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wing Forms: 1099-OID 1099-MISC 1099-C TABLE OF CONTENTS Consolidated 1099 Sections: 1099 Dividends and Interest 1099 Gross Proceeds Details: 1099 Dividend & Distribution Details 1099 Interest Income Details Investment Details PAGE 2 4 13 14 15 Page I of IS EFTA00315661 ETRADE CLEARING LLC PO BOX 484 JERSEY CITY,
IV: DIVIDENDS AND DISTRIBUTIONS (OMB NO. 1545-0110) la Total Ordinary Dividends 1b Qualified Dividends 2a Total Capital Gains Distribution 2b Unrecap Sec. 1250 gain 2c Section 1202 gain 2d Collectibles (28%) gain 3 Non dividend distributions 4 Federal income tax withheld 5 Investment Expenses
LANEOUS LESLEY KATHERINE GROFF & TWROS TABLE OF CONTENTS 1099 Dividends and Interest 3 Instructions for Forms 1099 4 1099 Gross Proceeds. 5 1099 Dividend & Distribution Details 10 1099 Interest Income Details 11 Investment Details 12 EFTA00315679 This page intentionally left blank. Paget of *. 2 EFTA00315680 E'TR
est Income not included in box 3 5763.74 1b Qualified Dividends $4,130.88 2 Early vAthdrawal penalty 2a 2b Total Capital Gain Distributions Unrecap Sec. 1250 gain 3 Interest on U.S. Savings Bonds & Treasury obligations 2c Section 1202 gain 4 Federal income tax withheld 2d Collectibles (28%)g
LANEOUS LESLEY KATHERINE GROFF & TWROS TABLE OF CONTENTS 1099 Dividends and Interest 3 Instructions for Forms 1099 4 1099 Gross Proceeds. 5 1099 Dividend & Distribution Details 10 1099 Interest Income Details 11 Investment Details 12 EFTA00315691 This page intentionally left blank. Paget of *. 2 EFTA00315692 E'TR
est Income not included in box 3 5763.74 1b Qualified Dividends $4,130.88 2 Early vAthdrawal penalty 2a 2b Total Capital Gain Distributions Unrecap Sec. 1250 gain 3 Interest on U.S. Savings Bonds & Treasury obligations 2c Section 1202 gain 4 Federal income tax withheld 2d Collectibles (28%)g
Entities connected to both 1099 Dividend & Distribution Details and Unrecap Sec

Lesley Groff
PERSONJERSEY CITY
LOCATIONREGIS
ORGANIZATIONBROKER & BARTER EXCHANGE
ORGANIZATIONBox la
LOCATIONCLEARING LLC
ORGANIZATIONFIRST MARBLEHEAD CORP
ORGANIZATIONCONVERGYS CORP
ORGANIZATIONDANIEL GROFF JTWROS
PERSON
Wilbur Ross
PERSONDoug Band
PERSON
Samantha Power
PERSON
the Internal Revenue Service
ORGANIZATIONUrban
PERSONManton
PERSONOsman
PERSONROIAK
ORGANIZATIONSandie
PERSONla Ilse
PERSONSEND USA SECURE
ORGANIZATION