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EFTA01222598

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K CORRECTED Of checked) PAYER'S name. street address. city or town. state or province. country, ZIP or foreign postal code. and telephone no. Payer's RTN (optional) OMB No. 1545.0112 018 Form 1099-INT 1 Interest income $ 2Earlywithdrawalperially $ PAYERS TIN RECIPIENT'S 11N 3 Interest on U.S. Savings Bonds and Treas. obligations $ RECIPIENT'S name Street address gncludirg apt. no.) City or town. state or province. country. and ZIP or foreign postal code 4 Federal income tax withheld $ S Investment expenses $ 6 Foreign tax paid $ 7 Foregn cowry or U.S. possession 8 Tax-exempt interest $ 9 Speofied private activity bond 'rarest $ 10 Market discount $ 11 Bond premium $ FATCA Sing requirement 0 12 Barxl premum al Tieasw otOgitris $ 13 Bond fawn 0.1 tax-exempt had $ Account number (see instructions) 14 Tax-exempt and tax credit bond CUSIP no. 15 State 16 Slate dentdcai,on no. Form 1099-INT (keep for your records) www.irs.gov/Forrn1099INT Interest Income Copy For Recipient This is important tax information and is being furnished to the IRS. II you are required to file a return, a negligence penalty or other sanction may be imposed on you if this income is taxable and the IRS determines that It has not been reported. 17 State tax withheld $ S Department of the Treastay - Internal Revenue Sews EFTA01222598

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