject to a 60% exclusion. See the Scheduie 0 (Form 1040) instructions. Box 2d. Shoes 28% rate gain from sake or exchanges of colkrctbles. If required. use this amount when completing the 28% Rea Gain Worksheet-Line 18 in the i
yer Identification Number and Certification, for information on backup withholding. Include this amount on your income tax return as tax withheld. Box 5. Shows dividends eligible for the 20% qualified business income deduction under section 199A. See the Instructions for Form 1040. Box 6. Shows your
ox 2a that is section 1202 gain from certain small business stock that may be subject to an exclusion. See the Schedule D (Form 1040) instructions. Box 2d. Shows 28% rate gain from sales or exchanges of collectibles. If required. use this amount when completing the 28% Rate Gain Worksheet-Line 18 in th
ayer Identification Number and Certification, for information on backup withholding. Include this amount on your income tax return as tax withheld. Box 5. Shows your share of expenses of a nonpublicly offered regulated investment company. generally a nonpublicly offered mutual fund. If you file Form
o a 50% exclusion and certain empowerment zone business stock that may be subject to a 60% exclusion. See the Schedule D (Form 1040) instructions. Box 2d. Shows 28% rate gain from sales or exchanges of collectibles. If required. use this amount when completing the 28% Rate Gain Worksheet-Line 18 in t
Entities connected to both Box 5 and Box 2d

Lesley Groff
PERSONBox la
LOCATION
the Internal Revenue Service
ORGANIZATIONBox 4
ORGANIZATIONBox 3
ORGANIZATIONBox 1
ORGANIZATIONBox 7
ORGANIZATIONShort-Term Capital Gains
ORGANIZATIONDepartment of the Treasury-Internal Revenue Service
ORGANIZATION
Prince Charles
PERSONDetail Information of Dividends
ORGANIZATIONSchwab
PERSONComplete
ORGANIZATIONLESLEY KATHERINE GROFF
PERSONthe Internal Revenue Service Center
ORGANIZATIONU.S. Savings Bonds
ORGANIZATION