., ST, Arne ecereaS4 et eras er Neon. ressofed a Cededered Ole MA tz Con Sen.yee V awe. Or, Senems •Ow Si..,. Smiler On. One YATATTIL Cense Nom. Onder. NY 1/2CT3SSA 027 This summary is for informational Wrposes only. k is not intended as a tax document. This statement shatas be retained for our r

d belief, with the exception of any com:ctions or notations made on die errate sheet, if one was executed. Dated this day of 2009. JANE DOE 1 Onder /3,2200 2 IiiiNEDDE Cae IsAD I. EDWARDS.11891.11RE 3 Remis ParerüldiAdls 114.9 CiiiiOne. Dale 100 40/ ridt Lee (11016/214ved Poft laudeda 14

0 Yes 0 No b If "Yes complete the fotlowing schedute. (a) Name of ereannahhn (b) Type of organaation (c) Ossenpoen of neatioraleP I Sign Here Onder penallies ot perpsy. I deciare that I e ithasfietum. incluctne accompanyme schedeles and statements, and to Me bost of my knowkdge and 'tel, II Is

e assignment races br toer or index oplions are rendOmly alocaled aflang snol pontons br an anarnalcd pratte. Free Credit Baboe« (Ra* 15634 II 3): Onder me tienti promotion tos. wo may use tree arde belenCes it yOur account n IN Ordhary omme ol cm boenen which en> parel» to yOu on derrerd. &bruin A

mrt races egt or index °plens ere rendOmly alocated aflang all doms' short pasnone try an aJlomaled °racete. Free Credit Relances (RUM 15634 & 3): Onder me tesent promotion (vlos. wo may uso free bedil belteres il yOur ECOunt n me Ordinery omme ot our boenen whkh ere pette to sou on damt. Martin Ao

noties kir Muty 0f inden options are tendomly alocalod amang all clromi shon posoons by an aulomatod proceckwe. Free Credit ~noes (Rob 15034 a 3): Onder me dient protection naos. wo may uso tree 0006 beknes n yOur MCOunt n Ine «Ohm/ Wast ol otit banen ',Midi ere malde to sau on dorheid. Maner A000u