text,label,label_id,label_name,record_id,group_id,document_status,tax_year,source_record_id,origin,layout,title_mode,ocr_noise,sub_kind
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: wages: USD 11,096.00; federal income tax withheld: USD 1,109.60; employer: Example Entity 8-0-2; employee: Example Entity 8-0-3",W-2,38,W-2,fdc-6e920947d2e7d81f2dc2b5c2,synthetic-form-layout-08,original,2023,fte-db729f19c364a28135e2db78,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: wages: USD 11,179.00; federal income tax withheld: USD 1,117.90; employer: Example Entity 8-1-2; employee: Example Entity 8-1-3",W-2,38,W-2,fdc-1adcda150a725b12178862a3,synthetic-form-layout-08,original,2024,fte-33043ba5161c2b9262217f88,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: wages: USD 11,262.00; federal income tax withheld: USD 1,126.20; employer: Example Entity 8-2-2; employee: Example Entity 8-2-3",W-2,38,W-2,fdc-3cfe87e513f08bd039e9fbd3,synthetic-form-layout-08,original,2025,fte-c262b51e4f20e70b74989342,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: wages: USD 11,345.00; federal income tax withheld: USD 1,134.50; employer: Example Entity 8-3-2; employee: Example Entity 8-3-3",W-2,38,W-2,fdc-a9986748f23daab3f62efaf4,synthetic-form-layout-08,original,2023,fte-9ce816db6227e9bb6c8103ab,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: wages: USD 11,428.00; federal income tax withheld: USD 1,142.80; employer: Example Entity 8-4-2; employee: Example Entity 8-4-3",W-2,38,W-2,fdc-e356ebe976cf83abcc2fde19,synthetic-form-layout-08,original,2024,fte-b3121d9af60de612f3704507,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: wages: USD 11,511.00; federal income tax withheld: USD 1,151.10; employer: Example Entity 8-5-2; employee: Example Entity 8-5-3",W-2,38,W-2,fdc-08461fff1450cb0c59582cbe,synthetic-form-layout-08,original,2025,fte-5db72c8656a7fd5c37f931c1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: wages: USD 11,594.00; federal income tax withheld: USD 1,159.40; employer: Example Entity 8-6-2; employee: Example Entity 8-6-3",W-2,38,W-2,fdc-0bb805abf211c61ac4f6dad9,synthetic-form-layout-08,original,2023,fte-1e222b417b6fed26962557a1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2: Wage and Tax Statement
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: wages: USD 11,677.00; federal income tax withheld: USD 1,167.70; employer: Example Entity 8-7-2; employee: Example Entity 8-7-3",W-2,38,W-2,fdc-fd8d733a09dac6d05c75faed,synthetic-form-layout-08,original,2024,fte-c18aca727a27ee552b6171b1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2: Wage and Tax Statement
Example Client 900 is the named party.
Information printed on this record:
wages: USD 11,233.00
federal income tax withheld: USD 1,123.30
employer: Example Entity 9-0-2
employee: Example Entity 9-0-3",W-2,38,W-2,fdc-bd564555f51ef21480dd4c7d,synthetic-form-layout-09,original,2023,fte-a8c63ef48363f128faa5e4e4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2: Wage and Tax Statement
Example Client 901 is the named party.
Information printed on this record:
wages: USD 11,316.00
federal income tax withheld: USD 1,131.60
employer: Example Entity 9-1-2
employee: Example Entity 9-1-3",W-2,38,W-2,fdc-cfd72de535b95aa064b8ba85,synthetic-form-layout-09,original,2024,fte-4b6f12609821e437fcfb6541,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-2: Wage and Tax Statement
Example Client 902 is the named party.
Information printed on this record:
wages: USD 11,399.00
federal income tax withheld: USD 1,139.90
employer: Example Entity 9-2-2
employee: Example Entity 9-2-3",W-2,38,W-2,fdc-1be807cb90843d063ce8519e,synthetic-form-layout-09,original,2025,fte-7169ac8834e3b731ecb5fb15,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2: Wage and Tax Statement
Example Client 903 is the named party.
Information printed on this record:
wages: USD 11,482.00
federal income tax withheld: USD 1,148.20
employer: Example Entity 9-3-2
employee: Example Entity 9-3-3",W-2,38,W-2,fdc-8c9805774503808d43c0310d,synthetic-form-layout-09,original,2023,fte-663cea56522cdf03f10fc430,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2: Wage and Tax Statement
Example Client 904 is the named party.
Information printed on this record:
wages: USD 11,565.00
federal income tax withheld: USD 1,156.50
employer: Example Entity 9-4-2
employee: Example Entity 9-4-3",W-2,38,W-2,fdc-1a44a62821ee601b168fedc5,synthetic-form-layout-09,original,2024,fte-2ecde11d47ba620cfaebee1b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-2: Wage and Tax Statement
Example Client 905 is the named party.
Information printed on this record:
wages: USD 11,648.00
federal income tax withheld: USD 1,164.80
employer: Example Entity 9-5-2
employee: Example Entity 9-5-3",W-2,38,W-2,fdc-6f92bc599a90b5b6de022756,synthetic-form-layout-09,original,2025,fte-b82f16f8f3577b7212c92dd3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2: Wage and Tax Statement
Example Client 906 is the named party.
Information printed on this record:
wages: USD 11,731.00
federal income tax withheld: USD 1,173.10
employer: Example Entity 9-6-2
employee: Example Entity 9-6-3",W-2,38,W-2,fdc-ea59b2597888aa5d8e706407,synthetic-form-layout-09,original,2023,fte-dcd92271b8b1ddcf2ed6c68f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2: Wage and Tax Statement
Example Client 907 is the named party.
Information printed on this record:
wages: USD 11,814.00
federal income tax withheld: USD 1,181.40
employer: Example Entity 9-7-2
employee: Example Entity 9-7-3",W-2,38,W-2,fdc-92ad07eb955fb3a0460a5f75,synthetic-form-layout-09,original,2024,fte-75f059227673395a6acdfac8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: previously reported wages: USD 11,096.00; correct wages: USD 11,096.00; employer: Example Entity 8-0-2; employee: Example Entity 8-0-3",W-2,38,W-2,fdc-2f0345dba013be6fdf719b57,synthetic-form-layout-08,corrected,2023,fte-289d3321b1946d8aeab5b3e5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: previously reported wages: USD 11,179.00; correct wages: USD 11,179.00; employer: Example Entity 8-1-2; employee: Example Entity 8-1-3",W-2,38,W-2,fdc-ae60949a24a99c2b7b196f2c,synthetic-form-layout-08,corrected,2024,fte-effc223befd1619a72c3b6cb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: previously reported wages: USD 11,262.00; correct wages: USD 11,262.00; employer: Example Entity 8-2-2; employee: Example Entity 8-2-3",W-2,38,W-2,fdc-84a17f1bc3ae3870ef81e919,synthetic-form-layout-08,corrected,2025,fte-9ba0422b5682d9cb7fb3e7d6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: previously reported wages: USD 11,345.00; correct wages: USD 11,345.00; employer: Example Entity 8-3-2; employee: Example Entity 8-3-3",W-2,38,W-2,fdc-cb7bc3a4740a773868fc6151,synthetic-form-layout-08,corrected,2023,fte-5d0d5e61600cdf24509ea6d1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: previously reported wages: USD 11,428.00; correct wages: USD 11,428.00; employer: Example Entity 8-4-2; employee: Example Entity 8-4-3",W-2,38,W-2,fdc-b96cad315a584e1a5300181b,synthetic-form-layout-08,corrected,2024,fte-03bdad20111a6230d4f0f2b7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: previously reported wages: USD 11,511.00; correct wages: USD 11,511.00; employer: Example Entity 8-5-2; employee: Example Entity 8-5-3",W-2,38,W-2,fdc-2d022c6d6864f6f72b53ab60,synthetic-form-layout-08,corrected,2025,fte-1c9b32a0a3c976c51112a4cf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: previously reported wages: USD 11,594.00; correct wages: USD 11,594.00; employer: Example Entity 8-6-2; employee: Example Entity 8-6-3",W-2,38,W-2,fdc-89ec71bc631179aaad6ba335,synthetic-form-layout-08,corrected,2023,fte-8d485dc4e7b6828c02727c08,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2c: Corrected Wage and Tax Statement
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: previously reported wages: USD 11,677.00; correct wages: USD 11,677.00; employer: Example Entity 8-7-2; employee: Example Entity 8-7-3",W-2,38,W-2,fdc-a7ddc97631050f308a72090d,synthetic-form-layout-08,corrected,2024,fte-33db7333337e28c0cbb73798,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 900 is the named party.
Information printed on this record:
previously reported wages: USD 11,233.00
correct wages: USD 11,233.00
employer: Example Entity 9-0-2
employee: Example Entity 9-0-3",W-2,38,W-2,fdc-589af0599724cb27b6aac6ae,synthetic-form-layout-09,corrected,2023,fte-1c2c6b18e675471081aaf645,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 901 is the named party.
Information printed on this record:
previously reported wages: USD 11,316.00
correct wages: USD 11,316.00
employer: Example Entity 9-1-2
employee: Example Entity 9-1-3",W-2,38,W-2,fdc-5aabce3e7bd57c9fb9e32e92,synthetic-form-layout-09,corrected,2024,fte-845636424b1b42810db58571,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 902 is the named party.
Information printed on this record:
previously reported wages: USD 11,399.00
correct wages: USD 11,399.00
employer: Example Entity 9-2-2
employee: Example Entity 9-2-3",W-2,38,W-2,fdc-c38c3fec596625f507bd0422,synthetic-form-layout-09,corrected,2025,fte-ab6474618b77c8380ff6ad0b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 903 is the named party.
Information printed on this record:
previously reported wages: USD 11,482.00
correct wages: USD 11,482.00
employer: Example Entity 9-3-2
employee: Example Entity 9-3-3",W-2,38,W-2,fdc-4395114bd6b46ebfa4d2ffdd,synthetic-form-layout-09,corrected,2023,fte-0e2508b20386f3244d652b60,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 904 is the named party.
Information printed on this record:
previously reported wages: USD 11,565.00
correct wages: USD 11,565.00
employer: Example Entity 9-4-2
employee: Example Entity 9-4-3",W-2,38,W-2,fdc-0c5fffaaefa2b2f486d208e3,synthetic-form-layout-09,corrected,2024,fte-e1bb28fb9e700a559946ef4d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 905 is the named party.
Information printed on this record:
previously reported wages: USD 11,648.00
correct wages: USD 11,648.00
employer: Example Entity 9-5-2
employee: Example Entity 9-5-3",W-2,38,W-2,fdc-9a953e218cdabe08103aa170,synthetic-form-layout-09,corrected,2025,fte-e2ae9095cc41b89ca37f7464,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 906 is the named party.
Information printed on this record:
previously reported wages: USD 11,731.00
correct wages: USD 11,731.00
employer: Example Entity 9-6-2
employee: Example Entity 9-6-3",W-2,38,W-2,fdc-5c13d781327f4fc3d456dcff,synthetic-form-layout-09,corrected,2023,fte-edbb9727b1ab12842d5ca250,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2c: Corrected Wage and Tax Statement
Example Client 907 is the named party.
Information printed on this record:
previously reported wages: USD 11,814.00
correct wages: USD 11,814.00
employer: Example Entity 9-7-2
employee: Example Entity 9-7-3",W-2,38,W-2,fdc-164e12f25a40962a4982297f,synthetic-form-layout-09,corrected,2024,fte-257d94a19e7753157e11f0f3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: reportable winnings: USD 11,096.00; date won: 2023-03-01; federal income tax withheld: USD 1,109.60",W-2G,39,W-2G,fdc-5229db39579988f36ea9a38c,synthetic-form-layout-08,original,2023,fte-a3677d22af8d220e134eb309,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: reportable winnings: USD 11,179.00; date won: 2024-03-02; federal income tax withheld: USD 1,117.90",W-2G,39,W-2G,fdc-3b6e57020becb16a7adff8dd,synthetic-form-layout-08,original,2024,fte-0a925fc0e9739ebf71e02c42,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: reportable winnings: USD 11,262.00; date won: 2025-03-03; federal income tax withheld: USD 1,126.20",W-2G,39,W-2G,fdc-a9979d5e09aa9115da295759,synthetic-form-layout-08,original,2025,fte-1f5c4b71bd9c21680e7f50e1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: reportable winnings: USD 11,345.00; date won: 2023-03-04; federal income tax withheld: USD 1,134.50",W-2G,39,W-2G,fdc-85f481ff09a7aef0c27ae325,synthetic-form-layout-08,original,2023,fte-4ec8e6ed2fa723b46ac3dc7c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: reportable winnings: USD 11,428.00; date won: 2024-03-05; federal income tax withheld: USD 1,142.80",W-2G,39,W-2G,fdc-79a17b6f45a6ed9770b70e07,synthetic-form-layout-08,original,2024,fte-afbc7989da4045d2f344f4c6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: reportable winnings: USD 11,511.00; date won: 2025-03-06; federal income tax withheld: USD 1,151.10",W-2G,39,W-2G,fdc-022b320b5614a40f81451616,synthetic-form-layout-08,original,2025,fte-22ed4d68afa3e35b5cadf3a5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: reportable winnings: USD 11,594.00; date won: 2023-03-07; federal income tax withheld: USD 1,159.40",W-2G,39,W-2G,fdc-0f6262db57adb012a0d21fc0,synthetic-form-layout-08,original,2023,fte-adf4cc9b7262cbe1e542ac9a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-2G: Certain Gambling Winnings
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: reportable winnings: USD 11,677.00; date won: 2024-03-08; federal income tax withheld: USD 1,167.70",W-2G,39,W-2G,fdc-18c0066ffbef12177024611e,synthetic-form-layout-08,original,2024,fte-bf7d7029a70adb371dd6ce40,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 900 is the named party.
Information printed on this record:
reportable winnings: USD 11,233.00
date won: 2023-03-01
federal income tax withheld: USD 1,123.30",W-2G,39,W-2G,fdc-58fe62b7fa658e1657df20fe,synthetic-form-layout-09,original,2023,fte-01ba58c9b4471ebb2c14a557,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 901 is the named party.
Information printed on this record:
reportable winnings: USD 11,316.00
date won: 2024-03-02
federal income tax withheld: USD 1,131.60",W-2G,39,W-2G,fdc-02c04b98c101dfa306a621f6,synthetic-form-layout-09,original,2024,fte-1c5e0ff000583f2ada564187,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 902 is the named party.
Information printed on this record:
reportable winnings: USD 11,399.00
date won: 2025-03-03
federal income tax withheld: USD 1,139.90",W-2G,39,W-2G,fdc-a55baec401aa646ac4009ec1,synthetic-form-layout-09,original,2025,fte-ac6dd3dacb3760c710a2f9f0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 903 is the named party.
Information printed on this record:
reportable winnings: USD 11,482.00
date won: 2023-03-04
federal income tax withheld: USD 1,148.20",W-2G,39,W-2G,fdc-667a27f8420b46de522e5927,synthetic-form-layout-09,original,2023,fte-80dd044c92cb76e7a482de34,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 904 is the named party.
Information printed on this record:
reportable winnings: USD 11,565.00
date won: 2024-03-05
federal income tax withheld: USD 1,156.50",W-2G,39,W-2G,fdc-bd43d426460eca37f88ae626,synthetic-form-layout-09,original,2024,fte-d44f4d92ba1d3a38b99143b0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 905 is the named party.
Information printed on this record:
reportable winnings: USD 11,648.00
date won: 2025-03-06
federal income tax withheld: USD 1,164.80",W-2G,39,W-2G,fdc-691e4ac19b2109c7e4305632,synthetic-form-layout-09,original,2025,fte-8a0600eec172f3a367073c62,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 906 is the named party.
Information printed on this record:
reportable winnings: USD 11,731.00
date won: 2023-03-07
federal income tax withheld: USD 1,173.10",W-2G,39,W-2G,fdc-4e6cdb070271e60187b35310,synthetic-form-layout-09,original,2023,fte-bbaa0194636995fea5a2081b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-2G: Certain Gambling Winnings
Example Client 907 is the named party.
Information printed on this record:
reportable winnings: USD 11,814.00
date won: 2024-03-08
federal income tax withheld: USD 1,181.40",W-2G,39,W-2G,fdc-38be22f955cacfcd3b12fba3,synthetic-form-layout-09,original,2024,fte-4efadc21efb70407f8b19f7d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: nonemployee compensation: Example Entity 8-0-0; payer: Example Entity 8-0-1; recipient: Example Entity 8-0-2; tax withheld: USD 1,109.60",1099,5,1099,fdc-691c17e6410de3a8d238ee84,synthetic-form-layout-08,original,2023,fte-1bbddb0f6c9f88079398cfae,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: nonemployee compensation: Example Entity 8-1-0; payer: Example Entity 8-1-1; recipient: Example Entity 8-1-2; tax withheld: USD 1,117.90",1099,5,1099,fdc-44f984f55afb771df3067d67,synthetic-form-layout-08,original,2024,fte-0f482f9672779e4fce872285,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: nonemployee compensation: Example Entity 8-2-0; payer: Example Entity 8-2-1; recipient: Example Entity 8-2-2; tax withheld: USD 1,126.20",1099,5,1099,fdc-63b5448465bcd206092f84e5,synthetic-form-layout-08,original,2025,fte-80380033ab8002ed31d91a8d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: nonemployee compensation: Example Entity 8-3-0; payer: Example Entity 8-3-1; recipient: Example Entity 8-3-2; tax withheld: USD 1,134.50",1099,5,1099,fdc-20b247aebb90932ff38a202a,synthetic-form-layout-08,original,2023,fte-9c94da5ecee9adf124d83bce,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: nonemployee compensation: Example Entity 8-4-0; payer: Example Entity 8-4-1; recipient: Example Entity 8-4-2; tax withheld: USD 1,142.80",1099,5,1099,fdc-dfadc99b8d8fe3ec1bfb8780,synthetic-form-layout-08,original,2024,fte-f1741d31ddfa2c6cefefb247,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: nonemployee compensation: Example Entity 8-5-0; payer: Example Entity 8-5-1; recipient: Example Entity 8-5-2; tax withheld: USD 1,151.10",1099,5,1099,fdc-865addd4be99843f14efe129,synthetic-form-layout-08,original,2025,fte-e767ac0535854a2778bed064,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: nonemployee compensation: Example Entity 8-6-0; payer: Example Entity 8-6-1; recipient: Example Entity 8-6-2; tax withheld: USD 1,159.40",1099,5,1099,fdc-653e3f28a7eb30f3f0eca1b0,synthetic-form-layout-08,original,2023,fte-6d8034dc85cf749a8a0eb250,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-NEC: Nonemployee Compensation
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: nonemployee compensation: Example Entity 8-7-0; payer: Example Entity 8-7-1; recipient: Example Entity 8-7-2; tax withheld: USD 1,167.70",1099,5,1099,fdc-59ab0bc41647820a8b71e298,synthetic-form-layout-08,original,2024,fte-af4607dd40c0a4c3054d9cef,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 900 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-0-0
payer: Example Entity 9-0-1
recipient: Example Entity 9-0-2
tax withheld: USD 1,123.30",1099,5,1099,fdc-c15d2816e7c02602fa2ab6fd,synthetic-form-layout-09,original,2023,fte-83e42cf3bca2b0c917e21865,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 901 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-1-0
payer: Example Entity 9-1-1
recipient: Example Entity 9-1-2
tax withheld: USD 1,131.60",1099,5,1099,fdc-c9902cba7148479706d84e09,synthetic-form-layout-09,original,2024,fte-ff8960205ee88928109afa15,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 902 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-2-0
payer: Example Entity 9-2-1
recipient: Example Entity 9-2-2
tax withheld: USD 1,139.90",1099,5,1099,fdc-8514d556aec8f08cb1e2eabc,synthetic-form-layout-09,original,2025,fte-b972588139b7f36345fa75e5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 903 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-3-0
payer: Example Entity 9-3-1
recipient: Example Entity 9-3-2
tax withheld: USD 1,148.20",1099,5,1099,fdc-ed37d7b45975eb4980ee55b3,synthetic-form-layout-09,original,2023,fte-210fb059d9566b9d06e76ebd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 904 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-4-0
payer: Example Entity 9-4-1
recipient: Example Entity 9-4-2
tax withheld: USD 1,156.50",1099,5,1099,fdc-c8de8b96fcda2da4c6c7cd7e,synthetic-form-layout-09,original,2024,fte-fd4632c3d913f17a43265821,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 905 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-5-0
payer: Example Entity 9-5-1
recipient: Example Entity 9-5-2
tax withheld: USD 1,164.80",1099,5,1099,fdc-7deda654d1028fbb897994b2,synthetic-form-layout-09,original,2025,fte-995927743ad930a2871b09e8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 906 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-6-0
payer: Example Entity 9-6-1
recipient: Example Entity 9-6-2
tax withheld: USD 1,173.10",1099,5,1099,fdc-e776d22899c9bf840cb0932a,synthetic-form-layout-09,original,2023,fte-055a60554a8230687d9308be,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-NEC: Nonemployee Compensation
Example Client 907 is the named party.
Information printed on this record:
nonemployee compensation: Example Entity 9-7-0
payer: Example Entity 9-7-1
recipient: Example Entity 9-7-2
tax withheld: USD 1,181.40",1099,5,1099,fdc-1913f14e8d64e5328d315a04,synthetic-form-layout-09,original,2024,fte-16bae6bf92006736400f94ee,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: rents: USD 11,096.00; royalties: USD 11,096.00; other income: USD 11,096.00; payer: Example Entity 8-0-3; recipient: Example Entity 8-0-4",1099,5,1099,fdc-d7af87b1adfac6cc28ce4fd4,synthetic-form-layout-08,original,2023,fte-13b0e94570421391bae258fa,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: rents: USD 11,179.00; royalties: USD 11,179.00; other income: USD 11,179.00; payer: Example Entity 8-1-3; recipient: Example Entity 8-1-4",1099,5,1099,fdc-c3f20793772e14dd520e9e7f,synthetic-form-layout-08,original,2024,fte-87ef1b447cafd3cbed49bddb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: rents: USD 11,262.00; royalties: USD 11,262.00; other income: USD 11,262.00; payer: Example Entity 8-2-3; recipient: Example Entity 8-2-4",1099,5,1099,fdc-56a8f06e2c61dd97d714429e,synthetic-form-layout-08,original,2025,fte-daacd7387b0089857ae0a8e6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: rents: USD 11,345.00; royalties: USD 11,345.00; other income: USD 11,345.00; payer: Example Entity 8-3-3; recipient: Example Entity 8-3-4",1099,5,1099,fdc-95a8ee620290852c5af54bcd,synthetic-form-layout-08,original,2023,fte-3ab6aeaa6804100d87eac497,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: rents: USD 11,428.00; royalties: USD 11,428.00; other income: USD 11,428.00; payer: Example Entity 8-4-3; recipient: Example Entity 8-4-4",1099,5,1099,fdc-0c648cf709673690c55b1ab8,synthetic-form-layout-08,original,2024,fte-007f0290db7dc878ebcec8a2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: rents: USD 11,511.00; royalties: USD 11,511.00; other income: USD 11,511.00; payer: Example Entity 8-5-3; recipient: Example Entity 8-5-4",1099,5,1099,fdc-0022304abbc582c88fc8fd35,synthetic-form-layout-08,original,2025,fte-74d828e036827af380824015,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: rents: USD 11,594.00; royalties: USD 11,594.00; other income: USD 11,594.00; payer: Example Entity 8-6-3; recipient: Example Entity 8-6-4",1099,5,1099,fdc-3645ed1b2fdacd1311e76077,synthetic-form-layout-08,original,2023,fte-d210ed65eb6f2e536ff2fdb6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-MISC: Miscellaneous Information
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: rents: USD 11,677.00; royalties: USD 11,677.00; other income: USD 11,677.00; payer: Example Entity 8-7-3; recipient: Example Entity 8-7-4",1099,5,1099,fdc-9d84fa0b4aa8d8d3a061b0f2,synthetic-form-layout-08,original,2024,fte-2c3014e43d62b88fa9052b7f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 900 is the named party.
Information printed on this record:
rents: USD 11,233.00
royalties: USD 11,233.00
other income: USD 11,233.00
payer: Example Entity 9-0-3
recipient: Example Entity 9-0-4",1099,5,1099,fdc-9d9e2e2eba1bb4a7d521daa7,synthetic-form-layout-09,original,2023,fte-b8673095a1b8204a62188e54,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 901 is the named party.
Information printed on this record:
rents: USD 11,316.00
royalties: USD 11,316.00
other income: USD 11,316.00
payer: Example Entity 9-1-3
recipient: Example Entity 9-1-4",1099,5,1099,fdc-52d3474743754a5492f40b85,synthetic-form-layout-09,original,2024,fte-5d972afa6fbe8f9b74d7001a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 902 is the named party.
Information printed on this record:
rents: USD 11,399.00
royalties: USD 11,399.00
other income: USD 11,399.00
payer: Example Entity 9-2-3
recipient: Example Entity 9-2-4",1099,5,1099,fdc-ee00bd2a9c8df675b44376e5,synthetic-form-layout-09,original,2025,fte-80fb25ecaa625145877db6c4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 903 is the named party.
Information printed on this record:
rents: USD 11,482.00
royalties: USD 11,482.00
other income: USD 11,482.00
payer: Example Entity 9-3-3
recipient: Example Entity 9-3-4",1099,5,1099,fdc-85f3ceb82f5bec7ee1628410,synthetic-form-layout-09,original,2023,fte-2b6e1bb297b18bf5c61c99e8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 904 is the named party.
Information printed on this record:
rents: USD 11,565.00
royalties: USD 11,565.00
other income: USD 11,565.00
payer: Example Entity 9-4-3
recipient: Example Entity 9-4-4",1099,5,1099,fdc-edae8c702fd3137121d3aa5b,synthetic-form-layout-09,original,2024,fte-ba331d3904a46b72d385f4eb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 905 is the named party.
Information printed on this record:
rents: USD 11,648.00
royalties: USD 11,648.00
other income: USD 11,648.00
payer: Example Entity 9-5-3
recipient: Example Entity 9-5-4",1099,5,1099,fdc-4ab54d400b69de98da6bd04b,synthetic-form-layout-09,original,2025,fte-cd8d325c825e663dae1fc3db,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 906 is the named party.
Information printed on this record:
rents: USD 11,731.00
royalties: USD 11,731.00
other income: USD 11,731.00
payer: Example Entity 9-6-3
recipient: Example Entity 9-6-4",1099,5,1099,fdc-46630bf5d3dbef9c980043fd,synthetic-form-layout-09,original,2023,fte-c6e9e3cf176347a3d01407d0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-MISC: Miscellaneous Information
Example Client 907 is the named party.
Information printed on this record:
rents: USD 11,814.00
royalties: USD 11,814.00
other income: USD 11,814.00
payer: Example Entity 9-7-3
recipient: Example Entity 9-7-4",1099,5,1099,fdc-e33e482360197e9d6732a6a2,synthetic-form-layout-09,original,2024,fte-fc62adb42c57893471290818,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: gross payment amount: USD 11,096.00; transactions: USD 11,096.00; payment settlement entity: USD 11,096.00; payee: USD 11,096.00",1099,5,1099,fdc-77ccbd58a725021325dae230,synthetic-form-layout-08,original,2023,fte-cd1d84245c5d2557617377ec,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: gross payment amount: USD 11,179.00; transactions: USD 11,179.00; payment settlement entity: USD 11,179.00; payee: USD 11,179.00",1099,5,1099,fdc-e197ff24e32d043fcbd425ce,synthetic-form-layout-08,original,2024,fte-250a445fabcc646ea5e96ec9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: gross payment amount: USD 11,262.00; transactions: USD 11,262.00; payment settlement entity: USD 11,262.00; payee: USD 11,262.00",1099,5,1099,fdc-ee9dc5e95f689c565df9d349,synthetic-form-layout-08,original,2025,fte-82d226185e19184e923ff366,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: gross payment amount: USD 11,345.00; transactions: USD 11,345.00; payment settlement entity: USD 11,345.00; payee: USD 11,345.00",1099,5,1099,fdc-3afabe7a8998c7a70ef4e27c,synthetic-form-layout-08,original,2023,fte-f68cc3658cae4a237825deda,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: gross payment amount: USD 11,428.00; transactions: USD 11,428.00; payment settlement entity: USD 11,428.00; payee: USD 11,428.00",1099,5,1099,fdc-93be3bbdc0dc2d1a9ac278da,synthetic-form-layout-08,original,2024,fte-918c8468f08ec98e30010cb3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: gross payment amount: USD 11,511.00; transactions: USD 11,511.00; payment settlement entity: USD 11,511.00; payee: USD 11,511.00",1099,5,1099,fdc-769962208a3d6a8fde4c7ecc,synthetic-form-layout-08,original,2025,fte-27fd0b65f54044219571d71e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: gross payment amount: USD 11,594.00; transactions: USD 11,594.00; payment settlement entity: USD 11,594.00; payee: USD 11,594.00",1099,5,1099,fdc-fc016514ce99ae8946bc45d1,synthetic-form-layout-08,original,2023,fte-a10d02bd35d9b5fdf1eab094,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-K: Payment Card and Third Party Network Transactions
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: gross payment amount: USD 11,677.00; transactions: USD 11,677.00; payment settlement entity: USD 11,677.00; payee: USD 11,677.00",1099,5,1099,fdc-eec458784b05588a49ba32a6,synthetic-form-layout-08,original,2024,fte-9f9a9e932e012f908121cf56,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 900 is the named party.
Information printed on this record:
gross payment amount: USD 11,233.00
transactions: USD 11,233.00
payment settlement entity: USD 11,233.00
payee: USD 11,233.00",1099,5,1099,fdc-d597bc62a123f17d93ed3f34,synthetic-form-layout-09,original,2023,fte-d7a3bd69213661227df3023c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 901 is the named party.
Information printed on this record:
gross payment amount: USD 11,316.00
transactions: USD 11,316.00
payment settlement entity: USD 11,316.00
payee: USD 11,316.00",1099,5,1099,fdc-6ef61b1a2e2ac76e6a488c6b,synthetic-form-layout-09,original,2024,fte-38e5413cb2aa975c3a7ddfd0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 902 is the named party.
Information printed on this record:
gross payment amount: USD 11,399.00
transactions: USD 11,399.00
payment settlement entity: USD 11,399.00
payee: USD 11,399.00",1099,5,1099,fdc-adf319a73360ce8027f30925,synthetic-form-layout-09,original,2025,fte-487eb239b7c645c8f3f7f8ee,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 903 is the named party.
Information printed on this record:
gross payment amount: USD 11,482.00
transactions: USD 11,482.00
payment settlement entity: USD 11,482.00
payee: USD 11,482.00",1099,5,1099,fdc-0b2537933456e4a826a74d86,synthetic-form-layout-09,original,2023,fte-7e2089e30c7f7498981e9815,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 904 is the named party.
Information printed on this record:
gross payment amount: USD 11,565.00
transactions: USD 11,565.00
payment settlement entity: USD 11,565.00
payee: USD 11,565.00",1099,5,1099,fdc-0d52050701140d0daab0132a,synthetic-form-layout-09,original,2024,fte-fc8771785bf39a19d85e8ff8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 905 is the named party.
Information printed on this record:
gross payment amount: USD 11,648.00
transactions: USD 11,648.00
payment settlement entity: USD 11,648.00
payee: USD 11,648.00",1099,5,1099,fdc-b808bc24c3e9e50fd014fd69,synthetic-form-layout-09,original,2025,fte-7ccc66e5aef67ebda83f1aa1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 906 is the named party.
Information printed on this record:
gross payment amount: USD 11,731.00
transactions: USD 11,731.00
payment settlement entity: USD 11,731.00
payee: USD 11,731.00",1099,5,1099,fdc-4b1730eb5915e1fa65ca2757,synthetic-form-layout-09,original,2023,fte-9276f133ad3588675ed2284e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-K: Payment Card and Third Party Network Transactions
Example Client 907 is the named party.
Information printed on this record:
gross payment amount: USD 11,814.00
transactions: USD 11,814.00
payment settlement entity: USD 11,814.00
payee: USD 11,814.00",1099,5,1099,fdc-f2e47ce8e6d88a797c3a6895,synthetic-form-layout-09,original,2024,fte-e8364e45564cb2200572b5ef,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: interest income: USD 11,096.00; early withdrawal penalty: USD 11,096.00; payer: Example Entity 8-0-2; recipient: Example Entity 8-0-3",1099,5,1099,fdc-36cd7b49fd75c5f911311133,synthetic-form-layout-08,original,2023,fte-119c0e515de71377bc28de2c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: interest income: USD 11,179.00; early withdrawal penalty: USD 11,179.00; payer: Example Entity 8-1-2; recipient: Example Entity 8-1-3",1099,5,1099,fdc-8da02fea9514ccc38559c90a,synthetic-form-layout-08,original,2024,fte-b8c914b03980aa546b751ed5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: interest income: USD 11,262.00; early withdrawal penalty: USD 11,262.00; payer: Example Entity 8-2-2; recipient: Example Entity 8-2-3",1099,5,1099,fdc-fcf1426320060dcd9bdc2805,synthetic-form-layout-08,original,2025,fte-c9cbb7f459b32ff9ecd785f8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: interest income: USD 11,345.00; early withdrawal penalty: USD 11,345.00; payer: Example Entity 8-3-2; recipient: Example Entity 8-3-3",1099,5,1099,fdc-a7b81e77cf84a8943edbe355,synthetic-form-layout-08,original,2023,fte-70bf06bd3be287a1d26b2f34,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: interest income: USD 11,428.00; early withdrawal penalty: USD 11,428.00; payer: Example Entity 8-4-2; recipient: Example Entity 8-4-3",1099,5,1099,fdc-9de409518a9cedb2cf7f9b28,synthetic-form-layout-08,original,2024,fte-fcd842adb03e69be9eec2ff3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: interest income: USD 11,511.00; early withdrawal penalty: USD 11,511.00; payer: Example Entity 8-5-2; recipient: Example Entity 8-5-3",1099,5,1099,fdc-7a61fd50495b3969a05e400a,synthetic-form-layout-08,original,2025,fte-43e9bcc16740e26073539681,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: interest income: USD 11,594.00; early withdrawal penalty: USD 11,594.00; payer: Example Entity 8-6-2; recipient: Example Entity 8-6-3",1099,5,1099,fdc-0f6e8562fca664e472712847,synthetic-form-layout-08,original,2023,fte-3f9c7afa0305cb14af3d8f95,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-INT: Interest Income
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: interest income: USD 11,677.00; early withdrawal penalty: USD 11,677.00; payer: Example Entity 8-7-2; recipient: Example Entity 8-7-3",1099,5,1099,fdc-47a5c51971c38d7c4657744e,synthetic-form-layout-08,original,2024,fte-9e43848f132a6281e660e468,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-INT: Interest Income
Example Client 900 is the named party.
Information printed on this record:
interest income: USD 11,233.00
early withdrawal penalty: USD 11,233.00
payer: Example Entity 9-0-2
recipient: Example Entity 9-0-3",1099,5,1099,fdc-748c757a3f9a67b8a8b12113,synthetic-form-layout-09,original,2023,fte-3237e859b718de42d88b9232,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-INT: Interest Income
Example Client 901 is the named party.
Information printed on this record:
interest income: USD 11,316.00
early withdrawal penalty: USD 11,316.00
payer: Example Entity 9-1-2
recipient: Example Entity 9-1-3",1099,5,1099,fdc-150c1f76a6b435dc345c3465,synthetic-form-layout-09,original,2024,fte-30d320718594057a17a9d7e1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-INT: Interest Income
Example Client 902 is the named party.
Information printed on this record:
interest income: USD 11,399.00
early withdrawal penalty: USD 11,399.00
payer: Example Entity 9-2-2
recipient: Example Entity 9-2-3",1099,5,1099,fdc-a2b56c290a53589e272dc9bd,synthetic-form-layout-09,original,2025,fte-25fa0dbb3070581fb7d4aa59,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-INT: Interest Income
Example Client 903 is the named party.
Information printed on this record:
interest income: USD 11,482.00
early withdrawal penalty: USD 11,482.00
payer: Example Entity 9-3-2
recipient: Example Entity 9-3-3",1099,5,1099,fdc-7c9352e6a3437656f3672672,synthetic-form-layout-09,original,2023,fte-fa4a1a52d4606283519bb827,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-INT: Interest Income
Example Client 904 is the named party.
Information printed on this record:
interest income: USD 11,565.00
early withdrawal penalty: USD 11,565.00
payer: Example Entity 9-4-2
recipient: Example Entity 9-4-3",1099,5,1099,fdc-60ef80c4d82f945797c90d42,synthetic-form-layout-09,original,2024,fte-71783a86c93dfb9564d2d297,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-INT: Interest Income
Example Client 905 is the named party.
Information printed on this record:
interest income: USD 11,648.00
early withdrawal penalty: USD 11,648.00
payer: Example Entity 9-5-2
recipient: Example Entity 9-5-3",1099,5,1099,fdc-f43a762cffda3308053304b4,synthetic-form-layout-09,original,2025,fte-35833d8a5c899a6eade628ec,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-INT: Interest Income
Example Client 906 is the named party.
Information printed on this record:
interest income: USD 11,731.00
early withdrawal penalty: USD 11,731.00
payer: Example Entity 9-6-2
recipient: Example Entity 9-6-3",1099,5,1099,fdc-dc23dcfbaa38edac7fe7ca5c,synthetic-form-layout-09,original,2023,fte-fd05e097ce9cca48396d027c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-INT: Interest Income
Example Client 907 is the named party.
Information printed on this record:
interest income: USD 11,814.00
early withdrawal penalty: USD 11,814.00
payer: Example Entity 9-7-2
recipient: Example Entity 9-7-3",1099,5,1099,fdc-5c151243685c365c29f52af9,synthetic-form-layout-09,original,2024,fte-703b3e4add5cfa2012ceef54,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: ordinary dividends: USD 11,096.00; qualified dividends: USD 6,657.60; capital gain distributions: USD 11,096.00",1099,5,1099,fdc-27a429b7bf20961b244e842e,synthetic-form-layout-08,original,2023,fte-b730747468a6a044148136b0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: ordinary dividends: USD 11,179.00; qualified dividends: USD 6,707.40; capital gain distributions: USD 11,179.00",1099,5,1099,fdc-16e4c339c6c8e0c12b18d46f,synthetic-form-layout-08,original,2024,fte-85ab50389f2afe303113294d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: ordinary dividends: USD 11,262.00; qualified dividends: USD 6,757.20; capital gain distributions: USD 11,262.00",1099,5,1099,fdc-39aed9f73c7c342be492f2de,synthetic-form-layout-08,original,2025,fte-7dc99cab97c9a5d86fa32b27,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: ordinary dividends: USD 11,345.00; qualified dividends: USD 6,807.00; capital gain distributions: USD 11,345.00",1099,5,1099,fdc-554a7ed731b180e1ab136dd7,synthetic-form-layout-08,original,2023,fte-fa16c13f9c2280a01d719fbe,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: ordinary dividends: USD 11,428.00; qualified dividends: USD 6,856.80; capital gain distributions: USD 11,428.00",1099,5,1099,fdc-1d5f2ab357bb6ab08a5ed3dd,synthetic-form-layout-08,original,2024,fte-730b4324a3621b5198b2b07b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: ordinary dividends: USD 11,511.00; qualified dividends: USD 6,906.60; capital gain distributions: USD 11,511.00",1099,5,1099,fdc-64df8ca3a21aa58d73e097da,synthetic-form-layout-08,original,2025,fte-43ecc1aaf4904955dc8b33b7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: ordinary dividends: USD 11,594.00; qualified dividends: USD 6,956.40; capital gain distributions: USD 11,594.00",1099,5,1099,fdc-036373bb01d5fb55397e7e8d,synthetic-form-layout-08,original,2023,fte-827950974b44309bf12d1864,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DIV: Dividends and Distributions
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: ordinary dividends: USD 11,677.00; qualified dividends: USD 7,006.20; capital gain distributions: USD 11,677.00",1099,5,1099,fdc-983489ab8e4496a8602a8115,synthetic-form-layout-08,original,2024,fte-b283dc9154907f123245cd0f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 900 is the named party.
Information printed on this record:
ordinary dividends: USD 11,233.00
qualified dividends: USD 6,739.80
capital gain distributions: USD 11,233.00",1099,5,1099,fdc-d3bd27b8d3a71f275676773d,synthetic-form-layout-09,original,2023,fte-a171d10c9b1996771b63a61c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 901 is the named party.
Information printed on this record:
ordinary dividends: USD 11,316.00
qualified dividends: USD 6,789.60
capital gain distributions: USD 11,316.00",1099,5,1099,fdc-a26f1316b5e654ccd4288ad5,synthetic-form-layout-09,original,2024,fte-b058f5102c50add06b830942,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 902 is the named party.
Information printed on this record:
ordinary dividends: USD 11,399.00
qualified dividends: USD 6,839.40
capital gain distributions: USD 11,399.00",1099,5,1099,fdc-de206a5e60072cb7cbedc2cb,synthetic-form-layout-09,original,2025,fte-3f58bec7f373ff76a44242fb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 903 is the named party.
Information printed on this record:
ordinary dividends: USD 11,482.00
qualified dividends: USD 6,889.20
capital gain distributions: USD 11,482.00",1099,5,1099,fdc-cdd0cc41d022c9d85076dc01,synthetic-form-layout-09,original,2023,fte-e17d7cdaa097c11e1edaa229,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 904 is the named party.
Information printed on this record:
ordinary dividends: USD 11,565.00
qualified dividends: USD 6,939.00
capital gain distributions: USD 11,565.00",1099,5,1099,fdc-5792a32a78d27d60b2632e97,synthetic-form-layout-09,original,2024,fte-2dad46e50d50fcb093be5207,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 905 is the named party.
Information printed on this record:
ordinary dividends: USD 11,648.00
qualified dividends: USD 6,988.80
capital gain distributions: USD 11,648.00",1099,5,1099,fdc-36c4ee5bde31881492c5b59f,synthetic-form-layout-09,original,2025,fte-a862a3eee2066834e231e16b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 906 is the named party.
Information printed on this record:
ordinary dividends: USD 11,731.00
qualified dividends: USD 7,038.60
capital gain distributions: USD 11,731.00",1099,5,1099,fdc-3f613f101767bbfb0fc63ce3,synthetic-form-layout-09,original,2023,fte-9b94362609424b9706aed11b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-DIV: Dividends and Distributions
Example Client 907 is the named party.
Information printed on this record:
ordinary dividends: USD 11,814.00
qualified dividends: USD 7,088.40
capital gain distributions: USD 11,814.00",1099,5,1099,fdc-dde11ccbd2b6da70db3815dc,synthetic-form-layout-09,original,2024,fte-91c1a6467af9ab324afa364e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: original issue discount: USD 11,096.00; other periodic interest: USD 11,096.00; payer: Example Entity 8-0-2; recipient: Example Entity 8-0-3",1099,5,1099,fdc-55b4db5698873d8e204aa375,synthetic-form-layout-08,original,2023,fte-fbd11b31a312888d577539f4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: original issue discount: USD 11,179.00; other periodic interest: USD 11,179.00; payer: Example Entity 8-1-2; recipient: Example Entity 8-1-3",1099,5,1099,fdc-c52361b6d3322dbe5b1efeec,synthetic-form-layout-08,original,2024,fte-4af5d61c3c11d0f1b6b566b1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: original issue discount: USD 11,262.00; other periodic interest: USD 11,262.00; payer: Example Entity 8-2-2; recipient: Example Entity 8-2-3",1099,5,1099,fdc-bfaf0cb204d16680a6c044ca,synthetic-form-layout-08,original,2025,fte-013f4fd25d535cd827cc8cb8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: original issue discount: USD 11,345.00; other periodic interest: USD 11,345.00; payer: Example Entity 8-3-2; recipient: Example Entity 8-3-3",1099,5,1099,fdc-859a4cb7e8abe11d66729410,synthetic-form-layout-08,original,2023,fte-0208091a8d52e3a5142132b8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: original issue discount: USD 11,428.00; other periodic interest: USD 11,428.00; payer: Example Entity 8-4-2; recipient: Example Entity 8-4-3",1099,5,1099,fdc-7b09e4fd65059ec62bd53203,synthetic-form-layout-08,original,2024,fte-dcc0fe074e32f16dc72a2a46,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: original issue discount: USD 11,511.00; other periodic interest: USD 11,511.00; payer: Example Entity 8-5-2; recipient: Example Entity 8-5-3",1099,5,1099,fdc-627d59b9e45ed1084551830a,synthetic-form-layout-08,original,2025,fte-6246089efe63901e1153706d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: original issue discount: USD 11,594.00; other periodic interest: USD 11,594.00; payer: Example Entity 8-6-2; recipient: Example Entity 8-6-3",1099,5,1099,fdc-d6d275144a8224efa58c0489,synthetic-form-layout-08,original,2023,fte-94ea26913f8c15cc345e24b1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-OID: Original Issue Discount
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: original issue discount: USD 11,677.00; other periodic interest: USD 11,677.00; payer: Example Entity 8-7-2; recipient: Example Entity 8-7-3",1099,5,1099,fdc-aa7c4dcb8d72640f3e05a7a1,synthetic-form-layout-08,original,2024,fte-ef801f330592557b33d39034,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-OID: Original Issue Discount
Example Client 900 is the named party.
Information printed on this record:
original issue discount: USD 11,233.00
other periodic interest: USD 11,233.00
payer: Example Entity 9-0-2
recipient: Example Entity 9-0-3",1099,5,1099,fdc-40ce30eb093cd7994896d334,synthetic-form-layout-09,original,2023,fte-7795e0ac0d13f26b35fc6586,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-OID: Original Issue Discount
Example Client 901 is the named party.
Information printed on this record:
original issue discount: USD 11,316.00
other periodic interest: USD 11,316.00
payer: Example Entity 9-1-2
recipient: Example Entity 9-1-3",1099,5,1099,fdc-15449521238c514a92b14284,synthetic-form-layout-09,original,2024,fte-6250270530b67f62ef34b046,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-OID: Original Issue Discount
Example Client 902 is the named party.
Information printed on this record:
original issue discount: USD 11,399.00
other periodic interest: USD 11,399.00
payer: Example Entity 9-2-2
recipient: Example Entity 9-2-3",1099,5,1099,fdc-19e797bc934f1d3090735bf7,synthetic-form-layout-09,original,2025,fte-9ec398091a375a09a94820f4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-OID: Original Issue Discount
Example Client 903 is the named party.
Information printed on this record:
original issue discount: USD 11,482.00
other periodic interest: USD 11,482.00
payer: Example Entity 9-3-2
recipient: Example Entity 9-3-3",1099,5,1099,fdc-ea8b2283c0a1b49b7eaba3d4,synthetic-form-layout-09,original,2023,fte-4d94363c6fa50e2558a4d98f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-OID: Original Issue Discount
Example Client 904 is the named party.
Information printed on this record:
original issue discount: USD 11,565.00
other periodic interest: USD 11,565.00
payer: Example Entity 9-4-2
recipient: Example Entity 9-4-3",1099,5,1099,fdc-502c38b23d001b5d0b7d7970,synthetic-form-layout-09,original,2024,fte-4a29464dfec1b09beac4bafb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-OID: Original Issue Discount
Example Client 905 is the named party.
Information printed on this record:
original issue discount: USD 11,648.00
other periodic interest: USD 11,648.00
payer: Example Entity 9-5-2
recipient: Example Entity 9-5-3",1099,5,1099,fdc-1f58520074db6cf7b4621bdb,synthetic-form-layout-09,original,2025,fte-9f93042aeb2cd5185015d7e7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-OID: Original Issue Discount
Example Client 906 is the named party.
Information printed on this record:
original issue discount: USD 11,731.00
other periodic interest: USD 11,731.00
payer: Example Entity 9-6-2
recipient: Example Entity 9-6-3",1099,5,1099,fdc-37a6b7c3b83194233fc55b14,synthetic-form-layout-09,original,2023,fte-eb5a0eda555b26282b1721c3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-OID: Original Issue Discount
Example Client 907 is the named party.
Information printed on this record:
original issue discount: USD 11,814.00
other periodic interest: USD 11,814.00
payer: Example Entity 9-7-2
recipient: Example Entity 9-7-3",1099,5,1099,fdc-ca09156ea1720bfb9620931e,synthetic-form-layout-09,original,2024,fte-dff623652d7c91740f8f0cf6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: description of property: Example Entity 8-0-0; date acquired: 2023-03-01; proceeds: USD 11,096.00; cost basis: USD 7,767.20",1099,5,1099,fdc-7749a12f0d18d72783daf871,synthetic-form-layout-08,original,2023,fte-4d00fd324cf34c11c25b1650,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: description of property: Example Entity 8-1-0; date acquired: 2024-03-02; proceeds: USD 11,179.00; cost basis: USD 7,825.30",1099,5,1099,fdc-6e10e6d21cebc90c23232c30,synthetic-form-layout-08,original,2024,fte-622bffe76082baba86d3b050,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: description of property: Example Entity 8-2-0; date acquired: 2025-03-03; proceeds: USD 11,262.00; cost basis: USD 7,883.40",1099,5,1099,fdc-33507bb906fd192cdb0d4306,synthetic-form-layout-08,original,2025,fte-04eb94dbee28a30334ec0fdd,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: description of property: Example Entity 8-3-0; date acquired: 2023-03-04; proceeds: USD 11,345.00; cost basis: USD 7,941.50",1099,5,1099,fdc-692d9ae199dd2420e856eac9,synthetic-form-layout-08,original,2023,fte-8892b1a64807d44c385cc8e3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: description of property: Example Entity 8-4-0; date acquired: 2024-03-05; proceeds: USD 11,428.00; cost basis: USD 7,999.60",1099,5,1099,fdc-706c84b3392f8239918263ab,synthetic-form-layout-08,original,2024,fte-547973b8ef33d7f990abe578,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: description of property: Example Entity 8-5-0; date acquired: 2025-03-06; proceeds: USD 11,511.00; cost basis: USD 8,057.70",1099,5,1099,fdc-a71625beb862e6fa461816b7,synthetic-form-layout-08,original,2025,fte-08285d6a8a6ff057907c390c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: description of property: Example Entity 8-6-0; date acquired: 2023-03-07; proceeds: USD 11,594.00; cost basis: USD 8,115.80",1099,5,1099,fdc-b5d1ca74bc16adef4f53ef74,synthetic-form-layout-08,original,2023,fte-88e8236ab465baf1bb3f5581,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: description of property: Example Entity 8-7-0; date acquired: 2024-03-08; proceeds: USD 11,677.00; cost basis: USD 8,173.90",1099,5,1099,fdc-76c46719a32c4e1fc50896ad,synthetic-form-layout-08,original,2024,fte-77b646b2154f9d6dc40aa75f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 900 is the named party.
Information printed on this record:
description of property: Example Entity 9-0-0
date acquired: 2023-03-01
proceeds: USD 11,233.00
cost basis: USD 7,863.10",1099,5,1099,fdc-7ca6d6a0d38bb451f1d01b1c,synthetic-form-layout-09,original,2023,fte-b16efa8c7b2f6d83d6dbdd6c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 901 is the named party.
Information printed on this record:
description of property: Example Entity 9-1-0
date acquired: 2024-03-02
proceeds: USD 11,316.00
cost basis: USD 7,921.20",1099,5,1099,fdc-3b4bb5585dedcb259d559cf9,synthetic-form-layout-09,original,2024,fte-575f090890cf8a2b5abf4fc9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 902 is the named party.
Information printed on this record:
description of property: Example Entity 9-2-0
date acquired: 2025-03-03
proceeds: USD 11,399.00
cost basis: USD 7,979.30",1099,5,1099,fdc-47cca8db69d014db21a4ce6b,synthetic-form-layout-09,original,2025,fte-3f127ac3cac35521568cd46b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 903 is the named party.
Information printed on this record:
description of property: Example Entity 9-3-0
date acquired: 2023-03-04
proceeds: USD 11,482.00
cost basis: USD 8,037.40",1099,5,1099,fdc-8f8cd7960fd565c10f14846e,synthetic-form-layout-09,original,2023,fte-dc2fe3c26cbbf7e9b5612e18,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 904 is the named party.
Information printed on this record:
description of property: Example Entity 9-4-0
date acquired: 2024-03-05
proceeds: USD 11,565.00
cost basis: USD 8,095.50",1099,5,1099,fdc-db971ddee62549653c60299d,synthetic-form-layout-09,original,2024,fte-faf3f46781703448b9e26446,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 905 is the named party.
Information printed on this record:
description of property: Example Entity 9-5-0
date acquired: 2025-03-06
proceeds: USD 11,648.00
cost basis: USD 8,153.60",1099,5,1099,fdc-9e7c9f17e05ef7b0c33e096a,synthetic-form-layout-09,original,2025,fte-408e21f89ac2f59fb7a6d4fa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 906 is the named party.
Information printed on this record:
description of property: Example Entity 9-6-0
date acquired: 2023-03-07
proceeds: USD 11,731.00
cost basis: USD 8,211.70",1099,5,1099,fdc-4ffd904655592086c574dd47,synthetic-form-layout-09,original,2023,fte-2c61dce9fc402e929b623ee9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-B: Proceeds From Broker and Barter Exchange Transactions
Example Client 907 is the named party.
Information printed on this record:
description of property: Example Entity 9-7-0
date acquired: 2024-03-08
proceeds: USD 11,814.00
cost basis: USD 8,269.80",1099,5,1099,fdc-6028dae60159463338c2e184,synthetic-form-layout-09,original,2024,fte-5ef2dc985d85670e83a6e679,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: digital asset: USD 11,096.00; proceeds: USD 11,096.00; date sold: 2025-03-01; basis if reported: USD 7,767.20",1099,5,1099,fdc-07ee169fc1b7e73cc032fae9,synthetic-form-layout-08,original,2025,fte-315f03b22995db672cf34b4b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: digital asset: USD 11,179.00; proceeds: USD 11,179.00; date sold: 2025-03-02; basis if reported: USD 7,825.30",1099,5,1099,fdc-1f6f679185eb409fc9284c55,synthetic-form-layout-08,original,2025,fte-f38756712fda70ec80c69673,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: digital asset: USD 11,262.00; proceeds: USD 11,262.00; date sold: 2025-03-03; basis if reported: USD 7,883.40",1099,5,1099,fdc-ec58f0a167b9745e79bc3b68,synthetic-form-layout-08,original,2025,fte-022c1ba0fb1d5f21599c8efe,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: digital asset: USD 11,345.00; proceeds: USD 11,345.00; date sold: 2025-03-04; basis if reported: USD 7,941.50",1099,5,1099,fdc-c378a759889703ede191c9b0,synthetic-form-layout-08,original,2025,fte-8f3573ea08a70bde81c0e39a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: digital asset: USD 11,428.00; proceeds: USD 11,428.00; date sold: 2025-03-05; basis if reported: USD 7,999.60",1099,5,1099,fdc-0c54ba97da0e1785d27537a6,synthetic-form-layout-08,original,2025,fte-3481777a28aa744c5cd71384,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: digital asset: USD 11,511.00; proceeds: USD 11,511.00; date sold: 2025-03-06; basis if reported: USD 8,057.70",1099,5,1099,fdc-73318151c5a36dfb22e26849,synthetic-form-layout-08,original,2025,fte-d9e858a32e364129237210fc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: digital asset: USD 11,594.00; proceeds: USD 11,594.00; date sold: 2025-03-07; basis if reported: USD 8,115.80",1099,5,1099,fdc-b137074e9c730ead0d86c817,synthetic-form-layout-08,original,2025,fte-6d01c5e59d859c99a01f2221,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-DA: Digital Asset Proceeds From Broker Transactions
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: digital asset: USD 11,677.00; proceeds: USD 11,677.00; date sold: 2025-03-08; basis if reported: USD 8,173.90",1099,5,1099,fdc-b2f93e739db0078d9231247a,synthetic-form-layout-08,original,2025,fte-8bc095c04e2980ae153a21b1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 900 is the named party.
Information printed on this record:
digital asset: USD 11,233.00
proceeds: USD 11,233.00
date sold: 2025-03-01
basis if reported: USD 7,863.10",1099,5,1099,fdc-684ce2f3529a9707530f1b92,synthetic-form-layout-09,original,2025,fte-bde0da90a1394fc99ca63e99,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 901 is the named party.
Information printed on this record:
digital asset: USD 11,316.00
proceeds: USD 11,316.00
date sold: 2025-03-02
basis if reported: USD 7,921.20",1099,5,1099,fdc-d5ad05a1b58dbde31e66db10,synthetic-form-layout-09,original,2025,fte-8e53827b7af1d572eede1b6c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 902 is the named party.
Information printed on this record:
digital asset: USD 11,399.00
proceeds: USD 11,399.00
date sold: 2025-03-03
basis if reported: USD 7,979.30",1099,5,1099,fdc-fe60f38e2b0bbae7da4ae969,synthetic-form-layout-09,original,2025,fte-dc3a0b35fb8734b917d9fbea,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 903 is the named party.
Information printed on this record:
digital asset: USD 11,482.00
proceeds: USD 11,482.00
date sold: 2025-03-04
basis if reported: USD 8,037.40",1099,5,1099,fdc-debebf3b9042345031fba68a,synthetic-form-layout-09,original,2025,fte-b2f45108d6b9ed5d113e663b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 904 is the named party.
Information printed on this record:
digital asset: USD 11,565.00
proceeds: USD 11,565.00
date sold: 2025-03-05
basis if reported: USD 8,095.50",1099,5,1099,fdc-6bb8f6fd576a65203a535bdf,synthetic-form-layout-09,original,2025,fte-31103a4d0e870e240023bc04,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 905 is the named party.
Information printed on this record:
digital asset: USD 11,648.00
proceeds: USD 11,648.00
date sold: 2025-03-06
basis if reported: USD 8,153.60",1099,5,1099,fdc-cc3b541ee9a50fe82fd80c5d,synthetic-form-layout-09,original,2025,fte-11cb2ef81e3259b7ca3cc78f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 906 is the named party.
Information printed on this record:
digital asset: USD 11,731.00
proceeds: USD 11,731.00
date sold: 2025-03-07
basis if reported: USD 8,211.70",1099,5,1099,fdc-08cb95d573d60e3853952f7e,synthetic-form-layout-09,original,2025,fte-347a3496e2fd82aec33d03f4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-DA: Digital Asset Proceeds From Broker Transactions
Example Client 907 is the named party.
Information printed on this record:
digital asset: USD 11,814.00
proceeds: USD 11,814.00
date sold: 2025-03-08
basis if reported: USD 8,269.80",1099,5,1099,fdc-f0f83ae83dccc3f737247ac8,synthetic-form-layout-09,original,2025,fte-15f792d9e1451d597f42c6ab,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: property description: Example Entity 8-0-0; proceeds: USD 11,096.00; cost basis: USD 7,767.20; adjustment: USD 11,096.00",8949,22,8949,fdc-ca14190992b2fdfd1d806fa6,synthetic-form-layout-08,original,2023,fte-3e5e48686439286ee3c19bd2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: property description: Example Entity 8-1-0; proceeds: USD 11,179.00; cost basis: USD 7,825.30; adjustment: USD 11,179.00",8949,22,8949,fdc-70fdc9e6bf03687e058b9267,synthetic-form-layout-08,original,2024,fte-d96d24a24847a6715ddaaeba,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: property description: Example Entity 8-2-0; proceeds: USD 11,262.00; cost basis: USD 7,883.40; adjustment: USD 11,262.00",8949,22,8949,fdc-5107e81b2f335d9d767f57b6,synthetic-form-layout-08,original,2025,fte-4d7296a32c51b3d998b2d299,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: property description: Example Entity 8-3-0; proceeds: USD 11,345.00; cost basis: USD 7,941.50; adjustment: USD 11,345.00",8949,22,8949,fdc-603d079a682db7aca35605fa,synthetic-form-layout-08,original,2023,fte-af73690326be89d4b27cbc21,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: property description: Example Entity 8-4-0; proceeds: USD 11,428.00; cost basis: USD 7,999.60; adjustment: USD 11,428.00",8949,22,8949,fdc-fd6db770f1419bb1da26cd79,synthetic-form-layout-08,original,2024,fte-38ffa6195d24812d00256ebe,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: property description: Example Entity 8-5-0; proceeds: USD 11,511.00; cost basis: USD 8,057.70; adjustment: USD 11,511.00",8949,22,8949,fdc-7644fe83d87bd578a6d4d80a,synthetic-form-layout-08,original,2025,fte-cf81cb4712ce08a07085a0ec,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: property description: Example Entity 8-6-0; proceeds: USD 11,594.00; cost basis: USD 8,115.80; adjustment: USD 11,594.00",8949,22,8949,fdc-b6bb4abc03881f224ed12eba,synthetic-form-layout-08,original,2023,fte-1cca5ef2bbef154282cfa57c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8949: Sales and Other Dispositions of Capital Assets
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: property description: Example Entity 8-7-0; proceeds: USD 11,677.00; cost basis: USD 8,173.90; adjustment: USD 11,677.00",8949,22,8949,fdc-fc46e3f8267deeec0578cde8,synthetic-form-layout-08,original,2024,fte-b24e0c179df5e8130cf056df,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 900 is the named party.
Information printed on this record:
property description: Example Entity 9-0-0
proceeds: USD 11,233.00
cost basis: USD 7,863.10
adjustment: USD 11,233.00",8949,22,8949,fdc-6ac66f040008162af8975472,synthetic-form-layout-09,original,2023,fte-8238a450e26b4ca907a69561,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 901 is the named party.
Information printed on this record:
property description: Example Entity 9-1-0
proceeds: USD 11,316.00
cost basis: USD 7,921.20
adjustment: USD 11,316.00",8949,22,8949,fdc-80e2756c656de0e77863f89c,synthetic-form-layout-09,original,2024,fte-15ca41be65bc9466b357c387,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 902 is the named party.
Information printed on this record:
property description: Example Entity 9-2-0
proceeds: USD 11,399.00
cost basis: USD 7,979.30
adjustment: USD 11,399.00",8949,22,8949,fdc-f58838bae444fc3884e3a28f,synthetic-form-layout-09,original,2025,fte-917f989d8cf9054e5e54beda,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 903 is the named party.
Information printed on this record:
property description: Example Entity 9-3-0
proceeds: USD 11,482.00
cost basis: USD 8,037.40
adjustment: USD 11,482.00",8949,22,8949,fdc-f738c0dd96db440db43eef33,synthetic-form-layout-09,original,2023,fte-4982f3e5edfc06210ecfb5ce,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 904 is the named party.
Information printed on this record:
property description: Example Entity 9-4-0
proceeds: USD 11,565.00
cost basis: USD 8,095.50
adjustment: USD 11,565.00",8949,22,8949,fdc-e9f67be30608ea646f0b5baf,synthetic-form-layout-09,original,2024,fte-8541327f272a13b6ca1b6898,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 905 is the named party.
Information printed on this record:
property description: Example Entity 9-5-0
proceeds: USD 11,648.00
cost basis: USD 8,153.60
adjustment: USD 11,648.00",8949,22,8949,fdc-e21042fb4aa3531a92e1d17f,synthetic-form-layout-09,original,2025,fte-bcde4ddfdd413e8f2c18c67f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 906 is the named party.
Information printed on this record:
property description: Example Entity 9-6-0
proceeds: USD 11,731.00
cost basis: USD 8,211.70
adjustment: USD 11,731.00",8949,22,8949,fdc-c7b446537dd114fabf335faa,synthetic-form-layout-09,original,2023,fte-2c07c34f4021b0f2519db846,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8949: Sales and Other Dispositions of Capital Assets
Example Client 907 is the named party.
Information printed on this record:
property description: Example Entity 9-7-0
proceeds: USD 11,814.00
cost basis: USD 8,269.80
adjustment: USD 11,814.00",8949,22,8949,fdc-3bff9c5bab834f3eefb1f75c,synthetic-form-layout-09,original,2024,fte-76d479e24bb786c8d54cd53d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: gross distribution: USD 11,096.00; taxable amount: USD 8,876.80; distribution code: 7",1099,5,1099,fdc-befca5dcfda7ef7dce97f56b,synthetic-form-layout-08,original,2023,fte-ddc0c7a6a5c03416ef33ef9c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: gross distribution: USD 11,179.00; taxable amount: USD 8,943.20; distribution code: 7",1099,5,1099,fdc-074be938e8371941656ce915,synthetic-form-layout-08,original,2024,fte-04b33b1742a8f55e145373e1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: gross distribution: USD 11,262.00; taxable amount: USD 9,009.60; distribution code: 7",1099,5,1099,fdc-de066b37fb31bd99498f0d01,synthetic-form-layout-08,original,2025,fte-ed07c3c3ff932910be87e325,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: gross distribution: USD 11,345.00; taxable amount: USD 9,076.00; distribution code: 7",1099,5,1099,fdc-4acaeb45058b1db176dbf30e,synthetic-form-layout-08,original,2023,fte-cc9466394d19c67abf5428ee,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: gross distribution: USD 11,428.00; taxable amount: USD 9,142.40; distribution code: 7",1099,5,1099,fdc-51d53e5bd2b4d98595b4e212,synthetic-form-layout-08,original,2024,fte-392379e6ff1194bda97a7493,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: gross distribution: USD 11,511.00; taxable amount: USD 9,208.80; distribution code: 7",1099,5,1099,fdc-33b10f67ecdf72eec2f68a8c,synthetic-form-layout-08,original,2025,fte-a90a6484135e6674060cfa49,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: gross distribution: USD 11,594.00; taxable amount: USD 9,275.20; distribution code: 7",1099,5,1099,fdc-af27a0d8178d58e65d58cd39,synthetic-form-layout-08,original,2023,fte-d0e4f9d1d9f2f744830718af,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: gross distribution: USD 11,677.00; taxable amount: USD 9,341.60; distribution code: 7",1099,5,1099,fdc-70f43e5ef245e233ddfa6913,synthetic-form-layout-08,original,2024,fte-a5e9e47dcb23da7b89640514,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 900 is the named party.
Information printed on this record:
gross distribution: USD 11,233.00
taxable amount: USD 8,986.40
distribution code: 7",1099,5,1099,fdc-6bd0fb0faf17ebef2ec5eb17,synthetic-form-layout-09,original,2023,fte-b289013873a304a98f562088,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 901 is the named party.
Information printed on this record:
gross distribution: USD 11,316.00
taxable amount: USD 9,052.80
distribution code: 7",1099,5,1099,fdc-1726097948d5e77477bc68ac,synthetic-form-layout-09,original,2024,fte-c2775d1b5eb7a3d75437ec34,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 902 is the named party.
Information printed on this record:
gross distribution: USD 11,399.00
taxable amount: USD 9,119.20
distribution code: 7",1099,5,1099,fdc-4231fb1f392930ce15722a9b,synthetic-form-layout-09,original,2025,fte-c5a46dadf123358909e84dd7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 903 is the named party.
Information printed on this record:
gross distribution: USD 11,482.00
taxable amount: USD 9,185.60
distribution code: 7",1099,5,1099,fdc-032081833c7d8f10ce23f424,synthetic-form-layout-09,original,2023,fte-406eae41c7c1c71c86c96aae,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 904 is the named party.
Information printed on this record:
gross distribution: USD 11,565.00
taxable amount: USD 9,252.00
distribution code: 7",1099,5,1099,fdc-e3252d760c34798284d432cb,synthetic-form-layout-09,original,2024,fte-053d23e0ddb11328e2bacf7a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 905 is the named party.
Information printed on this record:
gross distribution: USD 11,648.00
taxable amount: USD 9,318.40
distribution code: 7",1099,5,1099,fdc-613b3ac2d82298b4e2e65d7a,synthetic-form-layout-09,original,2025,fte-d45cdae80f584ebb48e4ea7d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 906 is the named party.
Information printed on this record:
gross distribution: USD 11,731.00
taxable amount: USD 9,384.80
distribution code: 7",1099,5,1099,fdc-215ffbbf23cd22920b85d1a5,synthetic-form-layout-09,original,2023,fte-da7c45ecaf6b06091b1ace6c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-R: Distributions From Pensions Annuities Retirement or Profit-Sharing Plans IRAs Insurance Contracts
Example Client 907 is the named party.
Information printed on this record:
gross distribution: USD 11,814.00
taxable amount: USD 9,451.20
distribution code: 7",1099,5,1099,fdc-499d5e63db4e69867dcedc78,synthetic-form-layout-09,original,2024,fte-6f98287518561a2301c2cc8a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: IRA contributions: USD 11,096.00; rollover contributions: USD 11,096.00; fair market value: USD 11,096.00",5498,14,5498,fdc-450978ae73428198abd78831,synthetic-form-layout-08,original,2023,fte-665b3cd135ac5983c54e9d10,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: IRA contributions: USD 11,179.00; rollover contributions: USD 11,179.00; fair market value: USD 11,179.00",5498,14,5498,fdc-fae19330737e947564b70df1,synthetic-form-layout-08,original,2024,fte-5348d7fbbf2331dc35d65300,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: IRA contributions: USD 11,262.00; rollover contributions: USD 11,262.00; fair market value: USD 11,262.00",5498,14,5498,fdc-9476cb645be4da1e5f0513d7,synthetic-form-layout-08,original,2025,fte-a53a2e856c71d5c5fb0b6589,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: IRA contributions: USD 11,345.00; rollover contributions: USD 11,345.00; fair market value: USD 11,345.00",5498,14,5498,fdc-79f58e6371e669467025fdaf,synthetic-form-layout-08,original,2023,fte-9832575186538f71791c3c41,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: IRA contributions: USD 11,428.00; rollover contributions: USD 11,428.00; fair market value: USD 11,428.00",5498,14,5498,fdc-7153c986ec57baf98e200143,synthetic-form-layout-08,original,2024,fte-128d5b1cdca40651ce8779d5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: IRA contributions: USD 11,511.00; rollover contributions: USD 11,511.00; fair market value: USD 11,511.00",5498,14,5498,fdc-36869d612a896fa4bc8e11ff,synthetic-form-layout-08,original,2025,fte-cea8e30ea3b4739b58252a97,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: IRA contributions: USD 11,594.00; rollover contributions: USD 11,594.00; fair market value: USD 11,594.00",5498,14,5498,fdc-ec9107d68cc87f58b744cd8c,synthetic-form-layout-08,original,2023,fte-97332c5c780b3ca1588e4298,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498: IRA Contribution Information
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: IRA contributions: USD 11,677.00; rollover contributions: USD 11,677.00; fair market value: USD 11,677.00",5498,14,5498,fdc-43ad1e5720f9aa9a09bb1c73,synthetic-form-layout-08,original,2024,fte-4d88e94af3bbd7b4b057d01f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498: IRA Contribution Information
Example Client 900 is the named party.
Information printed on this record:
IRA contributions: USD 11,233.00
rollover contributions: USD 11,233.00
fair market value: USD 11,233.00",5498,14,5498,fdc-4e230e24d895ba9e6547c65d,synthetic-form-layout-09,original,2023,fte-6088409dade743d98493ec24,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498: IRA Contribution Information
Example Client 901 is the named party.
Information printed on this record:
IRA contributions: USD 11,316.00
rollover contributions: USD 11,316.00
fair market value: USD 11,316.00",5498,14,5498,fdc-553698da5f389647f2d25a93,synthetic-form-layout-09,original,2024,fte-2b627f909b5362efe8be252f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5498: IRA Contribution Information
Example Client 902 is the named party.
Information printed on this record:
IRA contributions: USD 11,399.00
rollover contributions: USD 11,399.00
fair market value: USD 11,399.00",5498,14,5498,fdc-427fe9ff091e93bf9e256798,synthetic-form-layout-09,original,2025,fte-f1e58c6457685460e4e95f2b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498: IRA Contribution Information
Example Client 903 is the named party.
Information printed on this record:
IRA contributions: USD 11,482.00
rollover contributions: USD 11,482.00
fair market value: USD 11,482.00",5498,14,5498,fdc-ce87071ecb0c54f131529514,synthetic-form-layout-09,original,2023,fte-6cefd60b7e35fc8486ff3561,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498: IRA Contribution Information
Example Client 904 is the named party.
Information printed on this record:
IRA contributions: USD 11,565.00
rollover contributions: USD 11,565.00
fair market value: USD 11,565.00",5498,14,5498,fdc-aaf1d4f0579fae6db594a3b7,synthetic-form-layout-09,original,2024,fte-4140e8d005271ffd6d08c484,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5498: IRA Contribution Information
Example Client 905 is the named party.
Information printed on this record:
IRA contributions: USD 11,648.00
rollover contributions: USD 11,648.00
fair market value: USD 11,648.00",5498,14,5498,fdc-e522d512b7e3b51a6256dbe0,synthetic-form-layout-09,original,2025,fte-bf0c2bfd161d210d23c09525,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498: IRA Contribution Information
Example Client 906 is the named party.
Information printed on this record:
IRA contributions: USD 11,731.00
rollover contributions: USD 11,731.00
fair market value: USD 11,731.00",5498,14,5498,fdc-4651abb4ff51a6999c7684c3,synthetic-form-layout-09,original,2023,fte-938ad7b56cfe90df3152476d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498: IRA Contribution Information
Example Client 907 is the named party.
Information printed on this record:
IRA contributions: USD 11,814.00
rollover contributions: USD 11,814.00
fair market value: USD 11,814.00",5498,14,5498,fdc-27bb79ded54e5fc8880d9cb1,synthetic-form-layout-09,original,2024,fte-68e1e0a394112e5b9ea83620,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: unemployment compensation: USD 11,096.00; state income tax refunds: USD 11,096.00; tax year: 2023",1099,5,1099,fdc-c8aee6ac0488a527190c4b0a,synthetic-form-layout-08,original,2023,fte-2fbdaa2d03a7330d5da30fed,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: unemployment compensation: USD 11,179.00; state income tax refunds: USD 11,179.00; tax year: 2024",1099,5,1099,fdc-6489d1576800ce386f76f83a,synthetic-form-layout-08,original,2024,fte-3e3900691719ae24eed92b84,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: unemployment compensation: USD 11,262.00; state income tax refunds: USD 11,262.00; tax year: 2025",1099,5,1099,fdc-925b5567e106f650c0f0a306,synthetic-form-layout-08,original,2025,fte-a15cb4e99d03458b82da7ee2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: unemployment compensation: USD 11,345.00; state income tax refunds: USD 11,345.00; tax year: 2023",1099,5,1099,fdc-00b2b38358c9e08868523eaa,synthetic-form-layout-08,original,2023,fte-566515fc5d3a3d6dc0dbd6aa,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: unemployment compensation: USD 11,428.00; state income tax refunds: USD 11,428.00; tax year: 2024",1099,5,1099,fdc-5c778a7a8e1e3cc8148eaf67,synthetic-form-layout-08,original,2024,fte-5c2cec25446aad10d27061d5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: unemployment compensation: USD 11,511.00; state income tax refunds: USD 11,511.00; tax year: 2025",1099,5,1099,fdc-000edeb8ced928f853b6a8bf,synthetic-form-layout-08,original,2025,fte-aab5545be3990055912b3139,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: unemployment compensation: USD 11,594.00; state income tax refunds: USD 11,594.00; tax year: 2023",1099,5,1099,fdc-415684e2bee09959112d3a47,synthetic-form-layout-08,original,2023,fte-430ee98381e5578314a73666,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-G: Certain Government Payments
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: unemployment compensation: USD 11,677.00; state income tax refunds: USD 11,677.00; tax year: 2024",1099,5,1099,fdc-37a17b72b47b4c47fc2d492a,synthetic-form-layout-08,original,2024,fte-1e005661e8e1fb0eead435f8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-G: Certain Government Payments
Example Client 900 is the named party.
Information printed on this record:
unemployment compensation: USD 11,233.00
state income tax refunds: USD 11,233.00
tax year: 2023",1099,5,1099,fdc-b70222e920a7fa6817dac52a,synthetic-form-layout-09,original,2023,fte-ec0e64d2db092eeff453d37d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-G: Certain Government Payments
Example Client 901 is the named party.
Information printed on this record:
unemployment compensation: USD 11,316.00
state income tax refunds: USD 11,316.00
tax year: 2024",1099,5,1099,fdc-014a8ace9319e06f031486a1,synthetic-form-layout-09,original,2024,fte-8ce5d9c0cf32701fd3542f28,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-G: Certain Government Payments
Example Client 902 is the named party.
Information printed on this record:
unemployment compensation: USD 11,399.00
state income tax refunds: USD 11,399.00
tax year: 2025",1099,5,1099,fdc-5f317c6089f85d80d1233af6,synthetic-form-layout-09,original,2025,fte-56fbe41972959ad2dccb0364,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-G: Certain Government Payments
Example Client 903 is the named party.
Information printed on this record:
unemployment compensation: USD 11,482.00
state income tax refunds: USD 11,482.00
tax year: 2023",1099,5,1099,fdc-6b71fd4c859328297af91422,synthetic-form-layout-09,original,2023,fte-64c850b78a09efba600868a7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-G: Certain Government Payments
Example Client 904 is the named party.
Information printed on this record:
unemployment compensation: USD 11,565.00
state income tax refunds: USD 11,565.00
tax year: 2024",1099,5,1099,fdc-51326903334a428e8bfac849,synthetic-form-layout-09,original,2024,fte-d63d1df3c5c3aa44f8f6fa92,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-G: Certain Government Payments
Example Client 905 is the named party.
Information printed on this record:
unemployment compensation: USD 11,648.00
state income tax refunds: USD 11,648.00
tax year: 2025",1099,5,1099,fdc-df05456ddcd937271f9d8dc6,synthetic-form-layout-09,original,2025,fte-70c91a8f18b737e520286e7a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-G: Certain Government Payments
Example Client 906 is the named party.
Information printed on this record:
unemployment compensation: USD 11,731.00
state income tax refunds: USD 11,731.00
tax year: 2023",1099,5,1099,fdc-1e5585cc3906a1ca916397ef,synthetic-form-layout-09,original,2023,fte-e1107e4ce3f69d14e258f603,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-G: Certain Government Payments
Example Client 907 is the named party.
Information printed on this record:
unemployment compensation: USD 11,814.00
state income tax refunds: USD 11,814.00
tax year: 2024",1099,5,1099,fdc-80a909d5463f021e0340c7de,synthetic-form-layout-09,original,2024,fte-8a91fa8eee406989865ae697,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: closing date: 2023-03-01; gross proceeds: USD 11,096.00; property address: Example Entity 8-0-2",1099,5,1099,fdc-96c2b081e8c6c7d053eefd6b,synthetic-form-layout-08,original,2023,fte-012fcc850c6069c324d66fb0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: closing date: 2024-03-02; gross proceeds: USD 11,179.00; property address: Example Entity 8-1-2",1099,5,1099,fdc-ca4006ba532d718a127e4510,synthetic-form-layout-08,original,2024,fte-fed8c775e51723c27cff1208,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: closing date: 2025-03-03; gross proceeds: USD 11,262.00; property address: Example Entity 8-2-2",1099,5,1099,fdc-f866a2878e98153907d6f007,synthetic-form-layout-08,original,2025,fte-1a257621def41be0349e28d2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: closing date: 2023-03-04; gross proceeds: USD 11,345.00; property address: Example Entity 8-3-2",1099,5,1099,fdc-b61c06785dbaeaeaa465749f,synthetic-form-layout-08,original,2023,fte-10c6ab335bc99a88a052858a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: closing date: 2024-03-05; gross proceeds: USD 11,428.00; property address: Example Entity 8-4-2",1099,5,1099,fdc-b6f0c77e696f7f06fb9c4780,synthetic-form-layout-08,original,2024,fte-046c3246ab8be0dc5c1d4b6e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: closing date: 2025-03-06; gross proceeds: USD 11,511.00; property address: Example Entity 8-5-2",1099,5,1099,fdc-93b8fda2341bc16d0759e66a,synthetic-form-layout-08,original,2025,fte-6877f5eb64b43e0bc9863daf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: closing date: 2023-03-07; gross proceeds: USD 11,594.00; property address: Example Entity 8-6-2",1099,5,1099,fdc-0a53af0228615264e040ab13,synthetic-form-layout-08,original,2023,fte-95c298305958a336e035e467,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-S: Proceeds From Real Estate Transactions
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: closing date: 2024-03-08; gross proceeds: USD 11,677.00; property address: Example Entity 8-7-2",1099,5,1099,fdc-386315e2c26f502ccb72cca2,synthetic-form-layout-08,original,2024,fte-9ddef358102cd2469a8583bf,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 900 is the named party.
Information printed on this record:
closing date: 2023-03-01
gross proceeds: USD 11,233.00
property address: Example Entity 9-0-2",1099,5,1099,fdc-9fc612f99ac015035a2e5bda,synthetic-form-layout-09,original,2023,fte-c9210256e9138ed55828443f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 901 is the named party.
Information printed on this record:
closing date: 2024-03-02
gross proceeds: USD 11,316.00
property address: Example Entity 9-1-2",1099,5,1099,fdc-e4ab9f6d0b89b64c1af95ede,synthetic-form-layout-09,original,2024,fte-f38cf39f9daa9a67f967e0b3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 902 is the named party.
Information printed on this record:
closing date: 2025-03-03
gross proceeds: USD 11,399.00
property address: Example Entity 9-2-2",1099,5,1099,fdc-80847a29bd3a8861e4197a89,synthetic-form-layout-09,original,2025,fte-979e310101c16f1f19894b85,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 903 is the named party.
Information printed on this record:
closing date: 2023-03-04
gross proceeds: USD 11,482.00
property address: Example Entity 9-3-2",1099,5,1099,fdc-44098ba42bddf5967cca8441,synthetic-form-layout-09,original,2023,fte-c7fed6b2867130bcf2463212,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 904 is the named party.
Information printed on this record:
closing date: 2024-03-05
gross proceeds: USD 11,565.00
property address: Example Entity 9-4-2",1099,5,1099,fdc-f7f6d3cab4f4bd35271da2d6,synthetic-form-layout-09,original,2024,fte-706c12a116ad0cfab3f5c104,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 905 is the named party.
Information printed on this record:
closing date: 2025-03-06
gross proceeds: USD 11,648.00
property address: Example Entity 9-5-2",1099,5,1099,fdc-01e2cf1f203715ae9c24e024,synthetic-form-layout-09,original,2025,fte-33bdd5a75ca6d3f1cd78b8f7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 906 is the named party.
Information printed on this record:
closing date: 2023-03-07
gross proceeds: USD 11,731.00
property address: Example Entity 9-6-2",1099,5,1099,fdc-7114839b6d2d2c09b02af353,synthetic-form-layout-09,original,2023,fte-8cf9cd63d767a5286ae622f6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-S: Proceeds From Real Estate Transactions
Example Client 907 is the named party.
Information printed on this record:
closing date: 2024-03-08
gross proceeds: USD 11,814.00
property address: Example Entity 9-7-2",1099,5,1099,fdc-933c61519b6ae72ab14a9efc,synthetic-form-layout-09,original,2024,fte-1d36ba341c2ea479c9f3a2a3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: acquisition date: 2023-03-01; balance of principal: USD 166,440.00; property description: Example Entity 8-0-2",1099,5,1099,fdc-6c66ff96e303ce795f2cad4e,synthetic-form-layout-08,original,2023,fte-0dea2ea04b8fbcc941dc5aaa,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: acquisition date: 2024-03-02; balance of principal: USD 167,685.00; property description: Example Entity 8-1-2",1099,5,1099,fdc-e44fb320f36700eed9b2e2e8,synthetic-form-layout-08,original,2024,fte-c67e0d7cd1b9755f32337162,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: acquisition date: 2025-03-03; balance of principal: USD 168,930.00; property description: Example Entity 8-2-2",1099,5,1099,fdc-f21b2fb92e3bad58206d239f,synthetic-form-layout-08,original,2025,fte-dc2648dfbc868d17465eab62,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: acquisition date: 2023-03-04; balance of principal: USD 170,175.00; property description: Example Entity 8-3-2",1099,5,1099,fdc-d8fd4fa70d43ca224420f274,synthetic-form-layout-08,original,2023,fte-f779cdc5193ed340a6ae4139,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: acquisition date: 2024-03-05; balance of principal: USD 171,420.00; property description: Example Entity 8-4-2",1099,5,1099,fdc-9c5a155794ee89e1d4935c34,synthetic-form-layout-08,original,2024,fte-c43351977264957368ea7431,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: acquisition date: 2025-03-06; balance of principal: USD 172,665.00; property description: Example Entity 8-5-2",1099,5,1099,fdc-dbe28ff3ec8a8472034ed689,synthetic-form-layout-08,original,2025,fte-9912827280e107eef28e3989,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: acquisition date: 2023-03-07; balance of principal: USD 173,910.00; property description: Example Entity 8-6-2",1099,5,1099,fdc-4cdf2041d8878c43cef5dc49,synthetic-form-layout-08,original,2023,fte-57095e577d62b1bf7cae64b9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-A: Acquisition or Abandonment of Secured Property
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: acquisition date: 2024-03-08; balance of principal: USD 175,155.00; property description: Example Entity 8-7-2",1099,5,1099,fdc-a7c8b8541be480c5cb94d607,synthetic-form-layout-08,original,2024,fte-2227e871460eac565ae76235,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 900 is the named party.
Information printed on this record:
acquisition date: 2023-03-01
balance of principal: USD 168,495.00
property description: Example Entity 9-0-2",1099,5,1099,fdc-d001f3a084a9a22732a3ad31,synthetic-form-layout-09,original,2023,fte-74be535e401d14e978a03922,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 901 is the named party.
Information printed on this record:
acquisition date: 2024-03-02
balance of principal: USD 169,740.00
property description: Example Entity 9-1-2",1099,5,1099,fdc-ddcff02ca26112b3b818797c,synthetic-form-layout-09,original,2024,fte-5e2782f8c690988c94ca96a3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 902 is the named party.
Information printed on this record:
acquisition date: 2025-03-03
balance of principal: USD 170,985.00
property description: Example Entity 9-2-2",1099,5,1099,fdc-ba7f942587a0a6bb03086c4c,synthetic-form-layout-09,original,2025,fte-d8c34870c05fa6b6b5b7df45,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 903 is the named party.
Information printed on this record:
acquisition date: 2023-03-04
balance of principal: USD 172,230.00
property description: Example Entity 9-3-2",1099,5,1099,fdc-70eb9c5aa1d231da3a76d802,synthetic-form-layout-09,original,2023,fte-d2316046385ddc24967e2a0a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 904 is the named party.
Information printed on this record:
acquisition date: 2024-03-05
balance of principal: USD 173,475.00
property description: Example Entity 9-4-2",1099,5,1099,fdc-a0c74a6e3f17cb4265049758,synthetic-form-layout-09,original,2024,fte-79aebcaa25f66b685895dc0a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 905 is the named party.
Information printed on this record:
acquisition date: 2025-03-06
balance of principal: USD 174,720.00
property description: Example Entity 9-5-2",1099,5,1099,fdc-1eef569cfb96bb2491e2cc7f,synthetic-form-layout-09,original,2025,fte-547a5214dc23fe7685e67ee3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 906 is the named party.
Information printed on this record:
acquisition date: 2023-03-07
balance of principal: USD 175,965.00
property description: Example Entity 9-6-2",1099,5,1099,fdc-050367a28e3fa08a98280f6f,synthetic-form-layout-09,original,2023,fte-719cf15ef93412aa6055d6fb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-A: Acquisition or Abandonment of Secured Property
Example Client 907 is the named party.
Information printed on this record:
acquisition date: 2024-03-08
balance of principal: USD 177,210.00
property description: Example Entity 9-7-2",1099,5,1099,fdc-e8da3c2666222b7bcee9d2a0,synthetic-form-layout-09,original,2024,fte-343111045d3d62ee3a8d125d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: date of identifiable event: 2023-03-01; debt discharged: USD 11,096.00; interest included: USD 11,096.00",1099,5,1099,fdc-fb0aec5bed81435c313fe638,synthetic-form-layout-08,original,2023,fte-29be69bac9a7509f3883c420,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: date of identifiable event: 2024-03-02; debt discharged: USD 11,179.00; interest included: USD 11,179.00",1099,5,1099,fdc-db94886e51f04c327455c027,synthetic-form-layout-08,original,2024,fte-7bb5c6aa1e3c14efe120f29e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: date of identifiable event: 2025-03-03; debt discharged: USD 11,262.00; interest included: USD 11,262.00",1099,5,1099,fdc-180a01cb38f1d1338e77c878,synthetic-form-layout-08,original,2025,fte-3953f243077f611838ffb09f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: date of identifiable event: 2023-03-04; debt discharged: USD 11,345.00; interest included: USD 11,345.00",1099,5,1099,fdc-3a874a036e036dad1c7cb5a4,synthetic-form-layout-08,original,2023,fte-f5a73be2d19202091ebe7354,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: date of identifiable event: 2024-03-05; debt discharged: USD 11,428.00; interest included: USD 11,428.00",1099,5,1099,fdc-8249a76fca1697440f62264a,synthetic-form-layout-08,original,2024,fte-b1c4422bb0c6cbf7f21c3695,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: date of identifiable event: 2025-03-06; debt discharged: USD 11,511.00; interest included: USD 11,511.00",1099,5,1099,fdc-0922e40059d5959fc70ad0ab,synthetic-form-layout-08,original,2025,fte-54efabd0acd70bbc14780d26,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: date of identifiable event: 2023-03-07; debt discharged: USD 11,594.00; interest included: USD 11,594.00",1099,5,1099,fdc-120cd7b85f41fd4978a3254e,synthetic-form-layout-08,original,2023,fte-2009f23e82c8112f846bafb2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-C: Cancellation of Debt
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: date of identifiable event: 2024-03-08; debt discharged: USD 11,677.00; interest included: USD 11,677.00",1099,5,1099,fdc-0806da5fa1b37fe8f52423fd,synthetic-form-layout-08,original,2024,fte-3bc72b6cb077e3104b4b92e1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-C: Cancellation of Debt
Example Client 900 is the named party.
Information printed on this record:
date of identifiable event: 2023-03-01
debt discharged: USD 11,233.00
interest included: USD 11,233.00",1099,5,1099,fdc-f1460abd221830d3d48ead85,synthetic-form-layout-09,original,2023,fte-4dd648cc9b5ae2ca78ed08e8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-C: Cancellation of Debt
Example Client 901 is the named party.
Information printed on this record:
date of identifiable event: 2024-03-02
debt discharged: USD 11,316.00
interest included: USD 11,316.00",1099,5,1099,fdc-b7ff50ac009399945b055c8e,synthetic-form-layout-09,original,2024,fte-74d888db5243fa53dbe07c5b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-C: Cancellation of Debt
Example Client 902 is the named party.
Information printed on this record:
date of identifiable event: 2025-03-03
debt discharged: USD 11,399.00
interest included: USD 11,399.00",1099,5,1099,fdc-a1553fca66bc733843e1e9cf,synthetic-form-layout-09,original,2025,fte-874bc132fca362abce1c9350,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-C: Cancellation of Debt
Example Client 903 is the named party.
Information printed on this record:
date of identifiable event: 2023-03-04
debt discharged: USD 11,482.00
interest included: USD 11,482.00",1099,5,1099,fdc-22c64f86cdff3d835ca0addb,synthetic-form-layout-09,original,2023,fte-641a595cffd5e060137b0257,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-C: Cancellation of Debt
Example Client 904 is the named party.
Information printed on this record:
date of identifiable event: 2024-03-05
debt discharged: USD 11,565.00
interest included: USD 11,565.00",1099,5,1099,fdc-8bdf6796905c5c07f81c0b21,synthetic-form-layout-09,original,2024,fte-9ffb30c26608786931ee8207,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-C: Cancellation of Debt
Example Client 905 is the named party.
Information printed on this record:
date of identifiable event: 2025-03-06
debt discharged: USD 11,648.00
interest included: USD 11,648.00",1099,5,1099,fdc-51d628d851c1e694f6144da4,synthetic-form-layout-09,original,2025,fte-d8150708b0eafd45cc8150e8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-C: Cancellation of Debt
Example Client 906 is the named party.
Information printed on this record:
date of identifiable event: 2023-03-07
debt discharged: USD 11,731.00
interest included: USD 11,731.00",1099,5,1099,fdc-7e3d977c7225916287a3f1c7,synthetic-form-layout-09,original,2023,fte-0176dce1a421cebaf04184c6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-C: Cancellation of Debt
Example Client 907 is the named party.
Information printed on this record:
date of identifiable event: 2024-03-08
debt discharged: USD 11,814.00
interest included: USD 11,814.00",1099,5,1099,fdc-14d2b4a6134e039d76919d22,synthetic-form-layout-09,original,2024,fte-d6407aaa4ce1cb39a1f60ea8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: mortgage interest received: USD 11,096.00; principal: USD 166,440.00; points: USD 11,096.00; lender: USD 11,096.00",1098,4,1098,fdc-b1f86c300ade1e5b3fefe30b,synthetic-form-layout-08,original,2023,fte-41a2a3eea5a715db86f5b561,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: mortgage interest received: USD 11,179.00; principal: USD 167,685.00; points: USD 11,179.00; lender: USD 11,179.00",1098,4,1098,fdc-5041bfd48d5434435fb61e8d,synthetic-form-layout-08,original,2024,fte-dc3b7ff1ed44ad02e4993306,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: mortgage interest received: USD 11,262.00; principal: USD 168,930.00; points: USD 11,262.00; lender: USD 11,262.00",1098,4,1098,fdc-c37cd5edf05422ec3569752d,synthetic-form-layout-08,original,2025,fte-35e49ea36d6cf6cb307440c4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: mortgage interest received: USD 11,345.00; principal: USD 170,175.00; points: USD 11,345.00; lender: USD 11,345.00",1098,4,1098,fdc-d35bd462f52a792baf57f8a9,synthetic-form-layout-08,original,2023,fte-8cf7dfba47b0630a4424fc0e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: mortgage interest received: USD 11,428.00; principal: USD 171,420.00; points: USD 11,428.00; lender: USD 11,428.00",1098,4,1098,fdc-7f487c6591e2a98849ad2b78,synthetic-form-layout-08,original,2024,fte-adc14b3f9a6d4e8f472a22fe,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: mortgage interest received: USD 11,511.00; principal: USD 172,665.00; points: USD 11,511.00; lender: USD 11,511.00",1098,4,1098,fdc-6a1be7d45a77f2bfc9494931,synthetic-form-layout-08,original,2025,fte-6fba7e2cdfa6aa1a5825e777,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: mortgage interest received: USD 11,594.00; principal: USD 173,910.00; points: USD 11,594.00; lender: USD 11,594.00",1098,4,1098,fdc-b5daddb89b95fcf4921a65ec,synthetic-form-layout-08,original,2023,fte-0e23b18788176ded44b5cd8e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098: Mortgage Interest Statement
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: mortgage interest received: USD 11,677.00; principal: USD 175,155.00; points: USD 11,677.00; lender: USD 11,677.00",1098,4,1098,fdc-31518717e2ce35008fbe822a,synthetic-form-layout-08,original,2024,fte-7a5f3c064d202b399320a2c9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098: Mortgage Interest Statement
Example Client 900 is the named party.
Information printed on this record:
mortgage interest received: USD 11,233.00
principal: USD 168,495.00
points: USD 11,233.00
lender: USD 11,233.00",1098,4,1098,fdc-5240ea5187a0b877694fccdc,synthetic-form-layout-09,original,2023,fte-91355dc81ec0a442a6d705f1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098: Mortgage Interest Statement
Example Client 901 is the named party.
Information printed on this record:
mortgage interest received: USD 11,316.00
principal: USD 169,740.00
points: USD 11,316.00
lender: USD 11,316.00",1098,4,1098,fdc-3a339453394ccf2f18ff6d64,synthetic-form-layout-09,original,2024,fte-772295654ed55b179d04c860,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098: Mortgage Interest Statement
Example Client 902 is the named party.
Information printed on this record:
mortgage interest received: USD 11,399.00
principal: USD 170,985.00
points: USD 11,399.00
lender: USD 11,399.00",1098,4,1098,fdc-0f691c745f60d59a2d16bdf1,synthetic-form-layout-09,original,2025,fte-6a32707fef5fb6faca07a30d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098: Mortgage Interest Statement
Example Client 903 is the named party.
Information printed on this record:
mortgage interest received: USD 11,482.00
principal: USD 172,230.00
points: USD 11,482.00
lender: USD 11,482.00",1098,4,1098,fdc-79463aa7c11a2c11d6aeb9f0,synthetic-form-layout-09,original,2023,fte-31a5ef095e1106232d4daaf2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098: Mortgage Interest Statement
Example Client 904 is the named party.
Information printed on this record:
mortgage interest received: USD 11,565.00
principal: USD 173,475.00
points: USD 11,565.00
lender: USD 11,565.00",1098,4,1098,fdc-8f46273b306dee1c93e4bc5a,synthetic-form-layout-09,original,2024,fte-d75a3a5730509605400b4349,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098: Mortgage Interest Statement
Example Client 905 is the named party.
Information printed on this record:
mortgage interest received: USD 11,648.00
principal: USD 174,720.00
points: USD 11,648.00
lender: USD 11,648.00",1098,4,1098,fdc-a9e37784bf16f954e624c4e6,synthetic-form-layout-09,original,2025,fte-0a29694ad2153bdf582a85dc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098: Mortgage Interest Statement
Example Client 906 is the named party.
Information printed on this record:
mortgage interest received: USD 11,731.00
principal: USD 175,965.00
points: USD 11,731.00
lender: USD 11,731.00",1098,4,1098,fdc-5a7f4b28cbf1db85436d7f8f,synthetic-form-layout-09,original,2023,fte-ae53ed179da513a1ca1519c9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098: Mortgage Interest Statement
Example Client 907 is the named party.
Information printed on this record:
mortgage interest received: USD 11,814.00
principal: USD 177,210.00
points: USD 11,814.00
lender: USD 11,814.00",1098,4,1098,fdc-996c30a34b4ee454cef18d45,synthetic-form-layout-09,original,2024,fte-9fc1dcecfcdef20478e104bd,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: payments received for tuition: USD 11,096.00; scholarships: USD 11,096.00; student: Example Entity 8-0-2",1098,4,1098,fdc-966d5f4929bfcd8037fa884e,synthetic-form-layout-08,original,2023,fte-bb608456ecbc3183332c8cef,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: payments received for tuition: USD 11,179.00; scholarships: USD 11,179.00; student: Example Entity 8-1-2",1098,4,1098,fdc-b1822a396d6546e54274d437,synthetic-form-layout-08,original,2024,fte-b9f52a513cdc5d3362417d19,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: payments received for tuition: USD 11,262.00; scholarships: USD 11,262.00; student: Example Entity 8-2-2",1098,4,1098,fdc-aaba157c88d2e06252211553,synthetic-form-layout-08,original,2025,fte-bf27312d2298435d242820b6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: payments received for tuition: USD 11,345.00; scholarships: USD 11,345.00; student: Example Entity 8-3-2",1098,4,1098,fdc-090d9a825bc83e34b34587dd,synthetic-form-layout-08,original,2023,fte-1883a5f19cb225d4e32c5aad,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: payments received for tuition: USD 11,428.00; scholarships: USD 11,428.00; student: Example Entity 8-4-2",1098,4,1098,fdc-6e293cc7aa543037706816ac,synthetic-form-layout-08,original,2024,fte-f93b48c087099530b61c58d0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: payments received for tuition: USD 11,511.00; scholarships: USD 11,511.00; student: Example Entity 8-5-2",1098,4,1098,fdc-53c072cd31fdb82fa6831938,synthetic-form-layout-08,original,2025,fte-f588b0b4595735700916f83a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: payments received for tuition: USD 11,594.00; scholarships: USD 11,594.00; student: Example Entity 8-6-2",1098,4,1098,fdc-9ce5cd3626589a04f400c29b,synthetic-form-layout-08,original,2023,fte-51549897caf1f8a9538a1416,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-T: Tuition Statement
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: payments received for tuition: USD 11,677.00; scholarships: USD 11,677.00; student: Example Entity 8-7-2",1098,4,1098,fdc-bd776a8fc4fef55c11fd371a,synthetic-form-layout-08,original,2024,fte-aab353351014ebb71d4aadb6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-T: Tuition Statement
Example Client 900 is the named party.
Information printed on this record:
payments received for tuition: USD 11,233.00
scholarships: USD 11,233.00
student: Example Entity 9-0-2",1098,4,1098,fdc-afb54c7c06d52556b24bb85f,synthetic-form-layout-09,original,2023,fte-6b694f4dcf27bf8dd7ba14d2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-T: Tuition Statement
Example Client 901 is the named party.
Information printed on this record:
payments received for tuition: USD 11,316.00
scholarships: USD 11,316.00
student: Example Entity 9-1-2",1098,4,1098,fdc-8b0b90f252551de2d4f49e4f,synthetic-form-layout-09,original,2024,fte-6581288b14009119cd818785,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098-T: Tuition Statement
Example Client 902 is the named party.
Information printed on this record:
payments received for tuition: USD 11,399.00
scholarships: USD 11,399.00
student: Example Entity 9-2-2",1098,4,1098,fdc-8ab722a9935c3294101f40c5,synthetic-form-layout-09,original,2025,fte-d3ec2754e27e8b2b1f3e08d7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-T: Tuition Statement
Example Client 903 is the named party.
Information printed on this record:
payments received for tuition: USD 11,482.00
scholarships: USD 11,482.00
student: Example Entity 9-3-2",1098,4,1098,fdc-677750e8d2508eac57cd89dc,synthetic-form-layout-09,original,2023,fte-fbc2d2aa9dac8039131e16bd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-T: Tuition Statement
Example Client 904 is the named party.
Information printed on this record:
payments received for tuition: USD 11,565.00
scholarships: USD 11,565.00
student: Example Entity 9-4-2",1098,4,1098,fdc-113ddd0ce7db4864b2850325,synthetic-form-layout-09,original,2024,fte-cfc22ef92f98182da372a4a9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098-T: Tuition Statement
Example Client 905 is the named party.
Information printed on this record:
payments received for tuition: USD 11,648.00
scholarships: USD 11,648.00
student: Example Entity 9-5-2",1098,4,1098,fdc-e7a183ced53504761e1d23e4,synthetic-form-layout-09,original,2025,fte-c1938684c9d54cb9e2b0c7e5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-T: Tuition Statement
Example Client 906 is the named party.
Information printed on this record:
payments received for tuition: USD 11,731.00
scholarships: USD 11,731.00
student: Example Entity 9-6-2",1098,4,1098,fdc-eff299c925c9771600ec6d5f,synthetic-form-layout-09,original,2023,fte-ab578a8075da6232e95117e8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-T: Tuition Statement
Example Client 907 is the named party.
Information printed on this record:
payments received for tuition: USD 11,814.00
scholarships: USD 11,814.00
student: Example Entity 9-7-2",1098,4,1098,fdc-dde6216966bb23356c51351c,synthetic-form-layout-09,original,2024,fte-db54a033585e90d7e771852f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: student loan interest received: Example Entity 8-0-0; lender: USD 11,096.00; borrower: USD 11,096.00",1098,4,1098,fdc-bfeb4725f963d570938f254e,synthetic-form-layout-08,original,2023,fte-adaff890da768455d1ed454d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: student loan interest received: Example Entity 8-1-0; lender: USD 11,179.00; borrower: USD 11,179.00",1098,4,1098,fdc-4afa8fac03464dc6e111be9a,synthetic-form-layout-08,original,2024,fte-80a279d951029e7d868665e5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: student loan interest received: Example Entity 8-2-0; lender: USD 11,262.00; borrower: USD 11,262.00",1098,4,1098,fdc-451fb08003f1089e954df34a,synthetic-form-layout-08,original,2025,fte-5e1ca2b8072855f10920e5ef,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: student loan interest received: Example Entity 8-3-0; lender: USD 11,345.00; borrower: USD 11,345.00",1098,4,1098,fdc-fd56801939920ae8d83baf9c,synthetic-form-layout-08,original,2023,fte-a0deea39bf460731ef3fc54b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: student loan interest received: Example Entity 8-4-0; lender: USD 11,428.00; borrower: USD 11,428.00",1098,4,1098,fdc-277b1d6e141101449d5d1d94,synthetic-form-layout-08,original,2024,fte-443edf4f23f497f31c85ca57,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: student loan interest received: Example Entity 8-5-0; lender: USD 11,511.00; borrower: USD 11,511.00",1098,4,1098,fdc-483dbaa92367ef2ca7415eba,synthetic-form-layout-08,original,2025,fte-34899a13e1e8e76c9852c929,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: student loan interest received: Example Entity 8-6-0; lender: USD 11,594.00; borrower: USD 11,594.00",1098,4,1098,fdc-209991f87a8fb1459ebbaec9,synthetic-form-layout-08,original,2023,fte-4ba30a0ac8e91629f1347eee,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-E: Student Loan Interest Statement
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: student loan interest received: Example Entity 8-7-0; lender: USD 11,677.00; borrower: USD 11,677.00",1098,4,1098,fdc-2220beaa5d75bf33eac1857d,synthetic-form-layout-08,original,2024,fte-f6470e045be7914b1be638b0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 900 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-0-0
lender: USD 11,233.00
borrower: USD 11,233.00",1098,4,1098,fdc-d465785f8265fc51031833df,synthetic-form-layout-09,original,2023,fte-9683193b3787cab7e2c43200,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 901 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-1-0
lender: USD 11,316.00
borrower: USD 11,316.00",1098,4,1098,fdc-ee44a9a47baba50d8df65544,synthetic-form-layout-09,original,2024,fte-8c820ab17386c01467aca899,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 902 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-2-0
lender: USD 11,399.00
borrower: USD 11,399.00",1098,4,1098,fdc-3d3792c068b30993cb012610,synthetic-form-layout-09,original,2025,fte-433e0614e9ddf1e9d4789453,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 903 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-3-0
lender: USD 11,482.00
borrower: USD 11,482.00",1098,4,1098,fdc-9dc4788583f418caf5080fe1,synthetic-form-layout-09,original,2023,fte-238172df4fb54d34a976a57a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 904 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-4-0
lender: USD 11,565.00
borrower: USD 11,565.00",1098,4,1098,fdc-6d7469aaba684d22d9ebc144,synthetic-form-layout-09,original,2024,fte-a76b6bcb07a62887d43fa382,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 905 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-5-0
lender: USD 11,648.00
borrower: USD 11,648.00",1098,4,1098,fdc-f05f2231d3e96a57f91e5150,synthetic-form-layout-09,original,2025,fte-546e779800868518ad0d13e1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 906 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-6-0
lender: USD 11,731.00
borrower: USD 11,731.00",1098,4,1098,fdc-45a11908b32ef77793202d1a,synthetic-form-layout-09,original,2023,fte-8560af74c2d336d525aa2880,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-E: Student Loan Interest Statement
Example Client 907 is the named party.
Information printed on this record:
student loan interest received: Example Entity 9-7-0
lender: USD 11,814.00
borrower: USD 11,814.00",1098,4,1098,fdc-877931807f298f722d78611a,synthetic-form-layout-09,original,2024,fte-cb988839310ada2741938d22,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: gross distribution: USD 11,096.00; earnings: USD 11,096.00; basis: USD 7,767.20; recipient: Example Entity 8-0-3",1099,5,1099,fdc-eaa517d794c27e1e125c53bf,synthetic-form-layout-08,original,2023,fte-2a0f2dfe7ce2b352a4ce2a77,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: gross distribution: USD 11,179.00; earnings: USD 11,179.00; basis: USD 7,825.30; recipient: Example Entity 8-1-3",1099,5,1099,fdc-8fd2ea210678543e7ba8cb64,synthetic-form-layout-08,original,2024,fte-57e6abd62c5b72a06a4884ec,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: gross distribution: USD 11,262.00; earnings: USD 11,262.00; basis: USD 7,883.40; recipient: Example Entity 8-2-3",1099,5,1099,fdc-f9547d8aa29001cb42e213a5,synthetic-form-layout-08,original,2025,fte-d017bd616b83fa734db50325,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: gross distribution: USD 11,345.00; earnings: USD 11,345.00; basis: USD 7,941.50; recipient: Example Entity 8-3-3",1099,5,1099,fdc-904606ec5458393aa937b792,synthetic-form-layout-08,original,2023,fte-509ae625b32c042ed55d8083,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: gross distribution: USD 11,428.00; earnings: USD 11,428.00; basis: USD 7,999.60; recipient: Example Entity 8-4-3",1099,5,1099,fdc-27224c7e3c014805c3f88243,synthetic-form-layout-08,original,2024,fte-9af5640172a4e7246c6d7396,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: gross distribution: USD 11,511.00; earnings: USD 11,511.00; basis: USD 8,057.70; recipient: Example Entity 8-5-3",1099,5,1099,fdc-e1061092711a96defa55ee8c,synthetic-form-layout-08,original,2025,fte-267a96b77ace47b709e4d22c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: gross distribution: USD 11,594.00; earnings: USD 11,594.00; basis: USD 8,115.80; recipient: Example Entity 8-6-3",1099,5,1099,fdc-b00658795f0c92db1016e1ba,synthetic-form-layout-08,original,2023,fte-36f1864a059707f46eb87ba6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-Q: Payments From Qualified Education Programs
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: gross distribution: USD 11,677.00; earnings: USD 11,677.00; basis: USD 8,173.90; recipient: Example Entity 8-7-3",1099,5,1099,fdc-b9d4d473820581939b28cd00,synthetic-form-layout-08,original,2024,fte-9c0f29db10e1f13ffc969710,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 900 is the named party.
Information printed on this record:
gross distribution: USD 11,233.00
earnings: USD 11,233.00
basis: USD 7,863.10
recipient: Example Entity 9-0-3",1099,5,1099,fdc-caffad8e4513340d5e363ecf,synthetic-form-layout-09,original,2023,fte-f62231f30b05979a312f2e44,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 901 is the named party.
Information printed on this record:
gross distribution: USD 11,316.00
earnings: USD 11,316.00
basis: USD 7,921.20
recipient: Example Entity 9-1-3",1099,5,1099,fdc-ef2285dbeaca5863ab68a1b5,synthetic-form-layout-09,original,2024,fte-e1cc09453bf5aa2b3e7a4b2e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 902 is the named party.
Information printed on this record:
gross distribution: USD 11,399.00
earnings: USD 11,399.00
basis: USD 7,979.30
recipient: Example Entity 9-2-3",1099,5,1099,fdc-058a7ffd0afaaff960d40c73,synthetic-form-layout-09,original,2025,fte-f99fa3f136b9edad4d7ebe08,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 903 is the named party.
Information printed on this record:
gross distribution: USD 11,482.00
earnings: USD 11,482.00
basis: USD 8,037.40
recipient: Example Entity 9-3-3",1099,5,1099,fdc-04c4bcd5299f142fc9a96d8b,synthetic-form-layout-09,original,2023,fte-2717b360108aa45160e171b8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 904 is the named party.
Information printed on this record:
gross distribution: USD 11,565.00
earnings: USD 11,565.00
basis: USD 8,095.50
recipient: Example Entity 9-4-3",1099,5,1099,fdc-e3e87c93a241023ec29bd09d,synthetic-form-layout-09,original,2024,fte-a7d3401143656aa2cc9951e6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 905 is the named party.
Information printed on this record:
gross distribution: USD 11,648.00
earnings: USD 11,648.00
basis: USD 8,153.60
recipient: Example Entity 9-5-3",1099,5,1099,fdc-ac197a21b401222940dd05b7,synthetic-form-layout-09,original,2025,fte-632a9b3f9dc8494ff3a5a74b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 906 is the named party.
Information printed on this record:
gross distribution: USD 11,731.00
earnings: USD 11,731.00
basis: USD 8,211.70
recipient: Example Entity 9-6-3",1099,5,1099,fdc-9622e31e320bbbf06a83f6d4,synthetic-form-layout-09,original,2023,fte-50133ca57d5a60b27b0fc431,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-Q: Payments From Qualified Education Programs
Example Client 907 is the named party.
Information printed on this record:
gross distribution: USD 11,814.00
earnings: USD 11,814.00
basis: USD 8,269.80
recipient: Example Entity 9-7-3",1099,5,1099,fdc-4faa895e83fd8542bddba981,synthetic-form-layout-09,original,2024,fte-2214a84c829db4e31fbc17e0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: Coverdell ESA contributions: USD 11,096.00; rollover contributions: USD 11,096.00; beneficiary: Example Entity 8-0-2",5498,14,5498,fdc-6ab0fe2a536a755febb032b2,synthetic-form-layout-08,original,2023,fte-a68649bdd6182522f3b7f975,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: Coverdell ESA contributions: USD 11,179.00; rollover contributions: USD 11,179.00; beneficiary: Example Entity 8-1-2",5498,14,5498,fdc-408eb722a751374eed889f27,synthetic-form-layout-08,original,2024,fte-c8ebbdcc506f313b7bc8226c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Coverdell ESA contributions: USD 11,262.00; rollover contributions: USD 11,262.00; beneficiary: Example Entity 8-2-2",5498,14,5498,fdc-5852a31baa981d1b7405b99a,synthetic-form-layout-08,original,2025,fte-17823409a0ed44994aa67e82,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: Coverdell ESA contributions: USD 11,345.00; rollover contributions: USD 11,345.00; beneficiary: Example Entity 8-3-2",5498,14,5498,fdc-af5a90516e7117c0a07cc8d3,synthetic-form-layout-08,original,2023,fte-242d1b53775b1ecec4b3d32f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: Coverdell ESA contributions: USD 11,428.00; rollover contributions: USD 11,428.00; beneficiary: Example Entity 8-4-2",5498,14,5498,fdc-04c0952203ee15c469f07041,synthetic-form-layout-08,original,2024,fte-57a64193e5510ec176465281,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Coverdell ESA contributions: USD 11,511.00; rollover contributions: USD 11,511.00; beneficiary: Example Entity 8-5-2",5498,14,5498,fdc-a10e4ce19c567253a3d3e94e,synthetic-form-layout-08,original,2025,fte-fc98008094ce5e6e4a50ab74,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: Coverdell ESA contributions: USD 11,594.00; rollover contributions: USD 11,594.00; beneficiary: Example Entity 8-6-2",5498,14,5498,fdc-7084ff57085fa2dd88d80484,synthetic-form-layout-08,original,2023,fte-6cac8fbd509ce68b17b644b8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-ESA: Coverdell ESA Contribution Information
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: Coverdell ESA contributions: USD 11,677.00; rollover contributions: USD 11,677.00; beneficiary: Example Entity 8-7-2",5498,14,5498,fdc-e4100eed75533f3b5fbcbbe6,synthetic-form-layout-08,original,2024,fte-e2af0085dccdf57d933c97ee,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 900 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,233.00
rollover contributions: USD 11,233.00
beneficiary: Example Entity 9-0-2",5498,14,5498,fdc-b1d42e9f3c51f6da619f888c,synthetic-form-layout-09,original,2023,fte-bd952db0ca24781d67f031aa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 901 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,316.00
rollover contributions: USD 11,316.00
beneficiary: Example Entity 9-1-2",5498,14,5498,fdc-34ed4b09975d06d541985fe0,synthetic-form-layout-09,original,2024,fte-17ec1db9da292f5537098c0f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 902 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,399.00
rollover contributions: USD 11,399.00
beneficiary: Example Entity 9-2-2",5498,14,5498,fdc-efef45a5ab77defea2d0ec43,synthetic-form-layout-09,original,2025,fte-e8eef3b94a6417dd91120d57,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 903 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,482.00
rollover contributions: USD 11,482.00
beneficiary: Example Entity 9-3-2",5498,14,5498,fdc-357f5d34024d0efa5de1bde3,synthetic-form-layout-09,original,2023,fte-c156aef23cb6213149436611,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 904 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,565.00
rollover contributions: USD 11,565.00
beneficiary: Example Entity 9-4-2",5498,14,5498,fdc-0b5d7d033aaed6ecacd06583,synthetic-form-layout-09,original,2024,fte-6b9291ca70d27fb32b0549e0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 905 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,648.00
rollover contributions: USD 11,648.00
beneficiary: Example Entity 9-5-2",5498,14,5498,fdc-740f6fed5c9d44e2828755b4,synthetic-form-layout-09,original,2025,fte-700102ac8bb56d955cf80400,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 906 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,731.00
rollover contributions: USD 11,731.00
beneficiary: Example Entity 9-6-2",5498,14,5498,fdc-b8255e93aaef9a9532900158,synthetic-form-layout-09,original,2023,fte-d8bc0d7f30205300fada9d06,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498-ESA: Coverdell ESA Contribution Information
Example Client 907 is the named party.
