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ent001396-047
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I agree.FORM 3435 (Rev. Jan. 1965) U.S. Treasury Department?╟÷Internal Revenue Service REQUEST FOR IDENTIFYING NUMBER Please read the instructions before completing this form. J Publ ic Law 87?╟÷397 requires recipients of dividends, interest, or other payments to furnish identifying numbers to payers required to report such payment to the Internal Revenue Service. This number is required to be furnished to the payer whether or not the payee is required to file a tax return or is covered by Social Security. - 1. Enter the identifying number in this box (include all hyphens) ------------- 2. Please print or type the exact name and address of the record owner -------- ^ or owners of this account if it does not appear below. If the name or address is not correct make the necessary changes. (Underline name of the person whose number is used, if account is in more than one name.) jyj SclTldy Wo.t61TXn3.Tl Dr. :C^ F. Crossley. Jr. 3344 Dakota Way Las Vegas, Nevada 2nd Annual International Bridge Tournament The Sands, Las Vegas, Nevada 89109 3. Mail this form to