Partnership c Corporation d U Consolidated e Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Numbs *** -** -9816 If filer has no U S Identification 3a TIN type 4 Foreign identification (Complete only if item 3 is not applicable) 5 Individual's date of birth MWDD/YYYY In SSNATIN a Type' Pass

artnership c 0 Corporation d D Consolidated e Q Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Numbs 133495607 O If filer has no U S Identification 3a TIN type 4 Foreign identification (Complete only if item 3 is not applicable) 5 Individual's date of birth MWDD/YYYY SSNATIN a Type: Passpor

vidual b O Partnershp c Corporation d O Consolidated e 0 Fiduciary or other • Enter type 3 U.S. Taxpayer Identification Number If filer has no U S Identification 3a TIN type 4 Foreign identification (Complete only it item 3 is not applicable) 5 Individuals date of birth MWDD/YYYY SSN/ITIN a Type: Q Passp