Information printed on this record:
Coverdell ESA contributions: USD 11,814.00
rollover contributions: USD 11,814.00
beneficiary: Example Entity 9-7-2",5498,14,5498,fdc-8997c9e36e833699b88831c8,synthetic-form-layout-09,original,2024,fte-adf7cde253913d7d512e8438,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: monthly enrollment premiums: USD 11,096.00; advance premium tax credit: USD 11,096.00; covered individuals: USD 11,096.00",1095,3,1095,fdc-f2b09673649b8ab43ec489a8,synthetic-form-layout-08,original,2023,fte-d5625a35e23aa1d325021ef5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: monthly enrollment premiums: USD 11,179.00; advance premium tax credit: USD 11,179.00; covered individuals: USD 11,179.00",1095,3,1095,fdc-f129981cc8eeb9d539be30bf,synthetic-form-layout-08,original,2024,fte-20a31cae550700d4eb9b962c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: monthly enrollment premiums: USD 11,262.00; advance premium tax credit: USD 11,262.00; covered individuals: USD 11,262.00",1095,3,1095,fdc-fa6e629d0acc2e4361977e0d,synthetic-form-layout-08,original,2025,fte-4972ad07cece157b632a97cb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: monthly enrollment premiums: USD 11,345.00; advance premium tax credit: USD 11,345.00; covered individuals: USD 11,345.00",1095,3,1095,fdc-64b7571ab66ddb46bc1bb761,synthetic-form-layout-08,original,2023,fte-2e905e72387643495abb089b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: monthly enrollment premiums: USD 11,428.00; advance premium tax credit: USD 11,428.00; covered individuals: USD 11,428.00",1095,3,1095,fdc-e83e3b20aa9a04934ee4e0a4,synthetic-form-layout-08,original,2024,fte-42c94ccff313ab18a112ce01,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: monthly enrollment premiums: USD 11,511.00; advance premium tax credit: USD 11,511.00; covered individuals: USD 11,511.00",1095,3,1095,fdc-52bc39910e64ba7522f12881,synthetic-form-layout-08,original,2025,fte-c99c21f1027dc8633c007e47,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: monthly enrollment premiums: USD 11,594.00; advance premium tax credit: USD 11,594.00; covered individuals: USD 11,594.00",1095,3,1095,fdc-783100a351be0f2f2635c8ec,synthetic-form-layout-08,original,2023,fte-89b5ac13619401a8ee69f965,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-A: Health Insurance Marketplace Statement
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: monthly enrollment premiums: USD 11,677.00; advance premium tax credit: USD 11,677.00; covered individuals: USD 11,677.00",1095,3,1095,fdc-c961dae2f723d829507195ea,synthetic-form-layout-08,original,2024,fte-eaba975c5f9ddef37a0a7400,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 900 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,233.00
advance premium tax credit: USD 11,233.00
covered individuals: USD 11,233.00",1095,3,1095,fdc-98f9fbaae65593844c7a8f0f,synthetic-form-layout-09,original,2023,fte-d63109ffd9cfd77cc73e2eba,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 901 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,316.00
advance premium tax credit: USD 11,316.00
covered individuals: USD 11,316.00",1095,3,1095,fdc-f6c7b112ace359df81d0f5a7,synthetic-form-layout-09,original,2024,fte-97e1fa61b170072c5b726fa0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 902 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,399.00
advance premium tax credit: USD 11,399.00
covered individuals: USD 11,399.00",1095,3,1095,fdc-48dc1ce21510339c651dbee5,synthetic-form-layout-09,original,2025,fte-c55633de37696154b863bd3f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 903 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,482.00
advance premium tax credit: USD 11,482.00
covered individuals: USD 11,482.00",1095,3,1095,fdc-203d7ef271bface9720643e8,synthetic-form-layout-09,original,2023,fte-bf72659eb4321d4c1907a3cd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 904 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,565.00
advance premium tax credit: USD 11,565.00
covered individuals: USD 11,565.00",1095,3,1095,fdc-518d1d428a9d142a82efc532,synthetic-form-layout-09,original,2024,fte-4da144bf9390e56917761289,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 905 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,648.00
advance premium tax credit: USD 11,648.00
covered individuals: USD 11,648.00",1095,3,1095,fdc-b96c663082996577c0ef18da,synthetic-form-layout-09,original,2025,fte-9f070c1da3c261145a877d1a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 906 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,731.00
advance premium tax credit: USD 11,731.00
covered individuals: USD 11,731.00",1095,3,1095,fdc-620e81362edb998025f06180,synthetic-form-layout-09,original,2023,fte-10fc61a8218387dda292e8e1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-A: Health Insurance Marketplace Statement
Example Client 907 is the named party.
Information printed on this record:
monthly enrollment premiums: USD 11,814.00
advance premium tax credit: USD 11,814.00
covered individuals: USD 11,814.00",1095,3,1095,fdc-81dd76ddc113912ab59791fd,synthetic-form-layout-09,original,2024,fte-8849a3f6d67c360855fa1e2f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: responsible individual: USD 11,096.00; covered individuals: USD 11,096.00; months of coverage: January through December",1095,3,1095,fdc-59ebee4227a445c93a9318a1,synthetic-form-layout-08,original,2023,fte-a88a3ddd10dcec868e9bca10,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: responsible individual: USD 11,179.00; covered individuals: USD 11,179.00; months of coverage: January through December",1095,3,1095,fdc-a5e8200931db761a851c93f2,synthetic-form-layout-08,original,2024,fte-b44a47220eb0567d6a876ed5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: responsible individual: USD 11,262.00; covered individuals: USD 11,262.00; months of coverage: January through December",1095,3,1095,fdc-2a212b225b7c19ff9fac7701,synthetic-form-layout-08,original,2025,fte-79fa396c671301009d8961bb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: responsible individual: USD 11,345.00; covered individuals: USD 11,345.00; months of coverage: January through December",1095,3,1095,fdc-aad911de9e16f2343f255ebf,synthetic-form-layout-08,original,2023,fte-b8afb749164a23b3503ed977,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: responsible individual: USD 11,428.00; covered individuals: USD 11,428.00; months of coverage: January through December",1095,3,1095,fdc-4f5f2f7f57c9741c2a7d98b0,synthetic-form-layout-08,original,2024,fte-e9d4123dd10d956507ec0a08,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: responsible individual: USD 11,511.00; covered individuals: USD 11,511.00; months of coverage: January through December",1095,3,1095,fdc-9be1c459672065703bdee3d7,synthetic-form-layout-08,original,2025,fte-b03ccef6bb692ae6affd9c5f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: responsible individual: USD 11,594.00; covered individuals: USD 11,594.00; months of coverage: January through December",1095,3,1095,fdc-25556c2975b5ba57a7eb6d5b,synthetic-form-layout-08,original,2023,fte-466156926fbbbd8a61acc028,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-B: Health Coverage
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: responsible individual: USD 11,677.00; covered individuals: USD 11,677.00; months of coverage: January through December",1095,3,1095,fdc-f0463d42fa57d5f297fcaf47,synthetic-form-layout-08,original,2024,fte-517007e83ee784af4e38cbfd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-B: Health Coverage
Example Client 900 is the named party.
Information printed on this record:
responsible individual: USD 11,233.00
covered individuals: USD 11,233.00
months of coverage: January through December",1095,3,1095,fdc-7097b551b4cda05f6ff974d0,synthetic-form-layout-09,original,2023,fte-59a6220d97f770eb7e4dd844,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-B: Health Coverage
Example Client 901 is the named party.
Information printed on this record:
responsible individual: USD 11,316.00
covered individuals: USD 11,316.00
months of coverage: January through December",1095,3,1095,fdc-f4650601ea14ca68d68f33f8,synthetic-form-layout-09,original,2024,fte-c965a0111c03e53d18caadc1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1095-B: Health Coverage
Example Client 902 is the named party.
Information printed on this record:
responsible individual: USD 11,399.00
covered individuals: USD 11,399.00
months of coverage: January through December",1095,3,1095,fdc-738bdb8fa5488729bf041eec,synthetic-form-layout-09,original,2025,fte-e6c3e1b09d429acf69b50468,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-B: Health Coverage
Example Client 903 is the named party.
Information printed on this record:
responsible individual: USD 11,482.00
covered individuals: USD 11,482.00
months of coverage: January through December",1095,3,1095,fdc-68766b6ad938d3bed456ff69,synthetic-form-layout-09,original,2023,fte-0431acb34bf75f1996d05f65,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-B: Health Coverage
Example Client 904 is the named party.
Information printed on this record:
responsible individual: USD 11,565.00
covered individuals: USD 11,565.00
months of coverage: January through December",1095,3,1095,fdc-003105c1721aacc7cd62e633,synthetic-form-layout-09,original,2024,fte-f03604f4c4c517d54d87ed99,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1095-B: Health Coverage
Example Client 905 is the named party.
Information printed on this record:
responsible individual: USD 11,648.00
covered individuals: USD 11,648.00
months of coverage: January through December",1095,3,1095,fdc-d8becaf8ed432e9fc595113c,synthetic-form-layout-09,original,2025,fte-8c0c5d7a49fe90076d9e52b1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-B: Health Coverage
Example Client 906 is the named party.
Information printed on this record:
responsible individual: USD 11,731.00
covered individuals: USD 11,731.00
months of coverage: January through December",1095,3,1095,fdc-3b86f46772fc291fbf22fc9c,synthetic-form-layout-09,original,2023,fte-9c26cd9016c275da63f2e7a6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-B: Health Coverage
Example Client 907 is the named party.
Information printed on this record:
responsible individual: USD 11,814.00
covered individuals: USD 11,814.00
months of coverage: January through December",1095,3,1095,fdc-a3825a6671237ca43dd64760,synthetic-form-layout-09,original,2024,fte-8c93b6042a49b74b2c3ad788,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: employee: Example Entity 8-0-0; employer: Example Entity 8-0-1; offer of coverage: USD 11,096.00; monthly contribution: USD 11,096.00",1095,3,1095,fdc-bb946ad38ce5a1f7abd4590a,synthetic-form-layout-08,original,2023,fte-26bc6e19c013605d8f7f5eff,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: employee: Example Entity 8-1-0; employer: Example Entity 8-1-1; offer of coverage: USD 11,179.00; monthly contribution: USD 11,179.00",1095,3,1095,fdc-d0757c564abd376079767952,synthetic-form-layout-08,original,2024,fte-4384b439ad59ed14d55ac46e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: employee: Example Entity 8-2-0; employer: Example Entity 8-2-1; offer of coverage: USD 11,262.00; monthly contribution: USD 11,262.00",1095,3,1095,fdc-70bfbbe8f43d8f260b4d8722,synthetic-form-layout-08,original,2025,fte-c16021fda42b4cccab6e0b14,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: employee: Example Entity 8-3-0; employer: Example Entity 8-3-1; offer of coverage: USD 11,345.00; monthly contribution: USD 11,345.00",1095,3,1095,fdc-9d588f42e0e45dee2721ecaf,synthetic-form-layout-08,original,2023,fte-f70c6680274e3845ef264ad9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: employee: Example Entity 8-4-0; employer: Example Entity 8-4-1; offer of coverage: USD 11,428.00; monthly contribution: USD 11,428.00",1095,3,1095,fdc-bf7860afd03e6a09d9bb5716,synthetic-form-layout-08,original,2024,fte-1505adba53b36d0503ac1a2e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: employee: Example Entity 8-5-0; employer: Example Entity 8-5-1; offer of coverage: USD 11,511.00; monthly contribution: USD 11,511.00",1095,3,1095,fdc-6a85894d59510124b5747b5d,synthetic-form-layout-08,original,2025,fte-9af315148b0030ea0122c848,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: employee: Example Entity 8-6-0; employer: Example Entity 8-6-1; offer of coverage: USD 11,594.00; monthly contribution: USD 11,594.00",1095,3,1095,fdc-b9703b8c79ac3b9893e87e03,synthetic-form-layout-08,original,2023,fte-8202f69609047f67e391892b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: employee: Example Entity 8-7-0; employer: Example Entity 8-7-1; offer of coverage: USD 11,677.00; monthly contribution: USD 11,677.00",1095,3,1095,fdc-8aaace02cc567573323b6f5b,synthetic-form-layout-08,original,2024,fte-829c9acdc3981ae4dc77e929,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 900 is the named party.
Information printed on this record:
employee: Example Entity 9-0-0
employer: Example Entity 9-0-1
offer of coverage: USD 11,233.00
monthly contribution: USD 11,233.00",1095,3,1095,fdc-21c8fe095540572e6dad9c25,synthetic-form-layout-09,original,2023,fte-1f777e56f401e6c1dec568a2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 901 is the named party.
Information printed on this record:
employee: Example Entity 9-1-0
employer: Example Entity 9-1-1
offer of coverage: USD 11,316.00
monthly contribution: USD 11,316.00",1095,3,1095,fdc-4ff174b25bf9037cbcb2d0c0,synthetic-form-layout-09,original,2024,fte-4db8cbf3d79abb0b0bc6c8a6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 902 is the named party.
Information printed on this record:
employee: Example Entity 9-2-0
employer: Example Entity 9-2-1
offer of coverage: USD 11,399.00
monthly contribution: USD 11,399.00",1095,3,1095,fdc-e0855baaf0a50572f4b913e7,synthetic-form-layout-09,original,2025,fte-7ecd3ad006079259b080e847,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 903 is the named party.
Information printed on this record:
employee: Example Entity 9-3-0
employer: Example Entity 9-3-1
offer of coverage: USD 11,482.00
monthly contribution: USD 11,482.00",1095,3,1095,fdc-5d887d4174404a6fd2618636,synthetic-form-layout-09,original,2023,fte-3a3673f9380d652b36fbae79,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 904 is the named party.
Information printed on this record:
employee: Example Entity 9-4-0
employer: Example Entity 9-4-1
offer of coverage: USD 11,565.00
monthly contribution: USD 11,565.00",1095,3,1095,fdc-850e7953650ae35e3c97ad84,synthetic-form-layout-09,original,2024,fte-d1a959f6b526b702c2a8536d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 905 is the named party.
Information printed on this record:
employee: Example Entity 9-5-0
employer: Example Entity 9-5-1
offer of coverage: USD 11,648.00
monthly contribution: USD 11,648.00",1095,3,1095,fdc-a9b20ae540e123832a306d53,synthetic-form-layout-09,original,2025,fte-60716f97d3d13aefba08118c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 906 is the named party.
Information printed on this record:
employee: Example Entity 9-6-0
employer: Example Entity 9-6-1
offer of coverage: USD 11,731.00
monthly contribution: USD 11,731.00",1095,3,1095,fdc-e4f73dfee02c5590fbf059ac,synthetic-form-layout-09,original,2023,fte-d384c9befde636a8cdac0327,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
Example Client 907 is the named party.
Information printed on this record:
employee: Example Entity 9-7-0
employer: Example Entity 9-7-1
offer of coverage: USD 11,814.00
monthly contribution: USD 11,814.00",1095,3,1095,fdc-061e7650e0ed221632fe6a0d,synthetic-form-layout-09,original,2024,fte-687edf763ca5833e2c74586d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: gross distribution: USD 11,096.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-3e2b32b60942c9e2858d74d6,synthetic-form-layout-08,original,2023,fte-41e5e1cf2d7fb3739891ccaa,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: gross distribution: USD 11,179.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-fcdd95f442ecb849d02ddbe7,synthetic-form-layout-08,original,2024,fte-ca6bf0e3967456a897b5690a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: gross distribution: USD 11,262.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-edffea964afb466dd8fabe42,synthetic-form-layout-08,original,2025,fte-c289f6c8e6f93aa22756eda5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: gross distribution: USD 11,345.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-c25c42e4457c1608d5c3dc74,synthetic-form-layout-08,original,2023,fte-5ff3c6abd8cdddc6588f38f3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: gross distribution: USD 11,428.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-ce829a570cd95e490f8c505b,synthetic-form-layout-08,original,2024,fte-0aecadfbe4c9d3d14a2d045b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: gross distribution: USD 11,511.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-51a1e6eb544764bc5412d5c6,synthetic-form-layout-08,original,2025,fte-0dc7f32a033df06999bbaa77,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: gross distribution: USD 11,594.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-84f2d117c78f07b68ef73ea3,synthetic-form-layout-08,original,2023,fte-701827c9c85f8590feb18b92,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: gross distribution: USD 11,677.00; distribution code: 7; account type: HSA",1099,5,1099,fdc-974bea98f04ffd636842230a,synthetic-form-layout-08,original,2024,fte-251eaf7ac2a3bb7187d23a06,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 900 is the named party.
Information printed on this record:
gross distribution: USD 11,233.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-b5070112074e78f92a000d1f,synthetic-form-layout-09,original,2023,fte-48b95002664c6d91e2c44c57,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 901 is the named party.
Information printed on this record:
gross distribution: USD 11,316.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-1f9604a3bb4334aa420d820f,synthetic-form-layout-09,original,2024,fte-597b628380af238ff1f82ee1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 902 is the named party.
Information printed on this record:
gross distribution: USD 11,399.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-8911bf33c2aa69bd132f758c,synthetic-form-layout-09,original,2025,fte-0e671d865951735d95e47850,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 903 is the named party.
Information printed on this record:
gross distribution: USD 11,482.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-cfd11e8352da666c8be21a5b,synthetic-form-layout-09,original,2023,fte-92e7b235bd418a7449d351f2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 904 is the named party.
Information printed on this record:
gross distribution: USD 11,565.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-4e300b84dbe148952b7cde6b,synthetic-form-layout-09,original,2024,fte-26b00f1b64d2d005ac61a7cd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 905 is the named party.
Information printed on this record:
gross distribution: USD 11,648.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-840484d8dba5cfeb3bd96eb0,synthetic-form-layout-09,original,2025,fte-296caaa3fef5067671264370,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 906 is the named party.
Information printed on this record:
gross distribution: USD 11,731.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-8d400477a75577056a7c5786,synthetic-form-layout-09,original,2023,fte-2671e755bb50cbac1ac1730d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1099-SA: Distributions From an HSA Archer MSA or Medicare Advantage MSA
Example Client 907 is the named party.
Information printed on this record:
gross distribution: USD 11,814.00
distribution code: 7
account type: HSA",1099,5,1099,fdc-48f30357948ab10b6ccebfcb,synthetic-form-layout-09,original,2024,fte-1ae84757a2983c20090c1f23,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: contributions: USD 11,096.00; rollover contributions: USD 11,096.00; fair market value: USD 11,096.00",5498,14,5498,fdc-daa1fb6dd91213b6c0513346,synthetic-form-layout-08,original,2023,fte-e6d853cdca6a842f45bef663,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: contributions: USD 11,179.00; rollover contributions: USD 11,179.00; fair market value: USD 11,179.00",5498,14,5498,fdc-406db6ea14507e39127a5396,synthetic-form-layout-08,original,2024,fte-f4557fabec60e321dca333b8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: contributions: USD 11,262.00; rollover contributions: USD 11,262.00; fair market value: USD 11,262.00",5498,14,5498,fdc-5919369562e37c0a41f6cac7,synthetic-form-layout-08,original,2025,fte-0fcdc6ef44c0a230fb3a3e4d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: contributions: USD 11,345.00; rollover contributions: USD 11,345.00; fair market value: USD 11,345.00",5498,14,5498,fdc-d14733af29163bb1f7a0d21e,synthetic-form-layout-08,original,2023,fte-a5067c4e4d1b67daa767dac5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: contributions: USD 11,428.00; rollover contributions: USD 11,428.00; fair market value: USD 11,428.00",5498,14,5498,fdc-429d8642d90a5e52dadff80f,synthetic-form-layout-08,original,2024,fte-1d15a9d09afd859f4463ca7e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: contributions: USD 11,511.00; rollover contributions: USD 11,511.00; fair market value: USD 11,511.00",5498,14,5498,fdc-3256cf735cb01beb519a685a,synthetic-form-layout-08,original,2025,fte-ac1c35e09172b8cfd9717b94,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: contributions: USD 11,594.00; rollover contributions: USD 11,594.00; fair market value: USD 11,594.00",5498,14,5498,fdc-a494919923c39ee058c23809,synthetic-form-layout-08,original,2023,fte-f9ea35cf16be0ecabf14727d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: contributions: USD 11,677.00; rollover contributions: USD 11,677.00; fair market value: USD 11,677.00",5498,14,5498,fdc-11f8eea9a6b6adcaf40e5c6d,synthetic-form-layout-08,original,2024,fte-34f93b575a8be2f9991b0d2c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 900 is the named party.
Information printed on this record:
contributions: USD 11,233.00
rollover contributions: USD 11,233.00
fair market value: USD 11,233.00",5498,14,5498,fdc-6dbdd8d2403f520ad40659c0,synthetic-form-layout-09,original,2023,fte-6cbd0e05c5df9d8910add23f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 901 is the named party.
Information printed on this record:
contributions: USD 11,316.00
rollover contributions: USD 11,316.00
fair market value: USD 11,316.00",5498,14,5498,fdc-08a48b42ee95e0f5d38b31fa,synthetic-form-layout-09,original,2024,fte-6b01ff2208fcde98c5809088,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 902 is the named party.
Information printed on this record:
contributions: USD 11,399.00
rollover contributions: USD 11,399.00
fair market value: USD 11,399.00",5498,14,5498,fdc-74700ed1f6f3a3c268a9a8f5,synthetic-form-layout-09,original,2025,fte-06b66ba7c58dd9712e5a6149,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 903 is the named party.
Information printed on this record:
contributions: USD 11,482.00
rollover contributions: USD 11,482.00
fair market value: USD 11,482.00",5498,14,5498,fdc-d28f57f33d0418e355ee5bad,synthetic-form-layout-09,original,2023,fte-9057c7b933d252c3b33e3cf1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 904 is the named party.
Information printed on this record:
contributions: USD 11,565.00
rollover contributions: USD 11,565.00
fair market value: USD 11,565.00",5498,14,5498,fdc-e94c5ec04a8f708491b34355,synthetic-form-layout-09,original,2024,fte-6af0f67a27c9c6c030879446,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 905 is the named party.
Information printed on this record:
contributions: USD 11,648.00
rollover contributions: USD 11,648.00
fair market value: USD 11,648.00",5498,14,5498,fdc-b1e7e2bf34ffce895e4abe2c,synthetic-form-layout-09,original,2025,fte-4096df514408e599e0362135,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 906 is the named party.
Information printed on this record:
contributions: USD 11,731.00
rollover contributions: USD 11,731.00
fair market value: USD 11,731.00",5498,14,5498,fdc-aff843cf20565535d4fb2cf9,synthetic-form-layout-09,original,2023,fte-cfe93841d0073ff0c0788919,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5498-SA: HSA Archer MSA or Medicare Advantage MSA Information
Example Client 907 is the named party.
Information printed on this record:
contributions: USD 11,814.00
rollover contributions: USD 11,814.00
fair market value: USD 11,814.00",5498,14,5498,fdc-3dc22737f4b106264da95fc7,synthetic-form-layout-09,original,2024,fte-844837ac6d923a8fb4c07d94,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: HSA contributions: USD 11,096.00; distributions: USD 11,096.00; qualified medical expenses: USD 11,096.00",8889,19,8889,fdc-00c323f2494391bd732a5188,synthetic-form-layout-08,original,2023,fte-91a8b66387e117a517197962,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: HSA contributions: USD 11,179.00; distributions: USD 11,179.00; qualified medical expenses: USD 11,179.00",8889,19,8889,fdc-a2d6a9ffbb355286c70f3e72,synthetic-form-layout-08,original,2024,fte-b33a3f0a39b85fd02ea65c5e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: HSA contributions: USD 11,262.00; distributions: USD 11,262.00; qualified medical expenses: USD 11,262.00",8889,19,8889,fdc-ba9195b2353dac7f9b52d7a4,synthetic-form-layout-08,original,2025,fte-b85a6295dae36fbc851366aa,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: HSA contributions: USD 11,345.00; distributions: USD 11,345.00; qualified medical expenses: USD 11,345.00",8889,19,8889,fdc-671c65d5795eef986b10dc33,synthetic-form-layout-08,original,2023,fte-83d8f2065bc1b24935330fab,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: HSA contributions: USD 11,428.00; distributions: USD 11,428.00; qualified medical expenses: USD 11,428.00",8889,19,8889,fdc-7b926d95edf836b8b59cb044,synthetic-form-layout-08,original,2024,fte-c87d6b5e69a2ad95f222363f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: HSA contributions: USD 11,511.00; distributions: USD 11,511.00; qualified medical expenses: USD 11,511.00",8889,19,8889,fdc-aaf245f9439c53c32fe509d0,synthetic-form-layout-08,original,2025,fte-aec5960fd4ed40c266160748,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: HSA contributions: USD 11,594.00; distributions: USD 11,594.00; qualified medical expenses: USD 11,594.00",8889,19,8889,fdc-c979b2ab68c982dce74d8190,synthetic-form-layout-08,original,2023,fte-b51ccb2d17abe3b82c5a4342,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8889: Health Savings Accounts
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: HSA contributions: USD 11,677.00; distributions: USD 11,677.00; qualified medical expenses: USD 11,677.00",8889,19,8889,fdc-7c77e09f995e638f102c0ae2,synthetic-form-layout-08,original,2024,fte-f4a9867d5c2137ac9bbb5fe6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8889: Health Savings Accounts
Example Client 900 is the named party.
Information printed on this record:
HSA contributions: USD 11,233.00
distributions: USD 11,233.00
qualified medical expenses: USD 11,233.00",8889,19,8889,fdc-fc729a839904b3014a0d1655,synthetic-form-layout-09,original,2023,fte-ba8ebf7e949e7ba15a54341e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8889: Health Savings Accounts
Example Client 901 is the named party.
Information printed on this record:
HSA contributions: USD 11,316.00
distributions: USD 11,316.00
qualified medical expenses: USD 11,316.00",8889,19,8889,fdc-4d57d44b29fda7e9f0cb3339,synthetic-form-layout-09,original,2024,fte-d11ff6c52a9a4fbf2db92444,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8889: Health Savings Accounts
Example Client 902 is the named party.
Information printed on this record:
HSA contributions: USD 11,399.00
distributions: USD 11,399.00
qualified medical expenses: USD 11,399.00",8889,19,8889,fdc-131a9576c80fa099585d90ab,synthetic-form-layout-09,original,2025,fte-389862da9bb483acfdf91511,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8889: Health Savings Accounts
Example Client 903 is the named party.
Information printed on this record:
HSA contributions: USD 11,482.00
distributions: USD 11,482.00
qualified medical expenses: USD 11,482.00",8889,19,8889,fdc-322889a1185d7c1a5bb58f9b,synthetic-form-layout-09,original,2023,fte-ef4774c33a39bebeac253cd4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8889: Health Savings Accounts
Example Client 904 is the named party.
Information printed on this record:
HSA contributions: USD 11,565.00
distributions: USD 11,565.00
qualified medical expenses: USD 11,565.00",8889,19,8889,fdc-8d1151338eba4886c1b81074,synthetic-form-layout-09,original,2024,fte-5477aa82e0e172324d546d7e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8889: Health Savings Accounts
Example Client 905 is the named party.
Information printed on this record:
HSA contributions: USD 11,648.00
distributions: USD 11,648.00
qualified medical expenses: USD 11,648.00",8889,19,8889,fdc-376a8ec6f2d6d947e6fb7310,synthetic-form-layout-09,original,2025,fte-b54b9167e086ee7fc65ba7aa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8889: Health Savings Accounts
Example Client 906 is the named party.
Information printed on this record:
HSA contributions: USD 11,731.00
distributions: USD 11,731.00
qualified medical expenses: USD 11,731.00",8889,19,8889,fdc-16aa9059b672773cf8626e72,synthetic-form-layout-09,original,2023,fte-d56ab0d3a8db1b9cd477f569,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8889: Health Savings Accounts
Example Client 907 is the named party.
Information printed on this record:
HSA contributions: USD 11,814.00
distributions: USD 11,814.00
qualified medical expenses: USD 11,814.00",8889,19,8889,fdc-6b65afcc03d19c3d8e65403f,synthetic-form-layout-09,original,2024,fte-cc9aab166b3a113515ac92b6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: family size: 2; household income: USD 11,096.00; premium tax credit reconciliation: USD 11,096.00",8962,23,8962,fdc-cba7df2adfb1fb0c0ca5a7ca,synthetic-form-layout-08,original,2023,fte-103dba7f2a60198e2e329dd5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: family size: 2; household income: USD 11,179.00; premium tax credit reconciliation: USD 11,179.00",8962,23,8962,fdc-fd3418b53353cc7440166080,synthetic-form-layout-08,original,2024,fte-e63fce833f11cc1b3e24e908,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: family size: 2; household income: USD 11,262.00; premium tax credit reconciliation: USD 11,262.00",8962,23,8962,fdc-6bf21e055ab0588c63112d92,synthetic-form-layout-08,original,2025,fte-0aa1f96be283596071b9d839,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: family size: 2; household income: USD 11,345.00; premium tax credit reconciliation: USD 11,345.00",8962,23,8962,fdc-c71c1cbf99385e5aecf07f5e,synthetic-form-layout-08,original,2023,fte-87c9a5db875190b7ddbd9d45,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: family size: 2; household income: USD 11,428.00; premium tax credit reconciliation: USD 11,428.00",8962,23,8962,fdc-1424211dc079b3a812eb990b,synthetic-form-layout-08,original,2024,fte-2c8c79b80b995d944cc4a716,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: family size: 2; household income: USD 11,511.00; premium tax credit reconciliation: USD 11,511.00",8962,23,8962,fdc-3892ef9b1a6b9e1dacc208ff,synthetic-form-layout-08,original,2025,fte-f6d9bb59a61d8ecdada1c3dc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: family size: 2; household income: USD 11,594.00; premium tax credit reconciliation: USD 11,594.00",8962,23,8962,fdc-a48c6ebaca51fd33029e21d3,synthetic-form-layout-08,original,2023,fte-3f163a9589a1f7718715fadc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8962: Premium Tax Credit
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: family size: 2; household income: USD 11,677.00; premium tax credit reconciliation: USD 11,677.00",8962,23,8962,fdc-1349b006c22a10af0f8fd6d7,synthetic-form-layout-08,original,2024,fte-ac21874e6142670c9f54bc4e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8962: Premium Tax Credit
Example Client 900 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,233.00
premium tax credit reconciliation: USD 11,233.00",8962,23,8962,fdc-c6633bd550b98eb0645b55d6,synthetic-form-layout-09,original,2023,fte-4cfa5eb14d743a6a71a73422,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8962: Premium Tax Credit
Example Client 901 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,316.00
premium tax credit reconciliation: USD 11,316.00",8962,23,8962,fdc-f5e35aab4dfae7ae08f41a3a,synthetic-form-layout-09,original,2024,fte-cfcf1b3509663d130dd1f06a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8962: Premium Tax Credit
Example Client 902 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,399.00
premium tax credit reconciliation: USD 11,399.00",8962,23,8962,fdc-495c6e7fa5e307d38f2fde16,synthetic-form-layout-09,original,2025,fte-a8455c034c0833003ed5aba7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8962: Premium Tax Credit
Example Client 903 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,482.00
premium tax credit reconciliation: USD 11,482.00",8962,23,8962,fdc-d47dbf2edc4c4bc74ee4162d,synthetic-form-layout-09,original,2023,fte-46a31c34c77bfd48f6b4b937,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8962: Premium Tax Credit
Example Client 904 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,565.00
premium tax credit reconciliation: USD 11,565.00",8962,23,8962,fdc-9b1c1a3c6dff2801dcc2ef60,synthetic-form-layout-09,original,2024,fte-476dda00713e5b7f4839e064,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8962: Premium Tax Credit
Example Client 905 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,648.00
premium tax credit reconciliation: USD 11,648.00",8962,23,8962,fdc-8599d63c25660d6a9b366ae6,synthetic-form-layout-09,original,2025,fte-76b7f14cd8d5ee60d2a8fc75,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8962: Premium Tax Credit
Example Client 906 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,731.00
premium tax credit reconciliation: USD 11,731.00",8962,23,8962,fdc-568a0213e92c196199632e61,synthetic-form-layout-09,original,2023,fte-7c528a66b447189641bf1b44,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8962: Premium Tax Credit
Example Client 907 is the named party.
Information printed on this record:
family size: 2
household income: USD 11,814.00
premium tax credit reconciliation: USD 11,814.00",8962,23,8962,fdc-a569469588796c1e3e839858,synthetic-form-layout-09,original,2024,fte-ab6bf0ba8b878d8b7a4f233c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: date of contribution: 2023-03-01; vehicle: Example Entity 8-0-1; gross proceeds: USD 11,096.00; goods or services: USD 11,096.00",1098,4,1098,fdc-39b55ebd5b3002002a9e3e8e,synthetic-form-layout-08,original,2023,fte-2e2f368d5f979d1601d06281,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: date of contribution: 2024-03-02; vehicle: Example Entity 8-1-1; gross proceeds: USD 11,179.00; goods or services: USD 11,179.00",1098,4,1098,fdc-61904f91189df8b832c9c7e3,synthetic-form-layout-08,original,2024,fte-b2c1c84bfb1ba242dfad4fe0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: date of contribution: 2025-03-03; vehicle: Example Entity 8-2-1; gross proceeds: USD 11,262.00; goods or services: USD 11,262.00",1098,4,1098,fdc-77fac464734bd9fc2b475a50,synthetic-form-layout-08,original,2025,fte-3467b814d3410ce8515aae16,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: date of contribution: 2023-03-04; vehicle: Example Entity 8-3-1; gross proceeds: USD 11,345.00; goods or services: USD 11,345.00",1098,4,1098,fdc-9d563305d036960b80f7fcc7,synthetic-form-layout-08,original,2023,fte-ac3ed6d1a9459a59916360f6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: date of contribution: 2024-03-05; vehicle: Example Entity 8-4-1; gross proceeds: USD 11,428.00; goods or services: USD 11,428.00",1098,4,1098,fdc-550505b921199b6b03115a97,synthetic-form-layout-08,original,2024,fte-8749238600710133bff5aef9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: date of contribution: 2025-03-06; vehicle: Example Entity 8-5-1; gross proceeds: USD 11,511.00; goods or services: USD 11,511.00",1098,4,1098,fdc-1c08066f234cc8fe4d519e7e,synthetic-form-layout-08,original,2025,fte-7a6273ab1d8dc94cb631bb73,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: date of contribution: 2023-03-07; vehicle: Example Entity 8-6-1; gross proceeds: USD 11,594.00; goods or services: USD 11,594.00",1098,4,1098,fdc-ba0869a26ef04949a66809f2,synthetic-form-layout-08,original,2023,fte-8ed76ac1ab722dd3dc902a56,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: date of contribution: 2024-03-08; vehicle: Example Entity 8-7-1; gross proceeds: USD 11,677.00; goods or services: USD 11,677.00",1098,4,1098,fdc-7e92995776e66b797ab0c0be,synthetic-form-layout-08,original,2024,fte-b858da2eb82931f1ddea754b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 900 is the named party.
Information printed on this record:
date of contribution: 2023-03-01
vehicle: Example Entity 9-0-1
gross proceeds: USD 11,233.00
goods or services: USD 11,233.00",1098,4,1098,fdc-4a3cc55d4f8f3322dc8cbf1a,synthetic-form-layout-09,original,2023,fte-55cc07d9d24c8f2df0013d85,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 901 is the named party.
Information printed on this record:
date of contribution: 2024-03-02
vehicle: Example Entity 9-1-1
gross proceeds: USD 11,316.00
goods or services: USD 11,316.00",1098,4,1098,fdc-7ef542fb94872cb644fdf360,synthetic-form-layout-09,original,2024,fte-90363e8d5dfa3dafc62c973a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 902 is the named party.
Information printed on this record:
date of contribution: 2025-03-03
vehicle: Example Entity 9-2-1
gross proceeds: USD 11,399.00
goods or services: USD 11,399.00",1098,4,1098,fdc-950fdef07b2fe567cfc8a030,synthetic-form-layout-09,original,2025,fte-89ca8a48fce0ac0aeb28bddb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 903 is the named party.
Information printed on this record:
date of contribution: 2023-03-04
vehicle: Example Entity 9-3-1
gross proceeds: USD 11,482.00
goods or services: USD 11,482.00",1098,4,1098,fdc-a8d174c719b791061503082d,synthetic-form-layout-09,original,2023,fte-e79e64cdb685175ab6ab20d5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 904 is the named party.
Information printed on this record:
date of contribution: 2024-03-05
vehicle: Example Entity 9-4-1
gross proceeds: USD 11,565.00
goods or services: USD 11,565.00",1098,4,1098,fdc-1e4c8526dbf25cee9067859f,synthetic-form-layout-09,original,2024,fte-8c2fa694c63bdf97d3c79292,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 905 is the named party.
Information printed on this record:
date of contribution: 2025-03-06
vehicle: Example Entity 9-5-1
gross proceeds: USD 11,648.00
goods or services: USD 11,648.00",1098,4,1098,fdc-19adb85168d981afc878d9ce,synthetic-form-layout-09,original,2025,fte-6d394450a0920ca044a00083,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 906 is the named party.
Information printed on this record:
date of contribution: 2023-03-07
vehicle: Example Entity 9-6-1
gross proceeds: USD 11,731.00
goods or services: USD 11,731.00",1098,4,1098,fdc-55af780dc75a12bf9a80760c,synthetic-form-layout-09,original,2023,fte-d7805dd36da3803cc09e8d87,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1098-C: Contributions of Motor Vehicles Boats and Airplanes
Example Client 907 is the named party.
Information printed on this record:
date of contribution: 2024-03-08
vehicle: Example Entity 9-7-1
gross proceeds: USD 11,814.00
goods or services: USD 11,814.00",1098,4,1098,fdc-beb486021bf3b9912bc5dc40,synthetic-form-layout-09,original,2024,fte-4d99ec882fb60a2fd1e8b25d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: donated property description: Example Entity 8-0-0; acquisition date: 2023-03-01; donor basis: Example Entity 8-0-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-7edb13eb5a697ba76ebb189e,synthetic-form-layout-08,original,2023,fte-72862fc3069d8f31589f68a1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: donated property description: Example Entity 8-1-0; acquisition date: 2024-03-02; donor basis: Example Entity 8-1-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-c9a056640d84e773aa350805,synthetic-form-layout-08,original,2024,fte-9645ef9fa0f69b439ce95a36,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: donated property description: Example Entity 8-2-0; acquisition date: 2025-03-03; donor basis: Example Entity 8-2-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-aca55aa5665fbde33e1848d3,synthetic-form-layout-08,original,2025,fte-8b141ad53cf2dcd0297472a5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: donated property description: Example Entity 8-3-0; acquisition date: 2023-03-04; donor basis: Example Entity 8-3-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-978b6197b96577bf479a0637,synthetic-form-layout-08,original,2023,fte-23474554c006467edd462c69,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: donated property description: Example Entity 8-4-0; acquisition date: 2024-03-05; donor basis: Example Entity 8-4-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-41387fe40d90b1a227c5677a,synthetic-form-layout-08,original,2024,fte-d50f458ee3d85f4fe74fef5b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: donated property description: Example Entity 8-5-0; acquisition date: 2025-03-06; donor basis: Example Entity 8-5-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-0118f390aee197ee4179973a,synthetic-form-layout-08,original,2025,fte-972481fbc8ba4c5b302fffd7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: donated property description: Example Entity 8-6-0; acquisition date: 2023-03-07; donor basis: Example Entity 8-6-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-e68344566ddb5961080c11de,synthetic-form-layout-08,original,2023,fte-411bffd6bd65df9c1be50bda,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8283: Noncash Charitable Contributions
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: donated property description: Example Entity 8-7-0; acquisition date: 2024-03-08; donor basis: Example Entity 8-7-2; appraiser declaration: Example named signer; signed",8283,17,8283,fdc-3a9c70701b06f8829141d652,synthetic-form-layout-08,original,2024,fte-360dabaf422e960fccc79562,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 900 is the named party.
Information printed on this record:
donated property description: Example Entity 9-0-0
acquisition date: 2023-03-01
donor basis: Example Entity 9-0-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-53fd185a531a7e4ef032847c,synthetic-form-layout-09,original,2023,fte-ba705af5c3a41ae9c3cfc7fd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 901 is the named party.
Information printed on this record:
donated property description: Example Entity 9-1-0
acquisition date: 2024-03-02
donor basis: Example Entity 9-1-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-8c9f61482211cc2f4f741148,synthetic-form-layout-09,original,2024,fte-ef35537cdcf0a569b77cde9c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 902 is the named party.
Information printed on this record:
donated property description: Example Entity 9-2-0
acquisition date: 2025-03-03
donor basis: Example Entity 9-2-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-b9607511037935dd09211f09,synthetic-form-layout-09,original,2025,fte-e204389b6e25241fbae4822e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 903 is the named party.
Information printed on this record:
donated property description: Example Entity 9-3-0
acquisition date: 2023-03-04
donor basis: Example Entity 9-3-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-2a0567ed7a675fea39929e89,synthetic-form-layout-09,original,2023,fte-557e6bc97025de36f20be076,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 904 is the named party.
Information printed on this record:
donated property description: Example Entity 9-4-0
acquisition date: 2024-03-05
donor basis: Example Entity 9-4-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-c4931d0331cab7103b9a6544,synthetic-form-layout-09,original,2024,fte-5452621bf175df62c1ba31ff,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 905 is the named party.
Information printed on this record:
donated property description: Example Entity 9-5-0
acquisition date: 2025-03-06
donor basis: Example Entity 9-5-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-6f9aba1bf5bad54d05122724,synthetic-form-layout-09,original,2025,fte-35608d784a28412b39128345,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 906 is the named party.
Information printed on this record:
donated property description: Example Entity 9-6-0
acquisition date: 2023-03-07
donor basis: Example Entity 9-6-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-c785d84d1c837ea581ed8646,synthetic-form-layout-09,original,2023,fte-5f1ae04b9eb6440d2fbe0f0a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8283: Noncash Charitable Contributions
Example Client 907 is the named party.
Information printed on this record:
donated property description: Example Entity 9-7-0
acquisition date: 2024-03-08
donor basis: Example Entity 9-7-2
appraiser declaration: Example named signer; signed",8283,17,8283,fdc-75530a02e3bcc9ff791185bb,synthetic-form-layout-09,original,2024,fte-d86715bde64ed87b97b2c715,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: donor: Example Entity 8-0-0; donee: Example Entity 8-0-1; description of gift: Example Entity 8-0-2; date of gift: 2023-03-01; value: USD 11,096.00",709,16,709,fdc-1700fc3559818a55f9d16422,synthetic-form-layout-08,original,2023,fte-da0879d4c0e928a600e81611,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: donor: Example Entity 8-1-0; donee: Example Entity 8-1-1; description of gift: Example Entity 8-1-2; date of gift: 2024-03-02; value: USD 11,179.00",709,16,709,fdc-b7247930ed8b74149bc07306,synthetic-form-layout-08,original,2024,fte-68b1a3dc540605b7831c8a92,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: donor: Example Entity 8-2-0; donee: Example Entity 8-2-1; description of gift: Example Entity 8-2-2; date of gift: 2025-03-03; value: USD 11,262.00",709,16,709,fdc-cb18eb65a35d62731f916ef3,synthetic-form-layout-08,original,2025,fte-fe48952f520f402f730a6777,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: donor: Example Entity 8-3-0; donee: Example Entity 8-3-1; description of gift: Example Entity 8-3-2; date of gift: 2023-03-04; value: USD 11,345.00",709,16,709,fdc-0f0e29cdfe33f0fbe9529a80,synthetic-form-layout-08,original,2023,fte-c4c1898cacdb157d0061ee3a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: donor: Example Entity 8-4-0; donee: Example Entity 8-4-1; description of gift: Example Entity 8-4-2; date of gift: 2024-03-05; value: USD 11,428.00",709,16,709,fdc-767f6dccd9003ac5a5f973f2,synthetic-form-layout-08,original,2024,fte-cc4dd5bbf50addc61b69e2a9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: donor: Example Entity 8-5-0; donee: Example Entity 8-5-1; description of gift: Example Entity 8-5-2; date of gift: 2025-03-06; value: USD 11,511.00",709,16,709,fdc-185b19947810125bda7508c7,synthetic-form-layout-08,original,2025,fte-2d33f464454bd5be3d01d82b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: donor: Example Entity 8-6-0; donee: Example Entity 8-6-1; description of gift: Example Entity 8-6-2; date of gift: 2023-03-07; value: USD 11,594.00",709,16,709,fdc-e7026ff655b554b485ab3ccf,synthetic-form-layout-08,original,2023,fte-1ed85a8fb3f183ce83c56ea2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709: United States Gift and Generation-Skipping Transfer Tax Return
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: donor: Example Entity 8-7-0; donee: Example Entity 8-7-1; description of gift: Example Entity 8-7-2; date of gift: 2024-03-08; value: USD 11,677.00",709,16,709,fdc-16f5eca124927a453086f61d,synthetic-form-layout-08,original,2024,fte-81fc7e6e1503dbc4908c07ad,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 900 is the named party.
Information printed on this record:
donor: Example Entity 9-0-0
donee: Example Entity 9-0-1
description of gift: Example Entity 9-0-2
date of gift: 2023-03-01
value: USD 11,233.00",709,16,709,fdc-04460c1838a4537a0666754c,synthetic-form-layout-09,original,2023,fte-4d8c70048103a82455ac77b8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 901 is the named party.
Information printed on this record:
donor: Example Entity 9-1-0
donee: Example Entity 9-1-1
description of gift: Example Entity 9-1-2
date of gift: 2024-03-02
value: USD 11,316.00",709,16,709,fdc-eb46bce43feb4d2fe627187d,synthetic-form-layout-09,original,2024,fte-75bacb68f19acb303ae66f36,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 902 is the named party.
Information printed on this record:
donor: Example Entity 9-2-0
donee: Example Entity 9-2-1
description of gift: Example Entity 9-2-2
date of gift: 2025-03-03
value: USD 11,399.00",709,16,709,fdc-32cd934ae26dfcb31671c96e,synthetic-form-layout-09,original,2025,fte-1e72ef5a8ff800bb76ff0330,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 903 is the named party.
Information printed on this record:
donor: Example Entity 9-3-0
donee: Example Entity 9-3-1
description of gift: Example Entity 9-3-2
date of gift: 2023-03-04
value: USD 11,482.00",709,16,709,fdc-95adbf27b98f40d28407caa5,synthetic-form-layout-09,original,2023,fte-492989dc835bd0da286ceba7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 904 is the named party.
Information printed on this record:
donor: Example Entity 9-4-0
donee: Example Entity 9-4-1
description of gift: Example Entity 9-4-2
date of gift: 2024-03-05
value: USD 11,565.00",709,16,709,fdc-5167e960dffac01c354c0098,synthetic-form-layout-09,original,2024,fte-906891bc0bd37dc077e959fd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 905 is the named party.
Information printed on this record:
donor: Example Entity 9-5-0
donee: Example Entity 9-5-1
description of gift: Example Entity 9-5-2
date of gift: 2025-03-06
value: USD 11,648.00",709,16,709,fdc-1eb04d50dee53dfa326b91e1,synthetic-form-layout-09,original,2025,fte-a71a5d3a8f1d415eedf4ccd7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 906 is the named party.
Information printed on this record:
donor: Example Entity 9-6-0
donee: Example Entity 9-6-1
description of gift: Example Entity 9-6-2
date of gift: 2023-03-07
value: USD 11,731.00",709,16,709,fdc-8869c3749ce5f6ea6e20bc6b,synthetic-form-layout-09,original,2023,fte-b405f6c26f2c249783727640,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 709: United States Gift and Generation-Skipping Transfer Tax Return
Example Client 907 is the named party.
Information printed on this record:
donor: Example Entity 9-7-0
donee: Example Entity 9-7-1
description of gift: Example Entity 9-7-2
date of gift: 2024-03-08
value: USD 11,814.00",709,16,709,fdc-99a91dd2a192babcaf73e8e8,synthetic-form-layout-09,original,2024,fte-1be2f6968b6482762830eed0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: nonresident donor: Example Entity 8-0-0; property: Example Entity 8-0-1; donee: Example Entity 8-0-2; date of gift: 2023-03-01",709,16,709,fdc-ebdca54d422e861c21ccf704,synthetic-form-layout-08,original,2023,fte-3fb4cbdf6af81f4c8e5304bb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: nonresident donor: Example Entity 8-1-0; property: Example Entity 8-1-1; donee: Example Entity 8-1-2; date of gift: 2024-03-02",709,16,709,fdc-d86808e2ed2262654184d02f,synthetic-form-layout-08,original,2024,fte-da0f77aad9da9eea6edb5981,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: nonresident donor: Example Entity 8-2-0; property: Example Entity 8-2-1; donee: Example Entity 8-2-2; date of gift: 2025-03-03",709,16,709,fdc-478d943a212f955ae7431383,synthetic-form-layout-08,original,2025,fte-31025be892732197ea2994be,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: nonresident donor: Example Entity 8-3-0; property: Example Entity 8-3-1; donee: Example Entity 8-3-2; date of gift: 2023-03-04",709,16,709,fdc-7e66e4ae1b8cd3dcac8da99a,synthetic-form-layout-08,original,2023,fte-0572aa73767ce061a8e5796f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: nonresident donor: Example Entity 8-4-0; property: Example Entity 8-4-1; donee: Example Entity 8-4-2; date of gift: 2024-03-05",709,16,709,fdc-029defba8f27d8c93b00ed0c,synthetic-form-layout-08,original,2024,fte-fec7620cbee24375a604843d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: nonresident donor: Example Entity 8-5-0; property: Example Entity 8-5-1; donee: Example Entity 8-5-2; date of gift: 2025-03-06",709,16,709,fdc-e525f80057afdf27be314469,synthetic-form-layout-08,original,2025,fte-9b3e297d199170d17d7d0241,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: nonresident donor: Example Entity 8-6-0; property: Example Entity 8-6-1; donee: Example Entity 8-6-2; date of gift: 2023-03-07",709,16,709,fdc-3dddd8410c6a8433d0086dda,synthetic-form-layout-08,original,2023,fte-ce998590bac7101bcde717c8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: nonresident donor: Example Entity 8-7-0; property: Example Entity 8-7-1; donee: Example Entity 8-7-2; date of gift: 2024-03-08",709,16,709,fdc-f31a5521b58e58a2345575a9,synthetic-form-layout-08,original,2024,fte-9c76312ed6e11e90111318b3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 900 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-0-0
property: Example Entity 9-0-1
donee: Example Entity 9-0-2
date of gift: 2023-03-01",709,16,709,fdc-e25d961cb186a4af59d8d5cd,synthetic-form-layout-09,original,2023,fte-1356f0cf5b51ad2e9d853931,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 901 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-1-0
property: Example Entity 9-1-1
donee: Example Entity 9-1-2
date of gift: 2024-03-02",709,16,709,fdc-7adafa978032bb2c19d7d976,synthetic-form-layout-09,original,2024,fte-977f96d3e02886d5e9b38728,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 902 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-2-0
property: Example Entity 9-2-1
donee: Example Entity 9-2-2
date of gift: 2025-03-03",709,16,709,fdc-66a7d8761f9d38186788914f,synthetic-form-layout-09,original,2025,fte-471f9918d7910fb15e02d353,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 903 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-3-0
property: Example Entity 9-3-1
donee: Example Entity 9-3-2
date of gift: 2023-03-04",709,16,709,fdc-c6f5dae91f13eedc9349311d,synthetic-form-layout-09,original,2023,fte-4b9e2737504e299048e7624f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 904 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-4-0
property: Example Entity 9-4-1
donee: Example Entity 9-4-2
date of gift: 2024-03-05",709,16,709,fdc-a0555dc8583dee8ba4357f0a,synthetic-form-layout-09,original,2024,fte-aa31728f2c298f64191aef88,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 905 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-5-0
property: Example Entity 9-5-1
donee: Example Entity 9-5-2
date of gift: 2025-03-06",709,16,709,fdc-549d538ea60cdfc8248809a0,synthetic-form-layout-09,original,2025,fte-f4b0883ffc1e20bb3aa986d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 906 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-6-0
property: Example Entity 9-6-1
donee: Example Entity 9-6-2
date of gift: 2023-03-07",709,16,709,fdc-1535b1dcdd601927d2442c34,synthetic-form-layout-09,original,2023,fte-9a43ce8aaea597b3db86f66e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 709-NA: United States Gift and Generation-Skipping Transfer Tax Return of Nonresident Not a Citizen
Example Client 907 is the named party.
Information printed on this record:
nonresident donor: Example Entity 9-7-0
property: Example Entity 9-7-1
donee: Example Entity 9-7-2
date of gift: 2024-03-08",709,16,709,fdc-b76643646401ce395e5c4f61,synthetic-form-layout-09,original,2024,fte-416d65aa5a95289a1a6651a9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: foreign donor: Example Entity 8-0-0; recipient: Example Entity 8-0-1; foreign gifts: USD 11,096.00; trust transactions: USD 11,096.00",3520,11,3520,fdc-80b65974243d20d5b8bef4f8,synthetic-form-layout-08,original,2023,fte-95f132b7abcebefd3307fd3e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: foreign donor: Example Entity 8-1-0; recipient: Example Entity 8-1-1; foreign gifts: USD 11,179.00; trust transactions: USD 11,179.00",3520,11,3520,fdc-84fee5d57d9b02632742f631,synthetic-form-layout-08,original,2024,fte-aba044a909a25e112011f053,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: foreign donor: Example Entity 8-2-0; recipient: Example Entity 8-2-1; foreign gifts: USD 11,262.00; trust transactions: USD 11,262.00",3520,11,3520,fdc-48c317eb2f1e1225f3b7c63b,synthetic-form-layout-08,original,2025,fte-685ae68cf9c059c91d48a57c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: foreign donor: Example Entity 8-3-0; recipient: Example Entity 8-3-1; foreign gifts: USD 11,345.00; trust transactions: USD 11,345.00",3520,11,3520,fdc-b2d87d80d77acf163902b491,synthetic-form-layout-08,original,2023,fte-b8075350cd8054b0d976f5c0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: foreign donor: Example Entity 8-4-0; recipient: Example Entity 8-4-1; foreign gifts: USD 11,428.00; trust transactions: USD 11,428.00",3520,11,3520,fdc-7bb8ed3801b363ca14663cf0,synthetic-form-layout-08,original,2024,fte-c986806d71298f4be09d1301,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: foreign donor: Example Entity 8-5-0; recipient: Example Entity 8-5-1; foreign gifts: USD 11,511.00; trust transactions: USD 11,511.00",3520,11,3520,fdc-9d7544da53793b2ac8734700,synthetic-form-layout-08,original,2025,fte-0ecd85a90d54a73e9d0fcf45,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: foreign donor: Example Entity 8-6-0; recipient: Example Entity 8-6-1; foreign gifts: USD 11,594.00; trust transactions: USD 11,594.00",3520,11,3520,fdc-d505e991c261f575722406cc,synthetic-form-layout-08,original,2023,fte-febe4575bc3d6c48c9abed91,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: foreign donor: Example Entity 8-7-0; recipient: Example Entity 8-7-1; foreign gifts: USD 11,677.00; trust transactions: USD 11,677.00",3520,11,3520,fdc-adac2fd50c316f4e83da93da,synthetic-form-layout-08,original,2024,fte-e09a632bb866bb34b97ae801,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 900 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-0-0
recipient: Example Entity 9-0-1
foreign gifts: USD 11,233.00
trust transactions: USD 11,233.00",3520,11,3520,fdc-e25412972d7beffb61d8ffeb,synthetic-form-layout-09,original,2023,fte-04465feaa0aaed386388b49f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 901 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-1-0
recipient: Example Entity 9-1-1
foreign gifts: USD 11,316.00
trust transactions: USD 11,316.00",3520,11,3520,fdc-923443c2672e184ddd2713a7,synthetic-form-layout-09,original,2024,fte-4a05e0be3bf9529b49cd6145,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 902 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-2-0
recipient: Example Entity 9-2-1
foreign gifts: USD 11,399.00
trust transactions: USD 11,399.00",3520,11,3520,fdc-2700eb29578714980a2bbdf6,synthetic-form-layout-09,original,2025,fte-eb50fd95ca39cb92b7a7ce23,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 903 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-3-0
recipient: Example Entity 9-3-1
foreign gifts: USD 11,482.00
trust transactions: USD 11,482.00",3520,11,3520,fdc-c5a6ee8806d330f186f95d05,synthetic-form-layout-09,original,2023,fte-2774bd7fc53c373f5d6f9ca8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 904 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-4-0
recipient: Example Entity 9-4-1
foreign gifts: USD 11,565.00
trust transactions: USD 11,565.00",3520,11,3520,fdc-31532cd5f4683bbc3b3468da,synthetic-form-layout-09,original,2024,fte-5d2e12110b174b4f83e7694e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 905 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-5-0
recipient: Example Entity 9-5-1
foreign gifts: USD 11,648.00
trust transactions: USD 11,648.00",3520,11,3520,fdc-a8f242a3a314cb2f82b858ed,synthetic-form-layout-09,original,2025,fte-13e2fce07b1cb94806bebb4e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 906 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-6-0
recipient: Example Entity 9-6-1
foreign gifts: USD 11,731.00
trust transactions: USD 11,731.00",3520,11,3520,fdc-a1bf0c91543243fec49c8448,synthetic-form-layout-09,original,2023,fte-b32bb658d97cb2c383cd1c0b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 3520: Annual Return To Report Transactions With Foreign Trusts and Receipt of Certain Foreign Gifts
Example Client 907 is the named party.
Information printed on this record:
foreign donor: Example Entity 9-7-0
recipient: Example Entity 9-7-1
foreign gifts: USD 11,814.00
trust transactions: USD 11,814.00",3520,11,3520,fdc-fe58c0e51e079ad6e300e159,synthetic-form-layout-09,original,2024,fte-2a220659cdf1929bb4a82a1b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: filing status: Single; total income: USD 11,096.00; adjusted gross income: USD 9,986.40; payments: USD 11,096.00",1040,0,1040,fdc-e62e4bbb51403d960365aaaa,synthetic-form-layout-08,original,2023,fte-f3b63ec2928a562c9467542e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: filing status: Single; total income: USD 11,179.00; adjusted gross income: USD 10,061.10; payments: USD 11,179.00",1040,0,1040,fdc-b955232448bee361901bd426,synthetic-form-layout-08,original,2024,fte-b885cf0a82b864dcd630258e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: filing status: Single; total income: USD 11,262.00; adjusted gross income: USD 10,135.80; payments: USD 11,262.00",1040,0,1040,fdc-e9c956ead32d75eeb293c797,synthetic-form-layout-08,original,2025,fte-17dfb6977c8c5048d058cd21,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: filing status: Single; total income: USD 11,345.00; adjusted gross income: USD 10,210.50; payments: USD 11,345.00",1040,0,1040,fdc-5c408208e819d08f5acbfe33,synthetic-form-layout-08,original,2023,fte-405ab8b63fdb932ab18c9db1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: filing status: Single; total income: USD 11,428.00; adjusted gross income: USD 10,285.20; payments: USD 11,428.00",1040,0,1040,fdc-0abb8a0fbcd65b93811d09eb,synthetic-form-layout-08,original,2024,fte-45394a4488d1b38d2a42f78e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: filing status: Single; total income: USD 11,511.00; adjusted gross income: USD 10,359.90; payments: USD 11,511.00",1040,0,1040,fdc-19e423f4e2f9602d62f06854,synthetic-form-layout-08,original,2025,fte-36ad6f875d7cd1d26063f32b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: filing status: Single; total income: USD 11,594.00; adjusted gross income: USD 10,434.60; payments: USD 11,594.00",1040,0,1040,fdc-535886ce7f34826ebfbce3b0,synthetic-form-layout-08,original,2023,fte-ec9d2c2a61919424369505ad,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040: US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: filing status: Single; total income: USD 11,677.00; adjusted gross income: USD 10,509.30; payments: USD 11,677.00",1040,0,1040,fdc-525512b36484867327bc9c57,synthetic-form-layout-08,original,2024,fte-f9d8627a0196c91c1a5632d5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040: US Individual Income Tax Return
Example Client 900 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,233.00
adjusted gross income: USD 10,109.70
payments: USD 11,233.00",1040,0,1040,fdc-bd187cb2d465cf6794ac9dfc,synthetic-form-layout-09,original,2023,fte-2b72c6320b5df493ab05828f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040: US Individual Income Tax Return
Example Client 901 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,316.00
adjusted gross income: USD 10,184.40
payments: USD 11,316.00",1040,0,1040,fdc-c2e50be2b6e32b5180e6208b,synthetic-form-layout-09,original,2024,fte-e2d96b9a3054155af868e945,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040: US Individual Income Tax Return
Example Client 902 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,399.00
adjusted gross income: USD 10,259.10
payments: USD 11,399.00",1040,0,1040,fdc-ec703e8b68d65c9722375ca3,synthetic-form-layout-09,original,2025,fte-2d0eff02ab9d04a37ffe24b9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040: US Individual Income Tax Return
Example Client 903 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,482.00
adjusted gross income: USD 10,333.80
payments: USD 11,482.00",1040,0,1040,fdc-f82bf762dc7f4068fb23f263,synthetic-form-layout-09,original,2023,fte-1a974c098ee088f1bbeb5424,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040: US Individual Income Tax Return
Example Client 904 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,565.00
adjusted gross income: USD 10,408.50
payments: USD 11,565.00",1040,0,1040,fdc-98911e26501bbddbf3125481,synthetic-form-layout-09,original,2024,fte-81c838719aae3f90c649c91d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040: US Individual Income Tax Return
Example Client 905 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,648.00
adjusted gross income: USD 10,483.20
payments: USD 11,648.00",1040,0,1040,fdc-3f418fca70e5a81390cd12c0,synthetic-form-layout-09,original,2025,fte-e95953664215f857e683945b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040: US Individual Income Tax Return
Example Client 906 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,731.00
adjusted gross income: USD 10,557.90
payments: USD 11,731.00",1040,0,1040,fdc-b4e218572e15276b7c7858d4,synthetic-form-layout-09,original,2023,fte-f5fe5db9cd4d5630597dfccd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040: US Individual Income Tax Return
Example Client 907 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,814.00
adjusted gross income: USD 10,632.60
payments: USD 11,814.00",1040,0,1040,fdc-881dcc9775b9a59e474603c5,synthetic-form-layout-09,original,2024,fte-81d9b53f1dfdfcdd2ffec518,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: filing status: Single; total income: USD 11,096.00; adjusted gross income: USD 9,986.40; payments: USD 11,096.00",1040,0,1040,fdc-ae634b5d4ffbe091daa8ca36,synthetic-form-layout-08,original,2023,fte-fa09011ccd291b79d115d1b1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: filing status: Single; total income: USD 11,179.00; adjusted gross income: USD 10,061.10; payments: USD 11,179.00",1040,0,1040,fdc-f57fb9aee35d46e061a6a42c,synthetic-form-layout-08,original,2024,fte-d5eed0d36ad2681792a4afdf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: filing status: Single; total income: USD 11,262.00; adjusted gross income: USD 10,135.80; payments: USD 11,262.00",1040,0,1040,fdc-c79ee94581515eb2ffb483f9,synthetic-form-layout-08,original,2025,fte-1d344f780da1973facac469b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: filing status: Single; total income: USD 11,345.00; adjusted gross income: USD 10,210.50; payments: USD 11,345.00",1040,0,1040,fdc-98281031a67d5117fa502383,synthetic-form-layout-08,original,2023,fte-4cd716efc0d8458328ab9e7c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: filing status: Single; total income: USD 11,428.00; adjusted gross income: USD 10,285.20; payments: USD 11,428.00",1040,0,1040,fdc-f3b141b4773ddfc112d1ff85,synthetic-form-layout-08,original,2024,fte-f8f019bebea5fd3b8533f2a0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: filing status: Single; total income: USD 11,511.00; adjusted gross income: USD 10,359.90; payments: USD 11,511.00",1040,0,1040,fdc-da25408e72e1fee4eae92960,synthetic-form-layout-08,original,2025,fte-eaa273757613bb3e0251f891,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: filing status: Single; total income: USD 11,594.00; adjusted gross income: USD 10,434.60; payments: USD 11,594.00",1040,0,1040,fdc-b928a88b45a0f24ace0a8add,synthetic-form-layout-08,original,2023,fte-e0a748eb951f2a6d1d731729,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-SR: US Tax Return for Seniors
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: filing status: Single; total income: USD 11,677.00; adjusted gross income: USD 10,509.30; payments: USD 11,677.00",1040,0,1040,fdc-4efc6b66827d2919b35df4dc,synthetic-form-layout-08,original,2024,fte-cb672b2f21ba13dd630eeff1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 900 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,233.00
adjusted gross income: USD 10,109.70
payments: USD 11,233.00",1040,0,1040,fdc-eaeb23f204117ea9278bbe40,synthetic-form-layout-09,original,2023,fte-a800d8d36ee5317b7ce54f74,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 901 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,316.00
adjusted gross income: USD 10,184.40
payments: USD 11,316.00",1040,0,1040,fdc-7bc99da8c76633bcc7c4cf06,synthetic-form-layout-09,original,2024,fte-b06df82fa51bca5e44912886,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 902 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,399.00
adjusted gross income: USD 10,259.10
payments: USD 11,399.00",1040,0,1040,fdc-69dea78b4ed2c5a094625248,synthetic-form-layout-09,original,2025,fte-30360d45c38f253dd6a59396,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 903 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,482.00
adjusted gross income: USD 10,333.80
payments: USD 11,482.00",1040,0,1040,fdc-4919ed49d50afb700c4a6d7b,synthetic-form-layout-09,original,2023,fte-19576816d59ffcb4b4468081,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 904 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,565.00
adjusted gross income: USD 10,408.50
payments: USD 11,565.00",1040,0,1040,fdc-01ded1bc39dc65140eb5c91b,synthetic-form-layout-09,original,2024,fte-db02f3736917d2fd1d5ced27,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 905 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,648.00
adjusted gross income: USD 10,483.20
payments: USD 11,648.00",1040,0,1040,fdc-3703e92c98d6af8142d2fbad,synthetic-form-layout-09,original,2025,fte-2181d32408d8d6cee5c6863e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 906 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,731.00
adjusted gross income: USD 10,557.90
payments: USD 11,731.00",1040,0,1040,fdc-db96d5e4290781e66d1bc97f,synthetic-form-layout-09,original,2023,fte-09ba92b2e5a8c654e8e52596,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-SR: US Tax Return for Seniors
Example Client 907 is the named party.
Information printed on this record:
filing status: Single
total income: USD 11,814.00
adjusted gross income: USD 10,632.60
payments: USD 11,814.00",1040,0,1040,fdc-48e408edad0b0a394d4bc2d3,synthetic-form-layout-09,original,2024,fte-3865b416261d508adc4379c6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: filing status: Single; effectively connected income: USD 11,096.00; payments: USD 11,096.00",1040,0,1040,fdc-45a902232ad062c257c06d69,synthetic-form-layout-08,original,2023,fte-64c3b152e152fcd9247b1bc3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: filing status: Single; effectively connected income: USD 11,179.00; payments: USD 11,179.00",1040,0,1040,fdc-eb6dac11feaf7d5164cc1917,synthetic-form-layout-08,original,2024,fte-7c421f081b4e059fb3262338,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: filing status: Single; effectively connected income: USD 11,262.00; payments: USD 11,262.00",1040,0,1040,fdc-0aea9c1089f045a10b85e342,synthetic-form-layout-08,original,2025,fte-f8d4af11f7769776c52ce0a9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: filing status: Single; effectively connected income: USD 11,345.00; payments: USD 11,345.00",1040,0,1040,fdc-b7760f05c715e4ad43f9548a,synthetic-form-layout-08,original,2023,fte-c85dc369b582d45044ff88bc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: filing status: Single; effectively connected income: USD 11,428.00; payments: USD 11,428.00",1040,0,1040,fdc-34cdbc2979931e5e9234e0a7,synthetic-form-layout-08,original,2024,fte-3441f7eedc965d86ed305f6d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: filing status: Single; effectively connected income: USD 11,511.00; payments: USD 11,511.00",1040,0,1040,fdc-b8423366f6b84cc6a4a55b2c,synthetic-form-layout-08,original,2025,fte-89f485cb7dbf68cba910afcc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: filing status: Single; effectively connected income: USD 11,594.00; payments: USD 11,594.00",1040,0,1040,fdc-cf50de2b71d5ce1f8e7a6341,synthetic-form-layout-08,original,2023,fte-a529473013bb097b2b86e40e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-NR: US Nonresident Alien Income Tax Return
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: filing status: Single; effectively connected income: USD 11,677.00; payments: USD 11,677.00",1040,0,1040,fdc-08989d0541b5dd67025b3667,synthetic-form-layout-08,original,2024,fte-cd0cdccd51e8d2a7d1c63f50,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 900 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,233.00
payments: USD 11,233.00",1040,0,1040,fdc-2a3c4a8a7cc4d78aee2646f9,synthetic-form-layout-09,original,2023,fte-15afeaa038883a4feefa9f93,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 901 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,316.00
payments: USD 11,316.00",1040,0,1040,fdc-6440dfe557c8bf88f010eb82,synthetic-form-layout-09,original,2024,fte-64e7f1b4a5df10eb522fd359,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 902 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,399.00
payments: USD 11,399.00",1040,0,1040,fdc-0f990bb0295f512bc782a0c7,synthetic-form-layout-09,original,2025,fte-483440204c71ba7a13a4463c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 903 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,482.00
payments: USD 11,482.00",1040,0,1040,fdc-5b573958323a75977af9b4e1,synthetic-form-layout-09,original,2023,fte-488680c02f8ccd3294618350,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 904 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,565.00
payments: USD 11,565.00",1040,0,1040,fdc-38188a478e83cd15c8b25aee,synthetic-form-layout-09,original,2024,fte-1da88a828ea67ab4d1459680,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 905 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,648.00
payments: USD 11,648.00",1040,0,1040,fdc-31f21c93dce6f6a6234774d5,synthetic-form-layout-09,original,2025,fte-ddc8204f20f78fe37238d97e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 906 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,731.00
payments: USD 11,731.00",1040,0,1040,fdc-ba3c3517050e9dc44cacd661,synthetic-form-layout-09,original,2023,fte-1da3c7a54ab6761efd9be945,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-NR: US Nonresident Alien Income Tax Return
Example Client 907 is the named party.
Information printed on this record:
filing status: Single
effectively connected income: USD 11,814.00
payments: USD 11,814.00",1040,0,1040,fdc-5dec86af282096d5ceee51b8,synthetic-form-layout-09,original,2024,fte-761afd1f440e06e79cac1126,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: original amount: USD 11,096.00; net change: USD 11,096.00; correct amount: USD 11,096.00; explanation of changes: USD 11,096.00",1040,0,1040,fdc-a6d1a30189c472f6c65fce5a,synthetic-form-layout-08,original,2023,fte-e95be119891abfd1604be992,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: original amount: USD 11,179.00; net change: USD 11,179.00; correct amount: USD 11,179.00; explanation of changes: USD 11,179.00",1040,0,1040,fdc-4f26f16211b28b30d44d6f2d,synthetic-form-layout-08,original,2024,fte-5c50101108d545a0748dee06,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: original amount: USD 11,262.00; net change: USD 11,262.00; correct amount: USD 11,262.00; explanation of changes: USD 11,262.00",1040,0,1040,fdc-f1857acc7cadeb8fea1ca278,synthetic-form-layout-08,original,2025,fte-db85a9439d999f9448adce7a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: original amount: USD 11,345.00; net change: USD 11,345.00; correct amount: USD 11,345.00; explanation of changes: USD 11,345.00",1040,0,1040,fdc-c2ac1cd4edd1809bf5e5a034,synthetic-form-layout-08,original,2023,fte-df6c82e93fa9fe1026354f9b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: original amount: USD 11,428.00; net change: USD 11,428.00; correct amount: USD 11,428.00; explanation of changes: USD 11,428.00",1040,0,1040,fdc-585d7da323fb1c30f1202247,synthetic-form-layout-08,original,2024,fte-8c3e22a3ecf45e3c1b806bda,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: original amount: USD 11,511.00; net change: USD 11,511.00; correct amount: USD 11,511.00; explanation of changes: USD 11,511.00",1040,0,1040,fdc-8ffe15bd0b70f40cac9137d2,synthetic-form-layout-08,original,2025,fte-d661711060f0885a58ab00f7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: original amount: USD 11,594.00; net change: USD 11,594.00; correct amount: USD 11,594.00; explanation of changes: USD 11,594.00",1040,0,1040,fdc-8698d98bdd7c8eed2a18fa05,synthetic-form-layout-08,original,2023,fte-2937682b6fa452c3ad873b9c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-X: Amended US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: original amount: USD 11,677.00; net change: USD 11,677.00; correct amount: USD 11,677.00; explanation of changes: USD 11,677.00",1040,0,1040,fdc-da0207f897668801f0ef933e,synthetic-form-layout-08,original,2024,fte-ba16c81b110562a6dd23b7dc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 900 is the named party.
Information printed on this record:
original amount: USD 11,233.00
net change: USD 11,233.00
correct amount: USD 11,233.00
explanation of changes: USD 11,233.00",1040,0,1040,fdc-b28397f38d41c324f14e7485,synthetic-form-layout-09,original,2023,fte-d301a64f5d0bfee98374c378,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 901 is the named party.
Information printed on this record:
original amount: USD 11,316.00
net change: USD 11,316.00
correct amount: USD 11,316.00
explanation of changes: USD 11,316.00",1040,0,1040,fdc-0214fb2f5859ce64abb039af,synthetic-form-layout-09,original,2024,fte-7817b3944f0ce0141f9e7edd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 902 is the named party.
Information printed on this record:
original amount: USD 11,399.00
net change: USD 11,399.00
correct amount: USD 11,399.00
explanation of changes: USD 11,399.00",1040,0,1040,fdc-5f56e33e7145a326231c6a78,synthetic-form-layout-09,original,2025,fte-8704d8ba1214cc00ced6a31f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 903 is the named party.
Information printed on this record:
original amount: USD 11,482.00
net change: USD 11,482.00
correct amount: USD 11,482.00
explanation of changes: USD 11,482.00",1040,0,1040,fdc-9d140acb9a668424c1ee5892,synthetic-form-layout-09,original,2023,fte-5df0605948fb094cf8587962,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 904 is the named party.
Information printed on this record:
original amount: USD 11,565.00
net change: USD 11,565.00
correct amount: USD 11,565.00
explanation of changes: USD 11,565.00",1040,0,1040,fdc-37d706706a987d68e392aafe,synthetic-form-layout-09,original,2024,fte-3a83ee72938473f6dcc1c528,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 905 is the named party.
Information printed on this record:
original amount: USD 11,648.00
net change: USD 11,648.00
correct amount: USD 11,648.00
explanation of changes: USD 11,648.00",1040,0,1040,fdc-a270b9f034f969de1274f439,synthetic-form-layout-09,original,2025,fte-688d3e6130f97989f0651090,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 906 is the named party.
Information printed on this record:
original amount: USD 11,731.00
net change: USD 11,731.00
correct amount: USD 11,731.00
explanation of changes: USD 11,731.00",1040,0,1040,fdc-ba9cf22127421bf1467ff953,synthetic-form-layout-09,original,2023,fte-9416a8678c0cfdee528566fa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-X: Amended US Individual Income Tax Return
Example Client 907 is the named party.
Information printed on this record:
original amount: USD 11,814.00
net change: USD 11,814.00
correct amount: USD 11,814.00
explanation of changes: USD 11,814.00",1040,0,1040,fdc-ca99ee574cf9165834440799,synthetic-form-layout-09,original,2024,fte-3765e092bf73c248d0504147,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: estimated tax worksheet: USD 11,096.00; payment voucher: USD 11,096.00; taxpayer: Example Entity 8-0-2",1040,0,1040,fdc-0e368158481745abfe58e273,synthetic-form-layout-08,original,2023,fte-9557958480503656abfbb369,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: estimated tax worksheet: USD 11,179.00; payment voucher: USD 11,179.00; taxpayer: Example Entity 8-1-2",1040,0,1040,fdc-9a6c5baa282d00fec73de3ba,synthetic-form-layout-08,original,2024,fte-3f85428d6ff8a9b4bfffe197,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: estimated tax worksheet: USD 11,262.00; payment voucher: USD 11,262.00; taxpayer: Example Entity 8-2-2",1040,0,1040,fdc-611f4ce68728fd38529d522d,synthetic-form-layout-08,original,2025,fte-06023e7eec1590517a7e000d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: estimated tax worksheet: USD 11,345.00; payment voucher: USD 11,345.00; taxpayer: Example Entity 8-3-2",1040,0,1040,fdc-81e7ab318b8622dd90447a78,synthetic-form-layout-08,original,2023,fte-c3202d060c056b8c9c59998d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: estimated tax worksheet: USD 11,428.00; payment voucher: USD 11,428.00; taxpayer: Example Entity 8-4-2",1040,0,1040,fdc-bbdb3225f10b41470849c414,synthetic-form-layout-08,original,2024,fte-9ac9c8cfa5974aea9d01710f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: estimated tax worksheet: USD 11,511.00; payment voucher: USD 11,511.00; taxpayer: Example Entity 8-5-2",1040,0,1040,fdc-d5e105afe00c28820ead777b,synthetic-form-layout-08,original,2025,fte-cc71be7189ac3663b73ffb3b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: estimated tax worksheet: USD 11,594.00; payment voucher: USD 11,594.00; taxpayer: Example Entity 8-6-2",1040,0,1040,fdc-1b7b526832630c715b118de0,synthetic-form-layout-08,original,2023,fte-d997b21a5e0254574c526cb3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1040-ES: Estimated Tax for Individuals
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: estimated tax worksheet: USD 11,677.00; payment voucher: USD 11,677.00; taxpayer: Example Entity 8-7-2",1040,0,1040,fdc-968a79e320a10372086b7f97,synthetic-form-layout-08,original,2024,fte-26b650885f84347ef16399ec,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 900 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,233.00
payment voucher: USD 11,233.00
taxpayer: Example Entity 9-0-2",1040,0,1040,fdc-9c2917a319be43793ed8e452,synthetic-form-layout-09,original,2023,fte-c43f65c4a5386adefbe5f9dd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 901 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,316.00
payment voucher: USD 11,316.00
taxpayer: Example Entity 9-1-2",1040,0,1040,fdc-0f45361c44ef9ba1e096f724,synthetic-form-layout-09,original,2024,fte-9a33dfaaf360c06728cc7ab0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 902 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,399.00
payment voucher: USD 11,399.00
taxpayer: Example Entity 9-2-2",1040,0,1040,fdc-331e3a9be1fd40aa3bffe970,synthetic-form-layout-09,original,2025,fte-9c2587765b5fb1a74084ab98,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 903 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,482.00
payment voucher: USD 11,482.00
taxpayer: Example Entity 9-3-2",1040,0,1040,fdc-3241d210857da1b6681e8f88,synthetic-form-layout-09,original,2023,fte-4d357df55238cf24f163db43,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 904 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,565.00
payment voucher: USD 11,565.00
taxpayer: Example Entity 9-4-2",1040,0,1040,fdc-9ac38207d69849532da80c39,synthetic-form-layout-09,original,2024,fte-3850e0a66132dc79cedd11a3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 905 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,648.00
payment voucher: USD 11,648.00
taxpayer: Example Entity 9-5-2",1040,0,1040,fdc-019b81abb1a2f22950fdae0a,synthetic-form-layout-09,original,2025,fte-19206461961b975bb2945fc0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 906 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,731.00
payment voucher: USD 11,731.00
taxpayer: Example Entity 9-6-2",1040,0,1040,fdc-060ab8799693d25766da6b46,synthetic-form-layout-09,original,2023,fte-0e7af0ffa243c4f607777963,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1040-ES: Estimated Tax for Individuals
Example Client 907 is the named party.
Information printed on this record:
estimated tax worksheet: USD 11,814.00
payment voucher: USD 11,814.00
taxpayer: Example Entity 9-7-2",1040,0,1040,fdc-0ba3b6788bb50bdeaa894c43,synthetic-form-layout-09,original,2024,fte-f73becc528954b037df41092,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: estimate of total tax liability: USD 11,096.00; payments: USD 11,096.00; balance due: USD 11,096.00",4868,13,4868,fdc-4cd44ae874ca5ce3263dceae,synthetic-form-layout-08,original,2023,fte-b596d0171b28d6f9bf9d96c1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: estimate of total tax liability: USD 11,179.00; payments: USD 11,179.00; balance due: USD 11,179.00",4868,13,4868,fdc-55fbcc949c37e70f049d6dd8,synthetic-form-layout-08,original,2024,fte-1a04a0751cde4f0a43208125,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: estimate of total tax liability: USD 11,262.00; payments: USD 11,262.00; balance due: USD 11,262.00",4868,13,4868,fdc-4c76061a42c826fc98a814f7,synthetic-form-layout-08,original,2025,fte-2adcd065187935336da560b3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: estimate of total tax liability: USD 11,345.00; payments: USD 11,345.00; balance due: USD 11,345.00",4868,13,4868,fdc-8cdacc47ccf082dbe63466c9,synthetic-form-layout-08,original,2023,fte-616d0bdbb4a9afc18d20b01d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: estimate of total tax liability: USD 11,428.00; payments: USD 11,428.00; balance due: USD 11,428.00",4868,13,4868,fdc-e72f00360b1688f76b8e5e7b,synthetic-form-layout-08,original,2024,fte-807035ba4fe0f99b930e78b4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: estimate of total tax liability: USD 11,511.00; payments: USD 11,511.00; balance due: USD 11,511.00",4868,13,4868,fdc-9a8b698a6977c80117d8ef68,synthetic-form-layout-08,original,2025,fte-cd4564985d2dffabeaf87f94,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: estimate of total tax liability: USD 11,594.00; payments: USD 11,594.00; balance due: USD 11,594.00",4868,13,4868,fdc-84616011c1e23bce3d09fe74,synthetic-form-layout-08,original,2023,fte-f0b04d21a424944e54d3bf18,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: estimate of total tax liability: USD 11,677.00; payments: USD 11,677.00; balance due: USD 11,677.00",4868,13,4868,fdc-d4a6139c26f56d8c87cb6503,synthetic-form-layout-08,original,2024,fte-4a545fba08628648a7d072fe,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 900 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,233.00
payments: USD 11,233.00
balance due: USD 11,233.00",4868,13,4868,fdc-42d51cbc3c5d08a61ce150ea,synthetic-form-layout-09,original,2023,fte-e9b725fcf938f225248583ed,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 901 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,316.00
payments: USD 11,316.00
balance due: USD 11,316.00",4868,13,4868,fdc-efa6027373a0c752243c45bc,synthetic-form-layout-09,original,2024,fte-e8ac240b2069392f2f431ff0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 902 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,399.00
payments: USD 11,399.00
balance due: USD 11,399.00",4868,13,4868,fdc-b8b52428ae2bfac11842e537,synthetic-form-layout-09,original,2025,fte-fc3826653820d1567ed4382a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 903 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,482.00
payments: USD 11,482.00
balance due: USD 11,482.00",4868,13,4868,fdc-d5a844ccc6adb1690f04688a,synthetic-form-layout-09,original,2023,fte-12c34f915324d08be94b3343,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 904 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,565.00
payments: USD 11,565.00
balance due: USD 11,565.00",4868,13,4868,fdc-7c250dae96f6276b47a3d70a,synthetic-form-layout-09,original,2024,fte-4c5597572cbb2376184585f4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 905 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,648.00
payments: USD 11,648.00
balance due: USD 11,648.00",4868,13,4868,fdc-529f62e4d91c8c4464d0e550,synthetic-form-layout-09,original,2025,fte-8c24ef0b61a7fff3fd7614c0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 906 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,731.00
payments: USD 11,731.00
balance due: USD 11,731.00",4868,13,4868,fdc-565cc5e6d03a75aed37f7c16,synthetic-form-layout-09,original,2023,fte-55f11844e88ef1fa831e86c3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 4868: Application for Automatic Extension of Time To File US Individual Income Tax Return
Example Client 907 is the named party.
Information printed on this record:
estimate of total tax liability: USD 11,814.00
payments: USD 11,814.00
balance due: USD 11,814.00",4868,13,4868,fdc-0d8ab18bf0512d161726cdf8,synthetic-form-layout-09,original,2024,fte-bfba9e08592faa0645b78946,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: partnership: Example Entity 8-0-0; ordinary business income: USD 11,096.00; deductions: USD 11,096.00; partners: Example Entity 8-0-3",1065,2,1065,fdc-92e6686fe2d58732e311b53a,synthetic-form-layout-08,original,2023,fte-72eebf5777a87b8b251a38c3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: partnership: Example Entity 8-1-0; ordinary business income: USD 11,179.00; deductions: USD 11,179.00; partners: Example Entity 8-1-3",1065,2,1065,fdc-ee33b612476ea8544d296119,synthetic-form-layout-08,original,2024,fte-b979932d52d54154f6a945b4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: partnership: Example Entity 8-2-0; ordinary business income: USD 11,262.00; deductions: USD 11,262.00; partners: Example Entity 8-2-3",1065,2,1065,fdc-10ff8af42196e615e4b34863,synthetic-form-layout-08,original,2025,fte-cffba131ad72d9873f62eb64,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: partnership: Example Entity 8-3-0; ordinary business income: USD 11,345.00; deductions: USD 11,345.00; partners: Example Entity 8-3-3",1065,2,1065,fdc-0b7bb8326548a5a0fb80a0e3,synthetic-form-layout-08,original,2023,fte-a0b12c67497248bfe1c7e812,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: partnership: Example Entity 8-4-0; ordinary business income: USD 11,428.00; deductions: USD 11,428.00; partners: Example Entity 8-4-3",1065,2,1065,fdc-c4ebaaae7d44977f2c2c0cab,synthetic-form-layout-08,original,2024,fte-489ec405fcba0acdeb86ee62,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: partnership: Example Entity 8-5-0; ordinary business income: USD 11,511.00; deductions: USD 11,511.00; partners: Example Entity 8-5-3",1065,2,1065,fdc-5f5b49868b54d650f2fcf38b,synthetic-form-layout-08,original,2025,fte-64276e13e98a696227622633,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: partnership: Example Entity 8-6-0; ordinary business income: USD 11,594.00; deductions: USD 11,594.00; partners: Example Entity 8-6-3",1065,2,1065,fdc-35c62d84dd93b421e00c18bd,synthetic-form-layout-08,original,2023,fte-9a6a4a4217d2a3b3aa6f219d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1065: US Return of Partnership Income
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: partnership: Example Entity 8-7-0; ordinary business income: USD 11,677.00; deductions: USD 11,677.00; partners: Example Entity 8-7-3",1065,2,1065,fdc-49be158d7c70d6f6d78a90fa,synthetic-form-layout-08,original,2024,fte-d14732664a4e94a604522abc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1065: US Return of Partnership Income
Example Client 900 is the named party.
Information printed on this record:
partnership: Example Entity 9-0-0
ordinary business income: USD 11,233.00
deductions: USD 11,233.00
partners: Example Entity 9-0-3",1065,2,1065,fdc-83b9e177adb6c20074104a13,synthetic-form-layout-09,original,2023,fte-577a81ea1661610dccfc2ba4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1065: US Return of Partnership Income
Example Client 901 is the named party.
Information printed on this record:
partnership: Example Entity 9-1-0
ordinary business income: USD 11,316.00
deductions: USD 11,316.00
partners: Example Entity 9-1-3",1065,2,1065,fdc-ce34c4f79d209570514e08db,synthetic-form-layout-09,original,2024,fte-5cb76036deac204687b03971,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1065: US Return of Partnership Income
Example Client 902 is the named party.
Information printed on this record:
partnership: Example Entity 9-2-0
ordinary business income: USD 11,399.00
deductions: USD 11,399.00
partners: Example Entity 9-2-3",1065,2,1065,fdc-33263217e2d7b733b28fb217,synthetic-form-layout-09,original,2025,fte-f06f120654f66f0840ce729c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1065: US Return of Partnership Income
Example Client 903 is the named party.
Information printed on this record:
partnership: Example Entity 9-3-0
ordinary business income: USD 11,482.00
deductions: USD 11,482.00
partners: Example Entity 9-3-3",1065,2,1065,fdc-9a7ff0e053fd30931c371104,synthetic-form-layout-09,original,2023,fte-7aca4819bcc95eae531ac5d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1065: US Return of Partnership Income
Example Client 904 is the named party.
Information printed on this record:
partnership: Example Entity 9-4-0
ordinary business income: USD 11,565.00
deductions: USD 11,565.00
partners: Example Entity 9-4-3",1065,2,1065,fdc-152643a15c86f97bec2fef13,synthetic-form-layout-09,original,2024,fte-adaa33fd958526ed306142cc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1065: US Return of Partnership Income
Example Client 905 is the named party.
Information printed on this record:
partnership: Example Entity 9-5-0
ordinary business income: USD 11,648.00
deductions: USD 11,648.00
partners: Example Entity 9-5-3",1065,2,1065,fdc-db04175f607fdbc37540ff43,synthetic-form-layout-09,original,2025,fte-339e85eeb17816f7d55ce3ac,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1065: US Return of Partnership Income
Example Client 906 is the named party.
Information printed on this record:
partnership: Example Entity 9-6-0
ordinary business income: USD 11,731.00
deductions: USD 11,731.00
partners: Example Entity 9-6-3",1065,2,1065,fdc-68c578e5e8dd60a024301630,synthetic-form-layout-09,original,2023,fte-7f7b1fc0c065377cd24e1f4f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1065: US Return of Partnership Income
Example Client 907 is the named party.
Information printed on this record:
partnership: Example Entity 9-7-0
ordinary business income: USD 11,814.00
deductions: USD 11,814.00
partners: Example Entity 9-7-3",1065,2,1065,fdc-57c86df52a290c4d402122a8,synthetic-form-layout-09,original,2024,fte-d155e7509c43895114f83453,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: corporation: USD 11,096.00; ordinary business income: USD 11,096.00; deductions: USD 11,096.00; shareholders: Example Entity 8-0-3",1120-S,7,1120-S,fdc-a06da56e7eb370c1bff96c56,synthetic-form-layout-08,original,2023,fte-295df8a5534553468ac8f179,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: corporation: USD 11,179.00; ordinary business income: USD 11,179.00; deductions: USD 11,179.00; shareholders: Example Entity 8-1-3",1120-S,7,1120-S,fdc-45f372aba56c80cb6956cd73,synthetic-form-layout-08,original,2024,fte-f732373ff897357945daf0cb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: corporation: USD 11,262.00; ordinary business income: USD 11,262.00; deductions: USD 11,262.00; shareholders: Example Entity 8-2-3",1120-S,7,1120-S,fdc-b8a58530f2aeb66f0b2742e0,synthetic-form-layout-08,original,2025,fte-7a01981eb0fdfb4b156fb12e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: corporation: USD 11,345.00; ordinary business income: USD 11,345.00; deductions: USD 11,345.00; shareholders: Example Entity 8-3-3",1120-S,7,1120-S,fdc-345155170bec8a5d2672b2af,synthetic-form-layout-08,original,2023,fte-a52a2556f81e7830868ea1dd,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: corporation: USD 11,428.00; ordinary business income: USD 11,428.00; deductions: USD 11,428.00; shareholders: Example Entity 8-4-3",1120-S,7,1120-S,fdc-706a2a8fe8ab854f894a9d26,synthetic-form-layout-08,original,2024,fte-52fb9d07d54a2a29cb73d173,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: corporation: USD 11,511.00; ordinary business income: USD 11,511.00; deductions: USD 11,511.00; shareholders: Example Entity 8-5-3",1120-S,7,1120-S,fdc-5c63237be4a459c2a241fad0,synthetic-form-layout-08,original,2025,fte-0b0fd9a9b2d52b3c36f5b982,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: corporation: USD 11,594.00; ordinary business income: USD 11,594.00; deductions: USD 11,594.00; shareholders: Example Entity 8-6-3",1120-S,7,1120-S,fdc-8b8f63c499d3579697714b3d,synthetic-form-layout-08,original,2023,fte-d5bededde78ba84711281ef1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1120-S: US Income Tax Return for an S Corporation
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: corporation: USD 11,677.00; ordinary business income: USD 11,677.00; deductions: USD 11,677.00; shareholders: Example Entity 8-7-3",1120-S,7,1120-S,fdc-15783674764987a04298025b,synthetic-form-layout-08,original,2024,fte-94ea21a42213d64d723de8d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 900 is the named party.
Information printed on this record:
corporation: USD 11,233.00
ordinary business income: USD 11,233.00
deductions: USD 11,233.00
shareholders: Example Entity 9-0-3",1120-S,7,1120-S,fdc-ee43df2dfd804f0d779de2e6,synthetic-form-layout-09,original,2023,fte-8aa91b2d886435cfd7cf3cd4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 901 is the named party.
Information printed on this record:
corporation: USD 11,316.00
ordinary business income: USD 11,316.00
deductions: USD 11,316.00
shareholders: Example Entity 9-1-3",1120-S,7,1120-S,fdc-8dfdff037a8946948b2d77a2,synthetic-form-layout-09,original,2024,fte-d023acc8f25f687d7effa901,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 902 is the named party.
Information printed on this record:
corporation: USD 11,399.00
ordinary business income: USD 11,399.00
deductions: USD 11,399.00
shareholders: Example Entity 9-2-3",1120-S,7,1120-S,fdc-6c2a331a01c6a117525fb537,synthetic-form-layout-09,original,2025,fte-783f50b5120099d82fe6a90d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 903 is the named party.
Information printed on this record:
corporation: USD 11,482.00
ordinary business income: USD 11,482.00
deductions: USD 11,482.00
shareholders: Example Entity 9-3-3",1120-S,7,1120-S,fdc-61cfa68c12d7561f036088c5,synthetic-form-layout-09,original,2023,fte-25dd553b44a0508312ea4a70,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 904 is the named party.
Information printed on this record:
corporation: USD 11,565.00
ordinary business income: USD 11,565.00
deductions: USD 11,565.00
shareholders: Example Entity 9-4-3",1120-S,7,1120-S,fdc-e0df8adc0b8dcaa7986b8786,synthetic-form-layout-09,original,2024,fte-2c1ba229e731c60bd1fc1775,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 905 is the named party.
Information printed on this record:
corporation: USD 11,648.00
ordinary business income: USD 11,648.00
deductions: USD 11,648.00
shareholders: Example Entity 9-5-3",1120-S,7,1120-S,fdc-85ebb56d13b995cd46cff56c,synthetic-form-layout-09,original,2025,fte-ba871a264cae8143a811a68d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 906 is the named party.
Information printed on this record:
corporation: USD 11,731.00
ordinary business income: USD 11,731.00
deductions: USD 11,731.00
shareholders: Example Entity 9-6-3",1120-S,7,1120-S,fdc-47d9af032d24cd3b6b9977f8,synthetic-form-layout-09,original,2023,fte-92899fb3f6bebd1b8215d350,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1120-S: US Income Tax Return for an S Corporation
Example Client 907 is the named party.
Information printed on this record:
corporation: USD 11,814.00
ordinary business income: USD 11,814.00
deductions: USD 11,814.00
shareholders: Example Entity 9-7-3",1120-S,7,1120-S,fdc-e47b36411e88b58958f473dc,synthetic-form-layout-09,original,2024,fte-18182aef9d2a56cf897ca943,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: estate or trust: USD 11,096.00; fiduciary: Example Entity 8-0-1; income: USD 11,096.00; distributions: USD 11,096.00",1041,1,1041,fdc-75307ee353804c2c01678450,synthetic-form-layout-08,original,2023,fte-d9714f8214feab7b7e70dfb1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: estate or trust: USD 11,179.00; fiduciary: Example Entity 8-1-1; income: USD 11,179.00; distributions: USD 11,179.00",1041,1,1041,fdc-10f1d5869128cf68ea651bc1,synthetic-form-layout-08,original,2024,fte-1333c22426e195a0c6b3df6c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: estate or trust: USD 11,262.00; fiduciary: Example Entity 8-2-1; income: USD 11,262.00; distributions: USD 11,262.00",1041,1,1041,fdc-c47da50e8b4d9f704eef7c1c,synthetic-form-layout-08,original,2025,fte-f50f1a9a7d606f01eaeb9c6f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: estate or trust: USD 11,345.00; fiduciary: Example Entity 8-3-1; income: USD 11,345.00; distributions: USD 11,345.00",1041,1,1041,fdc-a1d83072c30a0002a5890117,synthetic-form-layout-08,original,2023,fte-eb7dd80d892f733ec294016f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: estate or trust: USD 11,428.00; fiduciary: Example Entity 8-4-1; income: USD 11,428.00; distributions: USD 11,428.00",1041,1,1041,fdc-76b3cdbf93694ad11b6e0120,synthetic-form-layout-08,original,2024,fte-03e486212086f93568c0057d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: estate or trust: USD 11,511.00; fiduciary: Example Entity 8-5-1; income: USD 11,511.00; distributions: USD 11,511.00",1041,1,1041,fdc-73e453de01660c74bd766db7,synthetic-form-layout-08,original,2025,fte-bcfd7199547f1ed8b04d33f2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: estate or trust: USD 11,594.00; fiduciary: Example Entity 8-6-1; income: USD 11,594.00; distributions: USD 11,594.00",1041,1,1041,fdc-95721b62ef3d89713d13ae1b,synthetic-form-layout-08,original,2023,fte-ddfc91a659b9baa4885a2311,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1041: US Income Tax Return for Estates and Trusts
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: estate or trust: USD 11,677.00; fiduciary: Example Entity 8-7-1; income: USD 11,677.00; distributions: USD 11,677.00",1041,1,1041,fdc-47fe105f7ff2154274ce017f,synthetic-form-layout-08,original,2024,fte-d5a61c649eba8cfcb7474367,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 900 is the named party.
Information printed on this record:
estate or trust: USD 11,233.00
fiduciary: Example Entity 9-0-1
income: USD 11,233.00
distributions: USD 11,233.00",1041,1,1041,fdc-8227a5b4c563937227a72d08,synthetic-form-layout-09,original,2023,fte-df350fdef2ce4978d0cf40ae,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 901 is the named party.
Information printed on this record:
estate or trust: USD 11,316.00
fiduciary: Example Entity 9-1-1
income: USD 11,316.00
distributions: USD 11,316.00",1041,1,1041,fdc-94172bb80cac9eed530c8b84,synthetic-form-layout-09,original,2024,fte-d81740dc204e4b8448d48277,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 902 is the named party.
Information printed on this record:
estate or trust: USD 11,399.00
fiduciary: Example Entity 9-2-1
income: USD 11,399.00
distributions: USD 11,399.00",1041,1,1041,fdc-d8a650c755da7d7f28d992c9,synthetic-form-layout-09,original,2025,fte-11cc39b5a288f36e54e37682,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 903 is the named party.
Information printed on this record:
estate or trust: USD 11,482.00
fiduciary: Example Entity 9-3-1
income: USD 11,482.00
distributions: USD 11,482.00",1041,1,1041,fdc-b58c8232d00801f19593345b,synthetic-form-layout-09,original,2023,fte-f2a3a4cd6eed4298c900b592,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 904 is the named party.
Information printed on this record:
estate or trust: USD 11,565.00
fiduciary: Example Entity 9-4-1
income: USD 11,565.00
distributions: USD 11,565.00",1041,1,1041,fdc-021d32595c7e81685737713d,synthetic-form-layout-09,original,2024,fte-53e8b06c37b1df1442817d67,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 905 is the named party.
Information printed on this record:
estate or trust: USD 11,648.00
fiduciary: Example Entity 9-5-1
income: USD 11,648.00
distributions: USD 11,648.00",1041,1,1041,fdc-465a69fe6562784d9d751f6b,synthetic-form-layout-09,original,2025,fte-4d485dcc15cd2fae7fbec00d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 906 is the named party.
Information printed on this record:
estate or trust: USD 11,731.00
fiduciary: Example Entity 9-6-1
income: USD 11,731.00
distributions: USD 11,731.00",1041,1,1041,fdc-d858c1dc39fa9fdb203ef7e0,synthetic-form-layout-09,original,2023,fte-d7cf92cc1ca2df9771eb1053,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1041: US Income Tax Return for Estates and Trusts
Example Client 907 is the named party.
Information printed on this record:
estate or trust: USD 11,814.00
fiduciary: Example Entity 9-7-1
income: USD 11,814.00
distributions: USD 11,814.00",1041,1,1041,fdc-fe4ef42351b6f3224ffc093f,synthetic-form-layout-09,original,2024,fte-facafc367499c98618eeda7a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: partnership: Example Entity 8-0-0; partner: Example Entity 8-0-1; ordinary business income: USD 11,096.00; distributions: USD 11,096.00",K-1,30,K-1,fdc-736163676fe2766583537eae,synthetic-form-layout-08,original,2023,fte-52276fa966eef4ce9eda5371,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: partnership: Example Entity 8-1-0; partner: Example Entity 8-1-1; ordinary business income: USD 11,179.00; distributions: USD 11,179.00",K-1,30,K-1,fdc-4289e4bfbf7675368349c7e3,synthetic-form-layout-08,original,2024,fte-474f18ba8c86a29b595ff715,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: partnership: Example Entity 8-2-0; partner: Example Entity 8-2-1; ordinary business income: USD 11,262.00; distributions: USD 11,262.00",K-1,30,K-1,fdc-efacdb478daf272af66b0910,synthetic-form-layout-08,original,2025,fte-27faef397352c35b9f4571be,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: partnership: Example Entity 8-3-0; partner: Example Entity 8-3-1; ordinary business income: USD 11,345.00; distributions: USD 11,345.00",K-1,30,K-1,fdc-3c098c9ee8ba7463bb605579,synthetic-form-layout-08,original,2023,fte-05979d766f4c54b40b99acf2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: partnership: Example Entity 8-4-0; partner: Example Entity 8-4-1; ordinary business income: USD 11,428.00; distributions: USD 11,428.00",K-1,30,K-1,fdc-a61b2baa5620af8792bc62d5,synthetic-form-layout-08,original,2024,fte-cb43b66e18169202778734a5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: partnership: Example Entity 8-5-0; partner: Example Entity 8-5-1; ordinary business income: USD 11,511.00; distributions: USD 11,511.00",K-1,30,K-1,fdc-2911e97abfdbc14d313b1f6e,synthetic-form-layout-08,original,2025,fte-5db51ae6e098e2278a29571b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: partnership: Example Entity 8-6-0; partner: Example Entity 8-6-1; ordinary business income: USD 11,594.00; distributions: USD 11,594.00",K-1,30,K-1,fdc-7c9e808bb5dde998583333f9,synthetic-form-layout-08,original,2023,fte-67915f968b5e8f0b04e68707,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: partnership: Example Entity 8-7-0; partner: Example Entity 8-7-1; ordinary business income: USD 11,677.00; distributions: USD 11,677.00",K-1,30,K-1,fdc-ce5b2f057a0b98546420e0fc,synthetic-form-layout-08,original,2024,fte-f706e0daf13e711f95ccdf3b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 900 is the named party.
Information printed on this record:
partnership: Example Entity 9-0-0
partner: Example Entity 9-0-1
ordinary business income: USD 11,233.00
distributions: USD 11,233.00",K-1,30,K-1,fdc-8405fe418c9e0d07c83e5656,synthetic-form-layout-09,original,2023,fte-106cbe6396cf6887e4c9eca3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 901 is the named party.
Information printed on this record:
partnership: Example Entity 9-1-0
partner: Example Entity 9-1-1
ordinary business income: USD 11,316.00
distributions: USD 11,316.00",K-1,30,K-1,fdc-2f2bb2b158f138f78147e4af,synthetic-form-layout-09,original,2024,fte-1f17dc1b1db7b39d7cd48e80,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 902 is the named party.
Information printed on this record:
partnership: Example Entity 9-2-0
partner: Example Entity 9-2-1
ordinary business income: USD 11,399.00
distributions: USD 11,399.00",K-1,30,K-1,fdc-ac2738e2b46ca9f6a5d05e97,synthetic-form-layout-09,original,2025,fte-3531046cf1e800bb174c9380,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 903 is the named party.
Information printed on this record:
partnership: Example Entity 9-3-0
partner: Example Entity 9-3-1
ordinary business income: USD 11,482.00
distributions: USD 11,482.00",K-1,30,K-1,fdc-b70ade79a8063892d89ef218,synthetic-form-layout-09,original,2023,fte-637003c0449bc0888df166c2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 904 is the named party.
Information printed on this record:
partnership: Example Entity 9-4-0
partner: Example Entity 9-4-1
ordinary business income: USD 11,565.00
distributions: USD 11,565.00",K-1,30,K-1,fdc-913daeec1a888e6b6e0e07cf,synthetic-form-layout-09,original,2024,fte-35b9abca7b8d217bb21bf866,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 905 is the named party.
Information printed on this record:
partnership: Example Entity 9-5-0
partner: Example Entity 9-5-1
ordinary business income: USD 11,648.00
distributions: USD 11,648.00",K-1,30,K-1,fdc-d05413f3082ee069b6e110db,synthetic-form-layout-09,original,2025,fte-715901d6de21280a11d43f0f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 906 is the named party.
Information printed on this record:
partnership: Example Entity 9-6-0
partner: Example Entity 9-6-1
ordinary business income: USD 11,731.00
distributions: USD 11,731.00",K-1,30,K-1,fdc-506cf5c27e4df335686effc3,synthetic-form-layout-09,original,2023,fte-9b6a08c2f956bcdbe6b315d0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1065: Schedule K-1 Form 1065 Partner Share of Income Deductions Credits
Example Client 907 is the named party.
Information printed on this record:
partnership: Example Entity 9-7-0
partner: Example Entity 9-7-1
ordinary business income: USD 11,814.00
distributions: USD 11,814.00",K-1,30,K-1,fdc-9a65e4ccc74bd6189f108482,synthetic-form-layout-09,original,2024,fte-d5f12e142edec5b7bbf777c5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: corporation: USD 11,096.00; shareholder: Example Entity 8-0-1; ordinary business income: USD 11,096.00; distributions: USD 11,096.00",K-1,30,K-1,fdc-d414ae0c923d28dd5c034ddd,synthetic-form-layout-08,original,2023,fte-5c568d72e3111e2583e7547b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: corporation: USD 11,179.00; shareholder: Example Entity 8-1-1; ordinary business income: USD 11,179.00; distributions: USD 11,179.00",K-1,30,K-1,fdc-fcb5d8faa1369bd319439d39,synthetic-form-layout-08,original,2024,fte-c0a0a1c86d4680e5493b7766,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: corporation: USD 11,262.00; shareholder: Example Entity 8-2-1; ordinary business income: USD 11,262.00; distributions: USD 11,262.00",K-1,30,K-1,fdc-4baf2fef86e747b60332d6ee,synthetic-form-layout-08,original,2025,fte-3ba82c4eb5184d40519a4ceb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: corporation: USD 11,345.00; shareholder: Example Entity 8-3-1; ordinary business income: USD 11,345.00; distributions: USD 11,345.00",K-1,30,K-1,fdc-0b3f727b3cb412318b6eee65,synthetic-form-layout-08,original,2023,fte-8e2f1fec4b7b1695ccf28f98,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: corporation: USD 11,428.00; shareholder: Example Entity 8-4-1; ordinary business income: USD 11,428.00; distributions: USD 11,428.00",K-1,30,K-1,fdc-99326c42cb712ac0555f9684,synthetic-form-layout-08,original,2024,fte-7d97448fe54c4671fcc2f1d4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: corporation: USD 11,511.00; shareholder: Example Entity 8-5-1; ordinary business income: USD 11,511.00; distributions: USD 11,511.00",K-1,30,K-1,fdc-1085a36c4169f430066a5b35,synthetic-form-layout-08,original,2025,fte-8916a37d7faf5f8d19d0fade,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: corporation: USD 11,594.00; shareholder: Example Entity 8-6-1; ordinary business income: USD 11,594.00; distributions: USD 11,594.00",K-1,30,K-1,fdc-21bb83fd0e569553d085c1c3,synthetic-form-layout-08,original,2023,fte-14a18e715145299d24a8b521,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: corporation: USD 11,677.00; shareholder: Example Entity 8-7-1; ordinary business income: USD 11,677.00; distributions: USD 11,677.00",K-1,30,K-1,fdc-cd5ab7b754f6d2556879adb1,synthetic-form-layout-08,original,2024,fte-93ddffd1ed6e425d57720ffb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 900 is the named party.
Information printed on this record:
corporation: USD 11,233.00
shareholder: Example Entity 9-0-1
ordinary business income: USD 11,233.00
distributions: USD 11,233.00",K-1,30,K-1,fdc-e0d5c6f1336dca0cfb9fa75d,synthetic-form-layout-09,original,2023,fte-2b20f872d09678354a0dcd4d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 901 is the named party.
Information printed on this record:
corporation: USD 11,316.00
shareholder: Example Entity 9-1-1
ordinary business income: USD 11,316.00
distributions: USD 11,316.00",K-1,30,K-1,fdc-b90d9d296f6ec38f6c86812e,synthetic-form-layout-09,original,2024,fte-b7e9e0cec58737f006c2fab4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 902 is the named party.
Information printed on this record:
corporation: USD 11,399.00
shareholder: Example Entity 9-2-1
ordinary business income: USD 11,399.00
distributions: USD 11,399.00",K-1,30,K-1,fdc-03550d37ed9fe68e60c77ed9,synthetic-form-layout-09,original,2025,fte-d825fcd5dff7bcaeeb440631,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 903 is the named party.
Information printed on this record:
corporation: USD 11,482.00
shareholder: Example Entity 9-3-1
ordinary business income: USD 11,482.00
distributions: USD 11,482.00",K-1,30,K-1,fdc-650b7c2ce3677919f893f103,synthetic-form-layout-09,original,2023,fte-59024140a452fe42f7aca1d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 904 is the named party.
Information printed on this record:
corporation: USD 11,565.00
shareholder: Example Entity 9-4-1
ordinary business income: USD 11,565.00
distributions: USD 11,565.00",K-1,30,K-1,fdc-50f7d2b203315a1d0865fd88,synthetic-form-layout-09,original,2024,fte-0c6fff877a677abd6c20f42e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 905 is the named party.
Information printed on this record:
corporation: USD 11,648.00
shareholder: Example Entity 9-5-1
ordinary business income: USD 11,648.00
distributions: USD 11,648.00",K-1,30,K-1,fdc-f91c4220c9fc840573b861aa,synthetic-form-layout-09,original,2025,fte-ef428ad184a2cc68c0eb308f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 906 is the named party.
Information printed on this record:
corporation: USD 11,731.00
shareholder: Example Entity 9-6-1
ordinary business income: USD 11,731.00
distributions: USD 11,731.00",K-1,30,K-1,fdc-eb3f9911fa42233cb56f0dcf,synthetic-form-layout-09,original,2023,fte-ded5ecd7ac3006f3c2fc106f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1120-S: Schedule K-1 Form 1120-S Shareholder Share of Income Deductions Credits
Example Client 907 is the named party.
Information printed on this record:
corporation: USD 11,814.00
shareholder: Example Entity 9-7-1
ordinary business income: USD 11,814.00
distributions: USD 11,814.00",K-1,30,K-1,fdc-c3e04c3e57f098547e8f45c8,synthetic-form-layout-09,original,2024,fte-6a59943aca8bed9ec603bdc0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: estate or trust: USD 11,096.00; beneficiary: Example Entity 8-0-1; income: USD 11,096.00; deductions: USD 11,096.00",K-1,30,K-1,fdc-a9677b0fbca7041d00fbe8c8,synthetic-form-layout-08,original,2023,fte-10eae8b8b0af2c306a108cee,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: estate or trust: USD 11,179.00; beneficiary: Example Entity 8-1-1; income: USD 11,179.00; deductions: USD 11,179.00",K-1,30,K-1,fdc-544330748cfb277e33a39a00,synthetic-form-layout-08,original,2024,fte-9b70fd4a74d0fad3af99f28e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: estate or trust: USD 11,262.00; beneficiary: Example Entity 8-2-1; income: USD 11,262.00; deductions: USD 11,262.00",K-1,30,K-1,fdc-8fe35ee6784f4a86174822c5,synthetic-form-layout-08,original,2025,fte-f2c09cc25079331abf171f29,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: estate or trust: USD 11,345.00; beneficiary: Example Entity 8-3-1; income: USD 11,345.00; deductions: USD 11,345.00",K-1,30,K-1,fdc-4dd229271aeb6cdea392ef72,synthetic-form-layout-08,original,2023,fte-cfc458a7581b24b5f2e3d154,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: estate or trust: USD 11,428.00; beneficiary: Example Entity 8-4-1; income: USD 11,428.00; deductions: USD 11,428.00",K-1,30,K-1,fdc-ae8dc662615f67218cea5041,synthetic-form-layout-08,original,2024,fte-9031bd51a5fd592d9fb4f15d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: estate or trust: USD 11,511.00; beneficiary: Example Entity 8-5-1; income: USD 11,511.00; deductions: USD 11,511.00",K-1,30,K-1,fdc-4c01e12898825d2360fbb12e,synthetic-form-layout-08,original,2025,fte-c3e211944006fd31f0c68402,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: estate or trust: USD 11,594.00; beneficiary: Example Entity 8-6-1; income: USD 11,594.00; deductions: USD 11,594.00",K-1,30,K-1,fdc-f618bdb10a3ce4e897f0474e,synthetic-form-layout-08,original,2023,fte-8c3df8329ef84714de24bb1a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: estate or trust: USD 11,677.00; beneficiary: Example Entity 8-7-1; income: USD 11,677.00; deductions: USD 11,677.00",K-1,30,K-1,fdc-19c823a8a1d41dfe0e3b5877,synthetic-form-layout-08,original,2024,fte-cfd99597bb9f9091e7eb14fe,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 900 is the named party.
Information printed on this record:
estate or trust: USD 11,233.00
beneficiary: Example Entity 9-0-1
income: USD 11,233.00
deductions: USD 11,233.00",K-1,30,K-1,fdc-0c1bdb4771fbbb3665186ede,synthetic-form-layout-09,original,2023,fte-de8e11875bb03cc5b752c3fa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 901 is the named party.
Information printed on this record:
estate or trust: USD 11,316.00
beneficiary: Example Entity 9-1-1
income: USD 11,316.00
deductions: USD 11,316.00",K-1,30,K-1,fdc-f9c1e13d66cb659c8c1a7576,synthetic-form-layout-09,original,2024,fte-ec80239b2f2cac59f6a0cd6c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 902 is the named party.
Information printed on this record:
estate or trust: USD 11,399.00
beneficiary: Example Entity 9-2-1
income: USD 11,399.00
deductions: USD 11,399.00",K-1,30,K-1,fdc-cfd8d5b378651d7eac910487,synthetic-form-layout-09,original,2025,fte-0a799923172bf73c60862c97,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 903 is the named party.
Information printed on this record:
estate or trust: USD 11,482.00
beneficiary: Example Entity 9-3-1
income: USD 11,482.00
deductions: USD 11,482.00",K-1,30,K-1,fdc-51a419ba86e520ab460eadc1,synthetic-form-layout-09,original,2023,fte-9194e8324ee11b76f535598e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 904 is the named party.
Information printed on this record:
estate or trust: USD 11,565.00
beneficiary: Example Entity 9-4-1
income: USD 11,565.00
deductions: USD 11,565.00",K-1,30,K-1,fdc-1cd09c4bea6a8f5e6a58c780,synthetic-form-layout-09,original,2024,fte-1f9c0d7e736038eaa6facc06,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 905 is the named party.
Information printed on this record:
estate or trust: USD 11,648.00
beneficiary: Example Entity 9-5-1
income: USD 11,648.00
deductions: USD 11,648.00",K-1,30,K-1,fdc-a83b8d8c4591017d854e2a3f,synthetic-form-layout-09,original,2025,fte-46e4dceb6dc26601a7dc8108,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 906 is the named party.
Information printed on this record:
estate or trust: USD 11,731.00
beneficiary: Example Entity 9-6-1
income: USD 11,731.00
deductions: USD 11,731.00",K-1,30,K-1,fdc-1b3cafb923ca9d4f89501413,synthetic-form-layout-09,original,2023,fte-ef360b29206e67e383995086,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: K-1-1041: Schedule K-1 Form 1041 Beneficiary Share of Income Deductions Credits
Example Client 907 is the named party.
Information printed on this record:
estate or trust: USD 11,814.00
beneficiary: Example Entity 9-7-1
income: USD 11,814.00
deductions: USD 11,814.00",K-1,30,K-1,fdc-a203d7af3c21171b3be21c05,synthetic-form-layout-09,original,2024,fte-d72a025ed34d5686851c336d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: medical expenses: USD 11,096.00; taxes paid: USD 11,096.00; interest: USD 11,096.00; gifts to charity: USD 11,096.00",SCHEDULE,34,SCHEDULE,fdc-d60ad58412da7381c57e41c0,synthetic-form-layout-08,original,2023,fte-ee9544bbd19c7773f425a058,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: medical expenses: USD 11,179.00; taxes paid: USD 11,179.00; interest: USD 11,179.00; gifts to charity: USD 11,179.00",SCHEDULE,34,SCHEDULE,fdc-98cde9c0efebda69358d20f0,synthetic-form-layout-08,original,2024,fte-80abc5a959a568a110618d83,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: medical expenses: USD 11,262.00; taxes paid: USD 11,262.00; interest: USD 11,262.00; gifts to charity: USD 11,262.00",SCHEDULE,34,SCHEDULE,fdc-5fa7ba0f2f149b62aecbe396,synthetic-form-layout-08,original,2025,fte-a06eed532ce89835a39441c1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: medical expenses: USD 11,345.00; taxes paid: USD 11,345.00; interest: USD 11,345.00; gifts to charity: USD 11,345.00",SCHEDULE,34,SCHEDULE,fdc-66a918c5c17c6f787700dddf,synthetic-form-layout-08,original,2023,fte-b8793c5e07c260f1cc4406a3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: medical expenses: USD 11,428.00; taxes paid: USD 11,428.00; interest: USD 11,428.00; gifts to charity: USD 11,428.00",SCHEDULE,34,SCHEDULE,fdc-73cc2096f4ff5421d6a23d4b,synthetic-form-layout-08,original,2024,fte-43e8cd912c5cb6b7b35120aa,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: medical expenses: USD 11,511.00; taxes paid: USD 11,511.00; interest: USD 11,511.00; gifts to charity: USD 11,511.00",SCHEDULE,34,SCHEDULE,fdc-d5eb728b9eab3520adf55c37,synthetic-form-layout-08,original,2025,fte-671fa60f9c5bbb8367580e2d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: medical expenses: USD 11,594.00; taxes paid: USD 11,594.00; interest: USD 11,594.00; gifts to charity: USD 11,594.00",SCHEDULE,34,SCHEDULE,fdc-d327659c3eff0e47aec93ae2,synthetic-form-layout-08,original,2023,fte-67ac82cd5c6e636bbaae61e2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-A: Schedule A Itemized Deductions
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: medical expenses: USD 11,677.00; taxes paid: USD 11,677.00; interest: USD 11,677.00; gifts to charity: USD 11,677.00",SCHEDULE,34,SCHEDULE,fdc-015a5d319abfdc7dc75e735b,synthetic-form-layout-08,original,2024,fte-1f1677def73601c3f0677256,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 900 is the named party.
Information printed on this record:
medical expenses: USD 11,233.00
taxes paid: USD 11,233.00
interest: USD 11,233.00
gifts to charity: USD 11,233.00",SCHEDULE,34,SCHEDULE,fdc-7c0bdc9430f9f377ed7e6d7d,synthetic-form-layout-09,original,2023,fte-3ec7667f96835c51c0d459e4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 901 is the named party.
Information printed on this record:
medical expenses: USD 11,316.00
taxes paid: USD 11,316.00
interest: USD 11,316.00
gifts to charity: USD 11,316.00",SCHEDULE,34,SCHEDULE,fdc-18dfbc2384084cf1d126f966,synthetic-form-layout-09,original,2024,fte-06460902b5cbce0c870de16c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 902 is the named party.
