sked to provide your social security number only to facilitate the identification of records relating to you. Without your social %aunty number. the Departmem may be unable to locate any or all records pertaining to you. ' Signature of individual who is the subject of the record sought. 101ISI OM lel EF

tar reporting information it is the practice of UBS to fide the ECOlicatie tai reporting forms with the US Internal Revenue Service and PR Treasury Departmem, and in such tout, accurately classify dm:tends Mora interest *Stan exerrpot or parade income. Please consult your indsidual !as prepares July 201