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ent001396-046
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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. Public Law 87?╟÷397 requires recipients of dividends, interest, or other payments to to report such payment to the Internal Revenue Service. This number is required to \ayee is required to file a tax return or is covered by Social Security. 1. Enter the identifying number in this box (include all hyphens) --------------------- furnish identifying numbers to payers required be furnished to the payer whether or not the 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.) r Mr. Matt Bartosik ?·-?√ß 1 P. 0. Box 7551^ 7>37.3> 1^ Lo.?║...Ao^eles.,.?╟?Califpxnia...5600i>^j ?╟÷1 J pssj Mr. Sandy Waterman 2nd Annual International Bridge Tournament The Safads, Las Vegas, Nevada 89109 3. Mail this form to ?√ß>