Information printed on this record:
medical expenses: USD 11,399.00
taxes paid: USD 11,399.00
interest: USD 11,399.00
gifts to charity: USD 11,399.00",SCHEDULE,34,SCHEDULE,fdc-e1bff9ea5de95e76aa7312e1,synthetic-form-layout-09,original,2025,fte-f1254c3eb304a20435a3a95e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 903 is the named party.
Information printed on this record:
medical expenses: USD 11,482.00
taxes paid: USD 11,482.00
interest: USD 11,482.00
gifts to charity: USD 11,482.00",SCHEDULE,34,SCHEDULE,fdc-b1126eb0c91c8326a4d3a421,synthetic-form-layout-09,original,2023,fte-b2ed5f735ee1f385f38799c8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 904 is the named party.
Information printed on this record:
medical expenses: USD 11,565.00
taxes paid: USD 11,565.00
interest: USD 11,565.00
gifts to charity: USD 11,565.00",SCHEDULE,34,SCHEDULE,fdc-67e7efb99a394f1aa3ef6ad4,synthetic-form-layout-09,original,2024,fte-6f02050bbe0da00c3df7193f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 905 is the named party.
Information printed on this record:
medical expenses: USD 11,648.00
taxes paid: USD 11,648.00
interest: USD 11,648.00
gifts to charity: USD 11,648.00",SCHEDULE,34,SCHEDULE,fdc-2bb1cb987303a43b9d225d59,synthetic-form-layout-09,original,2025,fte-4db9081361966f54b80a42d4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 906 is the named party.
Information printed on this record:
medical expenses: USD 11,731.00
taxes paid: USD 11,731.00
interest: USD 11,731.00
gifts to charity: USD 11,731.00",SCHEDULE,34,SCHEDULE,fdc-dcb7e05b37557168abdc22d0,synthetic-form-layout-09,original,2023,fte-45738db7bc8cb0f6d6f524a0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-A: Schedule A Itemized Deductions
Example Client 907 is the named party.
Information printed on this record:
medical expenses: USD 11,814.00
taxes paid: USD 11,814.00
interest: USD 11,814.00
gifts to charity: USD 11,814.00",SCHEDULE,34,SCHEDULE,fdc-ec207bb56fea9dce2d20552a,synthetic-form-layout-09,original,2024,fte-a13d34b47ab8c5e991765112,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: interest payer: Example Entity 8-0-0; ordinary dividends: USD 11,096.00; foreign accounts: USD 11,096.00",SCHEDULE,34,SCHEDULE,fdc-96f735803c7241408254353a,synthetic-form-layout-08,original,2023,fte-c667fcf0e2cd53297787d484,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: interest payer: Example Entity 8-1-0; ordinary dividends: USD 11,179.00; foreign accounts: USD 11,179.00",SCHEDULE,34,SCHEDULE,fdc-e2a6378c37e29ff34fe932ab,synthetic-form-layout-08,original,2024,fte-9065a747a1d977d8c6a8d134,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: interest payer: Example Entity 8-2-0; ordinary dividends: USD 11,262.00; foreign accounts: USD 11,262.00",SCHEDULE,34,SCHEDULE,fdc-03ae279252f22fd7e2af6456,synthetic-form-layout-08,original,2025,fte-18b1dbea7fffb906adfb65bf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: interest payer: Example Entity 8-3-0; ordinary dividends: USD 11,345.00; foreign accounts: USD 11,345.00",SCHEDULE,34,SCHEDULE,fdc-7a2941b4708cea0017a62303,synthetic-form-layout-08,original,2023,fte-eb03aa4060c20172cca9e3f6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: interest payer: Example Entity 8-4-0; ordinary dividends: USD 11,428.00; foreign accounts: USD 11,428.00",SCHEDULE,34,SCHEDULE,fdc-f7c0e1c794d879ff6c2a6364,synthetic-form-layout-08,original,2024,fte-6e087795c3b927d790672eb3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: interest payer: Example Entity 8-5-0; ordinary dividends: USD 11,511.00; foreign accounts: USD 11,511.00",SCHEDULE,34,SCHEDULE,fdc-24503664227f941197b0ccd4,synthetic-form-layout-08,original,2025,fte-4a17a5010fe12a7501227d16,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: interest payer: Example Entity 8-6-0; ordinary dividends: USD 11,594.00; foreign accounts: USD 11,594.00",SCHEDULE,34,SCHEDULE,fdc-76d5edcb64332052ae565074,synthetic-form-layout-08,original,2023,fte-ee10eb5410b26beadc53a34c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-B: Schedule B Interest and Ordinary Dividends
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: interest payer: Example Entity 8-7-0; ordinary dividends: USD 11,677.00; foreign accounts: USD 11,677.00",SCHEDULE,34,SCHEDULE,fdc-1ec0b32cce3c854ac98ace5b,synthetic-form-layout-08,original,2024,fte-facd531bdc7d52c9ae843a49,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 900 is the named party.
Information printed on this record:
interest payer: Example Entity 9-0-0
ordinary dividends: USD 11,233.00
foreign accounts: USD 11,233.00",SCHEDULE,34,SCHEDULE,fdc-b8697ae38b68fae5f4c9b906,synthetic-form-layout-09,original,2023,fte-aaed484c53ecbdf5d5ada484,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 901 is the named party.
Information printed on this record:
interest payer: Example Entity 9-1-0
ordinary dividends: USD 11,316.00
foreign accounts: USD 11,316.00",SCHEDULE,34,SCHEDULE,fdc-6f68f5e6f7beb1b1a08db791,synthetic-form-layout-09,original,2024,fte-eb1c12b05491774845b6563c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 902 is the named party.
Information printed on this record:
interest payer: Example Entity 9-2-0
ordinary dividends: USD 11,399.00
foreign accounts: USD 11,399.00",SCHEDULE,34,SCHEDULE,fdc-05b93f3092bfba0ea0188553,synthetic-form-layout-09,original,2025,fte-b199f0ecb1b96776c911b1fc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 903 is the named party.
Information printed on this record:
interest payer: Example Entity 9-3-0
ordinary dividends: USD 11,482.00
foreign accounts: USD 11,482.00",SCHEDULE,34,SCHEDULE,fdc-db619aa8fd4131d95747424e,synthetic-form-layout-09,original,2023,fte-f0c95a3d514f89d885ae1d23,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 904 is the named party.
Information printed on this record:
interest payer: Example Entity 9-4-0
ordinary dividends: USD 11,565.00
foreign accounts: USD 11,565.00",SCHEDULE,34,SCHEDULE,fdc-c84f922c8a371e5230b57c0a,synthetic-form-layout-09,original,2024,fte-99736df7f2f6c6f2d56035f3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 905 is the named party.
Information printed on this record:
interest payer: Example Entity 9-5-0
ordinary dividends: USD 11,648.00
foreign accounts: USD 11,648.00",SCHEDULE,34,SCHEDULE,fdc-7bd98cf7503daf34080c8fd5,synthetic-form-layout-09,original,2025,fte-7921cd3e494cd33335b05579,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 906 is the named party.
Information printed on this record:
interest payer: Example Entity 9-6-0
ordinary dividends: USD 11,731.00
foreign accounts: USD 11,731.00",SCHEDULE,34,SCHEDULE,fdc-155dd1f3829af48b83cd502e,synthetic-form-layout-09,original,2023,fte-e01ba9a37abcd60b85f3510c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-B: Schedule B Interest and Ordinary Dividends
Example Client 907 is the named party.
Information printed on this record:
interest payer: Example Entity 9-7-0
ordinary dividends: USD 11,814.00
foreign accounts: USD 11,814.00",SCHEDULE,34,SCHEDULE,fdc-84df06a30200e6450913bfc1,synthetic-form-layout-09,original,2024,fte-73dd174bf42ab67c0b5d359a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: business name: Example Entity 8-0-0; gross receipts: USD 11,096.00; expenses: USD 11,096.00; net profit: USD 11,096.00",SCHEDULE,34,SCHEDULE,fdc-5417a302655134d2d785bdd3,synthetic-form-layout-08,original,2023,fte-39f7951a31df485d8eec8331,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: business name: Example Entity 8-1-0; gross receipts: USD 11,179.00; expenses: USD 11,179.00; net profit: USD 11,179.00",SCHEDULE,34,SCHEDULE,fdc-a4e78da91fcaa1dc58f41e8c,synthetic-form-layout-08,original,2024,fte-b93d574f5192712fcd4e1ff4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: business name: Example Entity 8-2-0; gross receipts: USD 11,262.00; expenses: USD 11,262.00; net profit: USD 11,262.00",SCHEDULE,34,SCHEDULE,fdc-c3e84c6dae9b4b4009f2fc9b,synthetic-form-layout-08,original,2025,fte-cebbdea17a0225fc1ef34b77,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: business name: Example Entity 8-3-0; gross receipts: USD 11,345.00; expenses: USD 11,345.00; net profit: USD 11,345.00",SCHEDULE,34,SCHEDULE,fdc-2aa12808e024da434bd5e5b4,synthetic-form-layout-08,original,2023,fte-c65483883f45e7fc26952f87,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: business name: Example Entity 8-4-0; gross receipts: USD 11,428.00; expenses: USD 11,428.00; net profit: USD 11,428.00",SCHEDULE,34,SCHEDULE,fdc-0df97dc08af2e95a71cb92a5,synthetic-form-layout-08,original,2024,fte-c80747c9b47ebc0f83650ba0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: business name: Example Entity 8-5-0; gross receipts: USD 11,511.00; expenses: USD 11,511.00; net profit: USD 11,511.00",SCHEDULE,34,SCHEDULE,fdc-ff5df236ee9a729e2af3045d,synthetic-form-layout-08,original,2025,fte-cfed1a4fada41ce932263792,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: business name: Example Entity 8-6-0; gross receipts: USD 11,594.00; expenses: USD 11,594.00; net profit: USD 11,594.00",SCHEDULE,34,SCHEDULE,fdc-b9a7c430e705267fe3a38008,synthetic-form-layout-08,original,2023,fte-999ee9d56a55f367b24cb3d1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-C: Schedule C Profit or Loss From Business
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: business name: Example Entity 8-7-0; gross receipts: USD 11,677.00; expenses: USD 11,677.00; net profit: USD 11,677.00",SCHEDULE,34,SCHEDULE,fdc-955add435b9e033fd55d302c,synthetic-form-layout-08,original,2024,fte-467c790f747e7258a18e3532,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 900 is the named party.
Information printed on this record:
business name: Example Entity 9-0-0
gross receipts: USD 11,233.00
expenses: USD 11,233.00
net profit: USD 11,233.00",SCHEDULE,34,SCHEDULE,fdc-ec1585eae5f3481cb67cb337,synthetic-form-layout-09,original,2023,fte-d482d9266d8cc6e0ff8b8ec7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 901 is the named party.
Information printed on this record:
business name: Example Entity 9-1-0
gross receipts: USD 11,316.00
expenses: USD 11,316.00
net profit: USD 11,316.00",SCHEDULE,34,SCHEDULE,fdc-5369486ed12dd40d45d2e792,synthetic-form-layout-09,original,2024,fte-a26c99b7188dec2eeec84ff5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 902 is the named party.
Information printed on this record:
business name: Example Entity 9-2-0
gross receipts: USD 11,399.00
expenses: USD 11,399.00
net profit: USD 11,399.00",SCHEDULE,34,SCHEDULE,fdc-aa0b6b9751495d8a5191d256,synthetic-form-layout-09,original,2025,fte-de88781e75b2eed1072dcdd4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 903 is the named party.
Information printed on this record:
business name: Example Entity 9-3-0
gross receipts: USD 11,482.00
expenses: USD 11,482.00
net profit: USD 11,482.00",SCHEDULE,34,SCHEDULE,fdc-402da8a4fdaba220c6b5cf78,synthetic-form-layout-09,original,2023,fte-fd71161ca4f7bfb8dd9da278,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 904 is the named party.
Information printed on this record:
business name: Example Entity 9-4-0
gross receipts: USD 11,565.00
expenses: USD 11,565.00
net profit: USD 11,565.00",SCHEDULE,34,SCHEDULE,fdc-b51e99b28a57107cebfd1c5b,synthetic-form-layout-09,original,2024,fte-fafd4d87302edf17a8c347f4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 905 is the named party.
Information printed on this record:
business name: Example Entity 9-5-0
gross receipts: USD 11,648.00
expenses: USD 11,648.00
net profit: USD 11,648.00",SCHEDULE,34,SCHEDULE,fdc-309115773ebf6522891f1706,synthetic-form-layout-09,original,2025,fte-bca56bd7c955ef65d5917d7e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 906 is the named party.
Information printed on this record:
business name: Example Entity 9-6-0
gross receipts: USD 11,731.00
expenses: USD 11,731.00
net profit: USD 11,731.00",SCHEDULE,34,SCHEDULE,fdc-820cfaac8ee7d723050a0971,synthetic-form-layout-09,original,2023,fte-b8b09dd71e80c3ac9829d75e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-C: Schedule C Profit or Loss From Business
Example Client 907 is the named party.
Information printed on this record:
business name: Example Entity 9-7-0
gross receipts: USD 11,814.00
expenses: USD 11,814.00
net profit: USD 11,814.00",SCHEDULE,34,SCHEDULE,fdc-606b607a9dff25236db9e407,synthetic-form-layout-09,original,2024,fte-4a7eca75f3a81917dd76e925,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: short term gains: USD 11,096.00; long term gains: USD 11,096.00; carryover: USD 11,096.00",SCHEDULE,34,SCHEDULE,fdc-2ea7f28b028346732c495aac,synthetic-form-layout-08,original,2023,fte-1b53c850510aef2271933358,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: short term gains: USD 11,179.00; long term gains: USD 11,179.00; carryover: USD 11,179.00",SCHEDULE,34,SCHEDULE,fdc-f87d0920e0c0e8a6fdcb0ecf,synthetic-form-layout-08,original,2024,fte-fbdbc2a95b6a29f1487c307b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: short term gains: USD 11,262.00; long term gains: USD 11,262.00; carryover: USD 11,262.00",SCHEDULE,34,SCHEDULE,fdc-30c8ee8f2df445b6bc91c000,synthetic-form-layout-08,original,2025,fte-32fc6253b3ebc189dfbd7605,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: short term gains: USD 11,345.00; long term gains: USD 11,345.00; carryover: USD 11,345.00",SCHEDULE,34,SCHEDULE,fdc-c921523663224d8ead0e2d49,synthetic-form-layout-08,original,2023,fte-cd7e0d2606632945e0f24777,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: short term gains: USD 11,428.00; long term gains: USD 11,428.00; carryover: USD 11,428.00",SCHEDULE,34,SCHEDULE,fdc-b621785f1461f85dc11370c2,synthetic-form-layout-08,original,2024,fte-72f5a4c0c07e98e7df7aab76,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: short term gains: USD 11,511.00; long term gains: USD 11,511.00; carryover: USD 11,511.00",SCHEDULE,34,SCHEDULE,fdc-df9cd8f31b3c51a0babd5f9d,synthetic-form-layout-08,original,2025,fte-a82028e3e96017940d4a04e4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: short term gains: USD 11,594.00; long term gains: USD 11,594.00; carryover: USD 11,594.00",SCHEDULE,34,SCHEDULE,fdc-b9b87f6c47f9ea0a9c470d35,synthetic-form-layout-08,original,2023,fte-2fbf4c9cfc643cb977bf4341,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-D: Schedule D Capital Gains and Losses
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: short term gains: USD 11,677.00; long term gains: USD 11,677.00; carryover: USD 11,677.00",SCHEDULE,34,SCHEDULE,fdc-735456eff0a9fe3c5a52b3a5,synthetic-form-layout-08,original,2024,fte-4098da0ecb8369ad0e8ed3dc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 900 is the named party.
Information printed on this record:
short term gains: USD 11,233.00
long term gains: USD 11,233.00
carryover: USD 11,233.00",SCHEDULE,34,SCHEDULE,fdc-dc8bd31b912b53a084a47160,synthetic-form-layout-09,original,2023,fte-2f00c69091a4ed5077045b25,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 901 is the named party.
Information printed on this record:
short term gains: USD 11,316.00
long term gains: USD 11,316.00
carryover: USD 11,316.00",SCHEDULE,34,SCHEDULE,fdc-05d57777f25321026e516748,synthetic-form-layout-09,original,2024,fte-38c933ec04800be584cf35cd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 902 is the named party.
Information printed on this record:
short term gains: USD 11,399.00
long term gains: USD 11,399.00
carryover: USD 11,399.00",SCHEDULE,34,SCHEDULE,fdc-982ffdebad651db9c0602df0,synthetic-form-layout-09,original,2025,fte-bbd49ab7940def54053a9fc9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 903 is the named party.
Information printed on this record:
short term gains: USD 11,482.00
long term gains: USD 11,482.00
carryover: USD 11,482.00",SCHEDULE,34,SCHEDULE,fdc-ddb728922f2d294cca6ed751,synthetic-form-layout-09,original,2023,fte-df38e640375bbace259c7cab,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 904 is the named party.
Information printed on this record:
short term gains: USD 11,565.00
long term gains: USD 11,565.00
carryover: USD 11,565.00",SCHEDULE,34,SCHEDULE,fdc-7316ae8340c6bde8d7740f3d,synthetic-form-layout-09,original,2024,fte-07b3f42e44ac9682f06a4df1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 905 is the named party.
Information printed on this record:
short term gains: USD 11,648.00
long term gains: USD 11,648.00
carryover: USD 11,648.00",SCHEDULE,34,SCHEDULE,fdc-5fca64662c2c5e3caf83f55c,synthetic-form-layout-09,original,2025,fte-020b863657459c263885a690,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 906 is the named party.
Information printed on this record:
short term gains: USD 11,731.00
long term gains: USD 11,731.00
carryover: USD 11,731.00",SCHEDULE,34,SCHEDULE,fdc-b23478e044f62d0303b26799,synthetic-form-layout-09,original,2023,fte-37301532203a2e004b99bbab,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-D: Schedule D Capital Gains and Losses
Example Client 907 is the named party.
Information printed on this record:
short term gains: USD 11,814.00
long term gains: USD 11,814.00
carryover: USD 11,814.00",SCHEDULE,34,SCHEDULE,fdc-c08978fd69b61289aec8c739,synthetic-form-layout-09,original,2024,fte-983c3c40d1cf30887966df4b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: rental property: Example Entity 8-0-0; royalties: USD 11,096.00; partnerships: Example Entity 8-0-2; income: USD 11,096.00; expenses: USD 11,096.00",SCHEDULE,34,SCHEDULE,fdc-6dd5ea36d9d7304c2aa3abfe,synthetic-form-layout-08,original,2023,fte-4dd97ab3ac532effc293f2f1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: rental property: Example Entity 8-1-0; royalties: USD 11,179.00; partnerships: Example Entity 8-1-2; income: USD 11,179.00; expenses: USD 11,179.00",SCHEDULE,34,SCHEDULE,fdc-4aad47e799904d4842c6a7d2,synthetic-form-layout-08,original,2024,fte-1bb783ecd9bb348d3e5ae87f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: rental property: Example Entity 8-2-0; royalties: USD 11,262.00; partnerships: Example Entity 8-2-2; income: USD 11,262.00; expenses: USD 11,262.00",SCHEDULE,34,SCHEDULE,fdc-2668cf8507989a8c309db544,synthetic-form-layout-08,original,2025,fte-c2af9c9bd5b9ab3cab0b7417,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: rental property: Example Entity 8-3-0; royalties: USD 11,345.00; partnerships: Example Entity 8-3-2; income: USD 11,345.00; expenses: USD 11,345.00",SCHEDULE,34,SCHEDULE,fdc-6ff677b95dab9e3869d45b13,synthetic-form-layout-08,original,2023,fte-9542cf76ef6ff5d658bbab02,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: rental property: Example Entity 8-4-0; royalties: USD 11,428.00; partnerships: Example Entity 8-4-2; income: USD 11,428.00; expenses: USD 11,428.00",SCHEDULE,34,SCHEDULE,fdc-cb07511aa49699a2a5620768,synthetic-form-layout-08,original,2024,fte-0b9f16b926a94272983f07d5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: rental property: Example Entity 8-5-0; royalties: USD 11,511.00; partnerships: Example Entity 8-5-2; income: USD 11,511.00; expenses: USD 11,511.00",SCHEDULE,34,SCHEDULE,fdc-bcdd7a572891defcfd3439cb,synthetic-form-layout-08,original,2025,fte-d3f481dbd65c6c3c522e298e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: rental property: Example Entity 8-6-0; royalties: USD 11,594.00; partnerships: Example Entity 8-6-2; income: USD 11,594.00; expenses: USD 11,594.00",SCHEDULE,34,SCHEDULE,fdc-c5987ed815b7be315fd0e377,synthetic-form-layout-08,original,2023,fte-1c5c0205d46d5f16d8563a37,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-E: Schedule E Supplemental Income and Loss
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: rental property: Example Entity 8-7-0; royalties: USD 11,677.00; partnerships: Example Entity 8-7-2; income: USD 11,677.00; expenses: USD 11,677.00",SCHEDULE,34,SCHEDULE,fdc-add045494aa2c4e7c840bd2a,synthetic-form-layout-08,original,2024,fte-fae0ba93962dcda7fe51f53b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 900 is the named party.
Information printed on this record:
rental property: Example Entity 9-0-0
royalties: USD 11,233.00
partnerships: Example Entity 9-0-2
income: USD 11,233.00
expenses: USD 11,233.00",SCHEDULE,34,SCHEDULE,fdc-a4a848afce3e2af1b05fe578,synthetic-form-layout-09,original,2023,fte-9870fa85529ca656600cd266,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 901 is the named party.
Information printed on this record:
rental property: Example Entity 9-1-0
royalties: USD 11,316.00
partnerships: Example Entity 9-1-2
income: USD 11,316.00
expenses: USD 11,316.00",SCHEDULE,34,SCHEDULE,fdc-80d7c445c68534ab721cf3cd,synthetic-form-layout-09,original,2024,fte-92ca2eedcaba894f67ca10d2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 902 is the named party.
Information printed on this record:
rental property: Example Entity 9-2-0
royalties: USD 11,399.00
partnerships: Example Entity 9-2-2
income: USD 11,399.00
expenses: USD 11,399.00",SCHEDULE,34,SCHEDULE,fdc-6a707f3f5ae95b4859183ce9,synthetic-form-layout-09,original,2025,fte-586efb9735f5dd5346e6be42,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 903 is the named party.
Information printed on this record:
rental property: Example Entity 9-3-0
royalties: USD 11,482.00
partnerships: Example Entity 9-3-2
income: USD 11,482.00
expenses: USD 11,482.00",SCHEDULE,34,SCHEDULE,fdc-4529b1792680ebd44b17941c,synthetic-form-layout-09,original,2023,fte-eade399106c99718b0f2f03d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 904 is the named party.
Information printed on this record:
rental property: Example Entity 9-4-0
royalties: USD 11,565.00
partnerships: Example Entity 9-4-2
income: USD 11,565.00
expenses: USD 11,565.00",SCHEDULE,34,SCHEDULE,fdc-998f7be9606c524c6be1504b,synthetic-form-layout-09,original,2024,fte-37bd5a4d3514dd1d77e53aac,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 905 is the named party.
Information printed on this record:
rental property: Example Entity 9-5-0
royalties: USD 11,648.00
partnerships: Example Entity 9-5-2
income: USD 11,648.00
expenses: USD 11,648.00",SCHEDULE,34,SCHEDULE,fdc-a865b6845a934a94271fa6f1,synthetic-form-layout-09,original,2025,fte-eb88a0b2a067abe8c788f115,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 906 is the named party.
Information printed on this record:
rental property: Example Entity 9-6-0
royalties: USD 11,731.00
partnerships: Example Entity 9-6-2
income: USD 11,731.00
expenses: USD 11,731.00",SCHEDULE,34,SCHEDULE,fdc-cfe82e16fe32a45f785c1fc9,synthetic-form-layout-09,original,2023,fte-9cdb928a9b5417ade417136d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-E: Schedule E Supplemental Income and Loss
Example Client 907 is the named party.
Information printed on this record:
rental property: Example Entity 9-7-0
royalties: USD 11,814.00
partnerships: Example Entity 9-7-2
income: USD 11,814.00
expenses: USD 11,814.00",SCHEDULE,34,SCHEDULE,fdc-74a0099da26b4e936be25f32,synthetic-form-layout-09,original,2024,fte-1cdb30d31bdd89222c454d4a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: farm income: USD 11,096.00; farm expenses: USD 11,096.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-8823f2d16119f71de0d06b67,synthetic-form-layout-08,original,2023,fte-972c31944536d1908f206b5f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: farm income: USD 11,179.00; farm expenses: USD 11,179.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-3f4bc93dcdf6f1ad84daab8a,synthetic-form-layout-08,original,2024,fte-e32a12aef5f9f6b8eeb48541,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: farm income: USD 11,262.00; farm expenses: USD 11,262.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-7ac09a2c06832f8af41aea4f,synthetic-form-layout-08,original,2025,fte-12e40f4f710fb82049358945,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: farm income: USD 11,345.00; farm expenses: USD 11,345.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-d931c793a292b92a7827680c,synthetic-form-layout-08,original,2023,fte-4ad7c0426c8b986956f0b749,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: farm income: USD 11,428.00; farm expenses: USD 11,428.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-e2aa80d946de14c99b73b79c,synthetic-form-layout-08,original,2024,fte-aac9b2977293e527df78b9d8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: farm income: USD 11,511.00; farm expenses: USD 11,511.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-377d8fc70e2b4fb808efec89,synthetic-form-layout-08,original,2025,fte-3daa6e7da5b9ed23d9b39a70,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: farm income: USD 11,594.00; farm expenses: USD 11,594.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-765f230b2a34de679acd4887,synthetic-form-layout-08,original,2023,fte-6e4dc939f839b2dde54e4803,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-F: Schedule F Profit or Loss From Farming
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: farm income: USD 11,677.00; farm expenses: USD 11,677.00; accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-5234ae4fe8e19e9189f08a1a,synthetic-form-layout-08,original,2024,fte-ae1d0cda5cb33a5b29cb306e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 900 is the named party.
Information printed on this record:
farm income: USD 11,233.00
farm expenses: USD 11,233.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-43bfb958fd6fa846c485c2fd,synthetic-form-layout-09,original,2023,fte-aa90290716b5713ab1628689,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 901 is the named party.
Information printed on this record:
farm income: USD 11,316.00
farm expenses: USD 11,316.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-3be3ade8b357290cc710cead,synthetic-form-layout-09,original,2024,fte-653e5f6a8411d73dbdd57017,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 902 is the named party.
Information printed on this record:
farm income: USD 11,399.00
farm expenses: USD 11,399.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-efeff58774de4188c3c98c4e,synthetic-form-layout-09,original,2025,fte-a2a07586aea3451655f1612b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 903 is the named party.
Information printed on this record:
farm income: USD 11,482.00
farm expenses: USD 11,482.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-a54fea83021c8b4b11f54abd,synthetic-form-layout-09,original,2023,fte-6c92219291fca9801bb24b66,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 904 is the named party.
Information printed on this record:
farm income: USD 11,565.00
farm expenses: USD 11,565.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-e99a69262f6428563a85e7bc,synthetic-form-layout-09,original,2024,fte-ff4a1f5eacc9c46473c086d3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 905 is the named party.
Information printed on this record:
farm income: USD 11,648.00
farm expenses: USD 11,648.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-fef26b8980366030a8f01afd,synthetic-form-layout-09,original,2025,fte-b3d960beebaa224384f30bde,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 906 is the named party.
Information printed on this record:
farm income: USD 11,731.00
farm expenses: USD 11,731.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-41d50702602e74dd0fcfa639,synthetic-form-layout-09,original,2023,fte-b052298966aa902c04541eea,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-F: Schedule F Profit or Loss From Farming
Example Client 907 is the named party.
Information printed on this record:
farm income: USD 11,814.00
farm expenses: USD 11,814.00
accounting method: Cash method",SCHEDULE,34,SCHEDULE,fdc-420a641a3102f40fffec2fc7,synthetic-form-layout-09,original,2024,fte-fa5e2c8d5dc0240d9edb174e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: net earnings: USD 11,096.00; self employment tax: USD 11,096.00; adjustment: USD 11,096.00",SCHEDULE,34,SCHEDULE,fdc-6a77801acfa736dd2dc87694,synthetic-form-layout-08,original,2023,fte-1dbede87ebd9ba17305cf501,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: net earnings: USD 11,179.00; self employment tax: USD 11,179.00; adjustment: USD 11,179.00",SCHEDULE,34,SCHEDULE,fdc-f21e6588da0b69af1e9946cb,synthetic-form-layout-08,original,2024,fte-47f2e361f438cd8a3ec5cd7a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: net earnings: USD 11,262.00; self employment tax: USD 11,262.00; adjustment: USD 11,262.00",SCHEDULE,34,SCHEDULE,fdc-3ee3a58cad0d0d111b5ed9d6,synthetic-form-layout-08,original,2025,fte-d740c815b4587f5b5ae3e6ea,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: net earnings: USD 11,345.00; self employment tax: USD 11,345.00; adjustment: USD 11,345.00",SCHEDULE,34,SCHEDULE,fdc-f77b1e8f52fee673a1972c2b,synthetic-form-layout-08,original,2023,fte-9b561814360d1e86266e26a8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: net earnings: USD 11,428.00; self employment tax: USD 11,428.00; adjustment: USD 11,428.00",SCHEDULE,34,SCHEDULE,fdc-5d4a6bc3f0d0b45efd99c73d,synthetic-form-layout-08,original,2024,fte-749cdff4be0ed74f0a1532cd,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: net earnings: USD 11,511.00; self employment tax: USD 11,511.00; adjustment: USD 11,511.00",SCHEDULE,34,SCHEDULE,fdc-b571ba966205e5af228c78b8,synthetic-form-layout-08,original,2025,fte-4a01539c50d14468ea1fa6c2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: net earnings: USD 11,594.00; self employment tax: USD 11,594.00; adjustment: USD 11,594.00",SCHEDULE,34,SCHEDULE,fdc-9312bcc32007eccb7af90123,synthetic-form-layout-08,original,2023,fte-b833691fd08b6080bff08ee6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Schedule-SE: Schedule SE Self-Employment Tax
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: net earnings: USD 11,677.00; self employment tax: USD 11,677.00; adjustment: USD 11,677.00",SCHEDULE,34,SCHEDULE,fdc-58c909e990c9c7c1d6703684,synthetic-form-layout-08,original,2024,fte-45f33b177c2a947ba39b5b6f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 900 is the named party.
Information printed on this record:
net earnings: USD 11,233.00
self employment tax: USD 11,233.00
adjustment: USD 11,233.00",SCHEDULE,34,SCHEDULE,fdc-a68a554b1c7634c33883e481,synthetic-form-layout-09,original,2023,fte-b8bcb0f75da8bbd64ec5250a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 901 is the named party.
Information printed on this record:
net earnings: USD 11,316.00
self employment tax: USD 11,316.00
adjustment: USD 11,316.00",SCHEDULE,34,SCHEDULE,fdc-b90b173540fe6c13b825adca,synthetic-form-layout-09,original,2024,fte-e4173cee6defbf1dd95c9c9d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 902 is the named party.
Information printed on this record:
net earnings: USD 11,399.00
self employment tax: USD 11,399.00
adjustment: USD 11,399.00",SCHEDULE,34,SCHEDULE,fdc-5937d12f704183844fa9f3bb,synthetic-form-layout-09,original,2025,fte-4e4106a28c612f0afdb8bcfc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 903 is the named party.
Information printed on this record:
net earnings: USD 11,482.00
self employment tax: USD 11,482.00
adjustment: USD 11,482.00",SCHEDULE,34,SCHEDULE,fdc-9eec8d9bbb68316afb8fd127,synthetic-form-layout-09,original,2023,fte-12536ea251c040801442aa5c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 904 is the named party.
Information printed on this record:
net earnings: USD 11,565.00
self employment tax: USD 11,565.00
adjustment: USD 11,565.00",SCHEDULE,34,SCHEDULE,fdc-c4b6524409ad8e7c5f8a3895,synthetic-form-layout-09,original,2024,fte-6763aa271baf6d9a1ab82fde,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 905 is the named party.
Information printed on this record:
net earnings: USD 11,648.00
self employment tax: USD 11,648.00
adjustment: USD 11,648.00",SCHEDULE,34,SCHEDULE,fdc-509fc0152d232721d5d393ce,synthetic-form-layout-09,original,2025,fte-f2ea5133b66d9e45d88c82b5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 906 is the named party.
Information printed on this record:
net earnings: USD 11,731.00
self employment tax: USD 11,731.00
adjustment: USD 11,731.00",SCHEDULE,34,SCHEDULE,fdc-90c3a01fdfc8af69c96cbb85,synthetic-form-layout-09,original,2023,fte-22f64d55b4a19aeed18bb716,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Schedule-SE: Schedule SE Self-Employment Tax
Example Client 907 is the named party.
Information printed on this record:
net earnings: USD 11,814.00
self employment tax: USD 11,814.00
adjustment: USD 11,814.00",SCHEDULE,34,SCHEDULE,fdc-f5a947d918c075b62295ca8e,synthetic-form-layout-09,original,2024,fte-5bf33e31aced8696214d5269,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: name: Example Entity 8-0-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-0-2; certification: Example named signer; signed",W-9,41,W-9,fdc-b4a4ee0b26ea580c7f346d3c,synthetic-form-layout-08,original,2023,fte-e774bde860b762e34bb35daf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: name: Example Entity 8-1-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-1-2; certification: Example named signer; signed",W-9,41,W-9,fdc-8908e93d49968085f27a0b65,synthetic-form-layout-08,original,2024,fte-5639759b041d3e8a36cdc76c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: name: Example Entity 8-2-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-2-2; certification: Example named signer; signed",W-9,41,W-9,fdc-a6a7a28e269bd748e9bd55f5,synthetic-form-layout-08,original,2025,fte-4a012ae10b79c34cdd5e9517,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: name: Example Entity 8-3-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-3-2; certification: Example named signer; signed",W-9,41,W-9,fdc-849f49eb34d9760abfd56a31,synthetic-form-layout-08,original,2023,fte-84b02f624c9e2b762e8cfc2d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: name: Example Entity 8-4-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-4-2; certification: Example named signer; signed",W-9,41,W-9,fdc-ba9eee9482a5002e056760a6,synthetic-form-layout-08,original,2024,fte-8f2761df670654edd361d142,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: name: Example Entity 8-5-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-5-2; certification: Example named signer; signed",W-9,41,W-9,fdc-38e7d3f525303b17727d76ff,synthetic-form-layout-08,original,2025,fte-a6b3ec237327b4b192c4088d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: name: Example Entity 8-6-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-6-2; certification: Example named signer; signed",W-9,41,W-9,fdc-4a1e69c53db92b5b69d80d92,synthetic-form-layout-08,original,2023,fte-fffa6795c95a1bfd4e48fd90,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-9: Request for Taxpayer Identification Number and Certification
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: name: Example Entity 8-7-0; tax classification: Individual or sole proprietor; taxpayer identification number: Example Entity 8-7-2; certification: Example named signer; signed",W-9,41,W-9,fdc-8501e7410ae36f00625ce351,synthetic-form-layout-08,original,2024,fte-f19815d366a581389c7815e8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 900 is the named party.
Information printed on this record:
name: Example Entity 9-0-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-0-2
certification: Example named signer; signed",W-9,41,W-9,fdc-d3ea7cb0ea4a6a1359c90fd6,synthetic-form-layout-09,original,2023,fte-04eb3e0d005b1f314dbe07fa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 901 is the named party.
Information printed on this record:
name: Example Entity 9-1-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-1-2
certification: Example named signer; signed",W-9,41,W-9,fdc-ceb09c1e53e3b31df9fe63e2,synthetic-form-layout-09,original,2024,fte-47e155b0727171fd1ffb2c7c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 902 is the named party.
Information printed on this record:
name: Example Entity 9-2-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-2-2
certification: Example named signer; signed",W-9,41,W-9,fdc-3c34160aab2df0ebcb54c34d,synthetic-form-layout-09,original,2025,fte-09337896398e9b8926f9c017,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 903 is the named party.
Information printed on this record:
name: Example Entity 9-3-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-3-2
certification: Example named signer; signed",W-9,41,W-9,fdc-dcf4e734e7aee856cc5936a7,synthetic-form-layout-09,original,2023,fte-2aa511a8bd5e410d2089271c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 904 is the named party.
Information printed on this record:
name: Example Entity 9-4-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-4-2
certification: Example named signer; signed",W-9,41,W-9,fdc-6fe2177c3e387b0c2603dce7,synthetic-form-layout-09,original,2024,fte-23b0a364c4598c69d0dca092,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 905 is the named party.
Information printed on this record:
name: Example Entity 9-5-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-5-2
certification: Example named signer; signed",W-9,41,W-9,fdc-2f62d13268dae01f7f364788,synthetic-form-layout-09,original,2025,fte-06a61c425a0816c25481a1e4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 906 is the named party.
Information printed on this record:
name: Example Entity 9-6-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-6-2
certification: Example named signer; signed",W-9,41,W-9,fdc-b6bc308bb05fc041dc931b83,synthetic-form-layout-09,original,2023,fte-c8f8902a732d267060d9995c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-9: Request for Taxpayer Identification Number and Certification
Example Client 907 is the named party.
Information printed on this record:
name: Example Entity 9-7-0
tax classification: Individual or sole proprietor
taxpayer identification number: Example Entity 9-7-2
certification: Example named signer; signed",W-9,41,W-9,fdc-6816cd87b2c31c13aee90f77,synthetic-form-layout-09,original,2024,fte-d4b6d402976304833e05543b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: filing status: Single; dependents: USD 11,096.00; other adjustments: USD 11,096.00; signature: Example named signer; signed",W-4,40,W-4,fdc-27c9fe5384d932cf3ae0a9f5,synthetic-form-layout-08,original,2023,fte-385d160a66e80a51c2635c13,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: filing status: Single; dependents: USD 11,179.00; other adjustments: USD 11,179.00; signature: Example named signer; signed",W-4,40,W-4,fdc-2820d538824b25e0abf46493,synthetic-form-layout-08,original,2024,fte-abe53cc29c38c3eb42c9220b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: filing status: Single; dependents: USD 11,262.00; other adjustments: USD 11,262.00; signature: Example named signer; signed",W-4,40,W-4,fdc-cffcda54d889cf30af64ceb8,synthetic-form-layout-08,original,2025,fte-bf6bf539ab5ec7c1b9661851,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: filing status: Single; dependents: USD 11,345.00; other adjustments: USD 11,345.00; signature: Example named signer; signed",W-4,40,W-4,fdc-e303e9b60581f25633ed563a,synthetic-form-layout-08,original,2023,fte-e8690e3b6ca88ece27652e29,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: filing status: Single; dependents: USD 11,428.00; other adjustments: USD 11,428.00; signature: Example named signer; signed",W-4,40,W-4,fdc-10702d3331e3420dbf3c0e0a,synthetic-form-layout-08,original,2024,fte-af3e66c6f67a6c89068c1284,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: filing status: Single; dependents: USD 11,511.00; other adjustments: USD 11,511.00; signature: Example named signer; signed",W-4,40,W-4,fdc-0fb9bc30fa1e520197a58886,synthetic-form-layout-08,original,2025,fte-209c62f8a94ad61d821057f5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: filing status: Single; dependents: USD 11,594.00; other adjustments: USD 11,594.00; signature: Example named signer; signed",W-4,40,W-4,fdc-d205b15c2339ae716f007f07,synthetic-form-layout-08,original,2023,fte-204a68471580db1bc1f6599d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form W-4: Employee Withholding Certificate
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: filing status: Single; dependents: USD 11,677.00; other adjustments: USD 11,677.00; signature: Example named signer; signed",W-4,40,W-4,fdc-651f5724caaeb9513d5a6640,synthetic-form-layout-08,original,2024,fte-e5974ce1501469bcfce7ed1c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-4: Employee Withholding Certificate
Example Client 900 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,233.00
other adjustments: USD 11,233.00
signature: Example named signer; signed",W-4,40,W-4,fdc-caff072068c6e3049c1b3c67,synthetic-form-layout-09,original,2023,fte-7916a11f11dd8a94d1b13331,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-4: Employee Withholding Certificate
Example Client 901 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,316.00
other adjustments: USD 11,316.00
signature: Example named signer; signed",W-4,40,W-4,fdc-a2f6a6c9b5a254fdd77e7b42,synthetic-form-layout-09,original,2024,fte-dab55ed1ae5dfc0cf289a6e2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-4: Employee Withholding Certificate
Example Client 902 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,399.00
other adjustments: USD 11,399.00
signature: Example named signer; signed",W-4,40,W-4,fdc-e95aa9d77e25a8cd2cc8ae76,synthetic-form-layout-09,original,2025,fte-636f234c3cefdf491065adb5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-4: Employee Withholding Certificate
Example Client 903 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,482.00
other adjustments: USD 11,482.00
signature: Example named signer; signed",W-4,40,W-4,fdc-2dda04bef2a0ec63816e130d,synthetic-form-layout-09,original,2023,fte-55bdb3f818356ffbbb1e14cd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-4: Employee Withholding Certificate
Example Client 904 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,565.00
other adjustments: USD 11,565.00
signature: Example named signer; signed",W-4,40,W-4,fdc-885781c7d97f3dfbfb178211,synthetic-form-layout-09,original,2024,fte-edba583d63b83107489ffbaf,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form W-4: Employee Withholding Certificate
Example Client 905 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,648.00
other adjustments: USD 11,648.00
signature: Example named signer; signed",W-4,40,W-4,fdc-cd2df7861096f961e892a1f6,synthetic-form-layout-09,original,2025,fte-b83259b14dd7a06741bc06d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form W-4: Employee Withholding Certificate
Example Client 906 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,731.00
other adjustments: USD 11,731.00
signature: Example named signer; signed",W-4,40,W-4,fdc-c4e3347950df3dfc43ac8ae4,synthetic-form-layout-09,original,2023,fte-45150da8f13b2f2669107930,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form W-4: Employee Withholding Certificate
Example Client 907 is the named party.
Information printed on this record:
filing status: Single
dependents: USD 11,814.00
other adjustments: USD 11,814.00
signature: Example named signer; signed",W-4,40,W-4,fdc-df4a96ac0a1f0d8377c4bcfb,synthetic-form-layout-09,original,2024,fte-bd8d36b13e38fce7b4799976,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: taxpayer: Example Entity 8-0-0; return transcript: USD 11,096.00; tax year: 2023; signature: Example named signer; signed",4506-T,12,4506-T,fdc-fca9cf339489055a90afca88,synthetic-form-layout-08,original,2023,fte-26d530d45251c4c972dbff99,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: taxpayer: Example Entity 8-1-0; return transcript: USD 11,179.00; tax year: 2024; signature: Example named signer; signed",4506-T,12,4506-T,fdc-10c01d0d0290746c662cc2f9,synthetic-form-layout-08,original,2024,fte-5217f49605e094cdeec0979c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: taxpayer: Example Entity 8-2-0; return transcript: USD 11,262.00; tax year: 2025; signature: Example named signer; signed",4506-T,12,4506-T,fdc-55c53cd116c9c8596cb368e3,synthetic-form-layout-08,original,2025,fte-413224f93f0684c08898c12d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: taxpayer: Example Entity 8-3-0; return transcript: USD 11,345.00; tax year: 2023; signature: Example named signer; signed",4506-T,12,4506-T,fdc-8563e4c719a405d871a52218,synthetic-form-layout-08,original,2023,fte-3c98f0c3cf2f84cc9b1d538d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: taxpayer: Example Entity 8-4-0; return transcript: USD 11,428.00; tax year: 2024; signature: Example named signer; signed",4506-T,12,4506-T,fdc-6873f11a54ce42df6ccb0adf,synthetic-form-layout-08,original,2024,fte-7daf0e22c608c61ea04306c6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: taxpayer: Example Entity 8-5-0; return transcript: USD 11,511.00; tax year: 2025; signature: Example named signer; signed",4506-T,12,4506-T,fdc-da18236ebe99145a1c905699,synthetic-form-layout-08,original,2025,fte-8d88a83870e6c9883991212a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: taxpayer: Example Entity 8-6-0; return transcript: USD 11,594.00; tax year: 2023; signature: Example named signer; signed",4506-T,12,4506-T,fdc-d91643087dfb1ec85fa2c5a5,synthetic-form-layout-08,original,2023,fte-744c7a27c295e0e98070f970,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 4506-T: Request for Transcript of Tax Return
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: taxpayer: Example Entity 8-7-0; return transcript: USD 11,677.00; tax year: 2024; signature: Example named signer; signed",4506-T,12,4506-T,fdc-92bb19e976c8b0f2f461d3aa,synthetic-form-layout-08,original,2024,fte-7b44cabfdc0c8cf06b19a529,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 900 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-0-0
return transcript: USD 11,233.00
tax year: 2023
signature: Example named signer; signed",4506-T,12,4506-T,fdc-200fdc56ca78e835acafa32f,synthetic-form-layout-09,original,2023,fte-7805e541d74c8960b86ec784,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 901 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-1-0
return transcript: USD 11,316.00
tax year: 2024
signature: Example named signer; signed",4506-T,12,4506-T,fdc-2b3f887ff0b279e45ef66ace,synthetic-form-layout-09,original,2024,fte-ec467f5673697970f142cbfd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 902 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-2-0
return transcript: USD 11,399.00
tax year: 2025
signature: Example named signer; signed",4506-T,12,4506-T,fdc-e5a94afc085e7d94dfa36c43,synthetic-form-layout-09,original,2025,fte-47d13b3b29c13c9846d9ec19,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 903 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-3-0
return transcript: USD 11,482.00
tax year: 2023
signature: Example named signer; signed",4506-T,12,4506-T,fdc-f9e65eaeecdf965703516fe5,synthetic-form-layout-09,original,2023,fte-eab30a3b054bed1127ebb787,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 904 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-4-0
return transcript: USD 11,565.00
tax year: 2024
signature: Example named signer; signed",4506-T,12,4506-T,fdc-c7b6d5fe9b5e6b34a6f89be3,synthetic-form-layout-09,original,2024,fte-fd0f0c5c8908820514e51e6c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 905 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-5-0
return transcript: USD 11,648.00
tax year: 2025
signature: Example named signer; signed",4506-T,12,4506-T,fdc-8be45b3eab435e969fec49fb,synthetic-form-layout-09,original,2025,fte-4aa82bc45f259ea806edd8d0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 906 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-6-0
return transcript: USD 11,731.00
tax year: 2023
signature: Example named signer; signed",4506-T,12,4506-T,fdc-15195f3caf5d65d59f2f73fa,synthetic-form-layout-09,original,2023,fte-dcdbdfec1c275940ed650d76,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 4506-T: Request for Transcript of Tax Return
Example Client 907 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-7-0
return transcript: USD 11,814.00
tax year: 2024
signature: Example named signer; signed",4506-T,12,4506-T,fdc-359e1ec94d903fbcb87bd9e0,synthetic-form-layout-09,original,2024,fte-7bcdcaa3799298181463cb61,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: taxpayer: Example Entity 8-0-0; representative: Example Entity 8-0-1; tax matters: USD 11,096.00; authorization: USD 11,096.00",2848,10,2848,fdc-5627bcece8c16b91074d3ae6,synthetic-form-layout-08,original,2023,fte-a62493a0b776724d7745a13d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: taxpayer: Example Entity 8-1-0; representative: Example Entity 8-1-1; tax matters: USD 11,179.00; authorization: USD 11,179.00",2848,10,2848,fdc-4e389ffad4867b2045330eeb,synthetic-form-layout-08,original,2024,fte-e58c2f01a71839864fa81f34,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: taxpayer: Example Entity 8-2-0; representative: Example Entity 8-2-1; tax matters: USD 11,262.00; authorization: USD 11,262.00",2848,10,2848,fdc-73149cf2bedc412febaaf5b1,synthetic-form-layout-08,original,2025,fte-2f4461f20f13e38a62151ead,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: taxpayer: Example Entity 8-3-0; representative: Example Entity 8-3-1; tax matters: USD 11,345.00; authorization: USD 11,345.00",2848,10,2848,fdc-9bc7c17fa337641c8e8003ba,synthetic-form-layout-08,original,2023,fte-00d5919c0a311d351af7372b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: taxpayer: Example Entity 8-4-0; representative: Example Entity 8-4-1; tax matters: USD 11,428.00; authorization: USD 11,428.00",2848,10,2848,fdc-f726a408f9679391313ef6f9,synthetic-form-layout-08,original,2024,fte-ee68deaf466da1ae52a0cc39,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: taxpayer: Example Entity 8-5-0; representative: Example Entity 8-5-1; tax matters: USD 11,511.00; authorization: USD 11,511.00",2848,10,2848,fdc-cf5f1f68e902ed27a1c51ed9,synthetic-form-layout-08,original,2025,fte-bfa4b3afa4a0267bf63a90da,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: taxpayer: Example Entity 8-6-0; representative: Example Entity 8-6-1; tax matters: USD 11,594.00; authorization: USD 11,594.00",2848,10,2848,fdc-6849533ad519cdfd98d19aef,synthetic-form-layout-08,original,2023,fte-c522d36a2e3b771f4a50fef3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2848: Power of Attorney and Declaration of Representative
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: taxpayer: Example Entity 8-7-0; representative: Example Entity 8-7-1; tax matters: USD 11,677.00; authorization: USD 11,677.00",2848,10,2848,fdc-2d18a6da36e317f39ef15fe9,synthetic-form-layout-08,original,2024,fte-dbdb705f44d0a7d64847c6db,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 900 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-0-0
representative: Example Entity 9-0-1
tax matters: USD 11,233.00
authorization: USD 11,233.00",2848,10,2848,fdc-8dca420ce50c51d36e9bdfe6,synthetic-form-layout-09,original,2023,fte-32b85edac6c7f6afd79560b6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 901 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-1-0
representative: Example Entity 9-1-1
tax matters: USD 11,316.00
authorization: USD 11,316.00",2848,10,2848,fdc-1839e474c982214aff2ec922,synthetic-form-layout-09,original,2024,fte-55b4afb1f4f6d2d9d5a88276,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 902 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-2-0
representative: Example Entity 9-2-1
tax matters: USD 11,399.00
authorization: USD 11,399.00",2848,10,2848,fdc-af09f2cb15e63372c3343856,synthetic-form-layout-09,original,2025,fte-213c98fa455d7059c1e9826b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 903 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-3-0
representative: Example Entity 9-3-1
tax matters: USD 11,482.00
authorization: USD 11,482.00",2848,10,2848,fdc-6465e706669eeefe352b64e1,synthetic-form-layout-09,original,2023,fte-13d2fb87124ff0aba6acacd6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 904 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-4-0
representative: Example Entity 9-4-1
tax matters: USD 11,565.00
authorization: USD 11,565.00",2848,10,2848,fdc-3732c10a5205c464fb8a5149,synthetic-form-layout-09,original,2024,fte-24816120e0b1723b08f74b7f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 905 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-5-0
representative: Example Entity 9-5-1
tax matters: USD 11,648.00
authorization: USD 11,648.00",2848,10,2848,fdc-cf23ff6eeda271678203d807,synthetic-form-layout-09,original,2025,fte-e2ca0f8fe5e7e228a70f0a32,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 906 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-6-0
representative: Example Entity 9-6-1
tax matters: USD 11,731.00
authorization: USD 11,731.00",2848,10,2848,fdc-2fbe56b09fca387130a45759,synthetic-form-layout-09,original,2023,fte-c8584965bf377767171aa4f4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2848: Power of Attorney and Declaration of Representative
Example Client 907 is the named party.
Information printed on this record:
taxpayer: Example Entity 9-7-0
representative: Example Entity 9-7-1
tax matters: USD 11,814.00
authorization: USD 11,814.00",2848,10,2848,fdc-d8475c65750ab3d937f59bce,synthetic-form-layout-09,original,2024,fte-040ff7d01d4af0319ee67264,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: child: USD 11,096.00; custodial parent: USD 11,096.00; noncustodial parent: USD 11,096.00; release: USD 11,096.00",8332,18,8332,fdc-ae4ad882af24def42434236a,synthetic-form-layout-08,original,2023,fte-8d5fda0a8d61ffc938e6c173,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: child: USD 11,179.00; custodial parent: USD 11,179.00; noncustodial parent: USD 11,179.00; release: USD 11,179.00",8332,18,8332,fdc-7543ceb85f20db2632b21452,synthetic-form-layout-08,original,2024,fte-a657b5af35dbb2b2b4e0853a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: child: USD 11,262.00; custodial parent: USD 11,262.00; noncustodial parent: USD 11,262.00; release: USD 11,262.00",8332,18,8332,fdc-5524e03bfbe467e4c91d84fe,synthetic-form-layout-08,original,2025,fte-784755f919d41253f63de28d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: child: USD 11,345.00; custodial parent: USD 11,345.00; noncustodial parent: USD 11,345.00; release: USD 11,345.00",8332,18,8332,fdc-fc1ce530156229bf5deb2183,synthetic-form-layout-08,original,2023,fte-40cd8641d6b24c5f466f9f09,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: child: USD 11,428.00; custodial parent: USD 11,428.00; noncustodial parent: USD 11,428.00; release: USD 11,428.00",8332,18,8332,fdc-51dd29b5e0388f615e9e81d2,synthetic-form-layout-08,original,2024,fte-0fcec58dfc2d3821f67b187b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: child: USD 11,511.00; custodial parent: USD 11,511.00; noncustodial parent: USD 11,511.00; release: USD 11,511.00",8332,18,8332,fdc-f8e6891f98a67378a2fabb18,synthetic-form-layout-08,original,2025,fte-817f36a055d499f8f0a87fab,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: child: USD 11,594.00; custodial parent: USD 11,594.00; noncustodial parent: USD 11,594.00; release: USD 11,594.00",8332,18,8332,fdc-63d43032b24e368240b7c2fd,synthetic-form-layout-08,original,2023,fte-7912a257c7a78c6896e833b9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: child: USD 11,677.00; custodial parent: USD 11,677.00; noncustodial parent: USD 11,677.00; release: USD 11,677.00",8332,18,8332,fdc-8cb84859b903bfb97e65d6ec,synthetic-form-layout-08,original,2024,fte-6d9c2a3d74f6ce758f8c5da4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 900 is the named party.
Information printed on this record:
child: USD 11,233.00
custodial parent: USD 11,233.00
noncustodial parent: USD 11,233.00
release: USD 11,233.00",8332,18,8332,fdc-c7c5dcdea36cb9bfe6ed6b6c,synthetic-form-layout-09,original,2023,fte-5355b9551ddb19e056f1cfc4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 901 is the named party.
Information printed on this record:
child: USD 11,316.00
custodial parent: USD 11,316.00
noncustodial parent: USD 11,316.00
release: USD 11,316.00",8332,18,8332,fdc-db7b33781aa081a9de5bea54,synthetic-form-layout-09,original,2024,fte-33ddfb8b3b9d5cbcb9499e1a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 902 is the named party.
Information printed on this record:
child: USD 11,399.00
custodial parent: USD 11,399.00
noncustodial parent: USD 11,399.00
release: USD 11,399.00",8332,18,8332,fdc-ef3d0fb59ef2beea325ec6ed,synthetic-form-layout-09,original,2025,fte-4c7c94c6219c6a477069a362,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 903 is the named party.
Information printed on this record:
child: USD 11,482.00
custodial parent: USD 11,482.00
noncustodial parent: USD 11,482.00
release: USD 11,482.00",8332,18,8332,fdc-7ecba6ea3663c91502d1bf17,synthetic-form-layout-09,original,2023,fte-052eb294182ab1fd1754cd55,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 904 is the named party.
Information printed on this record:
child: USD 11,565.00
custodial parent: USD 11,565.00
noncustodial parent: USD 11,565.00
release: USD 11,565.00",8332,18,8332,fdc-64462dedca722211136f264c,synthetic-form-layout-09,original,2024,fte-3f659384b2e70895267251ab,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 905 is the named party.
Information printed on this record:
child: USD 11,648.00
custodial parent: USD 11,648.00
noncustodial parent: USD 11,648.00
release: USD 11,648.00",8332,18,8332,fdc-c47579b014373d5125ee0d59,synthetic-form-layout-09,original,2025,fte-4997d8dacce6632119b2ebef,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 906 is the named party.
Information printed on this record:
child: USD 11,731.00
custodial parent: USD 11,731.00
noncustodial parent: USD 11,731.00
release: USD 11,731.00",8332,18,8332,fdc-0c98aad6ad6be44754df345c,synthetic-form-layout-09,original,2023,fte-f4f504f326dae020855522ef,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8332: Release Revocation of Release of Claim to Exemption for Child by Custodial Parent
Example Client 907 is the named party.
Information printed on this record:
child: USD 11,814.00
custodial parent: USD 11,814.00
noncustodial parent: USD 11,814.00
release: USD 11,814.00",8332,18,8332,fdc-13d168166b6bba3d9ffd3f4f,synthetic-form-layout-09,original,2024,fte-0ecef5069dbe3032db94fff9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: care provider: Example Entity 8-0-0; qualifying person: USD 11,096.00; care expenses: USD 11,096.00",2441,8,2441,fdc-c80240259234090c7a834295,synthetic-form-layout-08,original,2023,fte-66e1ec0a0f4cd6892d71de1f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: care provider: Example Entity 8-1-0; qualifying person: USD 11,179.00; care expenses: USD 11,179.00",2441,8,2441,fdc-72e713253e729394b96c881d,synthetic-form-layout-08,original,2024,fte-2a737f95b4668518f3f44c70,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: care provider: Example Entity 8-2-0; qualifying person: USD 11,262.00; care expenses: USD 11,262.00",2441,8,2441,fdc-0131c8d294bb4e2caf828108,synthetic-form-layout-08,original,2025,fte-cc6bdabea0c92980f16a10f7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: care provider: Example Entity 8-3-0; qualifying person: USD 11,345.00; care expenses: USD 11,345.00",2441,8,2441,fdc-ddccee8def231e156a159dae,synthetic-form-layout-08,original,2023,fte-c004cd3fb9a7a0e6c68f606a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: care provider: Example Entity 8-4-0; qualifying person: USD 11,428.00; care expenses: USD 11,428.00",2441,8,2441,fdc-c5b0480d08bcc7346b7a190a,synthetic-form-layout-08,original,2024,fte-cde1887b8323fdc236dee955,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: care provider: Example Entity 8-5-0; qualifying person: USD 11,511.00; care expenses: USD 11,511.00",2441,8,2441,fdc-7447474b2ca7f856401e6a5f,synthetic-form-layout-08,original,2025,fte-a7b730de7114c40ccccea267,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: care provider: Example Entity 8-6-0; qualifying person: USD 11,594.00; care expenses: USD 11,594.00",2441,8,2441,fdc-9decaa0b863da923c3405445,synthetic-form-layout-08,original,2023,fte-dad63166fa7c7d97558ef1fd,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2441: Child and Dependent Care Expenses
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: care provider: Example Entity 8-7-0; qualifying person: USD 11,677.00; care expenses: USD 11,677.00",2441,8,2441,fdc-40bb7493ed8217a2ebd55f98,synthetic-form-layout-08,original,2024,fte-3b673cfb3d5ca2d9679b4469,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 900 is the named party.
Information printed on this record:
care provider: Example Entity 9-0-0
qualifying person: USD 11,233.00
care expenses: USD 11,233.00",2441,8,2441,fdc-b796b3cd9a9792acd4fdd538,synthetic-form-layout-09,original,2023,fte-1d5c05962980bb32e562ec5f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 901 is the named party.
Information printed on this record:
care provider: Example Entity 9-1-0
qualifying person: USD 11,316.00
care expenses: USD 11,316.00",2441,8,2441,fdc-4ec50bfe8d150545e6e39ec6,synthetic-form-layout-09,original,2024,fte-8fbd83f0a1fc4e3088a091aa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 902 is the named party.
Information printed on this record:
care provider: Example Entity 9-2-0
qualifying person: USD 11,399.00
care expenses: USD 11,399.00",2441,8,2441,fdc-920ea6d59bf9ddf5cca580c9,synthetic-form-layout-09,original,2025,fte-93ce53eb92b1b473fe46b807,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 903 is the named party.
Information printed on this record:
care provider: Example Entity 9-3-0
qualifying person: USD 11,482.00
care expenses: USD 11,482.00",2441,8,2441,fdc-2f39890055f45c4ac16f5bb6,synthetic-form-layout-09,original,2023,fte-23be63be54de01a1b6a4e6d0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 904 is the named party.
Information printed on this record:
care provider: Example Entity 9-4-0
qualifying person: USD 11,565.00
care expenses: USD 11,565.00",2441,8,2441,fdc-78a5709954ab75549248588a,synthetic-form-layout-09,original,2024,fte-1b7fe404a6589155e0d044bf,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 905 is the named party.
Information printed on this record:
care provider: Example Entity 9-5-0
qualifying person: USD 11,648.00
care expenses: USD 11,648.00",2441,8,2441,fdc-0968575bb3617f49c7ceaad4,synthetic-form-layout-09,original,2025,fte-bccec8e1393a82777cdfe3c7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 906 is the named party.
Information printed on this record:
care provider: Example Entity 9-6-0
qualifying person: USD 11,731.00
care expenses: USD 11,731.00",2441,8,2441,fdc-4ddd0b862b660bfbe9cbf1be,synthetic-form-layout-09,original,2023,fte-7a2c061327b614d907632715,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2441: Child and Dependent Care Expenses
Example Client 907 is the named party.
Information printed on this record:
care provider: Example Entity 9-7-0
qualifying person: USD 11,814.00
care expenses: USD 11,814.00",2441,8,2441,fdc-22ea0a8545dcf0c6369ea026,synthetic-form-layout-09,original,2024,fte-a8ff46c95337682958f31326,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: residential clean energy: USD 11,096.00; energy efficient home improvements: USD 11,096.00",5695,15,5695,fdc-65baecbb8c54f48fd9391e30,synthetic-form-layout-08,original,2023,fte-132b5b8fcccdf69ec83ac2ae,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: residential clean energy: USD 11,179.00; energy efficient home improvements: USD 11,179.00",5695,15,5695,fdc-a99a36c3f2030ce9978053d0,synthetic-form-layout-08,original,2024,fte-80c41dde0a377e8fba876bce,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: residential clean energy: USD 11,262.00; energy efficient home improvements: USD 11,262.00",5695,15,5695,fdc-af28306dd9042c06e69e1d05,synthetic-form-layout-08,original,2025,fte-c2abfa9e1dfa72ef2bc2b484,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: residential clean energy: USD 11,345.00; energy efficient home improvements: USD 11,345.00",5695,15,5695,fdc-acd9b7d57bd6861304a3b69a,synthetic-form-layout-08,original,2023,fte-e0a76927168de030dc6cb3a0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: residential clean energy: USD 11,428.00; energy efficient home improvements: USD 11,428.00",5695,15,5695,fdc-ec0b9bc028325eb97b4c594e,synthetic-form-layout-08,original,2024,fte-492f720c3fa64188c7dc3ba7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: residential clean energy: USD 11,511.00; energy efficient home improvements: USD 11,511.00",5695,15,5695,fdc-82d5ce6ea2a06989fc7c5a53,synthetic-form-layout-08,original,2025,fte-0840be188a0944be2ab79c3d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: residential clean energy: USD 11,594.00; energy efficient home improvements: USD 11,594.00",5695,15,5695,fdc-4bada6bba5de1d7b08e0f4e7,synthetic-form-layout-08,original,2023,fte-b2cf0ae71372caaf8b5690f4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 5695: Residential Energy Credits
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: residential clean energy: USD 11,677.00; energy efficient home improvements: USD 11,677.00",5695,15,5695,fdc-55d4458e6152ebebbbf38f69,synthetic-form-layout-08,original,2024,fte-0449fd503bf28bfdc6b04e1a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5695: Residential Energy Credits
Example Client 900 is the named party.
Information printed on this record:
residential clean energy: USD 11,233.00
energy efficient home improvements: USD 11,233.00",5695,15,5695,fdc-9fced5f659fc30823959e47e,synthetic-form-layout-09,original,2023,fte-0c544528d81aa0005a71adfe,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5695: Residential Energy Credits
Example Client 901 is the named party.
Information printed on this record:
residential clean energy: USD 11,316.00
energy efficient home improvements: USD 11,316.00",5695,15,5695,fdc-d392711428d388ad1b8f7a1c,synthetic-form-layout-09,original,2024,fte-f2ff248a999b79a4fd9762fb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5695: Residential Energy Credits
Example Client 902 is the named party.
Information printed on this record:
residential clean energy: USD 11,399.00
energy efficient home improvements: USD 11,399.00",5695,15,5695,fdc-4ef508638a7c7f73355fd144,synthetic-form-layout-09,original,2025,fte-b3f7977d417519e31b9e5b4c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5695: Residential Energy Credits
Example Client 903 is the named party.
Information printed on this record:
residential clean energy: USD 11,482.00
energy efficient home improvements: USD 11,482.00",5695,15,5695,fdc-474b5e932738aaf57eb5a952,synthetic-form-layout-09,original,2023,fte-a64a7a1f3f96d2212259058c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5695: Residential Energy Credits
Example Client 904 is the named party.
Information printed on this record:
residential clean energy: USD 11,565.00
energy efficient home improvements: USD 11,565.00",5695,15,5695,fdc-4c8c53865e7ebd2a56bb7fc8,synthetic-form-layout-09,original,2024,fte-ddf12bf35c1034c2cbc50b30,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 5695: Residential Energy Credits
Example Client 905 is the named party.
Information printed on this record:
residential clean energy: USD 11,648.00
energy efficient home improvements: USD 11,648.00",5695,15,5695,fdc-0eeef432cddb2c2ee23dab29,synthetic-form-layout-09,original,2025,fte-018e031815fe09c227658a14,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 5695: Residential Energy Credits
Example Client 906 is the named party.
Information printed on this record:
residential clean energy: USD 11,731.00
energy efficient home improvements: USD 11,731.00",5695,15,5695,fdc-e752dd4a30d4a0c0569e0eb2,synthetic-form-layout-09,original,2023,fte-6e8600cf0090a5cf34b6f55f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 5695: Residential Energy Credits
Example Client 907 is the named party.
Information printed on this record:
residential clean energy: USD 11,814.00
energy efficient home improvements: USD 11,814.00",5695,15,5695,fdc-5a5bfd1df8c7d182627a65c7,synthetic-form-layout-09,original,2024,fte-43449002723fe86a1ee8d024,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: vehicle: Example Entity 8-0-0; date placed in service: 2023-03-01; credit limitation: USD 11,096.00",8936,20,8936,fdc-518e2599cc8598d063b2f429,synthetic-form-layout-08,original,2023,fte-8367c341554b82435153c7cd,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: vehicle: Example Entity 8-1-0; date placed in service: 2024-03-02; credit limitation: USD 11,179.00",8936,20,8936,fdc-a0ab9079c77415bd9354c47b,synthetic-form-layout-08,original,2024,fte-fc56d26c24f616d9a5c67c62,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: vehicle: Example Entity 8-2-0; date placed in service: 2025-03-03; credit limitation: USD 11,262.00",8936,20,8936,fdc-2287e1be57f73899cbf841fd,synthetic-form-layout-08,original,2025,fte-e30cf6017ac0589e1e417d08,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: vehicle: Example Entity 8-3-0; date placed in service: 2023-03-04; credit limitation: USD 11,345.00",8936,20,8936,fdc-6bb0d11d1bffec3006666ee9,synthetic-form-layout-08,original,2023,fte-a7e6aa44c23424a7a7a5fcff,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: vehicle: Example Entity 8-4-0; date placed in service: 2024-03-05; credit limitation: USD 11,428.00",8936,20,8936,fdc-f4558211fc8355095802baa4,synthetic-form-layout-08,original,2024,fte-7434261be08efbc2ccb1dfe0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: vehicle: Example Entity 8-5-0; date placed in service: 2025-03-06; credit limitation: USD 11,511.00",8936,20,8936,fdc-e848141c362ece1758784909,synthetic-form-layout-08,original,2025,fte-d5dc3b8c62057dd0b50eed1f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: vehicle: Example Entity 8-6-0; date placed in service: 2023-03-07; credit limitation: USD 11,594.00",8936,20,8936,fdc-c5cf3882a0a8c5b434d8ef3d,synthetic-form-layout-08,original,2023,fte-be6818d4085eca314dc2796b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8936: Clean Vehicle Credits
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: vehicle: Example Entity 8-7-0; date placed in service: 2024-03-08; credit limitation: USD 11,677.00",8936,20,8936,fdc-bc47794e89ea57a1d3e7a16e,synthetic-form-layout-08,original,2024,fte-7487c603f6d07ec4ab9bb13b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8936: Clean Vehicle Credits
Example Client 900 is the named party.
Information printed on this record:
vehicle: Example Entity 9-0-0
date placed in service: 2023-03-01
credit limitation: USD 11,233.00",8936,20,8936,fdc-feb253ae23755a6eb37409fd,synthetic-form-layout-09,original,2023,fte-4837fc4a638adb961d469b92,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8936: Clean Vehicle Credits
Example Client 901 is the named party.
Information printed on this record:
vehicle: Example Entity 9-1-0
date placed in service: 2024-03-02
credit limitation: USD 11,316.00",8936,20,8936,fdc-c90e3e11512fe3ca9df2193f,synthetic-form-layout-09,original,2024,fte-7f541c58c55d963457f74067,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8936: Clean Vehicle Credits
Example Client 902 is the named party.
Information printed on this record:
vehicle: Example Entity 9-2-0
date placed in service: 2025-03-03
credit limitation: USD 11,399.00",8936,20,8936,fdc-afaf73f8c981036b8bff5ae7,synthetic-form-layout-09,original,2025,fte-2fee180a44f9c7b4ccbeb20d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8936: Clean Vehicle Credits
Example Client 903 is the named party.
Information printed on this record:
vehicle: Example Entity 9-3-0
date placed in service: 2023-03-04
credit limitation: USD 11,482.00",8936,20,8936,fdc-b4de81acff55870ddd37e2c2,synthetic-form-layout-09,original,2023,fte-8d70f43b46c8d6fa486d5f7b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8936: Clean Vehicle Credits
Example Client 904 is the named party.
Information printed on this record:
vehicle: Example Entity 9-4-0
date placed in service: 2024-03-05
credit limitation: USD 11,565.00",8936,20,8936,fdc-db97277aebbacd717da09026,synthetic-form-layout-09,original,2024,fte-de0ab666d6154248f71784b3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8936: Clean Vehicle Credits
Example Client 905 is the named party.
Information printed on this record:
vehicle: Example Entity 9-5-0
date placed in service: 2025-03-06
credit limitation: USD 11,648.00",8936,20,8936,fdc-884d785809ec310a3660f347,synthetic-form-layout-09,original,2025,fte-bfa15d6d01f1e33828d5963a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8936: Clean Vehicle Credits
Example Client 906 is the named party.
Information printed on this record:
vehicle: Example Entity 9-6-0
date placed in service: 2023-03-07
credit limitation: USD 11,731.00",8936,20,8936,fdc-108187e860bf907005a0e911,synthetic-form-layout-09,original,2023,fte-2a38c7f5840bcb0dcf6ac4f8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8936: Clean Vehicle Credits
Example Client 907 is the named party.
Information printed on this record:
vehicle: Example Entity 9-7-0
date placed in service: 2024-03-08
credit limitation: USD 11,814.00",8936,20,8936,fdc-c3e6754059a6add8a3782a7c,synthetic-form-layout-09,original,2024,fte-f1a0bad8c39dd8eb52aba6f5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: foreign source income: USD 11,096.00; foreign taxes paid: USD 11,096.00; credit limitation: USD 11,096.00",1116,6,1116,fdc-407d7f7cdef1e1574704cb7b,synthetic-form-layout-08,original,2023,fte-272dd6e67d3b038e70e1cdd2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: foreign source income: USD 11,179.00; foreign taxes paid: USD 11,179.00; credit limitation: USD 11,179.00",1116,6,1116,fdc-76ee31ea4f2239f7b1555c9d,synthetic-form-layout-08,original,2024,fte-bc3fae67e589985d1f78b72f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: foreign source income: USD 11,262.00; foreign taxes paid: USD 11,262.00; credit limitation: USD 11,262.00",1116,6,1116,fdc-119285874ea617b0694912d1,synthetic-form-layout-08,original,2025,fte-5097a24fba00a5217cd88030,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: foreign source income: USD 11,345.00; foreign taxes paid: USD 11,345.00; credit limitation: USD 11,345.00",1116,6,1116,fdc-6c6bc3a7d8db81c67db4c6fd,synthetic-form-layout-08,original,2023,fte-bf36373a60ca82b44d345c44,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: foreign source income: USD 11,428.00; foreign taxes paid: USD 11,428.00; credit limitation: USD 11,428.00",1116,6,1116,fdc-0c7eaec4b1858ff4d198da4c,synthetic-form-layout-08,original,2024,fte-f9f78fdd1cee80e477e1ee29,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: foreign source income: USD 11,511.00; foreign taxes paid: USD 11,511.00; credit limitation: USD 11,511.00",1116,6,1116,fdc-d615c03ce2ebf77e77efe23c,synthetic-form-layout-08,original,2025,fte-df34d63f4c726c3e922c3c16,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: foreign source income: USD 11,594.00; foreign taxes paid: USD 11,594.00; credit limitation: USD 11,594.00",1116,6,1116,fdc-373191845022c16f4f98ed37,synthetic-form-layout-08,original,2023,fte-7731f5cf258f7b7b96fe64f4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 1116: Foreign Tax Credit
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: foreign source income: USD 11,677.00; foreign taxes paid: USD 11,677.00; credit limitation: USD 11,677.00",1116,6,1116,fdc-9a92956ce898e8bd93b46bcb,synthetic-form-layout-08,original,2024,fte-22567972a9373636103630a9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1116: Foreign Tax Credit
Example Client 900 is the named party.
Information printed on this record:
foreign source income: USD 11,233.00
foreign taxes paid: USD 11,233.00
credit limitation: USD 11,233.00",1116,6,1116,fdc-ac260f832a6c92cea92f3c9c,synthetic-form-layout-09,original,2023,fte-685b9804a67679536a285210,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1116: Foreign Tax Credit
Example Client 901 is the named party.
Information printed on this record:
foreign source income: USD 11,316.00
foreign taxes paid: USD 11,316.00
credit limitation: USD 11,316.00",1116,6,1116,fdc-3141affff55d759e4f6611cc,synthetic-form-layout-09,original,2024,fte-a0220a5b22162f8058900866,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1116: Foreign Tax Credit
Example Client 902 is the named party.
Information printed on this record:
foreign source income: USD 11,399.00
foreign taxes paid: USD 11,399.00
credit limitation: USD 11,399.00",1116,6,1116,fdc-68995426d34758f4eae6c366,synthetic-form-layout-09,original,2025,fte-e770dbcf516332322f6e5ebf,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1116: Foreign Tax Credit
Example Client 903 is the named party.
Information printed on this record:
foreign source income: USD 11,482.00
foreign taxes paid: USD 11,482.00
credit limitation: USD 11,482.00",1116,6,1116,fdc-8164219935134ba3c25ac8cb,synthetic-form-layout-09,original,2023,fte-de6d0d88da4aa2cd452afc0e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1116: Foreign Tax Credit
Example Client 904 is the named party.
Information printed on this record:
foreign source income: USD 11,565.00
foreign taxes paid: USD 11,565.00
credit limitation: USD 11,565.00",1116,6,1116,fdc-c319b88f47d016044b928a72,synthetic-form-layout-09,original,2024,fte-db435c5d4c7a36fe7f16eb70,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 1116: Foreign Tax Credit
Example Client 905 is the named party.
Information printed on this record:
foreign source income: USD 11,648.00
foreign taxes paid: USD 11,648.00
credit limitation: USD 11,648.00",1116,6,1116,fdc-b104c0fe1663676eb60dfede,synthetic-form-layout-09,original,2025,fte-bfae881f66575cc45050096a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 1116: Foreign Tax Credit
Example Client 906 is the named party.
Information printed on this record:
foreign source income: USD 11,731.00
foreign taxes paid: USD 11,731.00
credit limitation: USD 11,731.00",1116,6,1116,fdc-3f5616e75fdbe723a48016a8,synthetic-form-layout-09,original,2023,fte-520c1bffa2782577cbc173c2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 1116: Foreign Tax Credit
Example Client 907 is the named party.
Information printed on this record:
foreign source income: USD 11,814.00
foreign taxes paid: USD 11,814.00
credit limitation: USD 11,814.00",1116,6,1116,fdc-b9cda6444f4a3e538a995f39,synthetic-form-layout-09,original,2024,fte-5565f376d9f541c90002da29,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: foreign address: Example Entity 8-0-0; physical presence: USD 11,096.00; foreign earned income: USD 11,096.00",2555,9,2555,fdc-dbce4756e23ac33daebc8e9c,synthetic-form-layout-08,original,2023,fte-35c97769962af4906b993bf6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: foreign address: Example Entity 8-1-0; physical presence: USD 11,179.00; foreign earned income: USD 11,179.00",2555,9,2555,fdc-22270469025e52d450777ce1,synthetic-form-layout-08,original,2024,fte-6005cb740460491731e5b186,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: foreign address: Example Entity 8-2-0; physical presence: USD 11,262.00; foreign earned income: USD 11,262.00",2555,9,2555,fdc-5f1b1441f867860b596ef3f6,synthetic-form-layout-08,original,2025,fte-28477bf875e0bd6c0338e3d0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: foreign address: Example Entity 8-3-0; physical presence: USD 11,345.00; foreign earned income: USD 11,345.00",2555,9,2555,fdc-d9cf0877e9acb0d7f6444e1b,synthetic-form-layout-08,original,2023,fte-42eb6cbaa7294c8187a93b0f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: foreign address: Example Entity 8-4-0; physical presence: USD 11,428.00; foreign earned income: USD 11,428.00",2555,9,2555,fdc-c9e298522286a5f086a32922,synthetic-form-layout-08,original,2024,fte-f1c70f118e3f0639771cf2f1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: foreign address: Example Entity 8-5-0; physical presence: USD 11,511.00; foreign earned income: USD 11,511.00",2555,9,2555,fdc-fec7e2717657941b1dff9b5e,synthetic-form-layout-08,original,2025,fte-2d8b26045f4a9be732cc6756,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: foreign address: Example Entity 8-6-0; physical presence: USD 11,594.00; foreign earned income: USD 11,594.00",2555,9,2555,fdc-03354f2df746067565a89989,synthetic-form-layout-08,original,2023,fte-594e63c545ffb7c7af33a8bb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 2555: Foreign Earned Income
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: foreign address: Example Entity 8-7-0; physical presence: USD 11,677.00; foreign earned income: USD 11,677.00",2555,9,2555,fdc-ca726f5ed6f7fc4784419fe4,synthetic-form-layout-08,original,2024,fte-5daf90d36e9c1638825df8d1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2555: Foreign Earned Income
Example Client 900 is the named party.
Information printed on this record:
foreign address: Example Entity 9-0-0
physical presence: USD 11,233.00
foreign earned income: USD 11,233.00",2555,9,2555,fdc-70122698eb585e6739fb2702,synthetic-form-layout-09,original,2023,fte-fe6e273aac637bf93506dca4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2555: Foreign Earned Income
Example Client 901 is the named party.
Information printed on this record:
foreign address: Example Entity 9-1-0
physical presence: USD 11,316.00
foreign earned income: USD 11,316.00",2555,9,2555,fdc-4f21e1355693db435e18f6b4,synthetic-form-layout-09,original,2024,fte-9bb1debd96f668922fa73e3d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 2555: Foreign Earned Income
Example Client 902 is the named party.
Information printed on this record:
foreign address: Example Entity 9-2-0
physical presence: USD 11,399.00
foreign earned income: USD 11,399.00",2555,9,2555,fdc-d55451da1854243aa21366a3,synthetic-form-layout-09,original,2025,fte-6b424538ed2bf630d04f2c3f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2555: Foreign Earned Income
Example Client 903 is the named party.
Information printed on this record:
foreign address: Example Entity 9-3-0
physical presence: USD 11,482.00
foreign earned income: USD 11,482.00",2555,9,2555,fdc-cabebc2aeeb1adf679cbbcc4,synthetic-form-layout-09,original,2023,fte-a3af9502445935cf963d0e7b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2555: Foreign Earned Income
Example Client 904 is the named party.
Information printed on this record:
foreign address: Example Entity 9-4-0
physical presence: USD 11,565.00
foreign earned income: USD 11,565.00",2555,9,2555,fdc-5f20e5090225dd81b267fd7c,synthetic-form-layout-09,original,2024,fte-8e85c13afe755e4dddb015cd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 2555: Foreign Earned Income
Example Client 905 is the named party.
Information printed on this record:
foreign address: Example Entity 9-5-0
physical presence: USD 11,648.00
foreign earned income: USD 11,648.00",2555,9,2555,fdc-15bd43d0c040634b04b2591a,synthetic-form-layout-09,original,2025,fte-eafaf6af75739ab87deb5a7a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 2555: Foreign Earned Income
Example Client 906 is the named party.
Information printed on this record:
foreign address: Example Entity 9-6-0
physical presence: USD 11,731.00
foreign earned income: USD 11,731.00",2555,9,2555,fdc-1d897a4b6dcb5f808a01a047,synthetic-form-layout-09,original,2023,fte-b49c1e121424dc6fe31b0fb7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 2555: Foreign Earned Income
Example Client 907 is the named party.
Information printed on this record:
foreign address: Example Entity 9-7-0
physical presence: USD 11,814.00
foreign earned income: USD 11,814.00",2555,9,2555,fdc-69240d5dacf9e32672f32898,synthetic-form-layout-09,original,2024,fte-9a357e0fb264a74c6f3a978a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2023. The statement belongs to Example Client 800.
Reported fields follow: foreign accounts: USD 11,096.00; assets: USD 11,096.00; maximum value: USD 11,096.00; income: USD 11,096.00",8938,21,8938,fdc-5904bed61d842f68adff98eb,synthetic-form-layout-08,original,2023,fte-4b3c206f4b727e0162bb7065,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2024. The statement belongs to Example Client 801.
Reported fields follow: foreign accounts: USD 11,179.00; assets: USD 11,179.00; maximum value: USD 11,179.00; income: USD 11,179.00",8938,21,8938,fdc-1fa0458f1383177a1bab929d,synthetic-form-layout-08,original,2024,fte-48db4e0f0f91a19e5085a41a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: foreign accounts: USD 11,262.00; assets: USD 11,262.00; maximum value: USD 11,262.00; income: USD 11,262.00",8938,21,8938,fdc-cb25086fcee30fa3195ca7fc,synthetic-form-layout-08,original,2025,fte-791b0b9db4bf0a7b060e2998,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2023. The statement belongs to Example Client 803.
Reported fields follow: foreign accounts: USD 11,345.00; assets: USD 11,345.00; maximum value: USD 11,345.00; income: USD 11,345.00",8938,21,8938,fdc-02fabf062b091ae8b7738898,synthetic-form-layout-08,original,2023,fte-e4dc33363cd63b7c3a08329d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2024. The statement belongs to Example Client 804.
Reported fields follow: foreign accounts: USD 11,428.00; assets: USD 11,428.00; maximum value: USD 11,428.00; income: USD 11,428.00",8938,21,8938,fdc-9563c94884a4cb3462c4a693,synthetic-form-layout-08,original,2024,fte-7ac9662ef95ae75e3365956e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: foreign accounts: USD 11,511.00; assets: USD 11,511.00; maximum value: USD 11,511.00; income: USD 11,511.00",8938,21,8938,fdc-b3c6102a58378ea261d8ff91,synthetic-form-layout-08,original,2025,fte-6d9fa957322fdf6dce01db2b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2023. The statement belongs to Example Client 806.
Reported fields follow: foreign accounts: USD 11,594.00; assets: USD 11,594.00; maximum value: USD 11,594.00; income: USD 11,594.00",8938,21,8938,fdc-8b7faa409826fd7152ff8009,synthetic-form-layout-08,original,2023,fte-04f1c5a78b426b8ca7a92c92,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Form 8938: Statement of Specified Foreign Financial Assets
For filing year 2024. The statement belongs to Example Client 807.
Reported fields follow: foreign accounts: USD 11,677.00; assets: USD 11,677.00; maximum value: USD 11,677.00; income: USD 11,677.00",8938,21,8938,fdc-3ac2b52ef75bd746ccdca233,synthetic-form-layout-08,original,2024,fte-5ce6ed300abe469c029ee5df,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 900 is the named party.
Information printed on this record:
foreign accounts: USD 11,233.00
assets: USD 11,233.00
maximum value: USD 11,233.00
income: USD 11,233.00",8938,21,8938,fdc-392d4ae531bfd6ba6e2b144b,synthetic-form-layout-09,original,2023,fte-e9112ea5d103408ababb9aef,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 901 is the named party.
Information printed on this record:
foreign accounts: USD 11,316.00
assets: USD 11,316.00
maximum value: USD 11,316.00
income: USD 11,316.00",8938,21,8938,fdc-325ec189ff597d1a746fe004,synthetic-form-layout-09,original,2024,fte-0d0463ac910b97bc9581e117,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 902 is the named party.
Information printed on this record:
foreign accounts: USD 11,399.00
assets: USD 11,399.00
maximum value: USD 11,399.00
income: USD 11,399.00",8938,21,8938,fdc-da6409583d32fe7a844898f3,synthetic-form-layout-09,original,2025,fte-ad209dc8a17a34e4a03d3863,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 903 is the named party.
Information printed on this record:
foreign accounts: USD 11,482.00
assets: USD 11,482.00
maximum value: USD 11,482.00
income: USD 11,482.00",8938,21,8938,fdc-84ce9810e97e942021011b1e,synthetic-form-layout-09,original,2023,fte-0b0f574bcdcbba9978e8fc6a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 904 is the named party.
Information printed on this record:
foreign accounts: USD 11,565.00
assets: USD 11,565.00
maximum value: USD 11,565.00
income: USD 11,565.00",8938,21,8938,fdc-39420cc6623a17a70d96cc42,synthetic-form-layout-09,original,2024,fte-f751009eb76c13456e0f69bf,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 905 is the named party.
Information printed on this record:
foreign accounts: USD 11,648.00
assets: USD 11,648.00
maximum value: USD 11,648.00
income: USD 11,648.00",8938,21,8938,fdc-426d6bbec9e70c51d1f2c567,synthetic-form-layout-09,original,2025,fte-0e70496e60192f02b614caa6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2023
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 906 is the named party.
Information printed on this record:
foreign accounts: USD 11,731.00
assets: USD 11,731.00
maximum value: USD 11,731.00
income: USD 11,731.00",8938,21,8938,fdc-22b81539645e112830d94784,synthetic-form-layout-09,original,2023,fte-acae45f9e85d474b0f3968fb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2024
Title shown: Form 8938: Statement of Specified Foreign Financial Assets
Example Client 907 is the named party.
Information printed on this record:
foreign accounts: USD 11,814.00
assets: USD 11,814.00
maximum value: USD 11,814.00
income: USD 11,814.00",8938,21,8938,fdc-08ca2712160028fbeb3fa071,synthetic-form-layout-09,original,2024,fte-3e72aaa2f8ee7ea998501308,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 484.00",DONATION_RECORD,28,DONATION_RECORD,fdc-9b726edbb0af8c4b98db76ca,synthetic-nonform-layout-08,original,2025,fte-27e37124574b8b5a9ff5086a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 503.00",DONATION_RECORD,28,DONATION_RECORD,fdc-6eec8a85d25cbf1931cdc3c5,synthetic-nonform-layout-08,original,2025,fte-6c6d646152057c2c4dd3ae78,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 522.00",DONATION_RECORD,28,DONATION_RECORD,fdc-a6324739beef34158ae48341,synthetic-nonform-layout-08,original,2025,fte-190920aee0c0f1a8746af424,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 541.00",DONATION_RECORD,28,DONATION_RECORD,fdc-2b63363585b3736f527e2ca9,synthetic-nonform-layout-08,original,2025,fte-253060f0d50f7d71e192bfae,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 560.00",DONATION_RECORD,28,DONATION_RECORD,fdc-49224b0e9b1c85e17fe36a0f,synthetic-nonform-layout-08,original,2025,fte-488ada9b9adfa6188a87338a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 579.00",DONATION_RECORD,28,DONATION_RECORD,fdc-4c2be9589af4e547c87505bb,synthetic-nonform-layout-08,original,2025,fte-ef24c97bcca5325606e7093b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 598.00",DONATION_RECORD,28,DONATION_RECORD,fdc-3e2590c4776769bab94c539e,synthetic-nonform-layout-08,original,2025,fte-21e97ae8492dd17109348e3b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Annual charitable giving statement
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named; Reference amount: 617.00",DONATION_RECORD,28,DONATION_RECORD,fdc-1b46141af7d1507a5124028b,synthetic-nonform-layout-08,original,2025,fte-754b07953a37a1f3d54c15b6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 900 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 507.00",DONATION_RECORD,28,DONATION_RECORD,fdc-2a07ab4bf45701897a5f7c74,synthetic-nonform-layout-09,original,2025,fte-bd09a61aa9fffd5230ce727a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 901 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 526.00",DONATION_RECORD,28,DONATION_RECORD,fdc-f4e2428df49b54904ffb8540,synthetic-nonform-layout-09,original,2025,fte-f73bc57aa2ff68eb362df885,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 902 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 545.00",DONATION_RECORD,28,DONATION_RECORD,fdc-7d8e44d168ddb4183c6766fd,synthetic-nonform-layout-09,original,2025,fte-1190b5be8fb828fda4db1fc9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 903 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 564.00",DONATION_RECORD,28,DONATION_RECORD,fdc-4a3050dee2ae2cd09ceea9cd,synthetic-nonform-layout-09,original,2025,fte-1fdb1e30acf1bc985fad8dd5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 904 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 583.00",DONATION_RECORD,28,DONATION_RECORD,fdc-a1066cd6777c5cea46f8ee91,synthetic-nonform-layout-09,original,2025,fte-2573bff41fa1d74694a31a11,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 905 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 602.00",DONATION_RECORD,28,DONATION_RECORD,fdc-60907690d389d2de7a3f32d0,synthetic-nonform-layout-09,original,2025,fte-8ad6d9dcdcc0daf48d8aa95e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 906 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 621.00",DONATION_RECORD,28,DONATION_RECORD,fdc-10b09ae466d1e2ce8c141780,synthetic-nonform-layout-09,original,2025,fte-c0066f0d1e9a2a0d6d45342b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Annual charitable giving statement
Example Client 907 is the named party.
Information printed on this record:
Individual gifts and dates; completed cash payments; no goods or services provided; donor and organization named
Reference amount: 640.00",DONATION_RECORD,28,DONATION_RECORD,fdc-13f94e21b989523f61606276,synthetic-nonform-layout-09,original,2025,fte-40c65f121ad841d0f4025c66,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 484.00",DONATION_RECORD,28,DONATION_RECORD,fdc-71168067c01f78a42aa3f198,synthetic-nonform-layout-08,original,2025,fte-3f7807f3e7e5c2e04e1a2669,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 503.00",DONATION_RECORD,28,DONATION_RECORD,fdc-6b40524df588d68043252ce1,synthetic-nonform-layout-08,original,2025,fte-43c2c7ad4d8e2e4852b19d26,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 522.00",DONATION_RECORD,28,DONATION_RECORD,fdc-c3fa7a1503c606f5266c5703,synthetic-nonform-layout-08,original,2025,fte-6b3fa98316e9696195eb2e9a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 541.00",DONATION_RECORD,28,DONATION_RECORD,fdc-92ca7f6f384aba8ec9546279,synthetic-nonform-layout-08,original,2025,fte-1bbbc068b3f6178754438ba5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 560.00",DONATION_RECORD,28,DONATION_RECORD,fdc-e8df09eab2ea66731e821841,synthetic-nonform-layout-08,original,2025,fte-282686affbf560e7b26ce478,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 579.00",DONATION_RECORD,28,DONATION_RECORD,fdc-860bbdd10bf79e5e74b270a8,synthetic-nonform-layout-08,original,2025,fte-ddf76677b9d354190b0e2b01,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 598.00",DONATION_RECORD,28,DONATION_RECORD,fdc-9917cbd756a1c85ac8c94d0b,synthetic-nonform-layout-08,original,2025,fte-b7005a06a223d7c908627d05,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Noncash donation acknowledgment
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied; Reference amount: 617.00",DONATION_RECORD,28,DONATION_RECORD,fdc-a2450e1a7ca716ef684c51b9,synthetic-nonform-layout-08,original,2025,fte-f109783a1bf238036b7dc183,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 900 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 507.00",DONATION_RECORD,28,DONATION_RECORD,fdc-fae9d5baae15828a0b9c8a09,synthetic-nonform-layout-09,original,2025,fte-e4ab5390f32c7c0aa45039fa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 901 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 526.00",DONATION_RECORD,28,DONATION_RECORD,fdc-e2849de89e9a15e8404a2864,synthetic-nonform-layout-09,original,2025,fte-7580aa31cb10fc06aa80f3f6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 902 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 545.00",DONATION_RECORD,28,DONATION_RECORD,fdc-4eddbdbd85d581f91c3e537a,synthetic-nonform-layout-09,original,2025,fte-f6fbb7ccceabcac84d6b93c9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 903 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 564.00",DONATION_RECORD,28,DONATION_RECORD,fdc-4304c206768d63db93b25447,synthetic-nonform-layout-09,original,2025,fte-69e1584b010c2191c3084a1d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 904 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 583.00",DONATION_RECORD,28,DONATION_RECORD,fdc-29a1ea6e82257877795cbb85,synthetic-nonform-layout-09,original,2025,fte-9143e571d58fbffcca5c2df0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 905 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 602.00",DONATION_RECORD,28,DONATION_RECORD,fdc-2fe22995ac29c89754ce0b37,synthetic-nonform-layout-09,original,2025,fte-31c3e8e635592fbd088fc662,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 906 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 621.00",DONATION_RECORD,28,DONATION_RECORD,fdc-2bf35870b262a8c81c8b632a,synthetic-nonform-layout-09,original,2025,fte-11b4d1a63a15e1a8d0c1b95e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Noncash donation acknowledgment
Example Client 907 is the named party.
Information printed on this record:
Donated household property described; charity confirms receipt; no value assigned by charity; goods and services statement supplied
Reference amount: 640.00",DONATION_RECORD,28,DONATION_RECORD,fdc-5dd785a7c87a6851b69898d3,synthetic-nonform-layout-09,original,2025,fte-4ad9093187838f1d8580bf1a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 484.00",DONATION_RECORD,28,DONATION_RECORD,fdc-0067a70fc7c447dbc7938777,synthetic-nonform-layout-08,original,2025,fte-3d36235faa8a50e605210a51,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 503.00",DONATION_RECORD,28,DONATION_RECORD,fdc-cfa6cbe8e82e7a909a990cd1,synthetic-nonform-layout-08,original,2025,fte-778db9a7c1c29746582824e6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 522.00",DONATION_RECORD,28,DONATION_RECORD,fdc-ef7da792fa4ca0bc6408b8a0,synthetic-nonform-layout-08,original,2025,fte-5833a07c402825fcf3025765,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 541.00",DONATION_RECORD,28,DONATION_RECORD,fdc-5f720a87d72f169c73669e1f,synthetic-nonform-layout-08,original,2025,fte-d3bce52096fef0c472c59a58,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 560.00",DONATION_RECORD,28,DONATION_RECORD,fdc-6a8f7aa3536a6ee4ce86d171,synthetic-nonform-layout-08,original,2025,fte-cd25399a5464d178ea3ef693,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 579.00",DONATION_RECORD,28,DONATION_RECORD,fdc-06c09f5d579ff503626d69e2,synthetic-nonform-layout-08,original,2025,fte-adb34b80711a6e81f453f8b3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 598.00",DONATION_RECORD,28,DONATION_RECORD,fdc-935f97a3c5a918b208d3c2cd,synthetic-nonform-layout-08,original,2025,fte-4359d833cbf470de2b75ca00,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Vehicle donation acknowledgment
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C; Reference amount: 617.00",DONATION_RECORD,28,DONATION_RECORD,fdc-19d60ce78583b2f295d526bd,synthetic-nonform-layout-08,original,2025,fte-d250ade8f92184efbfccf7d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 900 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 507.00",DONATION_RECORD,28,DONATION_RECORD,fdc-28f0b5b568153d5e14ab2e6e,synthetic-nonform-layout-09,original,2025,fte-c4679dc18feba94d3accde35,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 901 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 526.00",DONATION_RECORD,28,DONATION_RECORD,fdc-5182cad3ca7ff013b775b7c6,synthetic-nonform-layout-09,original,2025,fte-8a055d37c8efbe3b765bb2fa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 902 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 545.00",DONATION_RECORD,28,DONATION_RECORD,fdc-c150165f5250a8b6ffeae72d,synthetic-nonform-layout-09,original,2025,fte-e129b0c42bde0514f5a0dafa,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 903 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 564.00",DONATION_RECORD,28,DONATION_RECORD,fdc-658807eb735c806f896e51ab,synthetic-nonform-layout-09,original,2025,fte-63f1b91703bb2b1c105ef4b6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 904 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 583.00",DONATION_RECORD,28,DONATION_RECORD,fdc-4f7422d52e9b863cd7cd3d07,synthetic-nonform-layout-09,original,2025,fte-68449403b86262195ef47ef8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 905 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 602.00",DONATION_RECORD,28,DONATION_RECORD,fdc-7d7482adc914000b77aca97c,synthetic-nonform-layout-09,original,2025,fte-80670daa1cf10f8aff1adf25,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 906 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 621.00",DONATION_RECORD,28,DONATION_RECORD,fdc-9a26a8a853e1d62473c9f19e,synthetic-nonform-layout-09,original,2025,fte-417328b131c89e4d23d1f3c4,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Vehicle donation acknowledgment
Example Client 907 is the named party.
Information printed on this record:
Donor vehicle contribution recorded; sale proceeds and recipient organization shown; verify related 1098-C
Reference amount: 640.00",DONATION_RECORD,28,DONATION_RECORD,fdc-57660863a7be796a0353ac31,synthetic-nonform-layout-09,original,2025,fte-2fd106d79df9c10d2be431ed,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 484.00",GIFT_RECORD,29,GIFT_RECORD,fdc-11845eb764e28eed1acafc1e,synthetic-nonform-layout-08,original,2025,fte-4d21eac0b188dead0887b44e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 503.00",GIFT_RECORD,29,GIFT_RECORD,fdc-23f970306665a355bc4775e1,synthetic-nonform-layout-08,original,2025,fte-d6095cba2cd4aaeb21c88e61,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 522.00",GIFT_RECORD,29,GIFT_RECORD,fdc-2038970e27c09ca7c1c63908,synthetic-nonform-layout-08,original,2025,fte-35e4c395e6186e5d1172dac4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 541.00",GIFT_RECORD,29,GIFT_RECORD,fdc-0e40f2610333c91e4fe8e789,synthetic-nonform-layout-08,original,2025,fte-8b0b96024d4478f28df71236,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 560.00",GIFT_RECORD,29,GIFT_RECORD,fdc-7c8494e09a483c61a6f94870,synthetic-nonform-layout-08,original,2025,fte-cf1d4a2ce7a4bc5a0d35a96f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 579.00",GIFT_RECORD,29,GIFT_RECORD,fdc-19434b07005db1ac00b81a22,synthetic-nonform-layout-08,original,2025,fte-616b2e7c185fd4b992b57fa5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 598.00",GIFT_RECORD,29,GIFT_RECORD,fdc-c0ed27151655b4215cc5ad26,synthetic-nonform-layout-08,original,2025,fte-eecfa1be07d1dd824221a3cf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Personal gift letter
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation; Reference amount: 617.00",GIFT_RECORD,29,GIFT_RECORD,fdc-10bd421793b58e5246fd6320,synthetic-nonform-layout-08,original,2025,fte-5f56bcfeadf5a54077545e42,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 900 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 507.00",GIFT_RECORD,29,GIFT_RECORD,fdc-97911a85b0f8054fed10033c,synthetic-nonform-layout-09,original,2025,fte-72e48d43003ab7aaeb8eca33,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 901 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 526.00",GIFT_RECORD,29,GIFT_RECORD,fdc-0f4d8e5b3518ca10745d812d,synthetic-nonform-layout-09,original,2025,fte-fa44c8eb42498211ce17dfd2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 902 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 545.00",GIFT_RECORD,29,GIFT_RECORD,fdc-46047a17c32f53e1a28471d5,synthetic-nonform-layout-09,original,2025,fte-431130c4c20e06794774df9f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 903 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 564.00",GIFT_RECORD,29,GIFT_RECORD,fdc-f9afd36c685ff88e435516f9,synthetic-nonform-layout-09,original,2025,fte-7cb57b1ff10155dc409865cc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 904 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 583.00",GIFT_RECORD,29,GIFT_RECORD,fdc-91cba673d983f0d3b79eb37a,synthetic-nonform-layout-09,original,2025,fte-b638a6b38aded86a0c91c639,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 905 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 602.00",GIFT_RECORD,29,GIFT_RECORD,fdc-c0cc0786c177788659328b68,synthetic-nonform-layout-09,original,2025,fte-0deeb060f65d23ebb6be8194,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 906 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 621.00",GIFT_RECORD,29,GIFT_RECORD,fdc-ffd2f4e278880eecc5134efc,synthetic-nonform-layout-09,original,2025,fte-f6b76af34deb745b87910265,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Personal gift letter
Example Client 907 is the named party.
Information printed on this record:
Family donor states transfer is a completed personal gift, with no services, sale or repayment obligation
Reference amount: 640.00",GIFT_RECORD,29,GIFT_RECORD,fdc-69ad77395849164046c79b6c,synthetic-nonform-layout-09,original,2025,fte-e2a4fed0df58cc5721454410,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 484.00",GIFT_RECORD,29,GIFT_RECORD,fdc-1266e7edd41dacf115c7ca21,synthetic-nonform-layout-08,original,2025,fte-4961cd4be8734d89a8bad926,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 503.00",GIFT_RECORD,29,GIFT_RECORD,fdc-c57700d96741aaba22c20ba9,synthetic-nonform-layout-08,original,2025,fte-d67a9ed6f877d187c80deb06,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 522.00",GIFT_RECORD,29,GIFT_RECORD,fdc-27999dfc0b99e47a07fd658f,synthetic-nonform-layout-08,original,2025,fte-28919b8a44ad07d7296caee4,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 541.00",GIFT_RECORD,29,GIFT_RECORD,fdc-c37d150c5e91b673c6ab6004,synthetic-nonform-layout-08,original,2025,fte-1676b5d319c7e966beef3d39,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 560.00",GIFT_RECORD,29,GIFT_RECORD,fdc-292c27c0aead3c9f742f4faa,synthetic-nonform-layout-08,original,2025,fte-ebdbbe75ba992f035d7a78bc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 579.00",GIFT_RECORD,29,GIFT_RECORD,fdc-82fe3c9578d72801bac15ef4,synthetic-nonform-layout-08,original,2025,fte-bc230f4de706b9d15dc3b1be,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 598.00",GIFT_RECORD,29,GIFT_RECORD,fdc-68301d462ca9e336210e9fec,synthetic-nonform-layout-08,original,2025,fte-171f76ba35d5e7ff0d5490b2,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Foreign gift evidence
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review; Reference amount: 617.00",GIFT_RECORD,29,GIFT_RECORD,fdc-9f987514d8aaa8278948ef3d,synthetic-nonform-layout-08,original,2025,fte-e0dd320651682c4a0140a97b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 900 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 507.00",GIFT_RECORD,29,GIFT_RECORD,fdc-5e0bcc4280d8b35c75e07625,synthetic-nonform-layout-09,original,2025,fte-cb3f722bb7cb196622919aa1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 901 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 526.00",GIFT_RECORD,29,GIFT_RECORD,fdc-a8f7a2f1fd6e013d782c5279,synthetic-nonform-layout-09,original,2025,fte-f4a1240c7d2082d29da65302,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 902 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 545.00",GIFT_RECORD,29,GIFT_RECORD,fdc-32e3c641c969437acc029cd7,synthetic-nonform-layout-09,original,2025,fte-ff53b93c85161b443a9e412a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 903 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 564.00",GIFT_RECORD,29,GIFT_RECORD,fdc-ab18e5c786a848571d0ecd47,synthetic-nonform-layout-09,original,2025,fte-d4b66eab9f20f71746f19a42,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 904 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 583.00",GIFT_RECORD,29,GIFT_RECORD,fdc-7bf9a9a16c454edf0fd23331,synthetic-nonform-layout-09,original,2025,fte-8346b6705d333565ba306f36,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 905 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 602.00",GIFT_RECORD,29,GIFT_RECORD,fdc-b5774d0092129eb92032117d,synthetic-nonform-layout-09,original,2025,fte-0a64023f0321f171d136c009,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 906 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 621.00",GIFT_RECORD,29,GIFT_RECORD,fdc-72295ddd68099e5fbe5c2ac5,synthetic-nonform-layout-09,original,2025,fte-9c2521d7ade51c64fb9b7dce,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Foreign gift evidence
Example Client 907 is the named party.
Information printed on this record:
Letter identifies foreign donor and US recipient; no services; foreign information reporting requires specialist review
Reference amount: 640.00",GIFT_RECORD,29,GIFT_RECORD,fdc-2e7b214ab79e2eae24919d0a,synthetic-nonform-layout-09,original,2025,fte-6ade9f679edc4e9d2f940274,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 484.00",GIFT_RECORD,29,GIFT_RECORD,fdc-a1d6f0f6868402aacdb5be21,synthetic-nonform-layout-08,original,2025,fte-b11495ae645166c680db9f2a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 503.00",GIFT_RECORD,29,GIFT_RECORD,fdc-e3caa8372c56d4e07d657bd1,synthetic-nonform-layout-08,original,2025,fte-b1d238ae507e05f789f88ff7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 522.00",GIFT_RECORD,29,GIFT_RECORD,fdc-37b0fa5b03a2856675f95cd7,synthetic-nonform-layout-08,original,2025,fte-8dc9c5ebd14eb2661cebf423,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 541.00",GIFT_RECORD,29,GIFT_RECORD,fdc-021b93f855ce03454a8c52ac,synthetic-nonform-layout-08,original,2025,fte-9649b8d07a44198f7e67084e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 560.00",GIFT_RECORD,29,GIFT_RECORD,fdc-3befe544b9f5ea16bccb68c0,synthetic-nonform-layout-08,original,2025,fte-dfab78637db857721562a42d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 579.00",GIFT_RECORD,29,GIFT_RECORD,fdc-276f722053f3ac611fbc67f0,synthetic-nonform-layout-08,original,2025,fte-b0928a1ee760e5886629334f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 598.00",GIFT_RECORD,29,GIFT_RECORD,fdc-ae5933408678e8b40258a7ab,synthetic-nonform-layout-08,original,2025,fte-6dc61e7dfd66cc45e8dcd184,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Gift transfer agreement
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Donor and donee identified; property transferred without consideration; gift reporting facts require review; Reference amount: 617.00",GIFT_RECORD,29,GIFT_RECORD,fdc-473bee8058259961f9347c0f,synthetic-nonform-layout-08,original,2025,fte-c02e4b8abcb9ebbe8d27fed1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 900 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 507.00",GIFT_RECORD,29,GIFT_RECORD,fdc-fb2a70974ec826382feb854f,synthetic-nonform-layout-09,original,2025,fte-6f3651d9be685e2a34ef3482,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 901 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 526.00",GIFT_RECORD,29,GIFT_RECORD,fdc-95340b36ecc45722cc0f0c81,synthetic-nonform-layout-09,original,2025,fte-99cf4802591bd8b8dcc54b8e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 902 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 545.00",GIFT_RECORD,29,GIFT_RECORD,fdc-4a9d7927c044237bfa7460a7,synthetic-nonform-layout-09,original,2025,fte-d29fe675b3d8fec8492475e8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 903 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 564.00",GIFT_RECORD,29,GIFT_RECORD,fdc-363a0d404b9279e8c27a8216,synthetic-nonform-layout-09,original,2025,fte-addf116539b820612b488845,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 904 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 583.00",GIFT_RECORD,29,GIFT_RECORD,fdc-1f4a4557367da1ba75df0d61,synthetic-nonform-layout-09,original,2025,fte-6d5a4fd6bbd302b0b561d399,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 905 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 602.00",GIFT_RECORD,29,GIFT_RECORD,fdc-7a135acf81fccc36751d2797,synthetic-nonform-layout-09,original,2025,fte-cf123484691100b62fd56523,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 906 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 621.00",GIFT_RECORD,29,GIFT_RECORD,fdc-3236811c7f7cd3bdac51067e,synthetic-nonform-layout-09,original,2025,fte-3a521a95b3e5dab0fe51ba8a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Gift transfer agreement
Example Client 907 is the named party.
Information printed on this record:
Donor and donee identified; property transferred without consideration; gift reporting facts require review
Reference amount: 640.00",GIFT_RECORD,29,GIFT_RECORD,fdc-fcfb28cddfc19b8ac54d0909,synthetic-nonform-layout-09,original,2025,fte-582f8f510c52c2b0b53b442a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 484.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-1f2a5a044780441245b1620a,synthetic-nonform-layout-08,original,2025,fte-1ffd62af09865adc8faa80da,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 503.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-a018945784d04fd4a3601f49,synthetic-nonform-layout-08,original,2025,fte-054b3a547ac5ff234bf0a2cf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 522.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-7aff21e40ab0c098c47583b5,synthetic-nonform-layout-08,original,2025,fte-42330c83e3c4aa8b3efa5871,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 541.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-9f9ffee631c5d98d640c270c,synthetic-nonform-layout-08,original,2025,fte-5c47c98994728787a4aeec76,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 560.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-a39b8cc1c28288a79e84186c,synthetic-nonform-layout-08,original,2025,fte-62a31e26ab1d6fecaa4d0c6c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 579.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-0ff9a5ab114b8f8f943b6b11,synthetic-nonform-layout-08,original,2025,fte-30cdfb354a4774e521b3cc09,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 598.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-9dba207118603128a559edc9,synthetic-nonform-layout-08,original,2025,fte-135647fc638b329a64da56d3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Credit card account statement
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Purchases, payments and merchant credits are reported separately; no income tax form is enclosed; Reference amount: 617.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-9a96d1ac7fc948a12eec6ee7,synthetic-nonform-layout-08,original,2025,fte-bb49682f6b7475ef9e87f247,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 900 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 507.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-18503724ffca794dc12571fc,synthetic-nonform-layout-09,original,2025,fte-3138b081657685a37fb08e5d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 901 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 526.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-95f2112c0c11e86f900d5e41,synthetic-nonform-layout-09,original,2025,fte-c911f7fa2cdff98a89b625d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 902 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 545.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-797dd7fe7f8f53263b94196b,synthetic-nonform-layout-09,original,2025,fte-632665e81b87d37067715ba7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 903 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 564.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-795838db65791213ee536d9b,synthetic-nonform-layout-09,original,2025,fte-234c6fb2bbca14bcede238b7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 904 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 583.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-e6e1592a011f3944e8013838,synthetic-nonform-layout-09,original,2025,fte-5ef25d057dcc1f9f1aad38fd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 905 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 602.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-bafdab48a061b56f16b1d9cd,synthetic-nonform-layout-09,original,2025,fte-56e5850933d789e18c2aa939,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 906 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 621.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-00f168bd9f4a2a6035eaee17,synthetic-nonform-layout-09,original,2025,fte-518d3fdb90b7d581c89ad0f1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Credit card account statement
Example Client 907 is the named party.
Information printed on this record:
Purchases, payments and merchant credits are reported separately; no income tax form is enclosed
Reference amount: 640.00",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-5e5be49f234a6075f1b0b133,synthetic-nonform-layout-09,original,2025,fte-56101e8a9c9f67714d603597,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 484.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-a7ef2d5ecdc7d27826f25e26,synthetic-nonform-layout-08,original,2025,fte-595a7ae319fe5437b0f53023,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 503.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-79a468872b4de3a2d1ef88ed,synthetic-nonform-layout-08,original,2025,fte-b3a22af4461ff3e86d051278,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 522.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-0d47a0e0f4788cedf4954cca,synthetic-nonform-layout-08,original,2025,fte-f7bf4ec62ef33aa62e498668,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 541.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-e9e1163dbdcffa6782496457,synthetic-nonform-layout-08,original,2025,fte-8686ed2608945c458d315308,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 560.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-c9eb200ba0e6a7672f49cc9c,synthetic-nonform-layout-08,original,2025,fte-3f5d0f7a26b3894980766916,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 579.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-7323039ba1f1c2ab9a5dffdc,synthetic-nonform-layout-08,original,2025,fte-8e40f77effb76c8a1a950605,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 598.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-960e960eeeb32f6ffa906516,synthetic-nonform-layout-08,original,2025,fte-f7c86789e39d976e45f2fcdf,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Checking account activity
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Deposits and withdrawals shown; account ownership and source direction convention printed; Reference amount: 617.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-a3b0107379f27441a3b74941,synthetic-nonform-layout-08,original,2025,fte-bf2d578bf1f1aca181c69b7f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 900 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 507.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-23963e65acb1a9de39cd83f9,synthetic-nonform-layout-09,original,2025,fte-f35219bd488ba317b4595955,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 901 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 526.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-653742079a0afdead0e86123,synthetic-nonform-layout-09,original,2025,fte-f182c88a42ede92b3219a5dd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 902 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 545.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-57d8722e3cda121d60294237,synthetic-nonform-layout-09,original,2025,fte-d96bee3a6966224022ba984a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 903 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 564.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-b16db1ac6591d7840f7a6f6f,synthetic-nonform-layout-09,original,2025,fte-f96e881ca58cc5980847f626,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 904 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 583.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-73b8388104b1dc781d5a2705,synthetic-nonform-layout-09,original,2025,fte-1f2c412f0025a0f5965f1055,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 905 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 602.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-a77a09cc59fd03974e5e2cf0,synthetic-nonform-layout-09,original,2025,fte-2cb16a84c99d29f6bae681c8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 906 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 621.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-8bbac69a25b1fb31c5d3a6d8,synthetic-nonform-layout-09,original,2025,fte-c72ee74f8fbdbe0460763151,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Checking account activity
Example Client 907 is the named party.
Information printed on this record:
Deposits and withdrawals shown; account ownership and source direction convention printed
Reference amount: 640.00",BANK_STATEMENT,24,BANK_STATEMENT,fdc-a7827cf4bb2d8345db806a59,synthetic-nonform-layout-09,original,2025,fte-920d0c7124d54bb2d2fce2c8,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 484.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-e4f0802e0093fbe3c66b15b6,synthetic-nonform-layout-08,original,2025,fte-387effb6c6d418323cc094e0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 503.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-393cac0e2cd93294435cad49,synthetic-nonform-layout-08,original,2025,fte-749ebea6a7910ba72154cc03,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 522.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-da324c911808d267d7c09613,synthetic-nonform-layout-08,original,2025,fte-0e0fc7ad7fd138bcc4988139,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 541.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-345ad53736410b61173e71f3,synthetic-nonform-layout-08,original,2025,fte-c6626afc287e679e801faf67,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 560.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-c7f3394c9a5570fc40e95ffe,synthetic-nonform-layout-08,original,2025,fte-7c285976e66bf12b288e68d1,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 579.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-4a86bfeeb58b1c9495d0370d,synthetic-nonform-layout-08,original,2025,fte-2e7035a4160e9ebbad863f36,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 598.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-c1a337ac5b79ff64b7bb48bd,synthetic-nonform-layout-08,original,2025,fte-57bf10af5e624f2057266d05,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Retail purchase receipt
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Goods purchased for personal use; paid by card; seller and purchase amount shown; Reference amount: 617.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-9d0ef2fdd8e64bb29d7dbd05,synthetic-nonform-layout-08,original,2025,fte-2b1a3f1980a415f739e445e9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 900 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 507.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-f33cb14e2746605c9528cc6d,synthetic-nonform-layout-09,original,2025,fte-98b557488cf4278ad3f66436,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 901 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 526.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-7530f04d2b87859a239666c1,synthetic-nonform-layout-09,original,2025,fte-caede980ccd2d03de5c26599,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 902 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 545.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-a8bd8ad32036986dbfa3e0cb,synthetic-nonform-layout-09,original,2025,fte-11164772e5060527fad8a26b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 903 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 564.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-e2f7c23e885627b73d167786,synthetic-nonform-layout-09,original,2025,fte-ace03df5fe68b054122d676a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 904 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 583.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-697eddf43df9c19779a3ad27,synthetic-nonform-layout-09,original,2025,fte-fbeef72adf652b1f4b2a98a3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 905 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 602.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-bf156b174213d12783ab9b30,synthetic-nonform-layout-09,original,2025,fte-8e7ae25aafbe3f058fbfe780,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 906 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 621.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-4c32b934cd9f9b1992327dad,synthetic-nonform-layout-09,original,2025,fte-18b5e1c736b9b7f0b2e2e421,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Retail purchase receipt
Example Client 907 is the named party.
Information printed on this record:
Goods purchased for personal use; paid by card; seller and purchase amount shown
Reference amount: 640.00",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-925f41eb63abe2498c04c148,synthetic-nonform-layout-09,original,2025,fte-c0ce60d48647872c53d4c42a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 484.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-c17a75f7232beb34d5d5ad49,synthetic-nonform-layout-08,original,2025,fte-468478f5769da39bf9e9f89e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 503.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-9cac08bd4f030e7a4a469783,synthetic-nonform-layout-08,original,2025,fte-24fe57ebdf50b155217f1008,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 522.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-f20403717203da8650e3fdf6,synthetic-nonform-layout-08,original,2025,fte-b2b683c3f14612b43551ad94,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 541.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-f97a36c22724bd6812cd3b8b,synthetic-nonform-layout-08,original,2025,fte-571b50214947728d360b5085,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 560.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-f726c3837432fd4b114aee70,synthetic-nonform-layout-08,original,2025,fte-bf0eb66cbf2d4535269a2b58,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 579.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-44a7cfdfc89e87497cf512f1,synthetic-nonform-layout-08,original,2025,fte-420abad51aa1ea905356de12,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 598.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-8160da3a87b695e8ccd843c9,synthetic-nonform-layout-08,original,2025,fte-573e571588bea57d1f368711,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Charitable pledge reminder
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Promise of a future contribution; payment has not been received; Reference amount: 617.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-5c6a843a6140ddaa733ed54f,synthetic-nonform-layout-08,original,2025,fte-1051541eae01e70a8337411e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 900 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 507.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-005d13492a2606d55a1d34bc,synthetic-nonform-layout-09,original,2025,fte-32b45d173faaa9c01c34039a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 901 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 526.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-c4bbe2f6c3fa15acad532870,synthetic-nonform-layout-09,original,2025,fte-8b7cb7adaf5a5a686e025a79,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 902 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 545.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-a9b7517ceb6c607790147c23,synthetic-nonform-layout-09,original,2025,fte-80890b7be4cadb7e45375e5c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 903 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 564.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-b04b34c1148b7aa960fb7d88,synthetic-nonform-layout-09,original,2025,fte-e2f1eb31dbd230f0bcc8c46c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 904 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 583.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-6051511833a30ee46a50a3dd,synthetic-nonform-layout-09,original,2025,fte-5faa626e8d5760cee11102b8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 905 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 602.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-c9a32192e51de06f7ab381dc,synthetic-nonform-layout-09,original,2025,fte-dc9181db906a840181448cab,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 906 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 621.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-31910e0969c0614e57f07966,synthetic-nonform-layout-09,original,2025,fte-53748ceba5cfc59598b9c4fb,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Charitable pledge reminder
Example Client 907 is the named party.
Information printed on this record:
Promise of a future contribution; payment has not been received
Reference amount: 640.00",PLEDGE_NOTICE,32,PLEDGE_NOTICE,fdc-d3e57646e3e9c809624b4a69,synthetic-nonform-layout-09,original,2025,fte-ea1b0ea1c4e71b408aac65d9,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 484.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-480ef3eaa31421ea7448f400,synthetic-nonform-layout-08,instruction,2025,fte-3c3232f430129a049a762a7e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 503.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-633a9f37e117048171a93b7e,synthetic-nonform-layout-08,instruction,2025,fte-da881041307fc56bba85f71f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 522.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-58f035a6fdcbb144efe003c8,synthetic-nonform-layout-08,instruction,2025,fte-1db4d6a00fe793ec7dcde0be,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 541.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-4bf58f764701f1b0619cf3d9,synthetic-nonform-layout-08,instruction,2025,fte-18ee513c78b922e7c085d07f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 560.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-db0ef61dc7f4dcd56ffc9f5b,synthetic-nonform-layout-08,instruction,2025,fte-0e34237b2a572bec6ba04a4f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 579.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-749a9cee017220a23d11d33c,synthetic-nonform-layout-08,instruction,2025,fte-01f7fa9143d7e5ead7c69927,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 598.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-8f2358844ac5813d8e98ceac,synthetic-nonform-layout-08,instruction,2025,fte-3d983ef7eac609dcd16bf7b0,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Blank tax form instructions
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation; Reference amount: 617.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-22e2a9c2d292c43d1a47ce5b,synthetic-nonform-layout-08,instruction,2025,fte-e31955fe0892e0da8d6c709c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 900 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 507.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-e51362e237c7ed09a0f11f56,synthetic-nonform-layout-09,instruction,2025,fte-78ccff2ca2a6720fb40fff60,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 901 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 526.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-24d6f2764a03ff3f75355e12,synthetic-nonform-layout-09,instruction,2025,fte-e3a2243a98774ccd67ba8d5a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 902 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 545.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-36895860d01823e5cf98b5f9,synthetic-nonform-layout-09,instruction,2025,fte-dc3ba42fdb7b8d3291946c07,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 903 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 564.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-b7970a17fced31447d980cbe,synthetic-nonform-layout-09,instruction,2025,fte-a96017ba0685b17313355216,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 904 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 583.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-fb95950406a92601a330477b,synthetic-nonform-layout-09,instruction,2025,fte-a8c7866416705bbd9d792539,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 905 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 602.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-c9356120bcbc75922acefb83,synthetic-nonform-layout-09,instruction,2025,fte-ff9a4871f5773389590357c9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 906 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 621.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-b0e9bf4300c974faaf45ba8c,synthetic-nonform-layout-09,instruction,2025,fte-6045547efe88b5b7e6c4a869,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Blank tax form instructions
Example Client 907 is the named party.
Information printed on this record:
General directions mentioning W-2 and 1099-NEC; no completed payer statement or reported compensation
Reference amount: 640.00",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-0ab6be84610c6ab125b06bc4,synthetic-nonform-layout-09,instruction,2025,fte-e7dd387189a75e2b0f5f5926,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 484.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-1141c7645bdabd9868a50305,synthetic-nonform-layout-08,original,2025,fte-c054692f2ce0ae13bbd38567,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 503.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-2ac215b3a02228aa0e1743f6,synthetic-nonform-layout-08,original,2025,fte-1eae112393d54c997f1783d5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 522.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-55006e713794ac405d5829f4,synthetic-nonform-layout-08,original,2025,fte-c39e169ce09f571ac7e7105a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 541.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-ba3ef76d2acaec4e18c05902,synthetic-nonform-layout-08,original,2025,fte-9a4bb0a037fa048a8b013b0b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 560.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-e3df4e2c9b225c39a4f3823b,synthetic-nonform-layout-08,original,2025,fte-e2d311e66352930e54573f7a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 579.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-a33c4a78893beb0376f15eff,synthetic-nonform-layout-08,original,2025,fte-e13174f8a1b2d8bcd1102325,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 598.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-37e62cc9a8a296f19b0656ae,synthetic-nonform-layout-08,original,2025,fte-b16f3efb1ec1b4a861fe9676,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Donation appeal
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Request for future support; no completed donation or donor acknowledgment; Reference amount: 617.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-13dfa6a7acb9fd5647845a79,synthetic-nonform-layout-08,original,2025,fte-834319c6e54779c8db10cc9e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 900 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 507.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-578f61f89c54305bd777804f,synthetic-nonform-layout-09,original,2025,fte-26343e66a0f773a5e7b45ef3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 901 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 526.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-85a0a00bc7faf7a5b6bd287c,synthetic-nonform-layout-09,original,2025,fte-e66ec465a7ab890b27e02e1e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 902 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 545.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-b0d0f51c925fc2cced9ec39f,synthetic-nonform-layout-09,original,2025,fte-bd9f0ab0e269516ba2dd13b1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 903 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 564.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-156f88f20bffdf83deae7c8c,synthetic-nonform-layout-09,original,2025,fte-3d0cc87c53f0dad771354bca,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 904 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 583.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-6892d1ada120b76f213c3355,synthetic-nonform-layout-09,original,2025,fte-725212918d50d625824ac3d1,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 905 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 602.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-24d0d237df028b160ad0faf0,synthetic-nonform-layout-09,original,2025,fte-812f0fe542fa8dfa2ccb033e,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 906 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 621.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-3e226c5c1846c1c4beeddca8,synthetic-nonform-layout-09,original,2025,fte-440d738c27552853a1e4b100,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Donation appeal
Example Client 907 is the named party.
Information printed on this record:
Request for future support; no completed donation or donor acknowledgment
Reference amount: 640.00",DONATION_APPEAL,27,DONATION_APPEAL,fdc-cbe7c9c16ed335afc73a4d0a,synthetic-nonform-layout-09,original,2025,fte-c4dd27168c60867d3f70b546,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 484.00",DONATION_RECORD,28,DONATION_RECORD,fdc-b3d43fcc90ef92c5e9fbc6dd,synthetic-nonform-layout-08,original,2025,fte-c61fbcdaa4287dca068c0044,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 503.00",DONATION_RECORD,28,DONATION_RECORD,fdc-fb620deb42795441b29f8719,synthetic-nonform-layout-08,original,2025,fte-2581d0db9800ea1cd53bcdcb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 522.00",DONATION_RECORD,28,DONATION_RECORD,fdc-f046a0d7fe4d290026e2fcea,synthetic-nonform-layout-08,original,2025,fte-94b6708c7c7a3c6888244242,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 541.00",DONATION_RECORD,28,DONATION_RECORD,fdc-22a77d78536f8a84eb93822d,synthetic-nonform-layout-08,original,2025,fte-d7d13c28182252ca4ef2d0f3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 560.00",DONATION_RECORD,28,DONATION_RECORD,fdc-ab3b197742970b85ce8bcaa2,synthetic-nonform-layout-08,original,2025,fte-fc640b237318b22fcb489845,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 579.00",DONATION_RECORD,28,DONATION_RECORD,fdc-7ec8b902314abb0f47ebd640,synthetic-nonform-layout-08,original,2025,fte-250704cab81769a70ce9e903,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 598.00",DONATION_RECORD,28,DONATION_RECORD,fdc-1d0d84e0808591975dadda8b,synthetic-nonform-layout-08,original,2025,fte-0e1add7478c6c4372694e3bc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Fundraising dinner receipt
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction; Reference amount: 617.00",DONATION_RECORD,28,DONATION_RECORD,fdc-7e708d4dc2fc20bebfd08c30,synthetic-nonform-layout-08,original,2025,fte-eab1846aee2558dd0b7e3460,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 900 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 507.00",DONATION_RECORD,28,DONATION_RECORD,fdc-aee58f067a30e21a7cacacf5,synthetic-nonform-layout-09,original,2025,fte-9cb41c6269b75b3461fb74fd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 901 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 526.00",DONATION_RECORD,28,DONATION_RECORD,fdc-b7ae188b1ef684c4819dc8ed,synthetic-nonform-layout-09,original,2025,fte-32695f201674ce6b286e6724,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 902 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 545.00",DONATION_RECORD,28,DONATION_RECORD,fdc-873c59acdeba86f26f388ba8,synthetic-nonform-layout-09,original,2025,fte-a162b1c15b7bcfc35ca194cc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 903 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 564.00",DONATION_RECORD,28,DONATION_RECORD,fdc-8922bac2a7f6a6758633d0df,synthetic-nonform-layout-09,original,2025,fte-039e492a76eac122b92002b8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 904 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 583.00",DONATION_RECORD,28,DONATION_RECORD,fdc-454ad669c9bbfd305911106a,synthetic-nonform-layout-09,original,2025,fte-311266aa68eab65a769aa7b7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 905 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 602.00",DONATION_RECORD,28,DONATION_RECORD,fdc-b52d978b0b8d72310360df23,synthetic-nonform-layout-09,original,2025,fte-4db877249442ff6d31e2d3d8,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 906 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 621.00",DONATION_RECORD,28,DONATION_RECORD,fdc-67ed300c10673e483a8f1808,synthetic-nonform-layout-09,original,2025,fte-6fee5c80025ad433f5eb73ae,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Fundraising dinner receipt
Example Client 907 is the named party.
Information printed on this record:
Payment and fair value of dinner benefits separately stated; do not equate gross payment with deduction
Reference amount: 640.00",DONATION_RECORD,28,DONATION_RECORD,fdc-1c316312d02690b749320fc4,synthetic-nonform-layout-09,original,2025,fte-fcae5f800af7f8338ec9bb58,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 484.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-b2225e26a4b1d035a188ff81,synthetic-nonform-layout-08,original,2025,fte-97570df24b32b4f804b3ff49,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 503.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-893c1e8829b2adab9690d9ab,synthetic-nonform-layout-08,original,2025,fte-2cf3dd22b7be4b138dd4b272,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 522.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-143990e8fa0fb80d94334346,synthetic-nonform-layout-08,original,2025,fte-fc8b136263e5d50601e0416b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 541.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-0a7101575cf94e5bedfc892b,synthetic-nonform-layout-08,original,2025,fte-c50ea74a32433cc7f462978d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 560.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-cf6684b1be0fe96b82a41f0f,synthetic-nonform-layout-08,original,2025,fte-99f4ce38c756476254f09928,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 579.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-2b4c28d27b97ba7098be1cf0,synthetic-nonform-layout-08,original,2025,fte-68e56168adb2d9a6bae81742,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 598.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-9e180d91daf7596760a63f2c,synthetic-nonform-layout-08,original,2025,fte-21bf5ccf0fc2bc409226766b,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Medical expense receipt
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Patient paid for treatment; insurance reimbursement and qualified expense facts require verification; Reference amount: 617.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-93142e4fa4e2fdd064fa86e8,synthetic-nonform-layout-08,original,2025,fte-86c4129079405131d714abdf,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 900 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 507.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-a625d115c455557ba67f9ced,synthetic-nonform-layout-09,original,2025,fte-737148e88dc10a748aeb97c5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 901 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 526.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-360d3613ceeb43de0d78d927,synthetic-nonform-layout-09,original,2025,fte-c649ab4aed4772822f2d6b45,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 902 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 545.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-2a21fcca44ead4c5cbb5f98a,synthetic-nonform-layout-09,original,2025,fte-7950ce534d756eb91182fdd7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 903 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 564.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-3a1d33fb20ef5466481c6151,synthetic-nonform-layout-09,original,2025,fte-737abbf7c65069f195de9fa2,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 904 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 583.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-70f0b09b35a61dcfffa3a218,synthetic-nonform-layout-09,original,2025,fte-ed1ae851d30f28d075f1e75b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 905 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 602.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-4298537f8711fc96a5c22f78,synthetic-nonform-layout-09,original,2025,fte-83d9d6246a5e84f50d05c3fe,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 906 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 621.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-c3c423f85734287d353b7d6b,synthetic-nonform-layout-09,original,2025,fte-94ae22f1c19ace71a516f5e3,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Medical expense receipt
Example Client 907 is the named party.
Information printed on this record:
Patient paid for treatment; insurance reimbursement and qualified expense facts require verification
Reference amount: 640.00",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-e943eb03e327875ff341fabd,synthetic-nonform-layout-09,original,2025,fte-19482beece786c693e45b981,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 484.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-be0b3a3613e2cca65ecf1f85,synthetic-nonform-layout-08,original,2025,fte-38bb75f944df4136ca174d4c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 503.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-0a3d4471ce922f785be0c57a,synthetic-nonform-layout-08,original,2025,fte-f91f38667659553ca0c7e762,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 522.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-373b5a03a9039e296db0937d,synthetic-nonform-layout-08,original,2025,fte-bb9b52470430df2267e9f967,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 541.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-7be49ba9b0cb52d2719f59d5,synthetic-nonform-layout-08,original,2025,fte-fa79febd626aa9ed4c059751,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 560.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-2e44acd92eb96a4e149ec7f7,synthetic-nonform-layout-08,original,2025,fte-1e5e940be53bdac8d0cf0a8e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 579.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-5bbb8b0754a5ffc8cc375c88,synthetic-nonform-layout-08,original,2025,fte-34861f2fdce3b83c21c41890,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 598.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-add2324f45d0c2d6b7bd991d,synthetic-nonform-layout-08,original,2025,fte-7eee07bb2613cbf33cab9b36,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Estimated tax payment confirmation
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher; Reference amount: 617.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-205abb427c56561ddc8776b3,synthetic-nonform-layout-08,original,2025,fte-4d413777104f72f5849b8c63,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 900 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 507.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-9c4193cf5e7e09ba84923c2a,synthetic-nonform-layout-09,original,2025,fte-21449319b26340689aa89d51,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 901 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 526.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-20aa757ecea949698c09dfe0,synthetic-nonform-layout-09,original,2025,fte-cffed8ab9a5ce715d266e177,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 902 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 545.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-3bcb5a89109039297cc95292,synthetic-nonform-layout-09,original,2025,fte-1d80baee76ae49da4f47af2a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 903 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 564.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-a8817ab4f769ffae33fb9bbc,synthetic-nonform-layout-09,original,2025,fte-c78ea36c9e1ac5596fb92af0,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 904 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 583.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-e674d3fe4458922d69fbbc2a,synthetic-nonform-layout-09,original,2025,fte-163bd8116171e89d1ccb5a54,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 905 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 602.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-bac8276f81cb2bff411e1e8d,synthetic-nonform-layout-09,original,2025,fte-a857c43d6ebe5cee469a617b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 906 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 621.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-a9e779f05b4ec781e7d24101,synthetic-nonform-layout-09,original,2025,fte-8efd2c16978bd1208d325965,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Estimated tax payment confirmation
Example Client 907 is the named party.
Information printed on this record:
Payment completed; tax year and federal authority identified; this is not an unsubmitted voucher
Reference amount: 640.00",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-a7c7c70aa8de7c3f6b4a6c29,synthetic-nonform-layout-09,original,2025,fte-ca7cce03d95612a521022610,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 484.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-b6099991a59abfbb3b63eb43,synthetic-nonform-layout-08,original,2025,fte-8084762c091bc00e40abe31d,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 503.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-3322b9d8780db96bfad28162,synthetic-nonform-layout-08,original,2025,fte-207fa1f1f521b5d1df3c6482,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 522.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-98e0e09446f96bf5fd24c407,synthetic-nonform-layout-08,original,2025,fte-f5387c3438d47a0d0cd0c0c7,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 541.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-20c149e5d10516292312f414,synthetic-nonform-layout-08,original,2025,fte-e365fb3b4d9590f74f71eec3,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 560.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-c1f534b7e234efc0d6633a37,synthetic-nonform-layout-08,original,2025,fte-7b28b634e332a14b9b7f338a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 579.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-79159bae29b1748a4f4a5045,synthetic-nonform-layout-08,original,2025,fte-0a1ae310d435de1467e40879,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 598.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-02f986640182b937ac53f9e8,synthetic-nonform-layout-08,original,2025,fte-26d7d1e32e7bf10683824cb6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Business sales ledger
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Customer sales and processing fees shown separately; reconciliation needed to gross receipts; Reference amount: 617.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-e3d7d1c117d218f0c804de19,synthetic-nonform-layout-08,original,2025,fte-b2bc356ef8ba3234667d1ef6,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 900 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 507.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-7cae908564ca34e5a1362a1c,synthetic-nonform-layout-09,original,2025,fte-5c2c7379d6ac7dcb4f91bafe,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 901 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 526.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-d117852ed74b53de159ad51c,synthetic-nonform-layout-09,original,2025,fte-0fcb1845dc6e891a2e9037b9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 902 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 545.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-3b8789cbee468a93d2a87a46,synthetic-nonform-layout-09,original,2025,fte-07b41f38100a0b729c06276f,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 903 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 564.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-daf4c80d28e77acfe9cddd2c,synthetic-nonform-layout-09,original,2025,fte-95d64b58cd28963bd81603c5,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 904 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 583.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-278e5f88a9597f977650d619,synthetic-nonform-layout-09,original,2025,fte-fe13dacfac1a81d6c82ca15d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 905 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 602.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-d2c500e1b84bf556bf5d3120,synthetic-nonform-layout-09,original,2025,fte-8de37425a09c6ec16208bb12,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 906 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 621.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-44d17e32d87b143f8f789c1d,synthetic-nonform-layout-09,original,2025,fte-fc126bd4a008e934ee303fbc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Business sales ledger
Example Client 907 is the named party.
Information printed on this record:
Customer sales and processing fees shown separately; reconciliation needed to gross receipts
Reference amount: 640.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-85f7365e87682d35384be28c,synthetic-nonform-layout-09,original,2025,fte-7addb03d3a7f6bf517c3233e,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 484.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-11bab567ba3a393a64feb2fe,synthetic-nonform-layout-08,original,2025,fte-5b82d21adaa2a2556d1d87bc,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 503.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-a2f4d033ca7720d3a57264f4,synthetic-nonform-layout-08,original,2025,fte-555f2f665f2ace316980cf92,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 522.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-1bd04a0e8b386deb60dcae97,synthetic-nonform-layout-08,original,2025,fte-b668361cfab9e51dfaaac719,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 541.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-89cc03b484aabfc77f95cd81,synthetic-nonform-layout-08,original,2025,fte-a0e2bbe0959697081e22122a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 560.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-57bfbd5262f527a53954927c,synthetic-nonform-layout-08,original,2025,fte-c2ba1bbeb7a0ac7b1c77b4f5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 579.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-151c3d74a7c05df228d38882,synthetic-nonform-layout-08,original,2025,fte-946df58d74f32f40f2db20b6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 598.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-e39416363b3e28424fe522b5,synthetic-nonform-layout-08,original,2025,fte-958bb85c0dbf81603738299c,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Rental property income record
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Tenant rent and security deposit listed separately; expense records attached; Reference amount: 617.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-f78b41dc5817213af94fa909,synthetic-nonform-layout-08,original,2025,fte-19b667e83c65503554ddf22d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 900 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 507.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ceee9e0b6c51d75bb72c67ff,synthetic-nonform-layout-09,original,2025,fte-4a7b41075d1687001aad51ba,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 901 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 526.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-212d5f0dd9d382e7cc3b37b6,synthetic-nonform-layout-09,original,2025,fte-1fdb2a8c009dd5aafedaddb7,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 902 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 545.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-0fd22d1e94a512d27d95b00d,synthetic-nonform-layout-09,original,2025,fte-6a30b060dd1f06236bdaa50d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 903 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 564.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-b3cdbf883ce00d1bcdd61514,synthetic-nonform-layout-09,original,2025,fte-bd6dd3fae84ecca9097f778d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 904 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 583.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-77f2655111845842075beecb,synthetic-nonform-layout-09,original,2025,fte-9ee382219df350447829ccbc,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 905 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 602.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ba060b912bdc84d089c528f7,synthetic-nonform-layout-09,original,2025,fte-ed5184986bd6c5782e571577,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 906 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 621.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-5d07ab4a8e01043165420692,synthetic-nonform-layout-09,original,2025,fte-ba41dd0f23f89c8b09dac92d,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Rental property income record
Example Client 907 is the named party.
Information printed on this record:
Tenant rent and security deposit listed separately; expense records attached
Reference amount: 640.00",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-872e5214eb1b364b552e690a,synthetic-nonform-layout-09,original,2025,fte-d063f8747bd64a00348a988a,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 800.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 484.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-3bac808facb1240fb563a190,synthetic-nonform-layout-08,unknown,,fte-b4c3db3ea0ad03eb3d818983,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 801.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 503.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-d126e5225dc63e4d7c4214bd,synthetic-nonform-layout-08,unknown,,fte-e2866973d36cb4cc472c4fa6,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 802.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 522.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-9fadd6be7b0515158e03db8e,synthetic-nonform-layout-08,unknown,,fte-4396311d0e71d22d6ccddbdb,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 803.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 541.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-ceca0a0aa05ac967132c6eb5,synthetic-nonform-layout-08,unknown,,fte-54ebdfb47b2363d31950a6b5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 804.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 560.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-ab4d40d79597bf9f26573fef,synthetic-nonform-layout-08,unknown,,fte-833afa421a7d6f9e254ebdd5,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 805.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 579.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-bdb3099d6469f01a26533349,synthetic-nonform-layout-08,unknown,,fte-d56ddab79a753f3b66937894,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 806.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 598.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-e62fc06f0c7f93a7138629cb,synthetic-nonform-layout-08,unknown,,fte-8fcb66f64f381b1dbe05666f,synthetic_AI_labeled,v1_template,top,False,
"YEAR-END REPORT
Illegible record fragment
For filing year 2025. The statement belongs to Example Client 807.
Reported fields follow: Unusable cropped fragment; document title and tax year cannot be read; Reference amount: 617.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-6d79119ddaa1a9f68d562ff1,synthetic-nonform-layout-08,unknown,,fte-157fc7cca755cf1cfdaf4c41,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 900 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 507.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-b460b603a06d06602f2dfb50,synthetic-nonform-layout-09,unknown,,fte-23b9c1a735b2bd42b8fee23a,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 901 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 526.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-5c0decd4b432a217d1decaec,synthetic-nonform-layout-09,unknown,,fte-b6c992d3cf7b9e8dfb6351fd,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 902 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 545.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-397d319e5b65eaefa8abd0af,synthetic-nonform-layout-09,unknown,,fte-d409478643fdf92786fc89a9,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 903 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 564.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-37846931795f4e7aa55028de,synthetic-nonform-layout-09,unknown,,fte-cfbbe415e5a9e3364d813370,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 904 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 583.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-5a5438011e748dcac03709df,synthetic-nonform-layout-09,unknown,,fte-1b5a540c0fe8d30a06f2d30c,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 905 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 602.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-01c0da7f74f25607d1bef8d6,synthetic-nonform-layout-09,unknown,,fte-eb896495d9d9dba963f5b07b,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 906 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 621.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-e4a55c5bd5c3ab45767b6a2c,synthetic-nonform-layout-09,unknown,,fte-2939f9aa809140256f041e12,synthetic_AI_labeled,v1_template,top,False,
"Tax record delivered for 2025
Title shown: Illegible record fragment
Example Client 907 is the named party.
Information printed on this record:
Unusable cropped fragment; document title and tax year cannot be read
Reference amount: 640.00",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-b40dd39431040a41ca7207e2,synthetic-nonform-layout-09,unknown,,fte-ede6e5efce6268f871c7debb,synthetic_AI_labeled,v1_template,top,False,
"Form 1040U.S. Individual Income Tax Return 2025
Name:
Weí K. Larsen
24 Add lines 22 and 23. This ís your total tax
S7,715.98
37 Subtract line 33 from line 24. This is the amount you owe
8,834.22
15 Subtract 1ine 14 from line 11. If zero or less, enter -0-. This is your taxable income
17,154.02",1040,0,1040,fdc-fcff45e80cd7cbe9e377b510,v11-1040-stacked,original,2025,fgen-748920e06f5f65ae1890c215,synthetic_programmatic_template,stacked,top,True,
"CORRECTED (if checked)
Form 1040
U.S. Individual Income Tax Return
For calendar year 2024
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Lena Romero
Home address (number and street)
9849 Harbor View Rd Oak Grove, TX 75615
Your social security number
XXX-XX-5941
Filing Status
1a Total amount from Form(s) W-2, box 1
104,657.47
2b Taxable interest
7,011.47
11 Subtract line 10 from line 9. This is your adjusted gross income
121,729.18
12 Standard deduction or itemized deductions (from Schedule A)
129,990.55
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$131,792.12
33 Add lines 25d, 26, and 32. These are your total payments
$3,132.27
Department of the Treasury - Internal Revenue Service
Form 1040 (keep for your records)  www.irs.gov/Form1040",1040,0,1040,fdc-a30ab94fe103abb4047fde9c,v11-1040-stacked,original,2024,fgen-7fbe38c5c9ad215df8f3f9fb,synthetic_programmatic_template,stacked,top,False,
"For calendar year 2021
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Noah Tanaka
Home address (number and street)
2043 Maple Ridge Dr Bayside, WA 51495
Your social security number
****3819
Filing Status
1a Total amount from Form(s) W-2, box 1
14,500.26
2b Taxable interest
$7,601.70
3b Ordinary dividends
$3,346.05
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
110,690.38
11 Subtract line 10 from line 9. This is your adjusted gross income
$4,895.61
12 Standard deduction or itemized deductions (from Schedule A)
126,259.71
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$58,813.54
24 Add lines 22 and 23. This is your total tax
8,074.73
33 Add lines 25d, 26, and 32. These are your total payments
650.89
37 Subtract line 33 from line 24. This is the amount you owe
1,576.17
Department of the Treasury - Internal Revenue Service",1040,0,1040,fdc-528d5d3ec53857d6541160ed,v11-1040-stacked,original,2021,fgen-38062c7cae43b67f14591042,synthetic_programmatic_template,stacked,none,False,
"CORRECTED (if checked)
Form 1040
U.S. Individual Income Tax Return
For calendar year 2022
OMB No. 1545-0074
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Morgan Moreau
Home address (number and street)
8923 Willow Bend Way Bayside, WA 39476
Your social security number
***-**-4980
Filing Status
2b Taxable interest
6,795.68
3b Ordinary dividends
$99.74
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
47,833.91
11 Subtract line 10 from line 9. This is your adjusted gross income
$9,178.66
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$7,590.11
24 Add lines 22 and 23. This is your total tax
9,369.40
37 Subtract line 33 from line 24. This is the amount you owe
$7,972.14",1040,0,1040,fdc-166dff02f553477f1dc02058,v11-1040-stacked,original,2022,fgen-602388a5432085a39e585ec4,synthetic_programmatic_template,stacked,top,False,
"Form 1040
U.S. Individual Income Tax Return
For calendar year 2026
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
Your first name and middle initial  Last name
Alex Kowalski
Home address (number and street)
7692 Oak Hollow Ct Maplewood, MN 51065
Your social security number
***-**-8256
Filing Status
1a Total amount from Form(s) W-2, box 1
$119,738.77
2b Taxable interest
7,691.10
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
$71,341.83
11 Subtract line 10 from line 9. This is your adjusted gross income
136,630.08
12 Standard deduction or itemized deductions (from Schedule A)
134,539.98
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
79,588.99
24 Add lines 22 and 23. This is your total tax
5,404.19
33 Add lines 25d, 26, and 32. These are your total payments
5,181.02
37 Subtract line 33 from line 24. This is the amount you owe
$28.49
Department of the Treasury - Internal Revenue Service
Form 1040 (keep for your records)  www.irs.gov/Form1040",1040,0,1040,fdc-e4201f4292bb9311ad44af03,v11-1040-stacked,original,2026,fgen-acc94677d3a4cd9704a3e49c,synthetic_programmatic_template,stacked,top,False,
"Form 1040 U.S. Individual Income Tax Return
Name:
Wei Moreau
33 Add lines 25d, 26, and 32. These are your total payments
8,001.95
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
62,267.66",1040,0,1040,fdc-251ba8fb611e2ace4c53d9be,v11-1040-stacked,original,2026,fgen-b820c90e07b767bfe9f78dfb,synthetic_programmatic_template,stacked,top,False,
"Form 1040 U.5. Indívidual Income Tax Return
Name:
Amara Adeyemi
15 Subtract line 14 from line 11. If zero or less, enter -O-. This isyour taxable income
101,438.32
33 Add lines 25d, 26, and 32. These are your total payments
$1,247.95
2b Taxable interest
$1,098.36",1040,0,1040,fdc-badd37c7e3ee1f238a6a79f8,v11-1040-stacked,original,2021,fgen-eba36669b392ebc448772311,synthetic_programmatic_template,stacked,top,True,
"CORRECTED (if checked)
Form 1040
U.S. Individual Income Tax Return
For calendar year 2021
Department of the Treasury—Internal Revenue Service
Your first name and middle initial  Last name
Fatima C. Brennan
Home address (number and street)
7430 Elm Park Pl Oak Grove, TX 25347
Your social security number
ending in 5908
Filing Status
1a Total amount from Form(s) W-2, box 1
$78,877.74
2b Taxable interest
3,164.70
3b Ordinary dividends
2,614.83
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
106,559.52
12 Standard deduction or itemized deductions (from Schedule A)
$69,929.50
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
68,867.13
24 Add lines 22 and 23. This is your total tax
$6,732.57
33 Add lines 25d, 26, and 32. These are your total payments
295.53
37 Subtract line 33 from line 24. This is the amount you owe
$2,587.76
Department of the Treasury - Internal Revenue Service
Form 1040 (keep for your records)  www.irs.gov/Form1040",1040,0,1040,fdc-6fbcf7e2eb3ae174698e0d62,v11-1040-stacked,original,2021,fgen-cb05f4267a547b9f2e6118ae,synthetic_programmatic_template,stacked,top,False,
"For calendar year 2022
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
Your first name and middle initial  Last name
Alex Haddad
Home address (number and street)
101 Oak Hollow Ct Cedar Falls, IA 69891
Your social security number
***-**-2617
Filing Status
1a Total amount from Form(s) W-2, box 1
40,953.15
2b Taxable interest
$3,829.89
3b Ordinary dividends
3,891.41
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
96,853.57
11 Subtract line 10 from line 9. This is your adjusted gross income
$131,598.79
12 Standard deduction or itemized deductions (from Schedule A)
107,006.86
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$66,413.77
37 Subtract line 33 from line 24. This is the amount you owe
$3,944.06
Department of the Treasury - Internal Revenue Service",1040,0,1040,fdc-7af1e73614bbf5b6570d60e2,v11-1040-stacked,original,2022,fgen-7883a5b5bff17cd3d7673d14,synthetic_programmatic_template,stacked,none,False,
"Form 1040
U.S. Individual Income Tax Return
2024
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Riley Okafor
Home address (number and street)
499 Sample Street Brookhaven, PA 94556
Your social security number
***-**-2783
Filing Status
1a Total amount from Form(s) W-2, box 1
$59,288.19
2b Taxable interest
3,630.63
3b Ordinary dividends
3,369.54
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
8,585.90
11 Subtract line 10 from line 9. This is your adjusted gross income
130,220.01
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$49,319.60
37 Subtract line 33 from line 24. This is the amount you owe
$3,129.63
Department of the Treasury - Internal Revenue Service
Form 1040 (keep for your records)  www.irs.gov/Form1040",1040,0,1040,fdc-bae130766d7a4683c2ec2793,v11-1040-stacked,original,2024,fgen-c6736a70b6207c9940ed6e69,synthetic_programmatic_template,stacked,top,False,
"Form 1040
U.S. Individual Income Tax Return
2022
Your first name and middle initial  Last name
Jamie B. Castillo
Home address (number and street)
2865 Granite St Oak Grove, TX 21279
Your social security number
XXXXX9270
Filing Status
1a Total amount from Form(s) W-2, box 1
14,352.95
2b Taxable interest
6,274.88
3b Ordinary dividends
$6,264.27
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
87,415.47
11 Subtract line 10 from line 9. This is your adjusted gross income
21,329.64
12 Standard deduction or itemized deductions (from Schedule A)
$58,805.15
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$59,176.92
24 Add lines 22 and 23. This is your total tax
8,259.05
37 Subtract line 33 from line 24. This is the amount you owe
2,685.22
Department of the Treasury - Internal Revenue Service
Form 1040 (keep for your records)  www.irs.gov/Form1040",1040,0,1040,fdc-db47dbcba552f352f938a715,v11-1040-stacked,original,2022,fgen-9371ac97984b5cade6231ca3,synthetic_programmatic_template,stacked,top,False,
"CORRECTED (if checked)
Form 1040
U.S. Individual Income Tax Return
For calendar year 2021
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
Your first name and middle initial  Last name
Taylor Nguyen
Home address (number and street)
3806 Oak Hollow Ct Maplewood, MN 68753
Your social security number
XXXXX9268
Filing Status
1a Total amount from Form(s) W-2, box 1
41,904.66
2b Taxable interest
8,421.26
3b Ordinary dividends
7,191.18
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
18,002.41
11 Subtract line 10 from line 9. This is your adjusted gross income
36,285.21
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$66,203.93
24 Add lines 22 and 23. This is your total tax
$6,065.33
33 Add lines 25d, 26, and 32. These are your total payments
4,324.68
Department of the Treasury - Internal Revenue Service
Form 1040 (keep for your records)  www.irs.gov/Form1040",1040,0,1040,fdc-0b45d97a416b95af54eb80ff,v11-1040-stacked,original,2021,fgen-2cbab8d004f9fdb6663b267f,synthetic_programmatic_template,stacked,top,False,
"VOID  CORRECTED
Form 1040
U.S. Individual Income Tax Return
2021
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Mateo J. Tanaka
Home address (number and street)
1112 Cedar Ln Testville, IL 27733
Your social security number
****5960
Filing Status
1a Total amount from Form(s) W-2, box 1
$74,105.72
2b Taxable interest
7.17
3b Ordinary dividends
9,005.55
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
44,743.04
11 Subtract line 10 from line 9. This is your adjusted gross income
21,689.40
12 Standard deduction or itemized deductions (from Schedule A)
$68,940.45
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
33,488.27
24 Add lines 22 and 23. This is your total tax
8,763.07
33 Add lines 25d, 26, and 32. These are your total payments
9,415.00
37 Subtract line 33 from line 24. This is the amount you owe
7,152.05
Department of the Treasury - Internal Revenue Service
Form 1040 (keep for your records)  www.irs.gov/Form1040",1040,0,1040,fdc-068a0b407cf7442cd942d00c,v11-1040-stacked,original,2021,fgen-4647663e61cccf83b9efcb67,synthetic_programmatic_template,stacked,top,False,
"☐ CORRECTED
Form 1040
U.S. Individual Income Tax Return
For calendar year 2021
OMB No. 1545-0074
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Mateo Brennan
Home address (number and street)
6840 Elm Park Pl Bayside, WA 79691
Your social security number
XXXXX5204
Filing Status
1a Total amount from Form(s) W-2, box 1
$108,313.85
2b Taxable interest
4,775.61
3b Ordinary dividends
$4,794.03
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
12,751.74
11 Subtract line 10 from line 9. This is your adjusted gross income
$121,828.69
12 Standard deduction or itemized deductions (from Schedule A)
$60,434.04
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
$128,831.75
33 Add lines 25d, 26, and 32. These are your total payments
$1,755.48",1040,0,1040,fdc-48dfeaed150eca2d2731a27a,v11-1040-stacked,original,2021,fgen-d80956eb2c9e2ca49bf24c2c,synthetic_programmatic_template,stacked,top,False,
"2024
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Taylor Adeyemi
Home address (number and street)
2947 Oak Hollow Ct Riverton, WI 95356
Your social security number
***-**-6928
Filing Status
1a Total amount from Form(s) W-2, box 1
1,547.58
2b Taxable interest
$4,751.43
3b Ordinary dividends
2,529.83
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
$54,981.49
11 Subtract line 10 from line 9. This is your adjusted gross income
22,339.01
12 Standard deduction or itemized deductions (from Schedule A)
37,364.23
24 Add lines 22 and 23. This is your total tax
$8,844.76
37 Subtract line 33 from line 24. This is the amount you owe
210.09
Form 1040
U.S. Individual Income Tax Return",1040,0,1040,fdc-fae37ff47e46bf8246c2b452,v11-1040-stacked,original,2024,fgen-d8fc65e70548d9da2c482270,synthetic_programmatic_template,stacked,bottom,False,
"Form 1040
U.S. Individual Income Tax Return
For calendar year 2025
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
IRS Use Only—Do not write or staple in this space.
Your first name and middle initial  Last name
Sofia Moreau
Home address (number and street)
9789 Cedar Ln Brookhaven, PA 58194
Your social security number
****4959
Filing Status
2b Taxable interest
4,851.09
3b Ordinary dividends
$6,813.54
9 Add lines 1z, 2b, 3b, 4b, 5b, 6b, 7, and 8. This is your total income
36,347.68
11 Subtract line 10 from line 9. This is your adjusted gross income
134,529.01
12 Standard deduction or itemized deductions (from Schedule A)
67,049.24
15 Subtract line 14 from line 11. If zero or less, enter -0-. This is your taxable income
114,928.41
24 Add lines 22 and 23. This is your total tax
2,526.46
33 Add lines 25d, 26, and 32. These are your total payments
$1,937.42",1040,0,1040,fdc-f8d30c4a4045481d796bb9f1,v11-1040-stacked,original,2025,fgen-664e39998a804cef83570e62,synthetic_programmatic_template,stacked,top,False,
"Form 1040-ES Estimated Tax for Individuals 2021
Name: Sofia Romero
Amount of estimated tax you are paying by check or money order.      6,472.42
Voucher      1
Calendar year—Due  Sept. 15, 2021",1040,0,1040,fdc-1e69a0ef7865c84c3790c2aa,v11-1040-ES-inline,original,2021,fgen-4cbe203ed32fbea938ca8d48,synthetic_programmatic_template,inline,top,False,
"Form1040-ES Estimated Tax for Individuals
Name:   Alex Kowalski
Amount of estimated tax you are paying by check or money order.  $4,211.05
Voucher 3
Ca1endar year—Due Jan. 15, 2024",1040,0,1040,fdc-61aca71f44fdbb110f2e3dd1,v11-1040-ES-inline,original,2023,fgen-4971cc0b5e6a1c219883480f,synthetic_programmatic_template,inline,top,True,
"2022
OMB No. 1545-0074
File only if you are making a payment of estimated tax by check or money order.
Mail this voucher with your check or money order payable to ""United States Treasury.""
Your first name and middle initial  Your last name Olivia Larsen
Address (number, street, and apt. no.) 4791 Elm Park Pl Pinecrest, GA 33894
Your social security number XXX-XX-0493
Calendar year—Due
Amount of estimated tax you are paying by check or money order.      $3,755.95
Calendar year—Due June 15, 2022",1040,0,1040,fdc-aab1704cdb0d49d1a31dfe80,v11-1040-ES-inline,original,2022,fgen-788014572cad8c30cd603870,synthetic_programmatic_template,inline,none,False,
"☐ CORRECTED
Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
For calendar year 2026
File only if you are making a payment of estimated tax by check or money order.
Mail this voucher with your check or money order payable to ""United States Treasury.""
Your first name and middle initial  Your last name Mateo Sato
Address (number, street, and apt. no.) 9465 Prairie Ave Lakewood, CO 92300
Your social security number   XXX-XX-9207
Calendar year—Due
Amount of estimated tax you are paying by check or money order.  $8,715.77
Voucher  1
Calendar year—Due June 15, 2026",1040,0,1040,fdc-30f653ef7baa45196ca44a1d,v11-1040-ES-inline,original,2026,fgen-c2746e952f74d611cc3f3958,synthetic_programmatic_template,inline,top,False,
"☐ CORRECTED
Form 1040-ES
Estimatcd Tax for Individuals
Payment Voucher
For calendar year 2025
OMB No. 1545-0074
Mail this voucher with your check or money order payable to ""Uníted States Treasury.""
Your first name and middlc initial  Your last namc      Casey Okafor
Address (number, street, and apt. no.) 6811Lakeshore Blvd Pinecrest, GA 35602
Your social security number      ****1450
Calendar year—Due
Amount of estimated tax you are paying by check or money order.  89.59
Voucher l
Calendar year—Due April 15,2025
Dcpartment of the Treasury -Internal Revenue Service
Form 1O40-ES (keep for your records)  www.irs.gov/Forml040ES",1040,0,1040,fdc-b80a77810346459099845e50,v11-1040-ES-inline,original,2025,fgen-b25207fb84675ada7c3b436f,synthetic_programmatic_template,inline,top,True,
"VOID  CORRECTED
Form 1040-ES
Estimated Tax for Individua1s
Payment Voucher
Mail this voucher with your checkormoney order payable to ""United States Treasury.""
Your first name and middle initial  Your last name      Riley R. Nguyen
Address (number, street, and apt. no.)      6539 Oak Hollow Ct Lakewood, CO 61421
Your social securitynumber      ****6971
Calendar year—Due
Amount of estimated tax you are paying by check or money order. 6,251.92
Ca1endar year—Due      April 15, 2024",1040,0,1040,fdc-ec1f9d2c797a8da27e7caa5c,v11-1040-ES-inline,original,2024,fgen-1279ffe7028bbde953d3f4d7,synthetic_programmatic_template,inline,top,True,
"Form 1040-ES Estimated Tax for Individuals 2024
Name:   Fatima R. Adeyemi
Amount of estimated tax you are paying by check or money order.   1,205.28
Voucher   3
Calendar year—Due  June 15, 2024",1040,0,1040,fdc-bc31479734d0e5907b00a352,v11-1040-ES-inline,original,2024,fgen-15670bf3c94dad9a30736d12,synthetic_programmatic_template,inline,top,False,
"☐ CORRECTED
Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
For calendar year 2026
Your first name and middle initial  Your last name  Kwame Tanaka
Address (number, street, and apt. no.)     3188 Oak HollowCt Bayside, WA 79056
Your social sccurity number XXXXX0116
Calendar year—Due
Amount of estimated tax you are paying by check or money order.   S2,315.32
Voucher      2
Ca1endar year—Due April 15, 2026",1040,0,1040,fdc-3ca91ad3b6cf7eee6fc80472,v11-1040-ES-inline,original,2026,fgen-ccfa40778062c0bff8fd62b1,synthetic_programmatic_template,inline,top,True,
"Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
2024
OMB No. 1545-0074
File only if you are making a payment of estimated tax by check or money order.
Mail this voucher with your check or money order payable to ""United States Treasury.""
Your first name and middle initial  Your last name   Hiro Brennan
Address (number, street, and apt. no.)  5414 Willow Bend Way Lakewood, CO 96358
Your social security number  XXX-XX-6818
Calendar year—Due
Amount of estimated tax you are paying by check or money order. 97.34
Voucher   2
Calendar year—Due   Sept. 15, 2024
Department of the Treasury - Internal Revenue Service
Form 1040-ES (keep for your records)  www.irs.gov/Form1040ES",1040,0,1040,fdc-bea8a7eb612d47371ca3c2be,v11-1040-ES-inline,original,2024,fgen-0e35d9260f43c54f6db44df9,synthetic_programmatic_template,inline,top,False,
"Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
For calendar year 2023
OMB No. 1545-0074
Mail this voucher with your check or money order payable to ""United States Treasury.""
Your first name and middle initial  Your last name Hiro C. Larsen
Address (number, street, and apt. no.)      8923 Harbor View Rd Fairview, OH 31672
Your social security number ending in 3308
Calendar year—Due
Amount of estimated tax you are paying by check or money order. $9,277.38
Calendar year—Due Sept. 15, 2023",1040,0,1040,fdc-7ce62a45875c05cace4b781c,v11-1040-ES-inline,original,2023,fgen-8fbe955256132e81a32ab60d,synthetic_programmatic_template,inline,top,False,
"Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
For calendar year 2025
OMB No. 1545-0074
Your first name and middle initial  Your last name Jordan Moreau
Address (number, street, and apt. no.)      4826 Oak Hollow Ct Testville, IL 23594
Your social security number   XXX-XX-3182
Calendar year—Due
Amount of estimated tax you are paying by check or money order.      1,862.85
Voucher      1
Calendar year—Due June 15, 2025",1040,0,1040,fdc-d619bd9cc1b0cf27c677c7bc,v11-1040-ES-inline,original,2025,fgen-e223800c89babd9a3ebd7535,synthetic_programmatic_template,inline,top,False,
"CORRECTED (if checked)
Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
2022
OMB No. 1545-0074
Your first name and middle initial  Your last name   Olivia Castillo
Address (number, street, and apt. no.)      4161 Sample Street Lakewood, CO 95688
Your social security number      ****6049
Calendar year—Due
Amount of estimated tax you are paying by check or money order. $1,041.18
Voucher   1
Calendar year—Due Sept. 15, 2022
Department of the Treasury - Internal Revenue Service
Form 1040-ES (keep for your records)  www.irs.gov/Form1040ES",1040,0,1040,fdc-e81c3cf7b1207c420b032ecd,v11-1040-ES-inline,original,2022,fgen-c6f84cbd347836583ab058c3,synthetic_programmatic_template,inline,top,False,
"Name:      Amara Testcase
Amount of estimated tax you are paying by check ormoney order.  6,379.92
Voucher 3
Calendar year—Due Jan. 15, 2023",1040,0,1040,fdc-639a373ca0b522912f82fbaa,v11-1040-ES-inline,original,2022,fgen-75b3fcfd2e3829e26a9f023b,synthetic_programmatic_template,inline,none,True,
"Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
For calendar year 2022
File only if you are making a payment of estimated tax by check or money order.
Your first name and middle initial  Your last name   Jordan M. Adeyemi
Address (number, street, and apt. no.) 7388 Maple Ridge Dr Riverton, WI 60424
Your social security number  ****1509
Calendar year—Due
Amount of estimated tax you are paying by check or money order. $2,111.24
Voucher   4
Calendar year—Due Jan. 15, 2023
Department of the Treasury - Internal Revenue Service
Form 1040-ES (keep for your records)  www.irs.gov/Form1040ES",1040,0,1040,fdc-0768249708e324092931d4c9,v11-1040-ES-inline,original,2022,fgen-95889a528c4d8ed4501bacfc,synthetic_programmatic_template,inline,top,False,
"Form 1040-ES
Estimated Tax for Individuals
Payment Voucher
2024
OMB No. 1545-0074
File only if you are making a payment of estimated tax by check or money order.
Mail this voucher with your check or money order payable to ""United States Treasury.""
Your first name and middle initial  Your last name Avery Adeyemi
Address (number, street, and apt. no.)      9564 Granite St Oak Grove, TX 37180
Your social security number      XXX-XX-8632
Calendar year—Due
Amount of estimated tax you are paying by check or money order. $2,235.98
Voucher      2",1040,0,1040,fdc-5aa18c4b1e58712add5a1cca,v11-1040-ES-inline,original,2024,fgen-dff264470441ed284244c189,synthetic_programmatic_template,inline,top,False,
"CORRECTED (if checked)
2021
OMB No. 1545-0074
File only if you are making a payment of estimated tax by check or money order.
Mail this voucher with your check or money order payable to ""United States Treasury.""
Your first name and middle initial  Your last name  Priya J. Tanaka
Address (number, street, and apt. no.)      3041 Maple Ridge Dr Pinecrest, GA 16438
Your social security number   ***-**-9538
Calendar year—Due
Amount of estimated tax you are paying by check or money order. $7,011.77
Voucher  3
Calendar year—Due Jan. 15, 2022
Department of the Treasury - Internal Revenue Service",1040,0,1040,fdc-b9ef333b6d58a6496834a31a,v11-1040-ES-inline,original,2021,fgen-b34760281fb2ff974205a2a3,synthetic_programmatic_template,inline,none,False,
"2023
OMB No. 1545-0074
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Wei A. Adeyemi
4673 Cedar Ln Fairview, OH 41433
XXX-XX-1991
Filing status
1 Adjusted gross income  A. Original amount
1 B. Net change
1 C. Correct amount
5 Taxable income
6 Tax liability
Part II Explanation of Changes
$133,427.64
1,492.01
93,621.97
$86,969.96
321.43
Claimed a missed education credit.
Department of the Treasury - Internal Revenue Service",1040,0,1040,fdc-0629d970bdddc4e9ad7cf272,v11-1040-X-columns,original,2023,fgen-e5fa114f2c7668f94d12c872,synthetic_programmatic_template,columns,none,False,
"Name:
1 Adjusted gross income  A. Original amount
1 B. Net change
5 Taxable income
1 C. Correct amount
Mateo Romero
7,883.42
$7,311.98
101,014.09
81,081.73",1040,0,1040,fdc-ba7929b159e9497128dc97a0,v11-1040-X-columns,original,2026,fgen-548229fe287b587fdc06563f,synthetic_programmatic_template,columns,none,False,
"Form 1040-X
Amended U.S. Individual Income Tax Return
For calendar year 2024
OMB No. 1545-0074
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Jamie L. Rivera
2695 Oak Hollow Ct Maplewood, MN 34641
XXX-XX-5432
Filing status
1 Adjusted gross income  A. Original amount
1 C. Correct amount
5 Taxable income
6 Tax liability
131,946.51
92,775.53
$39,680.60
5,857.55
Department of the Treasury - Internal Revenue Service
Form 1040-X (keep for your records)  www.irs.gov/Form1040X",1040,0,1040,fdc-d8ba3ccb7093e9e1b7a98648,v11-1040-X-columns,original,2024,fgen-2bc00b9a023c7a8046a10520,synthetic_programmatic_template,columns,top,False,
"Form 1040-X Amended U.S. Individual Income Tax Return 2021
Name:
6 Tax liability
Lena Romero
9,313.30",1040,0,1040,fdc-87389b00cd8b7286a798083b,v11-1040-X-columns,original,2021,fgen-5bef4aea1d1b9349e7df9db0,synthetic_programmatic_template,columns,top,False,
"Form 1040-X
Amended U.S. Individual Income Tax Return
For calendar year 2026
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Jordan Okafor
28 Elm Park Pl Maplewood, MN 65654
****0851
Filing status
1 B. Net change
1 C. Correct amount
5 Taxable income
6 Tax liability
Part II Explanation of Changes
$2,766.45
98,809.97
19,507.48
$5,100.36
Claimed a missed education credit.
Department of the Treasury - Internal Revenue Service
Form 1040-X (keep for your records)  www.irs.gov/Form1040X",1040,0,1040,fdc-afe1c6f92ac3bc1d12ce415d,v11-1040-X-columns,original,2026,fgen-f7d9b71c176617b282e49451,synthetic_programmatic_template,columns,top,False,
"Form 1040-X
Amended U.S. Individual Income Tax Return
2026
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Fatima Kowalski
2759 Oak Hollow Ct Testville, IL 80285
****7225
Filing status
1 Adjusted gross income  A. Original amount
1 B. Net change
5 Taxable income
6 Tax liability
Part II Explanation of Changes
$83,227.26
6,091.17
$4,093.04
8,495.83
Reported omitted interest income.",1040,0,1040,fdc-2c66fc6d58084302d08d7c6a,v11-1040-X-columns,original,2026,fgen-d00e2e1133409571bf647662,synthetic_programmatic_template,columns,top,False,
"OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
This return is for calendar year
Your first name and middleinitial  Last name
Home address (number and street)
Your social security number
Avery Lindqvist
5lO3 Harbor View Rd Fairview, OH 37608
XXXXX9895
Filing status
l Adjusted gross income  A. Original amount
1 B. Net change
1C. Correct amount
5 Taxable income
6 Tax liability
$13,116.45
1,893.31
91,176.85
$4,596.94
$1,302.04
Department of the Treasury - Intemal Revenue Service
Form 1040-X
Amended U.S. Individua1 Income Tax Retum
Form 1040-X (keep for your rccords)  www.irs.gov/Forml040X",1040,0,1040,fdc-01a36d5069e7d6605194a042,v11-1040-X-columns,original,2026,fgen-729d2322f0ae081b25fa1e45,synthetic_programmatic_template,columns,bottom,True,
"Form 1040-X Amended U.S. Individual IncomeTax Return
Name:
Part II Explanation of Changes
1 B. Net change
1 Adjusted gross income  A. Original amount
6 Tax liability
Jordan E. Brennan
Reported omitted interest income.
6,475.6O
63,859.59
$6,7l4.49",1040,0,1040,fdc-f83e54ed2f1e66e70b948c19,v11-1040-X-columns,original,2023,fgen-c39abb07c6ab5bdfc36196c8,synthetic_programmatic_template,columns,top,True,
"Form 1040-X
Amended U.S. Individual Income Tax Return
2025
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Sofia Moreau
9380 Elm Park Pl Brookhaven, PA 23741
***-**-1764
Filing status
1 Adjusted gross income  A. Original amount
1 B. Net change
1 C. Correct amount
5 Taxable income
6 Tax liability
$59,645.86
4,605.92
10,105.37
$84,092.14
$4,875.27",1040,0,1040,fdc-cdabcc3383601f659cf95fa2,v11-1040-X-columns,original,2025,fgen-39ab71e3ad40e74336d71d54,synthetic_programmatic_template,columns,top,False,
"Name:
Part II Explanation of Changes
1 B. Net change
Taylor Castillo
Received a corrected Form 1099-DIV after filing.
$3,377.63
Form 1040-X Amended U.S. Individual Income Tax Return",1040,0,1040,fdc-4f0f40128f8d80556c7ab733,v11-1040-X-columns,original,2025,fgen-6a47c9518bd8270cf176e47d,synthetic_programmatic_template,columns,bottom,False,
"VOID  CORRECTED
Form 1040-X
Amended U.S. Individual Income Tax Return
For calendar year 2022
OMB No. 1545-0074
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Jordan Testcase
6958 Maple Ridge Dr Lakewood, CO 88680
****8082
Filing status
1 Adjusted gross income  A. Original amount
1 B. Net change
1 C. Correct amount
5 Taxable income
Part II Explanation of Changes
106,340.06
5,192.45
$60,280.11
47,278.43
Claimed a missed education credit.
Department of the Treasury - Internal Revenue Service
Form 1040-X (keep for your records)  www.irs.gov/Form1040X",1040,0,1040,fdc-d536701f6789f86663999f93,v11-1040-X-columns,original,2022,fgen-15ca22df6a71805c984251ce,synthetic_programmatic_template,columns,top,False,
"Name:
1 Adjusted gross income  A. Origina1 amount
1 B. Net change
NoahNguyen
S120,591.26
8,364.13",1040,0,1040,fdc-b99f8c36fd2669a6119233fe,v11-1040-X-columns,original,2025,fgen-33f6b5e6b0f476816c5e712b,synthetic_programmatic_template,columns,none,True,
"Form 1040-X
Amended U.S. Individual Income Tax Return
2024
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Olivia L. Rivera
3985 Granite St Brookhaven, PA 66470
****1206
Filing status
1 Adjusted gross income  A. Original amount
1 B. Net change
5 Taxable income
6 Tax liability
Part II Explanation of Changes
$45,787.84
$8,887.89
131,766.01
7,408.72
Claimed a missed education credit.
Department of the Treasury - Internal Revenue Service
Form 1040-X (keep for your records)  www.irs.gov/Form1040X",1040,0,1040,fdc-b9f499a4b412a71ec95da8a7,v11-1040-X-columns,original,2024,fgen-ab53e1dba03c3dcd371cac7a,synthetic_programmatic_template,columns,top,False,
"Form 1040-X Amended U.S. Individual Income Tax Return 2023
Name:
Part II Explanation of Changes
6 Tax liability
Riley M. Walsh
Reported omitted interest income.
4,153.86",1040,0,1040,fdc-b1b10a4504559675bdcdc907,v11-1040-X-columns,original,2023,fgen-7325b61898e7dacccb47749f,synthetic_programmatic_template,columns,top,False,
"Form 1040-X
Amended U.S. Individual Income Tax Return
2025
Department of the Treasury—Internal Revenue Service
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Jamie Castillo
6811 Harbor View Rd Fairview, OH 80068
XXX-XX-5130
Filing status
5 Taxable income
Part II Explanation of Changes
$35,452.70
Reported omitted interest income.
Department of the Treasury - Internal Revenue Service
Form 1040-X (keep for your records)  www.irs.gov/Form1040X",1040,0,1040,fdc-6d04010ffc6c8b1f59f7e212,v11-1040-X-columns,original,2025,fgen-9a772e022ce2debb4aec3fcc,synthetic_programmatic_template,columns,top,False,
"☐ CORRECTED
2021
OMB No. 1545-0074
Department of the Treasury—Internal Revenue Service
This return is for calendar year
Your first name and middle initial  Last name
Home address (number and street)
Your social security number
Kwame Brennan
3400 Lakeshore Blvd Pinecrest, GA 29881
XXXXX8195
Filing status
1 Adjusted gross income  A. Original amount
1 B. Net change
5 Taxable income
6 Tax liability
Part II Explanation of Changes
8,789.51
6,066.79
851.63
1,131.88
Received a corrected Form 1099-DIV after filing.",1040,0,1040,fdc-b010b59b3e3bb161be973e84,v11-1040-X-columns,original,2021,fgen-8ab5de8ca9e4be57572457b1,synthetic_programmatic_template,columns,none,False,
"VOID  CORRECTED
Part I Recipient Information: Sample Mutual Insurance 4657 Lakeshore Blvd Oak Grove, TX 65818
Line 2 Marketplace-assigned policy number: 23-6033390
Line 1 Marketplace identifier: Mateo L. Patel
Line 3 Policy issuer's name: ****6458
Street address (including apt. no.): 2404 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 53672
Part III Coverage Information: 
Line 21 January  A. Monthly enrollment premiums: 6,674.95
Line 21 C. Monthly advance payment of premium tax credit: $2,792.91
Line 33 Annual Totals: 14,714.09
Department of the Treasury - Internal Revenue Service
Form 1095-A
Health Insurance Marketplace Statement
Form 1095-A (keep for your records)  www.irs.gov/Form1095A",1095,3,1095,fdc-3094a60291b59a6cfaee4cdf,v11-1095-A-boxed,original,2025,fgen-28225b81c0f8d6838c5c4bcf,synthetic_programmatic_template,boxed,bottom,False,
"Form 1095-A Health Insurance Marketplace Statement 2026
Part I RecipientInformatíon'S name:: Evergreen Health Plan
RECIPIENT:: Casey Rivera
21 January  A. Monthly enrollment premiums: 7,587.6O",1095,3,1095,fdc-1e707942c4bae99e4335019f,v11-1095-A-boxed,original,2026,fgen-f17ae22c8c851aa605657823,synthetic_programmatic_template,boxed,top,True,
"Form 1095-A
Health Insurance Marketplace Statement
For calendar year 2022
OMB No. 1545-2232
VOID  CORRECTED
Part I Recipient Information: Granite Auto Insurance Co. 1692 Elm Park Pl Pinecrest, GA 56735
Line 2 Marketplace-assigned policy number: 86-1290923
Line 1 Marketplace identifier: Alex Lindqvist
Line 3 Policy issuer's name: XXXXX4952
Line 21 B. Monthly second lowest cost silver plan (SLCSP) premium: 1,953.24
Line 21 C. Monthly advance payment of premium tax credit: $6,523.21
Line 33 Annual Totals: $51,302.24
Department of the Treasury - Internal Revenue Service
Form 1095-A (keep for your records)  www.irs.gov/Form1095A",1095,3,1095,fdc-c5aa908959d46262880e82d7,v11-1095-A-boxed,original,2022,fgen-bf0f3a31ab6ee81b814c7da1,synthetic_programmatic_template,boxed,top,False,
"2026
OMB No. 1545-2232
VOID  CORRECTED
Do not attach to your tax return. Keep for your records.
Part I Recipient Information: Granite Auto Insurance Co. 481 Elm Park Pl Lakewood, CO 68786
Box 2 Marketplace-assigned policy number: 31-3010682
Box 1 Marketplace identifier: Noah Tanaka
Box 3 Policy issuer's name: ***-**-0837
Street address (including apt. no.): 261 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Lakewood, CO 77711
Part III Coverage Information: 
Box 21 January  A. Monthly enrollment premiums: $8,399.54
Box 21 B. Monthly second lowest cost silver plan (SLCSP) premium: $1,174.69
Box 21 C. Monthly advance payment of premium tax credit: 3,316.70
Box 33 Annual Totals: 130,217.42
Form 1095-A
Health Insurance Marketplace Statement",1095,3,1095,fdc-c77b6f9feafd0cbe65bd00be,v11-1095-A-boxed,original,2026,fgen-248ddb93716dd87ad1dbce50,synthetic_programmatic_template,boxed,bottom,False,
"From:: Evergreen Health Plan
Recipient's name:: Jamie Patel
21 January  A. Monthly enrollment premiums: $8,817.35
Form 1095-A Health Insurance Marketplace Statement 2024",1095,3,1095,fdc-f39d49e6ac64537a7ecb1549,v11-1095-A-boxed,original,2024,fgen-4b7ff8a8d812545e995c6f09,synthetic_programmatic_template,boxed,bottom,False,
"Form 1095-A Health Insurance Marketplace Statement
From:: Evergreen Health Plan
Recipient's name:: Jordan Rivera
21 B. Monthly second lowest cost silver plan (SLCSP) premium: 1,283.25
33 Annual Totals: $122,129.57
21 C. Monthly advance payment of premium tax credit: 2,777.91
21 January  A. Monthly enrollment premiums: $1,196.44",1095,3,1095,fdc-12dc137492b995b95f48e7d4,v11-1095-A-boxed,original,2024,fgen-06db1263a3d25be4587fa090,synthetic_programmatic_template,boxed,top,False,
"Form 1095-A Health Insurance Marketplace Statement
Part I Recipient Information'S name:: Evergreen Health Plan
RECIPIENT:: Priya Testcase
Line 21 B. Monthly second lowest cost silver plan (SLCSP) premium: $1,299.09
Line 33 Annual Totals: 33,741.27
Line 21 January  A. Monthly enrollment premiums: $8,156.05",1095,3,1095,fdc-933bdd7984453a407cc8f6ae,v11-1095-A-boxed,original,2021,fgen-b0164b2cdd0b8882fc9a8480,synthetic_programmatic_template,boxed,top,False,
"Form 1095-A Health Insurance Marketplace Statement
Part I Recipient Information:: Harbor Life Assurance
To::Jordan L. Kowa1ski
Line 33 Annua1 Totals: 51,445.99",1095,3,1095,fdc-b38921505eeda05b61c3407e,v11-1095-A-boxed,original,2021,fgen-d9d66c760d1011ca6decd4ed,synthetic_programmatic_template,boxed,top,True,
"Form 1095-A
Health Insurance Marketplace Statement
Do not attach to your tax return. Keep for your records.
Part I Recipient Information: Sample Mutual Insurance 2320 Lakeshore Blvd Brookhaven, PA 25713
2 Marketplace-assigned policy number: 13-9502080
1 Marketplace identifier: Hiro J. Fischer
3 Policy issuer's name: ending in 8447
Street address (including apt. no.): 2361 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Cedar Falls, IA 50856
Part III Coverage Information: 
21 January  A. Monthly enrollment premiums: $3,677.10
21 B. Monthly second lowest cost silver plan (SLCSP) premium: $4,231.53
33 Annual Totals: 43,269.72",1095,3,1095,fdc-d73114bd8d5dd110bf684875,v11-1095-A-boxed,original,2022,fgen-2ec3412e9845ab26e7132d06,synthetic_programmatic_template,boxed,top,False,
"For calendar year 2022
OMB No. 1545-2232
VOID  CORRECTED
Do not attach to your tax return. Keep for your records.
Part I Recipient Information: Harbor Life Assurance 4170 Elm Park Pl Cedar Falls, IA 17086
Box 2 Marketplace-assigned policy number: 79-6049548
Box 1 Marketplace identifier: Mateo K. Brennan
Box 3 Policy issuer's name: XXXXX1684
Street address (including apt. no.): 7101 Sample Street
City or town, state or province, country, and ZIP or foreign postal code: Pinecrest, GA 42560
Part III Coverage Information: 
Box 21 January  A. Monthly enrollment premiums: 4,715.14
Box 21 B. Monthly second lowest cost silver plan (SLCSP) premium: $6,377.50
Box 21 C. Monthly advance payment of premium tax credit: $2,022.93
Department of the Treasury - Internal Revenue Service
Form 1095-A
Health Insurance Marketplace Statement
Form 1095-A (keep for your records)  www.irs.gov/Form1095A",1095,3,1095,fdc-494d8ac2752ea44e76d510db,v11-1095-A-boxed,original,2022,fgen-e19a3d87332866eb14c1c7ec,synthetic_programmatic_template,boxed,bottom,False,
"Form 1095-A
Health Insurance Marketplace Statement
For calendar year 2025
OMB No. 1545-2232
VOID  CORRECTED
Do not attach to your tax return. Keep for your records.
Part I Recipient Information: Evergreen Health Plan 3463 Cedar Ln Maplewood, MN 78341
Box 2 Marketplace-assigned policy number: 75-8612581
Box 1 Marketplace identifier: Morgan Walsh
Box 3 Policy issuer's name: XXX-XX-1251
Street address (including apt. no.): 4924 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 37743
Part III Coverage Information: 
Box 21 January  A. Monthly enrollment premiums: 3,371.47
Box 21 B. Monthly second lowest cost silver plan (SLCSP) premium: 5,712.48
Box 21 C. Monthly advance payment of premium tax credit: 2,309.83
Box 33 Annual Totals: $27,355.27
Department of the Treasury - Internal Revenue Service
Form 1095-A (keep for your records)  www.irs.gov/Form1095A",1095,3,1095,fdc-4ea75712be2d873866785708,v11-1095-A-boxed,original,2025,fgen-ca018eccd4346a66f378e514,synthetic_programmatic_template,boxed,top,False,
"Form 1095-A Health Insurance Marketplace Statement 2025
Part I Recipient Information:: Harbor Life Assurance
Recipient's name:: Wei E. Sato
Box 21 C. Monthly advance payment of premium tax credit: $4,473.25",1095,3,1095,fdc-174babd9d598cbea4944346c,v11-1095-A-boxed,original,2025,fgen-7eb8d262c8dbd5a093e0b7d2,synthetic_programmatic_template,boxed,top,False,
"Form 1095-A
Health Insurance Marketplace Statement
2025
OMB No. 1545-2232
VOID  CORRECTED
Part I Recipient Information: Evergreen Health Plan 179 Willow Bend Way Lakewood, CO 11649
Box 2 Marketplace-assigned policy number: 42-2103786
Box 1 Marketplace identifier: Alex L. Tanaka
Box 3 Policy issuer's name: ***-**-2247
Account number (see instructions): XXX-XX-445645
Part III Coverage Information: 
Box 21 January  A. Monthly enrollment premiums: 7,443.23
Box 21 B. Monthly second lowest cost silver plan (SLCSP) premium: 4,668.63
Box 21 C. Monthly advance payment of premium tax credit: $5,431.23
Box 33 Annual Totals: 77,061.18
Department of the Treasury - Internal Revenue Service
Form 1095-A (keep for your records)  www.irs.gov/Form1095A",1095,3,1095,fdc-2a3727def0b6f175a394bb54,v11-1095-A-boxed,original,2025,fgen-febcf95d61f4e82f1b98d258,synthetic_programmatic_template,boxed,top,False,
"For calendar year 2023
VOID  CORRECTED
Do not attach to your tax return. Keep for your records.
Part I Recipient Information: Evergreen Health Plan 6856 Maple Ridge Dr Brookhaven, PA 58999
Box 2 Marketplace-assigned policy number: 53-6199156
Box 1 Marketplace identifier: Mateo Sato
Box 3 Policy issuer's name: XXXXX7563
Street address (including apt. no.): 977 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Brookhaven, PA 72774
Account number (see instructions): ***-**-300082
Part III Coverage Information: 
Box 21 C. Monthly advance payment of premium tax credit: 4,832.88
Box 33 Annual Totals: 129,966.50
Form 1095-A
Health Insurance Marketplace Statement",1095,3,1095,fdc-5b33e8c654c83517e4cb187d,v11-1095-A-boxed,original,2023,fgen-9b7023e154ba49a548989925,synthetic_programmatic_template,boxed,bottom,False,
"Part I Recipient Information'S name:: Harbor Life Assurance
To:: Morgan Haddad
Line 21 C. Monthly advance payment of premium tax credit: $2,824.21",1095,3,1095,fdc-271a1f8db2910e7a031423e0,v11-1095-A-boxed,original,2021,fgen-156b518f687c3c71b46e137f,synthetic_programmatic_template,boxed,none,False,
"Form 1095-A
Health Insurance Marketplace Statement
OMB No. 1545-2232
VOID  CORRECTED
Part I Recipient Information: Harbor Life Assurance 5011 Cedar Ln Riverton, WI 30080
Box 2 Marketplace-assigned policy number: 43-7175063
Box 1 Marketplace identifier: Amara Sato
Box 3 Policy issuer's name: ending in 5992
Account number (see instructions): XXX-XX-782049
Box 21 January  A. Monthly enrollment premiums: $719.65
Box 21 B. Monthly second lowest cost silver plan (SLCSP) premium: 2,149.34
Box 21 C. Monthly advance payment of premium tax credit: $5,860.19
Box 33 Annual Totals: 32,114.88
Department of the Treasury - Internal Revenue Service
Form 1095-A (keep for your records)  www.irs.gov/Form1095A",1095,3,1095,fdc-45ca5b43edbc4d930265afa7,v11-1095-A-boxed,original,2021,fgen-734f841b16f037abdbddcdb8,synthetic_programmatic_template,boxed,top,False,
"VOID CORRECTED Form 1095-B Health Covcragc For calendar year 2023 OMB No. 1545-2252 Part I Responsible Individual Evergreen
Health Plan 6587 Harbor View Rd Riverton, WI 47622 16 Name 68-5292523 Part III Issuer or Other Coverage Provider Morgan Kowalski 17 Employer identification number (EIN) ****7291 8 Enter 1etter identífying Origin of the Health Coverage B (d) Covered all 12 months X
Department ofthe Treasury - Intemal Revenue 5ervice Form 1095-B(keep for your records) www.irs.gov/Form1095B",1095,3,1095,fdc-5067a561d9c688b4ef4cad08,v11-1095-B-flat,original,2023,fgen-c65b292498a3f656e764f6b8,synthetic_programmatic_template,flat,top,True,
"Form 1095-B Health Coverage 2022 Part I
Responsible Individual: Granite Auto Insurance Co. RECIPIENT: Fatima Brennan 8 Enter letter identifying Origin of the Health Coverage A
(d) Covered all 12 months X Part IV Covered Individuals (a) Name of covered individual(s) Diego C. Haddad",1095,3,1095,fdc-62308d83523e254da39cce3d,v11-1095-B-flat,original,2022,fgen-b9ab2b3fdebef657b66ddebe,synthetic_programmatic_template,flat,top,False,
"VOID CORRECTED Form 1095-B Health Coverage 2023 OMB No. 1545-2252 VOID CORRECTED Part I
Responsible Individual Harbor Life Assurance 5855 Lakeshore Blvd Maplewood, MN 20724 16 Name 78-3184793 Part III Issuer or Other Coverage Provider Casey Patel 17 Employer identification number (EIN) ***-**-4085 Street address (including apt. no.) 791 Maple Ridge Dr City or town, state or province, country, and ZIP or foreign postal code Cedar Falls, IA 96539 8 Enter
letter identifying Origin of the Health Coverage D Part IV Covered Individuals (a) Name of covered individual(s) Riley Nguyen (d) Covered all 12 months X Department of the Treasury - Internal Revenue Service Form 1095-B (keep for your records) www.irs.gov/Form1095B",1095,3,1095,fdc-25726a0934c7f4b409a44deb,v11-1095-B-flat,original,2023,fgen-62bc2ba92676438b52387b9d,synthetic_programmatic_template,flat,top,False,
"2024 Department of the Treasury Internal Revenue Service Part I Responsible Individual Harbor Life Assurance 1323 Willow Bend Way Testville, IL 58927 16 Name 47-6817936 Part III Issuer or Other Coverage Provider Casey Nguyen 17 Employer identification number (EIN) ending in 9752 Street address (including apt. no.) 2288 Maple Ridge Dr City or town, state or
province, country, and ZIP or foreign postal code Lakewood, CO 16284 8 Enter letter identifying Origin of the Health Coverage B Part IV Covered Individuals (a) Name of covered individual(s) Priya Adeyemi (d) Covered all 12 months [X] Department of the
Treasury - Internal Revenue Service Form 1095-B Health Coverage Form 1095-B (keep for your records) www.irs.gov/Form1095B",1095,3,1095,fdc-691e61fc04c6e023840b8648,v11-1095-B-flat,original,2024,fgen-69c7c6937ad2c93d2b9d7ba3,synthetic_programmatic_template,flat,bottom,False,
"☐ CORRECTED Form 1095-B Health Coverage OMB No. 1545-2252 Department of the Treasury Internal Revenue Service Part
I Responsible Individual Granite Auto Insurance Co. 6134 Harbor View Rd Fairview, OH 58129 16 Name 88-5499477 Part III Issuer or Other Coverage Provider Sofia Castillo 17 Employer identification number (EIN) ending in 7971 Street address (including apt. no.) 7161 Cedar Ln City or town, state or province, country, and ZIP or foreign postal code Cedar Falls,
IA 44704 8 Enter letter identifying Origin of the Health Coverage B Part IV Covered Individuals (a) Name of covered individual(s) Alex C. Adeyemi (d) Covered all 12 months ☒",1095,3,1095,fdc-579d052eb8abc6e33f6bd275,v11-1095-B-flat,original,2024,fgen-dac219b26f303f484f9afdc2,synthetic_programmatic_template,flat,top,False,
"Form 1095-B Health Coverage From: GraniteAuto
Insurance Co.
To: Morgan Moreau Part IV Covered Individuals (a) Name of covered individual(s) Jamie 0kafor",1095,3,1095,fdc-563011f84c743aa16987fc4d,v11-1095-B-flat,original,2021,fgen-db2d37f75dd2957a75943313,synthetic_programmatic_template,flat,top,True,
"Form 1095-B Health Coverage 2021 Part I Responsible Individual: Evergreen Health Plan To: Casey S. Castillo (d) Covered all 12 months ☐
8 Enter
letter identifying Origin of the Health Coverage B",1095,3,1095,fdc-bdc1c5d3363aefbb0a058f94,v11-1095-B-flat,original,2021,fgen-6e90a085785cbd690cbadba8,synthetic_programmatic_template,flat,top,False,
"Form 1095-B Health Coverage Part I Responsible Individual'S name: Evergreen Health Plan RECIPIENT: Jamie
Adeyemi Part IV Covered Individuals (a) Name of covered individual(s) Casey Sato (d) Covered
all 12 months ☒ 8 Enter letter identifying Origin of the Health Coverage B",1095,3,1095,fdc-a59242d7a8ae307a26d974de,v11-1095-B-flat,original,2024,fgen-71ae295397d67e83c42de5d3,synthetic_programmatic_template,flat,top,False,
"VOID CORRECTED Form 1095-B Health Coverage VOID CORRECTED Department of the Treasury Internal Revenue Service Part I Responsible Individual Harbor Life Assurance 5905 Cedar Ln Maplewood, MN 72062 16 Name 91-3814435 Part III Issuer or Other Coverage Provider Jamie Patel 17 Employer identification number (EIN) XXX-XX-5694 Street address (including apt. no.) 6840 Elm Park Pl City or town, state or province, country, and ZIP or foreign
postal code Lakewood, CO 47783 Account number (see instructions) ***-**-490288 8 Enter letter identifying Origin of the Health Coverage C Part IV Covered Individuals (a) Name of covered individual(s) Wei Lindqvist (d)
Covered all 12 months ☒",1095,3,1095,fdc-28e6ec763f7549f25b11ae2c,v11-1095-B-flat,original,2024,fgen-f65fae1b4aaac94f7779ef9b,synthetic_programmatic_template,flat,top,False,
"☐ CORRECTED Form 1095-B Health Coverage Forcalendar year2021 OMB No. 1545-2252 VOID CORRECTED Part I Responsible Individual Evergreen Health P1an 2671 Oak Hollow Ct Oak Grove, TX 54889 16 Name 81-598O532 Part III Issuer or Other Coverage Províder Weí B. Rivera 17 Employer identification number (EIN) ending ín 0366 Street address (induding apt. no.) 1O67 Harbor View Rd City or town,
state or province, country, and ZIP or foreign postal codc Bayside, WA 77920 8 Enterletter identifying 0rigin of the Health Coverage B Part
IV Covered Individuals (a) Name of covered individual(s) Morgan Larsen",1095,3,1095,fdc-63ec25c85053976460bcce7c,v11-1095-B-flat,original,2021,fgen-147d16a996f786a22466e36a,synthetic_programmatic_template,flat,top,True,
"Form 1095-B Health Coverage For calendar year 2023 Department of the Treasury Internal Revenue Service Part I Responsible Individual Granite Auto Insurance Co. 6696 Granite St Maplewood, MN 17103 16 Name 14-4229451 Part III Issuer or Other Coverage Provider Noah M. Walsh 17 Employer identification number (EIN) ***-**-7579 Street address (including apt. no.) 3305 Willow Bend Way City or town, state or province, country, and ZIP or foreign postal code Lakewood, CO 36513 8 Enter letter identifying Origin
of
the Health Coverage A Part IV Covered Individuals (a) Name of covered individual(s) Noah D. Larsen (d) Covered all 12 months X Department of the Treasury - Internal Revenue Service Form 1095-B (keep for your records) www.irs.gov/Form1095B",1095,3,1095,fdc-9afa1aa4499bea89af67d8a2,v11-1095-B-flat,original,2023,fgen-cf53113d7932c46d7dee16b6,synthetic_programmatic_template,flat,top,False,
"Form 1095-B Health Coverage For calendar year 2025 OMB No. 1545-2252 VOID CORRECTED Department of the Treasury Internal Revenue Service Part I Responsible Individual Harbor Life Assurance 4734 Harbor View Rd Testville, IL 81383 16 Name 52-3747139 Part III Issuer or Other Coverage Provider Priya Tanaka 17 Employer identification number (EIN) XXXXX2558 Street address (including apt. no.) 4755 Sample Street City or town, state or province, country, and ZIP or foreign
postal code Testville, IL 13984 8 Enter letter identifying Origin of the Health Coverage B Part IV Covered Individuals (a) Name of covered individual(s) Alex Haddad
(d) Covered all 12 months [X]",1095,3,1095,fdc-c9e303850a0774f2c1a8f306,v11-1095-B-flat,original,2025,fgen-b39f718a2c91552592681263,synthetic_programmatic_template,flat,top,False,
"2025 OMB No. 1545-2252 Part I Responsible Individual Granite Auto Insurance Co. 4974 Lakeshore
Blvd Fairview, OH 53898 16 Name 36-8152951 Part III Issuer or Other Coverage Provider Olivia D. Haddad 17 Employer identification number (EIN) XXX-XX-2046 Street address (including apt. no.) 4085 Granite St City or town, state or province, country, and ZIP or foreign postal code Fairview, OH 98695 Account number (see instructions) ****360545 8 Enter letter identifying Origin of the Health Coverage B Part IV
Covered Individuals (a) Name of covered individual(s) Taylor Patel Department of the Treasury - Internal Revenue Service Form 1095-B Health Coverage Form 1095-B (keep for your records) www.irs.gov/Form1095B",1095,3,1095,fdc-95cf80c19756a6b1df27234e,v11-1095-B-flat,original,2025,fgen-03963d376c405e7e63b786bb,synthetic_programmatic_template,flat,bottom,False,
"VOID CORRECTED Form 1095-B Health
Coverage For calendar year 2022 OMB No. 1545-2252 Part I Responsible Individual
Granite Auto Insurance Co. 3058 Granite St Lakewood, CO 11010 16 Name 42-2845947 Part III Issuer or Other Coverage Provider Amara A. Okafor 17 Employer identification number (EIN) ending in 4794 Part IV Covered Individuals (a) Name of covered individual(s) Sofia Castillo (d) Covered all 12 months ☒ Department of the Treasury - Internal Revenue Service Form 1095-B (keep for your records) www.irs.gov/Form1095B",1095,3,1095,fdc-2f67c33878ddee0f5ec193ff,v11-1095-B-flat,original,2022,fgen-eafe937cab45237106573e51,synthetic_programmatic_template,flat,top,False,
"Form 1095-B Health Coverage From: Granite Auto Insurance Co.
To: Avery S. Rivera Part IV Covered Individuals (a)
Name of covered individual(s) MateoPatel",1095,3,1095,fdc-f4fe0b20836a4caa664fd0b5,v11-1095-B-flat,original,2024,fgen-edfdb06184caaf0b74ce9f9a,synthetic_programmatic_template,flat,top,True,
"CORRECTED (if checked) 2022 OMB No. 1545-2252 Department of the Treasury Internal Revenue Service Part I Responsible Individual Harbor Life Assurance 7048 Granite St Cedar Falls, IA 11488 16 Name 81-2470150 Part III Issuer or Other Coverage Provider Alex Sato 17 Employer identification number (EIN) ***-**-1748 Street address (including apt. no.) 6149 Sample Street City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 36698 Account number (see instructions) XXX-XX-230792 8 Enter letter identifying Origin of the
Health Coverage C (d) Covered all 12 months X Department of the
Treasury - Internal Revenue Service",1095,3,1095,fdc-fe085325f481c51ff0949365,v11-1095-B-flat,original,2022,fgen-44bc4c22e8737dfe0e53fcfd,synthetic_programmatic_template,flat,none,False,
"## OMB No. 1545-2251
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Employee | Granite Peak Manufacturing Co. 1496 Harbor View Rd Riverton, WI 60710 |
| 7 Name of employer | 57-3178854 |
| Applicable Large Employer Member (Employer) | Diego Kowalski |
| 8 Employer identification number (EIN) | ending in 3884 |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1A |
| 15 Employee Required Contribution (see instructions) | 3,909.67 |
| Plan Start Month (enter 2-digit number) | 01 |",1095,3,1095,fdc-d1ca1190ee54299e8dca09c1,v11-1095-C-markdown,original,2023,fgen-7aa9d1de8dc8787baa7c06d5,synthetic_programmatic_template,markdown,none,False,
"## Form 1095-C
Employer-Provided Health Insurance Offer and Coverage
OMB No. 1545-2251
| Field | Value |
| --- | --- |
| Part I Employee | Copperline Software Inc. 3638 Cedar Ln Oak Grove, TX 22982 |
| 7 Name of employer | 44-6971436 |
| Applicable Large Employer Member (Employer) | Taylor Tanaka |
| 8 Employer identification number (EIN) | ***-**-2013 |
| Street address (including apt. no.) | 8055 Lakeshore Blvd |
| City or town, state or province, country, and ZIP or foreign postal code | Bayside, WA 61068 |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1A |
| 15 Employee Required Contribution (see instructions) | $3,578.12 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2D |
| Plan Start Month (enter 2-digit number) | 03 |",1095,3,1095,fdc-ab9eef3df274e7790f2c406e,v11-1095-C-markdown,original,2023,fgen-f957c79b5eeb05059f563573,synthetic_programmatic_template,markdown,top,False,
"Form 1095-C Employer-Provided Health Insurance Offer and Coverage 2023
| Field | Value |
| --- | --- |
| From: | Maple Street Dental PC |
| To: | Fatima M. Adeyemi |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1A |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2C |
| Plan Start Month (enter 2-digit number) | 04 |",1095,3,1095,fdc-c8087c52e5129c9c51be33be,v11-1095-C-markdown,original,2023,fgen-def0a53b7967bf5d32db9067,synthetic_programmatic_template,markdown,top,False,
"VOID  CORRECTED
| Field | Value |
| --- | --- |
| Part I Employee | Tri-County School District 6238 Willow Bend Way Pinecrest, GA 31906 |
| 7 Name of employer | 47-8338275 |
| Applicable Large Employer Member (Employer) | Diego L. Patel |
| 8 Employer identification number (EIN) | XXXXX6630 |
| Street address (including apt. no.) | 860 Willow Bend Way |
| City or town, state or province, country, and ZIP or foreign postal code | Testville, IL 13182 |
| Account number (see instructions) | XXXXX134070 |
| 15 Employee Required Contribution (see instructions) | 1,364.69 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2C |
| Plan Start Month (enter 2-digit number) | 08 |
Department of the Treasury - Internal Revenue Service
Form 1095-C
## Employer-Provided Health Insurance Offer and Coverage
## Form 1095-C (keep for your records)  www.irs.gov/Form1095C",1095,3,1095,fdc-edff5431c0848e6e021ea40d,v11-1095-C-markdown,original,2021,fgen-ae785714ce20dea12f024368,synthetic_programmatic_template,markdown,bottom,False,
"| Field | Value |
| --- | --- |
| From: | Blue Heron Logistics LLC |
| RECIPIENT: | Jamie Haddad |
| Plan Start Month (enter 2-digit number) | 09 |",1095,3,1095,fdc-439627f26e188e6a23daacc4,v11-1095-C-markdown,original,2022,fgen-d1ffdb70e300137f1bead44d,synthetic_programmatic_template,markdown,none,False,
"Form 1095-C Employer-Provided Health Insurance Offer and Coverage 2026
| Field | Value |
| --- | --- |
| Part I Employee: | Maple Street Dental PC |
| To: | Mateo Sato |
| Plan Start Month (enter 2-digit number) | 09 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2H |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1E |",1095,3,1095,fdc-d9d86d589cdf0228064ee75b,v11-1095-C-markdown,original,2026,fgen-b189061d7297b8219ae49d42,synthetic_programmatic_template,markdown,top,False,
"Form 1095-C Employer-Provided Health Insurance Offer and Coverage
| Field | Value |
| --- | --- |
| Part I Employee'S name: | Copperline Software Inc. |
| Recipient's name: | Fatima Fischer |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1A |
| 15 Employee Required Contribution (see instructions) | $44.72 |
| Plan Start Month (enter 2-digit number) | 03 |",1095,3,1095,fdc-ba63909ecca4e111b03d1c5f,v11-1095-C-markdown,original,2022,fgen-45f2f34e569a27c51d404bff,synthetic_programmatic_template,markdown,top,False,
"## CORRECTED (if checked)
## For ca1endar year 2O26
## OMB No. l545-2251
VOID  CORRECTED
|Field | Value |
| --- | --- |
| Part I Employee | Tri-County School District 863l Harbor View Rd Pinecrest, GA 33735 |
| 7 Name of employer | 16-5455426 |
| Applicable Large Employer Member (Employer) | Alex J. Moreau |
| 8 Employer identification number (EIN) | ****4l96 |
| Street address (including apt. no.) | 6735 Cedar Ln |
|City or town, state or province, country, and ZIP or foreígn postal code | Maplewood, MN 40470 |
| 14 0ffer of Coverage(enter required code) All 12 Months | 1A |
| 15 Employee Required Contribution (see instructions) | 3,917.91|
| 16 Sectíon 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2C |
Form 1095-C
## Employcr-Províded Health Insurance Offer and Coverage",1095,3,1095,fdc-d0ed3b26d74dff00145bb2bc,v11-1095-C-markdown,original,2026,fgen-7d87bc7640bc161b5bf1bf80,synthetic_programmatic_template,markdown,bottom,True,
"## Form 1095-C
Employer-Provided Health Insurance Offer and Coverage
For calendar year 2022
OMB No. 1545-2251
| Field | Value |
| --- | --- |
| Part I Employee | Granite Peak Manufacturing Co. 9126 Lakeshore Blvd Testville, IL 62977 |
| 7 Name of employer | 23-4065085 |
| Applicable Large Employer Member (Employer) | Noah Moreau |
| 8 Employer identification number (EIN) | XXX-XX-6338 |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1E |
| 15 Employee Required Contribution (see instructions) | 659.27 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2H |
| Plan Start Month (enter 2-digit number) | 01 |
## Department of the Treasury - Internal Revenue Service
Form 1095-C (keep for your records)  www.irs.gov/Form1095C",1095,3,1095,fdc-e2cc18ba9d705ba3b548e095,v11-1095-C-markdown,original,2022,fgen-4ee1c3e17c1da0e11551c692,synthetic_programmatic_template,markdown,top,False,
"☐ CORRECTED
Form 1095-C
Employer-Provided Health Insurance Offer and Coverage
OMB No. 1545-2251
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Employee | Copperline Software Inc. 92 Oak Hollow Ct Testville, IL 64753 |
| 7 Name of employer | 57-4714878 |
| Applicable Large Employer Member (Employer) | Riley Okafor |
| 8 Employer identification number (EIN) | XXX-XX-1051 |
| Street address (including apt. no.) | 9848 Cedar Ln |
| City or town, state or province, country, and ZIP or foreign postal code | Brookhaven, PA 33095 |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1H |
| 15 Employee Required Contribution (see instructions) | $2,600.70 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2H |
| Plan Start Month (enter 2-digit number) | 02 |
Department of the Treasury - Internal Revenue Service
## Form 1095-C (keep for your records)  www.irs.gov/Form1095C",1095,3,1095,fdc-15ad027f10f08baf90631cde,v11-1095-C-markdown,original,2025,fgen-f1840f6000c47311123c953a,synthetic_programmatic_template,markdown,top,False,
"CORRECTED (if checked)
OMB No. 1545-2251
VOID  CORRECTED
| Field | Value |
| --- | --- |
| Part I Employee | Maple Street Dental PC 1075 Sample Street Cedar Falls, IA 41642 |
| 7 Name of employer | 42-4242218 |
| Applicable Large Employer Member (Employer) | Diego Romero |
| 8 Employer identification number (EIN) | ***-**-2889 |
| Street address (induding apt. no.) | 6574 Prairie Ave|
|City or town, state or province, country, and ZIP or foreígnpostal code | Pinecrest, GA 89283 |
| 14 0ffer ofCoverage (enter required code)  A1l 12 Months | 1H |
| 15 Emp1oyeeRequíred Contribution (sce instructions) | $6,241.22 |
| 16 5ection 498OH Safe Harbor and 0ther Relief (enter code, if applicable) | 2D |
| Plan Start Month (cnter 2-digit number) | 08 |
Department of the Treasury - Intemal Revenue Servicc",1095,3,1095,fdc-ddb11bae330f908a9f178df5,v11-1095-C-markdown,original,2023,fgen-34a1e213026d2b453efe3165,synthetic_programmatic_template,markdown,none,True,
"Form 1095-C Employer-Provided Health Insurance Offer and Coverage
| Field | Value |
| --- | --- |
| From: | Granite Peak Manufacturing Co. |
| RECIPIENT: | Alex Lindqvist |
| 15 Employee Required Contribution (see instructions) | $2,143.78 |
| Plan Start Month (enter 2-digit number) | 03 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2C |",1095,3,1095,fdc-2ff49808d8434f272a9178ac,v11-1095-C-markdown,original,2025,fgen-fb296e19044e47435f00df85,synthetic_programmatic_template,markdown,top,False,
"VOID  CORRECTED
## Form 1095-C
Employer-Provided Health Insurance Offer and Coverage
## For calendar year 2025
## OMB No. 1545-2251
VOID  CORRECTED
## Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Employee | Maple Street Dental PC 876 Prairie Ave Maplewood, MN 57124 |
| 7 Name of employer | 22-5107043 |
| Applicable Large Employer Member (Employer) | Taylor Castillo |
| 8 Employer identification number (EIN) | ending in 8300 |
| Account number (see instructions) | XXXXX474713 |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1H |
| 15 Employee Required Contribution (see instructions) | 4,932.40 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2H |
| Plan Start Month (enter 2-digit number) | 05 |
## Department of the Treasury - Internal Revenue Service
Form 1095-C (keep for your records)  www.irs.gov/Form1095C",1095,3,1095,fdc-e6eddea1328fa529fdf4098d,v11-1095-C-markdown,original,2025,fgen-023d2c02737b43e55e45c757,synthetic_programmatic_template,markdown,top,False,
"Form 1095-C Employer-Provided Health Insurance Offer and Coverage 2021
| Field | Value |
| --- | --- |
| Part I Employee: | Riverside Regional Hospital |
| Recipient's name: | Hiro M. Patel |
| 15 Employee Required Contribution (see instructions) | 7,874.91 |
| Plan Start Month (enter 2-digit number) | 10 |",1095,3,1095,fdc-66b1bd4e9f461c5e92b733dd,v11-1095-C-markdown,original,2021,fgen-3bfb33299fba8f76e819ae31,synthetic_programmatic_template,markdown,top,False,
"## Form 1095-C
## Employer-Provided Health Insurance Offer and Coverage
## For calendar year 2022
OMB No. 1545-2251
VOID  CORRECTED
| Field | Value |
| --- | --- |
| Part I Employee | Acme Test Corp 6291 Willow Bend Way Brookhaven, PA 31942 |
| 7 Name of employer | 80-7847869 |
| Applicable Large Employer Member (Employer) | Avery B. Walsh |
| 8 Employer identification number (EIN) | XXXXX6064 |
| Street address (including apt. no.) | 599 Cedar Ln |
| City or town, state or province, country, and ZIP or foreign postal code | Fairview, OH 88237 |
| Account number (see instructions) | XXX-XX-689027 |
| 14 Offer of Coverage (enter required code)  All 12 Months | 1E |
| 15 Employee Required Contribution (see instructions) | $1,542.79 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2D |
| Plan Start Month (enter 2-digit number) | 04 |
## Department of the Treasury - Internal Revenue Service
Form 1095-C (keep for your records)  www.irs.gov/Form1095C",1095,3,1095,fdc-7f1884f3fc96854e374ed63c,v11-1095-C-markdown,original,2022,fgen-16dc6437c5523dae265bf022,synthetic_programmatic_template,markdown,top,False,
"VOID  CORRECTED
## Form 1095-C
## Employer-Provided Health Insurance Offer and Coverage
2021
## OMB No. 1545-2251
VOID  CORRECTED
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Employee | Riverside Regional Hospital 8833 Sample Street Maplewood, MN 92797 |
| 7 Name of employer | 52-7560543 |
| Applicable Large Employer Member (Employer) | Priya Walsh |
| 8 Employer identification number (EIN) | ending in 0601 |
| Street address (including apt. no.) | 9835 Elm Park Pl |
| City or town, state or province, country, and ZIP or foreign postal code | Bayside, WA 14878 |
| 15 Employee Required Contribution (see instructions) | $6,380.39 |
| 16 Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | 2D |
| Plan Start Month (enter 2-digit number) | 04 |
Department of the Treasury - Internal Revenue Service
Form 1095-C (keep for your records)  www.irs.gov/Form1095C",1095,3,1095,fdc-7c0db7d1dac3db938de3cd13,v11-1095-C-markdown,original,2021,fgen-60bac109131171cbff0564f9,synthetic_programmatic_template,markdown,top,False,
"Form 1098 Mortgage Interest Statement 2022
RECIPIENT'S name:
Riverbend Mortgage Servicing
To:
Casey Fischer
3 Mortgage origination date
January 13, 2022
10 Other
$3,087.62",1098,4,1098,fdc-3e3295079a0bbfaf267aa07e,v11-1098-stacked,original,2022,fgen-91e0e9cb850b29e45ef515e4,synthetic_programmatic_template,stacked,top,False,
"From:
Pinecrest Mortgage Company
RECIPIENT:
Morgan Rivera
11 Mortgage acquisition date
9/10/21
2 Outstanding mortgage principal
106,947.35
3 Mortgage origination date
August 14, 2024",1098,4,1098,fdc-3da793a5d350be14a5527f54,v11-1098-stacked,original,2024,fgen-06c8943a020ee671264d1df5,synthetic_programmatic_template,stacked,none,False,
"Form 1098 Mortgage Interest Statement 2023
From:
Bluewater Loan Servicing
Recipient's name:
Riley R. Brennan
9 Number of properties securing the mortgage
1
3 Mortgage origination date
November 24, 2020
8 Address or description of property securing mortgage
3419 Maple Ridge Dr Fairview, OH 66408
10 Other
2,868.34",1098,4,1098,fdc-70151b9e2d54b6daacbd13dd,v11-1098-stacked,original,2023,fgen-6eb951f8d48e7d8efcfb0992,synthetic_programmatic_template,stacked,top,False,
"Form 1098 Mortgage Interest Statement 2026
RECIPIENT'S name:
Bluewater Loan Servicing
RECIPIENT:
Fatima Fischer
3 Mortgage origination date
9/19/25
11 Mortgage acquisition date
3/2/26
8 Address or description of property securing mortgage
3110 Cedar Ln Pinecrest, GA 31600",1098,4,1098,fdc-9cc6dc28da1e3153381ffec0,v11-1098-stacked,original,2026,fgen-44f65956749302cc0d13d14a,synthetic_programmatic_template,stacked,top,False,
"Form 1098
Mortgage Interest Statement
2021
OMB No. 1545-1380
The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Lakeshore Home Lending 658 Harbor View Rd Brookhaven, PA 68964
RECIPIENT'S/LENDER'S TIN
63-4643558
PAYER'S/BORROWER'S name
Alex Moreau
PAYER'S/BORROWER'S TIN
ending in 8997
Street address (including apt. no.)
4992 Granite St
City or town, state or province, country, and ZIP or foreign postal code
Lakewood, CO 91400
Account number (see instructions)
***-**-203179
1 Mortgage interest received from payer(s)/borrower(s)
$131,597.35
3 Mortgage origination date
07/16/2020
4 Refund of overpaid interest
5 Mortgage insurance premiums
$0.00
8 Address or description of property securing mortgage
2598 Oak Hollow Ct Oak Grove, TX 83803
9 Number of properties securing the mortgage
1
10 Other
$4,033.96
11 Mortgage acquisition date
11/06/2018
Department of the Treasury - Internal Revenue Service
Form 1098 (keep for your records)  www.irs.gov/Form1098",1098,4,1098,fdc-3d6923f2b8caa4522ec44e0a,v11-1098-stacked,original,2021,fgen-6610fbce5f68ccbb019a2d47,synthetic_programmatic_template,stacked,top,False,
"VOID  CORRECTED
Form 1098
Mortgage Intcrest Statement
2024
OMB No. 1545-1380
RECIPIENT'S/LENDER'S name, street addrcss, cityor town, state or province, country, ZIP or foreign posta1 code, and telephone no.
Keystone Home Loans 6613 Maple Ridge Dr Cedar Falls, IA 90708
RECIPIENT'5/LENDER'S TIN
72-1440556
PAYER'5/BORROWER'S namc
Lena Romero
PAYER'S/BORROWER'S TIN
***-**-l833
Street address(including apt. no.)
5760 Sample Street
City or town, state orprovince, country, and ZIP or foreign postal code
Maplewood, MN 90727
1 Mortgage interest received from payer(s)/borrower(s)
$29,318.73
2 0utstanding mortgage principal
$531,458.53
4 Refund of overpaid interest
5 Mortgage insurance premiums
$0.00
6 Points paid on purchase of principal residence
0.00
8 Address or descríption of property securing mortgage
5837 Granite St Lakewood, CO 38804
9Number of properties securing the mortgage
1
11 Mortgage acquisítion date
2023-01-11
Department of the Treasury - Intemal Revenue Service
Form 1098 (keep for your records)  www.irs.gov/Form1098",1098,4,1098,fdc-2e48cb0f4441a125cbbbbc09,v11-1098-stacked,original,2024,fgen-08165686e60b8f963c73de99,synthetic_programmatic_template,stacked,top,True,
"VOID  CORRECTED
Form 1098
Mortgage Interest Statement
For calendar year 2021
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Pinecrest Mortgage Company 6187 Prairie Ave Maplewood, MN 19715
RECIPIENT'S/LENDER'S TIN
60-8838702
PAYER'S/BORROWER'S name
Noah Romero
PAYER'S/BORROWER'S TIN
XXX-XX-8775
Street address (including apt. no.)
1892 Granite St
City or town, state or province, country, and ZIP or foreign postal code
Riverton, WI 41732
Account number (see instructions)
XXX-XX-135218
1 Mortgage interest received from payer(s)/borrower(s)
$85,377.52
2 Outstanding mortgage principal
$135,118.53
3 Mortgage origination date
1/6/20
4 Refund of overpaid interest
$0.00
5 Mortgage insurance premiums
6 Points paid on purchase of principal residence
8 Address or description of property securing mortgage
7296 Willow Bend Way Fairview, OH 95160
9 Number of properties securing the mortgage
1
10 Other
$7,607.26
11 Mortgage acquisition date
2020-01-03
Department of the Treasury - Internal Revenue Service
Form 1098 (keep for your records)  www.irs.gov/Form1098",1098,4,1098,fdc-306dbe037ad4b2deadfa8268,v11-1098-stacked,original,2021,fgen-54a8f6967d69a45b1ce57f62,synthetic_programmatic_template,stacked,top,False,
"2024
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Bluewater Loan Servicing 5572 Lakeshore Blvd Oak Grove, TX 26635
RECIPIENT'S/LENDER'S TIN
25-5972040
PAYER'S/BORROWER'S name
Sofia Moreau
PAYER'S/BORROWER'S TIN
ending in 3277
Account number (see instructions)
XXXXX755039
1 Mortgage interest received from payer(s)/borrower(s)
25,797.43
3 Mortgage origination date
5/3/21
5 Mortgage insurance premiums
6 Points paid on purchase of principal residence
$0.00
8 Address or description of property securing mortgage
6033 Maple Ridge Dr Lakewood, CO 69586
9 Number of properties securing the mortgage
1
10 Other
$623.60
11 Mortgage acquisition date
8/3/23
Department of the Treasury - Internal Revenue Service
Form 1098
Mortgage Interest Statement
Form 1098 (keep for your records)  www.irs.gov/Form1098",1098,4,1098,fdc-1c47593911ce66e852c4e889,v11-1098-stacked,original,2024,fgen-e82944866499c93ceac3f5fe,synthetic_programmatic_template,stacked,bottom,False,
"2023
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Riverbend Mortgage Servicing 1884 Sample Street Lakewood, CO 25749
RECIPIENT'S/LENDER'S TIN
87-2424978
PAYER'S/BORROWER'S name
Diego Kowalski
PAYER'S/BORROWER'S TIN
XXX-XX-0317
Street address (including apt. no.)
2400 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code
Pinecrest, GA 74934
Account number (see instructions)
XXX-XX-937209
1 Mortgage interest received from payer(s)/borrower(s)
$69,225.99
2 Outstanding mortgage principal
639,995.93
3 Mortgage origination date
August 23, 2022
4 Refund of overpaid interest
5 Mortgage insurance premiums
0.00
6 Points paid on purchase of principal residence
8 Address or description of property securing mortgage
1552 Granite St Pinecrest, GA 35135
10 Other
$5,925.76
11 Mortgage acquisition date
7/13/23
Form 1098
Mortgage Interest Statement",1098,4,1098,fdc-b31d17e136d543afc830a7c9,v11-1098-stacked,original,2023,fgen-b79465dc756f35e1737b7f3e,synthetic_programmatic_template,stacked,bottom,False,
"☐ CORRECTED
Form 1098
Mortgage Interest Statement
2026
Copy B For Payer/Borrower
The ínformation in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city or town,state or provincc, country, ZIP orforeign posta1 code, and te1ephone no.
Bluewater Loan Servicing 6345Sample Street Riverton, WI 86734
RECIPIENT'S/LENDER'5 TIN
18-6729406
PAYER'S/B0RROWER'S name
Priya Moreau
PAYER'S/B0RROWER'S TIN
ending in 9090
Account number (see instructions)
***-**-054836
1 Mortgage interest received from payer(s)/borrower(s)
$130,774.65
2 Outstandíng mortgage principal
419,6O4.73
3 Mortgage origination date
November 25, 2O23
4 Refund of ovcrpaid interest
5 Mortgage insurance premiums
$0.00
6 Points paid on purchase of príncipal residence
$0.00
8 Address or descríption of property securing mortgage
2107 Sample Street Fairview, OH 67933
9 Number of propertics securing the mortgage
1
10 Other
$4,612.42
11 Mortgageacquísition date
May 13, 2026
Dcpartment of the Treasury- Intemal Revenue Service
Form 1098 (keep for your records)  www.irs.gov/Form1098",1098,4,1098,fdc-e4eedcf44d89fb9acc685d80,v11-1098-stacked,original,2026,fgen-9e0f4e8fd3e2509bc5e488bf,synthetic_programmatic_template,stacked,top,True,
"From:
Lakeshore Home Lending
Recipient's name:
Mateo Castillo
10 Other
$4,335.07
Form 1098 Mortgage Interest Statement",1098,4,1098,fdc-0bbeaf6761d7e715506c5189,v11-1098-stacked,original,2024,fgen-fa4ec479678bc3b06db3886b,synthetic_programmatic_template,stacked,bottom,False,
"CORRECTED (if checked)
Form 1098
Mortgage Interest Statement
For calendar year 2021
OMB No. 1545-1380
The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Riverbend Mortgage Servicing 4743 Harbor View Rd Lakewood, CO 13816
RECIPIENT'S/LENDER'S TIN
23-7415037
PAYER'S/BORROWER'S name
Sofia Brennan
PAYER'S/BORROWER'S TIN
XXX-XX-0740
Account number (see instructions)
***-**-853432
1 Mortgage interest received from payer(s)/borrower(s)
$40,832.23
2 Outstanding mortgage principal
390,469.12
4 Refund of overpaid interest
0.00
5 Mortgage insurance premiums
6 Points paid on purchase of principal residence
8 Address or description of property securing mortgage
1295 Oak Hollow Ct Cedar Falls, IA 21951
9 Number of properties securing the mortgage
1
10 Other
8,548.55
11 Mortgage acquisition date
12/16/21",1098,4,1098,fdc-bd9fe7c1b891d9d47e3458b8,v11-1098-stacked,original,2021,fgen-e5c6252f2344a2de8e260c63,synthetic_programmatic_template,stacked,top,False,
"Form 1098
Mortgage Interest Statement
Copy B ForPayer/Borrower
RECIPIENT'S/LENDER'S name, street address, city ortown, state or province, country, ZIPor foreign posta1 code, and te1ephone no.
Keystone Home Loans 4458 Elm Park Pl Oak Grove, TX 63910
RECIPIENT'S/LENDER'S TIN
95-4824077
PAYER'S/BORROWER'S name
Hiro Fischer
PAYER'S/B0RROWER'S TIN
ending in 8749
Street address (induding apt. no.)
8401 Harbor Víew Rd
City or town, state or province, country, and ZIP or foreign postal code
Cedar Falls, IA 18058
2 Outstanding mortgage principal
$265,347.70
4 Refund of overpaid interest
5 Mortgage insurance premiums
$0.00
6 Points paid on purchase of principal residence
8 Address or description of propcrty securing mortgage
8090 Harbor View Rd Fairview, 0H 95090
9 Number of properties securing the mortgage
l
10 Othcr
2,218.34
11 Mortgage acquisition date
1O/28/2023
Department of the Treasury - Intemal Revenue 5ervicc
Form 1098 (keep for yourrecords)  www.irs.gov/Form1098",1098,4,1098,fdc-7c4c88aa55e64aecb24d9637,v11-1098-stacked,original,2026,fgen-f0bde411ac7120e011ca387a,synthetic_programmatic_template,stacked,top,True,
"Form 1098
Mortgage Interest Statement
For calendar year 2021
OMB No. 1545-1380
Copy B For Payer/Borrower
The information in boxes 1 through 9 and 11 is important tax information and is being furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Lakeshore Home Lending 1923 Lakeshore Blvd Maplewood, MN 68441
RECIPIENT'S/LENDER'S TIN
41-2093288
PAYER'S/BORROWER'S name
Amara Adeyemi
PAYER'S/BORROWER'S TIN
XXX-XX-5094
Street address (including apt. no.)
321 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code
Pinecrest, GA 25574
Account number (see instructions)
***-**-097338
1 Mortgage interest received from payer(s)/borrower(s)
72,824.97
2 Outstanding mortgage principal
$317,114.49
3 Mortgage origination date
2020-08-08
4 Refund of overpaid interest
5 Mortgage insurance premiums
6 Points paid on purchase of principal residence
8 Address or description of property securing mortgage
541 Harbor View Rd Maplewood, MN 66119
9 Number of properties securing the mortgage
1
10 Other
$2,365.38
11 Mortgage acquisition date
2018-06-10",1098,4,1098,fdc-e3a10699f94645219a6b2308,v11-1098-stacked,original,2021,fgen-64b74c5a381685d908418078,synthetic_programmatic_template,stacked,top,False,
"Form 1098 Mortgage Interest Statement 2024
RECIPIENT'S name:
Keystone Home Loans
To:
Mateo 5. Haddad
9 Number of properties securing the mortgage
1
1 Mortgage interest received frompayer(s)/borrower(s)
$90,182.82
11 Mortgage acquísition date
2024-06-11
10 0ther
$3,894.36",1098,4,1098,fdc-4b81cb1aeed5a03401434949,v11-1098-stacked,original,2024,fgen-49ee1c3636909881b6363470,synthetic_programmatic_template,stacked,top,True,
"Form 1098
Mortgage Interest Statement
OMB No. 1545-1380
Copy B For Payer/Borrower
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Lakeshore Home Lending 5139 Willow Bend Way Cedar Falls, IA 68324
RECIPIENT'S/LENDER'S TIN
76-1146919
PAYER'S/BORROWER'S name
Jamie Kowalski
PAYER'S/BORROWER'S TIN
XXXXX4474
3 Mortgage origination date
04/01/2023
4 Refund of overpaid interest
5 Mortgage insurance premiums
$0.00
6 Points paid on purchase of principal residence
0.00
9 Number of properties securing the mortgage
1
11 Mortgage acquisition date
2023-08-20
Department of the Treasury - Internal Revenue Service
Form 1098 (keep for your records)  www.irs.gov/Form1098",1098,4,1098,fdc-82e50e51e842fcfb93929e9d,v11-1098-stacked,original,2023,fgen-c4798c00cd9977df94492f18,synthetic_programmatic_template,stacked,top,False,
"CORRECTED (if checked)
For calendar year 2021
OMB No. 1545-1959
Copy B For Donor
DONEE'S name, street address, city or town, stateor province, country, ZIP or foreign postal code, and telephone no.  Riverbend Public Library Foundation 1449 Elm Park Pl Bayside, WA 66208
D0NEE'S TIN   63-7949395
DONOR'S name AlexBrennan
DONOR'S TIN   ending in 8202
1 Date of contribution 11/9/20
2a Odometer mileage   684
2b Year 202l
2c Make Ford
3 Vehicle or other identificationnumber RWYW75SJGVDJ4K8YZ
4a Donee certifies that vehic1e was sold in arm's length transaction to unrelated party
6a Did you provide goods or services in exchange for the vehide? No
Department of the Treasury - Internal Revenue 5ervice
Form lO98-C
Contributions of Motor Vehides, Boats, and Airplanes
Form l098-C (keep for your records)  www.irs.gov/Form1098C",1098,4,1098,fdc-e58e55210472404c8124d2e5,v11-1098-C-inline,original,2021,fgen-621a8473fa2648cc1ac4dda5,synthetic_programmatic_template,inline,bottom,True,
"DONEE:      Sample Community Food Bank
RECIPIENT:  Hiro Moreau
6a Did you provide goods or services in exchange for the vehicle? Yes ☐  No ☒
2d Model   F-150",1098,4,1098,fdc-97ab13291f9f4ad71d3d0603,v11-1098-C-inline,original,2024,fgen-db8e87bf52744f1dbb462139,synthetic_programmatic_template,inline,none,False,
"Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
For calendar year 2022
OMB No. 1545-1959
Copy B For Donor
This is important tax information and is being furnished to the IRS.
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Greenway Animal Rescue 7391 Willow Bend Way Maplewood, MN 55300
DONEE'S TIN  17-6317061
DONOR'S name Taylor Sato
DONOR'S TIN ***-**-0506
Account number (see instructions)   XXXXX865860
1 Date of contribution January 15, 2019
2a Odometer mileage 418
2b Year      2022
2c Make   Ford
2d Model      F-150
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party  [X]
4c Gross proceeds from sale 3,899.29
6a Did you provide goods or services in exchange for the vehicle?  Yes ☐  No ☒",1098,4,1098,fdc-c0d0bea77a20278d21fb6c74,v11-1098-C-inline,original,2022,fgen-680b97947ae53aef5d2337b6,synthetic_programmatic_template,inline,top,False,
"DONEE:      Riverbend Public Library Foundation
Recipient's name:   Jamie Kowalski
4c Gross proceeds from sale 7,464.68",1098,4,1098,fdc-41c23d97374a2ed59e82c09b,v11-1098-C-inline,original,2026,fgen-8368d4782939ac3bdfdb7cf1,synthetic_programmatic_template,inline,none,False,
"VOID  CORRECTED
Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
For calendar year 2023
Copy B For Donor
This is important tax information and is being furnished to the IRS.
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.      St. Brendan Parish 1143 Willow Bend Way Testville, IL 33769
DONEE'S TIN 12-1412048
DONOR'S name  Taylor M. Moreau
DONOR'S TIN ***-**-5007
Street address (including apt. no.) 2549 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code   Riverton, WI 44470
1 Date of contribution November 26, 2023
2a Odometer mileage   182
2b Year 2023
2c Make Honda
2d Model   Outback
3 Vehicle or other identification number   YK1LKNCFF88BRSJJ0
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party      ☒
6a Did you provide goods or services in exchange for the vehicle? No
Department of the Treasury - Internal Revenue Service
Form 1098-C (keep for your records)  www.irs.gov/Form1098C",1098,4,1098,fdc-04c042b76108537c3d717042,v11-1098-C-inline,original,2023,fgen-fb8c2e1287101dbe01a88ab1,synthetic_programmatic_template,inline,top,False,
"Form 1098-C Contributions of Motor Vehicles, Boats, and Airplanes
From: Sample Community Food Bank
Recipient's name: Sofia K. Sato
6a Did you provide goods or services in exchange for the vehicle?      Yes ☐  No ☒",1098,4,1098,fdc-e59e4c129d7329da988a3fb3,v11-1098-C-inline,original,2021,fgen-01ff925043c5112b4e614152,synthetic_programmatic_template,inline,top,False,
"For calendar year 2024
OMB No. 1545-1959
Copy B For Donor
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Riverbend Public Library Foundation 8464 Willow Bend Way Testville, IL 36194
DONEE'S TIN   12-4851033
DONOR'S name Casey Tanaka
DONOR'S TIN ****7716
Street address (including apt. no.)   7105 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code      Maplewood, MN 70059
1 Date of contribution   2024-10-12
2a Odometer mileage  363
2b Year  2024
2c Make  Ford
2d Model Outback
3 Vehicle or other identification number   XRMGGVNVZBHE7BX5X
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party
4c Gross proceeds from sale 7,610.06
6a Did you provide goods or services in exchange for the vehicle?      No
Department of the Treasury - Internal Revenue Service
Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
Form 1098-C (keep for your records)  www.irs.gov/Form1098C",1098,4,1098,fdc-433c78113156d4d5f432dd7c,v11-1098-C-inline,original,2024,fgen-2d3b1b9ac8a41b901e05b5fd,synthetic_programmatic_template,inline,bottom,False,
"For calendar year 2023
This is important tax information and is being furnished to the IRS.
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Riverbend Public Library Foundation 9052 Elm Park Pl Bayside, WA 91154
DONEE'S TIN   20-8828212
DONOR'S name Wei L. Larsen
DONOR'S TIN  XXXXX6946
Street address (including apt. no.)      8224 Willow Bend Way
City or town, state or province, country, and ZIP or foreign postal code   Fairview, OH 31123
1 Date of contribution 01/16/2020
2a Odometer mileage 53
2b Year 2023
2c Make      Honda
2d Model   Civic
3 Vehicle or other identification number   NMK4ZNA73Z06GX5W7
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party
4c Gross proceeds from sale      $9,182.33
6a Did you provide goods or services in exchange for the vehicle?      No
Department of the Treasury - Internal Revenue Service",1098,4,1098,fdc-1d6ed905b0cadb87a672d2f7,v11-1098-C-inline,original,2023,fgen-fb5a67e1000024778c10a8c1,synthetic_programmatic_template,inline,none,False,
"Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
For calendar year 2026
OMB No. 1545-1959
Copy B For Donor
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.   Riverbend Public Library Foundation 8561 Sample Street Pinecrest, GA 79568
DONEE'S TIN  28-5887749
DONOR'S name      Amara Walsh
DONOR'S TIN  ***-**-1130
Street address (including apt. no.)  3017 Granite St
City or town, state or province, country, and ZIP or foreign postal code   Brookhaven, PA 10228
1 Date of contribution      02/11/2025
2a Odometer mileage 785
2b Year      2026
2c Make      Honda
2d Model  F-150
3 Vehicle or other identification number MN2K2KN9M7A3W2B2C
4c Gross proceeds from sale  3,344.43",1098,4,1098,fdc-ec3fe6dbd3eb3e2e49b48dd6,v11-1098-C-inline,original,2026,fgen-44f828a664013fd4f6b42b3b,synthetic_programmatic_template,inline,top,False,
"Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
For calendar year 2025
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Hope Harbor Shelter 7216 Oak Hollow Ct Testville, IL 21303
DONEE'S TIN      29-8973542
DONOR'S name  Hiro S. Romero
DONOR'S TIN  XXX-XX-4943
Street address (including apt. no.)   2692 Elm Park Pl
City or town, state or province, country, and ZIP or foreign postal code Brookhaven, PA 69275
Account number (see instructions)   ending in 925711
1 Date of contribution      2025-09-08
2a Odometer mileage  589
2b Year      2025
2c Make  Toyota
2d Model F-150
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party [X]
6a Did you provide goods or services in exchange for the vehicle? No
Department of the Treasury - Internal Revenue Service
Form 1098-C (keep for your records)  www.irs.gov/Form1098C",1098,4,1098,fdc-162202b33756a4f4e385fd20,v11-1098-C-inline,original,2025,fgen-c9a879204d39ffb7476a7a07,synthetic_programmatic_template,inline,top,False,
"Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
For calendar year 2026
This is important tax information and is being furnished to the IRS.
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.   Riverbend Public Library Foundation 2392 Granite St Maplewood, MN 37338
DONEE'S TIN      95-1922823
DONOR'S name  Olivia Brennan
DONOR'S TIN  ****9516
Street address (including apt. no.) 5254 Sample Street
City or town, state or province, country, and ZIP or foreign postal code Testville, IL 76064
1 Date of contribution      10/23/2026
2a Odometer mileage  259
2b Year 2026
2c Make      Subaru
3 Vehicle or other identification number   39VY7C4TETPPWHFYC
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party
4c Gross proceeds from sale   8,470.59
6a Did you provide goods or services in exchange for the vehicle? No
Department of the Treasury - Internal Revenue Service
Form 1098-C (keep for your records)  www.irs.gov/Form1098C",1098,4,1098,fdc-1602bb3af7e7b0f1b7aedd1c,v11-1098-C-inline,original,2026,fgen-5cc382f0d6ff7689fd2db08c,synthetic_programmatic_template,inline,top,False,
"Form 1098-C Contributions of Motor Vehicles, Boats, and Airplanes 2022
DONEE:      Greenway Animal Rescue
Recipient's name: Casey R. Testcase
4c Gross proceeds from sale  5,756.81",1098,4,1098,fdc-7adbaa48586fe56dec797ce7,v11-1098-C-inline,original,2022,fgen-238e739c37b4d1e619ea1a84,synthetic_programmatic_template,inline,top,False,
"Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
2024
OMB No. 1545-1959
Copy B For Donor
DONEE'S name, streetaddress, cíty ortown, state or province, country, ZIP or foreign posta1 code, and telephone no.  St. Brendan Parish 1756 Oak Hollow Ct Fairview, OH 82246
DONEE'S TIN 29-4207043
DONOR'S name   Wei Haddad
DONOR'S TIN   XXXXX9000
Streetaddress (including apt. no.)     1294 Granite St
City or town, state or province, country, and ZIP or foreign postal code      Riverton, WI 49227
Accountnumber (see instructions)  XXXXX986845
2a 0dometer mileage   4l1
2b Year 2024
2c Make      Honda
2d Model   Corolla
3 Vehide or other identification number   GGA7KJDRLD7KYXKV3
4c Gross proceeds from sale   6,9l1.78
Department of the Treasury - Intemal Revenue 5ervice
Form lO98-C (keep for your records)  www.irs.gov/Form1098C",1098,4,1098,fdc-d55e58729e10c6f729e8eb72,v11-1098-C-inline,original,2024,fgen-743d19221c95c1b6ab3369ad,synthetic_programmatic_template,inline,top,True,
"VOID  CORRECTED
Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
2024
OMB No. 1545-1959
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. St. Brendan Parish 4112 Harbor View Rd Brookhaven, PA 17766
DONEE'S TIN  78-8503589
DONOR'S name Hiro D. Lindqvist
DONOR'S TIN XXX-XX-1098
1 Date of contribution 2024-09-01
2a Odometer mileage 394
2b Year 2024
2c Make   Toyota
3 Vehicle or other identification number BXZAD5G990JFT0UMX
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party
6a Did you provide goods or services in exchange for the vehicle? No",1098,4,1098,fdc-4d29ef9aaf851202749f00da,v11-1098-C-inline,original,2024,fgen-71926fb70f37b10933a7325a,synthetic_programmatic_template,inline,top,False,
"VOID  CORRECTED
Form 1098-C
Contributions of Motor Vehicles, Boats, and Airplanes
For calendar year 2021
OMB No. 1545-1959
Copy B For Donor
This is important tax information and is being furnished to the IRS.
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Hope Harbor Shelter 8427 Willow Bend Way Fairview, OH 32031
DONEE'S TIN  77-6661609
DONOR'S name   Hiro Moreau
DONOR'S TIN  ****5518
1 Date of contribution   11/20/2021
2b Year 2021
2c Make  Toyota
3 Vehicle or other identification number  F012YRFHU6GCSA7DC
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party   [X]
4c Gross proceeds from sale  7,346.64",1098,4,1098,fdc-5ca7fcc5f9a475bb2d446ca2,v11-1098-C-inline,original,2021,fgen-bc9532d97c050d69846538b0,synthetic_programmatic_template,inline,top,False,
"VOID  CORRECTED
OMB No. 1545-1959
Copy B For Donor
This is important tax information and is being furnished to the IRS.
DONEE'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.      Sample Community Food Bank 6079 Granite St Pinecrest, GA 64850
DONEE'S TIN      61-2798457
DONOR'S name   Avery Testcase
DONOR'S TIN  ending in 3458
Street address (including apt. no.)      1249 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code Fairview, OH 36265
Account number (see instructions)  XXX-XX-851899
2a Odometer mileage 306
2b Year   2022
2c Make   Ford
2d Model Outback
4a Donee certifies that vehicle was sold in arm's length transaction to unrelated party      [X]
4c Gross proceeds from sale  $7,641.87
6a Did you provide goods or services in exchange for the vehicle?  Yes ☐  No ☒",1098,4,1098,fdc-387eaac4a07945e313ab7b1b,v11-1098-C-inline,original,2022,fgen-23a1f86b80a893928d43d06a,synthetic_programmatic_template,inline,none,False,
"Form 1098-E Student Loan Interest Statement
RECIPIENT:
To:
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
Cedar Valley Credit Union
Hiro Testcase
X",1098,4,1098,fdc-8b93fbf7e22ec9755f690608,v11-1098-E-columns,original,2022,fgen-78bb1ac0434b373adb59e8b8,synthetic_programmatic_template,columns,top,False,
"Form 1098-E
Student Loan Interest Statement
For calendar year 2024
OMB No. 1545-1576
Copy B For Borrower
This is important tax information and is being furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
Account number (see instructions)
1 Student loan interest received by lender
Cedar Valley Credit Union 4964 Harbor View Rd Riverton, WI 35445
41-6727088
Wei A. Patel
XXX-XX-4838
****289908
8,126.81
Department of the Treasury - Internal Revenue Service
Form 1098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-2197422f9677367c606d0f85,v11-1098-E-columns,original,2024,fgen-4f5fbe4012943ebb0f6c574c,synthetic_programmatic_template,columns,top,False,
"RECIPIENT'S name:
To:
2 If checked, box 1 does not ínc1ude loan origination fees and/orcapitalized interest for loans made before September 1, 2004
Harbor Personal Lending
Hiro E. Nguyen
[X]",1098,4,1098,fdc-20fa38432a66fc1b40b8bb1b,v11-1098-E-columns,original,2025,fgen-2ca4a7fe06e73b9b01b10531,synthetic_programmatic_template,columns,none,True,
"CORRECTED (if checked)
Form 1098-E
Student Loan Interest Statement
2021
OMB No. 1545-1576
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
1 Student loan interest received by lender
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
Harbor Personal Lending 5622 Willow Bend Way Bayside, WA 75113
97-8316280
Kwame Patel
***-**-5392
9,118.60
☐
Department of the Treasury - Internal Revenue Service
Form 1098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-2ec44305d7fb40191fc0304f,v11-1098-E-columns,original,2021,fgen-0b2d53d0276bd1e317a432cb,synthetic_programmatic_template,columns,top,False,
"Form 1098-E
Student Loan Interest Statement
For calendar year 2025
OMB No. 1545-1576
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
1 Student loan interest received by lender
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
Granite Auto Finance 1362 Maple Ridge Dr Testville, IL 63123
12-2092283
Casey K. Kowalski
XXXXX7591
6492 Lakeshore Blvd
Oak Grove, TX 98628
8,517.67
☐
Department of the Treasury - Internal Revenue Service
Form 1098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-7c06b9953b9a5d64e9422fe5,v11-1098-E-columns,original,2025,fgen-711a0c8c6827cc148def923d,synthetic_programmatic_template,columns,top,False,
"Form 1098-E Student Loan Interest Statement 2021
RECIPIENT'S name:
RECIPIENT:
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
1 Student loan interest received by lender
Summit Student Loan Servicing
Lena E. Patel
[X]
4,459.55",1098,4,1098,fdc-8953f59b79bbb981609f040e,v11-1098-E-columns,original,2021,fgen-d833cdbeeb1adba4d860b028,synthetic_programmatic_template,columns,top,False,
"From:
Recipient's name:
1 Student loan interest received by lender
Granite Auto Finance
Riley Haddad
8,767.67
Form 1098-E Student Loan Interest Statement",1098,4,1098,fdc-2b4a532b1ccabd69a8a15996,v11-1098-E-columns,original,2024,fgen-3fcacc0371d98b6ef483adfd,synthetic_programmatic_template,columns,bottom,False,
"VOIDCORRECTED
OMB No. 1545-1576
Copy B For Borrower
This is important tax information and is bcing furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city ortown, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'5 TIN
B0RROWER'S name
BORROWER'S TIN
1 Student loan interest received by lender
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before Scptember 1, 2004
Harbor Personal Lendíng 7033 Willow Bend Way Brookhaven, PA 40585
68-3670055
Kwame Brennan
XXX-XX-8687
S6,6l8.15
[X]
Form 1098-E
Student Loan Interest Statement",1098,4,1098,fdc-5692ff085589944eb214ed96,v11-1098-E-columns,original,2025,fgen-895830e668e6ef400e8d4ead,synthetic_programmatic_template,columns,bottom,True,
"Form 1098-E
Student Loan Interest Statement
2021
OMB No. 1545-1576
This is important tax information and is being furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
Granite Auto Finance 2144 Elm Park Pl Maplewood, MN 20619
12-6592777
Morgan Larsen
ending in 4930
5581 Granite St
Testville, IL 12947
Department of the Treasury - Internal Revenue Service
Form 1098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-4c42684759fb62dc74c9a8c6,v11-1098-E-columns,original,2021,fgen-65971380e77759321881e7db,synthetic_programmatic_template,columns,top,False,
"For calendar year 2021
OMB No. 1545-1576
Copy B For Borrower
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
Account number (see instructions)
1 Student loan interest received by lender
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
Harbor Personal Lending 7215 Lakeshore Blvd Pinecrest, GA 91575
11-6356821
Amara A. Kowalski
ending in 4575
XXXXX789869
1,103.43
[X]",1098,4,1098,fdc-34a8748806d2a3ffca91ff22,v11-1098-E-columns,original,2021,fgen-4cb79a9016848a7af1dc0a6d,synthetic_programmatic_template,columns,none,False,
"VOID  CORRECTED
Form 1098-E
Student Loan Interest Statement
For calendar year 2022
OMB No. 1545-1576
Copy B For Borrower
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Summit Student Loan Servicing 6704 Sample Street Testville, IL 54408
66-8744043
Sofia Tanaka
XXXXX6311
9859 Prairie Ave
Riverton, WI 21419
Department of the Treasury - Internal Revenue Service
Form 1098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-212c43f5cdb674c92bb7cf5f,v11-1098-E-columns,original,2022,fgen-7d552c5e1f7d3c3076e5f203,synthetic_programmatic_template,columns,top,False,
"OMB No. 1545-1576
This is important tax information and is being furnished to the IRS.
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Student loan interest received by lender
Harbor Personal Lending 3235 Willow Bend Way Fairview, OH 91606
78-5269128
Wei Brennan
XXXXX0376
7505 Cedar Ln
Oak Grove, TX 86840
****906708
$3,620.37
Department of the Treasury - Internal Revenue Service
Form 1098-E
Student Loan Interest Statement
Form 1098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-6c3caab0cf748b833e067611,v11-1098-E-columns,original,2023,fgen-a7094c5c0e2a382da116745f,synthetic_programmatic_template,columns,bottom,False,
"CORRECTED (if checked)
Form 1O98-E
Student Loan Interest Statement
Copy B For Borrower
RECIPIENT'S/LENDER'S name, street addrcss, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S namc
BORROWER'S TIN
Street address(induding apt. no.)
City or town, state or province, country, andZIP or foreígn posta1 code
1 Student loan interest received by lender
Granite Auto Finance 3825 Granite St Oak Grove, TX 81435
42-2461842
Wei Testcase
ending in 1024
3289 Cedar Ln
Maplewood, MN 11841
9,002.13
Dcpartment of the Treasury -Internal Revenue 5ervice
Form l098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-813bb25cc6d752a1db8f7c6e,v11-1098-E-columns,original,2021,fgen-349197562f9ad18ad2a65fd4,synthetic_programmatic_template,columns,top,True,
"Form 1098-E Student Loan Interest Statement
RECIPIENT'S name:
To:
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
1 Student loan interest received by lender
Northwind Auto Credit
Diego Tanaka
[X]
$642.34",1098,4,1098,fdc-e9760191819ec307141df714,v11-1098-E-columns,original,2022,fgen-bcb2c134770181bb7a8bdff8,synthetic_programmatic_template,columns,top,False,
"Form 1098-E Student Loan Interest Statement
RECIPIENT'S name:
To:
1 Student loan interest received by lender
2 If checked, box 1 does not include loan origination fees and/or capitalizedinterest for loans made before 5eptember 1, 2004
Northwind Auto Credit
Fatima Testcase
$3,573.99
X",1098,4,1098,fdc-33d1d2873e6fbf56d07568f7,v11-1098-E-columns,original,2021,fgen-3963a01853b34dd04f735090,synthetic_programmatic_template,columns,top,True,
"☐ CORRECTED
2021
OMB No. 1545-1576
Copy B For Borrower
RECIPIENT'S/LENDER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number
RECIPIENT'S TIN
BORROWER'S name
BORROWER'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Student loan interest received by lender
2 If checked, box 1 does not include loan origination fees and/or capitalized interest for loans made before September 1, 2004
Harbor Personal Lending 7468 Granite St Testville, IL 97526
87-2015928
Avery J. Romero
ending in 6006
9248 Elm Park Pl
Fairview, OH 63269
***-**-165046
5,168.79
[X]
Department of the Treasury - Internal Revenue Service
Form 1098-E
Student Loan Interest Statement
Form 1098-E (keep for your records)  www.irs.gov/Form1098E",1098,4,1098,fdc-61189d25873bee5d331f107d,v11-1098-E-columns,original,2021,fgen-cb20edaf8748e9556c221cb3,synthetic_programmatic_template,columns,bottom,False,
"Form 1098-T
Tuition Statement
2021
Copy B For Student
FILER'S name, street address, city or town, state or province,country,ZIP or foreign postal code, and telephone number: Riverside Community College 8587 Elm Park Pl Lakewood, CO 62118
FILER'S employer identification no.: 19-5159198
STUDENT'S name: Kwame Lindqvist
STUDENT'S TIN: XXX-XX-5945
Strcet address (induding apt. no.): 6148 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 47526
Box 4 Adjustments made for a prior year
Box 5 5cholarships or grants: 6,622.61
Box6 Adjustments to scholarships or grants for a priorycar
Box 8 Checked if at least half-tíme student: [X]
Box 9 Checked if a graduate student: ☒
Department of the Treasury - Intemal Revenue Service
Form 1O98-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-28e4cc09f4f408682904ea06,v11-1098-T-boxed,original,2021,fgen-a8ce55b7665f858b2f5a4df4,synthetic_programmatic_template,boxed,top,True,
"☐ CORRECTED
Form 1098-T
Tuition Statement
Copy B For Student
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Lakeshore State University 3284 Cedar Ln Brookhaven, PA 50638
FILER'S employer identification no.: 46-4751572
STUDENT'S name: Riley Adeyemi
STUDENT'S TIN: XXXXX9382
Street address (including apt. no.): 6745 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Lakewood, CO 73239
Account number (see instructions): ****260414
4 Adjustments made for a prior year: $0.00
5 Scholarships or grants: 1,545.41
6 Adjustments to scholarships or grants for a prior year
9 Checked if a graduate student: ☒
Department of the Treasury - Internal Revenue Service
Form 1098-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-c5612ad1a12ad83180b5dadd,v11-1098-T-boxed,original,2023,fgen-6b14afeacee699e91b5704dc,synthetic_programmatic_template,boxed,top,False,
"Form 1098-T
Tuition Statement
2022
OMB No. 1545-1574
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Riverside Community College 8832 Oak Hollow Ct Testville, IL 96745
FILER'S employer ídentification no.: 92-4648852
STUDENT'S name: Fatima Castillo
STUDENT'S TIN: ending in 8161
Street address (induding apt. no.): 5785 Sample Street
City or town, state or province, country,and ZIP or foreign postal code: Brookhaven, PA 28396
Account number (see ínstructions): ****411291
Box 1 Payments receivedfor qualified tuitionand related expenses: 64,907.51
Box 5 Scholarships or grants: $2,295.61
Box 6 Adjustmentsto scholarships or grants for a prior ycar
Box9 Checked if a graduate student: [X]
Department of the Treasury - Intemal Revenue Service
Form 1098-T (keep for your records)  www.írs.gov/Form1O98T",1098,4,1098,fdc-7b79c44cab6e1a37b27e9b38,v11-1098-T-boxed,original,2022,fgen-c07ba32635a6de5ecb0da208,synthetic_programmatic_template,boxed,top,True,
"Form 1098-T
Tuition Statement
2025
OMB No. 1545-1574
Copy B For Student
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Northwind Technical Institute 1328 Willow Bend Way Oak Grove, TX 57265
FILER'S employer identification no.: 48-7196917
STUDENT'S name: Jordan Larsen
STUDENT'S TIN: XXX-XX-6782
Street address (including apt. no.): 2652 Elm Park Pl
City or town, state or province, country, and ZIP or foreign postal code: Oak Grove, TX 30445
Line 1 Payments received for qualified tuition and related expenses: $118,021.42
Line 5 Scholarships or grants: 8,140.16
Line 6 Adjustments to scholarships or grants for a prior year
Line 8 Checked if at least half-time student: [X]",1098,4,1098,fdc-d1f197dead4fa3ebd91f59e1,v11-1098-T-boxed,original,2025,fgen-6be61e7e983266a04fd91305,synthetic_programmatic_template,boxed,top,False,
"Form 1098-T Tuition Statement 2026
FILER'S name:: Riverside Community College
To:: Morgan Kowalski
Line 5 Scholarships or grants: $4,396.39
Line 9 Checked if a graduate student: ☐
Line 8 Checked if at least half-time student: X
Line 1 Payments received for qualified tuition and related expenses: 125,532.14",1098,4,1098,fdc-de3927779a4bdd74fe561b6f,v11-1098-T-boxed,original,2026,fgen-a9b5b0aa99145d05b632d8d2,synthetic_programmatic_template,boxed,top,False,
"CORRECTED (if checked)
Form 1098-T
Tuition Statement
For calendar year 2021
OMB No. 1545-1574
Copy B For Student
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Lakeshore State University 4947 Maple Ridge Dr Lakewood, CO 52201
FILER'S employer identification no.: 88-6119057
STUDENT'S name: Fatima Testcase
STUDENT'S TIN: ***-**-0711
Street address (including apt. no.): 8593 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code: Fairview, OH 11818
Line 1 Payments received for qualified tuition and related expenses: 107,622.27
Line 4 Adjustments made for a prior year: $0.00
Line 5 Scholarships or grants: $7,850.07
Line 6 Adjustments to scholarships or grants for a prior year: 0.00
Line 8 Checked if at least half-time student: ☒
Line 9 Checked if a graduate student: ☐
Department of the Treasury - Internal Revenue Service
Form 1098-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-ca3bdc0ebaf0690737517792,v11-1098-T-boxed,original,2021,fgen-9fa7aace2b4600106785d7df,synthetic_programmatic_template,boxed,top,False,
"From:: Lakeshore State University
RECIPIENT:: Jamie B. Okafor
9 Checked if a graduate student: ☒
Form 1098-T Tuition Statement 2026",1098,4,1098,fdc-dab0420cc4923363a875409e,v11-1098-T-boxed,original,2026,fgen-26068ccee8e1130e0fce183e,synthetic_programmatic_template,boxed,bottom,False,
"Form 1098-T
Tuition Statement
2025
Copy B For Student
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Lakeshore State University 7159 Cedar Ln Pinecrest, GA 11961
FILER'S employer identification no.: 97-1104373
STUDENT'S name: Morgan J. Lindqvist
STUDENT'S TIN: ***-**-0998
Account number (see instructions): ****114989
Box 1 Payments received for qualified tuition and related expenses: $116,185.87
Box 4 Adjustments made for a prior year: $0.00
Box 5 Scholarships or grants: 3,023.71
Box 6 Adjustments to scholarships or grants for a prior year
Box 8 Checked if at least half-time student: ☐
Box 9 Checked if a graduate student: ☐
Department of the Treasury - Internal Revenue Service
Form 1098-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-bbdc37904dfbd58ad6758194,v11-1098-T-boxed,original,2025,fgen-9c69425b585ce09a0109b7e8,synthetic_programmatic_template,boxed,top,False,
"Form 1098-T Tuition Statement 2026
FILER'S name:: Lakeshore State University
RECIPIENT:: Jamie Adeyemi
Line 1 Payments received for qualified tuition and related expenses: $43,173.90
Line 9 Checked if a graduate student: X",1098,4,1098,fdc-52d77d227b92a6ae3cf25806,v11-1098-T-boxed,original,2026,fgen-b6bbb930735e67b4608282d4,synthetic_programmatic_template,boxed,top,False,
"Form 1098-T
Tuition Statement
2023
OMB No. 1545-1574
Copy B For Student
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Northwind Technical Institute 2394 Prairie Ave Maplewood, MN 98308
FILER'S employer identification no.: 52-4631505
STUDENT'S name: Casey Moreau
STUDENT'S TIN: ****2993
Account number (see instructions): ***-**-428572
1 Payments received for qualified tuition and related expenses: 55,634.98
4 Adjustments made for a prior year: 0.00
5 Scholarships or grants: $2,730.22
6 Adjustments to scholarships or grants for a prior year
8 Checked if at least half-time student
9 Checked if a graduate student: ☒",1098,4,1098,fdc-aba906f0c6e1e9cb2ed71cb2,v11-1098-T-boxed,original,2023,fgen-1d8ebdf91b7a88e2829851d1,synthetic_programmatic_template,boxed,top,False,
"OMB No. 1545-1574
Copy B For Student
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Lakeshore State University 7284 Willow Bend Way Fairview, OH 83482
FILER'S employer identification no.: 15-7198264
STUDENT'S name: Noah Brennan
STUDENT'S TIN: XXX-XX-1691
Street address (including apt. no.): 6590 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code: Cedar Falls, IA 56582
Account number (see instructions): XXX-XX-570185
Line 1 Payments received for qualified tuition and related expenses: 12,618.59
Line 4 Adjustments made for a prior year
Line 5 Scholarships or grants: $1,130.32
Line 6 Adjustments to scholarships or grants for a prior year
Line 8 Checked if at least half-time student: ☐
Line 9 Checked if a graduate student: [X]
Department of the Treasury - Internal Revenue Service
Form 1098-T
Tuition Statement
Form 1098-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-a71496f396a5f57fe3391c3f,v11-1098-T-boxed,original,2026,fgen-6ee6a3f7b5238dc4a1cd40e5,synthetic_programmatic_template,boxed,bottom,False,
"Form 1098-T
Tuition Statement
OMB No. 1545-1574
Copy B For Student
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Northwind Technical Institute 9892 Harbor View Rd Maplewood, MN 20080
FILER'S employer identification no.: 34-2212521
STUDENT'S name: Casey Brennan
STUDENT'S TIN: ****7064
Street address (including apt. no.): 625 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code: Brookhaven, PA 74960
Account number (see instructions): XXXXX747864
1 Payments received for qualified tuition and related expenses: $13,793.69
4 Adjustments made for a prior year
5 Scholarships or grants: $2,967.87
6 Adjustments to scholarships or grants for a prior year: $0.00
9 Checked if a graduate student: ☒
Department of the Treasury - Internal Revenue Service
Form 1098-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-e39519a4081d3a8bfee7e1d8,v11-1098-T-boxed,original,2024,fgen-7d6a27ff89c5359dd88e769e,synthetic_programmatic_template,boxed,top,False,
"Form 1098-T
Tuition Statement
2023
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Riverside Community College 1249 Elm Park Pl Brookhaven, PA 63433
FILER'S employer identification no.: 23-3893406
STUDENT'S name: Kwame B. Tanaka
STUDENT'S TIN: ending in 3406
Street address (including apt. no.): 9178 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code: Brookhaven, PA 86482
Account number (see instructions): ***-**-152133
Line 1 Payments received for qualified tuition and related expenses: $37,117.31
Line 4 Adjustments made for a prior year
Line 5 Scholarships or grants: 4,960.83
Line 6 Adjustments to scholarships or grants for a prior year
Line 8 Checked if at least half-time student: [X]
Line 9 Checked if a graduate student
Department of the Treasury - Internal Revenue Service
Form 1098-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-b9adf777e10c9d029e604468,v11-1098-T-boxed,original,2023,fgen-c481cbb6021de905399b58ab,synthetic_programmatic_template,boxed,top,False,
"CORRECTED (if checked)
For calendar year 2026
OMB No. 1545-1574
Copy B For Student
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone number: Lakeshore State University 9488 Cedar Ln Lakewood, CO 95616
FILER'S employer identification no.: 30-4686007
STUDENT'S name: Diego Castillo
STUDENT'S TIN: ***-**-9940
Street address (including apt. no.): 3258 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Brookhaven, PA 81317
Account number (see instructions): ****827713
Line 1 Payments received for qualified tuition and related expenses: $1,277.43
Line 4 Adjustments made for a prior year
Line 5 Scholarships or grants: 2,038.14
Line 6 Adjustments to scholarships or grants for a prior year
Line 8 Checked if at least half-time student: ☒
Department of the Treasury - Internal Revenue Service
Form 1098-T
Tuition Statement
Form 1098-T (keep for your records)  www.irs.gov/Form1098T",1098,4,1098,fdc-b5ce66c6120b92a269d10459,v11-1098-T-boxed,original,2026,fgen-6a50f75a986cd577952640f1,synthetic_programmatic_template,boxed,bottom,False,
"☐ CORRECTED
Form 1098-T
Tuition Statement
For calendar year 2021
Copy B For Student
FILER'S name, street address, city or town, state or province, country, ZIP orforeígn posta1 code, and telephone number: Lakeshore 5tate University 156 Maple Ridge Dr Testville, IL 80837
FILER'S employer identification no.: 40-6314214
STUDENT'S name: Hiro Haddad
STUDENT'S TIN: ****765l
Street address (including apt. no.): 5222 Willow Bend Way
Cíty or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 49736
1 Payments received for qualífied tuition and related expenses: $42,283.69
4Adjustments made for a prior year
5 Scholarships or grants: $2,868.85
6 Adjustments toscholarships or grants for a prior ycar
8 Checked ifat 1east half-time student: [X]",1098,4,1098,fdc-c4eb751daa1b2f6004c3d40c,v11-1098-T-boxed,original,2021,fgen-05c834dbf7d12b4221dac7a1,synthetic_programmatic_template,boxed,top,True,
"CORRECTED (if checked)
Form 1098-T
Tuition Statement
2023
OMB No. 1545-1574
Copy B For Student
This is important tax information and is bcing furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, ZIPor foreign postal code, and telephone number: Lakeshore State Univcrsity 2041 Lakeshore Blvd Bayside, WA 16550
FILER'S employer identificationno.: 72-886l961
STUDENT'S name: Rilcy Romero
STUDENT'S TIN:****O767
Box 1 Payments received for qualified tuition and re1ated expenses: $51,823.42
Box 4 Adjustments made for a príor year
Box 5 Scholarships or grants: $3,640.03
Box 6 Adjustments to scholarships or grants for a prior year
Box 8 Checked if at least half-time student: ☐",1098,4,1098,fdc-3a3f30336253d2d4921f82d6,v11-1098-T-boxed,original,2023,fgen-4744998778a73f221fff3eff,synthetic_programmatic_template,boxed,top,True,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions 2022 From: Summit Investments To: Olivia Adeyemi 1c Date
sold or
disposed 03/10/2022",1099,5,1099,fdc-babea8055bdbdf056b8fe126,v11-1099-B-flat,original,2022,fgen-82a5bc28d14706154082a14b,synthetic_programmatic_template,flat,top,False,
"For calendar year 2021 OMB No. 1545-0715 Copy B For Recipient This is important tax information and is being furnished to the IRS. PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Summit Investments 8553 Prairie Ave Lakewood, CO 69186 PAYER'S TIN 61-2258286 RECIPIENT'S name Casey R. Brennan RECIPIENT'S TIN
XXXXX5887 Street address (including apt. no.) 9262 Oak Hollow Ct City or town, state or province, country, and ZIP or foreign postal code Brookhaven, PA 55202 1a Description of property VTI 1b Date
acquired 2018-08-14 1c Date sold or disposed 09/02/2018 1d Proceeds 78,782.87 1e Cost or other basis 91,783.21 1g Wash sale loss disallowed 2 Short-term gain or loss / Long-term gain or loss Short-term 4 Federal income tax withheld $0.00 5 Check if noncovered security X 6 Reported to IRS: Gross proceeds [X]",1099,5,1099,fdc-139322fc93821664085d9a70,v11-1099-B-flat,original,2021,fgen-07e925e3d335e9ebd91228ab,synthetic_programmatic_template,flat,none,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions For calendar year 2026 OMB No. 1545-0715 This is important tax information and is being furnished to the IRS. PAYER'S name, street address, city
or town, state or province, country, and ZIP or foreign postal code Evergreen Brokerage Services 1413 Harbor View Rd Riverton, WI 41900 PAYER'S TIN 30-5942141 RECIPIENT'S name Mateo Tanaka RECIPIENT'S TIN XXXXX7099 Street address
(including apt. no.) 2820 Prairie Ave City or town, state or province, country, and ZIP or foreign postal code Brookhaven, PA 80417 1a Description of property VTI 1b Date acquired 02/28/2023 1c Date sold or disposed 03/03/2025 1d Proceeds $54,438.09 1e Cost or other basis 136,905.13 1g Wash sale loss disallowed 2 Short-term gain or loss / Long-term gain or loss X Long-term 4 Federal income tax withheld $0.00 5 Check if noncovered security X 6 Reported to IRS: Gross proceeds ☐ Department of the Treasury - Internal Revenue Service Form 1099-B (keep for your records) www.irs.gov/Form1099B",1099,5,1099,fdc-9ac0b40d2f4dd2c9a2ec52f4,v11-1099-B-flat,original,2026,fgen-98826e0785b40f7bbfa576b0,synthetic_programmatic_template,flat,top,False,
"☐ CORRECTED Form 1099-B Proceeds From Broker and Barter Exchange Transactions For calendar year 2024 Copy B ForRecipient This is important tax informationand is being fumished to the IRS. PAYER'S name, streetaddress, city or town, state or province, country, and ZIP or foreign posta1 code Summit Investments 967 Maple Ridge Dr Lakewood, C0 30205 PAYER'S TIN 29-4l38403 RECIPIENT'S name KwameAdeyemi RECIPIENT'S TIN XXXXX4017 Street address (including apt. no.) 6459 Willow Bend Way City or
town,state or province, country, and ZIP or foreign postal code Bayside, WA
93411 1a Description of property VOO 1b Date acquíred O8/19/2O23 1c Date sold or disposed 5/21/23 1g Wash sale loss disallowed 0.00 4 Federal income tax withheld $0.00 5 Check if noncovered security X 6 Reported to IR5: Gross proceeds [X]",1099,5,1099,fdc-7aa769de88c32b4a91d49657,v11-1099-B-flat,original,2024,fgen-62f7a2a0ca20449cb2ed4555,synthetic_programmatic_template,flat,top,True,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions 2024 OMB No. 1545-0715 PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Evergreen Brokerage Services 528 Prairie Ave Fairview, OH 52704 PAYER'S TIN 58-2619277 RECIPIENT'S name Fatima Lindqvist RECIPIENT'S TIN XXX-XX-3050 Street address (including apt. no.) 4867 Lakeshore Blvd City or town, state or province, country, and ZIP or foreign postal code Lakewood, CO 14903 Account number (see instructions) ***-**-105500 1a Description of property SCHD 1b Date acquired 2021-11-07 1c
Date sold or disposed November 4, 2021 1e Cost or other basis 28,566.32 1g Wash sale loss disallowed 0.00 2 Short-term gain or loss / Long-term gain or loss X Long-term 4 Federal income
tax withheld 6 Reported to IRS: Gross proceeds X Department of the Treasury - Internal Revenue Service Form 1099-B (keep for your records) www.irs.gov/Form1099B",1099,5,1099,fdc-282814459e3a2850c5355d0d,v11-1099-B-flat,original,2024,fgen-f2fa089fef586575f9488852,synthetic_programmatic_template,flat,top,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions
From: Evergreen Brokerage Services To: Alex Fischer 1d Proceeds 94,139.51
1b Date acquired February 2, 2026 1e Cost or other basis 63,792.19",1099,5,1099,fdc-49efad2a5999be33d188085a,v11-1099-B-flat,original,2026,fgen-f82dd5e079577a72769d371d,synthetic_programmatic_template,flat,top,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions For calendar year 2025 OMB No. 1545-0715 Copy B For Recipient This is important tax information and is being furnished to the IRS. PAYER'S name, street
address, city or town, state or province, country, and ZIP or foreign
postal code Evergreen Brokerage Services 7937 Elm Park Pl Pinecrest, GA 40357 PAYER'S TIN 17-4695584 RECIPIENT'S name Amara Testcase RECIPIENT'S TIN ***-**-2840 Street address (including apt. no.) 8908 Cedar Ln City or town, state or province, country, and ZIP or foreign postal code Bayside, WA 29954 1b Date acquired June 7, 2022 1c Date sold or disposed January 27, 2024 1d Proceeds 9,470.86 1g Wash sale loss disallowed 2 Short-term gain or loss / Long-term gain or loss X Long-term 4 Federal income tax withheld 5 Check if noncovered security ☒ 6 Reported to IRS: Gross proceeds X",1099,5,1099,fdc-a8e6e9b32db11e4085cbff0c,v11-1099-B-flat,original,2025,fgen-d69687fc2a2b35acbd69bef0,synthetic_programmatic_template,flat,top,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions OMB No. 1545-0715 Copy B For Recipient This is important tax information and is being furnished to the IRS. PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Ironwood Wealth Partners 3377 Sample Street Oak
Grove, TX 41131 PAYER'S TIN 96-9505656 RECIPIENT'S name Casey Patel RECIPIENT'S TIN ending in 1621 Account number (see instructions) ****569043 1a Description of property SCHD 1c Date sold or disposed 08/18/2023 1d Proceeds 73,906.68 1g Wash sale loss disallowed 2 Short-term gain or loss / Long-term gain or loss Short-term 4 Federal income tax withheld 5 Check if noncovered security X Department of the Treasury - Internal Revenue Service Form 1099-B (keep for your
records) www.irs.gov/Form1099B",1099,5,1099,fdc-620f613e89be1c0547b20b87,v11-1099-B-flat,original,2026,fgen-1f133e5ca243677922810e7c,synthetic_programmatic_template,flat,top,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions Copy B For Recipient This is important tax information and is being furnished to the IRS. PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northstar Securities 4336 Maple Ridge Dr Fairview, OH 66968
PAYER'S TIN 34-2259453 RECIPIENT'S name Fatima Lindqvist RECIPIENT'S TIN XXX-XX-2259 Street address (including apt. no.) 7027 Lakeshore Blvd City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 13041 1a Description of property MSFT 1b Date acquired 02/21/2022 1c Date sold or disposed October 24, 2022 1d Proceeds $118,073.18 1e Cost or other basis 5,178.59 1g Wash sale loss disallowed $0.00 2 Short-term gain or loss / Long-term gain or loss X Long-term 4 Federal income tax withheld $0.00 5 Check if noncovered
security X 6 Reported to IRS: Gross proceeds ☐ Department of the Treasury - Internal Revenue Service Form 1099-B (keep for your records) www.irs.gov/Form1099B",1099,5,1099,fdc-ee2cf71682454f7ff779f67a,v11-1099-B-flat,original,2022,fgen-81534c9e7351b19e0e6fb332,synthetic_programmatic_template,flat,top,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions For calendar year 2021 OMB No. 1545-0715 Copy B For Recipient This is important tax information and
is being furnished to the IRS. PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northstar Securities 4985 Prairie Ave Pinecrest, GA 16637 PAYER'S TIN 26-1187789 RECIPIENT'S name Priya Testcase RECIPIENT'S TIN XXXXX5020 1a Description of property BND 1b Date acquired April 23, 2020 1c Date sold or disposed 2021-04-24 1e Cost or other basis $84,603.82 1g Wash sale loss disallowed 2 Short-term gain or loss / Long-term gain or loss X Long-term 4 Federal income tax withheld 5 Check if noncovered security [X] 6 Reported to
IRS: Gross proceeds X Department of the Treasury - Internal Revenue Service Form 1099-B (keep for your records) www.irs.gov/Form1099B",1099,5,1099,fdc-890e2e6241c06f8747b672e4,v11-1099-B-flat,original,2021,fgen-97ac4bc3c40f8320fb4440eb,synthetic_programmatic_template,flat,top,False,
"For calendar year 2025 OMB No. 1545-0715 Copy B For Recipient This is important tax information and is being furnished to the IRS. PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Clearwater Investing 4589 Granite St Riverton, WI 20185 PAYER'S TIN 65-5752606 RECIPIENT'S name Olivia Brennan RECIPIENT'S TIN XXXXX7376 Street address (including apt. no.) 2048 Elm Park Pl City or town, state or province, country, and ZIP or foreign postal code Fairview, OH 53309 1a Description of property 50 SH NORTHWIND INC 1c Date sold or disposed
2024-08-04 1d Proceeds $43,179.67 1e Cost or other basis 59,115.63 1g Wash sale loss disallowed 2 Short-term gain or loss / Long-term gain or loss Long-term 4 Federal income tax withheld 5 Check if noncovered security 6 Reported
to IRS: Gross proceeds X",1099,5,1099,fdc-9dcc445e0caafb538231b0af,v11-1099-B-flat,original,2025,fgen-761b1c2f3a125c037f0c7008,synthetic_programmatic_template,flat,none,False,
"☐ CORRECTED 2023 OMB No. 1545-0715 PAYER'S name, street address,cítyor town, state or province,
country, and ZIP or foreign postal code Evergreen Brokerage 5ervices 35O9 Oak Ho1low Ct Brookhaven,
PA 28850 PAYER'S TIN 8l-9465501 RECIPIENT'S name Diego Walsh RECIPIENT'5 TIN ****8141 Street address (induding apt. no.) 4962 Willow Bend Way Cityor town, state or province, country, and ZIP or foreign posta1 code Bayside, WA 17651 Account number (see instructions) ending in 656284 1a Description of property 5CHD 1b Date acquired 10/07/2023 1c Date so1dor disposed 2023-09-04 1d Proceeds $122,282.69 1e Cost or other basis $122,167.26 1g Wash sale loss disallowed 2 Short-term gain or loss / Long-term gain or 1oss X Long-term",1099,5,1099,fdc-a3ab53667fc6545b56b44986,v11-1099-B-flat,original,2023,fgen-b7e0348bd9e7936b47856a8e,synthetic_programmatic_template,flat,none,True,
"Form 1099-B Proceeds From Broker and
Barter Exchange Transactions For calendar year 2025 OMB No. 1545-0715 Copy
B For Recipient This is important tax information and is being furnished to the IRS. PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northstar Securities 8316 Prairie Ave Maplewood, MN 79787 PAYER'S TIN 56-3091879 RECIPIENT'S name Taylor Adeyemi RECIPIENT'S TIN XXXXX6093 1a Description of property BND 1b Date acquired November 16, 2022 1d Proceeds 139,770.28 1e Cost or other basis $29,841.10 1g Wash sale loss disallowed $0.00 2 Short-term gain or loss / Long-term gain or loss X Long-term 4 Federal income tax withheld 5 Check if noncovered security ☐ 6 Reported to IRS: Gross proceeds [X]",1099,5,1099,fdc-e40f0770b22561667959dff5,v11-1099-B-flat,original,2025,fgen-21494fed9e4f662f006bf465,synthetic_programmatic_template,flat,top,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions 2023 OMB No. 1545-0715 Copy B For Recipient This is
important tax information and is being furníshed to the IRS. PAYER'S name, streetaddress, city or town, state or province, country, and ZIP or foreign posta1 code Ironwood WealthPartners 7218 Maple Ridge Dr Maplewood, MN 28193 PAYER'S TIN 59-3674O13 RECIPIENT'S name Alex J. Okafor RECIPIENT'S TIN ***-**-8577
Street address (induding apt. no.) 2576 Granite St City or town, state or province, country, and ZIP or foreign postal code Cedar Falls, IA 67774 Account number (see instructions) ****787796 lb Date acquired 2023-12-20 1c Date sold ordisposed 2023-06-24 1d Proceeds $29,266.77 1e Cost or other basis 120,315.93 1g Washsale loss disallowed 2 Short-term gain or loss/ Long-termgain or loss Long-term 4 Federal income tax withheld $0.00 5 Check if noncovered security ☐ 6 Reported to IRS: Gross proceeds ☒ Department of thc Treasury - Intemal Revenue Service Form l099-B (keep for your records) www.irs.gov/Form1O99B",1099,5,1099,fdc-5b18a988886ee30e1f0d32c3,v11-1099-B-flat,original,2023,fgen-ea456dee8e3dfe2d45008ac4,synthetic_programmatic_template,flat,top,True,
"2022 OMB No. 1545-0715 Copy B For Recipient PAYER'S name, street address, city or town, state
or province, country, and ZIP or foreign postal code Evergreen Brokerage Services 1949 Maple Ridge Dr Maplewood, MN 80492 PAYER'S TIN 37-8992730 RECIPIENT'S name Diego Adeyemi RECIPIENT'S TIN XXX-XX-2596 1a Description of property SCHD 1b Date acquired 12/23/19 1c Date sold or disposed 5/21/19 1d Proceeds $48,308.29 1e
Cost or other basis $24,941.03 2 Short-term gain or loss / Long-term gain or loss X Short-term 4 Federal income tax withheld 6 Reported to IRS: Gross proceeds X Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-39bd1e1f21b53162e506f318,v11-1099-B-flat,original,2022,fgen-0b580c33d480698fefdfc455,synthetic_programmatic_template,flat,none,False,
"Form 1099-B Proceeds From Broker and Barter Exchange Transactions 2022
From: Summit Investments Recipient's name: Lena Romero 1d Proceeds $112,145.87 6 Reported to IRS: Gross proceeds [X] 1c
Date sold or disposed 2022-06-12",1099,5,1099,fdc-db6e77cf5598c79545311fd7,v11-1099-B-flat,original,2022,fgen-02b948e4326374e01c1d514b,synthetic_programmatic_template,flat,top,False,
"Form 1099-C
## Cancellation of Debt
## OMB No. 1545-1424
## This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| CREDITOR'5 name, street address, city or town, state orprovince, country, ZIP orforeign postal code,and telephone no. | Summit Card Services 99 Cedar Ln Maplewood, MN 83255 |
|CREDITOR'S TIN | 53-1288860 |
| DEBTOR'S name | Amara L. Lindqvist |
| DEBTOR'S TIN | ****1192 |
| Street address (induding apt. no.) | 3958 Wi1low Bend Way |
| City or town, state or province, country, and ZIP or foreígn posta1 code | Bayside, WA 17117 |
| 1 Date of identifiable event | 2O21-06-08 |
| 3 Interest, if induded in box 2 | $3,247.93 |
| 5 If checked, the debtor was personally liable for repayment of the debt |  |
| 6 Identifiableevent code | G |
| 7 Fair market value of property | $0.00|
Department of the Treasury - Internal Revenue 5ervíce
Form l099-C (keep for your records)  www.irs.gov/Forml099C",1099,5,1099,fdc-6ad50fbedb206b54d637ed4c,v11-1099-C-markdown,original,2024,fgen-d4eec78e0586d33e279bb361,synthetic_programmatic_template,markdown,top,True,
"| Field | Value |
| --- | --- |
| From: | Harbor Card Services |
| To: | Noah Fischer |
| 3 Interest, if included in box 2 | $4,165.78 |
| 6 Identifiable event code | F |
| 2 Amount of debt discharged | 63,051.30 |",1099,5,1099,fdc-318dc5de559d1d087b6a7b92,v11-1099-C-markdown,original,2024,fgen-93b949c6a6d4e5c500d2df90,synthetic_programmatic_template,markdown,none,False,
"Form 1099-C
Cancellation of Debt
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Bluewater Bank Card Center 5343 Prairie Ave Pinecrest, GA 87136 |
| CREDITOR'S TIN | 15-6007742 |
| DEBTOR'S name | Lena Nguyen |
| DEBTOR'S TIN | XXX-XX-8805 |
| Account number (see instructions) | ***-**-133677 |
| 1 Date of identifiable event | 03/16/2025 |
| 2 Amount of debt discharged | $25,039.24 |
| 3 Interest, if included in box 2 | $4,031.09 |
| 4 Debt description | Credit card |
| 5 If checked, the debtor was personally liable for repayment of the debt | ☐ |
| 6 Identifiable event code | 1 |
| 7 Fair market value of property |  |
Department of the Treasury - Internal Revenue Service
Form 1099-C (keep for your records)  www.irs.gov/Form1099C",1099,5,1099,fdc-ae3ce674c1eec8fc3cd3c127,v11-1099-C-markdown,original,2025,fgen-df360a2330c5b5f6458ceb1b,synthetic_programmatic_template,markdown,top,False,
"Form 1099-C
## Cancellation of Debt
For calendar year 2025
## OMB No. 1545-1424
Copy B For Debtor
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Northwind Card Member Services 5831 Oak Hollow Ct Lakewood, CO 99798 |
| CREDITOR'S TIN | 23-4689404 |
| DEBTOR'S name | Casey K. Patel |
| DEBTOR'S TIN | ending in 7872 |
| Street address (including apt. no.) | 924 Prairie Ave |
| City or town, state or province, country, and ZIP or foreign postal code | Brookhaven, PA 26229 |
| 1 Date of identifiable event | 2022-09-08 |
| 3 Interest, if included in box 2 | $8,862.41 |
| 4 Debt description | Credit card |
| 5 If checked, the debtor was personally liable for repayment of the debt | X |
| 6 Identifiable event code | A |
| 7 Fair market value of property |  |
Department of the Treasury - Internal Revenue Service
Form 1099-C (keep for your records)  www.irs.gov/Form1099C",1099,5,1099,fdc-01448ce0d9aae62462f38435,v11-1099-C-markdown,original,2025,fgen-c08a407b26ffea703c9d8905,synthetic_programmatic_template,markdown,top,False,
"## Form 1099-C
Cancellation of Debt
2023
OMB No. 1545-1424
Copy B For Debtor
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Harbor Card Services 8058 Oak Hollow Ct Brookhaven, PA 26960 |
| CREDITOR'S TIN | 10-3915928 |
| DEBTOR'S name | Alex Okafor |
| DEBTOR'S TIN | ending in 5704 |
| Street address (including apt. no.) | 320 Granite St |
| City or town, state or province, country, and ZIP or foreign postal code | Maplewood, MN 83734 |
| Account number (see instructions) | XXX-XX-515967 |
| 1 Date of identifiable event | 2023-01-22 |
| 2 Amount of debt discharged | 103,771.81 |
| 3 Interest, if included in box 2 | $729.28 |
| 4 Debt description | Personal loan |
| 5 If checked, the debtor was personally liable for repayment of the debt | [X] |
| 6 Identifiable event code | 1 |
| 7 Fair market value of property |  |",1099,5,1099,fdc-a76184a56cb84d1168376c0a,v11-1099-C-markdown,original,2023,fgen-66dbcfe6333d0034207a7f48,synthetic_programmatic_template,markdown,top,False,
"For calendar year 2024
OMB No. l545-1424
CopyB For Debtor
This is important tax information and is bcing furnished to the IRS.
| Fie1d| Value |
| --- | --- |
| CREDITOR'S name, street address, cityor town, state or province, country, ZIP or foreign postal code, and telephone no. | Summit Card Services 7825 Sample Street Pinecrest, GA 5O5O5 |
| CREDITOR'S TIN | l4-394O409 |
| DEBTOR'S name | Alex J. Okafor |
| DEBTOR'S TIN | ending in 5l88 |
|Street address (induding apt. no.) | 2772 Lakeshore Blvd |
| City or town, state or province, country, and ZIP or foreign postal code | Lakewood, CO 53542 |
| l Date of identifiable event |09/28/2023 |
| 2 Amount of debt discharged | 20,029.45 |
| 3 Interest, if induded in box 2 | 209.76 |
| 4 Debt description | Personal loan |
| 5If checked, the debtor was personally liable for repayment of the debt | X |
| 6 Identifiable event code | l |
| 7 Fair market value of property | |
Department of the Treasury - Intemal Revenue Service",1099,5,1099,fdc-cb70f8bea7e62e26a4d1e045,v11-1099-C-markdown,original,2024,fgen-c60d4097d89dd49e887f9e07,synthetic_programmatic_template,markdown,none,True,
"Form 1099-C
Cancellation of Debt
2026
OMB No. 1545-1424
Copy B For Debtor
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Bluewater Bank Card Center 9455 Oak Hollow Ct Maplewood, MN 21240 |
| CREDITOR'S TIN | 68-7511942 |
| DEBTOR'S name | Sofia Lindqvist |
| DEBTOR'S TIN | XXX-XX-7963 |
| Account number (see instructions) | ***-**-897730 |
| 1 Date of identifiable event | 02/12/2023 |
| 2 Amount of debt discharged | $13,822.30 |
| 3 Interest, if included in box 2 | $854.59 |
| 4 Debt description | Personal loan |
| 5 If checked, the debtor was personally liable for repayment of the debt | [X] |
| 6 Identifiable event code | 1 |
| 7 Fair market value of property |  |
Department of the Treasury - Internal Revenue Service
Form 1099-C (keep for your records)  www.irs.gov/Form1099C",1099,5,1099,fdc-e3203598e2f040b4e1f76fd5,v11-1099-C-markdown,original,2026,fgen-f21b16433824d9688bce4854,synthetic_programmatic_template,markdown,top,False,
"| Field | Value |
| --- | --- |
| CREDITOR'S name: | Bluewater Bank Card Center |
| Recipient's name: | Olivia Patel |
| 6 Identifiable event code | 2 |
Form 1099-C Cancellation of Debt 2021",1099,5,1099,fdc-52324f13769c71b0167e19ab,v11-1099-C-markdown,original,2021,fgen-671d68662b60b3663cfb3576,synthetic_programmatic_template,markdown,bottom,False,
"## CORRECTED (if checked)
2021
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Atlas Card Services 5909 Granite St Riverton, WI 21020 |
| CREDITOR'S TIN | 36-3619235 |
| DEBTOR'S name | Noah Haddad |
| DEBTOR'S TIN | ***-**-1890 |
| Street address (including apt. no.) | 1722 Granite St |
| City or town, state or province, country, and ZIP or foreign postal code | Lakewood, CO 67212 |
| 1 Date of identifiable event | 6/11/21 |
| 2 Amount of debt discharged | $87,110.23 |
| 5 If checked, the debtor was personally liable for repayment of the debt |  |
| 6 Identifiable event code | 2 |
| 7 Fair market value of property | 0.00 |
Form 1099-C
Cancellation of Debt",1099,5,1099,fdc-06e58edabb6f38a45e9831a1,v11-1099-C-markdown,original,2021,fgen-2b0bfb315f942bfa3356e981,synthetic_programmatic_template,markdown,bottom,False,
"Form 1099-C
## Cancellation of Debt
OMB No. 1545-1424
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Summit Card Services 8713 Harbor View Rd Oak Grove, TX 42357 |
| CREDITOR'S TIN | 35-8840749 |
| DEBTOR'S name | Casey Fischer |
| DEBTOR'S TIN | ***-**-8538 |
| Street address (including apt. no.) | 151 Maple Ridge Dr |
| City or town, state or province, country, and ZIP or foreign postal code | Bayside, WA 27452 |
| 1 Date of identifiable event | 07/27/2021 |
| 3 Interest, if included in box 2 | $8,920.14 |
| 4 Debt description | Credit card |
| 5 If checked, the debtor was personally liable for repayment of the debt |  |
| 6 Identifiable event code | G |
Department of the Treasury - Internal Revenue Service
## Form 1099-C (keep for your records)  www.irs.gov/Form1099C",1099,5,1099,fdc-87507624e7ff52cc48d4d19e,v11-1099-C-markdown,original,2021,fgen-937f127fc5c135bb9369ff8f,synthetic_programmatic_template,markdown,top,False,
"☐ CORRECTED
Form 1099-C
Cancellation of Debt
2025
## Copy B For Debtor
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Northwind Card Member Services 707 Granite St Fairview, OH 53712 |
| CREDITOR'S TIN | 81-7328205 |
| DEBTOR'S name | Hiro S. Larsen |
| DEBTOR'S TIN | ***-**-4469 |
| Street address (including apt. no.) | 2206 Cedar Ln |
| City or town, state or province, country, and ZIP or foreign postal code | Fairview, OH 78835 |
| 2 Amount of debt discharged | 62,718.79 |
| 3 Interest, if included in box 2 | 4,857.96 |
| 5 If checked, the debtor was personally liable for repayment of the debt | X |
| 6 Identifiable event code | A |
| 7 Fair market value of property | $0.00 |",1099,5,1099,fdc-cac3e68826c2bf1edb481631,v11-1099-C-markdown,original,2025,fgen-e2c79ce38b1c840f8ec2b796,synthetic_programmatic_template,markdown,top,False,
"☐ CORRECTED
Form 1099-C
Cancellation of Debt
2022
OMB No. 1545-1424
Copy B For Debtor
## This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Summit Card Services 2058 Lakeshore Blvd Lakewood, CO 74356 |
| CREDITOR'S TIN | 82-1105155 |
| DEBTOR'S name | Casey Tanaka |
| DEBTOR'S TIN | XXXXX8993 |
| 1 Date of identifiable event | 2019-11-20 |
| 2 Amount of debt discharged | 114,784.43 |
| 3 Interest, if included in box 2 | $2,062.82 |
| 4 Debt description | Auto loan deficiency |
| 5 If checked, the debtor was personally liable for repayment of the debt | ☒ |
| 6 Identifiable event code | G |
| 7 Fair market value of property |  |",1099,5,1099,fdc-2ac831582d036e6a64e82b59,v11-1099-C-markdown,original,2022,fgen-5ee257a0e25599e6e0315eba,synthetic_programmatic_template,markdown,top,False,
"CORRECTED (if checked)
## Form 1099-C
Cancellation of Debt
2023
OMB No. 1545-1424
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Bluewater Bank Card Center 1280 Maple Ridge Dr Lakewood, CO 49198 |
| CREDITOR'S TIN | 33-6594502 |
| DEBTOR'S name | Casey Brennan |
| DEBTOR'S TIN | ***-**-3592 |
| Street address (including apt. no.) | 1153 Elm Park Pl |
| City or town, state or province, country, and ZIP or foreign postal code | Riverton, WI 97369 |
| 1 Date of identifiable event | 8/4/23 |
| 2 Amount of debt discharged | $67,297.40 |
| 3 Interest, if included in box 2 | 7,232.79 |
| 4 Debt description | Auto loan deficiency |
| 5 If checked, the debtor was personally liable for repayment of the debt |  |
| 6 Identifiable event code | G |
| 7 Fair market value of property |  |
Department of the Treasury - Internal Revenue Service
## Form 1099-C (keep for your records)  www.irs.gov/Form1099C",1099,5,1099,fdc-54c619b21a528cd1bceadd79,v11-1099-C-markdown,original,2023,fgen-57940932ec26a4410ebd2923,synthetic_programmatic_template,markdown,top,False,
"☐ CORRECTED
Form 1099-C
Cancellation of Debt
2026
OMB No. 1545-1424
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Northwind Card Member Services 7270 Sample Street Maplewood, MN 55144 |
| CREDITOR'S TIN | 68-1934627 |
| DEBTOR'S name | Morgan Kowalski |
| DEBTOR'S TIN | ending in 5150 |
| Street address (including apt. no.) | 6040 Harbor View Rd |
| City or town, state or province, country, and ZIP or foreign postal code | Maplewood, MN 90000 |
| 1 Date of identifiable event | August 7, 2026 |
| 2 Amount of debt discharged | $1,960.06 |
| 3 Interest, if included in box 2 | 7,181.65 |
| 4 Debt description | Personal loan |
| 5 If checked, the debtor was personally liable for repayment of the debt | ☒ |
| 6 Identifiable event code | A |
Department of the Treasury - Internal Revenue Service
Form 1099-C (keep for your records)  www.irs.gov/Form1099C",1099,5,1099,fdc-521df06389f41a4ee394dfc7,v11-1099-C-markdown,original,2026,fgen-2a65de2106e66224173be232,synthetic_programmatic_template,markdown,top,False,
"## Form 1099-C Cancellation of Debt 2026
| Field | Value |
| --- | --- |
| CREDITOR'S name: | Harbor Card Services |
| To: | Amara C. Lindqvist |
| 3 Interest, if included in box 2 | 3,197.95 |
| 5 If checked, the debtor was personally liable for repayment of the debt | [X] |
| 2 Amount of debt discharged | $25,737.35 |
| 6 Identifiable event code | A |",1099,5,1099,fdc-05d45a2fa3f2c37b201118d0,v11-1099-C-markdown,original,2026,fgen-1d07d141fcbb3c2dafd32a59,synthetic_programmatic_template,markdown,top,False,
"Form 1099-C
## Cancellation of Debt
2024
Copy B For Debtor
## This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| CREDITOR'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Bluewater Bank Card Center 5448 Harbor View Rd Brookhaven, PA 85766 |
| CREDITOR'S TIN | 57-3872606 |
| DEBTOR'S name | Jamie Okafor |
| DEBTOR'S TIN | XXXXX7933 |
| Account number (see instructions) | XXX-XX-928343 |
| 1 Date of identifiable event | 08/22/2023 |
| 2 Amount of debt discharged | $129,833.38 |
| 4 Debt description | Auto loan deficiency |
| 5 If checked, the debtor was personally liable for repayment of the debt | [X] |
| 6 Identifiable event code | 1 |
| 7 Fair market value of property |  |
## Department of the Treasury - Internal Revenue Service
Form 1099-C (keep for your records)  www.irs.gov/Form1099C",1099,5,1099,fdc-6ffbee60eea806f6196a562c,v11-1099-C-markdown,original,2024,fgen-82c20236149f6302fd45db3e,synthetic_programmatic_template,markdown,top,False,
"2022
This is important tax information and is being furnished to the IRS.
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
CoinHarbor Exchange 1230 Lakeshore Blvd Bayside, WA 76492
BROKER'S TIN
51-8416876
RECIPIENT'S name
Avery L. Fischer
RECIPIENT'S TIN
ending in 3713
Street address (including apt. no.)
8965 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code
Bayside, WA 21875
Digital asset name
Solana (SOL)
Number of units
25.889438
Date acquired
3/23/21
Date sold or disposed
2021-02-22
Proceeds
$127,226.32
Cost or other basis
$85,971.03
Federal income tax withheld
0.00
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-4ebcdf2a29c6fc7e68be7af6,v11-1099-DA-stacked,original,2022,fgen-1cfdb60b26c0c7629c43c52d,synthetic_programmatic_template,stacked,none,False,
"CORRECTED (if checked)
Form 1099-DA
Digital Asset Proceeds From Broker Transactions
For calendar year 2023
Copy B For Recipient
BR0KER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
BitMeadow 5949 Prairie Ave Tcstvi1le, IL 29995
BROKER'S TIN
83-4l93096
RECIPIENT'S name
Fatima Okafor
RECIPIENT'S TIN
endingin 7703
5treet address (including apt. no.)
7l49 Granite St
City ortown, state or province, country, and ZIP or foreign postal code
Oak Grove, TX 80940
Digita1 assetname
U5D Coin (U5DC)
Number of units
28.520066
Date sold or disposed
March 11, 2022
Proceeds
S112,364.39
Cost or other basis
55,910.65
Federal income tax withheld
$0.00
Department of the Treasury - Intemal Revenue Service
Form 1099-DA (keep for your records)  www.irs.gov/Form1099DA",1099,5,1099,fdc-b873092d3144f21ffddcfc5b,v11-1099-DA-stacked,original,2023,fgen-4c886dcf2425eced6b757059,synthetic_programmatic_template,stacked,top,True,
"BROKER'S name:
CoinHarbor Exchange
To:
Wei Moreau
Date acquired
12/21/24
Date sold or disposed
2024-03-26
Proceeds
73,182.53
Form 1099-DA Digital Asset Proceeds From Broker Transactions 2024",1099,5,1099,fdc-f1a20510d11b8b91673d83ea,v11-1099-DA-stacked,original,2024,fgen-ab002ccd5df352abbf4ec2b7,synthetic_programmatic_template,stacked,bottom,False,
"For calendar year 2021
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
CoinHarbor Exchange 8337 Cedar Ln Lakewood, CO 76625
BROKER'S TIN
31-8129261
RECIPIENT'S name
Alex A. Patel
RECIPIENT'S TIN
***-**-7724
Street address (including apt. no.)
790 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code
Testville, IL 95940
Account number (see instructions)
XXX-XX-846537
Digital asset name
Bitcoin (BTC)
Number of units
22.287455
Date acquired
12/20/2021
Date sold or disposed
8/26/21
Proceeds
40,344.70
Cost or other basis
$83,512.92
Federal income tax withheld
$0.00
Form 1099-DA
Digital Asset Proceeds From Broker Transactions",1099,5,1099,fdc-adff7aabbdb9a6afeb2ed694,v11-1099-DA-stacked,original,2021,fgen-4944169fad4e53a9b48ddcd8,synthetic_programmatic_template,stacked,bottom,False,
"Form 1099-DA
Digital Asset Proceeds From Broker Transactions
2025
This is important tax information and is being furnished to the IRS.
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
CoinHarbor Exchange 2929 Willow Bend Way Riverton, WI 83050
BROKER'S TIN
27-6801400
RECIPIENT'S name
Lena C. Rivera
RECIPIENT'S TIN
XXX-XX-2248
Account number (see instructions)
****070135
Number of units
22.020443
Date acquired
1/2/25
Date sold or disposed
8/15/25
Proceeds
12,679.62
Cost or other basis
$60,952.05
Federal income tax withheld
$0.00
Department of the Treasury - Internal Revenue Service
Form 1099-DA (keep for your records)  www.irs.gov/Form1099DA",1099,5,1099,fdc-ec464ab6724beb8473326b28,v11-1099-DA-stacked,original,2025,fgen-026ac1c2592ad546cc7d9bd4,synthetic_programmatic_template,stacked,top,False,
"CORRECTED (if checked)
Form 1099-DA
Digital Asset Proceeds From Broker Transactions
2O23
Copy B For Rccipient
Thisis important taxinformation and is being furnished to the IRS.
BROKER'S namc, street address, city or town, state or province, country, ZIP or foreign postal code, and telephoneno.
LedgerPeak Markets 2887 Lakeshore Blvd Oak Grove, TX 79019
BROKER'S TIN
76-9839618
RECIPIENT'S name
Sofía Testcase
RECIPIENT'S TIN
ending in 3954
Account number (see instructions)
cnding in 682188
Digital asset name
Bitcoin (BTC)
Number of units
9.936825
Date acquired
O5/23/2O23
Datc sold or disposed
02/10/2023
Cost or other basis
3,204.68
Federal income tax withheld
Department of the Treasury - Internal Revenue 5ervice
Form 1099-DA (keep for your records)  www.írs.gov/Form1099DA",1099,5,1099,fdc-8a4c5fb557f984a59080580d,v11-1099-DA-stacked,original,2023,fgen-c06fb2f55dd6c2df303cc66d,synthetic_programmatic_template,stacked,top,True,
"Form 1099-DA
Digital Asset Proceeds From Broker Transactions
2024
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
CoinHarbor Exchange 5241 Elm Park Pl Cedar Falls, IA 92729
BROKER'S TIN
54-9741812
RECIPIENT'S name
Amara Sato
RECIPIENT'S TIN
ending in 7437
Street address (including apt. no.)
1955 Granite St
City or town, state or province, country, and ZIP or foreign postal code
Brookhaven, PA 63576
Number of units
33.774038
Date acquired
2023-05-11
Date sold or disposed
12/18/21
Proceeds
4,876.24
Cost or other basis
$33,149.87
Federal income tax withheld
Department of the Treasury - Internal Revenue Service
Form 1099-DA (keep for your records)  www.irs.gov/Form1099DA",1099,5,1099,fdc-e6c95c683538793d4c59f5d6,v11-1099-DA-stacked,original,2024,fgen-ed9898ac9bf82b7af8c9fac6,synthetic_programmatic_template,stacked,top,False,
"☐ CORRECTED
For calendar year 2022
This is important tax ínformation and is being fumished to the IRS.
BROKER'S name, street address, city or town, state or provincc, country, ZIP or foreign postal code, and telephone no.
CoinHarbor Exchange 3326 Lakcshore Blvd Maplewood, MN 45599
BROKER'S TIN
64-1048122
RECIPIENT'S name
Hiro Walsh
RECIPIENT'S TIN
XXXXX7099
Digital asset name
Ethereum (ETH)
Number of units
37.821614
Date acquired
2O22-O5-13
Date sold or disposed
12/12/22
Proceeds
S126,877.21
Cost or otherbasis
$73,2O0.92
Federalincome tax withheld
Department ofthe Treasury - Intemal Revenue 5ervice
Form 1099-DA
Digital Asset Proceeds From Broker Transactions
Form 1099-DA (keep for your records)  www.irs.gov/Form1099DA",1099,5,1099,fdc-feb20fe6b8374e6ec26128a5,v11-1099-DA-stacked,original,2022,fgen-33d286d1a75eca128c7bcc0e,synthetic_programmatic_template,stacked,bottom,True,
"Copy B For Recipient
This is important tax information and is being furnished to the IRS.
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
CoinHarbor Exchange 2961 Harbor View Rd Bayside, WA 84992
BROKER'S TIN
21-7474705
RECIPIENT'S name
Taylor Sato
RECIPIENT'S TIN
XXXXX7562
Street address (including apt. no.)
2362 Elm Park Pl
City or town, state or province, country, and ZIP or foreign postal code
Bayside, WA 66571
Account number (see instructions)
ending in 731511
Digital asset name
Bitcoin (BTC)
Number of units
23.773604
Date sold or disposed
May 12, 2021
Proceeds
43,214.16
Cost or other basis
129,588.92
Federal income tax withheld
Form 1099-DA
Digital Asset Proceeds From Broker Transactions",1099,5,1099,fdc-2343df7f0693477b365dd012,v11-1099-DA-stacked,original,2021,fgen-f04571b94b59efa58e384802,synthetic_programmatic_template,stacked,bottom,False,
"Form 1099-DA
Digital Asset Proceeds From Broker Transactions
2024
Copy B For Recipient
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
BitMeadow 4686 Lakeshore Blvd Lakewood, CO 87972
BROKER'S TIN
65-6419175
RECIPIENT'S name
Olivia M. Okafor
RECIPIENT'S TIN
ending in 8073
Street address (including apt. no.)
3108 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code
Lakewood, CO 40298
Account number (see instructions)
XXX-XX-910713
Digital asset name
Ethereum (ETH)
Number of units
15.187125
Date acquired
July 10, 2024
Proceeds
$109,179.69
Cost or other basis
$135,174.92
Federal income tax withheld
Department of the Treasury - Internal Revenue Service
Form 1099-DA (keep for your records)  www.irs.gov/Form1099DA",1099,5,1099,fdc-38121111d063bfb6b3d8aa07,v11-1099-DA-stacked,original,2024,fgen-6d783b7bf6636a227f4a99cb,synthetic_programmatic_template,stacked,top,False,
"BROKER'S name:
LedgerPeak Markets
RECIPIENT:
Lena Romero
Date sold or disposed
October 7, 2022
Date acquired
2022-08-21
Digital asset name
Solana (SOL)
Form 1099-DA Digital Asset Proceeds From Broker Transactions 2022",1099,5,1099,fdc-30266af0b011f13807343e11,v11-1099-DA-stacked,original,2022,fgen-360e0e139a50c5523234da4b,synthetic_programmatic_template,stacked,bottom,False,
"☐ CORRECTED
Form 1099-DA
Digital Asset Proceeds From Broker Transactions
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
CoinHarbor Exchange 4288 Granite St Cedar Falls, IA 86254
BROKER'S TIN
92-2024805
RECIPIENT'S name
Lena Moreau
RECIPIENT'S TIN
ending in 4224
Street address (including apt. no.)
9251 Granite St
City or town, state or province, country, and ZIP or foreign postal code
Pinecrest, GA 64501
Account number (see instructions)
***-**-340419
Number of units
30.718253
Date acquired
01/18/2022
Date sold or disposed
02/11/2024
Proceeds
17,786.37
Cost or other basis
$24,054.82
Federal income tax withheld",1099,5,1099,fdc-1c05c8151ab6137153a9fe28,v11-1099-DA-stacked,original,2025,fgen-5e04f3c148897ba9f5f45d80,synthetic_programmatic_template,stacked,top,False,
"Form 1099-DA Digital Asset Proceeds From Broker Transactions 2022
BROKER:
CoinHarbor Exchange
Recipient's name:
Amara Walsh
Number of units
35.277122",1099,5,1099,fdc-67207e584b5e028e0bb33d17,v11-1099-DA-stacked,original,2022,fgen-a50880d7a476cf0bf532234b,synthetic_programmatic_template,stacked,top,False,
"☐ CORRECTED
2025
Copy B For Recipient
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
BitMeadow 4283 Granite St Bayside, WA 73091
BROKER'S TIN
82-7108585
RECIPIENT'S name
Avery B. Testcase
RECIPIENT'S TIN
ending in 9540
Street address (including apt. no.)
3610 Sample Street
City or town, state or province, country, and ZIP or foreign postal code
Riverton, WI 95045
Account number (see instructions)
***-**-132934
Digital asset name
USD Coin (USDC)
Number of units
32.782895
Date sold or disposed
2022-12-11
Cost or other basis
$61,002.43
Federal income tax withheld
$0.00
Form 1099-DA
Digital Asset Proceeds From Broker Transactions",1099,5,1099,fdc-1b1a3e6f7bfbde6c94651a53,v11-1099-DA-stacked,original,2025,fgen-8f17492d29303511669dd6a1,synthetic_programmatic_template,stacked,bottom,False,
"Form 1099-DA Digital Asset Proceeds From Broker Transactions 2025
From:
BitMeadow
Recipient's name:
Avery Testcase
Cost or other basis
$20,844.57",1099,5,1099,fdc-9e5be4a8f9745828420da310,v11-1099-DA-stacked,original,2025,fgen-27af932bf71953843b9ad7a9,synthetic_programmatic_template,stacked,top,False,
"Form 1099-DA
Digital Asset Proceeds From Broker Transactions
For calendar year 2023
This is important tax information and is being furnished to the IRS.
BROKER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
BitMeadow 7683 Maple Ridge Dr Brookhaven, PA 90765
BROKER'S TIN
19-7112935
RECIPIENT'S name
Kwame Testcase
RECIPIENT'S TIN
***-**-9187
Street address (including apt. no.)
1295 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code
Riverton, WI 35701
Digital asset name
Solana (SOL)
Number of units
18.148597
Date acquired
2023-02-21
Date sold or disposed
01/21/2023
Proceeds
$127,085.09
Cost or other basis
$110,246.08",1099,5,1099,fdc-cd2afb00cf185b5f7272c062,v11-1099-DA-stacked,original,2023,fgen-1e0aba6d081cb93daac2916b,synthetic_programmatic_template,stacked,top,False,
"Form 1099-DIV Dividends and Distributions
From: Ironwood Wealth Partners
RECIPIENT:     Jordan B. Haddad
1a Total ordinary dividcnds 4,688.52
1b Qualífied dividends      S4,285.89
5 Section 199A dividends   $7,736.77",1099,5,1099,fdc-4c3a15cdce7dc6a0b9cd1d2b,v11-1099-DIV-inline,original,2023,fgen-530d4ba0e9f2812bd57739f7,synthetic_programmatic_template,inline,top,True,
"PAYER'S name:   Northstar Securities
To:  Olivia Tanaka
1b Qualified dividends $8,698.35
5 Section 199A dividends      $912.76
1a Total ordinary dividends $8,374.79
Form 1099-DIV Dividends and Distributions 2025",1099,5,1099,fdc-0dc993bcb9dc7efd8acd14a2,v11-1099-DIV-inline,original,2025,fgen-3aa472a90a77471feb226754,synthetic_programmatic_template,inline,bottom,False,
"OMB No. 1545-0110
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'Sname, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Clearwater Investing 4962 Sample Street Testville, IL 27742
PAYER'S TIN   4O-6537867
RECIPIENT'S name     Mateo Okafor
RECIPIENT'STIN ****2l56
Street address (induding apt. no.)      1399 Prairie Ave
City ortown, state or province, country, and ZIP or foreign posta1 code  Fairview,OH 20491
Account number (see ínstructions)  XXXXX716919
1a Total ordinary dividends $1,591.38
1b Qualified dividends 1,085.35
2a Total capítal gain distr. 8,620.34
2b Unrecap. Sec. l250 gain
3 Nondívidend distributions
4 Federal income tax withheld  $0.00
7 Foreign tax paid 3,391.54
Department of the Treasury - Intemal Revenue Service",1099,5,1099,fdc-5b06085f43a1ba067710d315,v11-1099-DIV-inline,original,2026,fgen-b281b6e99070ba7f68380ae5,synthetic_programmatic_template,inline,none,True,
"CORRECTED (if checked)
Form 1099-DIV
Dividends and Distributions
For calendar year 2023
OMB No. 1545-0110
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Evergreen Brokerage Services 3940 Oak Hollow Ct Bayside, WA 89338
PAYER'S TIN      52-8143209
RECIPIENT'S name  Alex Moreau
RECIPIENT'S TIN ending in 3895
1a Total ordinary dividends  $2,045.36
2a Total capital gain distr.  $40.59
3 Nondividend distributions
4 Federal income tax withheld 0.00
7 Foreign tax paid 4,261.79
12 Exempt-interest dividends",1099,5,1099,fdc-ce1f8844604e0cff4dc3d034,v11-1099-DIV-inline,original,2023,fgen-6987df976df00f0ab6e2408b,synthetic_programmatic_template,inline,top,False,
"From: Ironwood Wealth Partners
To:      Jamie Romero
1b Qualified dividends  $6,695.49
1a Total ordinary dividends      2,082.36
Form 1099-DIV Dividends and Distributions",1099,5,1099,fdc-36fa46c75dba7ada59260b13,v11-1099-DIV-inline,original,2023,fgen-d18b0405ca9e9bd5fc1ecd49,synthetic_programmatic_template,inline,bottom,False,
"Form 1099-DIV Dividends and Distributions
PAYER'S name:   Ironwood Wealth Partners
To: Riley Patel
1b Qualified dividends  $1,755.77",1099,5,1099,fdc-b96ae081f83192a2f401e333,v11-1099-DIV-inline,original,2024,fgen-2cdfac872bf989919fc03819,synthetic_programmatic_template,inline,top,False,
"Form 1099-DIV Dividends and Distributions
From: Ironwood Wealth Partners
Recipient's name: Morgan Castillo
7 Foreign tax paid  615.83
1b Qualified dividends      5,056.19",1099,5,1099,fdc-c37186023b3c52f723edfbef,v11-1099-DIV-inline,original,2021,fgen-c5dbb7cfe55bd8f97a4494eb,synthetic_programmatic_template,inline,top,False,
"Form 1099-DIV Dividends and Distributions 2025
PAYER:      Ironwood Wealth Partners
RECIPIENT: Olivia Haddad
1b Qualified dividends 8,995.50
2a Total capital gain distr.   4,791.52
5 Section 199A dividends $6,660.27",1099,5,1099,fdc-4a903d3c96973c1fe84ddc98,v11-1099-DIV-inline,original,2025,fgen-f6e740407c8c4e1f2d270fc4,synthetic_programmatic_template,inline,top,False,
"Form 1099-DIV Dividends and Distributions 2025
PAYER'S name:  Ironwood Wealth Partners
RECIPIENT:   Hiro Larsen
5 Section 199A dividends   3,809.10",1099,5,1099,fdc-5926be45bcbaeedbbb5b62ab,v11-1099-DIV-inline,original,2025,fgen-4b8e2f66cb39612525d0fd2d,synthetic_programmatic_template,inline,top,False,
"For calendar year 2026
OMB No. 1545-0110
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Summit Investments 484 Harbor View Rd Cedar Falls, IA 53023
PAYER'S TIN      94-2107935
RECIPIENT'S name Taylor Haddad
RECIPIENT'S TIN   ending in 3454
Street address (including apt. no.) 5513 Sample Street
City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 14836
1a Total ordinary dividends $4,213.62
1b Qualified dividends  1,531.55
2a Total capital gain distr. 1,397.56
2b Unrecap. Sec. 1250 gain      $0.00
3 Nondividend distributions 0.00
4 Federal income tax withheld   $0.00
5 Section 199A dividends $1,190.27
7 Foreign tax paid   $3,226.75
12 Exempt-interest dividends
Department of the Treasury - Internal Revenue Service
Form 1099-DIV
Dividends and Distributions
Form 1099-DIV (keep for your records)  www.irs.gov/Form1099DIV",1099,5,1099,fdc-2ce4440fddaea15c842846c6,v11-1099-DIV-inline,original,2026,fgen-730ff19f25d426611e07aace,synthetic_programmatic_template,inline,bottom,False,
"Form 1099-DIV
Dividends and Distributions
2024
This is important tax information and is bcing furnished to the IR5.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Evergreen Brokerage Services 221O Prairie Ave Bayside, WA 21471
PAYER'5 TIN 61-9603222
RECIPIENT'S nameJamie Testcase
RECIPIENT'S TIN  XXX-XX-9823
Street address (induding apt. no.)   3O65 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code   0ak Grove, TX 70666
Account number (see instructíons)XXXXX5l4751
1a Tota1 ordinary dividends   1,632.28
1b Qualified dividends      l,057.80
5Section 199A dividends   S9,044.45
7 Foreign tax paid $6,888.11
12 Exempt-interest dividends
Department of the Treasury - Intemal Revenue Service
Form 1099-DIV (kcep for your records)  www.irs.gov/Form1099DIV",1099,5,1099,fdc-078610cee4ae2894dba077df,v11-1099-DIV-inline,original,2024,fgen-2f75b857bdf10b3b2a1a78bb,synthetic_programmatic_template,inline,top,True,
"Form 1099-DIV
Dividends and Distributions
2024
OMB No. 1545-0110
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Northstar Securities 8062 Oak Hollow Ct Pinecrest, GA 16518
PAYER'S TIN   66-8354414
RECIPIENT'S name Jordan C. Rivera
RECIPIENT'S TIN ****6502
Street address (including apt. no.) 7838 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code  Brookhaven, PA 31986
Account number (see instructions) ***-**-340835
1b Qualified dividends   631.93
2b Unrecap. Sec. 1250 gain 0.00
3 Nondividend distributions
4 Federal income tax withheld
5 Section 199A dividends $7,858.43
7 Foreign tax paid 8,567.23
Department of the Treasury - Internal Revenue Service
Form 1099-DIV (keep for your records)  www.irs.gov/Form1099DIV",1099,5,1099,fdc-1589f1760a36b6911cc1fb1e,v11-1099-DIV-inline,original,2024,fgen-e421ba94b9a438984d323885,synthetic_programmatic_template,inline,top,False,
"PAYER'S name:      Northstar Securities
To:   Sofia Haddad
2a Total capital gain distr.      4,047.15
7 Foreign tax paid 6,853.62
1b Qualified dividends  5,567.92",1099,5,1099,fdc-445a527b931f1b9cdb673291,v11-1099-DIV-inline,original,2021,fgen-b8a028043fa92d0333b8a15d,synthetic_programmatic_template,inline,none,False,
"Form 1099-DIV
Dividends and Distributions
2023
OMB No. 1545-0110
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Evergreen Brokerage Services 1387 Elm Park Pl Lakewood, CO 95738
PAYER'S TIN  57-2089887
RECIPIENT'S name Wei Kowalski
RECIPIENT'S TIN   ***-**-2789
Street address (including apt. no.)   1822 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 93930
1a Total ordinary dividends $5,746.23
1b Qualified dividends      $8,538.88
2a Total capital gain distr.   $1,193.36
2b Unrecap. Sec. 1250 gain
3 Nondividend distributions
4 Federal income tax withheld $0.00
5 Section 199A dividends $6,289.42
7 Foreign tax paid  6,085.47
12 Exempt-interest dividends      $0.00
Department of the Treasury - Internal Revenue Service
Form 1099-DIV (keep for your records)  www.irs.gov/Form1099DIV",1099,5,1099,fdc-c94e30c270aaa7b8a0a94e89,v11-1099-DIV-inline,original,2023,fgen-2dbdda9ad7c5f5b3a99dfd1c,synthetic_programmatic_template,inline,top,False,
"☐ CORRECTED
Form 1099-DIV
Dividends and Distributions
2023
OMB No. 1545-0110
Copy B For Recipient
This isimportant tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or provincc, country, ZIP or forcign postal code, and telephone no. Clearwater Investing 5010 Oak Hollow CtBayside, WA 17827
PAYER'5 TIN 54-5832282
RECIPIENT'S name   Casey J. Fischer
RECIPIENT'S TIN ***-**-2526
Streetaddress (including apt. no.)   7336 Granite St
City or town, state or province, country, and ZIP or foreign postal code  Maplewood, MN 478l0
Account number (see instructions)   XXXXX523939
1a Total ordinary dividends      $9,214.41
2a Total capitalgain distr.   5,67l.54
2b Unrecap. Sec. l25O gain
3 Nondividend distributions
4 Federal income tax withheld
5 Section 199A dividends $5,890.94
12 Exempt-interest dividends",1099,5,1099,fdc-659475ec396e2fcb01c1fa5d,v11-1099-DIV-inline,original,2023,fgen-d7e19162913db72b2569c195,synthetic_programmatic_template,inline,top,True,
"Form 1099-DIV
Dividends and Distributions
OMB No. 1545-0110
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.  Summit Investments 6965 Harbor View Rd Brookhaven, PA 68050
PAYER'S TIN   84-2331583
RECIPIENT'S name  Jamie Haddad
RECIPIENT'S TIN ***-**-1723
1b Qualified dividends   $3,583.03
2a Total capital gain distr.   2,711.09
2b Unrecap. Sec. 1250 gain $0.00
3 Nondividend distributions
4 Federal income tax withheld  $0.00
5 Section 199A dividends  5,721.40
7 Foreign tax paid $4,908.61
12 Exempt-interest dividends
Department of the Treasury - Internal Revenue Service
Form 1099-DIV (keep for your records)  www.irs.gov/Form1099DIV",1099,5,1099,fdc-bf6014924151b2942a2695e2,v11-1099-DIV-inline,original,2025,fgen-757aad86c4a81155b847904d,synthetic_programmatic_template,inline,top,False,
"☐ CORRECTED
Form 1099-G
Certain Government Payments
2022
OMB No. 1545-0120
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
1 Unemployment compensation
2 State or local income tax refunds, credits, or offsets
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
Illinois Department of Employment Security 966 Prairie Ave Pinecrest, GA 75713
87-8921342
Priya Kowalski
ending in 3317
2238 Sample Street
Fairview, OH 94367
118,773.79
6,365.31
0.00
CO 9718740
$0.00",1099,5,1099,fdc-f0c50749b03a1c58e250b1e2,v11-1099-G-columns,original,2022,fgen-2f14176391c7a361e3ce0f3b,synthetic_programmatic_template,columns,top,False,
"Form 1099-G
Certain Government Payments
For calendar year 2025
OMB No. 1545-0120
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Unemployment compensation
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
4 Federal income tax withheld
6 Taxable grants
10a State
11 State income tax withheld
Wisconsin Department of Revenue 6868 Willow Bend Way Oak Grove, TX 18922
90-8139382
Alex Romero
****7243
4871 Lakeshore Blvd
Lakewood, CO 10326
****802113
54,452.74
$3,065.78
2025
$4,783.17
$0.00
PA 6572274",1099,5,1099,fdc-f847839577011ba094fbde02,v11-1099-G-columns,original,2025,fgen-204662d074a2022f9510a0a4,synthetic_programmatic_template,columns,top,False,
"Form 1099-G
Certain Government Payments
2023
OMB No. 1545-0120
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
Wisconsin Department of Revenue 8182 Maple Ridge Dr Riverton, WI 53468
40-4459004
Diego Larsen
XXX-XX-6777
8,203.35
2023
2,387.46
$0.00
PA 7546990",1099,5,1099,fdc-7633b08c392b5efe9772fe16,v11-1099-G-columns,original,2023,fgen-254c9e2f6c7f300e09406c7f,synthetic_programmatic_template,columns,top,False,
"VOID  CORRECTED
2024
OMB No. 1545-0120
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Unemployment compensation
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
State of Ohio Department of Taxation 3473 Oak Hollow Ct Pinecrest, GA 71591
82-1016462
Lena Sato
****8190
5270 Maple Ridge Dr
Bayside, WA 71650
****913517
32,627.48
$6,935.07
2024
CO 7640381
Department of the Treasury - Internal Revenue Service
Form 1099-G
Certain Government Payments
Form 1099-G (keep for your records)  www.irs.gov/Form1099G",1099,5,1099,fdc-6fa4a68329ba6b77cc2b286d,v11-1099-G-columns,original,2024,fgen-b2a3a36ce115a28aa6a7ee90,synthetic_programmatic_template,columns,bottom,False,
"Form 1099-G
Certain Government Payments
2024
Copy B For Recipient
This is important tax information and is being fumished to the IRS.
PAYER'S name, street address, cityor town, state or province, country, ZIP or foreign posta1 code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Streetaddress (including apt. no.)
City or town, state or province, country, and ZIP or foreign posta1 code
1 Unemployment compensation
4 Federal incometax withheld
6 Taxablegrants
7 Agriculture payments
11 State income tax withheld
Illinois Department of Employment Security 7780 Elm Park Pl Maplewood, MN 73856
67-1885515
Noah Adeyemi
XXX-XX-2810
4929 Maple Ridge Dr
Testville, IL 6462l
$49,221.52
2,461.72
0.00
Department of the Treasury - Intemal Revenue 5ervice
Form 1099-G (keep for your records)  www.irs.gov/Form1099G",1099,5,1099,fdc-0b61d67c7c9002b7c658aee2,v11-1099-G-columns,original,2024,fgen-7ee7b0f626bf14c44ac20bb7,synthetic_programmatic_template,columns,top,True,
"For calendar year 2024
OMB No. 1545-0120
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
State of Ohio Department of Taxation 4194 Granite St Bayside, WA 56405
11-6537148
Fatima Okafor
XXX-XX-0775
4011 Cedar Ln
Testville, IL 90808
****281423
$2,133.41
2024
$4,816.52
0.00
$0.00
PA 3520949
$0.00
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-013ba4c2440ec653fc1f9442,v11-1099-G-columns,original,2024,fgen-251f71553624b2effddb2d2a,synthetic_programmatic_template,columns,none,False,
"Form 1099-G
Certain Government Payments
2024
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Unemployment compensation
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
State of Ohio Department of Taxation 8036 Maple Ridge Dr Lakewood, CO 93904
27-1543508
Riley B. Larsen
****2050
1588 Lakeshore Blvd
Pinecrest, GA 25801
XXXXX197092
64,285.71
$7,426.18
2024
0.00
$0.00
IL 4176603
Department of the Treasury - Internal Revenue Service
Form 1099-G (keep for your records)  www.irs.gov/Form1099G",1099,5,1099,fdc-41ae532670658e383776eadd,v11-1099-G-columns,original,2024,fgen-129005740471646873f38f87,synthetic_programmatic_template,columns,top,False,
"Form 1099-G
Certain Government Payments
2025
OMB No. 1545-0120
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Account number (see instructions)
1 Unemployment compensation
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
Wisconsin Department of Revenue 5307 Oak Hollow Ct Pinecrest, GA 61230
57-9199781
Wei Patel
XXXXX6260
****339675
$53,076.19
$1,254.76
MN 6813122
Department of the Treasury - Internal Revenue Service
Form 1099-G (keep for your records)  www.irs.gov/Form1099G",1099,5,1099,fdc-a31f1a989c47ef96a3788d30,v11-1099-G-columns,original,2025,fgen-efef32c47aa8d18074a61b77,synthetic_programmatic_template,columns,top,False,
"Form 1099-G
Certain Government Payments
For ca1endar year 2025
OMB No. 1545-0120
Copy B For Recipient
This is important taxinformation andis being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign posta1 code, and telcphone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
1 Unemployment compensation
3 Box 2 amount is for tax ycar
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
l0a State
l1 State income tax withheld
State of Ohio Departmentof Taxation 9893 Harbor View Rd Bayside, WA 59774
46-1291072
Morgan M. Castillo
****0575
70,870.69
2025
4,918.47
OH 3429944",1099,5,1099,fdc-fa3e5f7dfba3f25eecc9b6d8,v11-1099-G-columns,original,2025,fgen-b61a6818863345954375339d,synthetic_programmatic_template,columns,top,True,
"Form 1099-G
Certain Government Payments
OMB No. 1545-0120
Copy B For Recipient
This is important taxínformation and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign posta1 code, and te1ephone no.
PAYER'5 TIN
RECIPIENT'S name
RECIPIENT'S TIN
2 State or local income tax refunds, credits,or offsets
3 Box2 amount is for tax year
6 Taxab1e grants
10a 5tate
11 State income tax withheld
State of 0hio Department of Taxation 4905 Elm Park Pl Oak Grove, TX 69783
62-8504673
Hiro Sato
****5959
5,641.33
2026
GA 6186938
S0.00
Department of the Treasury - Intemal Revenue Service
Form 1099-G (keep for your records)  www.irs.gov/Form1099G",1099,5,1099,fdc-4229cf1b412bb3e5f5a6f93d,v11-1099-G-columns,original,2026,fgen-a240675ad71766fb4802c326,synthetic_programmatic_template,columns,top,True,
"VOID  CORRECTED
For calendar year 2024
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
Illinois Department of Employment Security 9738 Lakeshore Blvd Oak Grove, TX 30653
41-4929505
Riley Nguyen
****9181
4934 Willow Bend Way
Lakewood, CO 51664
***-**-480811
$1,209.05
2024
$7,645.39
$0.00
IL 6158548
Form 1099-G
Certain Government Payments",1099,5,1099,fdc-341d35d41ef92a43f244c9f6,v11-1099-G-columns,original,2024,fgen-087b25b0a05fc7897bc921d7,synthetic_programmatic_template,columns,bottom,False,
"☐ CORRECTED
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
1 Unemployment compensation
2 State or local income tax refunds, credits, or offsets
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
State of Ohio Department of Taxation 2377 Lakeshore Blvd Lakewood, CO 57337
19-2118648
Sofia Moreau
****4349
91,099.80
$5,006.58
$7,467.32
OH 4002537
0.00
Form 1099-G
Certain Government Payments",1099,5,1099,fdc-23620d0c3dbdee42fc6d9bdf,v11-1099-G-columns,original,2021,fgen-345a829ab7878f7297b34a68,synthetic_programmatic_template,columns,bottom,False,
"Form 1099-G
Certain Government Payments
2026
OMB No. 1545-0120
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
1 Unemployment compensation
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
10a State
Wisconsin Department of Revenue 2238 Willow Bend Way Brookhaven, PA 51194
82-5938577
Mateo M. Testcase
***-**-7218
3825 Maple Ridge Dr
Testville, IL 27385
$22,149.29
$4,052.59
2026
951.50
$0.00
PA 4905465",1099,5,1099,fdc-ee04c86904498385d15ab75c,v11-1099-G-columns,original,2026,fgen-171983f16d6a7efb4bb3f1fe,synthetic_programmatic_template,columns,top,False,
"Form 1099-G
Certain Government Payments
OMB No. 1545-0120
This is important tax information and is beingfumished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postalcode, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
1Unemployment compensation
2 State or local income tax refunds,credits, or offsets
3 Box 2 amount is for tax ycar
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
1Oa State
11 State income tax withheld
Wisconsin Department of Revenue 8907 Granite St Fairview, 0H 68982
65-2500536
Wei Walsh
***-**-2169
5419 Cedar Ln
Cedar Falls, IA 21774
33,699.13
S5,450.56
2023
$2,765.32
C0 1476347
$0.00",1099,5,1099,fdc-387f5d3fe1a6a3d08ee53518,v11-1099-G-columns,original,2023,fgen-96e624385a8bbb18e92e6e34,synthetic_programmatic_template,columns,top,True,
"☐ CORRECTED
Form 1099-G
Certain Government Payments
2024
OMB No. 1545-0120
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Account number (see instructions)
1 Unemployment compensation
2 State or local income tax refunds, credits, or offsets
3 Box 2 amount is for tax year
4 Federal income tax withheld
6 Taxable grants
7 Agriculture payments
10a State
11 State income tax withheld
Wisconsin Department of Revenue 7646 Granite St Oak Grove, TX 11759
76-3216769
Sofia C. Patel
****0385
****204230
125,768.16
6,526.18
2024
2,302.86
0.00
PA 2221397",1099,5,1099,fdc-cab1cc7faa7a310e766c5aa8,v11-1099-G-columns,original,2024,fgen-eae8af268061ef662ffb4f63,synthetic_programmatic_template,columns,top,False,
"From:
RECIPIENT:
10a State
4 Federal income tax withheld
1 Unemployment compensation
Illinois Department of Employment Security
Mateo R. Testcase
CO 9463876
740.18
107,577.97",1099,5,1099,fdc-864f834bb14c6e2baf97bdba,v11-1099-G-columns,original,2026,fgen-0feb18eba9197d40926c049b,synthetic_programmatic_template,columns,none,False,
"Form 1099-INT
Interest Income
OMB No. 1545-0112
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Riverbend Bank & Trust 8014 Granite St Lakewood, CO 75619
PAYER'S TIN: 23-8763991
RECIPIENT'S name: Diego S. Romero
RECIPIENT'S TIN: ****8360
Box 1 Interest income: 7,260.39
Box 2 Early withdrawal penalty: 0.00
Box 3 Interest on U.S. Savings Bonds and Treasury obligations: $0.00
Box 4 Federal income tax withheld
Box 5 Investment expenses: $0.00
Box 8 Tax-exempt interest: $0.00
Box 11 Bond premium: 0.00",1099,5,1099,fdc-fe6b6dd5018256bea5b95689,v11-1099-INT-boxed,original,2023,fgen-374db630f656d18be62c3ea0,synthetic_programmatic_template,boxed,top,False,
"2021
OMB No. 1545-0112
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Riverbend Bank & Trust 4926 Harbor View Rd Lakewood, CO 34344
PAYER'S TIN: 89-2032532
RECIPIENT'S name: Avery Lindqvist
RECIPIENT'S TIN: XXXXX1191
Street address (including apt. no.): 9050 Granite St
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 28006
Account number (see instructions): XXX-XX-478278
Line 1 Interest income: 6,472.07
Line 2 Early withdrawal penalty
Line 3 Interest on U.S. Savings Bonds and Treasury obligations: 0.00
Line 4 Federal income tax withheld: $0.00
Line 5 Investment expenses: 0.00
Line 8 Tax-exempt interest: $0.00
Line 15 State: TX 6044641
Line 17 State tax withheld
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-bf2a84c588ef2dab15a7fbd2,v11-1099-INT-boxed,original,2021,fgen-ba2c384dd132b1c3eeb145d0,synthetic_programmatic_template,boxed,none,False,
"2026
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Northwind Financial 375 Lakeshore Blvd Pinecrest, GA 99897
PAYER'S TIN: 94-1587327
RECIPIENT'S name: Jordan Rivera
RECIPIENT'S TIN: XXXXX3512
Street address (including apt. no.): 8794 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code: Oak Grove, TX 89314
Box 1 Interest income: $120.23
Box 2 Early withdrawal penalty
Box 3 Interest on U.S. Savings Bonds and Treasury obligations: $0.00
Box 4 Federal income tax withheld
Box 5 Investment expenses: $0.00
Box 8 Tax-exempt interest: 0.00
Box 11 Bond premium: 0.00
Box 15 State: PA 2146560
Box 17 State tax withheld: 0.00
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-797b046efb6c5bae5596909f,v11-1099-INT-boxed,original,2026,fgen-504bf229ecdf7fe342f3cd01,synthetic_programmatic_template,boxed,none,False,
"2022
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Lakeshore National Bank 6451 Cedar Ln Brookhaven, PA 18554
PAYER'S TIN: 51-4253221
RECIPIENT'S name: Wei Patel
RECIPIENT'S TIN: ****0839
Line 1 Interest income: $4,227.68
Line 4 Federal income tax withheld: $0.00
Line 5 Investment expenses: $0.00
Line 8 Tax-exempt interest
Line 11 Bond premium: 0.00
Line 15 State: PA 1134874
Line 17 State tax withheld
Department of the Treasury - Internal Revenue Service
Form 1099-INT
Interest Income
Form 1099-INT (keep for your records)  www.irs.gov/Form1099INT",1099,5,1099,fdc-233ee5ae1cbd37c368e39490,v11-1099-INT-boxed,original,2022,fgen-fcbac6eb2bc4ad3fb5bb9012,synthetic_programmatic_template,boxed,bottom,False,
"Form 1099-INT
Interest Income
For calendar year 2024
OMB No. 1545-0112
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Granite Peak Bank 924 Elm Park Pl Maplewood, MN 65989
PAYER'S TIN: 53-6055720
RECIPIENT'S name: Avery M. Patel
RECIPIENT'S TIN: ***-**-3610
Street address (including apt. no.): 6660 Granite St
City or town, state or province, country, and ZIP or foreign postal code: Fairview, OH 69550
Account number (see instructions): XXXXX237687
Line 1 Interest income: 5,504.75
Line 2 Early withdrawal penalty: $0.00
Line 3 Interest on U.S. Savings Bonds and Treasury obligations
Line 4 Federal income tax withheld: $0.00
Line 5 Investment expenses: 0.00
Line 8 Tax-exempt interest
Line 11 Bond premium
Line 15 State: IL 7272237
Line 17 State tax withheld
Department of the Treasury - Internal Revenue Service
Form 1099-INT (keep for your records)  www.irs.gov/Form1099INT",1099,5,1099,fdc-6ce3052c9cb34be751b927e7,v11-1099-INT-boxed,original,2024,fgen-84a50fe23d88fc264986da0f,synthetic_programmatic_template,boxed,top,False,
"For calendar year 2025
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Bayview Community Bank 3604 Harbor View Rd Riverton, WI 32476
PAYER'S TIN: 70-1581708
RECIPIENT'S name: Fatima Testcase
RECIPIENT'S TIN: ****1424
Street address (including apt. no.): 5996 Willow Bend Way
City or town, state or province, country, and ZIP or foreign postal code: Maplewood, MN 51809
Line 1 Interest income: $5,579.57
Line 3 Interest on U.S. Savings Bonds and Treasury obligations
Line 4 Federal income tax withheld: 0.00
Line 8 Tax-exempt interest
Line 11 Bond premium
Line 15 State: PA 8655089
Line 17 State tax withheld: 0.00
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-536f79eccb7e82cc8876a88e,v11-1099-INT-boxed,original,2025,fgen-0af659d28d44eb90eac81ba4,synthetic_programmatic_template,boxed,none,False,
"Form 1099-INT Interest Income
From:: Prairie State Savings
RECIPIENT:: Wei Patel
Box 1 Interest income: 7,645.35
Box 15 State: OH 8175578",1099,5,1099,fdc-b5c99e82cce5dc2b9317e1a6,v11-1099-INT-boxed,original,2025,fgen-32c2b071bc5a0e98d5e89766,synthetic_programmatic_template,boxed,top,False,
"Form 1099-INT
Interest Income
2021
OMB No. 1545-0112
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Northwind Financial 2084 Harbor View Rd Brookhaven, PA 16849
PAYER'S TIN: 30-1529743
RECIPIENT'S name: Taylor B. Moreau
RECIPIENT'S TIN: XXX-XX-7391
Street address (including apt. no.): 7389 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Fairview, OH 67026
1 Interest income: $1,975.86
2 Early withdrawal penalty
3 Interest on U.S. Savings Bonds and Treasury obligations
5 Investment expenses
8 Tax-exempt interest: 0.00
11 Bond premium
15 State: IL 1193459
Department of the Treasury - Internal Revenue Service
Form 1099-INT (keep for your records)  www.irs.gov/Form1099INT",1099,5,1099,fdc-fdeac256d120a3a0a1ed0624,v11-1099-INT-boxed,original,2021,fgen-af28114600aefe10783e31fa,synthetic_programmatic_template,boxed,top,False,
"Form 1099-INT
Interest Income
OMB No. 1545-0112
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Harbor Federal Credit Union 1595 Granite St Oak Grove, TX 37947
PAYER'S TIN: 55-7946960
RECIPIENT'S name: Wei Fischer
RECIPIENT'S TIN: ****5332
Street address (including apt. no.): 6711 Granite St
City or town, state or province, country, and ZIP or foreign postal code: Brookhaven, PA 53310
Box 1 Interest income: $5,116.95
Box 2 Early withdrawal penalty: 0.00
Box 3 Interest on U.S. Savings Bonds and Treasury obligations
Box 4 Federal income tax withheld
Box 5 Investment expenses
Box 8 Tax-exempt interest: 0.00
Box 11 Bond premium
Box 17 State tax withheld",1099,5,1099,fdc-39be5591b24a7fe4a41f6cd3,v11-1099-INT-boxed,original,2022,fgen-682bcb12544e45d96bc52421,synthetic_programmatic_template,boxed,top,False,
"VOID  CORRECTED
Form 1099-INT
Interest Income
For calendar year 2023
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Bayview Community Bank 5001 Prairie Ave Fairview, OH 64523
PAYER'S TIN: 80-3261991
RECIPIENT'S name: Hiro Larsen
RECIPIENT'S TIN: XXXXX0873
Street address (including apt. no.): 9128 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Oak Grove, TX 44919
Account number (see instructions): XXXXX294132
1 Interest income: $8,549.42
2 Early withdrawal penalty
3 Interest on U.S. Savings Bonds and Treasury obligations
4 Federal income tax withheld
5 Investment expenses: 0.00
8 Tax-exempt interest: $0.00
17 State tax withheld: $0.00
Department of the Treasury - Internal Revenue Service
Form 1099-INT (keep for your records)  www.irs.gov/Form1099INT",1099,5,1099,fdc-1d8bc7008201aa12afa42fa2,v11-1099-INT-boxed,original,2023,fgen-79663e948cddbea3789c092e,synthetic_programmatic_template,boxed,top,False,
"☐ CORRECTED
OMB No. 1545-0112
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Northwind Financial 1417 Lakeshore Blvd Brookhaven, PA 64313
PAYER'S TIN: 62-5215607
RECIPIENT'S name: Kwame A. Rivera
RECIPIENT'S TIN: XXX-XX-3751
Line 3 Interest on U.S. Savings Bonds and Treasury obligations
Line 5 Investment expenses: $0.00
Line 8 Tax-exempt interest
Line 11 Bond premium: 0.00
Line 15 State: TX 1774864
Line 17 State tax withheld
Department of the Treasury - Internal Revenue Service
Form 1099-INT
Interest Income
Form 1099-INT (keep for your records)  www.irs.gov/Form1099INT",1099,5,1099,fdc-68f032f761e493dbf0e80aa1,v11-1099-INT-boxed,original,2022,fgen-2fb79408805a42244e3fcff8,synthetic_programmatic_template,boxed,bottom,False,
"Form 1099-INT Interest Income 2021
PAYER'S name:: Northwind Financial
To:: Fatima Fischer
Line 15 State: IL 5228724
Line 1 Interest income: $4,679.71",1099,5,1099,fdc-07222118c979d77791a1f8d0,v11-1099-INT-boxed,original,2021,fgen-ad197e782f91204525169349,synthetic_programmatic_template,boxed,top,False,
"Form 1099-INT
Interest Income
2021
OMB No. 1545-0112
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Harbor Federal Credit Union 5365 Harbor View Rd Pinecrest, GA 40664
PAYER'S TIN: 86-1359815
RECIPIENT'S name: Hiro K. Rivera
RECIPIENT'S TIN: XXXXX3080
Street address (including apt. no.): 3329 Granite St
City or town, state or province, country, and ZIP or foreign postal code: Oak Grove, TX 71499
Account number (see instructions): XXXXX823782
3 Interest on U.S. Savings Bonds and Treasury obligations
4 Federal income tax withheld
5 Investment expenses: $0.00
8 Tax-exempt interest
11 Bond premium
15 State: MN 9405374
17 State tax withheld
Department of the Treasury - Internal Revenue Service
Form 1099-INT (keep for your records)  www.irs.gov/Form1099INT",1099,5,1099,fdc-db55bcae209d90e49a0175b6,v11-1099-INT-boxed,original,2021,fgen-bc4d9f158f06b66ad15017f3,synthetic_programmatic_template,boxed,top,False,
"CORRECTED (if checked)
Form 1099-INT
Interest Income
OMB No. 1545-0112
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Granite Peak Bank 8065 Granite St Maplewood, MN 50066
PAYER'S TIN: 21-7219593
RECIPIENT'S name: Mateo Walsh
RECIPIENT'S TIN: XXXXX9021
Street address (including apt. no.): 2709 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code: Maplewood, MN 18702
Account number (see instructions): ending in 133929
Box 2 Early withdrawal penalty
Box 3 Interest on U.S. Savings Bonds and Treasury obligations
Box 4 Federal income tax withheld
Box 8 Tax-exempt interest
Box 15 State: CO 2608474
Box 17 State tax withheld: 0.00",1099,5,1099,fdc-a5c06f58b9d49e976cc9936c,v11-1099-INT-boxed,original,2024,fgen-8c825913ee1bd86542ef7dd5,synthetic_programmatic_template,boxed,top,False,
"CORRECTED (if checked)
Form 1099-INT
Interest Income
For calendar year 2021
OMB No. 1545-0112
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Meadowlark Savings Bank 7707 Prairie Ave Cedar Falls, IA 93769
PAYER'S TIN: 10-2406926
RECIPIENT'S name: Olivia Patel
RECIPIENT'S TIN: ****5223
1 Interest income: 2,970.02
3 Interest on U.S. Savings Bonds and Treasury obligations: $0.00
4 Federal income tax withheld: $0.00
5 Investment expenses
8 Tax-exempt interest: 0.00
15 State: GA 3042060
17 State tax withheld: $0.00",1099,5,1099,fdc-1957169da5942daa0867e83a,v11-1099-INT-boxed,original,2021,fgen-b38f0e11f71c4db6f84d6e84,synthetic_programmatic_template,boxed,top,False,
"OMB No. 1545-0112
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.: Lakeshore National Bank 3094 Elm Park Pl Bayside, WA 83475
PAYER'S TIN: 97-6315066
RECIPIENT'S name: Priya S. Kowalski
RECIPIENT'S TIN: XXX-XX-9113
Street address (including apt. no.): 6026 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Oak Grove, TX 44593
Line 1 Interest income: 7,043.44
Line 2 Early withdrawal penalty
Line 3 Interest on U.S. Savings Bonds and Treasury obligations: $0.00
Line 4 Federal income tax withheld: $0.00
Line 5 Investment expenses: $0.00
Line 8 Tax-exempt interest
Line 11 Bond premium
Line 15 State: PA 3948307
Line 17 State tax withheld: 0.00
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-5f95c48f9b947e6b14c3dd80,v11-1099-INT-boxed,original,2026,fgen-c08bc2f948fe518f05a7a5aa,synthetic_programmatic_template,boxed,none,False,
"Form 1099-K Payment Card and Third Party Network Transactions 2021 This is important tax information and is being furnished to the IRS. FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone
no. PayStream Networks Inc. 6853 Oak Hollow Ct Lakewood, CO 43672 FILER'S TIN 47-9276730 PAYEE'S name Morgan Nguyen PAYEE'S TIN ****5547 Street address (including apt. no.) 6337 Maple Ridge Dr City or town, state or province, country, and ZIP or foreign postal code Bayside, WA 75512 Account number (see instructions) ****495900 1a Gross amount of payment card/third party network transactions $99,199.05 1b Card Not Present transactions 102,438.59 2 Merchant category code 275 3 Number of payment
transactions 768 5a January $378.62 5b February 933.61 5c March $7,634.44 6 State IL 6820591 8 State income tax withheld",1099,5,1099,fdc-b68ed148d922ecc310e4ee59,v11-1099-K-flat,original,2021,fgen-adc2391755c40e43afc7f2f6,synthetic_programmatic_template,flat,top,False,
"Form 1099-K
Payment Card and Third Party
Network Transactions 2025 From: PayStream Networks Inc. Recipient's name: Taylor Patel 5c March $947.07",1099,5,1099,fdc-845011b7900322cb85c3f447,v11-1099-K-flat,original,2025,fgen-cf182bd1c9ec12527baae44c,synthetic_programmatic_template,flat,top,False,
"☐ CORRECTED For calendar year 2022 This is important tax information and is being furnished to the IRS. FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. PayStream Networks Inc. 7003 Elm Park Pl Brookhaven, PA 42999 FILER'S TIN 11-8135766 PAYEE'S name Morgan Okafor PAYEE'S TIN ***-**-9797 Street address (including apt. no.) 8423 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code Fairview, OH 11473 1a Gross amount of payment card/third party network transactions $123,249.89 1b Card Not Present transactions 100,833.93 2 Merchant category code 921 3 Number of payment transactions 705 4 Federal income tax withheld $0.00 5a January 8,119.02 5b February $2,435.72 5c March 9,233.95
8 State income tax withheld Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-98e8f6738c036839e1667424,v11-1099-K-flat,original,2022,fgen-b717ca89478f35863e1f71f4,synthetic_programmatic_template,flat,none,False,
"Form l099-K Payment Card and Third Party Network Transactions 2023 Copy B For Payee FILER'S name, street address, city or town, state or province, country, ZIPor foreígn posta1 codc, andtelephone no. Harbor Merchant Services 2626 Willow Bend Way Testville, IL15460 FILER'S TIN 36-7444307 PAYEE'Sname Kwame Sato
PAYEE'S TIN XXXXX4503 Street address (inc1uding apt. no.) 1582 Granitc St City or town, state or province, country, and ZIP or foreígn postal code Bayside, WA 73100 1a Gross amount of payment
card/third party network transactions $106,107.73 1b Card Not Prcsent transactions 135,592.7l 2 Mcrchant category code 759 3 Number of payment transactions 730 4 Federal income tax withheld 5a January 7,877.96 5bFebruary $5,0l8.50 5c March 9,30l.03 8 State income tax withheld $0.00 Department of the Treasury - Internal Revenue Service Form 1099-K (keep for your records) www.irs.gov/Form1099K",1099,5,1099,fdc-9e1218770ea935dc873503bb,v11-1099-K-flat,original,2023,fgen-4537444738ae0d35c4185f58,synthetic_programmatic_template,flat,top,True,
"Copy B For Payee This is
important tax information and is being furnished to the IRS. FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Harbor Merchant Services 2874 Sample Street Riverton, WI 68721 FILER'S TIN 26-3273279 PAYEE'S name Noah Rivera PAYEE'S TIN ending in 2443 Street address (including apt. no.) 1357 Maple Ridge Dr City
or town, state or province, country, and ZIP or foreign postal code Fairview, OH 22173 Account number (see instructions) ending in 690809 1a Gross amount of payment card/third party network transactions 74,666.54 1b Card Not Present transactions 30,003.45 2 Merchant category code 276 3 Number of payment transactions 512 4 Federal income tax withheld $0.00 5a January 5,253.64 5b February $3,269.57 5c March 5,700.56 6 State OH 5250988 8 State income tax withheld $0.00 Form 1099-K Payment Card and Third Party Network Transactions",1099,5,1099,fdc-7a5cddc4cb3802154dacf01f,v11-1099-K-flat,original,2025,fgen-5dc6a611b34edd639101c207,synthetic_programmatic_template,flat,bottom,False,
"VOID CORRECTED Form 1099-K Payment Card and Third Party Network Transactions 2025 OMB No. 1545-2205 Copy B For Payee FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. PayStream Networks Inc. 6272 Prairie Ave Bayside, WA 30093 FILER'S TIN 50-8469583 PAYEE'S name Mateo D. Okafor PAYEE'S TIN ***-**-5307 Street address
(including apt. no.) 6499 Lakeshore Blvd City or town, state or province, country, and ZIP or foreign postal code Lakewood, CO 25109 1a Gross amount of payment card/third party network transactions 106,061.88 1b Card Not Present transactions $965.66 2 Merchant category code 580 3 Number of payment transactions 213 4 Federal income tax withheld 5a January $681.04 5b February
5,801.72 8 State income tax withheld Department of the Treasury - Internal Revenue Service Form 1099-K (keep for your records) www.irs.gov/Form1099K",1099,5,1099,fdc-c2b2bcf4b8632e63e875a8b1,v11-1099-K-flat,original,2025,fgen-c61b31d53f76781535451f6b,synthetic_programmatic_template,flat,top,False,
"For calendar year 2022 OMB No. 1545-2205 Copy B For Payee This is important tax information and is being furnished to the IRS. FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Harbor Merchant Services 3081 Harbor View Rd Maplewood, MN 64151 FILER'S TIN 59-6036918 PAYEE'S name Jamie J. Sato PAYEE'S TIN ****0369 1a Gross
amount of payment card/third party network transactions 33,065.24 2 Merchant category code 51 3 Number of payment transactions 493 4 Federal income tax withheld 5a January 6,487.11 5c March $2,848.88 8 State income tax withheld $0.00 Department of the Treasury - Internal Revenue Service Form 1099-K Payment Card and Third Party Network Transactions Form 1099-K (keep for your records) www.irs.gov/Form1099K",1099,5,1099,fdc-a4bdc2148bc3b1fddff81128,v11-1099-K-flat,original,2022,fgen-6ad7dd8757af955e29540542,synthetic_programmatic_template,flat,bottom,False,
"Form 1099-K Payment Card and Third Party Network Transactions OMB No. 1545-22O5 This is important tax information and is being furnished to the IRS. FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal
code, and telephone no. Harbor Merchant Services
5810 Lakeshore B1vdPinecrest, GA 44881 FILER'S TIN24-6397589 PAYEE'S nameLena Testcase PAYEE'S TIN ***-**-1313 Street address (induding apt. no.) 2992 Elm Park Pl Cityor town,statc or province, country, and ZIP or foreign postal code Riverton, WI 96343 Account number (see instructions) ending in 9364O7 1a Gross amount of payment card/third party network transactions 68,381.37 1b Card Not Present transactions $11,496.51 2 Merchant category codc 4l 3 Number of payment transactions 534 4 Federal income tax withheld 5a January 2,134.56 5b February $4,412.04 6 5tate CO 2785810 8 Statc income tax withheld Department of the Treasury - Intemal Revenue Service Form 1099-K (keep for yourrecords) www.írs.gov/Form1O99K",1099,5,1099,fdc-b598ee08da8ef2b0a9079639,v11-1099-K-flat,original,2026,fgen-a6c6f7eff92def8816c26503,synthetic_programmatic_template,flat,top,True,
"Form 1099-K Payment Card and Third Party Network Transactions For calendar year 2026 OMB No. 1545-2205 FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. Harbor Merchant Services 6356 Elm Park Pl Oak Grove, TX 73934 FILER'S TIN 19-5442286 PAYEE'S name Kwame Larsen PAYEE'S TIN ending in 9229 Street address (including apt. no.) 111 Cedar
Ln City or town, state or
province, country, and ZIP or foreign postal code Riverton, WI 94351 Account number (see instructions) XXX-XX-238571 1a Gross amount of payment card/third party network transactions 65,487.28 1b Card Not Present transactions $115,180.36 2 Merchant category code 550 3 Number of payment transactions 485 4 Federal income tax withheld 0.00 5a January $1,800.42 5b February $6,131.11 5c March 8,631.04 6 State IL 5087110 8 State income tax withheld Department of the Treasury - Internal Revenue Service Form 1099-K (keep for your records) www.irs.gov/Form1099K",1099,5,1099,fdc-83506f003dc8864da8276822,v11-1099-K-flat,original,2026,fgen-f571eeeb641694a349b6810b,synthetic_programmatic_template,flat,top,False,
"Form 1099-K Payment Card and Third Party Network Transactions For calcndar year 2021 Copy B For Payee This is important tax information and is being furnished to thc IRS. FILER'S name, streetaddress, city ortown, state or province, country, ZIP or foreign postal codc, and telephoneno. Northwind Payments LLC 670 Harbor View Rd Fairview, OH 77271 FILER'S TIN 75-6939012 PAYEE'S name Kwame Testcase PAYEE'S TIN ending in4885 Street address (including apt. no.) 6662 Prairie Ave City or town, statc or province, country, and ZIP or foreign postal code Maplewood, MN75O02 la Gross amountof payment card/third party network transactions $4,37l.08 1b Card Not Prcsent transactions 119,197.49 2 Merchant
category code 268 3 Number of payment transactions 900 4 Federa1 income tax withheld 5a January 6,499.15 5b February $3,540.31 5c March 7,159.38 6 5tate GA 3604643 8 State income tax withheld Department of the Treasury - Internal Revenue Service Form
1099-K (keep for your records) www.irs.gov/Form1099K",1099,5,1099,fdc-20aed57746678f9dcbee4ad4,v11-1099-K-flat,original,2021,fgen-98308b0769eb3aa11a16226b,synthetic_programmatic_template,flat,top,True,
"From: PayStream Networks Inc. RECIPIENT: Hiro Walsh 6 State MN 2631077 3 Number of
payment transactions
995",1099,5,1099,fdc-69b5d3bbab668425074169d7,v11-1099-K-flat,original,2025,fgen-fdb36a0ecdbe7d3193223a5f,synthetic_programmatic_template,flat,none,False,
"FILER'S name: Harbor Merchant Services Recipient's
name: Morgan Moreau 1a Gross amount of payment card/third party
network transactions 129,956.01 5b February 5,735.55 2 Merchant category code 708 Form 1099-K Payment Card and Third Party Network Transactions 2022",1099,5,1099,fdc-7a1659b86c315c905aaeb676,v11-1099-K-flat,original,2022,fgen-a1624b5794cca89361d5819d,synthetic_programmatic_template,flat,bottom,False,
"Form 1099-K Payment Card and Third Party Network Transactions 2022 From: Northwind Payments LLC Recipient's name: Jamie Brennan 5b
February $6,012.45 6 State
IL 7905378",1099,5,1099,fdc-d8508ee314d8c2ab80d02d36,v11-1099-K-flat,original,2022,fgen-9818e8a463dac08744fa51b3,synthetic_programmatic_template,flat,top,False,
"Form 1099-K Payment Card and Third
Party Network Transactions FILER: Northwind Payments LLC Recipient's name: Kwame Testcase
6 State IL 5682539 1a Gross amount of payment card/third party network transactions $92,750.24 1b Card Not Present transactions 133,301.41 3 Number of payment transactions 463",1099,5,1099,fdc-3487ad5aebe006400bbe41b6,v11-1099-K-flat,original,2023,fgen-344a2e411b8822b4488d6743,synthetic_programmatic_template,flat,top,False,
"For calendar year 2023 OMB No. 1545-2205 FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. PayStream Networks Inc. 3967 Lakeshore Blvd Oak Grove, TX
97422 FILER'S TIN 62-2365680 PAYEE'S name Diego Brennan PAYEE'S TIN ending in 9953 Street address (including apt. no.) 5647 Harbor View Rd City or town, state or province, country, and ZIP or foreign postal code Cedar Falls, IA 76821 Account number (see instructions) ***-**-450317 1a Gross amount of payment card/third party network transactions $96,620.41 1b Card Not Present transactions $62,799.18 2 Merchant category code 870 3 Number of payment transactions 487 4 Federal income tax withheld 5a January $7,775.09 5c March $9,115.41 6
State PA 5029379 8 State income tax withheld Form 1099-K Payment Card and Third Party Network Transactions",1099,5,1099,fdc-3b73a871724946f154ebfa87,v11-1099-K-flat,original,2023,fgen-8518e918bda0b7eabc16d9a0,synthetic_programmatic_template,flat,bottom,False,
"2023 OMB No. 1545-2205 Copy B For Payee This is important tax information and is being furnished to the IRS. FILER'S name, street address, city or town, state or province, country, ZIP or foreign postal
code, and telephone no. PayStream Networks Inc. 6588 Lakeshore Blvd Bayside, WA 92330 FILER'S TIN 23-1592648 PAYEE'S name Lena K. Nguyen PAYEE'S TIN XXX-XX-2912 Street address (including apt. no.) 8200 Harbor View Rd City or town, state or province, country, and ZIP or foreign postal code Pinecrest, GA 56834 Account number (see instructions) XXXXX617578 1a Gross
amount of payment card/third party network transactions 57,945.96 1b Card Not Present transactions $134,589.16 2 Merchant category code 293 3 Number of payment transactions 369 4 Federal income tax withheld $0.00 5a January 4,179.49 5c March $7,805.87 6 State GA 1423004 8 State income tax withheld $0.00 Form 1099-K Payment Card and Third Party Network Transactions",1099,5,1099,fdc-411256eb38eb3c0d6967232b,v11-1099-K-flat,original,2023,fgen-4b4b91cb72dd15bd7f7b0f6c,synthetic_programmatic_template,flat,bottom,False,
"## Form 1099-MISC
## Miscellaneous Information
2022
OMB No. 1545-0115
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Bright Pixel Design LLC 403 Willow Bend Way Bayside, WA 53343 |
| PAYER'S TIN | 31-9098198 |
| RECIPIENT'S name | Alex Nguyen |
| RECIPIENT'S TIN | XXXXX7467 |
| Street address (including apt. no.) | 7869 Sample Street |
| City or town, state or province, country, and ZIP or foreign postal code | Fairview, OH 69374 |
| 2 Royalties |  |
| 4 Federal income tax withheld |  |
| 10 Gross proceeds paid to an attorney |  |
| 16 State tax withheld |  |
| 18 State income | 21,340.93 |
Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-b2dc086a3ff84719d5c1344b,v11-1099-MISC-markdown,original,2022,fgen-b5f6e9d40deb32b53e180705,synthetic_programmatic_template,markdown,top,False,
"For calendar year 2026
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Bright Pixel Design LLC 2572 Maple Ridge Dr Maplewood, MN 98933 |
| PAYER'S TIN | 73-6799997 |
| RECIPIENT'S name | Hiro Brennan |
| RECIPIENT'S TIN | XXXXX4066 |
| Street address (including apt. no.) | 4345 Elm Park Pl |
| City or town, state or province, country, and ZIP or foreign postal code | Maplewood, MN 50779 |
| Account number (see instructions) | XXXXX032835 |
| 2 Royalties |  |
| 3 Other income | $2,427.90 |
| 4 Federal income tax withheld |  |
| 10 Gross proceeds paid to an attorney | 0.00 |
| 16 State tax withheld |  |
| 18 State income | 32,181.75 |",1099,5,1099,fdc-4965775938eb0669e5f55d37,v11-1099-MISC-markdown,original,2026,fgen-cd4542088d64ba390bdedd0b,synthetic_programmatic_template,markdown,none,False,
"Form 1099-MISC
Miscellaneous Information
## 2024
## Copy B For Recipient
| Field | Value |
| --- | --- |
| PAYER'Sname, streetaddress, city or town, state or province, country, ZIP or foreign posta1 code, and telephone no. | Maple Street Bakery 6047 Sample Street Riverton, WI 35790 |
| PAYER'S TIN | 79-8162679 |
| RECIPIENT'S namc | Sofia Nguyen |
| RECIPIENT'S TIN | XXXXX6608 |
| 2 Royalties | 0.00 |
| 3 0ther income | S5,604.08|
| 4 Federal income tax withheld |  |
| 6 Medical and health care payments |  |
| 10 Gross proceeds paidto an attorney |  |
| 16 State tax withhe1d | 0.00 |
| 18 State income | 91,135.75 |",1099,5,1099,fdc-5bba374b64361604cc709f92,v11-1099-MISC-markdown,original,2024,fgen-22c5f497d14c263bba07ed06,synthetic_programmatic_template,markdown,top,True,
"Form 1099-MISC
Miscellaneous Information
2023
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Maple Street Bakery 8441 Granite St Bayside, WA 49480 |
| PAYER'S TIN | 75-5159453 |
| RECIPIENT'S name | Amara Okafor |
| RECIPIENT'S TIN | XXXXX8895 |
| Account number (see instructions) | ****459094 |
| 1 Rents | $13,801.95 |
| 2 Royalties |  |
| 3 Other income | 3,984.01 |
| 4 Federal income tax withheld |  |
| 6 Medical and health care payments |  |
| 10 Gross proceeds paid to an attorney |  |
| 16 State tax withheld |  |
| 18 State income | $7,891.40 |
Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-69687eae7d9e725372004688,v11-1099-MISC-markdown,original,2023,fgen-4e7b6e2d6d583d9cebff1f73,synthetic_programmatic_template,markdown,top,False,
"Form 1099-MISC
Miscellaneous Information
2026
OMB No. 1545-0115
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Riverbend Landscaping 7393 Lakeshore Blvd Riverton, WI 37494 |
| PAYER'S TIN | 81-6038242 |
| RECIPIENT'S name | Lena Castillo |
| RECIPIENT'S TIN | ending in 3659 |
| 1 Rents | 23,146.41 |
| 3 Other income | $4,527.73 |
| 4 Federal income tax withheld |  |
| 6 Medical and health care payments |  |
| 10 Gross proceeds paid to an attorney |  |
| 16 State tax withheld |  |
## Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-c146c24ec9a988f42f2d0787,v11-1099-MISC-markdown,original,2026,fgen-8168f38743a0dda97e7d84a9,synthetic_programmatic_template,markdown,top,False,
"## CORRECTED (if checked)
Form 1099-MISC
Miscellaneous Information
2023
OMB No. 1545-0115
Copy B For Recipient
## This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Copperline Consulting 9594 Willow Bend Way Pinecrest, GA 46493 |
| PAYER'S TIN | 69-3166540 |
| RECIPIENT'S name | Amara S. Okafor |
| RECIPIENT'S TIN | ending in 7704 |
| Account number (see instructions) | ending in 673410 |
| 1 Rents | 65,268.58 |
| 2 Royalties | 0.00 |
| 4 Federal income tax withheld | $0.00 |
| 6 Medical and health care payments |  |
| 10 Gross proceeds paid to an attorney | 0.00 |
| 16 State tax withheld | $0.00 |
| 18 State income | $87,538.39 |
Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-1e0daf6de04ba0f538028412,v11-1099-MISC-markdown,original,2023,fgen-24291ac689493cfee38aa84e,synthetic_programmatic_template,markdown,top,False,
"Form 1099-MISC
## Miscellaneous Information
For calendar year 2024
OMB No. 1545-0115
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Copperline Consulting 2250 Sample Street Riverton, WI 96655 |
| PAYER'S TIN | 20-8979791 |
| RECIPIENT'S name | Jordan Haddad |
| RECIPIENT'S TIN | XXX-XX-8565 |
| Street address (including apt. no.) | 3786 Elm Park Pl |
| City or town, state or province, country, and ZIP or foreign postal code | Fairview, OH 91158 |
| Account number (see instructions) | XXXXX498741 |
| 1 Rents | 38,418.32 |
| 3 Other income | $7,822.36 |
| 6 Medical and health care payments |  |
| 10 Gross proceeds paid to an attorney |  |
| 18 State income | $47,123.46 |
Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-603738b08b3cbf77706229a9,v11-1099-MISC-markdown,original,2024,fgen-36d8c4690c80edd422fa4e09,synthetic_programmatic_template,markdown,top,False,
"Form 1099-MISC
Miscellaneous Information
2026
OMB No. 1545-0115
Copy B For Recipient
## This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Maple Street Bakery 2269 Cedar Ln Maplewood, MN 50057 |
| PAYER'S TIN | 72-8484557 |
| RECIPIENT'S name | Hiro Sato |
| RECIPIENT'S TIN | ****3671 |
| Street address (including apt. no.) | 2941 Elm Park Pl |
| City or town, state or province, country, and ZIP or foreign postal code | Brookhaven, PA 35518 |
| Account number (see instructions) | ending in 910312 |
| 1 Rents | $123,973.52 |
| 2 Royalties |  |
| 3 Other income | $2,872.38 |
| 4 Federal income tax withheld | $0.00 |
| 6 Medical and health care payments | 0.00 |
| 16 State tax withheld |  |
| 18 State income | $2,357.02 |
Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-fea93811354fc202028181cc,v11-1099-MISC-markdown,original,2026,fgen-34f929a46eb53484f09f0128,synthetic_programmatic_template,markdown,top,False,
"CORRECTED (if checked)
## Form 1099-MISC
Miscellaneous Information
2023
OMB No. 1545-0115
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Maple Street Bakery 7334 Oak Hollow Ct Testville, IL 53826 |
| PAYER'S TIN | 93-2825697 |
| RECIPIENT'S name | Mateo Kowalski |
| RECIPIENT'S TIN | ending in 6936 |
| 1 Rents | $39,195.17 |
| 2 Royalties |  |
| 3 Other income | 8,653.67 |
| 4 Federal income tax withheld |  |
| 6 Medical and health care payments |  |
| 10 Gross proceeds paid to an attorney |  |
| 16 State tax withheld | 0.00 |
| 18 State income | 95,113.17 |
Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-d2ce8c9a29d635c7186ebe62,v11-1099-MISC-markdown,original,2023,fgen-1eaf77fd42d654faf98d1f20,synthetic_programmatic_template,markdown,top,False,
"VOID  CORRECTED
## Form 1099-MISC
## Miscellaneous Information
2023
OMB No. 1545-0115
Copy B For Recipient
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Copperline Consulting 6601 Sample Street Brookhaven, PA 65371 |
| PAYER'S TIN | 20-4015231 |
| RECIPIENT'S name | Mateo Patel |
| RECIPIENT'S TIN | XXX-XX-8778 |
| Street address (including apt. no.) | 1696 Oak Hollow Ct |
| City or town, state or province, country, and ZIP or foreign postal code | Cedar Falls, IA 86902 |
| Account number (see instructions) | ****221717 |
| 1 Rents | $119,358.10 |
| 4 Federal income tax withheld | $0.00 |
| 6 Medical and health care payments |  |
| 10 Gross proceeds paid to an attorney |  |
| 16 State tax withheld |  |
| 18 State income | $65,005.35 |",1099,5,1099,fdc-862cc10ffb432e303f7e25ea,v11-1099-MISC-markdown,original,2023,fgen-41fa7d6606e9e744acbf0336,synthetic_programmatic_template,markdown,top,False,
"## Form 1099-MISC
Miscellaneous Information
For calendar year 2022
## OMB No. 1545-0115
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Maple Street Bakery 9526 Sample Street Lakewood, CO 53751 |
| PAYER'S TIN | 88-1249239 |
| RECIPIENT'S name | Olivia C. Romero |
| RECIPIENT'S TIN | ***-**-6002 |
| Street address (including apt. no.) | 5807 Willow Bend Way |
| City or town, state or province, country, and ZIP or foreign postal code | Riverton, WI 86752 |
| 2 Royalties |  |
| 3 Other income | 2,649.14 |
| 4 Federal income tax withheld |  |
| 6 Medical and health care payments |  |
| 16 State tax withheld |  |
| 18 State income | 39,997.07 |
Department of the Treasury - Internal Revenue Service
## Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-1ce387a4b109c964dde362e0,v11-1099-MISC-markdown,original,2022,fgen-07ea7b8115c7e6111ffa4a6a,synthetic_programmatic_template,markdown,top,False,
"Form 1099-MISC
Miscellaneous Information
OMB No. 1545-0115
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Bright Pixel Design LLC 4987 Granite St Cedar Falls, IA 64217 |
| PAYER'S TIN | 36-4473364 |
| RECIPIENT'S name | Taylor Testcase |
| RECIPIENT'S TIN | ****4370 |
| 1 Rents | 44,367.88 |
| 2 Royalties | $0.00 |
| 3 Other income | $3,658.01 |
| 4 Federal income tax withheld |  |
| 10 Gross proceeds paid to an attorney | $0.00 |
| 18 State income | $132,732.48 |
Department of the Treasury - Internal Revenue Service
Form 1099-MISC (keep for your records)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-d49a9c4016bb6cb4710ee090,v11-1099-MISC-markdown,original,2025,fgen-b65e03dafb65b6743ba4c7e4,synthetic_programmatic_template,markdown,top,False,
"## For calendar year2026
OMB No. 1545-0115
Copy B For Recipient
| Field | Value|
| --- | --- |
| PAYER'S name, street address, cíty or town, state or province, country, ZIP or forcign postal code, and telephone no. | Bright Pixel Design LLC 8995Prairie Ave Pinecrest, GA 4086l |
| PAYER'S TIN | 95-8980585 |
| RECIPIENT'S name | Wei K. Fischer |
| RECIPIENT'STIN | ****8843 |
| Account number (see instructions) | ****l3l901 |
| 1 Rents | $53,251.31 |
| 2 Royaltíes |  |
| 3 Other income | $7,698.29 |
| 4 Federal income tax withheld |  |
| 6 Medical and health carepayments | $0.00 |
| 10 Gross procceds paid to an attomey |  |
| 16 State tax withhe1d | $0.00 |
Form 1099-MISC
Miscellaneous Information",1099,5,1099,fdc-3fbff56e600cf03a662f8be5,v11-1099-MISC-markdown,original,2026,fgen-6be935e2f6d837876929ae8a,synthetic_programmatic_template,markdown,bottom,True,
"Form 1099-MISC
## Miscellaneous Information
## 2023
This is important tax information and is being furnished to the IRS.
| Field | Value |
| --- | --- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no. | Riverbend Landscaping 8829 Willow Bend Way Bayside, WA 77707 |
| PAYER'S TIN | 59-1858090 |
| RECIPIENT'S name | Casey Patel |
| RECIPIENT'S TIN | ****5989 |
| Street address (including apt. no.) | 4274 Prairie Ave |
| City or town, state or province, country, and ZIP or foreign postal code | Testville, IL 53337 |
| Account number (see instructions) | ****800818 |
| 1 Rents | 30,678.61 |
| 2 Royalties | $0.00 |
| 3 Other income | $9,209.44 |
| 4 Federal income tax withheld |  |
| 6 Medical and health care payments | 0.00 |
| 10 Gross proceeds paid to an attorney |  |
| 16 State tax withheld | $0.00 |
| 18 State income | 41,963.53 |",1099,5,1099,fdc-135fdb4b22b3dcc07a998eeb,v11-1099-MISC-markdown,original,2023,fgen-90b523c883457c0c53da1f50,synthetic_programmatic_template,markdown,top,False,
"Form 1099-MISC
## Miscellaneous Information
For calendar year 2026
## OMB No. 1545-O115
This is important tax information and is being furnishcd to the IR5.
| Field | Value |
| --- |--- |
| PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code,and telephone no. | Copperline Consulting 885O Sample Street Brookhaven, PA 8393l |
| PAYER'S TIN | 23-6966439 |
| RECIPIENT'S name | Sofia E. Castillo |
| RECIPIENT'S TIN | ending in 4467 |
| Account number (see instructions) | ***-**-473983 |
| 2 Royalties |  |
| 4 Federal incometax withheld |  |
| l0 Gross proceeds paid to an attomey |  |
| 16 5tate tax withheld | S0.00 |
| 18 State income| 138,658.00 |
Department of the Treasury - Intemal Revenue Service
## Form 1099-MISC (keep for yourrecords)  www.irs.gov/Form1099MISC",1099,5,1099,fdc-0c6d6a901064259b9b136e86,v11-1099-MISC-markdown,original,2026,fgen-0ca48a30cf69245291dc1f69,synthetic_programmatic_template,markdown,top,True,
"Form 1099-MISC Miscellaneous Information 2022
| Field | Value |
| --- | --- |
| PAYER'S name: | Copperline Consulting |
| Recipient's name: | Casey Lindqvist |
| 3 Other income | 6,618.24 |
| 1 Rents | 63,391.08 |
| 18 State income | 93,233.69 |",1099,5,1099,fdc-ddeb09e86efe58de15d812a8,v11-1099-MISC-markdown,original,2022,fgen-2220bf5d0e3299536df6c141,synthetic_programmatic_template,markdown,top,False,
"Form 1099-NEC
Nonemployee Compensation
For calendar year 2022
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Maple Street Bakery 405 Elm Park Pl Fairview, OH 18550
PAYER'S TIN
54-4089120
RECIPIENT'S name
Noah Sato
RECIPIENT'S TIN
ending in 4050
Street address (including apt. no.)
7496 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code
Brookhaven, PA 62821
1 Nonemployee compensation
93,974.39
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
☐
4 Federal income tax withheld
5 State tax withheld
6 State/Payer's state no.
IL 4422179
7 State income
$113,632.56
Department of the Treasury - Internal Revenue Service
Form 1099-NEC (keep for your records)  www.irs.gov/Form1099NEC",1099,5,1099,fdc-9e7b5a3552cb8255d1320879,v11-1099-NEC-stacked,original,2022,fgen-08986a5f941210594ae126a4,synthetic_programmatic_template,stacked,top,False,
"VOID  CORRECTED
For calendar year 2022
OMB No. 1545-0116
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Maple Street Bakery 9362 Cedar Ln Fairview, OH 11988
PAYER'S TIN
10-7760706
RECIPIENT'S name
Noah Sato
RECIPIENT'S TIN
ending in 6205
Street address (including apt. no.)
2221 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code
Lakewood, CO 96552
1 Nonemployee compensation
$86,506.39
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
[X]
4 Federal income tax withheld
5 State tax withheld
6 State/Payer's state no.
GA 1352230
7 State income
20,468.06
Department of the Treasury - Internal Revenue Service
Form 1099-NEC
Nonemployee Compensation
Form 1099-NEC (keep for your records)  www.irs.gov/Form1099NEC",1099,5,1099,fdc-e35a0be54bceadd1c35aedec,v11-1099-NEC-stacked,original,2022,fgen-704440bae1687e9bbbf36fcf,synthetic_programmatic_template,stacked,bottom,False,
"For calendar year 2022
OMB No. 1545-0116
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Bright Pixel Design LLC 1555 Maple Ridge Dr Lakewood, CO 70175
PAYER'S TIN
23-5629303
RECIPIENT'S name
Sofia Fischer
RECIPIENT'S TIN
XXXXX8914
Account number (see instructions)
****853553
1 Nonemployee compensation
$60,410.84
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
[X]
4 Federal income tax withheld
6 State/Payer's state no.
CO 8187745
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-aabbe8f1e46f510dc22a81ca,v11-1099-NEC-stacked,original,2022,fgen-e6372d93a1d20d54f394bbaf,synthetic_programmatic_template,stacked,none,False,
"Form 1099-NEC
Nonemployee Compensation
2024
OMB No. 1545-0116
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Copperline Consulting 7249 Elm Park Pl Riverton, WI 63729
PAYER'S TIN
88-7290535
RECIPIENT'S name
Mateo E. Haddad
RECIPIENT'S TIN
ending in 1343
Street address (including apt. no.)
3131 Willow Bend Way
City or town, state or province, country, and ZIP or foreign postal code
Testville, IL 76408
Account number (see instructions)
****536163
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
4 Federal income tax withheld
$0.00
5 State tax withheld
$0.00
6 State/Payer's state no.
OH 1484150
7 State income
$113,848.99
Department of the Treasury - Internal Revenue Service
Form 1099-NEC (keep for your records)  www.irs.gov/Form1099NEC",1099,5,1099,fdc-a40ea7f9d6659dd0b21afd8f,v11-1099-NEC-stacked,original,2024,fgen-b71c5e73ff44d72eb6f864fb,synthetic_programmatic_template,stacked,top,False,
"Form 1099-NEC Nonemployee Compensation
PAYER'S name:
Riverbend Landscaping
RECIPIENT:
Olivia Tanaka
7 State income
$24,677.74
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
☐
1 Nonemployee compensation
$63,703.20
6 State/Payer's state no.
PA 1719641",1099,5,1099,fdc-287df0bb08e34f064eb8d945,v11-1099-NEC-stacked,original,2026,fgen-c050838fe7b6d72c6def6570,synthetic_programmatic_template,stacked,top,False,
"From:
Maple Street Bakery
Recipient's name:
Casey J. Kowalski
6 State/Payer's state no.
WI 7819935
1 Nonemployee compensation
$131,829.75
7 State income
106,432.88
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
0.00",1099,5,1099,fdc-25bd7303f2d423bed1618053,v11-1099-NEC-stacked,original,2025,fgen-6b25d7847b104182c73593bc,synthetic_programmatic_template,stacked,none,False,
"Form 1099-NEC Noncmployee Compensation
PAYER'5 name:
Copperline Consulting
Recipient's name:
Sofia Kowalski
2Payer made direct sales totaling S5,000 or more of consumer products to recipient for resale
☒
l Nonemployee compensation
51,935.78
6 State/Payer's state no.
C0 6279229
7 State income
$121,321.77",1099,5,1099,fdc-1c09e591bf9285a0e649aa13,v11-1099-NEC-stacked,original,2022,fgen-e76ec4f57b9c8a79e368d904,synthetic_programmatic_template,stacked,top,True,
"Form 1099-NEC Nonemployee Compensation 2025
PAYER:
Bright Pixel Design LLC
RECIPIENT:
Kwame Fischer
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
X
7 State income
$57,491.16
1 Nonemployee compensation
63,654.87
6 State/Payer's state no.
WI 7569491",1099,5,1099,fdc-c359af3ff04a48cf84256e06,v11-1099-NEC-stacked,original,2025,fgen-f77f06e3440bd119c76237bf,synthetic_programmatic_template,stacked,top,False,
"Form 1099-NEC
Nonemployee Compensation
For calendar year 2024
OMB No. 1545-0116
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Bright Pixel Design LLC 8975 Prairie Ave Oak Grove, TX 51984
PAYER'S TIN
58-9952823
RECIPIENT'S name
Diego K. Brennan
RECIPIENT'S TIN
ending in 0697
Street address (including apt. no.)
5985 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code
Maplewood, MN 87751
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
☒
4 Federal income tax withheld
$0.00
5 State tax withheld
0.00
6 State/Payer's state no.
WI 5142153
7 State income
$11,576.34
Department of the Treasury - Internal Revenue Service
Form 1099-NEC (keep for your records)  www.irs.gov/Form1099NEC",1099,5,1099,fdc-2693da64fa766dcb857aab54,v11-1099-NEC-stacked,original,2024,fgen-745ec38d335d4819cf49ab81,synthetic_programmatic_template,stacked,top,False,
"Form 1099-NEC
Nonemployee Compensation
2021
Copy B For Recipient
This is important tax information and is being furnished to the IR5.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Bright Pixel Design LLC 379l Willow Bend Way Brookhaven, PA 91764
PAYER'5 TIN
8O-1478050
RECIPIENT'S name
Kwame Adeyemi
RECIPIENT'S TIN
****8570
Street address (induding apt. no.)
5481 E1m Park Pl
City or town, state or province, country, and ZIP or foreign postalcode
Cedar Falls, IA 7678l
1 Nonemployee compensation
93,553.69
2 Payer made direct sales totaling $5,000 or more ofconsumerproducts to recipient for resale
[X]
4 Federalincome tax withheld
5 5tate tax withheld
6 5tate/Payer's state no.
WI 3904158
7 State income
$54,632.27
Department of the Treasury - Intemal Revenue Service
Form 1099-NEC (keep for your records)  www.irs.gov/Forml099NEC",1099,5,1099,fdc-271cd22eb6cd5e7ba1031838,v11-1099-NEC-stacked,original,2021,fgen-639830758e4a4a6d5c2ef229,synthetic_programmatic_template,stacked,top,True,
"CORRECTED (if checked)
Form 1099-NEC
Nonemployee Compensation
This is important tax information andis being furnished to the IRS.
PAYER'S name, street address, city or town, stateor province, country, ZIP or foreign posta1 code, andtelephone no.
Bright Pixel Design LLC 6866 Elm Park Pl Testville, IL 37567
PAYER'S TIN
79-45O26l4
RECIPIENT'S name
Jordan Rivera
RECIPIENT'S TIN
XXX-XX-2688
Street address (íncludíng apt. no.)
9498 Willow Bend Way
City or town, state or province, country, and ZIP or foreign postal code
Bayside, WA 74097
Account number (see instructions)
XXX-XX-796800
1 Nonemployee compensation
$62,474.99
4 Federal income tax withheld
$0.00
5 State tax withheld
7 State income
$10,842.01",1099,5,1099,fdc-b562a068c630b9df35329505,v11-1099-NEC-stacked,original,2023,fgen-7f1244ea616e6f009f645644,synthetic_programmatic_template,stacked,top,True,
"Form 1099-NEC
Nonemployee Compensation
2021
OMB No. 1545-0116
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Riverbend Landscaping 5617 Granite St Riverton, WI 40214
PAYER'S TIN
19-9755623
RECIPIENT'S name
Jordan Testcase
RECIPIENT'S TIN
XXX-XX-8991
Street address (including apt. no.)
7884 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code
Testville, IL 62685
1 Nonemployee compensation
$136,492.80
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
[X]
4 Federal income tax withheld
5 State tax withheld
6 State/Payer's state no.
GA 6266070
7 State income
83,488.66",1099,5,1099,fdc-86fe5e54505158a377d6fbd8,v11-1099-NEC-stacked,original,2021,fgen-dd746e6410e602c05ca51fba,synthetic_programmatic_template,stacked,top,False,
"OMB No. 1545-0116
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Maple Street Bakery 6767 Sample Street Cedar Falls, IA 56086
PAYER'S TIN
49-4433117
RECIPIENT'S name
Diego E. Patel
RECIPIENT'S TIN
XXXXX1866
1 Nonemployee compensation
5,069.11
4 Federal income tax withheld
5 State tax withheld
$0.00
6 State/Payer's state no.
OH 3373297
7 State income
83,786.16
Department of the Treasury - Internal Revenue Service
Form 1099-NEC
Nonemployee Compensation
Form 1099-NEC (keep for your records)  www.irs.gov/Form1099NEC",1099,5,1099,fdc-3668e4d2c6fd4d18dde6f518,v11-1099-NEC-stacked,original,2023,fgen-a20cbe1fd052ab9c99f8110a,synthetic_programmatic_template,stacked,bottom,False,
"From:
Bright Pixel Design LLC
To:
Priya Sato
1 Nonemployee compensation
92,663.50
2Payer made direct sales tota1ing $5,000 or more of consumer products to recipient for resale
0.00
6 5tate/Payer's state no.
OH 9340056
7 5tate income
$48,95l.05",1099,5,1099,fdc-d302800ffe1860bdeb50b7b1,v11-1099-NEC-stacked,original,2025,fgen-fe743bd1959cdc9b1836354b,synthetic_programmatic_template,stacked,none,True,
"CORRECTED (if checked)
2O25
OMB No. 1545-0116
CopyB For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S name, street address,city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Copperline Consulting 9823 Harbor ViewRd Brookhaven, PA 93348
PAYER'5 TIN
9O-656l796
RECIPIENT'S name
A1ex K. Romero
RECIPIENT'S TIN
XXXXX2810
Street address (including apt. no.)
9123 Elm Park Pl
Cíty or town, state or province, country, and ZIP or foreign postal code
0ak Grove, TX 44622
1 Nonemployee compensation
S1,779.15
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
☒
5 State tax withheld
7 State income
34,552.l5
Department of the Treasury - InternalRevenue Servíce
Form 1099-NEC
Nonemployee Compensation
Form 1099-NEC (keep for your records)  www.irs.gov/Form1099NEC",1099,5,1099,fdc-c86e3d9a169b137b37df68c6,v11-1099-NEC-stacked,original,2025,fgen-07a023ca21ae0e0e2b5c7dd0,synthetic_programmatic_template,stacked,bottom,True,
"For calendar year 2022
Copy B For Recipient
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and telephone no.
Maple Street Bakery 1654 Oak Hollow Ct Oak Grove, TX 73082
PAYER'S TIN
82-3097427
RECIPIENT'S name
Hiro Moreau
RECIPIENT'S TIN
ending in 4396
Street address (including apt. no.)
8691 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code
Oak Grove, TX 55715
1 Nonemployee compensation
110,142.44
2 Payer made direct sales totaling $5,000 or more of consumer products to recipient for resale
4 Federal income tax withheld
5 State tax withheld
$0.00
6 State/Payer's state no.
TX 9679958
7 State income
$43,066.93
Form 1099-NEC
Nonemployee Compensation",1099,5,1099,fdc-fb6037a9e236e31a1b309795,v11-1099-NEC-stacked,original,2022,fgen-87b294bee9cd81eb5672fc10,synthetic_programmatic_template,stacked,bottom,False,
"Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)
2024
OMB No. 1545-1760
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code      Evergreen Brokerage Services 5287 Maple Ridge Dr Riverton, WI 49575
PAYER'S/TRUSTEE'S TIN 95-3701792
RECIPIENT'S name Noah Nguyen
RECIPIENT'S TIN  XXX-XX-9747
Street address (including apt. no.)   3490 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code Cedar Falls, IA 60636
Account number (see instructions) ending in 648617
2 Earnings $9,205.76
3 Basis      117,701.49
4 Trustee-to-trustee transfer   [X]
5 Qualified tuition program—Private or State / Coverdell ESA      ☒
6 If this box is checked, the recipient is not the designated beneficiary",1099,5,1099,fdc-85f0148d6e33526ae20e28b9,v11-1099-Q-inline,original,2024,fgen-ece1f99bb89a8cf42e1815c8,synthetic_programmatic_template,inline,top,False,
"VOID  CORRECTED
2024
OMB No. 1545-1760
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code   Summit Investments 8712 Willow Bend Way Fairview, OH 33527
PAYER'S/TRUSTEE'S TIN 45-4359911
RECIPIENT'S name Riley Kowalski
RECIPIENT'S TIN XXX-XX-5109
Street address (including apt. no.)      1227 Granite St
City or town, state or province, country, and ZIP or foreign postal code  Lakewood, CO 70374
1 Gross distribution      $123,106.55
2 Earnings   $4,839.41
4 Trustee-to-trustee transfer ☐
5 Qualified tuition program—Private or State / Coverdell ESA ☒
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-ba0dd66e7a9bb4a81ead40fe,v11-1099-Q-inline,original,2024,fgen-a9ac85bb82e2a6ae52801863,synthetic_programmatic_template,inline,none,False,
"Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)
OMB No. 1545-1760
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code  Clearwater Investing 7385 Harbor View Rd Brookhaven, PA 52140
PAYER'S/TRUSTEE'S TIN 75-2020978
RECIPIENT'S name      Mateo Haddad
RECIPIENT'S TIN  XXXXX4058
Street address (including apt. no.) 7162 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code Lakewood, CO 92218
1 Gross distribution      $131,766.72
2 Earnings 1,223.51
3 Basis 124,102.70
4 Trustee-to-trustee transfer  [X]
6 If this box is checked, the recipient is not the designated beneficiary X
Department of the Treasury - Internal Revenue Service
Form 1099-Q (keep for your records)  www.irs.gov/Form1099Q",1099,5,1099,fdc-a6745430b9007bbf5371deff,v11-1099-Q-inline,original,2023,fgen-6c6365957a3ae76645e8ef62,synthetic_programmatic_template,inline,top,False,
"VOID  CORRECTED
For calendar year 2024
OMB No. 1545-1760
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Summit Investments 5776 Prairie Ave Brookhaven, PA 79064
PAYER'S/TRUSTEE'S TIN  25-4452574
RECIPIENT'S name  Diego Lindqvist
RECIPIENT'S TIN  XXXXX1762
Street address (including apt. no.)   4324 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code   Riverton, WI 47633
1 Gross distribution 6,947.55
2 Earnings $2,578.35
3 Basis   $56,399.00
4 Trustee-to-trustee transfer
5 Qualified tuition program—Private or State / Coverdell ESA      [X]
6 If this box is checked, the recipient is not the designated beneficiary ☒
Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)",1099,5,1099,fdc-13651615e331a033c9dff801,v11-1099-Q-inline,original,2024,fgen-737d989f5713c2cfc72d5178,synthetic_programmatic_template,inline,bottom,False,
"2021
OMB No. 1545-1760
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code   Evergreen Brokerage Services 8718 Maple Ridge Dr Testville, IL 53730
PAYER'S/TRUSTEE'S TIN   72-8719804
RECIPIENT'S name  Olivia M. Walsh
RECIPIENT'S TIN ending in 9989
Street address (including apt. no.)  7139 Sample Street
City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 89380
1 Gross distribution $115,717.80
2 Earnings  2,925.53
4 Trustee-to-trustee transfer  ☐
5 Qualified tuition program—Private or State / Coverdell ESA   X
Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)",1099,5,1099,fdc-bf4e54cc55b87db073e243c8,v11-1099-Q-inline,original,2021,fgen-d91eeca2d0e7e2edb8c782a6,synthetic_programmatic_template,inline,bottom,False,
"Form 1099-Q Payments From Qualified Education Programs (Under Sections 529 and 530)
PAYER: Northstar Securities
RECIPIENT: Priya Castillo
2 Earnings  4,665.23
1 Gross distribution $98,948.40
6 If this box is checked, the recipient is not the designated beneficiary   ☒",1099,5,1099,fdc-8a393e88e424a1a3c00a0dd3,v11-1099-Q-inline,original,2024,fgen-1fd8cee6fb73e932f739e0b8,synthetic_programmatic_template,inline,top,False,
"☐ CORRECTED
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northstar Securities 2633 Willow Bend Way Bayside, WA 96391
PAYER'S/TRUSTEE'S TIN   11-5240935
RECIPIENT'S name  Priya Patel
RECIPIENT'S TIN      ***-**-8067
Street address (including apt. no.)   2473 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 92648
Account number (see instructions)   XXXXX818144
1 Gross distribution 99,476.68
2 Earnings   $2,038.33
3 Basis   14,499.73
4 Trustee-to-trustee transfer [X]
5 Qualified tuition program—Private or State / Coverdell ESA   X
6 If this box is checked, the recipient is not the designated beneficiary      [X]
Department of the Treasury - Internal Revenue Service
Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)
Form 1099-Q (keep for your records)  www.irs.gov/Form1099Q",1099,5,1099,fdc-4d911574d4e87df414a9a0b3,v11-1099-Q-inline,original,2023,fgen-b1b87c82be741a6b45b0b5f1,synthetic_programmatic_template,inline,bottom,False,
"Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)
2022
OMB No. 1545-1760
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Summit Investments 8447 Oak Hollow Ct Bayside, WA 25905
PAYER'S/TRUSTEE'S TIN 93-8941096
RECIPIENT'S name Lena Moreau
RECIPIENT'S TIN ending in 6654
Street address (including apt. no.)  9515 Granite St
City or town, state or province, country, and ZIP or foreign postal code  Brookhaven, PA 40128
Account number (see instructions)      ****416603
1 Gross distribution   $25,816.65
2 Earnings  4,435.15
3 Basis  125,322.96
4 Trustee-to-trustee transfer ☒
5 Qualified tuition program—Private or State / Coverdell ESA   [X]
6 If this box is checked, the recipient is not the designated beneficiary   X",1099,5,1099,fdc-ef7c031f42f835b068a18d75,v11-1099-Q-inline,original,2022,fgen-e1c5272c28b484ecac88231d,synthetic_programmatic_template,inline,top,False,
"Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)
For calendar year 2025
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Ironwood Wealth Partners 1677 Maple Ridge Dr Pinecrest, GA 63698
PAYER'S/TRUSTEE'S TIN      59-3299584
RECIPIENT'S name Taylor Kowalski
RECIPIENT'S TIN      ****7725
Street address (including apt. no.) 9730 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code Testville, IL 25269
1 Gross distribution  46,080.89
2 Earnings      9,402.38
4 Trustee-to-trustee transfer      [X]
6 If this box is checked, the recipient is not the designated beneficiary X
Department of the Treasury - Internal Revenue Service
Form 1099-Q (keep for your records)  www.irs.gov/Form1099Q",1099,5,1099,fdc-b5efe7f959ee8553429254b6,v11-1099-Q-inline,original,2025,fgen-0bcd38dfedadd42f81c182df,synthetic_programmatic_template,inline,top,False,
"PAYER:   Ironwood Wealth Partners
RECIPIENT:  Mateo Adeyemi
4 Trustee-to-trustee transfer      [X]
3 Basis $18,049.92
Form 1099-Q Payments From Qualified Education Programs (Under Sections 529 and 530) 2022",1099,5,1099,fdc-e6428f67c5c37862f62ff0eb,v11-1099-Q-inline,original,2022,fgen-22da870df39d65b8467d1a00,synthetic_programmatic_template,inline,bottom,False,
"Form 1099-Q Payments From Qualified Education Programs (Under Sections 529 and 530)
PAYER: Northstar Securities
Recipient's name:  Avery Okafor
2 Earnings      9,327.94
6 If this box is checked, the recipient is not the designated beneficiary  ☒
1 Gross distribution $37,497.89",1099,5,1099,fdc-7fe2c5e95c02f5e5e841aefb,v11-1099-Q-inline,original,2024,fgen-97b71f6aaa8c104f0395cb7b,synthetic_programmatic_template,inline,top,False,
"Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)
For calendar year 2021
OMB No. 1545-1760
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code  Ironwood Wealth Partners 6926 Cedar Ln Riverton, WI 62380
PAYER'S/TRUSTEE'S TIN 50-4029308
RECIPIENT'S name Hiro Rivera
RECIPIENT'S TIN   XXX-XX-1105
1 Gross distribution      $36,756.64
3 Basis  $102,320.70
5 Qualified tuition program—Private or State / Coverdell ESA ☐
6 If this box is checked, the recipient is not the designated beneficiary [X]",1099,5,1099,fdc-632203648cbfbcb43390ddaf,v11-1099-Q-inline,original,2021,fgen-011b2c5ff63dc503cca98ed9,synthetic_programmatic_template,inline,top,False,
"2026
OMB No. 1545-1760
PAYER'S/TRUSTEE'S name, street address, cíty or town, state or province, country, and ZIP or foreign postal code Ironwood Wealth Partners 1O36 Willow Bend Way Testville, IL 60436
PAYER'S/TRUSTEE'S TIN   69-7911957
RECIPIENT'S name  Jamie Romero
RECIPIENT'S TIN XXX-XX-0078
Street address (including apt. no.) 985 GraniteSt
City or town, state or province,country, and ZIP or foreign postal code Cedar Falls, IA 983l9
1 Gross distribution 121,628.39
2 Eamíngs   3,881.55
3 Basis 44,532.62
4 Trustee-to-trustee transfer   [X]
5 Qua1ified tuition program—Private or 5tate / Coverdell ESA
6 If this box is chcckcd, the recipient is not the designated beneficiary X
Department of the Treasury -Intemal Revenue 5ervice",1099,5,1099,fdc-4632a2e041de190c3087c64b,v11-1099-Q-inline,original,2026,fgen-a3e081dbbbd47b73bda3381b,synthetic_programmatic_template,inline,none,True,
"Form 1099-Q
PaymentsFrom Qualified Education Programs (Undcr Sections 529 and 530)
For calendar year 2024
OMB No. 1545-1760
This is important tax information and is bcing furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, cityor town, state or province, country, and ZIP or foreign postal code      Ironwood Wea1thPartners 923 Oak HollowCt Oak Grove, TX 16487
PAYER'5/TRUSTEE'S TIN     98-1282659
RECIPIENT'S name  Sofia Walsh
RECIPIENT'S TIN  ****5717
Street address (including apt. no.) 7008 Oak Hollow Ct
City or town, state orprovince, country, and ZIP or foreign posta1 code Lakewood, CO 79826
2 Earnings      S4,782.2O
3 Basis      $11,O15.02
4 Trustce-to-trustee transfer
5 Qualified tuition program—Private or 5tate / Coverdell E5A      X
6 If this box is chccked, the recipient is not the designated beneficiary [X]
Department of the Treasury - Internal Revenue 5ervice
Form l099-Q (keep for your records)  www.irs.gov/Form1099Q",1099,5,1099,fdc-58501290810600c8e0f02757,v11-1099-Q-inline,original,2024,fgen-92d78d07678ba16f1031aea6,synthetic_programmatic_template,inline,top,True,
"PAYER:  Northstar Securities
To:      Sofia Okafor
4 Trustee-to-trustee transfer  ☒",1099,5,1099,fdc-fc76d9bc0b8a659297622526,v11-1099-Q-inline,original,2023,fgen-ea061f1baf52c89aaa28d5fe,synthetic_programmatic_template,inline,none,False,
"Form 1099-Q
Payments From Qualified Education Programs (Under Sections 529 and 530)
OMB No. 1545-1760
Copy B For Recipient
This is important tax information and is being furnished to the IRS.
PAYER'S/TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Ironwood Wealth Partners 5682 Sample Street Fairview, OH 33793
PAYER'S/TRUSTEE'S TIN      31-7589407
RECIPIENT'S name      Hiro C. Testcase
RECIPIENT'S TIN   ****2025
Street address (including apt. no.)      2764 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code      Maplewood, MN 68907
1 Gross distribution      45,865.34
2 Earnings $3,415.29
3 Basis   $96,790.21
4 Trustee-to-trustee transfer
5 Qualified tuition program—Private or State / Coverdell ESA      ☒
6 If this box is checked, the recipient is not the designated beneficiary  [X]",1099,5,1099,fdc-2586f37b8ed0231f403bcb62,v11-1099-Q-inline,original,2021,fgen-58e55a533de6b9c815dfe6b8,synthetic_programmatic_template,inline,top,False,
"CORRECTED (if checked)
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
For calendar year 2021
OMB No. 1545-0119
Copy B Report this income on your federal tax return.
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Summit Retirement Trust 4804 Prairie Ave Pinecrest, GA 54862
46-8368328
Mateo Castillo
***-**-3814
5228 Oak Hollow Ct
Cedar Falls, IA 20663
XXXXX181686
31,855.01
$122,627.10
2,411.01
0.00
1
[X]
$3,654.93
115,540.17",1099,5,1099,fdc-0b863cfaf5030b4e82efd940,v11-1099-R-columns,original,2021,fgen-4b0138c4956e5d85ca920186,synthetic_programmatic_template,columns,top,False,
"OMB No. 1545-0119
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
16 State distribution
Clearwater 401(k) Administration 9290 Willow Bend Way Oak Grove, TX 88867
61-4260021
Hiro Patel
ending in 1618
321 Maple Ridge Dr
Maplewood, MN 79706
$112,974.54
10,439.91
☒
3,873.68
$0.00
4
☒
117,308.39
Department of the Treasury - Internal Revenue Service
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
Form 1099-R (keep for your records)  www.irs.gov/Form1099R",1099,5,1099,fdc-f6c88805c4851535de35809a,v11-1099-R-columns,original,2025,fgen-31335797c6e166b91c1c2894,synthetic_programmatic_template,columns,bottom,False,
"Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
2021
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Summit Retirement Trust 1063 Sample Street Brookhaven, PA 69139
62-2015350
Fatima Romero
XXXXX9529
****459898
$40,631.26
$1,499.07
☐
7,260.63
0.00
7D
[X]
8,923.66
$100,637.80",1099,5,1099,fdc-a5fd1074c719c9d0b8e213a0,v11-1099-R-columns,original,2021,fgen-bb8bd5bdba5b9d1a11b2cc5b,synthetic_programmatic_template,columns,top,False,
"From:
RECIPIENT:
4 Federal incometax withheld
7 Distribution code(s)
l6 State distribution
Clearwater 4O1(k) Administration
Riley Tanaka
$4,571.84
7D
100,006.81",1099,5,1099,fdc-cfbb27dcb609b30c1946e978,v11-1099-R-columns,original,2024,fgen-e236132fa7e6e15dd2b8d468,synthetic_programmatic_template,columns,none,True,
"Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
2023
OMB No. 1545-0119
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Evergreen Retirement Services 3772 Prairie Ave Lakewood, CO 87682
22-4229329
Taylor Patel
XXX-XX-9665
5540 Harbor View Rd
Brookhaven, PA 42395
***-**-423981
$7,412.78
70,678.92
☒
$6,373.27
$0.00
4
☐
$7,394.90
107,749.71
Department of the Treasury - Internal Revenue Service
Form 1099-R (keep for your records)  www.irs.gov/Form1099R",1099,5,1099,fdc-e459d874143d0a3cb5cb864d,v11-1099-R-columns,original,2023,fgen-f069bbee0a81abdc91f66e87,synthetic_programmatic_template,columns,top,False,
"Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Northstar Retirement Plan Services 2564 Sample Street Bayside, WA 34311
82-7718407
Taylor Haddad
ending in 5161
4070 Maple Ridge Dr
Riverton, WI 71634
ending in 363617
73,500.44
10,223.81
[X]
2,760.03
$0.00
7D
[X]
8,030.56
$42,215.65
Department of the Treasury - Internal Revenue Service
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
Form 1099-R (keep for your records)  www.irs.gov/Form1099R",1099,5,1099,fdc-32410ac916b2a79b7764eee9,v11-1099-R-columns,original,2026,fgen-afccf69805c196be46e337e4,synthetic_programmatic_template,columns,bottom,False,
"Form 1099-R Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
PAYER:
RECIPIENT:
4 Federal income tax withheld
7 IRA/SEP/SIMPLE
Northstar Retirement Plan Services
Olivia Walsh
$380.50
☐",1099,5,1099,fdc-0581a0e2e4bb90baa6a21f84,v11-1099-R-columns,original,2022,fgen-c5869eef375794e871d45bb0,synthetic_programmatic_template,columns,top,False,
"From:
Recipient's name:
7IRA/SEP/SIMPLE
14 State tax withheld
2a Taxab1e amount
Clearwater 401(k) Admínistration
Olivia Brennan
[X]
$5,080.37
22,389.80",1099,5,1099,fdc-9712147a06c56a7d991179d3,v11-1099-R-columns,original,2022,fgen-6551f9aabe7fa7f164c489e4,synthetic_programmatic_template,columns,none,True,
"Form 1099-R Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc. 2021
PAYER:
To:
1 Gross distribution
Clearwater 401(k) Administration
Jordan S. Romero
$108,343.18",1099,5,1099,fdc-e3bdca8d8282ddee4d32fb4c,v11-1099-R-columns,original,2021,fgen-811c4ba4a93948856653488b,synthetic_programmatic_template,columns,top,False,
"☐ CORRECTED
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
2024
OMB No. 1545-0119
Copy B Report this income on your federal tax return.
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
Clearwater 401(k) Administration 2847 Oak Hollow Ct Testville, IL 72075
88-8351746
Alex Romero
XXXXX9198
$117,285.24
132,431.69
☒
0.00
2
X
2,993.18",1099,5,1099,fdc-974ea2b900c6f99134e38d47,v11-1099-R-columns,original,2024,fgen-18cbe0cd9161ef08f43bc900,synthetic_programmatic_template,columns,top,False,
"2022
OMB No. 1545-0119
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Clearwater 401(k) Administration 6135 Harbor View Rd Fairview, OH 65920
91-1975173
Fatima Tanaka
***-**-0924
2775 Cedar Ln
Oak Grove, TX 87585
ending in 948293
103,972.05
99,060.47
☒
$6,633.07
1
☐
894.02
$19,059.79
Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-6811ac1fc1666013622b84db,v11-1099-R-columns,original,2022,fgen-bd34b49f9581d62b925cfd08,synthetic_programmatic_template,columns,none,False,
"CORRECTED (if checked)
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
For calendar year 2024
OMB No. 1545-0119
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Summit Retirement Trust 4003 Harbor View Rd Brookhaven, PA 61756
63-1018489
Fatima Testcase
XXXXX9688
284 Prairie Ave
Brookhaven, PA 41665
****024860
41,650.95
$17,035.84
☐
$7,082.57
4
[X]
$7,945.59
$31,911.16
Department of the Treasury - Internal Revenue Service
Form 1099-R (keep for your records)  www.irs.gov/Form1099R",1099,5,1099,fdc-de888ff3c94247a715fc8d38,v11-1099-R-columns,original,2024,fgen-ac514fc661ebccd588d71273,synthetic_programmatic_template,columns,top,False,
"Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
For calendar year 2025
OMB No. 1545-0119
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Northstar Retirement Plan Services 3231 Prairie Ave Riverton, WI 60253
71-5684617
Mateo Romero
****1039
2923 Willow Bend Way
Bayside, WA 81781
81,358.23
[X]
$688.43
☒
547.77
$129,838.83
Department of the Treasury - Internal Revenue Service
Form 1099-R (keep for your records)  www.irs.gov/Form1099R",1099,5,1099,fdc-1c1e7ad5e7801d44b171a7e7,v11-1099-R-columns,original,2025,fgen-1ac0cf6f4b39ee685ebd41b7,synthetic_programmatic_template,columns,top,False,
"☐ CORRECTED
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
For calendar year 2023
OMB No. 1545-0119
Copy B Report this income on your federal tax return.
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
1 Gross distribution
2a Taxable amount
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Evergreen Retirement Services 3319 Oak Hollow Ct Brookhaven, PA 79061
23-7670119
Riley Castillo
****2123
41,413.52
$109,230.42
X
3,263.95
4
☐
9,030.78
$68,815.34",1099,5,1099,fdc-cd4662e3411cebe179ad4496,v11-1099-R-columns,original,2023,fgen-29f36516cf28fd7125792f67,synthetic_programmatic_template,columns,top,False,
"For calendar year 2025
OMB No. 1545-0119
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
7 IRA/SEP/SIMPLE
14 State tax withheld
16 State distribution
Clearwater 401(k) Administration 5129 Maple Ridge Dr Bayside, WA 15819
24-9278217
Morgan Brennan
XXX-XX-6789
8781 Sample Street
Cedar Falls, IA 23274
$2,990.89
0.00
7D
X
8,494.32
$104,121.33
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.",1099,5,1099,fdc-9f83eb5c1efc80acf300d260,v11-1099-R-columns,original,2025,fgen-72a6132c0e93a04382820956,synthetic_programmatic_template,columns,bottom,False,
"CORRECTED (if checked)
Form 1099-R
Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
2024
OMB No. 1545-0119
Copy C For Recipient's Records
PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no.
PAYER'S TIN
RECIPIENT'S name
RECIPIENT'S TIN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
1 Gross distribution
2b Taxable amount not determined
4 Federal income tax withheld
5 Employee contributions/Designated Roth contributions or insurance premiums
7 Distribution code(s)
16 State distribution
Evergreen Retirement Services 4507 Oak Hollow Ct Lakewood, CO 89871
81-9245427
Wei Patel
XXX-XX-0152
7354 Cedar Ln
Fairview, OH 49278
$10,263.27
☒
$2,689.09
4
$86,879.28
Department of the Treasury - Internal Revenue Service
Form 1099-R (keep for your records)  www.irs.gov/Form1099R",1099,5,1099,fdc-1846f881f5fe9f7ab9ce289b,v11-1099-R-columns,original,2024,fgen-0a0f676fe4f51c0011150f49,synthetic_programmatic_template,columns,top,False,
"CORRECTED (if checked)
For calendar year 2022
OMB No. 1545-0997
Copy B For Transferor
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Lakeshore Closing Services 4624 Lakeshore Blvd Maplewood, MN 78376
FILER'S TIN: 67-7584403
TRANSFEROR'S name: Priya Rivera
TRANSFEROR'S TIN: XXX-XX-6332
Street address (including apt. no.): 4225 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code: Testville, IL 99985
Account number (see instructions): ****432951
Box 1 Date of closing: 6/23/22
Box 2 Gross proceeds: $274,216.05
Box 3 Address or legal description (including city, state, and ZIP code): 3603 Prairie Ave Lakewood, CO 70778
Box 4 Check here if the transferor received or will receive property or services as part of the consideration
Box 5 Check here if the transferor is a foreign person: ☒
Box 6 Buyer's part of real estate tax: $2,743.29",1099,5,1099,fdc-9c0b2dc394dab28897c1346b,v11-1099-S-boxed,original,2022,fgen-672aff28711d8b4ddd8bc7bd,synthetic_programmatic_template,boxed,none,False,
"Form 1099-S
Proceeds From Real Estate Transactions
For calendar year 2023
OMB No. 1545-0997
Copy B For Transferor
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Summit Land Title Co. 7703 Oak Hollow Ct Lakewood, CO 72740
FILER'S TIN: 33-9206852
TRANSFEROR'S name: Lena J. Testcase
TRANSFEROR'S TIN: XXXXX5033
Street address (including apt. no.): 9299 Granite St
City or town, state or province, country, and ZIP or foreign postal code: Bayside, WA 58585
Line 1 Date of closing: 2020-01-21
Line 2 Gross proceeds: $500,810.20
Line 3 Address or legal description (including city, state, and ZIP code): 8409 Harbor View Rd Riverton, WI 15755
Line 4 Check here if the transferor received or will receive property or services as part of the consideration: ☒
Line 5 Check here if the transferor is a foreign person: [X]
Line 6 Buyer's part of real estate tax: $3,571.61",1099,5,1099,fdc-c31bff178107f0a49c5b7fa4,v11-1099-S-boxed,original,2023,fgen-84d0778f3b346fc0d6ac9282,synthetic_programmatic_template,boxed,top,False,
"VOID  CORRECTED
Form 1099-S
Proceeds From Real Estate Transactions
For calendar year 2024
OMB No. 1545-0997
Copy B For Transferor
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Cedar Title & Escrow 8153 Lakeshore Blvd Cedar Falls, IA 17237
FILER'S TIN: 87-8565351
TRANSFEROR'S name: Fatima L. Walsh
TRANSFEROR'S TIN: ****8640
Street address (including apt. no.): 5468 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 83617
Account number (see instructions): XXXXX045308
1 Date of closing: 11/23/2023
2 Gross proceeds: $397,393.20
3 Address or legal description (including city, state, and ZIP code): 3477 Lakeshore Blvd Riverton, WI 78280
4 Check here if the transferor received or will receive property or services as part of the consideration: ☒
5 Check here if the transferor is a foreign person: X
6 Buyer's part of real estate tax: 687.16",1099,5,1099,fdc-32600d362b8aa8addf167348,v11-1099-S-boxed,original,2024,fgen-284e335baef10b572f5b19aa,synthetic_programmatic_template,boxed,top,False,
"VOID  CORRECTED
2021
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Cedar Title & Escrow 4647 Elm Park Pl Maplewood, MN 44061
FILER'S TIN: 74-8844764
TRANSFEROR'S name: Kwame K. Walsh
TRANSFEROR'S TIN: ending in 6475
Street address (including apt. no.): 262 Elm Park Pl
City or town, state or province, country, and ZIP or foreign postal code: Maplewood, MN 72554
1 Date of closing: 11/13/21
2 Gross proceeds: $82,999.42
3 Address or legal description (including city, state, and ZIP code): 3170 Oak Hollow Ct Riverton, WI 13440
5 Check here if the transferor is a foreign person: ☒
6 Buyer's part of real estate tax: $7,058.73
Department of the Treasury - Internal Revenue Service
Form 1099-S
Proceeds From Real Estate Transactions
Form 1099-S (keep for your records)  www.irs.gov/Form1099S",1099,5,1099,fdc-0fe2b81d44fe11f0b014a145,v11-1099-S-boxed,original,2021,fgen-75430ee099f8f6e2c3685ca8,synthetic_programmatic_template,boxed,bottom,False,
"Form 1099-S
Proceeds From Real Estate Transactions
2022
OMB No. 1545-0997
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Summit Land Title Co. 7222 Prairie Ave Testville, IL 83807
FILER'S TIN: 61-6257600
TRANSFEROR'S name: Jordan Adeyemi
TRANSFEROR'S TIN: ****9191
Street address (including apt. no.): 8363 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 85784
Account number (see instructions): XXXXX900557
Line 1 Date of closing: August 5, 2022
Line 2 Gross proceeds: 517,959.42
Line 3 Address or legal description (including city, state, and ZIP code): 6190 Granite St Testville, IL 68530
Line 4 Check here if the transferor received or will receive property or services as part of the consideration: ☐
Line 5 Check here if the transferor is a foreign person: X
Line 6 Buyer's part of real estate tax: 13.97",1099,5,1099,fdc-cd5e8a6e33c19f73ccffe851,v11-1099-S-boxed,original,2022,fgen-fac99eac9af52178d387f621,synthetic_programmatic_template,boxed,top,False,
"Form 1099-S Proceeds From Real Estate Transactions 2022
FILER:: Summit Land Titlc Co.
Recipient's name:: Avery Okafor
Box 4 Check here if the transferorrcceived or will rcceive property or services as part of the consideration: X
Box 2 Gross proceeds: 2O4,315.13",1099,5,1099,fdc-3941ca3bdb27bde3361b38e6,v11-1099-S-boxed,original,2022,fgen-d613a223dbefcbe11183f291,synthetic_programmatic_template,boxed,top,True,
"Form 1099-S Proceeds From Real Estate Transactions 2023
FILER:: Summit Land Title Co.
RECIPIENT:: Alex C. Nguyen
Line 6 Buyer's part of real estate tax: 6,123.28
Line 4 Check here if the transferor received or will receive property or services as part of the consideration: ☐
Line 3 Address or legal description (including city, state, and ZIP code): 92 Prairie Ave Fairview, OH 69465
Line 5 Check here if the transferor is a foreign person: 0.00",1099,5,1099,fdc-093e5500b44c0f23247ec220,v11-1099-S-boxed,original,2023,fgen-d2f639906e2164152cfa6559,synthetic_programmatic_template,boxed,top,False,
"Form 1099-S
Proceeds From Real Estate Transactions
For calendar year 2021
OMB No. 1545-0997
Copy B For Transferor
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Cedar Title & Escrow 2739 Oak Hollow Ct Brookhaven, PA 83882
FILER'S TIN: 91-5182985
TRANSFEROR'S name: Mateo Haddad
TRANSFEROR'S TIN: ****0153
Street address (including apt. no.): 218 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code: Pinecrest, GA 12214
Box 1 Date of closing: 12/21/2021
Box 2 Gross proceeds: $339,566.48
Box 3 Address or legal description (including city, state, and ZIP code): 7640 Oak Hollow Ct Oak Grove, TX 93446
Box 4 Check here if the transferor received or will receive property or services as part of the consideration: [X]
Box 5 Check here if the transferor is a foreign person: X
Box 6 Buyer's part of real estate tax: $8,234.30
Department of the Treasury - Internal Revenue Service
Form 1099-S (keep for your records)  www.irs.gov/Form1099S",1099,5,1099,fdc-35ec2c70755cfd5486b6d846,v11-1099-S-boxed,original,2021,fgen-f5aacc81aca9434b5a3f2ed6,synthetic_programmatic_template,boxed,top,False,
"Form 1099-S Proceeds From Real Estate Transactions
FILER:: Lakeshore Closing Services
Recipient's name:: Fatima Castillo
Box 6 Buyer's part of real estate tax: 5,110.66
Box 1 Date of closing: 6/11/23",1099,5,1099,fdc-9513e0ffa95510ea48ae7e85,v11-1099-S-boxed,original,2023,fgen-e1b634258a2047658bd14685,synthetic_programmatic_template,boxed,top,False,
"OMB No. 1545-0997
FILER'S name, street address, cityor town, state or province, country, and ZIP or foreign postal codc: Lakeshore Closing Services 5776 Maple Ridge Dr Brookhaven, PA 36729
FILER'S TIN: 88-8O36718
TRAN5FEROR'S namc: Morgan S. Testcase
TRANSFEROR'S TIN: ***-**-9248
Box 1 Date of closing: July 15, 2023
Box 2 Gross proceeds: S130,060.33
Box 3 Address or legal description (including city, state, and ZIP code): 6267 Elm Park Pl Brookhaven, PA 18159
Box 5 Check here if the transferoris a foreign person: ☐
Box 6 Buyer'spart of rea1 estate tax: $4,373.85
Department of the Treasury - Intemal Revenue 5ervice",1099,5,1099,fdc-3713d4840c30ac9df9c28f7c,v11-1099-S-boxed,original,2026,fgen-f8556c0a1c71e8466b04a55a,synthetic_programmatic_template,boxed,none,True,
"2021
OMB No. 1545-0997
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Lakeshore Closing Services 5449 Lakeshore Blvd Fairview, OH 10044
FILER'S TIN: 77-5963220
TRANSFEROR'S name: Taylor Lindqvist
TRANSFEROR'S TIN: XXXXX5790
Street address (including apt. no.): 7016 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code: Brookhaven, PA 86588
Box 1 Date of closing: 07/15/2021
Box 2 Gross proceeds: $400,403.00
Box 3 Address or legal description (including city, state, and ZIP code): 5144 Oak Hollow Ct Maplewood, MN 28582
Box 4 Check here if the transferor received or will receive property or services as part of the consideration: X
Box 5 Check here if the transferor is a foreign person: [X]
Box 6 Buyer's part of real estate tax: $4,644.69
Department of the Treasury - Internal Revenue Service
Form 1099-S
Proceeds From Real Estate Transactions
Form 1099-S (keep for your records)  www.irs.gov/Form1099S",1099,5,1099,fdc-37a8828c3dbdbc617de5a997,v11-1099-S-boxed,original,2021,fgen-c2bc824b462939a1fc2c451b,synthetic_programmatic_template,boxed,bottom,False,
"Form 1099-S Proceeds From Real Estate Transactions 2021
FILER:: Lakeshore Closing Services
To:: Avery Nguyen
4 Check here if the transferor received or will receive property or services as part of the consideration: 0.00",1099,5,1099,fdc-abde97c48e4eff6834a74a25,v11-1099-S-boxed,original,2021,fgen-cf70490c3cb9811ff0a20a14,synthetic_programmatic_template,boxed,top,False,
"Form 1099-S
Proceeds From Real Estate Transactions
OMB No. 1545-0997
Copy B For Transferor
This is important tax information and is being furnished to the IRS.
FILER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code: Summit Land Title Co. 2641 Prairie Ave Brookhaven, PA 35640
FILER'S TIN: 91-7152034
TRANSFEROR'S name: Jamie Larsen
TRANSFEROR'S TIN: XXXXX2394
Account number (see instructions): XXXXX249629
Box 1 Date of closing: 11/27/22
Box 2 Gross proceeds: 207,089.27
Box 3 Address or legal description (including city, state, and ZIP code): 6648 Sample Street Bayside, WA 25916
Box 4 Check here if the transferor received or will receive property or services as part of the consideration: X
Box 5 Check here if the transferor is a foreign person: X
Box 6 Buyer's part of real estate tax: 1,608.64
Department of the Treasury - Internal Revenue Service
Form 1099-S (keep for your records)  www.irs.gov/Form1099S",1099,5,1099,fdc-bf6abe2c9fb812a3672a38be,v11-1099-S-boxed,original,2022,fgen-90d644a94d04b9f0267453b1,synthetic_programmatic_template,boxed,top,False,
"From:: Lakeshore Closing Services
RECIPIENT:: Taylor Patel
6 Buyer's part of real estate tax: S7,032.40
4 Check here if the transferor received or wi1l receive property orservices as part of the consideration: ☒
Form 1099-5 Proceeds From Real Estate Transactions 2023",1099,5,1099,fdc-7ea70aeecc804d14f12db66f,v11-1099-S-boxed,original,2023,fgen-dd3b18a98d2c4b725677863f,synthetic_programmatic_template,boxed,bottom,True,
"CORRECTED (if chccked)
Form 1099-S
Proceeds From Real Estate Transactions
2026
OMB No. l545-0997
Copy B For Transfcror
FILER'S name, street address, cíty or town, state or province, country, andZIP or foreígn postal code: Summit Land Title Co. 1433 Sample Street Lakewood, CO19003
FILER'S TIN: 84-2882537
TRANSFER0R'S name: Sofia K. Romero
TRANSFEROR'S TIN: ***-**-5111
Street address (inc1uding apt. no.): 51 Cedar Ln
City or town, state or province, country,and ZIP or foreign postal code: Lakewood, CO l9878
Box 2 Gross proceeds: S232,695.26
Box 4 Check here if the transferor received or will receive property or services aspart of the consideration:☐
Box 5 Check here if the transferor is a foreign person: ☐
Box 6 Buyer's part of real estate tax: 5,345.43
Department of the Treasury - Intemal Revenue Service
Form lO99-S (keep for your records)  www.irs.gov/Form1O99S",1099,5,1099,fdc-866891f018c859e372f5a09c,v11-1099-S-boxed,original,2026,fgen-d7a3bfcf8c81b5d3657471dc,synthetic_programmatic_template,boxed,top,True,
"From:: Lakeshore Closing Services
To:: Casey C. Adeyemi
Line 2 Gross proceeds: $413,779.55
Line 4 Check here if the transferor received or will receive property or services as part of the consideration: [X]
Form 1099-S Proceeds From Real Estate Transactions 2024",1099,5,1099,fdc-53d9fb4ddd6dd69a5fe53eee,v11-1099-S-boxed,original,2024,fgen-0e46e97aae23faf9e9e318c7,synthetic_programmatic_template,boxed,bottom,False,
"For calendar year 2024 Copy B For Recipient This information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Evergreen Health Savings 68 Maple Ridge Dr Riverton, WI 28629 PAYER'S TIN 91-3718652 RECIPIENT'S name Diego Haddad RECIPIENT'S TIN XXX-XX-7528 Account
number (see
instructions) XXXXX862102 1 Gross distribution 2,718.95 2 Earnings on excess cont. 3 Distribution code G 4 FMV on date of death Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-43879e136bd7fbde2255a9c0,v11-1099-SA-flat,original,2024,fgen-89dc85ff44b56c72ad5484d4,synthetic_programmatic_template,flat,none,False,
"Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA For calendar year 2022 OMB No. 1545-1517 Copy
B For Recipient This information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country,
and ZIP or foreign postal code Evergreen Health Savings 339 Maple Ridge Dr Brookhaven, PA 10584 PAYER'S TIN 43-3575702 RECIPIENT'S name Sofia K. Larsen RECIPIENT'S TIN ****2215 Street address (including apt. no.) 5824 Willow Bend Way City or town, state or province, country, and ZIP or foreign postal code Maplewood, MN 68177 3 Distribution code A 4 FMV on date of death 0.00 5 HSA / Archer MSA / MA MSA HSA ☒",1099,5,1099,fdc-2af8a9843c7834a39fe0deb0,v11-1099-SA-flat,original,2022,fgen-f7aba49a32b6415a82bf90e7,synthetic_programmatic_template,flat,top,False,
"From: Northwind HSA Custodian RECIPIENT: Jamie Testcase 5
HSA / Archer MSA / MA MSA HSA ☒ 3 Distribution
code G",1099,5,1099,fdc-3a7941ca58fcd4306edb9c3e,v11-1099-SA-flat,original,2023,fgen-0bec33852e7a25aed9dcd3fa,synthetic_programmatic_template,flat,none,False,
"Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA For calendar year 2022 Copy B For Recipient This information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Sample HSA Bank
1708 Cedar Ln Fairview, OH 86182 PAYER'S TIN 93-7929984 RECIPIENT'S name Amara Rivera RECIPIENT'S TIN XXXXX5333 Street address (including apt. no.) 4557 Oak Hollow Ct City or town, state or province, country, and ZIP or foreign postal code Lakewood,
CO 39019 1 Gross distribution $1,179.63 2 Earnings on excess cont. 0.00 3 Distribution code A 4 FMV on date of death 5 HSA / Archer MSA / MA MSA HSA ☒",1099,5,1099,fdc-c1d842ca3466101a40ac0108,v11-1099-SA-flat,original,2022,fgen-81575e901d71720c67833308,synthetic_programmatic_template,flat,top,False,
"Form 1099-SA Distributions From an HSA, Archer MSA, or
Medicare Advantage
MSA 2024 TRUSTEE'S name: Sample HSA Bank To: Noah Rivera 5 HSA / Archer MSA / MA MSA HSA ☒ 3 Distribution code F 1 Gross distribution $2,127.41",1099,5,1099,fdc-eb4ea0e3d98e402f8529c3e8,v11-1099-SA-flat,original,2024,fgen-6e3703cd40ec4d8f28d7a110,synthetic_programmatic_template,flat,top,False,
"2025 Copy B For Recipient This
information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or
foreign postal code Evergreen Health Savings 3683 Willow Bend Way Bayside, WA 67308 PAYER'S TIN 13-6436917 RECIPIENT'S name Jordan S. Adeyemi RECIPIENT'S TIN XXXXX4602 Account number (see instructions) ending in 117428 1 Gross distribution 919.06 2 Earnings on excess cont. $0.00 3 Distribution code F 5 HSA / Archer MSA / MA MSA HSA ☒ Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA",1099,5,1099,fdc-abcdeaaac8caa8b94847d674,v11-1099-SA-flat,original,2025,fgen-a24be2efcda65380cce80b15,synthetic_programmatic_template,flat,bottom,False,
"2024
Copy B For Recipient This information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northwind HSA Custodian 7015 Maple Ridge Dr Brookhaven, PA 72286 PAYER'S TIN 61-4102924
RECIPIENT'S name Taylor Testcase RECIPIENT'S TIN XXX-XX-5088 Street address (including apt. no.) 6070 Willow Bend Way City or town, state or province, country, and ZIP or foreign postal code Pinecrest, GA 76360 Account number (see instructions) ending in 797392 1 Gross distribution 4,294.87 2 Earnings on excess cont. 3 Distribution code 1 4 FMV on date of death 5 HSA / Archer MSA / MA MSA HSA ☒ Department of the Treasury - Internal Revenue Service",1099,5,1099,fdc-9046dd2be7465cb3b13f6f53,v11-1099-SA-flat,original,2024,fgen-4d3b7d5c5dde80df36adfdc8,synthetic_programmatic_template,flat,none,False,
"Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA For calendar year 2021 OMB No. 1545-1517 CopyBFor Recipient This information is being furnishcd to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Sample HSA Bank 9460 Harbor
Vicw Rd Brookhaven, PA 30178 PAYER'S TIN 85-6142492 RECIPIENT'S name Avery S.Romero RECIPIENT'S
TIN ****4381 Street address (induding apt. no.) 7499 E1m Park PlCity or town, statc or province, country, and ZIP or foreign postal code Cedar Falls, IA 23938 1 Gross distribution $4,O60.19 2 Eamings on excess cont. 3 Distribution code 1 4 FMV on date of death 0.00 5 HSA / Archer MSA / MA MSA HSA ☒ Department of the Treasury - Intemal Revenue 5erviceForm 1O99-SA (keep for your records) www.irs.gov/FormlO99SA",1099,5,1099,fdc-4878393422de6450d725ca66,v11-1099-SA-flat,original,2021,fgen-338531a5a138cf49f15ffd23,synthetic_programmatic_template,flat,top,True,
"Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA OMB No. 1545-1517 Copy B For Recipient TRUSTEE'S/PAYER'S name, street
address, city
or town, state or province, country, and ZIP or foreign postal code Sample HSA Bank 4883 Sample Street Cedar Falls, IA 72934 PAYER'S TIN 43-6820094 RECIPIENT'S name Jordan R. Rivera RECIPIENT'S TIN XXXXX9238 Street address (including apt. no.) 4760 Granite St City or town, state or province, country, and ZIP or foreign postal code Testville, IL 46498 Account number (see instructions) XXXXX189031 1 Gross distribution 9,371.28 2 Earnings on excess cont. $0.00 3 Distribution code 1 4 FMV on date of death 0.00 5 HSA / Archer MSA / MA MSA HSA ☒ Department of the Treasury - Internal Revenue Service Form 1099-SA (keep for your records) www.irs.gov/Form1099SA",1099,5,1099,fdc-bdb99b9e4ebc5ba3f952cf84,v11-1099-SA-flat,original,2025,fgen-4eb70b68323e99b80619716b,synthetic_programmatic_template,flat,top,False,
"Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA 2022 TRUSTEE: Northwind HSA Custodian RECIPIENT: Jamie
Fischer 1 Gross distribution$7,055.96
3 Distribution code A",1099,5,1099,fdc-685b473cd3c4843ffb623a64,v11-1099-SA-flat,original,2022,fgen-a41f553c4bed2d05cfd1e910,synthetic_programmatic_template,flat,top,True,
"From: Evergreen Health Savings Recipient's name:Mateo Castillo 5
HSA / Archer MSA / MA MSA HSA ☒ 3
Distribution code G Form 1099-SA Distributions From an HSA, Archcr MSA, or Medicare Advantage MSA",1099,5,1099,fdc-afc37049860b7064c8276769,v11-1099-SA-flat,original,2022,fgen-5bee0afabfa3805f55e7b071,synthetic_programmatic_template,flat,bottom,True,
"VOID CORRECTED Form
1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA For calendar year 2025 OMB No. 1545-1517 Copy B For Recipient This information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northwind HSA Custodian 572 Cedar Ln Testville, IL 10150 PAYER'S TIN 51-3283045 RECIPIENT'S name Riley Sato RECIPIENT'S TIN ****2951 Street address (including apt. no.) 533 Elm Park Pl City or town, state or
province, country, and ZIP or foreign postal code Bayside, WA 38879 1 Gross distribution $5,348.04 2 Earnings on excess cont. 3 Distribution code A 4 FMV on date of death 0.00 5 HSA / Archer MSA / MA MSA HSA ☒",1099,5,1099,fdc-0913be281e1a999b67189bbe,v11-1099-SA-flat,original,2025,fgen-73505f8e5473fc2dbaa3de8c,synthetic_programmatic_template,flat,top,False,
"Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA 2023 Copy B For Recipient TRUSTEE'S/PAYER'S name, street address,
city or town, state or province, country, and ZIP or foreign postal code Evergreen Health Savings 2673 Oak Hollow Ct Oak Grove, TX 49684 PAYER'S TIN 33-2028541 RECIPIENT'S name Jamie Brennan RECIPIENT'S TIN XXXXX1683 Account number (see instructions) ending in 873018 2 Earnings on excess cont. 3 Distribution code F 4 FMV on date of death 5 HSA / Archer MSA / MA MSA
HSA ☒ Department of the Treasury - Internal Revenue Service Form 1099-SA (keep for your records) www.irs.gov/Form1099SA",1099,5,1099,fdc-b3d24f899ee714400a46c159,v11-1099-SA-flat,original,2023,fgen-16e4ef0e45e8aee2414970ff,synthetic_programmatic_template,flat,top,False,
"☐ CORRECTED For calendar year 2024 OMB No. 1545-1517 Copy B For Recipient TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal
code Sample HSA Bank 1786 Elm Park Pl Brookhaven, PA 39226 PAYER'S TIN 60-5396293 RECIPIENT'S name Priya D. Rivera RECIPIENT'S TIN ending in 3175 Street address (including apt. no.) 6683 Elm Park Pl City or town, state or province, country, and ZIP or foreign postal code Fairview, OH 31903 1 Gross distribution $467.24 2 Earnings on excess cont. 0.00 3 Distribution code F 5 HSA / Archer MSA / MA MSA HSA ☒
Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA",1099,5,1099,fdc-6e731ab392b2e9b05bf75d5a,v11-1099-SA-flat,original,2024,fgen-df144ef96fdc9ebe24c82ee9,synthetic_programmatic_template,flat,bottom,False,
"2023 OMB No. 1545-1517 Copy B For Recipient This information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or foreign postal
code Evergreen Health Savings 9862 Oak Hollow Ct Cedar Falls, IA 79236 PAYER'S TIN 51-5958118 RECIPIENT'S name Taylor Testcase RECIPIENT'S TIN ending in 5675 Street address (including apt. no.) 5494 Cedar Ln City or town, state or province, country, and ZIP or foreign postal code Lakewood, CO 66478 Account number (see instructions) ***-**-010938 2 Earnings on excess cont. 3 Distribution code 2 4 FMV on date of death 5 HSA
/ Archer MSA / MA MSA HSA ☒ Department of the Treasury - Internal Revenue Service Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA Form 1099-SA (keep for your records) www.irs.gov/Form1099SA",1099,5,1099,fdc-572f43bd8c767341d87c1b2e,v11-1099-SA-flat,original,2023,fgen-1ba3679f36e83060639ce233,synthetic_programmatic_template,flat,bottom,False,
"2026 OMB No. 1545-1517 Copy B For Recipient This information is being furnished to the IRS. TRUSTEE'S/PAYER'S name, street address, city or town, state or province, country, and ZIP or
foreign postal code Evergreen Health
Savings 8998 Willow Bend Way Fairview, OH 70239 PAYER'S TIN 25-7356563 RECIPIENT'S name Kwame Sato RECIPIENT'S TIN ***-**-0147 Street address (including apt. no.) 6912 Granite St City or town, state or province, country, and ZIP or foreign postal code Brookhaven, PA 67874 Account number (see instructions) XXXXX317008 1 Gross distribution $2,219.19 2 Earnings on excess cont. 3 Distribution code G 4 FMV on date of death Department of the Treasury - Internal Revenue Service Form 1099-SA Distributions From an HSA, Archer MSA, or Medicare Advantage MSA Form 1099-SA (keep for your records) www.irs.gov/Form1099SA",1099,5,1099,fdc-da03e0cf805715d730158a69,v11-1099-SA-flat,original,2026,fgen-2ca879a60d438de60c4b99b4,synthetic_programmatic_template,flat,bottom,False,
"## For calendar year 2023
OMB No. 1545-0747
Copy B For Participant
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Clearwater Investing 1935 Willow Bend Way Oak Grove, TX 60506 |
| TRUSTEE'S or ISSUER'S TIN | 48-8329424 |
| PARTICIPANT'S name | Hiro Walsh |
| PARTICIPANT'S TIN | XXX-XX-3773 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | 8,063.24 |
| 2 Rollover contributions | $0.00 |
| 3 Roth IRA conversion amount | $0.00 |
| 5 Fair market value of account | 130,261.93 |
| 7 IRA / SEP / SIMPLE / Roth IRA | SEP ☒ |
| 10 Roth IRA contributions | 4,890.93 |
| 11 Check if RMD for next year | X |
Department of the Treasury - Internal Revenue Service
Form 5498
## IRA Contribution Information
## Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-8b09fec9eb5adb2476a7b430,v11-5498-markdown,original,2023,fgen-3a470496411fd75f2b4687f5,synthetic_programmatic_template,markdown,bottom,False,
"2026
## OMB No. 1545-0747
Copy B For Participant
This information is being furnished to the IRS.
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Evergreen Brokerage Services 1426 Lakeshore Blvd Testville, IL 79326 |
| TRUSTEE'S or ISSUER'S TIN | 94-8270866 |
| PARTICIPANT'S name | Kwame Walsh |
| PARTICIPANT'S TIN | ****2028 |
| Street address (including apt. no.) | 3379 Willow Bend Way |
| City or town, state or province, country, and ZIP or foreign postal code | Pinecrest, GA 22227 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | 1,900.41 |
| 2 Rollover contributions |  |
| 3 Roth IRA conversion amount |  |
| 5 Fair market value of account | 134,165.71 |
| 7 IRA / SEP / SIMPLE / Roth IRA | Roth IRA ☒ |
| 10 Roth IRA contributions | $4,947.37 |
| 11 Check if RMD for next year | [X] |
## Department of the Treasury - Internal Revenue Service",5498,14,5498,fdc-9d6790732ff09e457031d6bd,v11-5498-markdown,original,2026,fgen-7b8a7138034c4a4053c749af,synthetic_programmatic_template,markdown,none,False,
"## Form 5498
IRA Contribution Information
For calendar year 2025
OMB No. 1545-0747
This information is being furnished to the IRS.
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Clearwater Investing 2475 Granite St Maplewood, MN 24431 |
| TRUSTEE'S or ISSUER'S TIN | 70-8319561 |
| PARTICIPANT'S name | Kwame Sato |
| PARTICIPANT'S TIN | ending in 0674 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | 2,377.25 |
| 2 Rollover contributions |  |
| 3 Roth IRA conversion amount | $0.00 |
| 7 IRA / SEP / SIMPLE / Roth IRA | Roth IRA ☒ |
| 10 Roth IRA contributions | $4,726.33 |
| 11 Check if RMD for next year | [X] |
## Department of the Treasury - Internal Revenue Service
Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-1d725fdc136c27bc89f575b8,v11-5498-markdown,original,2025,fgen-429213a914d857b00f8f4bb5,synthetic_programmatic_template,markdown,top,False,
"VOID  CORRECTED
Form 5498
IRA Contribution Information
OMB No. 1545-0747
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Clearwater Investing 1001 Prairie Ave Bayside, WA 46919 |
| TRUSTEE'S or ISSUER'S TIN | 22-7742937 |
| PARTICIPANT'S name | Alex Tanaka |
| PARTICIPANT'S TIN | ending in 6903 |
| Account number (see instructions) | ending in 776543 |
| 2 Rollover contributions | $0.00 |
| 3 Roth IRA conversion amount | 0.00 |
| 5 Fair market value of account | $422,738.76 |
| 7 IRA / SEP / SIMPLE / Roth IRA | SEP ☒ |
| 10 Roth IRA contributions | $4,380.62 |
| 11 Check if RMD for next year | ☐ |
## Department of the Treasury - Internal Revenue Service
Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-40e6bc1396c551e6773ba473,v11-5498-markdown,original,2022,fgen-9d10230da63c29f994d23f9e,synthetic_programmatic_template,markdown,top,False,
"## Form 5498 IRA Contribution Information 2022
| Field | Value |
| --- | --- |
| TRUSTEE'S name: | Clearwater Investing |
| Recipient's name: | Hiro Romero |
| 11 Check if RMD for next year | [X] |",5498,14,5498,fdc-b2a4f5b7e5e71126e435723c,v11-5498-markdown,original,2022,fgen-acdb3cd4d1b79ced8093e63f,synthetic_programmatic_template,markdown,top,False,
"## Form 5498
## IRA Contribution Information
## 2021
OMB No. 1545-0747
## This information is being furnished to the IRS.
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Evergreen Brokerage Services 5553 Harbor View Rd Cedar Falls, IA 15996 |
| TRUSTEE'S or ISSUER'S TIN | 40-5319397 |
| PARTICIPANT'S name | Noah Fischer |
| PARTICIPANT'S TIN | ending in 3389 |
| Street address (including apt. no.) | 8986 Willow Bend Way |
| City or town, state or province, country, and ZIP or foreign postal code | Maplewood, MN 47708 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | $926.82 |
| 5 Fair market value of account | 205,075.51 |
| 7 IRA / SEP / SIMPLE / Roth IRA | Roth IRA ☒ |
| 10 Roth IRA contributions | $2,255.31 |
| 11 Check if RMD for next year | [X] |
Department of the Treasury - Internal Revenue Service
## Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-10ae46c14761d549d1615c08,v11-5498-markdown,original,2021,fgen-a7aeba2ff2ef7b04d20312e5,synthetic_programmatic_template,markdown,top,False,
"2025
OMB No. 1545-0747
Copy B For Participant
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Clearwater Investing 1607 Prairie Ave Pinecrest, GA 60473 |
| TRUSTEE'S or ISSUER'S TIN | 56-9474625 |
| PARTICIPANT'S name | Lena Testcase |
| PARTICIPANT'S TIN | ****7729 |
| 2 Rollover contributions | 0.00 |
| 3 Roth IRA conversion amount |  |
| 5 Fair market value of account | $434,515.73 |
| 7 IRA / SEP / SIMPLE / Roth IRA | SEP ☒ |
| 10 Roth IRA contributions | 7,522.34 |
| 11 Check if RMD for next year | [X] |
Department of the Treasury - Internal Revenue Service
## Form 5498
IRA Contribution Information
Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-3e48db0c8abe74857abfc578,v11-5498-markdown,original,2025,fgen-b2592e9c0fcaaf995e5a84cc,synthetic_programmatic_template,markdown,bottom,False,
"Form 5498
IRA Contribution Information
2026
## OMB No. 1545-0747
## This information isbeing furnished to the IRS.
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP orforeign postal code| Clearwater Investing 1989 Prairie Ave Fairview, 0H 71112 |
| TRU5TEE'S or ISSUER'S TIN | 2O-8298973 |
| PARTICIPANT'S name | Diego Romero |
| PARTICIPANT'S TIN | ***-**-5405 |
| Account number (see instructions) | ***-**-920368 |
| l IRA contributions (other than amounts in boxes 2–4, 8–10,13a,14a, and 15a) | $6,966.27 |
| 2 Rollover contributions | $0.00 |
| 3 Roth IRA convcrsion amount |  |
| 5 Fairmarkct value of account | 492,628.05 |
| 7 IRA / SEP / SIMPLE / Roth IRA | SEP ☒ |
| l1 Check íf RMD for next year | ☒ |
Department of the Treasury - Intemal Revcnue 5ervice
Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-b4f15fbc390256401f452fc0,v11-5498-markdown,original,2026,fgen-71e87c0e435fb994a06a9c22,synthetic_programmatic_template,markdown,top,True,
"Form 5498
## IRA Contribution Information
2023
Copy B For Participant
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Clearwater Investing 1036 Granite St Riverton, WI 24491 |
| TRUSTEE'S or ISSUER'S TIN | 16-8591853 |
| PARTICIPANT'S name | Fatima Brennan |
| PARTICIPANT'S TIN | ****4548 |
| Street address (including apt. no.) | 4841 Oak Hollow Ct |
| City or town, state or province, country, and ZIP or foreign postal code | Lakewood, CO 31478 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | $6,254.18 |
| 2 Rollover contributions |  |
| 3 Roth IRA conversion amount |  |
| 5 Fair market value of account | $81,483.71 |
| 7 IRA / SEP / SIMPLE / Roth IRA | IRA ☒ |
| 10 Roth IRA contributions | $687.19 |
| 11 Check if RMD for next year | ☒ |
## Department of the Treasury - Internal Revenue Service
## Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-1b14f778dc986376251048a6,v11-5498-markdown,original,2023,fgen-eefb56817e35d11c44ab8537,synthetic_programmatic_template,markdown,top,False,
"OMB No. 1545-0747
This information is being furnished to the IRS.
| Field |Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, cíty or town, state or province, country, and ZIP or foreign posta1 code | Summit Investments 8166 Harbor Víew RdLakewood, CO 43355 |
| TRUSTEE'S or ISSUER'S TIN | 43-6604524 |
| PARTICIPANT'S name | Diego Haddad |
| PARTICIPANT'S TIN | ***-**-5353 |
| 1 IRA contributions (othcr than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | 7,903.96 |
| 3 Roth IRA conversion amount | 0.00 |
| 5 Fair market value of account | 259,32l.21 |
| 7 IRA / SEP / SIMPLE / Roth IRA | RothIRA ☒ |
| 10 Roth IRA contributions | $4,426.78 |
|11 Check íf RMD fornext year | ☒ |
Department of the Treasury - Intemal Revenue Servíce
Form 5498
IRA Contribution Information
Form 5498 (keep for your records)  www.irs.gov/Form5498",5498,14,5498,fdc-39729bcec854908c462c169a,v11-5498-markdown,original,2021,fgen-70b52698e016d0c1c80c2798,synthetic_programmatic_template,markdown,bottom,True,
"VOID  CORRECTED
Form 5498
IRA Contribution Information
For calendar year 2026
OMB No. 1545-0747
Copy B For Participant
This information is being furnished to the IRS.
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Northstar Securities 7226 Willow Bend Way Riverton, WI 93787 |
| TRUSTEE'S or ISSUER'S TIN | 25-5902647 |
| PARTICIPANT'S name | Riley M. Fischer |
| PARTICIPANT'S TIN | ****1453 |
| Street address (including apt. no.) | 3261 Willow Bend Way |
| City or town, state or province, country, and ZIP or foreign postal code | Brookhaven, PA 32955 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | $8,534.94 |
| 2 Rollover contributions |  |
| 3 Roth IRA conversion amount | $0.00 |
| 5 Fair market value of account | 518,752.39 |
| 10 Roth IRA contributions | 8,335.01 |",5498,14,5498,fdc-07bc24be56f3f408a203da73,v11-5498-markdown,original,2026,fgen-d37327a93664f881bcd20da9,synthetic_programmatic_template,markdown,top,False,
"CORRECTED (if checked)
## Form 5498
IRA Contribution Information
2025
## OMB No. 1545-0747
Copy B For Participant
This information is being furnished to the IRS.
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Ironwood Wealth Partners 7556 Lakeshore Blvd Cedar Falls, IA 19855 |
| TRUSTEE'S or ISSUER'S TIN | 38-7093219 |
| PARTICIPANT'S name | Jordan Romero |
| PARTICIPANT'S TIN | ending in 4298 |
| Street address (including apt. no.) | 4203 Granite St |
| City or town, state or province, country, and ZIP or foreign postal code | Lakewood, CO 66711 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | $9,113.61 |
| 2 Rollover contributions | $0.00 |
| 3 Roth IRA conversion amount |  |
| 5 Fair market value of account | $332,509.04 |
| 7 IRA / SEP / SIMPLE / Roth IRA | Roth IRA ☒ |
| 10 Roth IRA contributions | 144.36 |",5498,14,5498,fdc-9b96fbb922aa7fa71d0deb3e,v11-5498-markdown,original,2025,fgen-59627893d5b2e4848fd0d2ec,synthetic_programmatic_template,markdown,top,False,
"Form 5498
## IRA Contribution Information
2024
## Copy B For Participant
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city ortown, state or province, country, and ZIP or foreígn postal code | Clearwater Investing 8645 WillowBend Way Fairview, OH 40069|
| TRUSTEE'S or ISSUER'S TIN | 27-5018241 |
| PARTICIPANT'S name | RileyS. Testcase |
| PARTICIPANT'S TIN | ***-**-6455 |
| Account numbcr (see instructions) | ***-**-968282 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a,and 15a) | 5,591.42 |
| 2 Ro1lover contríbutions |  |
| 3 Roth IRA conversion amount |  |
| 5 Fair market va1ue of account | 81,067.62 |
| 7 IRA / SEP / SIMPLE / Roth IRA | SEP ☒ |
| 11 Check if RMD for next year | ☒ |",5498,14,5498,fdc-6f74a479e6a13ddc8aceab13,v11-5498-markdown,original,2024,fgen-f4b01c8ed2bdfa0863d24356,synthetic_programmatic_template,markdown,top,True,
"| Field | Value |
| --- | --- |
| TRUSTEE: | Clearwater Investing |
| RECIPIENT: | Wei Fischer |
| 11 Check if RMD for next year | 0.00 |
| 7 IRA / SEP / SIMPLE / Roth IRA | IRA ☒ |",5498,14,5498,fdc-4c1344d99e4dfa68abcefbac,v11-5498-markdown,original,2022,fgen-e5762e2e151744ff5ae09909,synthetic_programmatic_template,markdown,none,False,
"Copy B For Participant
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, city or town, state or province, country, and ZIP or foreign postal code | Ironwood Wealth Partners 9071 Harbor View Rd Pinecrest, GA 20796 |
| TRUSTEE'S or ISSUER'S TIN | 23-4053892 |
| PARTICIPANT'S name | Kwame Testcase |
| PARTICIPANT'S TIN | ending in 7760 |
| Account number (see instructions) | XXX-XX-923772 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–10, 13a, 14a, and 15a) | 37.80 |
| 2 Rollover contributions | $0.00 |
| 3 Roth IRA conversion amount |  |
| 5 Fair market value of account | $610,698.65 |
| 7 IRA / SEP / SIMPLE / Roth IRA | IRA ☒ |
| 10 Roth IRA contributions | 3,836.56 |
| 11 Check if RMD for next year | ☒ |
## Department of the Treasury - Internal Revenue Service",5498,14,5498,fdc-89b2a0b29f918aed748efa54,v11-5498-markdown,original,2021,fgen-3425db66f2d7c46d0326ab7e,synthetic_programmatic_template,markdown,none,False,
"Form 5498
IRA Contribution Information
## 2023
OMB No. 1545-0747
Copy B For Participant
## This information is being fumished to the IRS.
| Field | Value |
| --- | --- |
| TRUSTEE'S or ISSUER'S name, street address, cíty or town, state or province, country, andZIP or foreign postal code | Clearwater Investing 6l98 Lakeshore Blvd 0ak Grove, TX 17199 |
| TRU5TEE'S or ISSUER'S TIN |59-8118640 |
| PARTICIPANT'S name | Lena Patel |
| PARTICIPANT'5 TIN | ****6728 |
| Street address (induding apt. no.) | 443 ElmPark Pl |
| City or town, state or province, country, and ZIP or foreign postal code| Testville, IL 18784 |
| 1 IRA contributions (other than amounts in boxes 2–4, 8–1O,13a, 14a, and 15a) | S3,331.09 |
| 2 Rollover contributions | |
| 3 Roth IRA conversion amount |  |
| 5 Fair market va1ue of account | $473,472.52 |
| 7 IRA / 5EP / SIMPLE / Roth IRA | IRA ☒ |
| 11 Check if RMD for next year | ☒ |",5498,14,5498,fdc-5664802a624e6da33bcfb640,v11-5498-markdown,original,2023,fgen-43a7e0baa8d516d4f001c2f3,synthetic_programmatic_template,markdown,top,True,
"VOID  CORRECTED
Form 5498-ESA
Coverdell ESA Contribution Information
2021
OMB No. 1545-1815
Copy B For Beneficiary
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Summit Investments 5699 Harbor View Rd Lakewood, CO 90292
TRUSTEE'S TIN
87-5533122
BENEFICIARY'S name
Diego Patel
BENEFICIARY'S TIN
XXXXX1163
Street address (including apt. no.)
746 Sample Street
City or town, state or province, country, and ZIP or foreign postal code
Maplewood, MN 56439
1 Coverdell ESA contributions
6,849.00
2 Rollover contributions
Department of the Treasury - Internal Revenue Service
Form 5498-ESA (keep for your records)  www.irs.gov/Form5498ESA",5498,14,5498,fdc-5507812522f810cb9cec6c34,v11-5498-ESA-stacked,original,2021,fgen-19f065cee715558357a1c0d7,synthetic_programmatic_template,stacked,top,False,
"2023
Copy B For Beneficiary
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Northstar Securities 5925 Harbor View Rd Pinecrest, GA 17101
TRUSTEE'S TIN
53-2434087
BENEFICIARY'S name
Alex E. Romero
BENEFICIARY'S TIN
XXXXX3913
Street address (including apt. no.)
2798 Sample Street
City or town, state or province, country, and ZIP or foreign postal code
Cedar Falls, IA 31250
Account number (see instructions)
****727802
1 Coverdell ESA contributions
2,350.74
2 Rollover contributions
Department of the Treasury - Internal Revenue Service",5498,14,5498,fdc-da9eacef37dfa288686278be,v11-5498-ESA-stacked,original,2023,fgen-a5d2078ad85f437c4bf585bc,synthetic_programmatic_template,stacked,none,False,
"Form 5498-ESA
Coverdell ESA Contribution Information
2025
OMB No. 1545-1815
Copy B For Beneficiary
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Clearwater Investing 8985 Oak Hollow Ct Pinecrest, GA 75050
TRUSTEE'S TIN
93-8848732
BENEFICIARY'S name
Amara Kowalski
BENEFICIARY'S TIN
XXXXX1000
Street address (including apt. no.)
1230 Elm Park Pl
City or town, state or province, country, and ZIP or foreign postal code
Fairview, OH 33859
1 Coverdell ESA contributions
$2,656.45
2 Rollover contributions
0.00
Department of the Treasury - Internal Revenue Service
Form 5498-ESA (keep for your records)  www.irs.gov/Form5498ESA",5498,14,5498,fdc-aba28b3e8db14f0fc5a4cd15,v11-5498-ESA-stacked,original,2025,fgen-ce11e05bf76b1f74bf040289,synthetic_programmatic_template,stacked,top,False,
"CORRECTED (if checked)
Form 5498-ESA
Coverdell ESA Contribution Information
For calendar year 2021
OMB No. 1545-1815
Copy B For Beneficiary
This information is bcing furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign posta1 code
Summit Invcstments 15O6 Granite St Brookhaven, PA 60198
TRUSTEE'S TIN
34-9375382
BENEFICIARY'S name
Kwame L.Tanaka
BENEFICIARY'S TIN
****7939
1 Coverdell ESA contríbutíons
$4,186.87
2 Rollovercontributions
Department of the Treasury - Intemal Revenue Service
Form 5498-ESA (keep for your records)  www.irs.gov/Form5498ESA",5498,14,5498,fdc-a686423086eb99e536eab562,v11-5498-ESA-stacked,original,2021,fgen-c91317d0b01eaecbf77123b4,synthetic_programmatic_template,stacked,top,True,
"Form 5498-ESA Coverdell ESA Contribution Information 2025
TRUSTEE:
Summit Investments
To:
Taylor Adeyemi
1 Coverdell ESA contributions
3,908.46",5498,14,5498,fdc-fa179cf61c9824d59caa0768,v11-5498-ESA-stacked,original,2025,fgen-b6e1e40bfae8bc687e598b3c,synthetic_programmatic_template,stacked,top,False,
"Forcalendar year 2025
OMB No. 1545-1815
Copy B For Beneficiary
TRU5TEE'5 name, street address, city or town, state or province, country, and ZIP or foreign postal code
Northstar Securities 6687 Harbor View Rd Oak Grove, TX 23395
TRUSTEE'S TIN
39-3721841
BENEFICIARY'5 name
Priya Sato
BENEFICIARY'S TIN
****8249
Account number (see instructions)
****460165
1 Coverdell ESA contributions
$2,102.99",5498,14,5498,fdc-d53b92c6f1f5f3380d86d83a,v11-5498-ESA-stacked,original,2025,fgen-9456520410151c9f8fc0acab,synthetic_programmatic_template,stacked,none,True,
"Form 5498-ESA Coverdell ESA Contribution Information 2025
TRUSTEE'S name:
Ironwood Wealth Partners
RECIPIENT:
Riley Kowalski
1 Coverdell ESA contributions
$6,434.95",5498,14,5498,fdc-009c3fcdf89ce38a0a606bef,v11-5498-ESA-stacked,original,2025,fgen-e8b8c0ee42378ab0b886cc59,synthetic_programmatic_template,stacked,top,False,
"Form 5498-ESA Coverdell ESA Contribution Information 2025
From:
Clearwater Investing
Recipient's name:
Riley Kowalski
1 Coverdell ESA contributions
7,634.90",5498,14,5498,fdc-212ef21f288042710eb455fb,v11-5498-ESA-stacked,original,2025,fgen-fa31e407f0679015fc0fbb19,synthetic_programmatic_template,stacked,top,False,
"For calendar year 2025
OMB No. 1545-1815
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Clearwater Investing 8707 Lakeshore Blvd Maplewood, MN 17108
TRUSTEE'S TIN
49-3190694
BENEFICIARY'S name
Morgan Tanaka
BENEFICIARY'S TIN
XXX-XX-3147
Street address (including apt. no.)
2468 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code
Riverton, WI 34515
1 Coverdell ESA contributions
$1,919.18
2 Rollover contributions
Department of the Treasury - Internal Revenue Service
Form 5498-ESA
Coverdell ESA Contribution Information
Form 5498-ESA (keep for your records)  www.irs.gov/Form5498ESA",5498,14,5498,fdc-ec482009755c5882f5138924,v11-5498-ESA-stacked,original,2025,fgen-842ce847d34eb4f1524c62bd,synthetic_programmatic_template,stacked,bottom,False,
"VOID CORRECTED
OMB No. 1545-1815
Copy B For Beneficiary
This information is being fumished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Evergreen Brokerage 5ervices 5423 Willow Bend Way Riverton, WI 4l062
TRU5TEE'S TIN
38-7913380
BENEFICIARY'S name
Wei Nguyen
BENEFICIARY'S TIN
****1997
Street address (including apt. no.)
8231 Prairie Ave
City or town,state or province, country, and ZIP or foreign postal code
Fairview, OH 80372
1 Coverde1l ESA contributions
4,930.54
Form 5498-ESA
Coverdell E5A Contríbution Information",5498,14,5498,fdc-6e2227190b8edbc1fda96718,v11-5498-ESA-stacked,original,2025,fgen-3b844347bf3540ec47c072c8,synthetic_programmatic_template,stacked,bottom,True,
"For calendar year 2023
OMB No. 1545-1815
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Evergreen Brokerage Services 3603 Lakeshore Blvd Oak Grove, TX 89432
TRUSTEE'S TIN
65-5972762
BENEFICIARY'S name
Jordan Tanaka
BENEFICIARY'S TIN
XXXXX8886
Account number (see instructions)
XXXXX458952
1 Coverdell ESA contributions
$1,939.47
2 Rollover contributions
0.00
Department of the Treasury - Internal Revenue Service
Form 5498-ESA
Coverdell ESA Contribution Information
Form 5498-ESA (keep for your records)  www.irs.gov/Form5498ESA",5498,14,5498,fdc-392a06f38670dbf48c862d34,v11-5498-ESA-stacked,original,2023,fgen-d2a8d376d1fb43cc6286f467,synthetic_programmatic_template,stacked,bottom,False,
"Form 5498-ESA
Coverdell ESA Contribution Information
2021
OMB No. 1545-1815
Copy B For Beneficiary
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Clearwater Investing 5789 Sample Street Lakewood, CO 12382
TRUSTEE'S TIN
34-8131371
BENEFICIARY'S name
Jamie Haddad
BENEFICIARY'S TIN
***-**-1494
1 Coverdell ESA contributions
$4,997.26
2 Rollover contributions",5498,14,5498,fdc-3ce9e4f4752072dec69af309,v11-5498-ESA-stacked,original,2021,fgen-2cddb4b1f08743226918d449,synthetic_programmatic_template,stacked,top,False,
"Form 5498-ESA
Coverdell ESA Contribution Information
2021
OMB No. 1545-1815
Copy B For Beneficiary
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code
Northstar Securities 7617 Granite St Riverton, WI 91738
TRUSTEE'S TIN
51-3613128
BENEFICIARY'S name
Jamie Lindqvist
BENEFICIARY'S TIN
****1044
Street address (including apt. no.)
8826 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code
Pinecrest, GA 31091
1 Coverdell ESA contributions
7,169.78
2 Rollover contributions
$0.00
Department of the Treasury - Internal Revenue Service
Form 5498-ESA (keep for your records)  www.irs.gov/Form5498ESA",5498,14,5498,fdc-0e345769bfd97d26122dae1f,v11-5498-ESA-stacked,original,2021,fgen-791f0a90bca371372d6cd34c,synthetic_programmatic_template,stacked,top,False,
"2025
Copy B For Beneficiary
TRUSTEE'S name,street address, city or town, state or province, country, and ZIP or foreign postal code
Ironwood Wealth Partners 9894 0ak Hollow Ct Cedar Falls, IA 21390
TRUSTEE'S TIN
54-9271587
BENEFICIARY'S name
Alex Romero
BENEFICIARY'S TIN
ending in 8l56
Street address (induding apt. no.)
2098 Maple Ridge Dr
City or town, state or province, country, and ZIP orforeígn postal code
Pinecrest, GA 87232
1 Coverdell ESA contributions
S3,918.99
2 Rollovcr contributions
Department of the Treasury - Intemal Revenue Service",5498,14,5498,fdc-0e6e86668df48924bcc61918,v11-5498-ESA-stacked,original,2025,fgen-f847d3c12efb28fc7bdca0ec,synthetic_programmatic_template,stacked,none,True,
"TRUSTEE:
Clearwater Investing
To:
Kwame Moreau
1 Coverdell ESA contributions
5,341.21",5498,14,5498,fdc-46cf9e84d3b9752f77b809dc,v11-5498-ESA-stacked,original,2023,fgen-c95c7d2176e238942742c420,synthetic_programmatic_template,stacked,none,False,
"Form 5498-ESA
Coverdell ESA Contribution Information
0MB No. 1545-1815
Copy B For Beneficiary
This information is being fumished to the IRS.
TRUSTEE'S name, street address, city or town,stateor provínce, country, and ZIP or foreign postal code
Northstar Securities 7006 Maple Ridge Dr 0ak Grove, TX 91823
TRU5TEE'S TIN
94-8913850
BENEFICIARY'S name
Priya Rivera
BENEFICIARY'S TIN
XXXXX2508
Account number (see instructions)
***-**-540858
l Coverdell ESA contributions
S8,843.37",5498,14,5498,fdc-498ddc539b581d4463454753,v11-5498-ESA-stacked,original,2021,fgen-e3497030546db0e6bc4145ba,synthetic_programmatic_template,stacked,top,True,
"☐ CORRECTED
Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
For calendar year 2021
OMB No. 1545-1518
Copy B For Participant
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code      Northwind HSA Custodian 5590 Harbor View Rd Fairview, OH 48505
TRUSTEE'S TIN      43-4843741
PARTICIPANT'S name Kwame Larsen
PARTICIPANT'S TIN      XXXXX8586
Street address (including apt. no.)      7160 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code Lakewood, CO 53332
1 Employee or self-employed person's Archer MSA contributions
2 Total contributions made in the tax year $6,185.04
3 Total HSA or Archer MSA contributions made in the following year for the tax year $0.00
4 Rollover contributions
5 Fair market value of HSA, Archer MSA, or MA MSA      124,261.74
6 HSA / Archer MSA / MA MSA HSA ☒",5498,14,5498,fdc-ff2bd60ee3731d3cacd06541,v11-5498-SA-inline,original,2021,fgen-868165d609222ffb5f9e1878,synthetic_programmatic_template,inline,top,False,
"For calendar year 2022
OMB No. 1545-1518
Copy B For Participant
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northwind HSA Custodian 1549 Lakeshore Blvd Cedar Falls, IA 65481
TRUSTEE'S TIN  58-3268787
PARTICIPANT'S name Casey K. Adeyemi
PARTICIPANT'S TIN XXX-XX-2878
Street address (including apt. no.) 2006 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code Brookhaven, PA 43831
1 Employee or self-employed person's Archer MSA contributions
2 Total contributions made in the tax year   1,681.28
3 Total HSA or Archer MSA contributions made in the following year for the tax year
4 Rollover contributions 0.00
5 Fair market value of HSA, Archer MSA, or MA MSA 137,865.88
6 HSA / Archer MSA / MA MSA  HSA ☒
Department of the Treasury - Internal Revenue Service
Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
Form 5498-SA (keep for your records)  www.irs.gov/Form5498SA",5498,14,5498,fdc-9dea72a14d48e62afb857562,v11-5498-SA-inline,original,2022,fgen-35138320a24addf7bfba39b7,synthetic_programmatic_template,inline,bottom,False,
"Form 5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information 2026
From:   Northwind HSA Custodian
RECIPIENT: Priya A. Walsh
6 HSA / Archer MSA / MA MSA HSA ☒
5 Fair market value of HSA, Archer MSA, or MA MSA $110,268.85
2 Total contributions made in the tax year  $2,684.15",5498,14,5498,fdc-078bdd0ac5bb887ee7a63b45,v11-5498-SA-inline,original,2026,fgen-4b3a6aa5935c7177bae68e60,synthetic_programmatic_template,inline,top,False,
"Form 5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information 2021
TRUSTEE'S name: Northwind HSA Custodian
Recipient's name:      Casey Testcase
2 Total contributions made in the tax year $3,510.71
6 HSA / Archer MSA / MA MSA HSA ☒
5 Fair market value of HSA, Archer MSA, or MA MSA      92,338.18",5498,14,5498,fdc-c723f28d5fca8922bb65b438,v11-5498-SA-inline,original,2021,fgen-4afa45a937dcf729980941a6,synthetic_programmatic_template,inline,top,False,
"Form 5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information
From: Evergreen Health Savings
Recipient's name:      Olivia B. Moreau
6 HSA / Archer MSA / MA MSA      HSA ☒
2 Total contributions made in the tax year      4,712.15
5 Fair market value of HSA, Archer MSA, or MA MSA      9,459.62",5498,14,5498,fdc-8fe6243a3b9e64eb06cdaefd,v11-5498-SA-inline,original,2023,fgen-b9cc3babffecb481b6afef53,synthetic_programmatic_template,inline,top,False,
"Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
2025
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code  Northwind HSA Custodian 3621 Elm Park Pl Cedar Falls, IA 97612
TRUSTEE'S TIN 38-5292360
PARTICIPANT'S name   Morgan Tanaka
PARTICIPANT'S TIN ending in 7110
Account number (see instructions)      ****949817
1 Employee or self-employed person's Archer MSA contributions   $0.00
2 Total contributions made in the tax year      4,478.18
4 Rollover contributions
5 Fair market value of HSA, Archer MSA, or MA MSA 137,920.37
6 HSA / Archer MSA / MA MSA HSA ☒
Department of the Treasury - Internal Revenue Service
Form 5498-SA (keep for your records)  www.irs.gov/Form5498SA",5498,14,5498,fdc-b49a2f7dde20a0dc718840fe,v11-5498-SA-inline,original,2025,fgen-a0c1cc7224345c62b53f0aa3,synthetic_programmatic_template,inline,top,False,
"From:  Evergreen Health Savings
To: Amara Wa1sh
2 Total contributions made in the tax year  8,452.70",5498,14,5498,fdc-841ba47b26210c131f681b56,v11-5498-SA-inline,original,2022,fgen-cef3c522e72877880d190785,synthetic_programmatic_template,inline,none,True,
"☐ CORRECTED
For calendar year 2021
Copy B For Participant
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Northwind HSA Custodian 7551 Willow Bend Way Oak Grove, TX 80122
TRUSTEE'S TIN      24-2607121
PARTICIPANT'S name Olivia Romero
PARTICIPANT'S TIN  ***-**-6093
Street address (including apt. no.)  5015 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code  Lakewood, CO 12015
Account number (see instructions) ****388341
1 Employee or self-employed person's Archer MSA contributions
2 Total contributions made in the tax year   3,239.56
3 Total HSA or Archer MSA contributions made in the following year for the tax year  $0.00
4 Rollover contributions $0.00
5 Fair market value of HSA, Archer MSA, or MA MSA      19,820.96
Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information",5498,14,5498,fdc-800a83903f0cdbd90dc1e0b4,v11-5498-SA-inline,original,2021,fgen-18f557e2d91f831a3677b648,synthetic_programmatic_template,inline,bottom,False,
"Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
For calendar year 2025
OMB No. 1545-1518
Copy B For Participant
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code  Sample HSA Bank 6013 Granite St Fairview, OH 69491
TRUSTEE'S TIN 31-5044396
PARTICIPANT'S name      Noah Romero
PARTICIPANT'S TIN  ****2679
Street address (including apt. no.)  8823 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code  Maplewood, MN 25032
Account number (see instructions)   ****424526
1 Employee or self-employed person's Archer MSA contributions
2 Total contributions made in the tax year      $473.90
3 Total HSA or Archer MSA contributions made in the following year for the tax year
4 Rollover contributions $0.00
5 Fair market value of HSA, Archer MSA, or MA MSA   126,158.88",5498,14,5498,fdc-cb805b690f79befab8af58e9,v11-5498-SA-inline,original,2025,fgen-498285d948a24f2bd9127be5,synthetic_programmatic_template,inline,top,False,
"VOID  CORRECTED
Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
For calendar year 2022
OMB No. 1545-1518
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code  Evergreen Health Savings 6265 Lakeshore Blvd Testville, IL 21224
TRUSTEE'S TIN 13-2696454
PARTICIPANT'S name  Jamie Romero
PARTICIPANT'S TIN      ****0960
Street address (including apt. no.) 8603 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code   Fairview, OH 89083
1 Employee or self-employed person's Archer MSA contributions      $0.00
2 Total contributions made in the tax year 822.76
3 Total HSA or Archer MSA contributions made in the following year for the tax year      $0.00
5 Fair market value of HSA, Archer MSA, or MA MSA  37,355.71
6 HSA / Archer MSA / MA MSA  HSA ☒
Department of the Treasury - Internal Revenue Service
Form 5498-SA (keep for your records)  www.irs.gov/Form5498SA",5498,14,5498,fdc-489d3e0e6e58d038ce2fc910,v11-5498-SA-inline,original,2022,fgen-9216a00a573ed4e889379a14,synthetic_programmatic_template,inline,top,False,
"CORRECTED (if checked)
Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
2026
OMB No. 1545-1518
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code Sample HSA Bank 7308 Lakeshore Blvd Lakewood, CO 98020
TRUSTEE'S TIN  77-6996269
PARTICIPANT'S name Sofia Adeyemi
PARTICIPANT'S TIN   ***-**-0861
Account number (see instructions)      XXXXX302525
1 Employee or self-employed person's Archer MSA contributions 0.00
2 Total contributions made in the tax year      $3,561.19
3 Total HSA or Archer MSA contributions made in the following year for the tax year
5 Fair market value of HSA, Archer MSA, or MA MSA      11,701.54
6 HSA / Archer MSA / MA MSA   HSA ☒
Department of the Treasury - Internal Revenue Service
Form 5498-SA (keep for your records)  www.irs.gov/Form5498SA",5498,14,5498,fdc-05230d63758ca3c73fbe9229,v11-5498-SA-inline,original,2026,fgen-e4fc1b4f355cedf05a665dbe,synthetic_programmatic_template,inline,top,False,
"For calendar year 2021
This information is beingfurnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign posta1 code Evergreen Hea1th Savings 403 Cedar Ln Fairview, OH 54489
TRUSTEE'S TIN 37-6330388
PARTICIPANT'S name NoahJ. Rivera
PARTICIPANT'S TIN ending in 2911
Street address (induding apt. no.)   4164 Willow Bend Way
City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 72070
Account number (see instructions) XXXXX966023
2 Total contributions made in the tax year 2,120.38
3 Total H5A or Archer MSAcontributions made in the following year for the tax year $0.00
4Rollover contributions
5 Fair market value of HSA, Archer MSA, or MA MSA      $l26,356.25
6 HSA / Archer MSA / MA MSA HSA ☒
Departmentof the Treasury - Internal Revenue Servíce
Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
Form 5498-SA (keep for your records)  www.irs.gov/Form5498SA",5498,14,5498,fdc-b9f42fc3ec5c9a0ede6e3aee,v11-5498-SA-inline,original,2021,fgen-de2146630384305527b4a6de,synthetic_programmatic_template,inline,bottom,True,
"Form 5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information
From:   Evergreen Health Savings
Recipient's name: Jamie R. Testcase
2 Total contributions made in the tax year $3,441.43
6 HSA / Archer MSA / MA MSA HSA ☒
5 Fair market value of HSA, Archer MSA, or MA MSA   $77,374.66",5498,14,5498,fdc-48e69ab89d08be0379e20711,v11-5498-SA-inline,original,2021,fgen-e0cd42b70dd11f37ca777ae0,synthetic_programmatic_template,inline,top,False,
"VOID  CORRECTED
Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
For calendar year 2026
OMB No. 1545-1518
Copy B For Participant
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code   Sample HSA Bank 1970 Willow Bend Way Maplewood, MN 40663
TRUSTEE'S TIN   14-8852202
PARTICIPANT'S name      Sofia Brennan
PARTICIPANT'S TIN ***-**-9062
1 Employee or self-employed person's Archer MSA contributions   0.00
3 Total HSA or Archer MSA contributions made in the following year for the tax year
4 Rollover contributions
5 Fair market value of HSA, Archer MSA, or MA MSA $89,788.66
6 HSA / Archer MSA / MA MSA  HSA ☒
Department of the Treasury - Internal Revenue Service
Form 5498-SA (keep for your records)  www.irs.gov/Form5498SA",5498,14,5498,fdc-2239c047afacb3c810dda0b9,v11-5498-SA-inline,original,2026,fgen-70b5752e524e3f810168b300,synthetic_programmatic_template,inline,top,False,
"Form 5498-SA HSA, Archer MSA, or Medicare Advantage MSA Information 2026
From: Evergreen Health Savings
RECIPIENT: Morgan M. Brennan
5 Fair market value of HSA, Archer MSA, or MA MSA $30,869.78",5498,14,5498,fdc-3bac329052bc087294fad7d5,v11-5498-SA-inline,original,2026,fgen-dc1f83ecc85d5cb6db38cc8e,synthetic_programmatic_template,inline,top,False,
"Form 5498-SA
HSA, Archer MSA, or Medicare Advantage MSA Information
2021
OMB No. 1545-1518
This information is being furnished to the IRS.
TRUSTEE'S name, street address, city or town, state or province, country, and ZIP or foreign postal code  Northwind HSA Custodian 2239 Willow Bend Way Cedar Falls, IA 42538
TRUSTEE'S TIN      21-5414007
PARTICIPANT'S name Taylor D. Walsh
PARTICIPANT'S TIN ***-**-5551
1 Employee or self-employed person's Archer MSA contributions
2 Total contributions made in the tax year $7,807.92
3 Total HSA or Archer MSA contributions made in the following year for the tax year
4 Rollover contributions   $0.00
6 HSA / Archer MSA / MA MSA HSA ☒",5498,14,5498,fdc-6777c9666cfcdeca55ad0687,v11-5498-SA-inline,original,2021,fgen-72c49e7eacefa5499fb96df0,synthetic_programmatic_template,inline,top,False,
"☐ CORRECTED
Form 8283
Noncash Charitable Contributions
For calendar year 2025
OMB No. 1545-0074
Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property.
Department of the Treasury Internal Revenue Service
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Sample Community Food Bank 8387 Willow Bend Way Brookhaven, PA 87286
27-8288098
Morgan J. Nguyen
****1623
4486 Maple Ridge Dr
Lakewood, CO 11634
***-**-996600
Laptop computer, fair
09/21/2025
October 28, 2024
Purchase
3,137.12
$3,249.35
Appraisal
Department of the Treasury - Internal Revenue Service
Form 8283 (keep for your records)  www.irs.gov/Form8283",8283,17,8283,fdc-ad921feeb6bb9f7a12f05b88,v11-8283-columns,original,2025,fgen-146e0abc76859e51ae6a2d72,synthetic_programmatic_template,columns,top,False,
"Form8283
Noncash Charitable Contributions
2024
OMB No. 1545-0074
Attach one or more Forms 8283 to your tax return if you claimed a total dcduction of over $5O0 for all contríbuted property.
Department of the Treasury Internal Revenue Service
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, statc or province, country, and ZIP or foreignpostal code
(b) Ifdonated property ísavehicle (see instructions), check the box.Also enter the vehícle identification number
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basís
(h) Fair market va1ue (see ínstructions)
(i) Method used to determine the fair market value
Greenway Animal Rescue 5888 Willow Bend Way Maplewood, MN 44096
29-36246l7
Mateo Testcase
***-**-0984
68l6 Harbor View Rd
Lakewood, CO l6584
Laptop computcr, fair
O2/l8/2024
2024-08-12
Purchase
8,430.39
$6,262.07
Comparablc sales
Department of the Treasury - Intemal Revenue Service
Form 8283 (keep for your records)  www.irs.gov/Form8283",8283,17,8283,fdc-047d2335cc221bffebc19c98,v11-8283-columns,original,2024,fgen-f29969d0dd8bb3f35bff8848,synthetic_programmatic_template,columns,top,True,
"Form 8283
Noncash Charitable Contributions
For calendar year2025
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded 5ecurities
Identifying number
(a) Name and address of the donee organization
5treet address (includingapt. no.)
Cityor town, statc orprovince, country, and ZIP or foreign postal code
(b) If donated property is a vehicle (see instructions),check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(d) Datc of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(i) Method used to determine the fair market value
Riverbend Public Library Foundation 5444 0ak Hollow Ct Pinecrest, GA 53788
l3-5776696
Fatima Walsh
XXX-XX-6223
5796 Ccdar Ln
Fairview, 0H 5366O
Household furniture, good condition
2O24-05-24
2022-06-l0
Purchase
$9,122.12
Thrift shop value
Department of the Treasury - Intemal Revenue Servíce
Form 8283 (keep for your records)  www.irs.gov/Form8283",8283,17,8283,fdc-5f1a7611fc435cfd5c0f849e,v11-8283-columns,original,2025,fgen-39c075caf594e69f08996fd5,synthetic_programmatic_template,columns,top,True,
"Form 8283
Noncash Charitable Contributions
2023
OMB No. 1545-0074
Department of the Treasury Internal Revenue Service
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Riverbend Public Library Foundation 5606 Granite St Maplewood, MN 97495
10-9229839
Hiro Moreau
ending in 3160
Laptop computer, fair
October 13, 2023
November 11, 2022
Inheritance
$5,696.23
9,444.91
Appraisal",8283,17,8283,fdc-f84dba161f672b7fb12e8a78,v11-8283-columns,original,2023,fgen-bdb7a79805f28af4abe033db,synthetic_programmatic_template,columns,top,False,
"Form 8283
Noncash Charitable Contributions
2023
Attach one or more Forms 8283 to your tax rcturn if you daimed a total deduction of overS500 for all contributed property.
Departmentof the Treasury Internal Revenue Service
Name(s) shown on your income tax return
5ection A. Donated Property of $5,000 or Less and Pub1idy Traded Securities
Identifying numbcr
(a) Name and address of the donee organization
Street address (induding apt. no.)
City or town, state or province, country, and ZIP or foreign posta1 code
Account number (see instructions)
(b) If donated property is a vehide (see instructions), check the box.Also enter the vehicle identification number
(c) Description and condition ofdonated property
(d) Dateof the contribution
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Sample Community Food Bank 71O0 Lakeshore Blvd Maplewood, MN 88673
83-3849881
Jamie Walsh
***-**-5215
6696 Prairic Ave
Cedar Falls, IA 34345
***-**-626744
Clothíng, 6 bags, good used
06/28/2023
Gift
8,100.14
8,626.80
Thrift shop value",8283,17,8283,fdc-88649e1d239c5fdcf69af65b,v11-8283-columns,original,2023,fgen-316bc274713a602429038752,synthetic_programmatic_template,columns,top,True,
"Form 8283
Noncash Charitable Contributions
2026
Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property.
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
St. Brendan Parish 2059 Sample Street Bayside, WA 14508
83-5414534
Amara Kowalski
***-**-7163
923 Elm Park Pl
Brookhaven, PA 79686
Clothing, 6 bags, good used
3/11/26
01/20/2026
Inheritance
$5,351.36
Appraisal",8283,17,8283,fdc-9e362cbaa16ed6c737256f4b,v11-8283-columns,original,2026,fgen-18bce6dc753615e19f0800fd,synthetic_programmatic_template,columns,top,False,
"Form 8283 Noncash Charitable Contributions 2026
Name(s) shown on your income tax return:
Recipient's name:
(c) Description and condition of donated property
(i) Method used to determine the fair market value
(d) Date of the contribution
Greenway Animal Rescue
Sofia R. Brennan
Household furniture, good condition
Comparable sales
11/19/2026",8283,17,8283,fdc-6c58f77f7491e61e160241bd,v11-8283-columns,original,2026,fgen-1cc9b3752f6ae8c23bf74599,synthetic_programmatic_template,columns,top,False,
"☐ CORRECTED
Form 8283
Noncash Charitable Contributions
For calendar year 2026
OMB No. 1545-0074
Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property.
Department of the Treasury Internal Revenue Service
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(i) Method used to determine the fair market value
St. Brendan Parish 3628 Sample Street Riverton, WI 18805
88-2778749
Lena Walsh
XXX-XX-9155
7606 Maple Ridge Dr
Pinecrest, GA 82014
Household furniture, good condition
6/28/26
01/19/2026
Gift
5,639.84
Appraisal",8283,17,8283,fdc-36e85ffaaa5acbf919ad6c70,v11-8283-columns,original,2026,fgen-6bc6cb6e2ec8932dd0d298b8,synthetic_programmatic_template,columns,top,False,
"☐ CORRECTED
Form 8283
Noncash Charitable Contributions
2024
OMB No. 1545-0074
Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property.
Department of the Treasury Internal Revenue Service
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Riverbend Public Library Foundation 3895 Lakeshore Blvd Oak Grove, TX 55159
39-3252009
Riley Okafor
***-**-6366
8941 Maple Ridge Dr
Fairview, OH 54629
ending in 433053
Laptop computer, fair
12/28/24
11/12/2024
2,940.26
9,359.07
Appraisal",8283,17,8283,fdc-2ad670a95e6eae44483d87ae,v11-8283-columns,original,2024,fgen-4d46e240432aa1b3fc03fe17,synthetic_programmatic_template,columns,top,False,
"Form 8283
Noncash Charitable Contributions
2023
OMB No. 1545-0074
Department of the Treasury Internal Revenue Service
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(d) Date of the contribution
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Sample Community Food Bank 357 Granite St Fairview, OH 76212
30-3642025
Taylor Larsen
***-**-9890
6894 Lakeshore Blvd
Pinecrest, GA 43407
ending in 219334
Clothing, 6 bags, good used
January 24, 2020
Purchase
$2,767.44
4,919.35
Thrift shop value
Department of the Treasury - Internal Revenue Service
Form 8283 (keep for your records)  www.irs.gov/Form8283",8283,17,8283,fdc-a10660b60fd3deec06afe37c,v11-8283-columns,original,2023,fgen-45242f0ba0c9d24188f5a9dd,synthetic_programmatic_template,columns,top,False,
"☐ CORRECTED
Form 8283
Noncash Charitable Contributions
For calendar year 2025
OMB No. 1545-0074
Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property.
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
Hope Harbor Shelter 3415 Oak Hollow Ct Bayside, WA 13615
61-9242441
Avery Brennan
XXX-XX-6867
8/21/25
2024-05-25
Inheritance
$5,748.94
$52.13
Department of the Treasury - Internal Revenue Service
Form 8283 (keep for your records)  www.irs.gov/Form8283",8283,17,8283,fdc-3cbb9df0cd70c246e61cd2d9,v11-8283-columns,original,2025,fgen-d1996cb87a8256c4fc47de5a,synthetic_programmatic_template,columns,top,False,
"Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Hope Harbor Shelter 7086 Willow Bend Way Brookhaven, PA 29751
66-3985505
Lena L. Haddad
XXXXX0578
9096 Prairie Ave
Bayside, WA 90054
XXXXX228804
Laptop computer, fair
10/24/2019
2021-12-14
Inheritance
$6,378.94
4,982.38
Thrift shop value
Form 8283
Noncash Charitable Contributions",8283,17,8283,fdc-877873e4bd6cbbb8987f5d84,v11-8283-columns,original,2022,fgen-907cd77e1c1fb8486dc15772,synthetic_programmatic_template,columns,bottom,False,
"CORRECTED (if checked)
Form 8283
Noncash Charitable Contributions
OMB No. 1545-0074
Name(s) shown on your income tax return
SectionA. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicleidentification number
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h)Fair market value (see instructions)
(i) Method used to determine the fair markct value
Hope Harbor Shelter 8840 Granite St Bayside, WA 76338
89-4342l37
Hiro Walsh
****0406
Household fumiture, good condition
2023-09-20
0l/20/2026
Gift
36l.99
5,072.49
Thrift shop value
Departmentof the Treasury - Intemal Revenue Service
Form 8283 (keep for your rccords)  www.irs.gov/Form8283",8283,17,8283,fdc-36f37865fde97d7757e06e3b,v11-8283-columns,original,2026,fgen-25af5287b2ffb2eafcee0cc2,synthetic_programmatic_template,columns,top,True,
"VOID  CORRECTED
Form 8283
Noncash Charitable Contributions
2021
Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property.
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(d) Date of the contribution
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Greenway Animal Rescue 8703 Prairie Ave Brookhaven, PA 16525
85-8205031
Jamie Haddad
****8443
7657 Willow Bend Way
Oak Grove, TX 15159
Laptop computer, fair
June 26, 2021
2021-10-05
Purchase
$5,791.34
6,106.39
Appraisal",8283,17,8283,fdc-85d9d5365f3a224884b82e5a,v11-8283-columns,original,2021,fgen-3ddbf7734ff4bc7913efd952,synthetic_programmatic_template,columns,top,False,
"Form 8283
Noncash Charitable Contributions
For calendar year 2023
Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property.
Department of the Treasury Internal Revenue Service
Name(s) shown on your income tax return
Section A. Donated Property of $5,000 or Less and Publicly Traded Securities
Identifying number
(a) Name and address of the donee organization
(b) If donated property is a vehicle (see instructions), check the box. Also enter the vehicle identification number
(c) Description and condition of donated property
(e) Date acquired by donor (mo., yr.)
(f) How acquired by donor
(g) Donor's cost or adjusted basis
(h) Fair market value (see instructions)
(i) Method used to determine the fair market value
Hope Harbor Shelter 6615 Harbor View Rd Maplewood, MN 67320
58-8943525
Jamie Okafor
****0504
Clothing, 6 bags, good used
January 13, 2023
Gift
$9,151.43
$3,496.48
Thrift shop value",8283,17,8283,fdc-5194690d758cbdc4e8da6c51,v11-8283-columns,original,2023,fgen-9ffba83815abb447f4878773,synthetic_programmatic_template,columns,top,False,
"Form 8283 Noncash Charitable Contributions 2021
From:
To:
(i) Method used to determine the fair market value
(f) How acquired by donor
Sample Community Food Bank
Lena Haddad
Thrift shop value
Purchase",8283,17,8283,fdc-0ea08ac561c7075800d8f29d,v11-8283-columns,original,2021,fgen-75cbc3abf35fbc16f4dd24c1,synthetic_programmatic_template,columns,top,False,
"Name:: Wei Nguyen
(e) Cost or other basis: $68,917.52
(a) Description of property: 100 SH ACME CORP
(h) Gain or (loss): 18,466.06
(b) Date acquired: September 4, 2025",8949,22,8949,fdc-d92fbfe98d8271c2be7553e8,v11-8949-boxed,original,2026,fgen-7e93bc6268ee8b67cee0763c,synthetic_programmatic_template,boxed,none,False,
"Form 8949 Sales and Other Dispositions of Capital Assets 2025
Name:: Priya K. Romero
(c) Date sold or disposed of: February 2, 2022",8949,22,8949,fdc-ac9d58cf16bd15b5b56b742f,v11-8949-boxed,original,2025,fgen-6f1d0376e25d3d61850dfa53,synthetic_programmatic_template,boxed,top,False,
"Form 8949 Sales and Other Dispositions of Capital Assets 2022
Name:: Diego Testcase
(h) Gain or (loss): 26,429.91
(a) Description of property: 100 SH ACME CORP",8949,22,8949,fdc-686e196f80b727bb28adb218,v11-8949-boxed,original,2022,fgen-ef382bbfbf67e5cca5a052ce,synthetic_programmatic_template,boxed,top,False,
"Form 8949
Sales and Other Dispositions of Capital Assets
OMB No. 1545-0074
Department of the Treasury Internal Revenue Service
Name(s) shown on return: Jamie Kowalski
Social security number or taxpayer identification number: 784 Willow Bend Way Bayside, WA 57660
Part I Short-Term.: ending in 4137
Part II Long-Term.
(a) Description of property: 50 SH NORTHWIND INC
(b) Date acquired: 2025-11-17
(e) Cost or other basis: $67,018.10
(h) Gain or (loss): 14,089.48",8949,22,8949,fdc-abedcfe1afc43e3688443999,v11-8949-boxed,original,2026,fgen-6cfa2ba560e4ffca703d4eaf,synthetic_programmatic_template,boxed,top,False,
"Form 8949
Sales and Other Dispositions of Capital Assets
2022
Attach to your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Name(s) shown on return: Casey M. Testcase
Social security number or taxpayer identification number: 2964 Maple Ridge Dr Pinecrest, GA 46176
Part I Short-Term.: ending in 1628
Part II Long-Term.
(a) Description of property: VTI
(b) Date acquired: 12/13/2022
(c) Date sold or disposed of: 07/08/2022
(d) Proceeds (sales price): $122,860.48
(e) Cost or other basis: 51,301.34
(h) Gain or (loss): 9,054.45
Department of the Treasury - Internal Revenue Service
Form 8949 (keep for your records)  www.irs.gov/Form8949",8949,22,8949,fdc-9bccabdab46ab8067c56feac,v11-8949-boxed,original,2022,fgen-8632403c0912784ba6f5e633,synthetic_programmatic_template,boxed,top,False,
"☐ CORRECTED
Form 8949
Sales and Other Dispositions of Capital Assets
2025
OMB No. 1545-0074
Attach to your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Department of the Treasury Internal Revenue Service
Name(s) shown on return: Noah Romero
Social security number or taxpayer identification number: 8507 Prairie Ave Bayside, WA 89328
Part I Short-Term.: ending in 5630
Part II Long-Term.
(a) Description of property: 100 SH ACME CORP
(b) Date acquired: 01/08/2025
(c) Date sold or disposed of: 2/24/22
(d) Proceeds (sales price): 113,760.80
(e) Cost or other basis: $73,415.36
Department of the Treasury - Internal Revenue Service
Form 8949 (keep for your records)  www.irs.gov/Form8949",8949,22,8949,fdc-c735ea9156791dffd27f6c99,v11-8949-boxed,original,2025,fgen-8498bb5cad55d1337238fb4b,synthetic_programmatic_template,boxed,top,False,
"OMB No. 1545-0074
Name(s) shown on return: Diego Romero
Social security number or taxpayer identification number: 2109 Maple Ridge Dr Oak Grove, TX 51530
Part I Short-Term.: XXXXX2496
Part II Long-Term.
(a) Description of property: VTI
(b) Date acquired: November 14, 2021
(c) Date sold or disposed of: 2022-11-16
(d) Proceeds (sales price): $129,222.09
(e) Cost or other basis: 124,274.55
Form 8949
Sales and Other Dispositions of Capital Assets",8949,22,8949,fdc-dbb724040f7b31484457a70e,v11-8949-boxed,original,2022,fgen-2db806f11cad8dee151d96eb,synthetic_programmatic_template,boxed,bottom,False,
"CORRECTED (if checked)
Form 8949
Sales and Other Dispositions of Capital Assets
For calendar year 2026
OMB No. 1545-0074
Attach to your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Department of the Treasury Internal Revenue Service
Name(s) shown on return: Kwame Sato
Social security number or taxpayer identification number: 825 Sample Street Pinecrest, GA 22401
Part I Short-Term.: ****9431
Part II Long-Term.
(a) Description of property: BND
(b) Date acquired: 08/13/2023
(c) Date sold or disposed of: 2023-05-24
(d) Proceeds (sales price): 104,995.85
(e) Cost or other basis: 73,490.05
(h) Gain or (loss): 16,350.54
Department of the Treasury - Internal Revenue Service
Form 8949 (keep for your records)  www.irs.gov/Form8949",8949,22,8949,fdc-8d10b3eb073cc232ed854267,v11-8949-boxed,original,2026,fgen-563c7edcc6c591a796fe8c68,synthetic_programmatic_template,boxed,top,False,
"Form 8949
Sales and Other Dispositions of Capital Assets
2025
OMB No. 1545-0074
Attach to your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Name(s) shown on return: Sofia Kowalski
Social security number or taxpayer identification number: 5437 Lakeshore Blvd Oak Grove, TX 30510
Part I Short-Term.: ***-**-5796
Part II Long-Term.
(b) Date acquired: June 1, 2024
(c) Date sold or disposed of: 1/13/25
(d) Proceeds (sales price): $56,966.56
(e) Cost or other basis: $97,609.88
(h) Gain or (loss): (6,623.81)",8949,22,8949,fdc-3fbc22419daeee3f1c1aba00,v11-8949-boxed,original,2025,fgen-352f389f0ededc2654992241,synthetic_programmatic_template,boxed,top,False,
"Name:: Mateo M. Tanaka
(c) Date sold or disposed of: August 4, 2018
Form 8949 Sales and Other Dispositions of Capital Assets 2021",8949,22,8949,fdc-9bcc92c896f90b025924a6de,v11-8949-boxed,original,2021,fgen-2bdd4f1a1dd6befbc42af00a,synthetic_programmatic_template,boxed,bottom,False,
"Form 8949
Sales and Other Dispositions of Capital Assets
Attach to your Schedule D to list your transactions for lincs 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Departmentof the Treasury Internal Revenue Service
Name(s) shown on return:Lena Larsen
Social security number or taxpaycr identification number: 3584 Cedar Ln 0ak Grove, TX 64526
Part I Short-Term.: XXX-XX-2882
Part II Long-Term.
(a) Description of property: MSFT
(b) Date acquíred: Ju1y 20, 2023
(d) Procceds (sales price): 36,155.76
(e) Cost orother basis: S32,774.92
(h) Gain or (loss): (6,O94.92)",8949,22,8949,fdc-186355b8ff7e3d690ee46ed5,v11-8949-boxed,original,2026,fgen-fcc1511650da755f71b2f7bc,synthetic_programmatic_template,boxed,top,True,
"For calendar year 2024
OMB No. 1545-0074
Name(s) shown on return: Casey Adeyemi
Social security number or taxpayer identification number: 4295 Oak Hollow Ct Testville, IL 98652
Part I Short-Term.: ****9061
Part II Long-Term.
(a) Description of property: SCHD
(b) Date acquired: October 15, 2024
(c) Date sold or disposed of: April 18, 2023
(d) Proceeds (sales price): 104,187.35
(e) Cost or other basis: 14,362.86
(h) Gain or (loss): (120.16)
Department of the Treasury - Internal Revenue Service
Form 8949
Sales and Other Dispositions of Capital Assets
Form 8949 (keep for your records)  www.irs.gov/Form8949",8949,22,8949,fdc-29d1f976109d8c57f7c5d0b1,v11-8949-boxed,original,2024,fgen-5be868781c501f1a7d8cd399,synthetic_programmatic_template,boxed,bottom,False,
"OMB No. 1545-0074
Attach to your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Name(s) shown on return: Jamie Testcase
Social security number or taxpayer identification number: 1738 Oak Hollow Ct Bayside, WA 73319
Part I Short-Term.: XXX-XX-4572
Part II Long-Term.
(b) Date acquired: 01/13/2021
(c) Date sold or disposed of: 06/13/2021
(d) Proceeds (sales price): 90,891.97
(e) Cost or other basis: 26,219.23
(h) Gain or (loss): (5,782.22)",8949,22,8949,fdc-c40fdfc139ea3db8fe978309,v11-8949-boxed,original,2024,fgen-de1e44c44df7a99bda55f417,synthetic_programmatic_template,boxed,none,False,
"Form 8949
Sales and Other Dispositions of Capital Assets
For calendar year 2024
Department of the Treasury Internal Revenue Service
Name(s) shown on return: Taylor Sato
Social security number or taxpayer identification number: 8533 Granite St Oak Grove, TX 83933
Part I Short-Term.: ****0377
Part II Long-Term.
(a) Description of property: VTI
(b) Date acquired: 10/18/2024
(c) Date sold or disposed of: October 1, 2024
(d) Proceeds (sales price): 32,016.61
(e) Cost or other basis: $45,910.52
(h) Gain or (loss): 8,843.95
Department of the Treasury - Internal Revenue Service
Form 8949 (keep for your records)  www.irs.gov/Form8949",8949,22,8949,fdc-e0ddd46a13eba8456671b9b6,v11-8949-boxed,original,2024,fgen-960ad15871d75be78ca3588b,synthetic_programmatic_template,boxed,top,False,
"Form 8949
Sales and Other Dispositions of Capital Assets
OMB No. 1545-0074
Attach to your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Department of the Treasury Internal Revenue Service
Name(s) shown on return: Fatima M. Rivera
Social security number or taxpayer identification number: 7445 Oak Hollow Ct Fairview, OH 90861
Part I Short-Term.: ****4111
Part II Long-Term.
(a) Description of property: 100 SH ACME CORP
(c) Date sold or disposed of: June 22, 2020
(d) Proceeds (sales price): 96,686.15
(e) Cost or other basis: $72,880.60
(h) Gain or (loss): 2,647.64",8949,22,8949,fdc-3ebf9eda3e849317c4f446d1,v11-8949-boxed,original,2023,fgen-3157bff1cde3666fd7cd9b14,synthetic_programmatic_template,boxed,top,False,
"2025
Attach to your Schedule D to list your transactions for lines 1b, 2, 3, 8b, 9, and 10 of Schedule D.
Name(s) shown on return: Alex Castillo
Social security number or taxpayer identification number: 9790 Elm Park Pl Brookhaven, PA 52874
Part I Short-Term.: XXXXX0307
Part II Long-Term.
(b) Date acquired: April 22, 2025
(c) Date sold or disposed of: 8/3/24
(d) Proceeds (sales price): 31,492.14
(e) Cost or other basis: $11,424.57
(h) Gain or (loss): 15,091.51
Form 8949
Sales and Other Dispositions of Capital Assets",8949,22,8949,fdc-287ad373e91c63fa516f1d1e,v11-8949-boxed,original,2025,fgen-804eb049dd95275e4fd42140,synthetic_programmatic_template,boxed,bottom,False,
"2025 AnnualGiving Statement St. Brendan Parish Tax ID 34-6313338 A 501(c)(3) organization Dear Jamie S. 0kafor, Thank you for your gencrous support
this year. Date Method Amount February 27, 2025 Cash 390.56 12/15/25 On1ine gift 1,003.11 12/07/2025
Online gift 2,368.24 January 6, 2025 Stock transfer 173.43 9/26/25 Cash l,047.45 8/17/25 Stock transfer 324.24 Total contributions $5,307.03 Onlyintangible religious benefits were provided in exchange for your gifts.",DONATION_RECORD,28,DONATION_RECORD,fdc-82a92da8e53c3f91c74ee6f9,v11-ANNUAL_GIVING_STATEMENT-flat,original,2025,fgen-da1b6a66d49bd2d0dd8c1b52,synthetic_programmatic_template,flat,top,True,daf_grant_summary
"Contribution Statement for 2024 St. Brendan Parish Tax ID 40-4504839 A 501(c)(3) organization Dear Lena Walsh, Thank you for your generous support this year. Date Method Amount July 2, 2024 Check #9738 368.37 05/13/2024 Stock transfer 741.69 3/1/24 Online gift 1,973.36
7/7/24 Check #8673 2,028.38 6/14/24 Cash 739.35 Total contributions $5,851.15 No goods or services were
provided in exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-db630a7854c07e4ec688d3fd,v11-ANNUAL_GIVING_STATEMENT-flat,original,2024,fgen-aa55c0bfd0d1fe8a547435a0,synthetic_programmatic_template,flat,top,False,nonprofit
"Year-End Giving Summary Hope Harbor Shelter Tax ID 89-2181267 A 501(c)(3) organization Dear Kwame Rivera, Thank you
for your generous support this year.Date Method Amount Apri1 8, 2O24 Stock transfer 1,677.52 2024-01-07 Check #7821 1,077.13 3/17/24 Online gift 1,231.76 Tota1
contributions S3,986.41 No goods orservices were provided in exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-8654b8273d08bb571ea0ec23,v11-ANNUAL_GIVING_STATEMENT-flat,original,2024,fgen-91543c40920225b9579fed58,synthetic_programmatic_template,flat,top,True,nonprofit
"Contribution Statement for 2023 St. Brendan Parish Tax ID 73-2825171 A 501(c)(3) organization Dcar Morgan
5ato, Thank you for your gcnerous support thís year. DateMethod Amount
May 2, 2023 Online gift 2,076.76 2023-11-27 Cash 1,561.22 2023-10-22 Onlinegift 1,215.07 2023-08-03 Check #1957 1,287.02 May 6, 2023 5tock transfer 2,063.08 Total contributions $8,203.15 No goods or services were provided in exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-d121bb32e4d1e197dfc848dc,v11-ANNUAL_GIVING_STATEMENT-flat,original,2023,fgen-b413c0a1655bd5fb734816c3,synthetic_programmatic_template,flat,top,True,daf_grant_summary
"Riverbend Public Library Foundation Tax ID 25-2369856
A 501(c)(3) organization Dear Amara Romero, Thank you for your generous support this year. Date Method Amount January 23, 2026 Stock
transfer 413.30 08/16/2026 Cash 45.13 09/07/2026 Stock transfer 938.12 Total contributions $1,396.55 Only intangible religious benefits were provided in exchange for your gifts.",DONATION_RECORD,28,DONATION_RECORD,fdc-1069786787593062d19b1345,v11-ANNUAL_GIVING_STATEMENT-flat,original,2026,fgen-c527100400a26fc094360dc9,synthetic_programmatic_template,flat,none,False,church
"Year-End Giving Summary Hope Harbor Shelter Tax ID
11-3115068 A 501(c)(3) organization Dear
Fatima Castillo, Thank you for your generous support this year. Date Method Amount 11/6/25 Check #4586 1,084.03 October 3, 2025 Cash 1,666.36 2025-11-21 Stock transfer 2,179.80 04/15/2025 Stock transfer 1,153.77 2/11/25 Check #4624 74.05 November 2, 2025 Cash 296.12 Total contributions $6,454.13 No goods or services were provided in exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-be0600b0cc915205f5d05889,v11-ANNUAL_GIVING_STATEMENT-flat,original,2025,fgen-d79341f915af15a29635cca9,synthetic_programmatic_template,flat,top,False,nonprofit
"Hope Harbor Shelter Tax ID
69-8587458 A 501(c)(3) organization Dear Morgan Patel, Thank you for your generous support this year. Date Method Amount 9/26/24 Online gift
1,348.36 09/27/2024 Cash 1,062.20 2024-04-24 Cash 1,896.45 2024-07-21 Stock transfer 2,140.47 Total contributions $6,447.48 No goods or services were provided in exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-ae25169130031139810dfe07,v11-ANNUAL_GIVING_STATEMENT-flat,original,2024,fgen-98ed5aae6b9525c39f3505c7,synthetic_programmatic_template,flat,none,False,nonprofit
"Contribution Statement for 2023 Riverbend Public Library Foundation Tax ID 23-4209388 A 501(c)(3) organization Dear Taylor K. Adeyemi, Thank you for your generous support this year. Date Method Amount 03/07/2023 Check #8779 276.67
2023-04-18 Online gift 1,242.92 04/27/2023 Check #4213 490.35 2023-04-13 Stock transfer 1,754.77 2/14/23 Cash
79.35 2023-08-09 Check #6754 383.47 04/03/2023 Check #8104 345.16 8/24/23 Online gift 1,286.64 Total contributions $5,859.33 Only intangible religious benefits were provided in exchange for your gifts.",DONATION_RECORD,28,DONATION_RECORD,fdc-c4a1386a8afbf2286994270b,v11-ANNUAL_GIVING_STATEMENT-flat,original,2023,fgen-cd2f206fa4ef0fdc48c9c880,synthetic_programmatic_template,flat,top,False,church
"Riverbend Public Library Foundation Tax
ID 43-9722851 A 501(c)(3) organization Dear Noah Tanaka, Thank you for your generous support this year. Date Method Amount 2021-04-02 Stock transfer 1,043.35 September 11, 2021 Stock transfer 1,310.62 June 2, 2021 Cash 1,611.35 Total contributions $3,965.32 No goods or services were provided in
exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-39619360bb7b1663b00373fb,v11-ANNUAL_GIVING_STATEMENT-flat,original,2021,fgen-a450f4325e943a1830674542,synthetic_programmatic_template,flat,none,False,nonprofit
"2026 Annual Giving Statement Riverbend Public Library Foundation Tax ID 32-8645303 A 501(c)(3) organization Dear Lena B. Castillo, Thank you for your generous support this year. Date Method Amount 10/25/26 Stock transfer 2,349.77 1/19/26 Check #7095 1,124.18 January 12, 2026 Stock transfer 10.71 2026-09-13 Cash 1,034.57 12/23/2026 Stock transfer 329.73 Total contributions $4,848.96
No
goods or services were provided in exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-328fa3f66001e4982b0319a2,v11-ANNUAL_GIVING_STATEMENT-flat,original,2026,fgen-e02dd312bd5f15656af84d72,synthetic_programmatic_template,flat,top,False,nonprofit
"2021 Annual Giving Statement Hope Harbor Shelter Tax ID 45-6704121 A 501(c)(3) organization Dear Sofia R. Adeyemi, Thank you for your generous support this year. Date Method Amount March 21, 2021 Online gift 97.22 December 1, 2021 Online
gift 939.04
3/15/21 Cash 2,086.66 2021-10-15 Stock transfer 711.14 01/27/2021 Online gift 932.59 08/26/2021 Check #6092 2,449.18 2021-03-27 Online gift 1,622.03 2021-09-26 Stock transfer 849.37 Total contributions $9,687.23 No goods or services were provided in exchange for these contributions.",DONATION_RECORD,28,DONATION_RECORD,fdc-cb1b036f81341089d963c04a,v11-ANNUAL_GIVING_STATEMENT-flat,original,2021,fgen-17d5285d6d3ee4c70d9aa55b,synthetic_programmatic_template,flat,top,False,nonprofit
"St.Brendan Parish Tax ID 83-7159872 A 501(c)(3) organization Dear Hiro Fischer, Thank you
for your generous support this year. Date Method Amount 02/25/2022 5tock transfer
429.3O May 4, 2022 Online gift 455.27 September 26, 2022 Onlinegift 1,850.28 09/04/2022 Check #1713 1,249.42 October 3, 2022 0nline gift l,487.75 Total contributions $5,472.02 No goods or services were provided in exchange for these contributions. Contribution Statement for 2022",DONATION_RECORD,28,DONATION_RECORD,fdc-15dc08626cc341f3f16e8377,v11-ANNUAL_GIVING_STATEMENT-flat,original,2022,fgen-40ede6396259237b3e669d48,synthetic_programmatic_template,flat,bottom,True,nonprofit
"Year-End Giving Summary Hope Harbor Shelter Tax ID 36-9624919 A 501(c)(3) organization Dear Kwame Brennan, Thank you for your generous support
this year. Date Method Amount April 7, 2025 Check #3293 103.87 2025-04-02 Check #8479 1,473.20 02/14/2025 Check #5941 1,023.22 2025-04-02 Stock transfer 1,038.69 December 2, 2025 Stock transfer 663.13 Total contributions
$4,302.11 Only intangible religious benefits were provided in exchange for your gifts.",DONATION_RECORD,28,DONATION_RECORD,fdc-f2e91cfa3c9bcfb7ec683f54,v11-ANNUAL_GIVING_STATEMENT-flat,original,2025,fgen-41ffc675fe11aecb2e9eded4,synthetic_programmatic_template,flat,top,False,nonprofit
"2021 Annual Giving Statement Sample Community Food Bank Tax ID 38-8861789 A 501(c)(3) organization Dear Amara Sato, Thank you for your generous support this year.
Date Method Amount 01/12/2021 Stock transfer 264.45 August 2, 2021 Online gift 1,239.84 July 2, 2021 Online gift 300.11 2021-02-16 Check #8743 774.07 Total
contributions $2,578.47 Only intangible religious benefits were provided in exchange for your gifts.",DONATION_RECORD,28,DONATION_RECORD,fdc-cc6d7e5ca063ed0702337eba,v11-ANNUAL_GIVING_STATEMENT-flat,original,2021,fgen-03320cb3f221da3fe3d039ac,synthetic_programmatic_template,flat,top,False,daf_grant_summary
"Contribution Statement for 2022 Riverbend Public Library Foundation Tax ID 78-8730595 A 501(c)(3) organization Dear Amara
J. Okafor, Thank you for your generous support this year. Date Method
Amount 10/20/2022 Stock transfer 882.20 June 7, 2022 Cash 1,674.91 2022-03-19 Online gift 1,393.04 2022-04-18 Check #5164 921.12 Total contributions $4,871.27 Only intangible religious benefits were provided in exchange for your gifts.",DONATION_RECORD,28,DONATION_RECORD,fdc-cc5037e8c43baf927b71d342,v11-ANNUAL_GIVING_STATEMENT-flat,original,2022,fgen-c0bc4b1535a74e11bae4f821,synthetic_programmatic_template,flat,top,False,daf_grant_summary
"Greenway Animal Rescue Tax ID 64-3534581 A 501(c)(3) organization Dear Priya Moreau, Thank you foryour generous support this
year. Date Method Amount 2025-08-19 0nline gift 613.75 2025-12-12 Cash 2,267.24 2025-06-17 Check #3291 1,298.87 Total contributions $4,179.86 Only intangiblc religious benefíts were
provided in exchange for your gifts.2025 Annual Giving 5tatement",DONATION_RECORD,28,DONATION_RECORD,fdc-b023e12315f45372ad00cf0d,v11-ANNUAL_GIVING_STATEMENT-flat,original,2025,fgen-3dccbe974d21e58778f35449,synthetic_programmatic_template,flat,bottom,True,daf_grant_summary
"Checking Account Statement
HarborFederal CreditUnion
| Field | Value |
| --- | --- |
| Account number | ending in 1210 |
|5tatement period | 04/0l/2026 - 04/28/2026 |
Wei Haddad
## 1813 Harbor View Rd Riverton, WI 24269
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $53,424.49 |
| Deposits and othcr credits | $5,723.52 |
| Withdrawals and otherdebits | -$1,549.95 |
| Ending balance | $57,598.06 |
| Interest paid this period | 9.41 |
| Interest paid year-to-date | 740.73 |
| Annual percentage yield earned | 1.33% |
| Date| Description | Amount |
| --- | --- | --- |
| 01/08 | CV5/PHARMACY 0832 | -237.02 |
| 01/24 | WH0LE FOOD5 #1021 | -797.63 |
| 04/13 | STARBUCKS #11872 | -18.86 |
| 01/04 | NETFLIX.C0M | -612.83 |
| 11/17 | AMAZON MKTPLACE | -300.68 |
## Fcdcrally ínsured by NCUA",BANK_STATEMENT,24,BANK_STATEMENT,fdc-36c8048122b81f6598ab11e4,v11-BANK_STATEMENT-markdown,original,2026,fgen-736c9b5f8d76b93c7dd9dc1d,synthetic_programmatic_template,markdown,top,True,checking
"Savings Statement
## Harbor Federal Credit Union
| Field | Value |
| --- | --- |
| Account number | ending in 0384 |
| Statement period | 01/01/2021 - 01/30/2021 |
Avery R. Lindqvist
4018 Harbor View Rd Cedar Falls, IA 45342
## Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $33,184.45 |
| Deposits and other credits | $5,767.78 |
| Withdrawals and other debits | -$2,020.97 |
| Ending balance | $36,931.27 |
| Interest paid this period | $45.74 |
| Interest paid year-to-date | $159.26 |
| Annual percentage yield earned | 2.32% |
| Date | Description | Amount |
| --- | --- | --- |
| 06/04 | TARGET T-2231 | -893.02 |
| 05/14 | TARGET T-2231 | -615.08 |
| 10/11 | HOME DEPOT 0612 | -665.14 |
| 01/07 | UBER TRIP | -517.81 |
| 12/15 | UBER TRIP | -507.02 |
Equal Housing Lender",BANK_STATEMENT,24,BANK_STATEMENT,fdc-fbfd2f01c95c51a8a3aaa84e,v11-BANK_STATEMENT-markdown,original,2021,fgen-5b1933876f130f8d8baa76f1,synthetic_programmatic_template,markdown,top,False,savings
"## Savings Account XXXX1063 - transactions
| Posting Date | Description | Amount | Type | Balance | Check or Slip # |
| --- | --- | --- | --- | --- | --- |
| 15/09/2023 | SHELL OIL 5741 | -2351.28 | CHECK_PAID | 29605.49 |  |
| 22/09/2023 | AMAZON MKTPLACE | -354.50 | CHECK_PAID | 4800.49 |  |
| 17/08/2023 | TARGET T-2231 | -369.30 | CHECK_PAID | 7947.59 |  |
| 17/12/2023 | CVS/PHARMACY 0832 | 323.55 | ACH_CREDIT | 3583.89 |  |
| 09/02/2023 | WHOLE FOODS #1021 | 1996.72 | ATM | 5593.70 |  |
| 2023-10-10 | WHOLE FOODS #1021 | -712.76 | ACH_CREDIT | 19310.13 | 1043 |",BANK_STATEMENT,24,BANK_STATEMENT,fdc-50c2042dfaae5c35fed94b1b,v11-BANK_STATEMENT-markdown,original,2023,fgen-2ef5e723aa457d96ca041e2e,synthetic_programmatic_template,markdown,top,False,raw_export
"Money Market Account Statement
Cedar Valley Credit Union
| Field | Value |
| --- | --- |
| Account number | ending in 5770 |
| Statement period | 08/01/2021 - 08/28/2021 |
## Avery Haddad
3174 Cedar Ln Riverton, WI 43049
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $15,511.56 |
| Deposits and other credits | $559.19 |
| Withdrawals and other debits | -$3,911.29 |
| Ending balance | $12,159.46 |
| Interest paid this period | 33.95 |
| Interest paid year-to-date | $7.61 |
| Annual percentage yield earned | 0.71% |
| Date | Description | Amount |
| --- | --- | --- |
| 09/26 | TARGET T-2231 | 642.24 |
| 04/27 | WHOLE FOODS #1021 | -378.28 |
| 08/17 | SHELL OIL 5741 | -603.54 |
| 06/19 | AMAZON MKTPLACE | -215.45 |
| 09/17 | STARBUCKS #11872 | -235.71 |
| 09/20 | STARBUCKS #11872 | 461.53 |
| 07/20 | COSTCO WHSE #412 | -370.04 |
IRS Form 1099-INT information for 2021 will be mailed separately.
Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-31f85db8a3ed55f25b266207,v11-BANK_STATEMENT-markdown,original,2021,fgen-0eed1108484c51bc845cfc00,synthetic_programmatic_template,markdown,top,False,money_market
"Checking Account Statement
Summit Ridge Bank
| Field | Value |
| --- | --- |
| Account number| XXXXX1187 |
| Statement períod | 03/01/2022 - 03/31/2022 |
Kwame C. Sato
7971 Oak Hollow Ct Cedar Falls, IA 90467
Account summary
| Field | Value |
| ---| --- |
| Beginning balance | $41,782.75 |
| Deposits and other credits | $8,710.90 |
| Withdrawals and other debits | -$1,883.57 |
| Ending balance | $48,61O.08 |
| Date | Description | Amount |
| --- | --- | --- |
| 05/04 | SHELL 0IL 5741 | -416.22 |
| 10/19 | STARBUCKS #11872 | -858.19 |
| 01/11 | CVS/PHARMACY 0832 | -515.70 |
| 06/21 | AMAZONMKTPLACE | 53.60|
| 06/24 | SHELL 0IL 5741 | 72.13 |
## Taxremínder: amounts on thís statement may diffcr from your Form 1099-INT.
Equa1 Housing Lender",BANK_STATEMENT,24,BANK_STATEMENT,fdc-4fb71c86c38a77b324c32e9d,v11-BANK_STATEMENT-markdown,original,2022,fgen-6d53c8e8da6c8ae583e17507,synthetic_programmatic_template,markdown,top,True,checking
"Summit Ridge Bank
| Field | Value |
| --- | --- |
| Account number | ****8626 |
| Statement period | 10/01/2026 - 10/31/2026 |
Morgan Romero
3568 Sample Street Pinecrest, GA 83908
## Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $23,714.18 |
| Deposits and other credits | $5,972.27 |
| Withdrawals and other debits | -$7,662.90 |
| Ending balance | $22,023.55 |
| Interest paid this period | 29.47 |
| Interest paid year-to-date | 598.89 |
| Annual percentage yield earned | 3.78% |
Tax reminder: amounts on this statement may differ from your Form 1099-INT.
Equal Housing Lender",BANK_STATEMENT,24,BANK_STATEMENT,fdc-e8f997ab149aaa6e855be477,v11-BANK_STATEMENT-markdown,original,2026,fgen-1cad218c84ca779982f09812,synthetic_programmatic_template,markdown,none,False,year_end
"Downloaded 03/10/2026
| Transaction Date | Transaction Description | Debit | Credit | Balance |
| --- | --- | --- | --- | --- |
| 12/17/2026 | WHOLE FOODS #1021 | 507.12 | 1863.35 | 7298.15 |
| 18/12/2026 | AMAZON MKTPLACE | 459.69 | 2603.30 | 19434.05 |
| 2026-11-02 | COSTCO WHSE #412 |  | 2660.51 | 20510.17 |
| 05/15/2026 | MOBILE DEPOSIT | 141.77 |  | 28563.88 |
| 17/05/2026 | STARBUCKS #11872 | 226.31 | 2426.13 | 23490.01 |",BANK_STATEMENT,24,BANK_STATEMENT,fdc-1d29f9ed64f11a56cbb4eb76,v11-BANK_STATEMENT-markdown,original,2026,fgen-0853caa6fc9830995edc7e43,synthetic_programmatic_template,markdown,none,False,raw_export
"Savings Statement
## Riverbend Bank & Trust
| Field | Value |
| --- | --- |
| Account number | ending in 0914 |
| Statement period | 09/01/2026 - 09/28/2026 |
## Hiro R. Romero
8181 Cedar Ln Fairview, OH 42463
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $38,867.47 |
| Deposits and other credits | $1,562.46 |
| Withdrawals and other debits | -$6,535.98 |
| Ending balance | $33,893.96 |
| Interest paid this period | 12.79 |
| Interest paid year-to-date | $762.92 |
| Annual percentage yield earned | 4.54% |
| Date | Description | Amount |
| --- | --- | --- |
| 07/23 | DELTA AIR LINES | -872.77 |
| 01/03 | STARBUCKS #11872 | -437.81 |
| 06/02 | WHOLE FOODS #1021 | -437.49 |
| 07/01 | TARGET T-2231 | -234.66 |
| 06/17 | CVS/PHARMACY 0832 | -527.05 |
| 12/17 | SHELL OIL 5741 | 572.01 |
| 10/06 | TARGET T-2231 | -596.93 |
Federally insured by NCUA",BANK_STATEMENT,24,BANK_STATEMENT,fdc-630dbaeec574adb1ed4a4d79,v11-BANK_STATEMENT-markdown,original,2026,fgen-265da48fec3ccbeba208fb86,synthetic_programmatic_template,markdown,top,False,savings
"Northwind Financial
| Field | Value |
| --- | --- |
| Account number | ****6603 |
| Statement period | 12/01/2022 - 12/28/2022 |
Amara Fischer
2203 Harbor View Rd Fairview, OH 40782
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $47,154.77 |
| Deposits and other credits | $8,480.36 |
| Withdrawals and other debits | -$107.46 |
| Ending balance | $55,527.67 |
| Interest paid this period | 37.84 |
| Interest paid year-to-date | 504.03 |
| Annual percentage yield earned | 3.06% |
| Date | Description | Amount |
| --- | --- | --- |
| 04/17 | UBER TRIP | -847.11 |
| 07/26 | HOME DEPOT 0612 | -515.53 |
| 01/22 | COSTCO WHSE #412 | -799.98 |
| 12/24 | CVS/PHARMACY 0832 | 459.24 |
| 12/11 | AMAZON MKTPLACE | -774.38 |
Your 2022 Form 1099-INT will be available online by January 31, 2023.
Federally insured by NCUA
Money Market Account Statement",BANK_STATEMENT,24,BANK_STATEMENT,fdc-62d25fb3b20e9ab88cbd87a0,v11-BANK_STATEMENT-markdown,original,2022,fgen-928031d4cf04b593b606b7f7,synthetic_programmatic_template,markdown,bottom,False,money_market
"Savings Statement
## Harbor Federal Credit Union
| Field | Value |
| --- | --- |
| Account number | XXX-XX-0284 |
| Statement period | 06/01/2021 - 06/30/2021 |
Noah Castillo
## 1119 Lakeshore Blvd Bayside, WA 58215
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $1,405.41 |
| Deposits and other credits | $5,855.92 |
| Withdrawals and other debits | -$2,563.30 |
| Ending balance | $4,698.03 |
| Interest paid this period | 11.49 |
| Interest paid year-to-date | $81.81 |
| Annual percentage yield earned | 0.06% |
| Date | Description | Amount |
| --- | --- | --- |
| 10/03 | NETFLIX.COM | -540.69 |
| 08/04 | NETFLIX.COM | -81.53 |
| 06/24 | DELTA AIR LINES | -540.23 |
| 05/28 | DELTA AIR LINES | -885.29 |
| 07/22 | UBER TRIP | -771.22 |
| 12/24 | TARGET T-2231 | -73.05 |
## Your 2021 Form 1099-INT will be available online by January 31, 2022.
## Federally insured by NCUA",BANK_STATEMENT,24,BANK_STATEMENT,fdc-0ece5f0072b0c4d5cd4d1304,v11-BANK_STATEMENT-markdown,original,2021,fgen-2cf8714d3bcfc1949abd4a59,synthetic_programmatic_template,markdown,top,False,savings
"Savings Statement
## Granite Peak Bank
| Field | Value |
| --- | --- |
| Account number | ****5624 |
| Statement period | 05/01/2023 - 05/30/2023 |
Diego B. Brennan
8896 Sample Street Brookhaven, PA 71582
## Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $56,369.95 |
| Deposits and other credits | $7,185.93 |
| Withdrawals and other debits | -$2,436.45 |
| Ending balance | $61,119.43 |
| Interest paid this period | 33.26 |
| Interest paid year-to-date | $568.03 |
| Annual percentage yield earned | 3.09% |
| Date | Description | Amount |
| --- | --- | --- |
| 04/03 | STARBUCKS #11872 | 605.16 |
| 08/19 | CVS/PHARMACY 0832 | 772.36 |
| 05/15 | NETFLIX.COM | 539.31 |
| 09/15 | NETFLIX.COM | -29.31 |
## This statement is not a Form 1099-INT. Keep it for your records.
Equal Housing Lender",BANK_STATEMENT,24,BANK_STATEMENT,fdc-2fda0df1688ff641318d17c7,v11-BANK_STATEMENT-markdown,original,2023,fgen-ac4e29d683598e2cbcb34ba6,synthetic_programmatic_template,markdown,top,False,savings
"Savings Statement
Prairie State Savings
| Fíeld | Va1ue |
| --- | --- |
| Account number | ****187O |
| Statement period | 11/01/2024 - 11/30/2024 |
Kwame M. Kowalski
7446 Oak Hollow Ct Cedar Falls, IA 26037
Account summary
| Ficld | Valuc |
| --- | --- |
| Beginning balance | $29,438.58 |
| Dcposits and other credits | $1,228.93|
| Withdrawals and other debits | -$7,77O.15 |
| Ending balance | $22,897.35 |
| Interest paid this period | $41.O1 |
| Interest paid year-to-date | $300.83 |
| Annual percentage yield earned | 2.l4% |
| Date | Descríption | Amount |
| --- | --- | --- |
| 10/24 | SHELL OIL 5741 | -894.79|
| 09/05 | STARBUCKS #11872 | -423.47 |
| 10/08 | NETFLIX.COM | -140.44 |
|04/12 | TARGET T-2231 | -665.17 |
| 02/09 | COSTCO WHSE#412 |-822.80 |
| 09/21 | CVS/PHARMACY 0832 | -791.61 |
IRS Form 1099-INT ínformation for 2024 will be mailed separate1y.
MemberFDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-aa55beaf5ad926027270428c,v11-BANK_STATEMENT-markdown,original,2024,fgen-f44a62593b2aaf3836afabc4,synthetic_programmatic_template,markdown,top,True,savings
"| Date | Payee | Memo | Withdrawal | Deposit | Balance |
| --- | --- | --- | --- | --- | --- |
| 2022-06-09 | DELTA AIR LINES |  | 134.10 |  | 14019.51 |
| 2022-10-05 | CVS/PHARMACY 0832 | utilities | 178.52 |  | 12217.66 |
| 01/26/2022 | AMAZON MKTPLACE | utilities | 93.57 |  | 16250.60 |
| 01/06/2022 | COSTCO WHSE #412 |  | 747.20 |  | 15076.79 |
| 14/06/2022 | CVS/PHARMACY 0832 | groceries | 701.03 |  | 14777.58 |
Everyday Checking ...2325",BANK_STATEMENT,24,BANK_STATEMENT,fdc-93e35895ba6fd866c9b74b43,v11-BANK_STATEMENT-markdown,original,2022,fgen-61a7f88277222683def02be6,synthetic_programmatic_template,markdown,bottom,False,raw_export
"Money Market Account Statement
Bayview Community Bank
| Field | Value |
| --- | --- |
| Account number | ***-**-4448 |
| Statement period | 03/01/2022 - 03/28/2022 |
## Diego E. Walsh
4225 Willow Bend Way Cedar Falls, IA 11936
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $53,143.50 |
| Deposits and other credits | $4,361.11 |
| Withdrawals and other debits | -$3,047.59 |
| Ending balance | $54,457.02 |
| Interest paid this period | $56.39 |
| Interest paid year-to-date | 850.40 |
| Annual percentage yield earned | 2.87% |
| Date | Description | Amount |
| --- | --- | --- |
| 09/07 | UBER TRIP | 78.24 |
| 07/07 | CVS/PHARMACY 0832 | -67.06 |
| 11/11 | CVS/PHARMACY 0832 | -803.28 |
| 03/21 | AMAZON MKTPLACE | -835.30 |
| 12/14 | TARGET T-2231 | -47.10 |
| 04/10 | HOME DEPOT 0612 | -154.87 |
| 07/03 | NETFLIX.COM | 471.96 |
Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-c77090d1c214a3b42b9c74bb,v11-BANK_STATEMENT-markdown,original,2022,fgen-754b790985cdbf33dfc80d83,synthetic_programmatic_template,markdown,top,False,money_market
"Checking Account Statement
Northwind Financial
| Field | Value |
| --- | --- |
| Account number | XXXXX0491 |
| Statement period | 06/01/2024 - 06/31/2024 |
## Riley Brennan
## 8505 Maple Ridge Dr Testville, IL 80067
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $16,814.73 |
| Deposits and other credits | $2,775.21 |
| Withdrawals and other debits | -$3,462.93 |
| Ending balance | $16,127.01 |
| Interest paid this period | $10.83 |
| Interest paid year-to-date | 345.53 |
| Annual percentage yield earned | 0.78% |
| Date | Description | Amount |
| --- | --- | --- |
| 05/09 | NETFLIX.COM | -597.80 |
| 02/22 | COSTCO WHSE #412 | -776.62 |
| 01/04 | COSTCO WHSE #412 | -95.57 |
| 10/03 | WHOLE FOODS #1021 | -230.83 |
| 05/15 | TARGET T-2231 | -744.71 |
| 02/16 | STARBUCKS #11872 | 22.50 |
| 01/03 | HOME DEPOT 0612 | 709.05 |
Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-ff31560a02768714f267c18d,v11-BANK_STATEMENT-markdown,original,2024,fgen-307691b8a70dcf42f1c379ef,synthetic_programmatic_template,markdown,top,False,checking
"Meadowlark Savings Bank
| Field | Value |
| --- | --- |
| Account number | XXXXX0358 |
| Statement period | 11/01/2021 - 11/30/2021 |
Avery Adeyemi
3048 Sample Street Oak Grove, TX 11845
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $1,538.21 |
| Deposits and other credits | $899.65 |
| Withdrawals and other debits | -$4,999.54 |
| Ending balance | $0.00 |
| Interest paid this period | 49.93 |
| Interest paid year-to-date | 202.34 |
| Annual percentage yield earned | 2.20% |
| Date | Description | Amount |
| --- | --- | --- |
| 01/26 | SHELL OIL 5741 | -73.32 |
| 05/11 | NETFLIX.COM | -520.69 |
| 04/03 | UBER TRIP | 85.07 |
## Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-19598a72512dc4208113a61c,v11-BANK_STATEMENT-markdown,original,2021,fgen-1e171a0cc988429a5963a342,synthetic_programmatic_template,markdown,none,False,money_market
"2025 Year-End Account Summary
Meadowlark Savings Bank
| Field | Value |
| --- | --- |
| Account number | ending in 6929 |
| Statement period | 10/01/2025 - 10/31/2025 |
Wei J. Patel
8520 Harbor View Rd Oak Grove, TX 32266
## Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $30,213.25 |
| Deposits and other credits | $3,382.88 |
| Withdrawals and other debits | -$7,025.16 |
| Ending balance | $26,570.98 |
| Interest paid this period | $42.77 |
| Interest paid year-to-date | 511.69 |
| Annual percentage yield earned | 0.87% |
## Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-e425f0310f680367a367b6ae,v11-BANK_STATEMENT-markdown,original,2025,fgen-d376383d1b4043a3e5cb7754,synthetic_programmatic_template,markdown,top,False,year_end
"## Savings Statement
Lakeshore National Bank
| Field | Value |
| --- | --- |
| Account number | ***-**-1360 |
| Statement period | 06/01/2023 - 06/30/2023 |
## Diego Rivera
4400 Elm Park Pl Cedar Falls, IA 85677
## Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $53,412.99 |
| Deposits and other credits | $5,844.98 |
| Withdrawals and other debits | -$5,783.59 |
| Ending balance | $53,474.38 |
| Interest paid this period | 12.11 |
| Interest paid year-to-date | $843.97 |
| Annual percentage yield earned | 3.05% |
| Date | Description | Amount |
| --- | --- | --- |
| 01/09 | SHELL OIL 5741 | -189.32 |
| 03/23 | HOME DEPOT 0612 | -727.54 |
| 09/12 | COSTCO WHSE #412 | -483.41 |
| 09/28 | AMAZON MKTPLACE | -547.40 |
This statement is not a Form 1099-INT. Keep it for your records.
## Federally insured by NCUA",BANK_STATEMENT,24,BANK_STATEMENT,fdc-edf36fd6894391436af0e7c5,v11-BANK_STATEMENT-markdown,original,2023,fgen-10d24a017cc2303359ac4325,synthetic_programmatic_template,markdown,top,False,savings
"## Savings Statement
## Northwind Financial
| Field | Value |
| --- | --- |
| Account number | XXX-XX-7006 |
| Statement period | 06/01/2022 - 06/30/2022 |
Jordan Brennan
1030 Prairie Ave Riverton, WI 18287
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $31,527.15 |
| Deposits and other credits | $2,038.93 |
| Withdrawals and other debits | -$3,623.17 |
| Ending balance | $29,942.91 |
| Interest paid this period | 46.90 |
| Interest paid year-to-date | $454.19 |
| Annual percentage yield earned | 4.24% |
| Date | Description | Amount |
| --- | --- | --- |
| 01/26 | COSTCO WHSE #412 | -464.93 |
| 01/03 | AMAZON MKTPLACE | -340.36 |
| 05/16 | AMAZON MKTPLACE | -354.48 |
| 07/18 | NETFLIX.COM | -10.45 |
| 12/04 | UBER TRIP | -690.16 |
| 03/14 | WHOLE FOODS #1021 | -578.85 |
| 05/25 | SHELL OIL 5741 | -773.14 |
## This statement is not a Form 1099-INT. Keep it for your records.
Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-42cca0399cd9c6ac9d7c787f,v11-BANK_STATEMENT-markdown,original,2022,fgen-ca02921a05d00e6536ce0d6c,synthetic_programmatic_template,markdown,top,False,savings
"Savings Statement
Cedar Valley Credit Union
| Field | Value |
| --- | --- |
| Account number | XXXXX8770 |
| Statement period | 11/01/2022 - 11/28/2022 |
Noah Moreau
9029 Sample Street Fairview, OH 66875
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $23,748.91 |
| Deposits and other credits | $5,095.90 |
| Withdrawals and other debits | -$5,691.00 |
| Ending balance | $23,153.81 |
| Interest paid this period | $35.87 |
| Interest paid year-to-date | 722.59 |
| Annual percentage yield earned | 0.13% |
| Date | Description | Amount |
| --- | --- | --- |
| 05/04 | TARGET T-2231 | -525.61 |
| 11/05 | DELTA AIR LINES | -474.00 |
| 06/21 | NETFLIX.COM | -476.40 |
| 01/21 | COSTCO WHSE #412 | -94.32 |
| 10/24 | UBER TRIP | -603.25 |
| 05/22 | TARGET T-2231 | -603.15 |
## Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-31cea6aa7e87c1e83a19a573,v11-BANK_STATEMENT-markdown,original,2022,fgen-6aaebaf6246557c1430cabf1,synthetic_programmatic_template,markdown,top,False,savings
"## Checking Account Statement
## Granite Peak Bank
| Field | Value |
| --- | --- |
| Account number | XXXXX4966 |
| Statement period | 05/01/2023 - 05/28/2023 |
Lena Romero
## 9304 Willow Bend Way Maplewood, MN 28926
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $41,366.64 |
| Deposits and other credits | $6,690.24 |
| Withdrawals and other debits | -$2,103.79 |
| Ending balance | $45,953.09 |
| Date | Description | Amount |
| --- | --- | --- |
| 03/26 | TARGET T-2231 | -291.89 |
| 12/18 | UBER TRIP | -313.46 |
| 05/28 | AMAZON MKTPLACE | 776.19 |
| 02/18 | NETFLIX.COM | -21.83 |
| 08/28 | NETFLIX.COM | 286.68 |
| 11/23 | WHOLE FOODS #1021 | -557.04 |
Federally insured by NCUA",BANK_STATEMENT,24,BANK_STATEMENT,fdc-c0fd5bd1d76f7ae54dd04740,v11-BANK_STATEMENT-markdown,original,2023,fgen-427d3ae2f900631ed58bdbf6,synthetic_programmatic_template,markdown,top,False,checking
"## 2023 Year-End Account Summary
## Lakeshore National Bank
| Field | Value |
| --- | --- |
| Account number | ***-**-7624 |
| Statement period | 05/01/2023 - 05/28/2023 |
Jordan K. Brennan
9102 Granite St Riverton, WI 61159
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $40,498.97 |
| Deposits and other credits | $986.90 |
| Withdrawals and other debits | -$3,799.26 |
| Ending balance | $37,686.61 |
| Interest paid this period | $49.38 |
| Interest paid year-to-date | 144.14 |
| Annual percentage yield earned | 4.46% |
Equal Housing Lender",BANK_STATEMENT,24,BANK_STATEMENT,fdc-6eb76676e0633f1b158c6111,v11-BANK_STATEMENT-markdown,original,2023,fgen-c44cb65fde1e351dd8a4fe93,synthetic_programmatic_template,markdown,top,False,year_end
"Money Market Account Statement
Northwind Financial
| Field | Value |
| --- | --- |
| Account number | XXXXX7529 |
| Statement period | 08/01/2021 - 08/30/2021 |
## Hiro A. Romero
7656 Cedar Ln Pinecrest, GA 39959
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $57,838.75 |
| Deposits and other credits | $2,416.94 |
| Withdrawals and other debits | -$382.73 |
| Ending balance | $59,872.96 |
| Interest paid this period | 51.79 |
| Interest paid year-to-date | $406.37 |
| Annual percentage yield earned | 4.72% |
| Date | Description | Amount |
| --- | --- | --- |
| 01/19 | DELTA AIR LINES | -857.09 |
| 11/20 | UBER TRIP | -513.81 |
| 06/08 | DELTA AIR LINES | -300.97 |
Your 2021 Form 1099-INT will be available online by January 31, 2022.
## Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-e9a6b7544f9a503edbff709e,v11-BANK_STATEMENT-markdown,original,2021,fgen-b051c1254ca5f34fc62a0fbb,synthetic_programmatic_template,markdown,top,False,money_market
"## Northwind Financial
| Field | Value |
| --- | --- |
| Account number | ending in 4566 |
| Statement period | 02/01/2022 - 02/28/2022 |
## Diego Patel
4031 Elm Park Pl Cedar Falls, IA 28257
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $53,174.75 |
| Deposits and other credits | $107.71 |
| Withdrawals and other debits | -$411.22 |
| Ending balance | $52,871.24 |
| Interest paid this period | 46.04 |
| Interest paid year-to-date | 371.33 |
| Annual percentage yield earned | 1.93% |
| Date | Description | Amount |
| --- | --- | --- |
| 06/19 | TARGET T-2231 | -833.11 |
| 12/26 | UBER TRIP | -603.92 |
| 07/24 | UBER TRIP | 784.21 |
| 01/08 | SHELL OIL 5741 | -149.71 |
| 06/28 | SHELL OIL 5741 | -820.71 |
IRS Form 1099-INT information for 2022 will be mailed separately.
Federally insured by NCUA
## Checking Account Statement",BANK_STATEMENT,24,BANK_STATEMENT,fdc-96047a7394016712e91db52d,v11-BANK_STATEMENT-markdown,original,2022,fgen-47abb70ffae5a829903f2de2,synthetic_programmatic_template,markdown,bottom,False,checking
"Savings Account XXXX6191 - transactions
Downloaded 2024-08-09
| Date | Payee | Memo | Withdrawal | Deposit | Balance |
| --- | --- | --- | --- | --- | --- |
| 02/05/2024 | HOME DEPOT 0612 | utilities | 670.07 |  | 12107.24 |
| 06/06/2024 | TARGET T-2231 | rent | 145.18 |  | 10931.04 |
| 11/10/2024 | UBER TRIP | groceries | 709.61 |  | 711.86 |
| 2024-05-05 | DELTA AIR LINES |  | 825.71 |  | 19186.24 |
| 25/05/2024 | CVS/PHARMACY 0832 | utilities | 113.33 |  | 1740.18 |",BANK_STATEMENT,24,BANK_STATEMENT,fdc-c17e429c551d18cd2cdd8cdc,v11-BANK_STATEMENT-markdown,original,2024,fgen-7a487213c14a5141a1e33488,synthetic_programmatic_template,markdown,top,False,raw_export
"## Cedar Valley Credit Union
| Field | Value |
| --- | --- |
| Account number | XXXXX9295 |
| Statement period | 11/01/2022 - 11/30/2022 |
## Casey Tanaka
9576 Maple Ridge Dr Brookhaven, PA 75533
## Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $42,831.95 |
| Deposits and other credits | $430.01 |
| Withdrawals and other debits | -$2,021.40 |
| Ending balance | $41,240.57 |
| Interest paid this period | 29.99 |
| Interest paid year-to-date | 410.15 |
| Annual percentage yield earned | 4.33% |
| Date | Description | Amount |
| --- | --- | --- |
| 06/14 | TARGET T-2231 | -597.53 |
| 12/22 | NETFLIX.COM | -280.54 |
| 04/07 | TARGET T-2231 | 73.16 |
| 01/07 | SHELL OIL 5741 | -324.65 |
| 07/13 | CVS/PHARMACY 0832 | 313.12 |
| 01/23 | UBER TRIP | -505.24 |
| 04/05 | COSTCO WHSE #412 | -417.27 |
## Tax reminder: amounts on this statement may differ from your Form 1099-INT.
Federally insured by NCUA
Money Market Account Statement",BANK_STATEMENT,24,BANK_STATEMENT,fdc-52101dde4f575aed86e10f4a,v11-BANK_STATEMENT-markdown,original,2022,fgen-f09c4a6ca5becedd6df3297a,synthetic_programmatic_template,markdown,bottom,False,money_market
"## Everyday Checking ...2985
## Downloaded 23/08/2026
| Transaction Date | Transaction Description | Debit | Credit | Balance |
| --- | --- | --- | --- | --- |
| 05/06/2026 | CVS/PHARMACY 0832 |  |  | 23767.71 |
| 06/01/2026 | AMAZON MKTPLACE |  | 1555.47 | 26889.09 |
| 21/11/2026 | AMAZON MKTPLACE |  |  | 27685.41 |",BANK_STATEMENT,24,BANK_STATEMENT,fdc-b4d6f70e2b8e421a86c8c6f4,v11-BANK_STATEMENT-markdown,original,2026,fgen-cadf91a6873b1a84e531dea1,synthetic_programmatic_template,markdown,top,False,raw_export
"Money Market Account Statement
Meadowlark Savings Bank
| Field | Value |
| --- | --- |
| Account number | ***-**-4475 |
| Statement period | 09/01/2023 - 09/30/2023 |
Fatima Haddad
4497 Maple Ridge Dr Pinecrest, GA 33390
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $46,401.06 |
| Deposits and other credits | $4,020.47 |
| Withdrawals and other debits | -$6,305.03 |
| Ending balance | $44,116.50 |
| Interest paid this period | 39.69 |
| Interest paid year-to-date | $3.82 |
| Annual percentage yield earned | 3.33% |
| Date | Description | Amount |
| --- | --- | --- |
| 05/02 | NETFLIX.COM | 648.82 |
| 03/25 | UBER TRIP | -699.58 |
| 07/14 | CVS/PHARMACY 0832 | -772.55 |
| 03/21 | WHOLE FOODS #1021 | 823.29 |
| 01/21 | CVS/PHARMACY 0832 | -486.69 |
| 11/22 | TARGET T-2231 | 482.85 |
## Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-25d60f5dc660bb43ee5d6c7c,v11-BANK_STATEMENT-markdown,original,2023,fgen-309064ec5aed4ecd04dcc7b6,synthetic_programmatic_template,markdown,top,False,money_market
"Money Market AccountStatement
## MeadowlarkSavings Bank
| Field | Value |
| --- | --- |
| Account number | ****5869 |
| Statement period | 09/01/2022 - 09/28/2022 |
Priya Testcase
## 1713 Willow Bcnd Way Pinecrest, GA 59270
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $55,692.51 |
| Deposits and other credits | $6,475.64 |
| Withdrawals and other debits | -$106.54 |
| Ending balance | $62,061.61 |
| Interest paid this period | $41.30 |
| Interest paid year-to-date | $184.41 |
| Annua1 percentage yield eamed | 1.24% |
| Date | Description | Amount |
| --- | --- |--- |
| lO/01 |5HELL OIL 5741 | -16.11 |
| 07/24 | UBER TRIP | 325.60 |
| 09/04 | COSTCO WHSE #412 | -70.26 |
| 07/15 | WHOLE FOODS #1021 | -321.85 |
| 04/l7| CVS/PHARMACY 0832 | 690.95 |
## Your 2022Form 1099-INT will be available online by January 31, 2023.
Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-206bf82753985203a4ee8014,v11-BANK_STATEMENT-markdown,original,2022,fgen-e4bcede9b0c22a7d4ba166f2,synthetic_programmatic_template,markdown,top,True,money_market
"Savings Statement
Lakeshore National Bank
| Field | Value |
| --- | --- |
| Account number | XXX-XX-3865 |
| Statement period | 10/01/2023 - 10/30/2023 |
Mateo Nguyen
6729 Harbor View Rd Bayside, WA 50016
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $16,615.07 |
| Deposits and other credits | $3,808.14 |
| Withdrawals and other debits | -$7,878.01 |
| Ending balance | $12,545.21 |
| Interest paid this period | $26.35 |
| Interest paid year-to-date | 651.56 |
| Annual percentage yield earned | 2.92% |
| Date | Description | Amount |
| --- | --- | --- |
| 04/22 | SHELL OIL 5741 | 92.02 |
| 12/03 | STARBUCKS #11872 | 897.05 |
| 04/28 | TARGET T-2231 | -535.51 |
| 04/06 | SHELL OIL 5741 | 432.62 |
| 01/22 | SHELL OIL 5741 | -103.30 |
| 09/22 | NETFLIX.COM | -412.55 |
| 12/27 | HOME DEPOT 0612 | -899.12 |
This statement is not a Form 1099-INT. Keep it for your records.
Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-3be5a44519a1dd6fcc3ac607,v11-BANK_STATEMENT-markdown,original,2023,fgen-27e0df4f5d0ba8085d40e885,synthetic_programmatic_template,markdown,top,False,savings
"## Checking Account Statement
Prairie State Savings
| Field | Value |
| --- | --- |
| Account number | XXXXX2811 |
| Statement period | 06/01/2026 - 06/28/2026 |
Sofia Lindqvist
## 8957 Sample Street Lakewood, CO 86546
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $52,349.02 |
| Deposits and other credits | $903.97 |
| Withdrawals and other debits | -$4,639.47 |
| Ending balance | $48,613.52 |
| Date | Description | Amount |
| --- | --- | --- |
| 03/27 | COSTCO WHSE #412 | 443.77 |
| 11/04 | STARBUCKS #11872 | -514.02 |
| 06/20 | HOME DEPOT 0612 | -620.30 |
Equal Housing Lender",BANK_STATEMENT,24,BANK_STATEMENT,fdc-9a1c1d8d102ecd5b9dc4c029,v11-BANK_STATEMENT-markdown,original,2026,fgen-6bfbbffeac3cf85cc5f5187d,synthetic_programmatic_template,markdown,top,False,checking
"Granite Peak Bank
| Field | Value |
| --- | --- |
| Account number | ending in 9460 |
| Statement period | 05/01/2025 - 05/30/2025 |
Riley Sato
6866 Willow Bend Way Pinecrest, GA 76022
Account summary
| Field | Value |
| --- | --- |
| Beginning balance | $1,753.75 |
| Deposits and other credits | $5,884.59 |
| Withdrawals and other debits | -$5,147.96 |
| Ending balance | $2,490.39 |
| Interest paid this period | 42.83 |
| Interest paid year-to-date | 89.45 |
| Annual percentage yield earned | 3.08% |
| Date | Description | Amount |
| --- | --- | --- |
| 05/01 | DELTA AIR LINES | -114.42 |
| 02/20 | SHELL OIL 5741 | -341.81 |
| 12/14 | NETFLIX.COM | -48.93 |
Member FDIC",BANK_STATEMENT,24,BANK_STATEMENT,fdc-d8594af7f4cfd84a6972cb7a,v11-BANK_STATEMENT-markdown,original,2025,fgen-79df8f81910a0d07997c3511,synthetic_programmatic_template,markdown,none,False,money_market
"Portfolio Positions
Downloaded 01/27/2025
Run Date  Action  Symbol  Security Description  Quantity  Price  Amount  Settlement Date
07/24/2025
DIVIDEND RECEIVED
VTI
APPLE INC
52.56
493.96
8036.63
2025-05-07
2025-04-16
YOU SOLD
AAPL
APPLE INC
3.08
131.04
5819.02
07/17/2025
2025-05-14
YOU BOUGHT
SCHD
SCHWAB US DIVIDEND EQUITY ETF
35.43
114.83
-8345.58
02/08/2025
2025-10-23
YOU BOUGHT
VTI
SCHWAB US DIVIDEND EQUITY ETF
93.11
269.00
-3981.59
07/25/2025
07/18/2025
INTEREST EARNED
AAPL
SCHWAB US DIVIDEND EQUITY ETF
6.15
60.97
927.02
09/17/2025",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-e1752afb127cdddced997270,v11-BROKERAGE_STATEMENT-stacked,original,2025,fgen-1749d59da9dd221cae3cbb1b,synthetic_programmatic_template,stacked,top,False,raw_export
"Evergreen Brokerage Services
Account
Individual - TOD ***-**-6597
Statement period
07/01/2026 - 07/31/2026
Beginning account value
$826,696.29
Ending account value
$908,315.87
Income summary  This period  Year to date
Dividends
250.83  5,859.36
Interest
88.31  153.11
Realized gain/loss
-1,883.30
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
QQQ
397.879
38.45
15,298.43
1,867.32
SCHB
307.579
451.80
138,965.16
-353.77
VOO
165.380
324.85
53,723.68
5,854.34
SCHD
397.947
340.93
135,671.71
3,318.63
Securities offered through a member of FINRA/SIPC. Not FDIC insured.
Investment Report",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-b51f9f64977d0887dff6321c,v11-BROKERAGE_STATEMENT-stacked,original,2026,fgen-82d18a031e5fbeb4624c311b,synthetic_programmatic_template,stacked,bottom,False,monthly
"Portfolio Positions
Symbol  Description  Quantity  Price  Market Value  Cost Basis  Gain/Loss
SCHD
ISHARES CORE S&P 500
254.56
150.96
83294.14
45811.07
-4475.84
QQQ
MONEY MARKET
338.94
6.29
49834.25
33553.41
-4758.62
VTI
ISHARES CORE S&P 500
84.88
468.62
53236.07
7026.11
5365.90",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-81e80e0c6772b26b9d1a5100,v11-BROKERAGE_STATEMENT-stacked,original,2021,fgen-f6b166ceb601cde59cbdf067,synthetic_programmatic_template,stacked,top,False,raw_export
"Ironwood Wealth Partners
Account
Individual - TOD ending in 1505
Statement period
02/01/2022 - 02/28/2022
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
SCHD
132.504
135.29
17,925.90
6,716.97
MSFT
398.181
262.76
104,625.70
-407.40
AAPL
203.503
483.69
98,432.14
488.59
VTI
76.215
21.22
1,617.09
3,582.75
This statement is not a Form 1099. Keep it for your records.
Positions",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-29a47586e872d44e3bc5b3de,v11-BROKERAGE_STATEMENT-stacked,original,2022,fgen-4fbf62502df592cd63118ad2,synthetic_programmatic_template,stacked,bottom,False,holdings_export
"Quarterly Account Statement
Evergreen Brokerage Services
Account
Individual Brokerage Account ***-**-8384
Statement period
01/01/2022 - 01/30/2022
Beginning account value
$755,020.43
Ending account value
$713,793.27
Income summary  This period  Year to date
Dividends
361.81  6,714.18
Interest
38.41  534.96
Realized gain/loss
7,771.62
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
MSFT
90.642
271.54
24,613.18
-1,925.71
AAPL
70.722
151.15
10,689.74
-1,820.75
SCHB
83.303
488.41
40,685.74
448.00
VOO
79.491
192.62
15,311.86
4,978.38
IRS Form 1099 information for 2022 will be mailed separately.
Securities offered through a member of FINRA/SIPC. Not FDIC insured.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-e3a9deefbf835f5d29da4071,v11-BROKERAGE_STATEMENT-stacked,original,2022,fgen-dc81b5eacd4b5f2a32b1cd43,synthetic_programmatic_template,stacked,top,False,quarterly
"Brokerage Account ...4224- Activity
Downloaded 2023-04-13
Trade Date  Transaction Type  Investment Name  Shares  Share Price  Net Amount
2023-03-l7
Sell
500 Index Admiral
76.68
433.77
-8944.07
21/01/2023
Sell
500 Index Admíral
62.48
257.50
-4674.79
2023-09-05
Capital gain (LT)
Total Stock Markct Index Admiral
78.63
243.55
-3559.29
06/27/2023
Sell
Total Bond Market ETF
29.02
227.66
-7288.52
09/03/2023
Rcinvestment
500 Index Admiral
77.70
325.32
-7862.73",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-9c7d4e11ceb840ee4faf554f,v11-BROKERAGE_STATEMENT-stacked,original,2023,fgen-9298bbc8f0ed8c46478193f4,synthetic_programmatic_template,stacked,top,True,raw_export
"Run Date  Action  Symbol  Security Description  Quantity  Price  Amount  Settlement Date
07/17/2022
DIVIDEND RECEIVED
VTI
VANGUARD INDEX FDS
26.15
261.60
-4905.25
05/24/2022
2022-01-24
YOU BOUGHT
VTI
APPLE INC
82.60
395.91
5740.10
11/16/2022
10/17/2022
INTEREST EARNED
VTI
APPLE INC
56.35
279.71
-5484.27
2022-08-06
2022-06-14
YOU SOLD
VTI
VANGUARD INDEX FDS
96.94
114.84
-5309.59
05/04/2022
03/04/2022
YOU BOUGHT
AAPL
APPLE INC
60.56
415.56
-4276.64
13/04/2022
06/09/2022
REINVESTMENT
VTI
APPLE INC
5.81
446.66
-6180.00
21/11/2022
2022-10-09
YOU BOUGHT
AAPL
SCHWAB US DIVIDEND EQUITY ETF
80.11
43.27
-6777.18
07/07/2022
23/08/2022
INTEREST EARNED
VTI
VANGUARD INDEX FDS
56.80
368.17
-817.01
11/14/2022",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-6d56376754c4743dfd46013e,v11-BROKERAGE_STATEMENT-stacked,original,2022,fgen-0f53dc9c9964f06bb5bca33d,synthetic_programmatic_template,stacked,none,False,raw_export
"Investment Report
Ironwood Wealth Partners
Account
Joint WROS ending in 9133
Statement period
09/01/2026 - 09/31/2026
Beginning account value
$340,096.52
Ending account value
$314,317.48
Income summary  This period  Year to date
Dividends
436.41  972.90
Interest
55.77  322.34
Realized gain/loss
190.68
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
BND
298.974
463.21
138,488.46
-654.27
MSFT
341.372
406.64
138,813.88
1,199.22
SCHD
153.223
286.46
43,892.43
-47.03
SCHB
378.254
112.01
42,367.49
1,016.89
Securities offered through a member of FINRA/SIPC. Not FDIC insured.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-8d5a1775bea87a2485fa0100,v11-BROKERAGE_STATEMENT-stacked,original,2026,fgen-0852a593ab5fea07d1b43f5a,synthetic_programmatic_template,stacked,top,False,monthly
"Investment Report
Ironwood Wealth Partners
Account
Joint WROS ***-**-2418
Statement period
02/01/2025 - 02/28/2025
Beginning account value
$407,752.33
Ending account value
$393,738.02
Income summary  This period  Year to date
Dividends
702.29  1,357.77
Interest
81.65  53.61
Realized gain/loss
-1,179.79
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
QQQ
167.566
433.23
72,595.08
7,040.76
SCHB
196.006
310.88
60,934.21
-1,036.53
IVV
25.360
45.63
1,157.18
7,663.12
VTI
310.596
330.02
102,501.61
4,052.94
Tax reminder: amounts on this statement may differ from your Form 1099.
Securities offered through a member of FINRA/SIPC. Not FDIC insured.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-2556aaaff7455aecd1ed0ab9,v11-BROKERAGE_STATEMENT-stacked,original,2025,fgen-6350da7f143f682ac4acfe57,synthetic_programmatic_template,stacked,top,False,monthly
"Portfolio Positions
Account Number  Account Name  Symbol  Description  Quantity  Last Price  Current Value  Total Gain/Loss Dollar  Percent Of Account
Z19537564
Individual
VOO
FIDELITY 500 INDEX
355.50
688.20
45471.88
6022.68
13.82%
Z18792588
Individual
VOO
FIDELITY 500 INDEX
116.98
44.29
46040.26
-6119.45
52.27%
Z46282920
Individual
FXAIX
VANGUARD S&P 500 ETF
373.48
561.61
23263.70
198.98
20.79%
Z20922039
Individual
AMZN
FIDELITY 500 INDEX
244.31
832.16
36054.34
-1642.79
15.98%
Z88110393
Individual
NVDA
NVIDIA CORP
1.77
482.28
5624.74
-1635.06
51.06%",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-9be24f87745031fbca79ba0e,v11-BROKERAGE_STATEMENT-stacked,original,2023,fgen-8b02135c38fb01a10179307a,synthetic_programmatic_template,stacked,top,False,raw_export
"Positions
Summit Investments
Account
Individual Brokerage Account ****0273
Statement period
09/01/2024 - 09/31/2024
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
VTI
380.412
267.85
101,894.55
2,813.18
SCHB
245.778
180.24
44,299.90
8,243.22
AAPL
36.288
287.19
10,421.53
4,816.19
MSFT
37.601
208.67
7,846.13
8,462.23",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-bfc6c1773f578eaf693ff005,v11-BROKERAGE_STATEMENT-stacked,original,2024,fgen-efc0ec1345e19c71b414db14,synthetic_programmatic_template,stacked,top,False,holdings_export
"Ironwood Wealth Partners
Account
Joint WROS ***-**-8701
Statement period
11/01/2021 - 11/31/2021
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
VTI
74.148
181.18
13,434.31
1,427.52
BND
253.726
422.35
107,162.50
-1,064.32
AAPL
317.398
389.75
123,707.02
4,825.24
MSFT
42.278
360.05
15,222.27
6,708.91
IRS Form 1099 information for 2021 will be mailed separately.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-2e9e20fb46fe5365cddcc572,v11-BROKERAGE_STATEMENT-stacked,original,2021,fgen-565280797ad7562b4bc41b15,synthetic_programmatic_template,stacked,none,False,holdings_export
"Positions
Evergreen Brokerage Services
Account
Individual - TOD ending in 4676
Statement period
02/01/2024 - 02/28/2024
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
IVV
115.194
384.61
44,304.67
5,053.39
VOO
289.440
247.08
71,513.85
4,479.27
AAPL
377.183
473.31
178,523.91
-1,858.48
VTI
124.707
223.12
27,824.61
5,765.83",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-233e07aa4bf0c8631613d865,v11-BROKERAGE_STATEMENT-stacked,original,2024,fgen-684087431c596e5c06d79452,synthetic_programmatic_template,stacked,top,False,holdings_export
"Positions as of 2024-08-01
Downloaded 2024-07-01
Symbol  Description  Quantity  Price  Market Value  Cost Basis  Gain/Loss
MSFT
ISHARES CORE S&P 500
67.53
50.54
83014.55
65634.16
-5499.62
BND
VANGUARD TOTAL STOCK MKT ETF
133.60
309.07
51185.36
30903.72
7446.00
VTI
APPLE INC
317.27
162.49
62723.30
28090.43
-4432.84
MSFT
VANGUARD TOTAL STOCK MKT ETF
358.45
251.45
28501.41
55622.42
2538.34
BND
APPLE INC
54.92
486.86
29796.70
17368.19
4724.40
AAPL
VANGUARD TOTAL STOCK MKT ETF
209.85
267.73
53150.99
19708.60
-6870.89
AAPL
VANGUARD TOTAL STOCK MKT ETF
11.91
378.29
83533.10
18996.54
5971.52
VTI
MONEY MARKET
32.65
265.73
4762.90
13020.31
6743.74",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-4ca8dba5a84a88fdedd0b343,v11-BROKERAGE_STATEMENT-stacked,original,2024,fgen-7e8888e56d94fb82b038d8ac,synthetic_programmatic_template,stacked,top,False,raw_export
"Symbol  Description  Quantity  Price  Market Value  Cost Basis  Gain/Loss
SPAXX**
ISHARES CORE S&P 5O0
212.23
269.90
64182.52
36967.33
8344.13
SPAXX**
VANGUARD TOTAL STOCK MKT ETF
173.76
111.42
3932O.80
57534.43
2903.94
MSFT
ISHARES CORE S&P500
216.73
351.15
29205.02
44406.26
6126.80
QQQ
APPLE INC
153.30
448.49
28099.55
20258.30
8545.50",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-e723e6ae025baaf7703ef9b1,v11-BROKERAGE_STATEMENT-stacked,original,2025,fgen-4f4bf3c8e2380029f0dd0581,synthetic_programmatic_template,stacked,none,True,raw_export
"Positions
Evergreen Brokerage Services
Account
Individual - TOD ***-**-3933
Statement period
10/01/2024 - 10/31/2024
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
AAPL
202.891
138.57
28,114.72
655.93
SCHD
322.064
122.75
39,534.89
-1,293.35
VTI
244.271
485.20
118,519.92
4,260.60
IVV
37.393
445.13
16,644.47
7,684.54
Tax remínder: amounts onthis statement may differ from your Form 1099.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-a728c481c16eec49c94ad419,v11-BROKERAGE_STATEMENT-stacked,original,2024,fgen-33239f5bbe3bcdbfe14d58be,synthetic_programmatic_template,stacked,top,True,holdings_export
"Quarterly Account Statement
Northstar 5ecurities
Account
Individual Brokerage Account ending in 6741
Statement period
05/01/2026 -05/30/2026
Beginning account value
$366,161.35
Ending account value
$365,750.91
Income summary  This period  Year to date
Dividends
20.65  3,277.49
Interest
57.22  451.07
Realized gain/loss
4,986.98
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
VTI
50.054
431.83
21,614.77
-331.34
VOO
113.938
264.06
30,086.73
-1,844.75
QQQ
133.789
282.12
37,745.05
7,971.13
5CHB
398.730
298.45
119,000.12
1,100.08
This statcment is not a Form 1099. Keep it for your records.
Securities offered through a member of FINRA/SIPC. Not FDICinsured.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-64afd65a97d67a9c4ae1b8f9,v11-BROKERAGE_STATEMENT-stacked,original,2026,fgen-eea5fecc3e2d0197d8f53b77,synthetic_programmatic_template,stacked,top,True,quarterly
"Positions
Evergreen Brokerage Services
Account
Individual Brokerage Account ***-**-7337
Statement period
04/01/2023 - 04/30/2023
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
SCHB
326.153
221.55
72,259.37
1,156.10
IVV
98.660
421.51
41,585.64
7,642.84
VTI
386.609
257.52
99,561.44
2,420.13
VOO
144.465
73.50
10,618.64
-1,318.00
Tax reminder: amounts on this statement may differ from your Form 1099.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-0675ce23c8d2a74857798e95,v11-BROKERAGE_STATEMENT-stacked,original,2023,fgen-80f09439c9ee2eb96bb057e2,synthetic_programmatic_template,stacked,top,False,holdings_export
"Positions
Clearwater Investing
Account
Individual - TOD ****l926
Statement period
03/01/2025 - 03/31/2025
Symbol  Quantity  Last Pricc  Current Value  Total Gain/Loss
SCHB
187.435
420.72
78,856.96
1,639.03
SCHD
56.151
335.33
18,829.20
3,701.60
QQQ
2.846
311.63
886.79
5,439.14
AAPL
232.313
295.75
68,705.60
-443.00
This statement is not a Form 1099. Keep it for yourrecords.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-636ab3ba594b91fb3ab07cfa,v11-BROKERAGE_STATEMENT-stacked,original,2025,fgen-66552743ea151a570339f4a9,synthetic_programmatic_template,stacked,top,True,holdings_export
"Positions
Summit Investments
Account
Individual - TOD XXXXX9549
Statement period
08/01/2024 - 08/31/2024
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
AAPL
212.627
207.57
44,134.81
-396.48
SCHB
17.293
122.30
2,114.90
4,041.73
QQQ
187.609
442.31
82,981.09
-816.30
IVV
395.729
219.15
86,725.35
4,348.02
Tax reminder: amounts on this statement may differ from your Form 1099.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-55708b83332c124c57f35f3b,v11-BROKERAGE_STATEMENT-stacked,original,2024,fgen-f1c3cb7bad16d11ea0468f1a,synthetic_programmatic_template,stacked,top,False,holdings_export
"Positions
Evergreen Brokerage Services
Account
Joint WROS ending in 7591
Statement period
12/01/2024 - 12/30/2024
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
QQQ
210.620
98.49
20,743.70
148.43
BND
97.156
186.04
18,075.27
4,742.80
VTI
318.188
219.37
69,802.39
5,110.55
MSFT
91.570
20.48
1,874.96
250.63",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-cbc518db12e0a92610197507,v11-BROKERAGE_STATEMENT-stacked,original,2024,fgen-55166f3e5c4b3919a83fe60b,synthetic_programmatic_template,stacked,top,False,holdings_export
"Brokerage Account ...1950 - Activity
Run Date  Action  Symbol  Security Description  Quantity  Price  Amount  Settlement Date
2026-11-24
INTEREST EARNED
VTI
VANGUARD INDEX FDS
82.84
479.69
-4464.99
2026-07-27
2026-01-04
DIVIDEND RECEIVED
AAPL
VANGUARD INDEX FDS
42.70
445.24
3598.26
01/18/2026
08/12/2026
YOU BOUGHT
VTI
SCHWAB US DIVIDEND EQUITY ETF
0.81
152.23
7183.13
05/06/2026
21/11/2026
DIVIDEND RECEIVED
SCHD
APPLE INC
38.09
442.86
1924.67
03/05/2026
07/01/2026
DIVIDEND RECEIVED
AAPL
SCHWAB US DIVIDEND EQUITY ETF
89.42
110.02
5840.31
2026-10-16
23/05/2026
YOU SOLD
SCHD
SCHWAB US DIVIDEND EQUITY ETF
11.82
123.59
-8190.68
2026-10-07
2026-12-02
YOU SOLD
VTI
VANGUARD INDEX FDS
53.10
238.75
-2889.55
10/11/2026
04/14/2026
REINVESTMENT
SCHD
SCHWAB US DIVIDEND EQUITY ETF
89.50
430.65
8452.63
2026-08-12",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-49278f5f48bee48fc00868c2,v11-BROKERAGE_STATEMENT-stacked,original,2026,fgen-2fdc306314acc9f63265e42d,synthetic_programmatic_template,stacked,top,False,raw_export
"Quarterly Account Statement
Northstar 5ecurities
Account
Joint WROS ****7028
Statement period
07/01/2021 - 07/30/2021
Beginning account value
$336,754.85
Ending account value
$305,676.67
Income summary  This period  Year to date
Dividends
297.8l  101.91
Interest
15.58  498.88
Rea1ized gain/loss
8,438.39
Symbol  Quantity  Last Price  Current Value Total Gain/Loss
IVV
2O.69l
432.09
8,940.48
569.46
BND
284.468
98.23
27,944.53
1,904.09
MSFT
18.265
58.56
1,069.63
314.02
SCHD
289.047
497.08
143,679.25
-1,962.75
Securities offered through a member of FINRA/5IPC. Not FDIC insured.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-c44cb39b095a48b14f8653a6,v11-BROKERAGE_STATEMENT-stacked,original,2021,fgen-cc5dc0ba3addd8e7da56b0d6,synthetic_programmatic_template,stacked,top,True,quarterly
"Clearwater Investing
Account
Individual Brokcrage Account XXX-XX-6359
Statement period
l2/O1/2025- 12/28/2025
Beginning account value
$357,657.42
Ending account value
$376,973.05
Income summary  This period  Year to date
Dividends
170.70  1,142.06
Interest
31.18  128.24
Rea1ized gain/loss
2,439.74
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
AAPL
366.734
300.17
110,082.95
7,869.08
SCHD
21.285
300.47
6,395.42
8,454.00
MSFT
358.736
308.47
110,659.04
822.05
SCHB
335.102
183.99
61,654.80
106.47",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-e3b5024c433d9db489c091de,v11-BROKERAGE_STATEMENT-stacked,original,2025,fgen-e171ba670175d86f4558652b,synthetic_programmatic_template,stacked,none,True,monthly
"Clearwater Investing
Account
Individual - TOD XXXXX5073
Statement period
08/01/2021 - 08/28/2021
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
MSFT
31.481
66.25
2,085.56
8,692.09
BND
66.301
200.87
13,318.19
1,990.34
VOO
214.814
403.82
86,746.42
2,078.31
AAPL
239.118
254.90
60,950.66
8,719.32
IRS Form 1099 information for 2021 will be mailed separately.
Securities offered through a member of FINRA/SIPC. Not FDIC insured.
Positions",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-0345d715e472a24f10a730df,v11-BROKERAGE_STATEMENT-stacked,original,2021,fgen-327127184f8b7a07aeaec623,synthetic_programmatic_template,stacked,bottom,False,holdings_export
"Quarterly Account Statement
Ironwood Wealth Partners
Account
Individual - TOD XXXXX1195
Statement period
02/01/2025 - 02/28/2025
Beginning account value
$30,248.26
Ending account value
$31,727.84
Income summary  This period  Year to date
Dividends
725.14  2,998.84
Interest
72.03  95.93
Realized gain/loss
5,554.72
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
IVV
378.564
332.81
125,989.44
-720.45
SCHB
259.149
234.75
60,834.59
3,469.39
SCHD
76.263
113.35
8,644.11
4,353.76
MSFT
220.022
379.54
83,506.46
3,376.17",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-1dc4188d6f6c2729109ff76a,v11-BROKERAGE_STATEMENT-stacked,original,2025,fgen-5312e6eab600a634b76da0b5,synthetic_programmatic_template,stacked,top,False,quarterly
"Downloaded 05/18/2021
Symbol  Description  Quantity  Price  Market Value  Cost Basis  Gain/Loss
MSFT
ISHARES CORE S&P 500
327.10
226.22
62058.47
71356.82
-3329.18
AAPL
VANGUARD TOTAL STOCK MKT ETF
203.31
351.73
39466.06
67176.25
-8601.53
QQQ
VANGUARD TOTAL STOCK MKT ETF
186.38
69.33
33254.15
31658.58
5344.51
SPAXX**
ISHARES CORE S&P 500
246.00
276.88
74389.23
53934.80
2175.35
SCHD
MONEY MARKET
100.53
322.28
45398.16
68292.30
2768.32
SCHD
APPLE INC
39.93
403.16
44631.31
51925.93
73.35
SCHD
APPLE INC
213.37
33.19
42435.86
63310.76
3539.79",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-6df888ed8277cb3cda399ac9,v11-BROKERAGE_STATEMENT-stacked,original,2021,fgen-e11a451081519131da84746b,synthetic_programmatic_template,stacked,top,False,raw_export
"Evergreen Brokerage Services
Account
Joint WROS XXXXX0306
Statement period
10/01/2021 - 10/30/2021
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
VOO
98.538
251.78
24,810.15
2,476.94
MSFT
272.098
286.80
78,037.07
7,555.29
VTI
361.539
226.45
81,872.13
5,739.22
SCHD
45.405
128.32
5,826.28
2,042.84
IRS Form 1099 information for 2021 will be mailed separately.
Securities offered through a member of FINRA/SIPC. Not FDIC insured.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-c2310b6e9bb98471dcebbf7b,v11-BROKERAGE_STATEMENT-stacked,original,2021,fgen-60abb44e81f9a66b62b2e773,synthetic_programmatic_template,stacked,none,False,holdings_export
"Investment Report
Northstar Securities
Account
Individual - TOD ****9261
Statement period
01/01/2022 - 01/31/2022
Beginning account value
$813,298.35
Ending account value
$806,721.31
Income summary  This period  Year to date
Dividends
823.85  2,587.49
Interest
6.51  456.18
Realized gain/loss
-701.73
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
BND
34.210
408.26
13,966.74
6,121.55
SCHD
377.663
188.09
71,033.74
-150.56
SCHB
292.876
377.18
110,467.98
6,060.27
VTI
21.480
51.63
1,108.97
4,883.84",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-b3b45a3c6c092cbf9f0c0800,v11-BROKERAGE_STATEMENT-stacked,original,2022,fgen-ee3aadb395ccc634ab48ca4e,synthetic_programmatic_template,stacked,top,False,monthly
"Positions
Summit Investments
Account
Individual - TOD XXXXX3096
Statement period
04/01/2021 - 04/31/2021
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
MSFT
296.051
282.61
83,667.14
-1,347.91
AAPL
94.530
366.97
34,690.26
1,729.07
SCHD
273.447
350.14
95,743.97
631.93
QQQ
203.983
24.59
5,015.46
6,121.69",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-006a07bba2d56c987e05b37f,v11-BROKERAGE_STATEMENT-stacked,original,2021,fgen-4eb0ff9a8b78cfeb936d3be4,synthetic_programmatic_template,stacked,top,False,holdings_export
"Positions
Evergreen Brokerage Services
Account
Individual - TOD ending in 6409
Statement period
05/01/2025 - 05/28/2025
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
BND
103.669
67.74
7,022.60
4,531.94
SCHB
21.434
260.24
5,578.12
-500.98
VOO
249.329
399.53
99,614.23
-1,768.75
VTI
52.934
471.36
24,951.06
3,340.90
IRS Form 1099 information for 2025 will be mailed separately.
Securities offered through a member of FINRA/SIPC. Not FDIC insured.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-98202092640adef41c399a77,v11-BROKERAGE_STATEMENT-stacked,original,2025,fgen-42aa4f8263ae99301a9cc887,synthetic_programmatic_template,stacked,top,False,holdings_export
"Ironwood Wealth Partners
Account
Individual Brokerage Account XXX-XX-0773
Statement period
08/01/2022 - 08/30/2022
Beginning account value
$67,884.18
Ending account value
$65,811.33
Income summary  This period  Year to date
Dividends
85.39  7,974.14
Interest
12.44  503.77
Realized gain/loss
-1,739.56
Symbol  Quantity  Last Price  Current Value  Total Gain/Loss
AAPL
293.800
401.24
117,885.72
4,968.80
BND
142.718
221.39
31,596.52
5,545.24
IVV
283.646
117.64
33,367.29
-892.84
QQQ
156.990
146.56
23,008.72
6,372.16
Your 2022 Form 1099 will be available online by January 31, 2023.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-b79457a43be85f5b9dbf6107,v11-BROKERAGE_STATEMENT-stacked,original,2022,fgen-a7d049efeb44565ee47149b9,synthetic_programmatic_template,stacked,none,False,quarterly
"Gala Ticket Receipt
Greenway Animal Rescue
Attendee  Diego B. Walsh
Event date   July 17, 2023
Amount paid   $425.63
Fair market value of dinner and entertainment  $250.17
Deductible portion   $175.46
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-08f5f4268b9c88e1a7e519b0,v11-CHARITY_EVENT_RECEIPT-inline,original,2023,fgen-969ea97268ef53dfd708b6b2,synthetic_programmatic_template,inline,top,False,event
"Riverbend Public Library Foundation
Attendee  Riley Kowalski
Event date      11/15/2022
Amount paid $239.61
Fair market value of dinner and entertainment $113.76
Deductible portion $125.84
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-eb7007e2165389a95410258d,v11-CHARITY_EVENT_RECEIPT-inline,original,2022,fgen-401799a04b1404de2904fc84,synthetic_programmatic_template,inline,none,False,event
"Charity Auction Receipt
St. Brendan Parish
Attendee   Fatima Haddad
Event date   2025-05-18
Amount paid  $82.93
Fair market value of dinner and entertainment $40.80
Deductible portion  $42.13
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-011a7f31906279df80c49a95,v11-CHARITY_EVENT_RECEIPT-inline,original,2025,fgen-d8aad615612c37ddbe7a8284,synthetic_programmatic_template,inline,top,False,event
"Sample Community Food Bank
Attendee  Alex Moreau
Event date  5/20/26
Amount paid $405.88
Fair market value of dinner and entertainment      $191.28
Deductible portion  $214.59
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-f9e3bfa5a3c663f0cbcfead8,v11-CHARITY_EVENT_RECEIPT-inline,original,2026,fgen-71600ca9780c2d057414fe23,synthetic_programmatic_template,inline,none,False,event
"Hope Harbor Shelter
Attendee  Avery S. Kowalski
Event date      04/26/2026
Amount paid   $391.16
Fair market value of dinner and entertainment $146.16
Deductible portion   $245.00
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-9a38c7bcc02a3b57c3f7a51f,v11-CHARITY_EVENT_RECEIPT-inline,original,2026,fgen-c79d22b5116c63625dce672e,synthetic_programmatic_template,inline,none,False,event
"Gala Ticket Receipt
Greenway Animal Rescue
Attendee Noah Patel
Event date  August 20, 2024
Amount paid S445.13
Fair market value of dinner and entertainment $116.15
Deductib1e portion  $328.97
The deductible amount is limited to the excess of your payment over the valueof goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-0ad34ac25c20d13efbe2784c,v11-CHARITY_EVENT_RECEIPT-inline,original,2024,fgen-46e139ba849eccb247e574b3,synthetic_programmatic_template,inline,top,True,event
"CharityAuction Receipt
Sample Community Food Bank
Attendee   Olivia L. Lindqvist
Event date      December 28, 2025
Amount paid  $269.51
Fair market value ofdinner and entertainment      $109.51
Deductible portion      $160.00
Thc deductible amount is limited to the excess of your payment over the value of goods and servíces received.",DONATION_RECORD,28,DONATION_RECORD,fdc-21641ac26b612313abc704dd,v11-CHARITY_EVENT_RECEIPT-inline,original,2025,fgen-82e8dff255296ee0654a289d,synthetic_programmatic_template,inline,top,True,event
"Gala Ticket Receipt
Riverbend Public Library Foundation
Attendee Kwame M. Brennan
Event date  2/2/24
Amount paid  $192.84
Fair market value of dinner and entertainment $87.57
Deductible portion      $105.28
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-213647ead7beb6182f4763af,v11-CHARITY_EVENT_RECEIPT-inline,original,2024,fgen-6b98d534b2b5d03ea2b24cab,synthetic_programmatic_template,inline,top,False,event
"Event Registration Receipt
Greenway Animal Rcscue
Attendee  Jordan A. Lindqvist
Event datc   August 4, 2O25
Amount paid      S2O7.71
Fair market value of dinner and entertainment $79.08
Deductible portion $128.64
The deductible amount is limited tothe excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-0649e4d576298e83a557be53,v11-CHARITY_EVENT_RECEIPT-inline,original,2025,fgen-a4a5c179aafcfc704e624f7a,synthetic_programmatic_template,inline,top,True,event
"Charity Auction Receipt
Sample Community Food Bank
Attendee Diego R. Adeyemi
Event date 3/13/24
Amount paid $246.98
Fair market value of dinner and entertainment $141.55
Dcductible portion     $105.44
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-7b984e242e2ba14c4c54a4bc,v11-CHARITY_EVENT_RECEIPT-inline,original,2024,fgen-232d40113a4da041cdcf1512,synthetic_programmatic_template,inline,top,True,event
"Gala Ticket Receipt
Riverbend Public Library Foundation
Attendee Riley Walsh
Event date 11/17/24
Amount paid $481.32
Fair market value of dinner and entertainment $1O0.23
Deductible portion  $381.10
The deductible amountis limited to the excess of your payment over the value of goods and servíces received.",DONATION_RECORD,28,DONATION_RECORD,fdc-64b81173a2b87b745ef68e83,v11-CHARITY_EVENT_RECEIPT-inline,original,2024,fgen-7e4b52566b29fc1af9fb12cf,synthetic_programmatic_template,inline,top,True,event
"Charity Auction Receipt
Riverbend Public LibraryFoundation
Attendee   Casey Tanaka
Event date      October 22, 2023
Amount paid S310.37
Fair market value of dinner and entertainment  $164.87
Deductible portion  $145.49
The deductible amount íslimited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-bf1dac4c6b850cead7a00cfc,v11-CHARITY_EVENT_RECEIPT-inline,original,2023,fgen-cd3e1ab52252653bda614da0,synthetic_programmatic_template,inline,top,True,event
"Gala Ticket Receipt
Greenway Animal Rescue
Attendee   Mateo Kowalski
Event date 10/27/2026
Amount paid $430.68
Fair market value of dinner and entertainment  $189.57
Deductible portion   $241.11
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-5a3d0f6037aa2558669edea0,v11-CHARITY_EVENT_RECEIPT-inline,original,2026,fgen-a75df4a4db7dcec2f4798e90,synthetic_programmatic_template,inline,top,False,event
"Gala Ticket Receipt
Hope Harbor Shelter
Attendee      Fatima K. Sato
Event date 5/10/26
Amount paid      $235.44
Fair market value of dinner and entertainment   $126.65
Deductible portion $108.79
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-1aa3172d067536d55417068b,v11-CHARITY_EVENT_RECEIPT-inline,original,2026,fgen-31e049d30c7007db6469a225,synthetic_programmatic_template,inline,top,False,event
"Greenway Animal Rescue
Attendee   Alex J. Larsen
Event date 5/16/22
Amount paid $3O1.32
Fair market value of dinner and entertaínment $145.57
Deductible portion      $155.75
The deductible amount is limitedto the excess of your payment over the value of goods and services received.
Charíty Auction Rcceipt",DONATION_RECORD,28,DONATION_RECORD,fdc-0bcfbf083d581acc755f2c97,v11-CHARITY_EVENT_RECEIPT-inline,original,2022,fgen-7c122821383dde27c34d0284,synthetic_programmatic_template,inline,bottom,True,event
"Gala Ticket Receipt
St. Brendan Parish
Attendee Noah Castillo
Event date 3/24/23
Amount paid   $329.50
Fair market value of dinner and entertainment   $88.84
Deductible portion  $240.66
The deductible amount is limited to the excess of your payment over the value of goods and services received.",DONATION_RECORD,28,DONATION_RECORD,fdc-f99ed6cfacb420527768483d,v11-CHARITY_EVENT_RECEIPT-inline,original,2023,fgen-031343f44978ec814e779364,synthetic_programmatic_template,inline,top,False,event
"Form 1099 Composite & Year-End Summary
Ironwood Wea1th Partners
Account
Recipient
Payer's Federal ID number
***-**-2218
Amara Castillo
55-3126519
Copy Bfor Recipient  OMB No. 1545-0715
Page 1 of 11
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basís
Wash saleloss disallowed
Net gain or loss
Short
A (basis reported to the IR5)
33,727.43
68,665.98
0.00
6,246.21
Long
D (basís reported to the IRS)
5,104.29
43,485.34
0.00
29,098.88
This is important tax information and is being fumished to the Intemal Revenue Service.",1099,5,1099,fdc-16948ff5933825ac95360b2a,v11-CONSOLIDATED_1099-columns,original,2026,fgen-f569d4b99fea31041772e734,synthetic_programmatic_template,columns,top,True,b_detail
"2022 Consolidated Form 1099
Ironwood Wealth Partners
Account
Recipient
Payer's Federal ID number
****8503
Riley Kowalski
87-3623235
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 24
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
6,112.27
4,761.88
2,900.95
1099-INT  Interest Income
1 Interest income
103.80
1099-MISC  Miscellaneous Information
3 Other income
88.67
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-baa52948a2775dc8d8357938,v11-CONSOLIDATED_1099-columns,original,2022,fgen-8a6f69abd5a52983de8f9d27,synthetic_programmatic_template,columns,top,False,div_int_detail
"Form 1099 Composite & Year-End Summary
Evergreen Brokerage Services
Account
Recipient
Payer's Federal ID number
***-**-4149
Lena E. Fischer
11-3616599
Copy B for Recipient  OMB No. 1545-O715
Page 2 of 9
1099-DIV  Dividends and Dístributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
7,640.53
7,646.15
2,734.57
1099-INT  Interest Income
1 Interest income
33.36
1099-MI5C  Miscellaneous Information
3 Otherincome
156.42
1099-B  Summary of Procccds, Gains& Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
77,222.55
261.24
O.00
6,721.91
Long
D (basis reported to the IRS)
17,685.32
75,328.09
0.00
6,880.10
This is important tax information and is being fumishedto the Intemal Revenue Servicc.",1099,5,1099,fdc-666daa0834f767a6f533838d,v11-CONSOLIDATED_1099-columns,original,2024,fgen-2499c3611853a1f094291a70,synthetic_programmatic_template,columns,top,True,summary_page
"Ironwood Wealth Partners
Account
Recipient
Payer's Federal ID number
***-**-7095
Hiro Okafor
26-8140977
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 22
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
5,558.55
4,857.47
1,800.69
1099-INT  Interest Income
1 Interest income
825.70
1099-MISC  Miscellaneous Information
3 Other income
62.26
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
32,387.70
55,575.63
0.00
708.86
Long
D (basis reported to the IRS)
17,489.86
17,234.49
0.00
-505.85
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-c9a6c391f2b0e2d71477816f,v11-CONSOLIDATED_1099-columns,original,2026,fgen-7f20d7b3e80f717ff5c1f65b,synthetic_programmatic_template,columns,none,False,summary_page
"Ironwood Wealth Partners
Account
Recipient
Payer's Federal ID number
ending in 6185
Sofia Kowalski
84-7066215
Copy B for Recipient  OMB No. 1545-0715
Page 2 of 10
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
46,738.42
86,483.05
0.00
1,409.54
Long
D (basis reported to the IRS)
14,604.58
72,507.70
0.00
8,808.28
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-6a2d2d24f7cb49c484296f33,v11-CONSOLIDATED_1099-columns,original,2022,fgen-dddcf925291819157f8e7c4d,synthetic_programmatic_template,columns,none,False,b_detail
"2026 Tax Information Statement
Summit Investments
Account
Recipient
Payer's Federal ID number
XXXXX7680
Diego E. Sato
61-4355872
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 21
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
84,638.22
52,617.03
0.00
1,054.66
Long
D (basis reported to the IRS)
24,569.95
22,241.81
0.00
11,796.63
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-ca056e66f28868f0335f9952,v11-CONSOLIDATED_1099-columns,original,2026,fgen-b5b50c1dc3eea1f4139efe77,synthetic_programmatic_template,columns,top,False,b_detail
"Form 1099 Composite & Year-End Summary
Ironwood Wealth Partners
Account
Recipient
Payer's Federal ID number
XXX-XX-5359
Jordan Adeyemi
95-1498662
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 21
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
1,436.35
5,982.41
750.90
1099-INT  Interest Income
1 Interest income
582.65
1099-MISC  Miscellaneous Information
3 Other income
93.54
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
6,173.73
9,836.79
0.00
-2,120.05
Long
D (basis reported to the IRS)
41,292.65
70,674.41
0.00
13,328.33
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-fd875a12ead47eb8f6b70fd4,v11-CONSOLIDATED_1099-columns,original,2021,fgen-016e28beb3559f13a2bd8f8d,synthetic_programmatic_template,columns,top,False,summary_page
"Clearwater Investing
Account
Recipient
Payer's Federal ID number
XXX-XX-1337
Noah E. Testcase
35-7786870
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 9
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
2,716.77
708.45
999.07
1099-INT  Interest Income
1 Interest income
384.17
1099-MISC  Miscellaneous Information
3 Other income
83.70
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
57,512.10
84,065.70
0.00
3,463.23
Long
D (basis reported to the IRS)
15,548.97
53,363.82
0.00
18,393.15
This is important tax information and is being furnished to the Internal Revenue Service.
2021 Consolidated Form 1099",1099,5,1099,fdc-ed64c1a49d8c603876b701fa,v11-CONSOLIDATED_1099-columns,original,2021,fgen-66205b056e790544d3343fa1,synthetic_programmatic_template,columns,bottom,False,summary_page
"2023 Consolidated Form 1099
Evergreen Brokerage Services
Account
Recipient
Payer's Federal ID number
ending in 1643
Taylor Adeyemi
59-6492434
Copy B for Recipient  OMB No. 1545-0715
Page 2 of 28
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
2,245.23
7,735.75
507.59
1099-INT  Interest Income
1 Interest income
226.54
1099-MISC  Miscellaneous Information
3 Other income
13.22
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
67,910.39
69,148.98
0.00
4,777.79
Long
D (basis reported to the IRS)
18,094.49
73,211.80
0.00
24,933.12
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-eb98d084c012689a91fa0437,v11-CONSOLIDATED_1099-columns,original,2023,fgen-a52d38396065f7abf4eaefc1,synthetic_programmatic_template,columns,top,False,summary_page
"2025 Tax Information Statement
Clearwater Investing
Account
Recipient
Payer's Federal ID number
****7920
Sofia Fischer
72-3134735
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 26
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
1,839.03
3,473.67
2,473.81
1099-INT  Interest Income
1 Interest income
372.92
1099-MISC  Miscellaneous Information
3 Other income
170.12
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-fd7e9ce885a3cd375ad8b585,v11-CONSOLIDATED_1099-columns,original,2025,fgen-fe7fd1567904080d6f8bd470,synthetic_programmatic_template,columns,top,False,div_int_detail
"2024 Consolidated Form 1099
Summit Investments
Account
Recipient
Payer's Federal ID number
XXXXX5976
Diego S. Lindqvist
71-8162233
Copy B for Recipient  OMB No. 1545-0715
Page 2 of 23
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
8,522.03
33,783.21
0.00
3,494.58
Long
D (basis reported to the IRS)
26,344.14
78,406.23
0.00
18,794.32
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-53a3b9f8ff07d6d9a9037907,v11-CONSOLIDATED_1099-columns,original,2024,fgen-6ffba8019bc34e32f3b78788,synthetic_programmatic_template,columns,top,False,b_detail
"2021 Tax Information Statement
Summit Investments
Account
Recipient
Payer's Federal ID number
XXX-XX-2158
Jordan Kowalski
51-4376873
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 29
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
8,335.06
5,209.10
2,202.54
1099-INT  Interest Income
1 Interest income
254.82
1099-MISC  Miscellaneous Information
3 Other income
38.06
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-b68cb5f0603a1b1bf863a7a8,v11-CONSOLIDATED_1099-columns,original,2021,fgen-55f9b173b61d343c7701833e,synthetic_programmatic_template,columns,top,False,div_int_detail
"Northstar Securities
Account
Recipient
Payer's Federal ID number
****6631
Fatima Patel
17-1881950
Copy B for Recipient  OMB No. 1545-0715
Page 2 of 22
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
7,942.56
l,425.85
1,784.48
1O99-INT  InterestIncome
1 Interest income
833.24
l099-MISC  Miscellaneous Information
3 0ther income
29.79
1O99-B  5ummaryof Proceeds, Gains & Losses, Adjustments and Wíthholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basisreported to the IRS)
3,219.73
63,989.91
0.00
-3,029.49
Long
D (basis reported to the IRS)
27,125.89
82,048.49
0.00
15,161.19
This is important tax information and is being fumished to the Interna1 Revenue Service.",1099,5,1099,fdc-e46cae5061dc8edc35209bcf,v11-CONSOLIDATED_1099-columns,original,2021,fgen-77f488d1cfb8208b01bfaef5,synthetic_programmatic_template,columns,none,True,summary_page
"2025 Consolidated Form 1099
Summit Investments
Account
Recipient
Payer's Federal ID number
XXX-XX-7703
Diego Walsh
20-1104774
Copy B for Recipient  OMB No. 1545-0715
Page 2 of 9
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
5,893.89
1,954.59
925.71
1099-INT  Interest Income
1 Interest income
788.54
1099-MISC  Miscellaneous Information
3 Other income
27.50
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-e85a5838d6dc0fae79705bab,v11-CONSOLIDATED_1099-columns,original,2025,fgen-e90ba0a563c6d0f8bbef0466,synthetic_programmatic_template,columns,top,False,div_int_detail
"2024 Consolidated Form 1099
Clearwater Investing
Account
Recipient
Payer's Federal ID number
ending in 3206
Mateo Testcase
86-9836920
Copy B for Recipient  0MB No. 1545-0715
Page 1 of 26
1099-DIV Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
1,837.25
7,156.45
2,666.58
1099-INT  Interest Income
1 Interest income
670.83
l099-MI5C  Miscellaneous Information
3 0ther income
141.52
This is important tax information and is being furnished to the Internal Revenue5ervice.",1099,5,1099,fdc-9f340b0cafd29220f80c9392,v11-CONSOLIDATED_1099-columns,original,2024,fgen-a09ecc78ab31613597b893a7,synthetic_programmatic_template,columns,top,True,div_int_detail
"Form 1099 Composite & Year-End Summary
Northstar Securities
Account
Recipient
Payer's Federal ID number
****1777
Lena Testcase
48-7677709
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 9
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
8,473.27
2,385.19
2,399.65
1099-INT  Interest Income
1 Interest income
771.91
1099-MISC  Miscellaneous Information
3 Other income
59.43
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-a4b34c9cdbe06193a5f2bb35,v11-CONSOLIDATED_1099-columns,original,2024,fgen-502aa75a411b427a3cc62dde,synthetic_programmatic_template,columns,top,False,div_int_detail
"Summit Investments
Account
Recipient
Payer's Federal ID number
XXXXX7119
Noah Lindqvist
71-7526678
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 8
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
7,072.45
4,643.48
2,030.35
1099-INT  Interest Income
1 Interest income
509.34
1099-MISC  Miscellaneous Information
3 Other income
11.88
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
82,454.82
45,443.74
0.00
5,465.23
Long
D (basis reported to the IRS)
16,118.27
61,189.39
0.00
26,571.47
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-fe12a27f63cb868ce193fa77,v11-CONSOLIDATED_1099-columns,original,2022,fgen-f45dbf89e09aebc35dcdaa2f,synthetic_programmatic_template,columns,none,False,summary_page
"2026 Tax Information Statement
Northstar Securities
Account
Recipient
Payer's Federal ID number
XXX-XX-6874
Olivia Haddad
47-8155849
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 25
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
6,197.06
3,563.51
2,683.57
1099-INT  Interest Income
1 Interest income
791.14
1099-MISC  Miscellaneous Information
3 Other income
31.74
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-ee4e83cab2ef07c99b87046c,v11-CONSOLIDATED_1099-columns,original,2026,fgen-9aa37b74bda18f39a47e7c10,synthetic_programmatic_template,columns,top,False,div_int_detail
"2023 Tax Information Statement
Northstar Securities
Account
Recipient
Payer's Federal ID number
***-**-4530
Amara M. Moreau
52-7867356
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 20
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
2,564.88
733.90
509.31
1099-INT  Interest Income
1 Interest income
657.60
1099-MISC  Miscellaneous Information
3 Other income
13.68
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-d132fe946e8096d41fdf59e7,v11-CONSOLIDATED_1099-columns,original,2023,fgen-4b2e4d9e36aacc94e57b0f2a,synthetic_programmatic_template,columns,top,False,div_int_detail
"Form 1099 Composite & Year-End Summary
Evergreen Brokerage Services
Account
Recipient
Payer's Federal ID number
***-**-6732
Fatima Moreau
76-7589904
Copy B for Recipient  OMB No. 1545-0715
Page 2 of 11
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
8,510.74
4,973.14
1,973.00
1099-INT  Interest Income
1 Interest income
737.42
1099-MISC  Miscellaneous Information
3 Other income
189.15
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-287223c9c13b43e468bb9d71,v11-CONSOLIDATED_1099-columns,original,2026,fgen-86d7c9fc8040a2be043dad7c,synthetic_programmatic_template,columns,top,False,div_int_detail
"Clearwater Investing
Account
Recipient
Payer's Federal ID number
XXXXX5463
Sofia S. Walsh
55-5404997
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 26
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
6,863.30
4,822.38
2,820.53
1099-INT  Interest Income
1 Interest income
209.20
1099-MISC  Miscellaneous Information
3 Other income
35.89
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
13,685.92
69,841.19
0.00
-2,522.55
Long
D (basis reported to the IRS)
12,505.04
64,753.79
0.00
-2,324.91
This is important tax information and is being furnished to the Internal Revenue Service.
Form 1099 Composite & Year-End Summary",1099,5,1099,fdc-b8560d7e05e3552e336319ef,v11-CONSOLIDATED_1099-columns,original,2022,fgen-61378b81202c786b97be4610,synthetic_programmatic_template,columns,bottom,False,summary_page
"Tax Reporting Statement
Northstar Securities
Account
Recipient
Payer's Federal ID number
***-**-2842
Noah Moreau
47-5315645
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 24
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
58,656.36
5,017.31
0.00
5,346.33
Long
D (basis reported to the IRS)
82,923.83
22,644.62
0.00
-1,028.73
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-5868767699e097474d0910db,v11-CONSOLIDATED_1099-columns,original,2025,fgen-7f2346c98756e70c1712a1ac,synthetic_programmatic_template,columns,top,False,b_detail
"2022 Consolidated Form 1099
Northstar Securities
Account
Recipient
Payer's Federal ID number
****8669
Fatima Walsh
53-8859687
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 17
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
40,429.30
4,652.57
0.00
8,521.31
Long
D (basis reported to the IRS)
87,590.84
13,370.61
0.00
1,358.59
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-a79f55cff4ba7516d743a370,v11-CONSOLIDATED_1099-columns,original,2022,fgen-49ec3915bcf3b6cec1594fcb,synthetic_programmatic_template,columns,top,False,b_detail
"2022 Tax Information Statement
Northstar Securities
Account
Recipient
Payer's Federal ID number
XXX-XX-1768
Jordan Brennan
44-2363539
Copy B for Recipient  OMB No. 1545-0715
Page 2 of 23
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
88,682.91
74,545.80
0.00
-2,881.52
Long
D (basis reported to the IRS)
81,159.96
12,496.60
0.00
3,685.77
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-228de48ec8f7cfa6ff85c62a,v11-CONSOLIDATED_1099-columns,original,2022,fgen-e9c64b6a4423aec752a19936,synthetic_programmatic_template,columns,top,False,b_detail
"2024 Tax Information Statement
Northstar Securities
Account
Recipient
Payer's Federal ID number
XXX-XX-4566
Hiro Sato
91-2780548
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 11
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
245.67
1,087.44
279.90
1099-INT  Interest Income
1 Interest income
131.01
1099-MISC  Miscellaneous Information
3 Other income
149.29
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-82529b14f1c339d6b4c77a7f,v11-CONSOLIDATED_1099-columns,original,2024,fgen-f4207562f1913d08a848d2fd,synthetic_programmatic_template,columns,top,False,div_int_detail
"Tax Reporting Statement
Clearwater Investing
Account
Recipient
Payer's Federal ID number
****8885
Casey C. Kowalski
22-5460462
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 26
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
5,079.82
3,731.87
2,831.48
1099-INT  Interest Income
1 Interest income
570.31
1099-MISC  Miscellaneous Information
3 Other income
96.17
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-5e8093fcb0c769bab264b320,v11-CONSOLIDATED_1099-columns,original,2021,fgen-a142a21ba8135f4b1f46b3d0,synthetic_programmatic_template,columns,top,False,div_int_detail
"Form 1099 Composite & Year-End Summary
Evergreen Brokerage Services
Account
Recipient
Payer's Federal ID number
****6382
Lena Sato
32-9866473
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 29
1099-B  5ummary of Proceeds, Gains & Losses, Adjustments and Withho1ding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
7,563.82
32,973.22
O.O0
-3,984.96
Long
D (basis reported to theIRS)
37,604.14
24,615.28
0.00
-2,130.43
This is important tax information and is being fumished to the InternalRevenue 5ervice.",1099,5,1099,fdc-b9cfefe553d43630264d075f,v11-CONSOLIDATED_1099-columns,original,2021,fgen-44382922c643d00c652fef73,synthetic_programmatic_template,columns,top,True,b_detail
"Form 1099 Composite & Year-End Summary
Clearwater Investing
Account
Recipient
Payer's Federal ID number
XXXXX7408
Noah C. Tanaka
95-7l83760
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 26
1099-DIV  Dividends and Distributions
la Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
4,170.84
7,800.91
1,504.59
1099-INT  Interest Income
l Interest income
816.44
1099-MI5C  Miscellaneous Information
3 Other income
19.40
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form8949 type
Proceeds
Cost basís
Wash sa1e loss disallowed
Netgain or loss
Short
A (basis reported to the IRS)
19,234.69
88,3O2.23
0.00
8,059.46
Long
D(basis reported to the IRS)
73,553.90
5,715.09
0.00
-3,513.49
This is important tax information and is being fumished to the Internal Revenue Service.",1099,5,1099,fdc-a129d578ea96300570223b43,v11-CONSOLIDATED_1099-columns,original,2023,fgen-9846311c1525a2ace2bf9483,synthetic_programmatic_template,columns,top,True,summary_page
"2021 Consolidated Form 1099
Clearwater Investing
Account
Recipient
Payer's Federal ID number
XXXXX1100
Noah Rivera
26-1961908
Copy B for Recipient  OMB No. 1545-0715
Page 3 of 10
1099-DIV  Dividends and Distributions
1a Total ordinary dividends
1b Qualified dividends
2a Total capital gain distributions
4,298.21
4,388.02
1,515.91
1099-INT  Interest Income
1 Interest income
634.91
1099-MISC  Miscellaneous Information
3 Other income
103.90
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
6,465.46
74,734.23
0.00
3,581.57
Long
D (basis reported to the IRS)
1,060.42
71,731.13
0.00
-3,345.48
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-6aaf130cd65738c8a9d1059f,v11-CONSOLIDATED_1099-columns,original,2021,fgen-55d9441883065c02cd98b123,synthetic_programmatic_template,columns,top,False,summary_page
"Tax Reporting Statement
Ironwood Wealth Partners
Account
Recipient
Payer's Federal ID number
***-**-9494
Riley Tanaka
98-6710067
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 16
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
80,913.80
84,146.05
0.00
385.32
Long
D (basis reported to the IRS)
83,252.96
82,711.32
0.00
10,287.10
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-3c91f04822adf0376eedf5e3,v11-CONSOLIDATED_1099-columns,original,2021,fgen-3b266eb60abd40675d0009b5,synthetic_programmatic_template,columns,top,False,b_detail
"Evergreen Brokerage Services
Account
Recipient
Payer's Federal ID number
XXX-XX-l997
Hiro Lindqvist
93-1083496
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 9
1099-DIV Dividends and Distributions
1a Total ordinary dividcnds
1b Qualified dividends
2a Total capital gain distributions
74.70
2,104.19
1,241.89
1099-INT  Interest Income
1 Interest íncome
534.65
1099-MI5C  Míscellaneous Information
3 0ther income
18.52
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Washsale loss disallowed
Net gain or loss
Short
A (basis reported to thc IRS)
64,793.26
73,923.45
0.00
3,777.30
Long
D (basis reported to the IRS)
87,ll3.64
87,543.11
0.00
1,758.46
This is important tax information and is being furnished to the Internal RevenueService.
2026 Conso1idated Form 1099",1099,5,1099,fdc-e56a5111344a407ae1d7204b,v11-CONSOLIDATED_1099-columns,original,2026,fgen-b669bf2878b09a739fc238b7,synthetic_programmatic_template,columns,bottom,True,summary_page
"Form 1099 Composite & Year-End Summary
Northstar Securities
Account
Recipient
Payer's Federal ID number
ending in 4092
Wei D. Brennan
48-6680470
Copy B for Recipient  OMB No. 1545-0715
Page 1 of 27
1099-B  Summary of Proceeds, Gains & Losses, Adjustments and Withholding
Term
Form 8949 type
Proceeds
Cost basis
Wash sale loss disallowed
Net gain or loss
Short
A (basis reported to the IRS)
27,901.92
84,779.45
0.00
-4,574.44
Long
D (basis reported to the IRS)
87,961.90
72,083.53
0.00
15,944.94
This is important tax information and is being furnished to the Internal Revenue Service.",1099,5,1099,fdc-26f66feb9373a55661ab29a7,v11-CONSOLIDATED_1099-columns,original,2022,fgen-d4bfb2a223ab8a70d18cd16f,synthetic_programmatic_template,columns,top,False,b_detail
"Everyday Cash Card
Bluewater Bank Card Center
Account ending in,9140
Opening/Closing Date,07/01/2026 - 07/31/2026
Account Summary
Previous Balance,""$5,892.12""
""Payments, Credits"",""-$5,892.12""
Purchases,""$2,998.66""
Fees Charged,$0.00
Interest Charged,$18.45
New Balance,""$3,985.13""
Minimum Payment Due,$151.59
Payment Due Date,9/20/26
Purchase APR,18.92%
Trans Date,Description,Amount
08/05,UBER TRIP,568.22
05/14,TARGET T-2231,302.77
10/14,AMAZON MKTPLACE,503.23
09/18,NETFLIX.COM,856.00
10/06,WHOLE FOODS #1021,443.64
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-165126057f005edaaba3d77b,v11-CREDIT_CARD_STATEMENT-csv,original,2026,fgen-f53fa8bd54281fc67bcc1d06,synthetic_programmatic_template,csv,top,False,monthly
"Trans. Date,Post Date,Description,Amount,Category
02/06/2025,2025-09-19,DELTA AIR LINES,670.11,Merchandise
04/04/2025,2025-04-09,AMAZ0N MKTPLACE,53.28,Merchandise
03/08/2025,02/l0/2025,DELTA AIRLINE5,513.93,Merchandise
2025-09-28,27/04/2025,COSTCO WHSE #412,-658.74,Restaurants
01/28/2025,19/02/2025,AMAZON MKTPLACE,-383.06,Merchandise
06/23/2025,2025-06-16,AMAZON MKTPLACE,423.74,Restaurants",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-6483d8023401d1d2da39018e,v11-CREDIT_CARD_STATEMENT-csv,original,2025,fgen-8da12fbffd5db1c2d764594e,synthetic_programmatic_template,csv,top,True,raw_export
"Bluewater Bank Card Center
Account ending in,4364
Opening/Closing Date,07/01/2023 - 07/30/2023
Account Summary
Previous Balance,""$4,863.59""
""Payments, Credits"",""-$4,863.59""
Purchases,""$2,891.41""
Fees Charged,$0.00
Interest Charged,$50.93
New Balance,""$1,167.91""
Minimum Payment Due,$138.91
Payment Due Date,09/05/2023
Purchase APR,19.84%
Trans Date,Description,Amount
10/10,CVS/PHARMACY 0832,483.22
07/27,STARBUCKS #11872,275.95
06/02,TARGET T-2231,131.73
10/19,STARBUCKS #11872,352.15
05/02,STARBUCKS #11872,811.31",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-f60bd555fb76bfce50104f6a,v11-CREDIT_CARD_STATEMENT-csv,original,2023,fgen-fb754ca7a11728eb4b70a5e2,synthetic_programmatic_template,csv,none,False,monthly
"Card ending in 2298 - Activity
Transaction Date,Post Date,Description,Category,Type,Amount,Memo
19/02/2022,11/16/2022,CVS/PHARMACY 0832,Food & Drink,Sale,844.74,
2022-07-01,04/17/2022,WHOLE FOODS #1021,Groceries,Sale,-772.24,
2022-08-09,2022-08-04,UBER TRIP,Travel,Sale,-68.91,
09/08/2022,03/17/2022,HOME DEPOT 0612,Food & Drink,Return,-372.28,
06/12/2022,2022-08-01,AMAZON MKTPLACE,Gas,Sale,310.61,
03/27/2022,04/01/2022,DELTA AIR LINES,Food & Drink,Return,-885.17,
04/14/2022,02/20/2022,DELTA AIR LINES,Gas,Payment,-422.19,
06/28/2022,11/02/2022,UBER TRIP,Shopping,Sale,-565.26,",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-f1305f5993e01df7cbdcba1a,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-02afadcefcacf655ad4fd92a,synthetic_programmatic_template,csv,top,False,raw_export
"World Elite Mastercard
Bluewater Bank Card Center
Account ending in,7802
Opening/Closing Date,02/01/2026 - 02/28/2026
Account Summary
Previous Balance,""$6,538.58""
""Payments, Credits"",""-$6,538.58""
Purchases,""$2,205.20""
Fees Charged,$0.00
Interest Charged,$75.24
New Balance,""$1,355.30""
Minimum Payment Due,$37.85
Payment Due Date,""May 21, 2026""
Purchase APR,27.82%
Trans Date,Description,Amount
01/22,WHOLE FOODS #1021,535.39
08/06,COSTCO WHSE #412,100.00
06/20,TARGET T-2231,862.55
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-edf8c1f87c7ec8ce9e95c9ee,v11-CREDIT_CARD_STATEMENT-csv,original,2026,fgen-99381e220829bd5ee6e5ca98,synthetic_programmatic_template,csv,top,False,monthly
"Bluewater Bank Card Center
Account ending in,7378
Opening/Closing Date,12/01/2026 - 12/30/2026
Account Summary
Previous Balance,""$3,375.56""
""Payments, Credits"",""-$3,375.56""
Purchases,""$1,777.81""
Fees Charged,$0.00
Interest Charged,$65.51
New Balance,""$5,273.83""
Minimum Payment Due,$47.67
Payment Due Date,""September 14, 2026""
Purchase APR,26.92%
Trans Date,Description,Amount
05/11,DELTA AIR LINES,796.54
05/03,TARGET T-2231,389.18
09/22,SHELL OIL 5741,20.30
11/19,CVS/PHARMACY 0832,136.34
05/27,CVS/PHARMACY 0832,526.83",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-42c6baecc36f2e37c03cf388,v11-CREDIT_CARD_STATEMENT-csv,original,2026,fgen-beca7635a37d5d7154e356d3,synthetic_programmatic_template,csv,none,False,monthly
"Downloaded 09/08/2022
Transaction Date,Post Date,Description,Category,Type,Amount,Memo
02/05/2022,07/25/2022,NETFLIX.COM,Shopping,Sale,40.14,
2022-12-10,2022-10-26,SHELL OIL 5741,Food & Drink,Sale,-438.24,
12/05/2022,04/22/2022,WHOLE FOODS #1021,Food & Drink,Sale,-308.34,
Rewards Visa ...5084",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-10a7cbf0c3df3930aa4c5cd9,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-5cf52567b8e8c9df34105dcd,synthetic_programmatic_template,csv,bottom,False,raw_export
"Harbor Card Services
Account ending in,0439
Opening/Closing Date,08/01/2025 - 08/30/2025
Account Summary
Previous Balance,""$3,932.10""
""Payments, Credits"",""-$3,932.10""
Purchases,""$2,806.40""
Fees Charged,$0.00
Interest Charged,$81.39
New Balance,""$2,147.48""
Minimum Payment Due,$27.20
Payment Due Date,10/16/2025
Purchase APR,23.88%
Trans Date,Description,Amount
02/17,TARGET T-2231,194.84
02/22,DELTA AIR LINES,891.47
11/21,SHELL OIL 5741,601.97
06/25,NETFLIX.COM,223.04
09/11,TARGET T-2231,651.63
09/22,WHOLE FOODS #1021,448.87
01/27,DELTA AIR LINES,526.48
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.
Cash Back Mastercard",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-f4dbdb06840142e13bf4dc52,v11-CREDIT_CARD_STATEMENT-csv,original,2025,fgen-e68f4cd2259f1711491ce224,synthetic_programmatic_template,csv,bottom,False,monthly
"Northwind Card Member Services
Account ending in,6008
Opening/Closing Date,03/01/2021 - 03/28/2021
Account Summary
Previous Balance,""$4,312.70""
""Payments, Credits"",""-$4,312.70""
Purchases,""$4,425.76""
Fees Charged,$0.00
Interest Charged,$25.91
New Balance,""$4,076.54""
Minimum Payment Due,$190.29
Payment Due Date,02/04/2021
Purchase APR,17.23%
Trans Date,Description,Amount
06/21,UBER TRIP,659.54
07/23,CVS/PHARMACY 0832,131.60
06/26,AMAZON MKTPLACE,616.98
06/24,WHOLE FOODS #1021,336.40
12/18,CVS/PHARMACY 0832,412.81",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-2dcfbb90244216209ed3310b,v11-CREDIT_CARD_STATEMENT-csv,original,2021,fgen-96e17f8f871a1cb4af0169e2,synthetic_programmatic_template,csv,none,False,monthly
"Credit Card Transactions
Transaction Datc,Post Date,Description,Category,Type,Amount,Memo
O3/07/2021,01/05/2021,DELTA AIR LINE5,Groceries,Return,-493.94,
15/1O/2021,02/23/2O21,HOME DEPOT 0612,Shopping,Sale,-368.85,
2021-08-07,17/04/2021,HOMEDEPOT 0612,Food & Drink,Sale,-460.45,
01/23/2021,2021-09-03,HOME DEPOT 0612,Food & Drínk,Sale,-117.22,
2021-08-08,13/11/2021,TARGET T-2231,Groceries,Payment,-743.90,
11/02/2021,06/27/2021,AMAZON MKTPLACE,Shopping,Retum,-11.86,
04/09/2021,12/01/2021,SHELL OIL 5741,Food & Drink,Sale,-31.79,
15/12/2021,07/01/2021,AMAZON MKTPLACE,Gas,Sale,-161.52,
2O21-01-06,21/06/2021,TARGET T-2231,5hopping,Retum,815.93,",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-7091929c61e59d8c0c50aade,v11-CREDIT_CARD_STATEMENT-csv,original,2021,fgen-d175406706244c30258d74c3,synthetic_programmatic_template,csv,top,True,raw_export
"Rewards Visa Signature
Atlas Card Services
Account ending in,2554
Opening/Closing Date,08/01/2021 - 08/30/2021
Account Summary
Previous Balance,""$1,964.33""
""Payments, Credits"",""-$1,964.33""
Purchases,""$4,082.60""
Fees Charged,$0.00
Interest Charged,$5.84
New Balance,""$3,020.64""
Minimum Payment Due,$111.50
Payment Due Date,06/05/2021
Purchase APR,26.56%
Trans Date,Description,Amount
07/24,COSTCO WHSE #412,768.79
01/06,UBER TRIP,61.47
02/12,WHOLE FOODS #1021,500.84
08/01,COSTCO WHSE #412,50.11
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-4ac9d866f9599fd393ec2dd0,v11-CREDIT_CARD_STATEMENT-csv,original,2021,fgen-8ecaf2ebd6219a045cfb02a3,synthetic_programmatic_template,csv,top,False,monthly
"Rewards Visa...7530
Downloaded 2021-07-04
Transaction Date,Post Date,Description,Category,Type,Amount,Memo
02/19/2021,18/07/2021,HOME DEPOT 0612,Travcl,Retum,-555.99,
2021-02-20,24/11/2021,WHOLE FOODS #1021,Food & Drink,Payment,-607.10,
07/04/2021,11/28/2021,COSTCO WHSE #412,Groceries,Payment,721.91,
2021-06-18,18/11/2021,UBER TRIP,Travel,Sale,187.77,",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-a71982e3871aa5523f7f8599,v11-CREDIT_CARD_STATEMENT-csv,original,2021,fgen-5a8bc693ec658295a21a04f1,synthetic_programmatic_template,csv,top,True,raw_export
"Northwind Card Member Services
Category,Transactions,Total
Dining,58,318.67
Travel,53,526.16
Merchandise,79,""6,335.64""
Groceries,50,""2,846.91""
Total purchases this year,""51,250.04""
Total interest charged this year,$349.63
This summary is provided for your records and is not a tax form.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-1a0cdf0ad3d45818a2f6308c,v11-CREDIT_CARD_STATEMENT-csv,original,2025,fgen-acffefc7fdc1f47b1f5d2459,synthetic_programmatic_template,csv,none,False,year_end_summary
"Summit Card Services
Account ending in,2563
Opening/Closing Date,06/01/2022 - 06/30/2022
Account Summary
Previous Balance,""$4,273.44""
""Payments, Credits"",""-$4,273.44""
Purchases,""$4,233.80""
Fees Charged,$0.00
Interest Charged,$25.77
New Balance,""$3,762.83""
Minimum Payment Due,$77.04
Payment Due Date,7/28/22
Purchase APR,23.53%
Trans Date,Description,Amount
04/19,UBER TRIP,464.69
07/09,DELTA AIR LINES,297.36
03/19,AMAZON MKTPLACE,335.05
07/04,AMAZON MKTPLACE,151.33
01/20,TARGET T-2231,646.41
03/12,SHELL OIL 5741,498.25
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-90354d80629d1589c21fbfe7,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-4dc2240cbdde2cb546be238e,synthetic_programmatic_template,csv,none,False,monthly
"Credit Card Transactions
Date,Description,Card Member,Account #,Amount
2025-11-08,DELTA AIR LINES,MORGAN MOREAU,-36538,849.97
01/21/2025,COSTCO WHSE #412,SOFIA WALSH,-39985,789.85
12/05/2025,COSTCO WHSE #412,NOAH RIVERA,-86230,170.15
09/04/2025,HOME DEPOT 0612,OLIVIA B. CASTILLO,-28254,100.40
2025-09-02,WHOLE FOODS #1021,KWAME WALSH,-86342,102.31
2025-03-15,WHOLE FOODS #1021,DIEGO S. TANAKA,-46388,853.85
02/06/2025,DELTA AIR LINES,ALEX TANAKA,-11648,636.77
02/11/2025,SHELL OIL 5741,LENA HADDAD,-72401,879.95",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-6292f91b277a3465a4e34cb8,v11-CREDIT_CARD_STATEMENT-csv,original,2025,fgen-f2cfd7186e85cb08e1ff40f6,synthetic_programmatic_template,csv,top,False,raw_export
"World Elite Mastercard
2022 Year-End Summary
Harbor Card Services
Category,Transactions,Total
Dining,50,972.76
Groceries,15,""4,556.04""
Merchandise,79,""1,938.37""
Travel,85,""5,898.15""
Total purchases this year,""36,727.34""
Total interest charged this year,610.44
This summary is provided for your records and is not a tax form.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-e33897087a2a935829a46e37,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-f16bf97332e996ea8705e8a0,synthetic_programmatic_template,csv,top,False,year_end_summary
"Northwind Card Member Services
Category,Transactions,Total
Gas,13,""7,313.34""
Services,26,""1,565.40""
Merchandise,25,""3,871.31""
Travel,2,""6,700.72""
Total purchases this year,""48,468.12""
Total interest charged this year,$873.02
This summary is provided for your records and is not a tax form.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-6b4ad887ece61db5bb21911a,v11-CREDIT_CARD_STATEMENT-csv,original,2026,fgen-5b545bdf7ee345ae0704243c,synthetic_programmatic_template,csv,none,False,year_end_summary
"Travel Rewards Visa
Summit Card Services
Account ending in,8103
Opening/Closing Date,10/01/2022 - 10/31/2022
Account Summary
Previous Balance,""$3,340.59""
""Payments, Credits"",""-$3,340.59""
Purchases,""$2,403.34""
Fees Charged,$0.00
Interest Charged,$106.76
New Balance,$919.87
Minimum Payment Due,$105.63
Payment Due Date,10/12/22
Purchase APR,21.25%
Trans Date,Description,Amount
03/10,AMAZON MKTPLACE,756.87
08/03,DELTA AIR LINES,541.35
11/21,HOME DEPOT 0612,739.14
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-0e3a24bb0313115bb4e48731,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-3e6ff8df54bcb8d9592b92d3,synthetic_programmatic_template,csv,top,False,monthly
"World Elite Mastercard
Northwind Card Member Services
Account ending in,4624
Opening/Closing Date,06/01/2024 - 06/28/2024
Account Summary
Previous Balance,""$5,029.30""
""Payments, Credits"",""-$5,029.30""
Purchases,""$3,029.69""
Fees Charged,$0.00
Interest Charged,$78.54
New Balance,""$3,759.34""
Minimum Payment Due,$156.29
Payment Due Date,11/03/2024
Purchase APR,23.10%
Trans Date,Description,Amount
07/13,COSTCO WHSE #412,639.21
02/20,TARGET T-2231,221.70
09/24,HOME DEPOT 0612,838.78
06/10,AMAZON MKTPLACE,582.75
07/21,HOME DEPOT 0612,238.51
08/18,HOME DEPOT 0612,35.17
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-29e107708dc54f40d21dce74,v11-CREDIT_CARD_STATEMENT-csv,original,2024,fgen-03afd243c24eb767b100eebd,synthetic_programmatic_template,csv,top,False,monthly
"Card ending ín 2438 - Activity
Trans.Date,Post Date,Description,Amount,Category
2023-05-20,10/15/2023,NETFLIX.COM,608.11,Restaurants
01/14/2023,12/02/2023,UBER TRIP,-732.94,Restaurants
24/03/2023,19/04/2023,AUT0PAY PAYMENT - THANK YOU,824.03,Restaurants
2023-09-l4,06/10/2023,CVS/PHARMACY 0832,80.01,Restaurants",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-2f7351221be10f55f5e78d5c,v11-CREDIT_CARD_STATEMENT-csv,original,2023,fgen-76109ae1aff4da5533ab2464,synthetic_programmatic_template,csv,top,True,raw_export
"Travel Rewards Visa
2025 Year-End Summary
Atlas Card Services
Category,Transactions,Total
Merchandise,73,""4,668.84""
Gas,71,""7,126.52""
Dining,5,""5,878.11""
Travel,68,""1,591.90""
Total purchases this year,""23,003.31""
Total interest charged this year,376.87
This summary is provided for your records and is not a tax form.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-d8d3056ada9c56aebd81880f,v11-CREDIT_CARD_STATEMENT-csv,original,2025,fgen-3ffab1b0d7b7524c1eacf720,synthetic_programmatic_template,csv,top,False,year_end_summary
"Cash Back Mastercard
Harbor Card Services
Account ending in,8805
Opening/Closing Date,02/01/2022 - 02/28/2022
Account Summary
Previous Balance,""$7,845.85""
""Payments, Credits"",""-$7,845.85""
Purchases,""$4,947.41""
Fees Charged,$0.00
Interest Charged,$8.21
New Balance,""$1,578.07""
Minimum Payment Due,$141.18
Payment Due Date,""August 10, 2022""
Purchase APR,21.07%
Trans Date,Description,Amount
07/13,NETFLIX.COM,350.02
11/12,STARBUCKS #11872,574.73
04/06,SHELL OIL 5741,319.11
01/03,TARGET T-2231,211.05
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-0f06f084ac58ced460fd15ad,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-5135d2447e40dbc3e9961e17,synthetic_programmatic_template,csv,top,False,monthly
"Transaction Date,Post Date,Description,Category,Type,Amount,Memo
10/23/2022,04/07/2022,CVS/PHARMACY 0832,Travel,Sale,553.05,
03/15/2022,28/08/2022,CVS/PHARMACY 0832,Travel,Sale,-371.09,
2022-09-03,15/05/2022,STARBUCKS #11872,Shopping,Payment,-636.26,
07/21/2022,2022-06-27,SHELL OIL 5741,Groceries,Sale,-363.92,
18/03/2022,2022-06-10,COSTCO WHSE #412,Shopping,Payment,-478.85,
04/14/2022,2022-02-04,NETFLIX.COM,Travel,Sale,-607.10,
06/05/2022,02/16/2022,HOME DEPOT 0612,Food & Drink,Sale,600.68,
2022-03-27,16/12/2022,UBER TRIP,Food & Drink,Payment,-677.97,
04/21/2022,11/24/2022,STARBUCKS #11872,Travel,Payment,-418.38,",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-bf4647c69e23e8ae6750d5fb,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-72f8f1b6a95bae08e8dc7a2f,synthetic_programmatic_template,csv,top,False,raw_export
"World Elite Mastercard
Atlas Card Services
Account ending in,4546
Opening/Closing Date,03/01/2024 - 03/31/2024
Account Summary
Previous Balance,""$4,852.71""
""Payments, Credits"",""-$4,852.71""
Purchases,$932.63
Fees Charged,$0.00
Interest Charged,$40.65
New Balance,""$2,675.77""
Minimum Payment Due,$160.90
Payment Due Date,06/25/2024
Purchase APR,27.55%
Trans Date,Description,Amount
03/18,TARGET T-2231,155.57
02/15,DELTA AIR LINES,612.91
08/12,COSTCO WHSE #412,215.98
01/02,DELTA AIR LINES,328.30
10/22,WHOLE FOODS #1021,146.05
04/22,DELTA AIR LINES,742.35",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-d87f77372bc17116abe99883,v11-CREDIT_CARD_STATEMENT-csv,original,2024,fgen-a411660bb59ea6defb1dcb3b,synthetic_programmatic_template,csv,top,False,monthly
"World Elite Mastercard
Harbor Card Services
Account ending in,4908
Opening/Closing Date,03/01/2021 - 03/30/2021
Account Summary
Previous Balance,""$7,835.89""
""Payments, Credits"",""-$7,835.89""
Purchases,""$3,689.08""
Fees Charged,$0.00
Interest Charged,$102.10
New Balance,""$3,509.99""
Minimum Payment Due,$43.07
Payment Due Date,2021-05-11
Purchase APR,18.90%
Trans Date,Description,Amount
03/01,AMAZON MKTPLACE,99.67
12/12,HOME DEPOT 0612,826.80
08/08,NETFLIX.COM,441.79
05/22,WHOLE FOODS #1021,148.69",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-bb00ebf0a86db6d3fc5606fa,v11-CREDIT_CARD_STATEMENT-csv,original,2021,fgen-28360109785148b4b34f8791,synthetic_programmatic_template,csv,top,False,monthly
"Credit Card Transactions
Date,Description,Card Member,Account #,Amount
2022-12-08,CVS/PHARMACY 0832,NOAH TESTCASE,-29517,455.93
11/16/2022,WHOLE FOODS #1021,FATIMA MOREAU,-13202,280.60
2022-03-04,SHELL OIL 5741,AMARA HADDAD,-27119,784.73
14/01/2022,UBER TRIP,AMARA E. WALSH,-56300,273.70
13/06/2022,DELTA AIR LINES,TAYLOR E. FISCHER,-58276,883.58
20/03/2022,COSTCO WHSE #412,DIEGO J. HADDAD,-58840,734.78
2022-10-28,UBER TRIP,TAYLOR LARSEN,-83039,625.39",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-15efc77800aa8756026a52c4,v11-CREDIT_CARD_STATEMENT-csv,original,2022,fgen-a7562a0f616d8e1b71b962d2,synthetic_programmatic_template,csv,top,False,raw_export
"Rewards Visa ...5480
Downloadcd 03/02/2023
Date,Description,Card Member,Account #,Amount
17/10/2023,NETFLIX.COM,KWAME E. ADEYEMI,-23420,797.26
22/02/2023,NETFLIX.COM,DIEGO LARSEN,-93472,105.36
09/10/2023,STARBUCKS #11872,HIRO NGUYEN,-15636,40.07
2023-07-06,STARBUCKS#11872,MORGAN ROMERO,-35947,92.09
l0/24/2023,AMAZON MKTPLACE,RILEY ROMERO,-25833,202.28
05/18/2023,UBER TRIP,AMARA TESTCASE,-3977O,277.82
10/23/2023,UBER TRIP,SOFIA FISCHER,-83555,850.05",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-bbdfbd87eaa499bc16d0d25f,v11-CREDIT_CARD_STATEMENT-csv,original,2023,fgen-8ff2e63b652ff03950d5fa1d,synthetic_programmatic_template,csv,top,True,raw_export
"Travel Rewards Visa
Northwind Card Member Services
Account ending in,3550
Opening/Closing Date,06/01/2024 - 06/31/2024
Account Summary
Previous Balance,""$7,168.25""
""Payments, Credits"",""-$7,168.25""
Purchases,""$1,567.69""
Fees Charged,$0.00
Interest Charged,$68.09
New Balance,""$1,248.64""
Minimum Payment Due,$128.02
Payment Due Date,03/12/2024
Purchase APR,28.23%
Trans Date,Description,Amount
03/22,CVS/PHARMACY 0832,96.45
09/17,WHOLE FOODS #1021,501.07
10/22,HOME DEPOT 0612,557.74
01/10,CVS/PHARMACY 0832,825.76
02/02,COSTCO WHSE #412,252.36
11/27,SHELL OIL 5741,68.85",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-575b14d03e51bf27918e948d,v11-CREDIT_CARD_STATEMENT-csv,original,2024,fgen-811c23e1a5ed455e4118c000,synthetic_programmatic_template,csv,top,False,monthly
"Platinum Card
Harbor Card Services
Account ending in,7084
Opening/Closing Date,07/01/2024 - 07/31/2024
Account Summary
Previous Balance,""$3,144.79""
""Payments, Credits"",""-$3,144.79""
Purchases,""$3,448.14""
Fees Charged,$0.00
Interest Charged,$47.50
New Balance,""$5,487.71""
Minimum Payment Due,$31.50
Payment Due Date,06/03/2024
Purchase APR,27.41%
Trans Date,Description,Amount
03/24,STARBUCKS #11872,536.01
06/27,TARGET T-2231,55.00
02/15,UBER TRIP,422.85",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-09c6c8b0268aabdebbfc627b,v11-CREDIT_CARD_STATEMENT-csv,original,2024,fgen-7cb95e6d342a22889a8b1996,synthetic_programmatic_template,csv,top,False,monthly
"Atlas Card Scrvices
Account ending in,7664
Opening/C1osing Date,11/01/2026 - 11/31/2026
Account Summary
Previous Balance,""$1,162.97""
""Payments, Credits"",""-$1,162.97""
Purchases,""$3,522.52""
Fees Charged,$0.00
Interest Charged,$11.74
New Balance,""$1,739.41""
Minimum Payment Due,$148.05
Payment Due Date,""December 9, 2026""
Purchase APR,27.03%
Trans Date,Description,Amount
06/19,WHOLE FOOD5 #1021,498.89
10/02,CO5TCO WHSE #412,399.88
10/10,STARBUCKS #11872,520.95
07/12,DELTAAIR LINES,319.17
04/03,TARGET T-2231,609.55
09/28,DELTA AIR LINES,43l.75
Late Payment Wamíng: If we do not receíve your minimum payment by the date listedabovc, you may have to pay a late fee.
Everyday Cash Card",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-f82c406e1c4d1df6d1cd18da,v11-CREDIT_CARD_STATEMENT-csv,original,2026,fgen-b72a3d4ce77ea77082ef8f9c,synthetic_programmatic_template,csv,bottom,True,monthly
"Transaction Date,Post Date,Description,Category,Type,Amount,Memo
02/20/2024,12/06/2024,STARBUCKS #11872,Travel,Sale,-52.37,
2024-12-24,12/23/2024,TARGET T-2231,Gas,Payment,-375.17,
21/12/2024,2024-03-19,STARBUCKS #11872,Groceries,Sale,-104.18,
2024-02-13,2024-11-01,AMAZON MKTPLACE,Shopping,Payment,-28.54,
04/03/2024,15/10/2024,AMAZON MKTPLACE,Travel,Payment,-238.92,",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-b2d6310ff8f9b9eda227c9de,v11-CREDIT_CARD_STATEMENT-csv,original,2024,fgen-90e95b79853a4a1746a8ea6b,synthetic_programmatic_template,csv,bottom,False,raw_export
"Everyday Cash Card
Summit Card Services
Account ending in,5775
Opening/Closing Date,01/01/2021 - 01/30/2021
Account Summary
Previous Balance,$498.43
""Payments, Credits"",-$498.43
Purchases,""$3,501.76""
Fees Charged,$0.00
Interest Charged,$2.33
New Balance,""$1,721.59""
Minimum Payment Due,$38.11
Payment Due Date,""October 12, 2021""
Purchase APR,20.93%
Trans Date,Description,Amount
03/08,TARGET T-2231,337.31
09/01,HOME DEPOT 0612,237.41
12/26,CVS/PHARMACY 0832,471.97
07/09,COSTCO WHSE #412,74.06
08/08,SHELL OIL 5741,24.81
08/02,UBER TRIP,270.35
05/17,WHOLE FOODS #1021,390.30
Late Payment Warning: If we do not receive your minimum payment by the date listed above, you may have to pay a late fee.",CREDIT_CARD_STATEMENT,26,CREDIT_CARD_STATEMENT,fdc-7d4d6253e2fe1e2c3c60e174,v11-CREDIT_CARD_STATEMENT-csv,original,2021,fgen-b6cad5ca1147f385b5152199,synthetic_programmatic_template,csv,top,False,monthly
"Crypto Transaction
History Export CoinLedger-style report Account Wei Okafor Cost basis method FIFO Asset Amount Date Acquired Date Sold Proceeds Cost Basis USDC 12.885467 02/22/2021 4/25/23 4,637.89 5,542.04 USDC 16.150729 3/7/21 05/17/2023 401.08 329.04 SOL
3.631517 2022-06-03 2023-03-11 3,432.73 4,371.16 USDC 14.677756 May 3, 2021 06/17/2023 17,416.29 10,615.20 USDC 7.321714 2/11/23 5/24/23 15,341.29 12,760.17 USDC 5.272225 03/19/2022 10/16/23 4,238.11 2,564.44 Generated by tax software from your exchange history.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-9a702e6dd20d9eab636d6e88,v11-CRYPTO_TAX_REPORT-flat,original,2023,fgen-84c780cbed1ec43862b238a0,synthetic_programmatic_template,flat,top,False,transaction_history
"2021 Crypto Tax Summary CoinLedger-style report Account Morgan Sato Cost basis method HIFO Short-term realized gain/loss -3,004.72 Long-term realized gain/loss 22,280.07 Staking and other income 2,996.13 Asset Amount Date Acquired
Date Sold Proceeds Cost Basis ADA 20.824486 11/21/2021 3/16/21
5,111.54 3,138.24 BTC 20.897699 May 10, 2021 2021-08-22 8,249.15 8,223.85 BTC 19.679548 2020-03-19 January 19, 2021 18,360.22 13,601.15 BTC 8.288660 December 4, 2020 08/23/2021 11,274.42 12,495.07 BTC 12.699913 1/20/20 1/16/21 6,852.79 8,603.67 Use this report to prepare Form 8949; it is not a Form 1099-DA.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-5e764a9533a6e29e0f167a31,v11-CRYPTO_TAX_REPORT-flat,original,2021,fgen-c5f533ac4f950e1af064f664,synthetic_programmatic_template,flat,top,False,tax_software_summary
"2021 Crypto Tax Summary LedgerPeak Markets Account Sofia J. Patel Cost basis method Specific ID Short-term realized gain/loss 4,505.31 Long-term realized gain/loss -8,099.38 Staking
and other income 2,266.16 Asset Amount Date Acquired Date Sold Proceeds
Cost Basis ETH 12.338210 09/09/2019 06/17/2021 7,869.01 8,336.71 ETH 2.956937 10/8/19 November 22, 2021 2,943.26 3,295.54 BTC 5.644502 2020-09-21 7/20/21 17,886.52 17,096.82 SOL 7.593291 12/9/19 08/23/2021 10,783.26 6,005.91 ADA 27.892411 07/18/2019 04/09/2021 9,145.58 5,830.36 ADA 16.526747 2020-07-03 06/07/2021 11,327.30 11,018.35 This report is for informational purposes and is not an IRS form.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-40e0322d0daf7b6c53375950,v11-CRYPTO_TAX_REPORT-flat,original,2021,fgen-87f09b145622e952c1ff2e03,synthetic_programmatic_template,flat,top,False,tax_software_summary
"Timestamp
Transaction Type Asset Quantity TransactedSpot Price at Transaction Subtotal Total (inclusive of fees) Fees 2025-10-15T12:08:00Z Buy BTC 19.110612 5693.63 8591.20 6376.70 2.83 17/08/2025T03:22:00Z Send BTC 1.028805 1404.84 1640.18 1601.90 34.98 08/05/2025T19:58:00Z Convert BTC
9.093840 29208.72 8156.40 6518.53 5.52",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-465510ac3473ab5aac9f9cd5,v11-CRYPTO_TAX_REPORT-flat,original,2025,fgen-b7bbba04fc6bb101b9691a39,synthetic_programmatic_template,flat,top,True,raw_export
"2022 Realized
Gains and Losses Report CoinLedger-style report Account Avery D.
Kowalski Cost basis method FIFO Short-term realized gain/loss 19,099.34 Long-term realized gain/loss -2,745.07 Staking and other income 1,571.43 Asset Amount Date Acquired Date Sold Proceeds Cost Basis USDC 0.005624 08/05/2021 August 23, 2022 10,483.92 6,483.45 SOL 1.842821 July 3, 2021 April 27, 2022 17,397.30 19,678.88 BTC 6.662502 12/13/20 2022-07-25 4,561.44 5,390.57 This report is for informational purposes and is not an IRS form.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-38428b7b3b951e4ef63995e0,v11-CRYPTO_TAX_REPORT-flat,original,2022,fgen-a1281d368a7441899c96c8f5,synthetic_programmatic_template,flat,top,False,gain_loss
"Crypto Transaction History Export LedgerPeak Markets Account Fatima D. Nguyen Cost basis methodHIFO Asset Amount Date Acquired Datc Sold Procceds Cost Basis BTC 9.856427 08/23/2022 l0/14/22 8,782.59 7,694.67 ETH 10.081991 08/01/2020 2022-04-12
11,359.62 6,789.87 ETH 19.354657 August l4, 2020 2022-10-24 4,841.34 3,678.88 Generated by tax software from your
exchange history.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-99b2864b520a62c1c1c91fa7,v11-CRYPTO_TAX_REPORT-flat,original,2022,fgen-abce29b1b8c1cbb2a168d2d0,synthetic_programmatic_template,flat,top,True,transaction_history
"BitMeadow Account Mateo Castillo Cost basis method HIFO Short-term realized gain/loss -5,224.52 Long-term realized gain/loss 10,890.37 Staking and other income 1,152.16 Asset Amount Date Acquired Date Sold Proceeds Cost Basis ETH 19.600050 11/08/2024 11/19/25 601.11 317.48 SOL 0.391203 November 19, 2024 06/07/2025 8,855.68 7,048.66 ETH 18.717856 March 2, 2023 October 1, 2025 13,743.93 7,640.45 BTC 22.879587 04/12/2024 8/18/25 14,319.57 14,216.40 BTC 7.053067 01/07/2024 04/13/2025
5,508.81 6,231.15
SOL 9.146637 4/28/24 7/10/25 16,212.98 10,975.21 Use this report to prepare Form 8949; it is not a Form 1099-DA.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-a3896efad35cac1177c5d93a,v11-CRYPTO_TAX_REPORT-flat,original,2025,fgen-be38c5adf3922660d77d4ee6,synthetic_programmatic_template,flat,none,False,tax_software_summary
"Crypto gains and losses - 2025 Timestamp Transaction Type
Asset Quantity Transacted Spot Price at Transaction Subtotal Total (inclusive of fees) Fees 2025-06-19T11:41:00Z Buy USDC 16.111574 34575.95 5527.05 8083.84 21.39 08/03/2025T18:33:00Z Buy BTC 7.859655 22946.65 5638.30 1187.31 23.29 05/09/2025T07:54:00Z
Buy BTC 8.472556 46931.96 7206.32 6898.33 0.06 27/01/2025T03:25:00Z Buy SOL 4.965141 34880.18 82.42 7367.99 13.48 22/06/2025T09:06:00Z Staking Income ETH 18.247243 53640.50 4052.47 8472.02 24.31 16/05/2025T22:02:00Z Buy ETH 3.752120 16760.66 6599.11 2437.74 39.23 18/10/2025T07:58:00Z Staking Income SOL 9.990599 34668.94 4883.33 8108.92 0.20 04/06/2025T20:05:00Z Receive USDC 7.945269 2234.60 6482.45 906.02 0.92 12/08/2025T08:51:00Z Staking Income SOL 9.415567 44123.56 2870.13 912.51 1.01",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-4479bf012bf76c2171b597a4,v11-CRYPTO_TAX_REPORT-flat,original,2025,fgen-91d98a2e1c008c0f23ec0fc5,synthetic_programmatic_template,flat,top,False,raw_export
"2026 Realized Gains and Losses Report CoinHarbor Exchange Account Olivia Brennan Cost basis method Specific ID Short-term realized gain/loss 10,163.05 Long-term realized
gain/loss -2,083.70 Staking and other income 1,250.61 Asset Amount Date
Acquired Date Sold Proceeds Cost Basis BTC 17.378856 2026-11-09 February 17, 2026 2,913.02 3,144.44 ADA 25.491508 2024-10-12 05/22/2026 19,762.23 13,700.96 SOL 27.362540 04/18/2025 2026-07-11 2,671.19 1,701.30 USDC 5.753249 2026-11-27 August 22, 2026 12,550.63 9,781.86 SOL 7.368788 11/24/26 10/21/26 10,060.81 12,215.08 SOL 13.412850 April 1, 2024 2026-06-06 3,604.58 4,527.47 Generated by tax software from your exchange history.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-9cf83b8b4d5d7bdaf7809448,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-03f312aaa27e0adcea47be8b,synthetic_programmatic_template,flat,top,False,gain_loss
"Timestamp Transaction Type Asset Quantity Transacted Spot Price at Transaction Subtotal Total (inclusive of fees) Fees 03/24/2025T10:24:00Z Receive ETH 17.980019 29645.31 2712.94 6402.89 10.75 2025-09-06T06:49:00Z Receive U5DC8.183444
15624.46 4505.46 2186.64 38.24 10/03/2025T03:41:00Z Sell USDC 14.353512 61226.80 5591.06 3262.52
12.57 15/07/2025T10:54:00Z Sell U5DC l.617821 56949.92 6202.50 2354.75 5.51 06/05/2025T22:23:00Z 5takíng Income SOL 9.041507 56541.85 4112.57 6024.08 38.18 2025-12-20T03:59:00Z Convert 5OL 9.602653 68333.62 4872.40 1849.99 20.33 2025-05-06T08:46:00Z Convert BTC 7.57424345603.92 3885.017742.68 2.17 2025-12-12T17:44:00Z Buy ETH 8.814480 48568.40 4933.07 5201.35 3.37",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-27c6017d0bdb3ef2e4a37d29,v11-CRYPTO_TAX_REPORT-flat,original,2025,fgen-848e9426e55961cfece0e82a,synthetic_programmatic_template,flat,bottom,True,raw_export
"Crypto Transaction History Export CoinHarbor Exchange Account Taylor Walsh Cost basis method
FIFO Asset Amount Date Acquired Date So1d Proceeds CostBasis SOL 8.711151 2O25-01-26 2026-04-25
5,112.22 3,486.35 BTC 12.724376 08/14/2026 2026-08-02 11,623.14 14,052.01 USDC 3.501824 4/28/24 2026-10-11 5,269.40 4,769.40 Use this report to prepare Form 8949; it is not aForm 1099-DA.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-84ef60d220bc389bc53a8598,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-3cf2e72ae56636e1b17274d1,synthetic_programmatic_template,flat,top,True,transaction_history
"2026 Realized Gains and Losses Report LedgerPeak Markets Account Lena Walsh Cost basis method HIFO Short-term realized gaín/loss 6,692.l8 Long-term realized gain/loss 26,375.67 Staking andother income 2,939.O0 Asset Amount Date Acquired Date Sold Proceeds Cost Basis ADA 20.482706 3/20/25 November 22, 2026
4,718.42 4,237.06 ADA 14.646569 April 10, 2026 August19, 2026 5,008.28 5,168.15
USDC 13.175341 2026-04-25 2026-01-17 4,932.96 2,602.61 USDC9.427976 12/22/24 2026-01-02 966.78 1,263.76 Usc this report to prepare Form 8949; it is not a Form 1099-DA.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-5dc31b241529c764383fbc92,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-b6a148bfcd96257c1815d123,synthetic_programmatic_template,flat,top,True,gain_loss
"Crypto gains and losses - 2021 Timestamp Transaction Type Asset Quantity Transacted Spot Price at Transaction Subtotal Total (inclusive of fees) Fees 2021-03-05T23:14:00Z Sell BTC 11.529311 12901.57 6334.42 4045.56 19.37 2021-06-17T09:17:00Z Send
BTC 2.480921 25197.20 6631.41 6389.53 5.23 2021-11-18T02:33:00Z Send SOL 16.648688 27480.95 7355.89 8036.37 11.77 2021-01-15T11:06:00Z
Send USDC 4.490534 62954.62 685.22 5112.97 36.94",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-baf4870a7fbc67e31312c3b3,v11-CRYPTO_TAX_REPORT-flat,original,2021,fgen-62f7c51b3905615621fd1633,synthetic_programmatic_template,flat,top,False,raw_export
"Asset Date Acquired Date Sold Proceeds Cost Basis Gain (Loss) Holding Period ETH 2025-02-09 2026-02-13 5804.36 5294.02 964.09 Short-term BTC 2025-10-16 18/11/2026
11135.89 11692.05 -3343.38 Long-term SOL
2025-02-23 2026-01-01 3976.44 10155.51 -680.83 Short-term BTC 05/13/2025 04/01/2026 8351.19 13711.77 370.79 Long-term",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-837145370510166db683404e,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-ba0254430da9fa3c65357e90,synthetic_programmatic_template,flat,top,False,raw_export
"BitMeadow Account Jordan A. Fischer Cost basis method Specific ID Asset Amount Date Acquired Date Sold Proceeds Cost Basis ADA 13.690530 2022-08-22 11/01/2024 3,306.45 3,037.25 BTC 28.987932 2023-02-20 2024-11-15 9,478.91 10,354.09 BTC 24.074044
04/15/2023 3/11/24 10,509.43 10,384.91 ETH 14.473199 03/18/2023 2024-07-26 5,571.81 4,303.66 SOL 21.613632 December 2, 2022 12/18/2024 12,972.02 13,763.14 Use this report to prepare
Form 8949; it is not a Form 1099-DA. Crypto Transaction History Export",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-ac74f51924568e911eea81eb,v11-CRYPTO_TAX_REPORT-flat,original,2024,fgen-16f5f2746d12a6cf926d0493,synthetic_programmatic_template,flat,bottom,False,transaction_history
"Downloaded 10/28/2024 Date Sent Amount Sent CurrencyReceíved Amount Received Currency Fee Amount Fee Currency Tag 09/03/2024 3162.7590 BTC 2844.139344 USD 1.6160 USD trade 05/02/2024
498.8049 USD 2886.926250 ETH 3.7269 USD staking 2024-07-14 2157.4765 BTC 4191.520854 ETH 0.0996 USD airdrop 23/04/2024 1907.9928 USD 4379.250545 ETH 1.6564 USD staking 2024-09-15 2556.4339BTC
l817.329157 U5D2.4704 USD staking 07/17/2024 1115.9893 BTC 675.341019 USD 2.0949 USD airdrop 11/03/2024 1911.1592 USD 1612.537729 ETH 4.6785 USD aírdrop 2024-02-09 2l82.9783 USD 3552.208133 USD 0.8389 USD tradc 20/03/2024 1627.0000 BTC 4437.535464 USD 1.2401 USD trade",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-0a332cbce1a4b881a3d02a7f,v11-CRYPTO_TAX_REPORT-flat,original,2024,fgen-92bd407e217ba2de4c723157,synthetic_programmatic_template,flat,top,True,raw_export
"2023 Crypto
Tax Summary CoinHarbor ExchangeAccount Amara Lindqvist Cost basis method Specific ID Short-term realized gain/loss l1,037.66 Long-term realized gain/loss 2,220.01 Staking and other income $2,314.38 Asset Amount Date Acquired Date SoldProceeds Cost Basis BTC 21.149887 12/8/23 12/16/2023 3,926.05 5,052.20 SOL 23.450502 02/27/2021 August 19, 2023 6,694.87 6,227.25 SOL 16.8106172022-11-22 O1/08/2023 1,308.61 705.17 SOL 22.313030 08/15/2022 03/25/2023 17,951.47 13,677.83 BTC 25.781464 11/02/2023 Fcbruary 27, 2023 11,565.22 8,66l.01 ETH
3.318688 12/16/2021 8/27/23 19,133.47 24,535.23 Generated by tax software from your exchange hístory.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-b3d894227dacf13e5a52964a,v11-CRYPTO_TAX_REPORT-flat,original,2023,fgen-566a302da5ee490938673f75,synthetic_programmatic_template,flat,top,True,tax_software_summary
"2022 Crypto Tax Summary BitMeadow AccountFatima Brennan Cost basis method FIFO Short-term realized gain/loss 16,927.86 Long-term realized gain/loss 26,546.83 5taking and other
income S387.37 Asset Amount Date Acquircd Date Sold Proceeds Cost Basis BTC 12.O26978 September 22, 2022 9/19/22 8,673.25 5,669.48 USDC 6.779025 01/13/2020 10/20/22 10,991.37 7,783.59
ETH 3.717437 05/27/2021 10/16/22 9,352.36 8,346.52 ETH 2.263870 January27, 2021 2022-10-23 12,738.53 12,531.07 Use thís report to prepare Form 8949; ít is not a Form 1099-DA.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-4755f070def96f26d68860ee,v11-CRYPTO_TAX_REPORT-flat,original,2022,fgen-f34cb47337c575d9ceff5bf1,synthetic_programmatic_template,flat,top,True,tax_software_summary
"2024 Realized Gains and Losscs Report TaxBit-style report
Account Casey A. Okafor Costbasis method HIFO Short-term
realized gain/loss -2,255.28 Long-term realized gain/loss 3,881.81 Staking and other income 1,572.88 Asset Amount Date Acquired Date Sold Procceds Cost Basis SOL 10.503299 07/14/2024 O3/14/2024 16,963.59 12,121.29 ADA 13.914034 05/17/2023 2024-05-2l 832.02 736.82 ETH 17.796892 1/3/24 7/11/24 4,967.39 6,093.39 Generated by tax software from yourexchange hístory.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-197815e8657e1558981fdfa6,v11-CRYPTO_TAX_REPORT-flat,original,2024,fgen-9d6e730433d3b1b23c5661cf,synthetic_programmatic_template,flat,top,True,gain_loss
"CoinHarbor Exchange Account Alex Brennan Cost basis
method Specific ID Asset Amount Date Acquired Date Sold Proceeds Cost Basis ETH 4.692497 01/17/2023 2024-09-07 1,266.87 1,538.76 SOL 17.557825 May 10, 2023
5/20/24 18,623.65 17,692.38 BTC 10.113798 2/11/24 2/7/24 17,572.47 18,067.34 Use this report to prepare Form 8949; it is not a Form 1099-DA. Crypto Transaction History Export",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-8511cc796b3cd55915e408ad,v11-CRYPTO_TAX_REPORT-flat,original,2024,fgen-1e8ed40400c7f2e57a5271b0,synthetic_programmatic_template,flat,bottom,False,transaction_history
"2023
Realized Gains and Losses Report BitMeadow Account Casey L. Rivera Cost basis method FIFO Short-term realized gain/loss 3,538.85 Long-term realized gain/loss 11,309.14 Staking and other income 1,259.62 Asset Amount Date Acquired Date Sold Proceeds Cost Basis ADA 10.070307 08/11/2021 03/14/2023 5,231.68 3,588.21 ADA
5.043830 6/5/22 3/18/23 16,282.89 8,866.51 USDC 2.744179 9/28/22 3/6/23 16,408.49 9,239.14 Generated by tax software from your exchange history.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-cab13276bd37c2d91fdce869,v11-CRYPTO_TAX_REPORT-flat,original,2023,fgen-b9a6821028317bf1c0a6d696,synthetic_programmatic_template,flat,top,False,gain_loss
"2024 Realized Gains and Losses Report CoinHarbor Exchange Account Riley C. Patel Cost basis method FIFO Short-term realízed gain/loss 11,258.31Long-term realized gain/loss
6,231.87 Staking and other income $771.47 Asset Amount Date Acquired Date Sold Proceeds Cost Basis ETH 2.592189 4/18/22 January 22, 2O24 473.13 547.78SOL 13.382379 2023-08-12 3/16/24 11,410.54 6,823.88 ADA 20.274304 August 7,
2022 2024-12-16 2,676.63 2,866.56 ADA 29.845031 October 14, 2022 2024-01-07 274.09 376.57 U5DC 3.286814 6/6/24 8/23/245,500.71 5,731.43 Generated by tax software from your exchange hístory.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-89f29625fe25f11ac3a58d93,v11-CRYPTO_TAX_REPORT-flat,original,2024,fgen-b0e053d68476f7304c526b7c,synthetic_programmatic_template,flat,top,True,gain_loss
"Downloaded 12/19/2022 Timestamp Transaction Type Asset Quantity Transacted Spot Price at Transaction Subtotal Total (inclusive of fees) Fees 03/09/2022T03:43:00Z Send SOL 17.880282 32741.06 6232.93 8218.70 20.40 09/06/2022T02:34:00Z Sell SOL 15.920998 66574.17 5758.23 6652.28 31.30 01/02/2022T22:45:00Z Staking Income ETH
3.342486 6101.56 3708.27 6340.21 23.38 2022-02-22T14:44:00Z Sell BTC 9.242983 61451.44 3032.42 8141.37 16.65 05/15/2022T17:18:00Z Convert USDC 0.799270 43585.19 7383.91 5740.39 3.78 2022-05-11T23:37:00Z Convert ETH 6.127975 58821.89 5889.77 5681.63 23.42 05/24/2022T21:26:00Z Staking Income SOL 7.625362 63561.53 7430.79 3255.56 17.33 26/05/2022T05:20:00Z Send BTC 12.450208 30935.96 5912.95 7494.34 3.14 07/13/2022T05:56:00Z Staking Income
SOL 15.828356 60979.98 8208.94 5421.05 36.45",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-05209e29eed744eee46c2722,v11-CRYPTO_TAX_REPORT-flat,original,2022,fgen-76c949a8d9a4277d8d55ee0b,synthetic_programmatic_template,flat,top,False,raw_export
"2023
Realized Gains and Losses Report CoinHarbor Exchange Account Lena J. Adeyemí Cost basis method FIFO5hort-term realized gain/loss 17,034.23 Long-term realized gain/loss 18,523.O8 Staking and other income 2,052.68 Asset Amount Date Acquired Date Sold Proceeds Cost
Basis SOL 19.403761 2023-05-06 February l7, 2023 15,612.97 17,545.93 ETH 17.781130 06/13/2021 10/27/2023 2,505.862,955.97 ADA 7.839739 3/6/23 Fcbruary 24, 2023 7,608.56 8,304.95 ADA 13.760031 10/23/2023 07/17/2023 9,694.62 9,644.51 Gcnerated by tax software from your exchange history.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-62f67ef70ae690cda183531c,v11-CRYPTO_TAX_REPORT-flat,original,2023,fgen-a68571bda74582f10d10861e,synthetic_programmatic_template,flat,top,True,gain_loss
"2025 Realized Gains and Losses Report LedgerPeak Markets Account Priya Patel Cost basis method HIFO Short-term realized gain/loss 7,699.63 Long-term realized gain/loss -4,723.67 Staking and other income 691.64 Asset Amount Date Acquired Date Sold Proceeds Cost Basis USDC 15.765007 December 13, 2024 July 11, 2025 15,393.57
19,668.71 ETH 7.252500 2023-01-18 1/26/25 16,341.27 19,928.85 ADA 11.170018 11/3/25 12/02/2025 16,170.96 15,941.90 ADA 28.838575 2025-10-05 2025-03-14 16,295.81 12,797.36 ADA 6.313972 April 12, 2023 2025-05-05
8,668.78 5,606.00 SOL 27.370396 April 28, 2024 July 10, 2025 17,017.40 9,013.30 This report is for informational purposes and is not an IRS form.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-5bc227779c1ee803d8354054,v11-CRYPTO_TAX_REPORT-flat,original,2025,fgen-55a4c3b160f598a1b38f9b86,synthetic_programmatic_template,flat,top,False,gain_loss
"Exchange account statement Downloaded 04/09/2023 Asset
Date Acquired Date Sold Proceeds Cost Basis Gain (Loss) Holding Period ETH 15/01/2022 2023-10-19 12331.17 6325.46 1217.61 Long-term BTC 27/04/2022 01/11/2023 14195.70 1350.14 4761.38 Long-term ETH 2022-09-07 2023-08-07 19661.32
4212.20 -5861.02 Long-term SOL 05/10/2022 27/04/2023 6143.60 10864.51 7090.69 Short-term",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-46256f61327891eb0b932416,v11-CRYPTO_TAX_REPORT-flat,original,2023,fgen-17129b0c069236a6d3da67c4,synthetic_programmatic_template,flat,top,False,raw_export
"Date Sent Amount Sent Currency Received Amount Received
Currency Fee Amount Fee Currency Tag 01/21/2026 1889.0912 BTC
1257.389632 ETH 4.3345 USD staking 25/01/2026 4128.7189 BTC 3362.056377 ETH 3.4318 USD airdrop 2026-01-26 1064.5317 USD 678.867057 ETH 4.3230 USD staking",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-ea2f200ce4c1299f8662024d,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-795f606d456ad3c0110d6677,synthetic_programmatic_template,flat,none,False,raw_export
"2026 Realized Gains and Losses Report CoinLedger-style report Account Kwame Adeyemi Cost basis method Specific ID Short-term realized gain/loss 17,247.99 Long-term realized gain/loss 24,805.28 Staking and other income 2,549.68 Asset Amount Date Acquired Date Sold Proceeds Cost Basis USDC 22.901778
03/15/2024 February 9,
2026 10,952.31 10,977.40 ETH 27.991573 02/22/2026 07/22/2026 2,773.34 2,046.65 ETH 26.913290 12/20/2025 7/28/26 2,862.03 1,942.18 Generated by tax software from your exchange history.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-ccd11ddf21a5a57ceb79473f,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-cb3e8889351c271d6203b0db,synthetic_programmatic_template,flat,top,False,gain_loss
"Asset Date Acquired Date Sold Proceeds Cost Basis Gain (Loss) Holding
Period BTC 03/23/2023
11/09/2024 15232.23 13836.09 3382.14 Long-term SOL 2023-01-01 11/22/2024 8043.93 15024.61 7296.63 Short-term BTC 08/25/2023 06/04/2024 7447.75 9975.78 -8197.52 Long-term BTC 2023-09-19 2024-10-06 19832.67 1739.40 6433.59 Short-term",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-3f56a7a4340a9f5425ba502e,v11-CRYPTO_TAX_REPORT-flat,original,2024,fgen-e9e91adf279bebc8ffbd0610,synthetic_programmatic_template,flat,top,False,raw_export
"Crypto Transaction History Export CoinHarbor ExchangeAccount Noah Sato Cost basis method FIFO Asset Amount Date Acquired Date 5oldProceeds Cost Basis ETH 6.O38087 06/06/2024 2026-10-23 3,477.09 3,545.03 SOL 8.635818 2024-04-12 2026-05-26 19,174.35 11,616.38 BTC 29.428076 5/19/24 3/5/26 18,122.95 15,585.48 SOL 27.620692 7/6/26 March 26, 2026 2,119.79 1,358.82 ADA 17.142822 February 13, 2026 06/07/2026 317.05 296.01 ETH 4.666800 August 19, 2026 Dccember 20,
2026
832.47 1,047.10 Use thís report to prepareForm 8949; it is not a Form 1099-DA.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-6559e1780039a5f5ddc82827,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-0f7c6b4b6e2a9fb1a5d4e774,synthetic_programmatic_template,flat,top,True,transaction_history
"2026 Crypto Tax Summary BitMeadow Account Priya Nguyen Cost basis mcthod HIFO 5hort-term rea1ized gain/loss 12,819.48 Long-term realized gain/loss 38,475.59 Staking and other income $2,123.68 Asset Amount Date Acquired Date Sold
Proceeds Cost Basis SOL 17.672l05 2025-08-24 2026-11-22 12,912.06 6,472.93 BTC 12.103605 09/12/2026 2026-07-21 16,979.11 8,496.32 USDC 0.645337 12/25/2024March 6, 2026 7,481.76 6,452.45 ETH 19.996837 November 19, 2026 2026-06-27
8,044.62 9,557.10Use thís report to prepare Form 8949; it is not a Form 1099-DA.",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-879a09810134c13446a75e33,v11-CRYPTO_TAX_REPORT-flat,original,2026,fgen-ec089ff473312690d4a8c06e,synthetic_programmatic_template,flat,top,True,tax_software_summary
"Date Sent Amount Sent Currency Received Amount Received Currency Fee Amount Fee Currency Tag 2024-04-19 4579.6952 USD 4875.716648 USD 4.9127 USD trade 09/10/2024 2524.6035 BTC 3206.760884 USD 0.6183 USD airdrop
2024-12-14 252.0938
ETH 2936.438455 USD 3.9628 USD staking",CRYPTO_TAX_REPORT,46,CRYPTO_TAX_REPORT,fdc-bf95fe1b7a9f45c4ae2471cd,v11-CRYPTO_TAX_REPORT-flat,original,2024,fgen-3c4db0d10827f969d58b0f17,synthetic_programmatic_template,flat,bottom,False,raw_export
"Double your impact today
Hope Harbor Shelter
## Dear Friend,
Your gift may be tax-deductible to the extent allowed by law.
Scan the QR code or call 899-555-6189 to give by phone.
## Last year you helped serve 7,365 neighbors.
## We are $79,000 away from our 2025 goal.
Give $50, $100, or $500 today.
## P.S. Gifts made by December 31 count toward this year's campaign.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-c652892208b933f76908993d,v11-DONATION_APPEAL-markdown,original,2025,fgen-fa099a318263c36cb236d72e,synthetic_programmatic_template,markdown,top,False,email
"Will you help a neighbor this winter?
Riverbend Public Library Foundation
Dear Friend,
We are $81,000 away from our 2026 goal.
## Your gift may be tax-deductible to the extent allowed by law.
## This is a solicitation for a charitable contribution, not a receipt.
Donate now at our website or return the enclosed reply card.
| Field | Value |
| --- | --- |
| Name | Wei Larsen |
| Gift amount | $______ |
☐ Check enclosed  ☐ Charge my card",DONATION_APPEAL,27,DONATION_APPEAL,fdc-dc0cee0d730b295b1c5e8d1e,v11-DONATION_APPEAL-markdown,original,2026,fgen-5f98a4df04a89d1d3953a082,synthetic_programmatic_template,markdown,top,False,reply_card
"Sample Community Food Bank
Dear Supporter,
Scan the QR code or call 383-555-2769 to give by phone.
P.S. Gifts made by December 31 count toward this year's campaign.
This is a solicitation for a charitable contribution, not a receipt.
## Give $25, $150, or $250 today.
Become a monthly sustainer and make a difference all year long.
## Please give before midnight",DONATION_APPEAL,27,DONATION_APPEAL,fdc-881e94b381c8bc6ba230572c,v11-DONATION_APPEAL-markdown,original,2023,fgen-b2924fc6a11c2a0dcb3de659,synthetic_programmatic_template,markdown,bottom,False,year_end_letter
"## Spring Giving Campaign
St. Brendan Parish
Dear Supporter,
Give $50, $100, or $1000 today.
Every gift provides warm meals and shelter for families in need.
We are $886,000 away from our 2023 goal.
A generous donor will match every gift until 2023-05-13.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-c0970d64ea446aafb2db325d,v11-DONATION_APPEAL-markdown,original,2023,fgen-7722eee428340b79fb829d03,synthetic_programmatic_template,markdown,top,False,year_end_letter
"Please give before midnight
Greenway Animal Rescue
Dear Neighbor,
Your gift may be tax-deductible to the extent allowed by law.
## P.S. Gifts made by December 31 count toward this year's campaign.
Last year you helped serve 38,514 neighbors.
| Field | Value |
| --- | --- |
| Name | Priya Sato |
| Gift amount | $______ |
☐ Check enclosed  ☐ Charge my card",DONATION_APPEAL,27,DONATION_APPEAL,fdc-758979c16ec1541c86b179e2,v11-DONATION_APPEAL-markdown,original,2023,fgen-16ca360717bb9ec18afdeab1,synthetic_programmatic_template,markdown,top,False,reply_card
"St. Brendan Parish
Dear Alex,
Every gift provides warm meals and shelter for families in need.
## Scan the QR code or call 475-555-2076 to give by phone.
## Last year you helped serve 35,714 neighbors.
| Field | Value |
| --- | --- |
| Name | Mateo Romero |
| Gift amount | $______ |
## ☐ Check enclosed  ☐ Charge my card
Your gift matters",DONATION_APPEAL,27,DONATION_APPEAL,fdc-17d4909a02ca920f16444920,v11-DONATION_APPEAL-markdown,original,2021,fgen-959b4ef6aac1e9fdf1bea669,synthetic_programmatic_template,markdown,bottom,False,reply_card
"## Will you help a neighbor this winter?
## Sample Community Food Bank
Dear Supporter,
## Donate now at our website or return the enclosed reply card.
Every gift provides warm meals and shelter for families in need.
## P.S. Gifts made by December 31 count toward this year's campaign.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-ab0479247d17e821ae32fda8,v11-DONATION_APPEAL-markdown,original,2022,fgen-1b36dfb32cdd6d8876507841,synthetic_programmatic_template,markdown,top,False,email
"Double your impact today
Greenway Animal Rescue
Dear Alex,
## Give $25, $150, or $250 today.
We are $23,000 away from our 2024 goal.
Become a monthly sustainer and make a difference all year long.
Donate now at our website or return the enclosed reply card.
## Your gift may be tax-deductible to the extent allowed by law.
P.S. Gifts made by December 31 count toward this year's campaign.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-9b3856326adb4b195154cb3f,v11-DONATION_APPEAL-markdown,original,2024,fgen-43cf1bd65921991364f6dac4,synthetic_programmatic_template,markdown,top,False,year_end_letter
"Will you help a neighbor this winter?
## St. Brendan Parish
## Dear Supporter,
## Last year you helped serve 32,303 neighbors.
Become a monthly sustainer and make a difference all year long.
This is a solicitation for a charitable contribution, not a receipt.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-d5752cb422c317eca3ea56ff,v11-DONATION_APPEAL-markdown,original,2023,fgen-fc32fce55410b27bf06f65b3,synthetic_programmatic_template,markdown,top,False,email
"Riverbend Public Library Foundation
Dear Neighbor,
Give $50, $100, or $1000 today.
## Become a monthly sustainer and make a difference all year long.
This is a solicitation for a charitable contribution, not a receipt.
Scan the QR code or call 965-555-9314 to give by phone.
## Last year you helped serve 11,343 neighbors.
| Field | Value |
| --- | --- |
| Name | Riley Larsen |
| Gift amount | $______ |
☐ Check enclosed  ☐ Charge my card",DONATION_APPEAL,27,DONATION_APPEAL,fdc-c4ce780045ab87e74a5367b6,v11-DONATION_APPEAL-markdown,original,2025,fgen-66a118aefdec34320e1e37b9,synthetic_programmatic_template,markdown,none,False,reply_card
"Spring Giving Campaign
Greenway Animal Rescue
Dear Kwame,
Your gift may be tax-deductible to the extent allowed by law.
This is a solicitation for a charitable contribution, not a receipt.
Become a monthly sustainer and make a difference all year long.
| Field | Value |
| --- | --- |
| Name | Morgan Nguyen |
| Gift amount | $______ |
☐ Check enclosed  ☐ Charge my card",DONATION_APPEAL,27,DONATION_APPEAL,fdc-c66136ea480603459796ae14,v11-DONATION_APPEAL-markdown,original,2021,fgen-f1e3bf3868dfa409f7173d15,synthetic_programmatic_template,markdown,top,False,reply_card
"Riverbend Public Library Foundation
Dear Neighbor,
## This is a solicitation for a charitable contribution, not a receipt.
Last year you helped serve 34,708 neighbors.
Scan the QR code or call 458-555-2548 to give by phone.
## Become a monthly sustainer and make a difference all year long.
Donate now at our website or return the enclosed reply card.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-57c84b760b206d6a1f53d64b,v11-DONATION_APPEAL-markdown,original,2021,fgen-3771395b5c5ee6cbf1eb076b,synthetic_programmatic_template,markdown,none,False,year_end_letter
"## 2025 Annual Appeal
St. Brendan Parish
## Dear Neighbor,
Every gift provides warm meals and shelter for families in need.
P.S. Gifts made by December 31 count toward this year's campaign.
This is a solicitation for a charitable contribution, not a receipt.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-9a4607fec2aee7f576068b5c,v11-DONATION_APPEAL-markdown,original,2025,fgen-000c3d6386e1e9d37a712d47,synthetic_programmatic_template,markdown,top,False,email
"Greenway Animal Rescue
Dear Supporter,
Give S75, $100, or $250 today.
Wcare $76,000 away from our 2024 goal.
This is a solicitation for a charitable contribution, not a receipt.
Last year you helped serve 39,920 neighbors.
Double your impact today",DONATION_APPEAL,27,DONATION_APPEAL,fdc-2b2c77024b69ab2327201dbe,v11-DONATION_APPEAL-markdown,original,2024,fgen-57ad30eae3f59c0d16963f1c,synthetic_programmatic_template,markdown,bottom,True,matching_campaign
"Sample Community Food Bank
Dear Supporter,
P.S. Gifts made by December 31 count toward this year's campaign.
We are $559,000 away from our 2023 goal.
Every gift provides warm meals and shelter for families in need.
## A generous donor will match every gift until 6/18/23.
## Will you help a neighbor this winter?",DONATION_APPEAL,27,DONATION_APPEAL,fdc-24c9539699a1efc38e70d024,v11-DONATION_APPEAL-markdown,original,2023,fgen-ee560937ae897bb473b18976,synthetic_programmatic_template,markdown,bottom,False,matching_campaign
"St. Brendan Parish
Dear Olivia,
## Your gift may be tax-deductible to the extent allowed by law.
## We are $20,000 away from our 2026 goal.
## Become a monthly sustainer and make a difference all year long.
Give $75, $150, or $1000 today.",DONATION_APPEAL,27,DONATION_APPEAL,fdc-0e62009b7074428582050060,v11-DONATION_APPEAL-markdown,original,2026,fgen-8072e63a06d9cd1884ccd480,synthetic_programmatic_template,markdown,none,False,matching_campaign
"Tax Payment Receipt
Confirmation number
6994-2682-5720
Name
Morgan Tanaka
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2021
Payment amount
$8,603.87
Payment date
December 18, 2021
Bank account
XXX-XX-7258
Convenience fee
$6.81
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-dee9a53027ca02a200609e2b,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2021,fgen-1b6eadd83de3a227708cbde1,synthetic_programmatic_template,stacked,top,False,card_processor
"Estimated Payment Submitted
Confirmation number
8295-9029-6016
Name
Diego Lindqvist
Reason for payment
Estimated Tax
Apply payment to
Form 1040-ES
Tax period for payment
2025
Payment amount
$6,817.06
Payment date
02/18/2025
Bank account
XXXXX5482
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-45260dd906d20a0630e9cc90,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2025,fgen-ff570fd042a4f8b19fe2b849,synthetic_programmatic_template,stacked,top,False,state_portal
"Estimated Payment Submitted
Confirmation number
6572-4292-2737
Name
Lena M.Adeyemi
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2026
Payment amount
$19,752.91
Payment date
July 26, 2026
Bank account
ending in 7718
Do not mail a voucher for payments made online.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-4a2dd83c4bbb1e2c70e07843,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2026,fgen-b0fb4d0971d1b27f25074799,synthetic_programmatic_template,stacked,top,True,state_portal
"Estimated Payment Submitted
Confirmation number
8078-9103-6219
Name
Alex K. Okafor
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2022
Payment amount
$11,435.45
Payment date
5/12/22
Bank account
****4745
Your payment has been scheduled.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-32038b0d552ea292f25366f1,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2022,fgen-14646f01431b494195011477,synthetic_programmatic_template,stacked,top,False,state_portal
"Tax Payment Receipt
Confirmation number
3268-6149-6500
Namc
Jamie Walsh
Reason for payment
Estimated Tax
Apply payment to
l040ES (for 1040, 1040A, 1040EZ)
Tax period for payment
2022
Payment amount
$5,474.98
Payment date
August 14, 2022
Bank account
****0289
Convenience fee
$50.34
Keep this confirmation foryour records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-ba75c2628865bdce86ddefe7,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2022,fgen-13eed0f1056989051cc39b05,synthetic_programmatic_template,stacked,top,True,card_processor
"IRS Direct Pay - Payment Confirmation
Confirmation number
5437-8589-1563
Name
Diego Larsen
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2022
Payment amount
$18,458.82
Payment date
10/2/22
Bank account
XXX-XX-8516
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-75e68c1e98109385ce322516,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2022,fgen-33ec85cb017ca1b99b75e0ad,synthetic_programmatic_template,stacked,top,False,direct_pay
"Confirmation number
4886-4688-3270
Name
Avery Fischer
Reason for payment
Estimated Tax
Apply payment to
Form 1040-ES
Tax period for payment
2023
Payment amount
$7,974.31
Payment date
09/01/2023
Bank account
XXX-XX-4113
Keep this confirmation for your records.
Estimated Payment Submitted",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-fbdfdffcec8374dcda25c6e7,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2023,fgen-5c45e4f642c2aa6eb9558b62,synthetic_programmatic_template,stacked,bottom,False,state_portal
"EFTPS Payment Acknowledgement
Confirmation number
1091-3371-1910
Name
Taylor K. 5ato
Reason for payment
EstimatedTax
App1y payment to
1040ES (for 1040, 1040A, 1040EZ)
Tax period for payment
2021
Payment amount
$205.90
Payment date
9/22/21
Bank account
XXX-XX-5619
Do not mail a voucher for payments made online.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-0fc9717f6845758910830fd4,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2021,fgen-181927aef1d97c1a22011023,synthetic_programmatic_template,stacked,top,True,eftps
"Tax Payment Receipt
Confirmation number
6096-6933-7353
Name
Jamie Kowalski
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2024
Payment amount
$3,289.88
Payment date
7/17/24
Bank account
XXX-XX-9668
Convenience fee
$51.49
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-1befce2228bc6df221ec3a69,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2024,fgen-6f32c7bd85a42ff2793dfa6c,synthetic_programmatic_template,stacked,top,False,card_processor
"IRS Direct Pay - Payment Confirmation
Confirmation number
8078-2198-8433
Name
Wei Romero
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2025
Payment amount
$13,681.67
Payment date
10/19/25
Bank account
***-**-7313
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-82ec7a3449639678ebaea410,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2025,fgen-f0508c0f88474a75f806debc,synthetic_programmatic_template,stacked,top,False,direct_pay
"Estimated Payment Submitted
Confirmation number
6449-5349-4022
Name
Casey Haddad
Reason for payment
Estimated Tax
Apply payment to
Form 1040-ES
Tax period for payment
2021
Payment amount
$848.90
Payment date
02/14/2021
Bank account
XXXXX4951
Your payment has been scheduled.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-839d9c0130a0575e1254a876,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2021,fgen-79f83b83344d0a50d486b880,synthetic_programmatic_template,stacked,top,False,state_portal
"Estimated Payment Submitted
Confirmation number
9868-4191-7653
Name
Priya B. Testcase
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2021
Payment amount
$13,954.98
Payment date
6/13/21
Bank account
***-**-1201
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-64a6ff045d0d67f58179c667,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2021,fgen-c14dc60aca2896d77c4b7d18,synthetic_programmatic_template,stacked,top,False,state_portal
"IRS Direct Pay - Payment Confirmation
Confirmation number
5102-6549-3185
Name
Noah Moreau
Reason for payment
Estimated Tax
Apply payment to
Form 1040-ES
Tax period for payment
2022
Payment amount
$6,019.25
Payment date
September 7, 2022
Bank account
XXX-XX-2910
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-4f4888a3fbd7bdaa030d69b5,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2022,fgen-2c1a4c6770422a566f68ed29,synthetic_programmatic_template,stacked,top,False,direct_pay
"Confirmation number
4460-1500-4793
Name
Amara Nguyen
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2024
Payment amount
$2,9l0.45
Payment date
February 2, 2024
Bankaccount
ending in 0052
Convenience fee
$35.77
Do not mail a voucher for payments made online.
Tax Payment Receipt",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-46c4ea3166d708a1e95b1ab7,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2024,fgen-48f3b2065ef15842c90b3d71,synthetic_programmatic_template,stacked,bottom,True,card_processor
"Tax Payment Receipt
Confirmation number
9547-8776-4569
Name
Jordan Tanaka
Reason for payment
Estimated Tax
Apply payment to
Estimated tax
Tax period for payment
2022
Payment amount
$6,662.79
Payment date
May 13, 2022
Bank account
****7100
Convenience fee
$12.13
Keep this confirmation for your records.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-e54ec803de1792edb42861a5,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2022,fgen-e222e7ce04c05a237b0ae364,synthetic_programmatic_template,stacked,top,False,card_processor
"Estimated Payment Submitted
Confirmation number
6343-9224-1687
Name
Diego Adeyemi
Reason for payment
Estimated Tax
Apply payment to
1040ES (for 1040, 1040A, 1040EZ)
Tax period for payment
2022
Payment amount
$19,612.10
Payment date
2022-07-08
Bank account
***-**-3228
Do not mail a voucher for payments made online.",TAX_PAYMENT_CONFIRMATION,36,TAX_PAYMENT_CONFIRMATION,fdc-79fd3b4618d96c1b983059ba,v11-ESTIMATED_TAX_PAYMENT_CONFIRMATION-stacked,original,2022,fgen-d47fc4bd894184fc6cd8ca7e,synthetic_programmatic_template,stacked,top,False,state_portal
"HSA Transaction History
Northwind HSA Custodian
Account holder Lena L. Sato
Account number XXX-XX-6018
Date      Description      Amount
February 28, 2022   Payroll contribution   100.19
2022-03-17 Interest 465.51
2022-01-11      Card purchase CVS/PHARMACY      -369.42
Your 2022 Form 1099-SA will be available online by January 31, 2023.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-74ca78d49823337dfe11b87e,v11-HSA_ACCOUNT_STATEMENT-inline,original,2022,fgen-7ae5405a22dd79329ce85eb6,synthetic_programmatic_template,inline,top,False,transaction_export
"Evergreen Health Savings
Account holder Wei Brennan
Account number ***-**-1137
Cash balance 722.49
Invested balance      1,018.55
Employer contributions  408.34
Employee contributions 2,905.64
Distributions / claims paid $3,391.22
Interest and earnings   338.50
Date Description Amount
2026-09-04 Employer contribution 501.51
12/27/26 Payroll contribution 41.13
2026-01-01  Employer contribution  579.32
2026-04-28 Interest 594.55
07/03/2026   Employer contribution   506.70
IRS Form 5498-SA information for 2026 will be mailed separately.
Health Savings Account Statement",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-5b9a6e69cee61884784b8707,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-1533db19e203dae8ed0f5d40,synthetic_programmatic_template,inline,bottom,False,monthly
"Health Savings Account ...2364 transactions
Downloaded 20/01/2021
Transaction Date Merchant Category Amount Status Receipt
15/01/2021 BRIGHTSMILE DENTAL Vision 285.40 Pending Missing
05/27/2021 SAMPLE FAMILY CLINIC Vision 432.60 Posted Uploaded
2021-04-11 CVS PHARMACY Medical 641.97 Posted Uploaded
2021-05-21 VISION CENTER Medical 219.80 Posted Missing
18/08/2021 VISION CENTER Dental 102.10 Posted Missing
2021-09-28  BRIGHTSMILE DENTAL  Vision  199.72  Posted  Missing
2021-02-17  CVS PHARMACY  Dental  413.81  Pending  Uploaded
2021-04-03 VISION CENTER Pharmacy 32.63 Pending Missing
06/22/2021  SAMPLE FAMILY CLINIC  Dental  260.41  Posted  Missing",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-9c27f67b5d20fe7f83a5c71d,v11-HSA_ACCOUNT_STATEMENT-inline,original,2021,fgen-47b7a3a9fdce00789e3e0df1,synthetic_programmatic_template,inline,top,False,raw_export
"HSA Transaction History
Northwind HSA Custodian
Account holder      Alex Fischer
Account number   XXXXX3457
Date  Description  Amount
December 26, 2021  Claim reimbursement - Sample Family Clinic  -742.02
2021-05-20  Claim reimbursement - Sample Family Clinic  -312.38
2021-05-18 Payroll contribution 740.30
1/14/21      Interest      475.24
12/09/2021 Payroll contribution 608.11",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-bed0e895ebf12dc6d80ffb12,v11-HSA_ACCOUNT_STATEMENT-inline,original,2021,fgen-b3e79854ccbd720aaed0b1c1,synthetic_programmatic_template,inline,top,False,transaction_export
"Transaction Date Merchant Category Amount Status Receipt
09/07/2024      SAMPLE FAMILY CLINIC      Medical      316.33      Posted      Missing
06/05/2024 SAMPLE FAMILY CLINIC Medical 268.36 Posted Missing
06/11/2024 SAMPLE FAMILY CLINIC Medical 815.17 Pending Uploaded
2024-03-26      BRIGHTSMILE DENTAL      Vision      351.79      Pending      Uploaded
01/09/2024      CVS PHARMACY      Medical      882.07      Posted      Missing
Health Savings Account ...2268 transactions",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-1d68427e67c4bef2effa5732,v11-HSA_ACCOUNT_STATEMENT-inline,original,2024,fgen-74c686d562211b4c00cba221,synthetic_programmatic_template,inline,bottom,False,raw_export
"Health Savings Account Statement
Evergreen Health Savings
Account holder      Wei Patel
Account number ***-**-2488
Cash balance $3,854.43
Invested balance   $25,148.19
Employer contributions   $865.46
Employee contributions  l,677.25
Distributions / daims paid   $3,239.O0
Interest and earnings      854.98
Date  Description Amount
2023-12-04  Interest  62l.75
11/20/2023    Emp1oyer contribution      573.71
11/25/23   Claim reimbursement - Sample Family Clinic   -355.00
January 5, 2023  Claim reimbursement - Sample Family Clinic  -634.36
l2/6/23   Card purchase CVS/PHARMACY   -567.16",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-d34b47a6da9f04a6576a5cea,v11-HSA_ACCOUNT_STATEMENT-inline,original,2023,fgen-6017e748427acbf0a34f99c7,synthetic_programmatic_template,inline,top,True,monthly
"HSA Transaction History
Northwind HSA Custodian
Account holder Diego Adeyemi
Account number   ****6042
Date Description Amount
June 7, 2021  Claim reimbursement - Sample Family Clinic  -373.50
5/19/21 Employer contribution 193.39
2021-11-21   Employer contribution   648.89
December 9, 2021 Employer contribution 564.03
8/20/21  Payroll contribution  106.67
2/8/21   Claim reimbursement - Sample Family Clinic   -633.62",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-8647e1569a92f69066c1f9bb,v11-HSA_ACCOUNT_STATEMENT-inline,original,2021,fgen-36f51593fed6dd344ac84c93,synthetic_programmatic_template,inline,top,False,transaction_export
"2024 HSA Annual Summary
Northwind HSA Custodian
Account holder Riley A. Castillo
Account number XXXXX0999
Cash balance   7,132.90
Invested balance $16,814.33
Employer contributions   $1,073.78
Employee contributions $1,967.18
Distributions / claims paid  2,545.32
Interest and earnings   $305.95
Date  Description  Amount
April 2, 2024  Card purchase Brightsmile Dental  -721.55
2024-04-16      Employer contribution      439.69
2024-07-20 Card purchase Brightsmile Dental -23.03
February 15, 2024  Interest  116.32
April 28, 2024   Interest   613.86
Your 2024 Form 1099-SA will be available online by January 31, 2025.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-f3fb0aacca4de6e79e1d50a1,v11-HSA_ACCOUNT_STATEMENT-inline,original,2024,fgen-6ec63c6e8a35cc831dff332d,synthetic_programmatic_template,inline,top,False,annual_summary
"Northwind HSA Custodian
Account holder Avery Patel
Account number   ending in 4691
Cash balance $6,469.97
Invested balance      $10,491.50
Employer contributions      2.25
Employee contributions $1,800.21
Distributions / claims paid  $2,207.56
Interest and earnings   25.42
Date      Description      Amount
2022-01-14   Card purchase Brightsmile Dental   -68.46
5/4/22  Card purchase Brightsmile Dental  -219.25
January 25, 2022      Card purchase Brightsmile Dental      -561.91
Health Savings Account Statement",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-d0f5ee9fb4c3209969571e42,v11-HSA_ACCOUNT_STATEMENT-inline,original,2022,fgen-50fd77488d81e830c891b83e,synthetic_programmatic_template,inline,bottom,False,monthly
"Health 5avings AccountStatcment
Northwind HSA Custodian
Account holder Casey Larsen
Account number XXXXX3526
Cash balance 1,593.16
Invested balance $38,277.22
Employer contributions      $33.54
Employee contributions      1,045.61
Distributions / claims paid      3,840.04
Interest and eamings  $545.67
Date      Descríption      Amount
January 15, 2021 Cardpurchase CVS/PHARMACY -558.82
September 2, 2021  Card purchase CVS/PHARMACY  -569.17
2021-01-26   Card purchase Brightsmile Dental  -468.04
Tax reminder: amounts on this statcment may differ from your Form 1099-SA.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-7c2d375b702acdb878a8b686,v11-HSA_ACCOUNT_STATEMENT-inline,original,2021,fgen-0ba120fdd1af498cd3f69efd,synthetic_programmatic_template,inline,top,True,monthly
"HSA Transaction History
Northwind HSA Custodian
Account holdcr  Noah Castillo
Account number  XXX-XX-7337
Date      Description      Amount
O6/l5/2023      Claim reimbursement- 5ample Family Clinic      -694.03
2023-04-23      Card purchase CVS/PHARMACY      -254.25
2023-12-23      Claimreimbursement - SampleFamily Clínic      -140.76
06/08/2023  Claim reimbursement - Sample Family Clinic  -424.40
This statement is not a Form 5498-SA. Keep it for your records.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-154e1d6eae4e7966e529a3f9,v11-HSA_ACCOUNT_STATEMENT-inline,original,2023,fgen-4a8da9f65bb1cd2fd4d4ffab,synthetic_programmatic_template,inline,top,True,transaction_export
"2021 HSA Annual Summary
Northwind HSA Custodian
Account holder Avery B. Adeyemi
Account number      XXX-XX-6780
Cash balance   $1,489.13
Invested balance  20,890.20
Employer contributions  706.34
Employee contributions      3,034.61
Distributions / claims paid $635.85
Interest and earnings      $110.56
Date   Description   Amount
11/1/21 Claim reimbursement - Sample Family Clinic -642.09
2021-12-13   Payroll contribution   683.40
April 16, 2021 Employer contribution 493.24
Tax reminder: amounts on this statement may differ from your Form 5498-SA.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-26f2c890afeca8c80897cd07,v11-HSA_ACCOUNT_STATEMENT-inline,original,2021,fgen-0c53eb63808fd430680f4d19,synthetic_programmatic_template,inline,top,False,annual_summary
"2026 H5A Annual Summary
Northwind HSA Custodian
Account holder Casey Haddad
Account number  endíng in 0141
Cash balance S2,373.87
Invested balance      23,73O.53
Employer contributions   225.87
Employee contributions $3,6l5.21
Distributions / daims paid  $1,053.59
Interest and eamings 131.41
Date      Description      Amount
4/9/26  Claim reimbursement - 5ample Family Clinic  -588.10
2026-08-17      Claim reimbursement - Sample Family Clinic      -554.82
12/27/26 Payroll contribution 538.68
0ctober 3, 2026 Card purchase CVS/PHARMACY -147.70
09/20/2026      Interest     113.61",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-ad29c5e9cfa24abf26a64eac,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-81004848516ffc160756c6a5,synthetic_programmatic_template,inline,top,True,annual_summary
"Date      Description      Type      Amount      Cash Balance
2021-07-08      Card purchase - Pharmacy      Contribution      -296.30      11919.13
2021-10-01   HSA interest   Distribution   -384.56   8811.21
26/05/2021      HSA interest      Transfer      -391.65      8079.39
2021-12-14      HSA interest      Transfer      500.40      11612.63
03/07/2021 Payroll contribution Transfer 203.74 3753.31
05/08/2021 Employer HSA contribution Contribution -108.26 10761.20",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-a8caa9b62d85eec2798324ab,v11-HSA_ACCOUNT_STATEMENT-inline,original,2021,fgen-9e6451f18b8b4329e9de2cf2,synthetic_programmatic_template,inline,top,False,raw_export
"Northwind HSA Custodian
Account holder Casey Brennan
Account number      ending in 7156
Date  Description  Amount
5/5/21      Claim reimbursement - Sample Family Clinic      -261.51
4/5/21      Card purchase Brightsmile Dental      -676.40
07/19/2021 Employer contribution 627.77",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-fbc4d954b0ae17bf7c4503cc,v11-HSA_ACCOUNT_STATEMENT-inline,original,2021,fgen-84b6c2d16bb3aa528d8249fd,synthetic_programmatic_template,inline,none,False,transaction_export
"Health Savings Account Statement
Sample HSA Bank
Account holder   Casey J. Haddad
Account number      ending in 0680
Cash balance      $2,218.35
Invested balance  $1,929.26
Employer contributions 406.60
Employee contributions   2,333.95
Distributions / claims paid   $2,633.25
Interest and earnings   491.46
Date  Description  Amount
January 4, 2024  Payroll contribution  409.83
01/06/2024      Card purchase Brightsmile Dental      -205.58
January 28, 2024 Interest 428.15
June 15, 2024   Claim reimbursement - Sample Family Clinic   -240.56",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-768e4e06233a7b289a8d13dc,v11-HSA_ACCOUNT_STATEMENT-inline,original,2024,fgen-19cfb713e91fa6537e9cd291,synthetic_programmatic_template,inline,top,False,monthly
"2023 HSA Annual Summary
Northwind HSA Custodian
Account holder  Avery Rivera
Account number   ending in 6290
Cash balance 3,399.14
Invested balance   $23,084.96
Employer contributions   499.80
Employee contributions   204.97
Distributions / claims paid 601.90
Interest and earnings $876.51
Date   Description   Amount
12/18/2023 Card purchase Brightsmile Dental -631.52
03/25/2023 Card purchase CVS/PHARMACY -107.53
September 15, 2023      Employer contribution      413.70
07/22/2023      Card purchase CVS/PHARMACY      -581.70
05/05/2023 Claim reimbursement - Sample Family Clinic -663.47
03/02/2023 Claim reimbursement - Sample Family Clinic -454.47",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-eb3af662e430252ba4ed550e,v11-HSA_ACCOUNT_STATEMENT-inline,original,2023,fgen-70dfcbbb29a80fe2b3e66644,synthetic_programmatic_template,inline,top,False,annual_summary
"HSA Transaction History
Evergreen Health Savings
Account holder  Kwame M. Testcase
Account number  ****3766
Date   Description   Amount
March 11, 2025      Payroll contribution      545.08
9/20/25   Card purchase Brightsmile Dental   -770.49
2025-08-12 Payroll contribution 630.65
2025-05-10      Payroll contribution      417.23
Your 2025 Form 5498-SA will be available online by January 31, 2026.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-1f7bfc6b5d9c14d4569d6c68,v11-HSA_ACCOUNT_STATEMENT-inline,original,2025,fgen-5a2e2a77a236b146819bad1f,synthetic_programmatic_template,inline,top,False,transaction_export
"Evergreen Health Savings
Account holder Kwame Haddad
Account number   XXXXX5346
Cash balance  $8,378.43
Invested balance      $22,012.92
Employer contributions $139.16
Employee contributions   $4,227.26
Distributions / claims paid      $355.77
Interest and earnings      477.31
Date   Description   Amount
12/9/26   Card purchase Brightsmile Dental   -239.80
September 9, 2026   Card purchase Brightsmile Dental   -643.66
August 3, 2026      Employer contribution      735.69
3/9/26 Interest 352.93
Health Savings Account Statement",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-63261753f0bf8e3cc2078be8,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-87a65da37224d656cfa0c1d8,synthetic_programmatic_template,inline,bottom,False,monthly
"HSA Activity
Downloaded 2022-01-03
Transaction Date      Merchant      Category      Amount      Status      Receipt
25/03/2022 CVS PHARMACY Pharmacy 661.63 Posted Uploaded
02/06/2022 CVS PHARMACY Medical 722.71 Posted Uploaded
09/26/2022      CVS PHARMACY      Medical      561.40      Pending      Uploaded
2022-12-19 CVS PHARMACY Pharmacy 882.28 Pending Uploaded",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-f0d0fb433dcfecbbd272abd2,v11-HSA_ACCOUNT_STATEMENT-inline,original,2022,fgen-92b086ea66bfb2b4bdf35f60,synthetic_programmatic_template,inline,top,False,raw_export
"Health Savings Account Statement
Sample HSA Bank
Account holder Jordan Haddad
Account number  ***-**-5808
Cash balance $200.40
Invested balance 24,766.42
Employer contributions      $35.34
Employee contributions $1,489.23
Distributions / claims paid      368.94
Interest and earnings      $894.95
Date      Description      Amount
August 19, 2026  Card purchase Brightsmile Dental  -323.79
7/21/26 Claim reimbursement - Sample Family Clinic -700.52
2026-01-21 Claim reimbursement - Sample Family Clinic -371.51
05/16/2026      Card purchase CVS/PHARMACY      -355.38
8/6/26  Card purchase CVS/PHARMACY  -138.71
July 10, 2026      Payroll contribution      655.91",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-a7e29cc4d90ce274f5ec33f4,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-b708ff6d90baa1ee6e703395,synthetic_programmatic_template,inline,top,False,monthly
"2024 HSA Annual Summary
Evergreen Health Savings
Account holder   Diego Larsen
Account number      ***-**-4177
Cash balance  7,130.73
Invested balance $16,298.47
Employer contributions  $583.04
Employee contributions      1,771.67
Distributions / claims paid      3,968.53
Interest and earnings      483.82
Date   Description   Amount
10/16/24 Claim reimbursement - Sample Family Clinic -549.23
5/23/24  Card purchase Brightsmile Dental  -772.56
January 17, 2024      Claim reimbursement - Sample Family Clinic      -746.67
May 16, 2024 Card purchase Brightsmile Dental -34.74",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-ea3064eb3e483f9f8a6e8327,v11-HSA_ACCOUNT_STATEMENT-inline,original,2024,fgen-2138fe433fcde6c23a40a5e4,synthetic_programmatic_template,inline,top,False,annual_summary
"2022 HSA Annual Summary
Northwind HSA Custodian
Account holder   Avery Tanaka
Account number   XXX-XX-2835
Cash balance  4,242.06
Invested balance  $8,162.38
Employer contributions 361.57
Employee contributions $453.43
Distributions / claims paid      $738.37
Interest and earnings  641.74
Date Description Amount
2022-09-08  Employer contribution  137.79
2022-09-02      Employer contribution      190.53
January 13, 2022   Employer contribution   614.97
11/28/22  Claim reimbursement - Sample Family Clinic  -256.55
09/27/2022 Card purchase CVS/PHARMACY -361.05",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-ea3ca80f057d7700c9409c84,v11-HSA_ACCOUNT_STATEMENT-inline,original,2022,fgen-fd07dc980be7261f3dfa09e5,synthetic_programmatic_template,inline,top,False,annual_summary
"2022 HSA Annual Summary
Sample HSA Bank
Account holder Kwame Fischer
Account number XXX-XX-1669
Cash balance  $4,965.98
Invested balance      20,437.77
Employer contributions $1,044.55
Employee contributions 1,602.10
Distributions / claims paid 2,258.09
Interest and earnings      $617.69
Date Description Amount
2022-01-02 Card purchase Brightsmile Dental -673.79
2022-11-23   Employer contribution   538.52
03/26/2022   Employer contribution   369.60
March 22, 2022 Interest 15.05
11/18/2022 Payroll contribution 653.29",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-ff634ac6b8cca6c4f374f9d9,v11-HSA_ACCOUNT_STATEMENT-inline,original,2022,fgen-5494d846b51a86cf5f7babcd,synthetic_programmatic_template,inline,top,False,annual_summary
"HSA Claims and Contributions
Downloaded 01/02/2025
Transaction Date Merchant Category Amount Status Receipt
17/03/2025  BRIGHTSMILE DENTAL  Medical  383.92  Pending  Missing
2025-11-24 CVS PHARMACY Pharmacy 539.97 Pending Missing
2025-09-14  SAMPLE FAMILY CLINIC  Vision  656.27  Posted  Uploaded",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-8fc2bcfc628923b97ef7ec9c,v11-HSA_ACCOUNT_STATEMENT-inline,original,2025,fgen-dfd381e10f48b8cdf0382b89,synthetic_programmatic_template,inline,top,False,raw_export
"Health Savings Account Statement
Evergreen Health Savings
Account holder   Hiro Patel
Account number      ****6715
Cash balance 2,023.04
Invested balance 32,105.91
Employer contributions  443.34
Employee contributions   2,460.05
Distributions / claims paid $3,958.12
Interest and earnings   $297.20
Date   Description   Amount
April 5, 2026 Payroll contribution 65.91
4/17/26  Payroll contribution  613.06
01/04/2026 Interest 612.74
09/26/2026  Payroll contribution  783.42",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-f173e90c63f1a76e5bc873e6,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-7ad28ff7ac2ed60dd9e388d8,synthetic_programmatic_template,inline,top,False,monthly
"Health Savings Account ...3225 transactions
Date   Description   Type   Amount   Cash Balance
11/20/2025   Card purchase - Pharmacy   Interest   -287.74   185.94
18/08/2025   Card purchase - Pharmacy   Distribution   -485.40   8559.50
09/08/2025   Reimbursement to self   Transfer   42.06   9089.15",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-2220d7d9fc674a0a923bee67,v11-HSA_ACCOUNT_STATEMENT-inline,original,2025,fgen-ed860087123c5db2b7e13339,synthetic_programmatic_template,inline,top,False,raw_export
"Transaction Date  Merchant  Category  Amount  Status  Receipt
2026-07-14   SAMPLE FAMILY CLINIC   Dental   241.53   Posted   Missing
2026-01-09   BRIGHTSMILE DENTAL   Vision   466.88   Posted   Missing
03/28/2026 BRIGHTSMILE DENTAL Dental 823.26 Pending Missing
08/13/2026 CVS PHARMACY Medical 242.04 Pending Uploaded
2026-03-21 SAMPLE FAMILY CLINIC Medical 456.53 Pending Missing
04/16/2026   CVS PHARMACY   Vision   317.96   Pending   Uploaded
08/26/2026      CVS PHARMACY      Pharmacy      588.60      Posted      Missing",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-ee5bb907672369adc8907bb7,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-65b026aa5578601b77ebf638,synthetic_programmatic_template,inline,none,False,raw_export
"Sample HSA Bank
Account holder  Jamie Rivera
Account number   ****6763
Cash balance      1,245.41
Invested balance      21,586.51
Employer contributions  1,105.09
Employee contributions      2,813.59
Distributions / claims paid 3,079.54
Interest and earnings      $228.10
Date  Description  Amount
05/25/2023      Card purchase Brightsmile Dental      -575.86
2023-07-18 Card purchase Brightsmile Dental -724.72
05/20/2023   Employer contribution   389.05
1/3/23 Interest 53.54
November 28, 2023      Card purchase CVS/PHARMACY      -596.99
1/12/23      Interest      349.67",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-0e09370a11cec3d179329ce1,v11-HSA_ACCOUNT_STATEMENT-inline,original,2023,fgen-3e5fb40739159e9cc710e486,synthetic_programmatic_template,inline,none,False,annual_summary
"HSA Activity
Transaction Date  Merchant  Category  Amount Status  Receipt
08/07/2026      BRIGHTSMILE DENTAL      Vision     758.17      Pending      Missing
17/03/2026  BRIGHTSMILE DENTAL  Pharmacy  495.90  Posted  Uploaded
16/02/2026  BRIGHT5MILE DENTAL  Vision  435.99  Posted  Missing",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-0128fe62fa659457c1241050,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-91299a5390546577778c030a,synthetic_programmatic_template,inline,top,True,raw_export
"HSA Transaction History
Evergreen Health Savings
Account holder  Casey Nguyen
Account number      ending in 7639
Date  Description  Amount
03/04/2022      Payroll contribution      514.47
2022-06-16   Claim reimbursement - Sample Family Clinic   -67.42
April 11, 2022 Card purchase CVS/PHARMACY -393.01",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-a4dd14ec97d3ecfa4d284102,v11-HSA_ACCOUNT_STATEMENT-inline,original,2022,fgen-caf888ba66c32c9bab7561ab,synthetic_programmatic_template,inline,top,False,transaction_export
"Health Savings Account Statement
Sample HSA Bank
Account holder  Wei K. Sato
Account number   XXXXX7565
Cash balance  $5,681.60
Invested balance  $29,604.20
Employer contributions $730.85
Employee contributions  $2,663.79
Distributions / claims paid 3,531.86
Interest and earnings $288.98
Date      Description      Amount
2/26/26 Employer contribution 434.05
9/16/26 Card purchase Brightsmile Dental -332.32
March 19, 2026   Card purchase Brightsmile Dental   -152.94",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-837a4b2fe24f46cdf59576da,v11-HSA_ACCOUNT_STATEMENT-inline,original,2026,fgen-c55f89b1e746ae5a07c272fc,synthetic_programmatic_template,inline,top,False,monthly
"Auto Policy Declarations
Sample Mutual Insurance
Polícynumber
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-943512
5/16/25 to 4/26/26
Riley A. Romero
2023 Ford F-150
S100,000 / $300,000
$500
$1,300.79",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-fa2853ea2d9381ab89e217af,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-a944b9bbc443d283b79da1e8,synthetic_programmatic_template,columns,top,True,auto_declarations
"Sample Mutual Insurance
Policy number
Policyholder
Amount due
Due date
89263775
Sofia C. Romero
$1,150.91
2024-03-25
Pay online to avoid a lapse in coverage.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-e185e661badbccaa9c6c45e0,v11-INSURANCE_DOCUMENT-columns,original,2024,fgen-baa44e2ff1d46188d89a5351,synthetic_programmatic_template,columns,none,False,premium_notice
"Evergreen Health Plan
Policy number
Residence premises
Coverage A - Dwelling
Coverage E -Personal liability
All other perils dcductible
Annual prcmium
Mortgagee
HO-712507
4949 Oak Hollow Ct Cedar Falls, IA 14939
$289,196.98
$300,000
$1,000
$2,454.06
Pínecrest Mortgage Company",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-2fb8f3da05b0048968c9f758,v11-INSURANCE_DOCUMENT-columns,original,2026,fgen-3c1ab176ecd8a72db53259d3,synthetic_programmatic_template,columns,none,True,home_declarations
"Premium Due Notice
Harbor Life Assurance
Policy number
Policyholder
Amount due
Due date
85141329
Kwame E. Brennan
S657.40
07/10/2025
Pay online to avoid a lapse in coverage.
Health coverage information forms (1095) are issued separate1ywhen required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-1f49a7396c86729c2b1108b8,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-50eedccac79eee0fe474ac63,synthetic_programmatic_template,columns,top,True,premium_notice
"Explanation of Benefits
Harbor Life Assurance
THIS ISNOT A BILL
Member
Claím number
Provider
Date of service
Mateo J. Romero
5093l23538
Riverside Urgent Care
2023-02-02
Amount billed
Plan discount
Plan paid
You may owe
3,987.l2
1,196.14
1,993.56
797.42
Deductible met year to date
$872.31",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-f2893ec0350d2ce8fb81adb0,v11-INSURANCE_DOCUMENT-columns,original,2023,fgen-493cbd701be612ab2bd0ca4d,synthetic_programmatic_template,columns,top,True,eob
"Premium Due Notice
HarborLife Assurance
Policy number
Policyholder
Amount due
Due date
42766743
Jordan Patel
S1,56O.43
November 11, 2022
Pay online to avoid a lapse in coverage.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-e5f32d1889629979fac5a177,v11-INSURANCE_DOCUMENT-columns,original,2022,fgen-3186a455d7c1b25ea3942d0b,synthetic_programmatic_template,columns,top,True,premium_notice
"Auto Policy Declarations
Harbor Life Assurance
Policy number
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-564580
2024-04-26 to February 23, 2025
Fatima Okafor
2016 Toyota Corolla
$100,000 / $300,000
$500
$883.86
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-0e9311bb8b5c648923245da4,v11-INSURANCE_DOCUMENT-columns,original,2024,fgen-f87ec8d0bdf1488e34553b0f,synthetic_programmatic_template,columns,top,False,auto_declarations
"Annual Policy Statement - Universal Life
Harbor Life Assurance
Policy number
Insured
Death benefit
Premiums paid thís year
Cash value
Costof insurance charges
UL2974169
Dicgo Nguyen
S474,812.13
$1,616.97
$56,202.12
$1,110.89",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-bc3aa5aa535a07c4c97916f5,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-5716fd62b7e64650e3941e42,synthetic_programmatic_template,columns,top,True,life_annual
"Premium Due Notice
Harbor Life Assurance
Policy number
Policyholder
Amount due
Due date
57941323
Amara B. Brennan
$855.78
11/17/2023
Pay online to avoid a lapse in coverage.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-e0b8ec4e6543306d761019b7,v11-INSURANCE_DOCUMENT-columns,original,2023,fgen-de34a16abbcfa72a9c8fcba5,synthetic_programmatic_template,columns,top,False,premium_notice
"Auto Policy Declarations
Evergreen Health Plan
Policy number
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-569061
April 13, 2024 to 2025-03-26
Kwame Castillo
2020 Ford F-150
$100,000 / $300,000
$500
$1,736.80",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-e40b39f8459452ca9c3e30e5,v11-INSURANCE_DOCUMENT-columns,original,2024,fgen-781c105843ba3b736a66e5f1,synthetic_programmatic_template,columns,top,False,auto_declarations
"Annual Policy Statement - Universal Life
Evergreen Health Plan
Policy number
Insured
Death benefit
Premiums paid this year
Cash value
Cost of insurance charges
UL7365584
AlexOkafor
$864,2O6.33
$8,944.18
$69,079.95
$2,4l5.57
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-e803ed533c00f0d6369938b4,v11-INSURANCE_DOCUMENT-columns,original,2026,fgen-ca7bd3297e6d8120d0529233,synthetic_programmatic_template,columns,top,True,life_annual
"Annual Policy Statement - Universal Life
Harbor Life Assurance
Policy number
Insured
Death benefit
Premiums paid this year
Cash value
Cost of insurance charges
UL8004944
Jordan Nguyen
$899,262.36
$5,531.25
$34.96
$210.12",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-effed8d96c819405b3fae132,v11-INSURANCE_DOCUMENT-columns,original,2026,fgen-a26316d7f9b39620d84d2888,synthetic_programmatic_template,columns,top,False,life_annual
"Explanation of Benefits
Sample Mutual Insurance
THIS IS NOT A BILL
Member
Claim number
Provider
Date of service
Amara S. Sato
7091134060
Sample Family Clinic
September 10, 2024
Amount billed
Plan discount
Plan paid
You may owe
1,045.19
313.56
522.59
209.04
Deductible met year to date
$1,745.22",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-5333e1b86f2d7068599b7a04,v11-INSURANCE_DOCUMENT-columns,original,2024,fgen-bb529bafd32133d19e92bf84,synthetic_programmatic_template,columns,top,False,eob
"Harbor Life Assurance
Policy number
Policyholder
Amount due
Due date
42755159
Alex Kowalski
$333.54
10/23/21
Pay online to avoid a lapse in coverage.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-6484afaea185e5631ac2b4e7,v11-INSURANCE_DOCUMENT-columns,original,2021,fgen-d671d4cd651fbc752f61a6b9,synthetic_programmatic_template,columns,none,False,premium_notice
"Auto Policy Declarations
Sample Mutual Insurance
Policy number
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-601392
09/26/2025 to 4/19/26
Sofia J. Larsen
2018 Subaru Outback
$100,000 / $300,000
$500
$1,349.28
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-e737edae128f27637de16c65,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-6ff5a222eb32d47b57232837,synthetic_programmatic_template,columns,top,False,auto_declarations
"Harbor Life Assurance
THIS IS NOT A BILL
Member
Claim number
Provider
Date of service
Diego S. Walsh
5466721159
Riverside Urgent Care
August 6, 2023
Amount billed
Plan discount
Plan paid
You may owe
2,249.96
674.99
1,124.98
449.99
Deductible met year to date
$2,498.39",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-0979405b8ea9a944771f3264,v11-INSURANCE_DOCUMENT-columns,original,2023,fgen-34b4f4e1d4e6a477e5e0b797,synthetic_programmatic_template,columns,none,False,eob
"Explanation of Benefits
Evergreen Health Plan
THIS IS NOT A BILL
Member
Claim number
Provider
Date of service
Mateo Larsen
7349363095
Lakeshore Pharmacy
03/24/2021
Amount billed
Plan discount
Plan paid
You may owe
3,986.10
1,195.83
1,993.05
797.22
Deductible met year to date
$1,291.10
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-9752c52f95bc4ed43f61810a,v11-INSURANCE_DOCUMENT-columns,original,2021,fgen-cb8af505ac790bfb555c40c0,synthetic_programmatic_template,columns,top,False,eob
"Evergreen Health Plan
Policy number
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-816556
09/16/2021 to 2022-08-11
Olivia C. Tanaka
2020 Ford F-150
$100,000 / $300,000
$500
$508.94
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-13c37023eb148f42b5002df6,v11-INSURANCE_DOCUMENT-columns,original,2021,fgen-469d3f9414953f4c0dbc7368,synthetic_programmatic_template,columns,none,False,auto_declarations
"Premium Due Notice
Sample Mutual Insurance
Policy number
Policyholder
Amount due
Due date
98839716
Priya Fischer
$960.50
9/15/22
Pay online to avoid a lapse in coverage.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-67132a84b9098748efb3d12e,v11-INSURANCE_DOCUMENT-columns,original,2022,fgen-79ca27c8b21dea4f98c578e3,synthetic_programmatic_template,columns,top,False,premium_notice
"Sample Mutual Insurance
Policy number
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-576872
9/22/22 to 11/23/2023
Avery Moreau
2014 Toyota Corolla
$100,000 / $300,000
$500
$683.32",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-b935a5ae325e9880cc09e1b8,v11-INSURANCE_DOCUMENT-columns,original,2022,fgen-b5f57bbd013528898bce7908,synthetic_programmatic_template,columns,none,False,auto_declarations
"Sample Mutual Insurance
Policy number
Residence premises
Coverage A - Dwelling
Coverage E - Personal liability
All other perils deductible
Annual premium
Mortgagee
HO-392750
4078 Cedar Ln Lakewood, CO 28890
$780,543.61
$300,000
$1,000
$1,187.52
Bluewater Loan Servicing
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-3ae0cc76647b4881f6e3c94b,v11-INSURANCE_DOCUMENT-columns,original,2024,fgen-7d5d8e6183a5737037a9a8dc,synthetic_programmatic_template,columns,none,False,home_declarations
"Homeowners Policy Declarations
Granite Auto Insurance Co.
Policy number
Residence premises
Coverage A - Dwelling
Coverage E - Personal liability
All other perils deductible
Annual premium
Mortgagee
HO-370727
2874 Oak Hollow Ct Brookhaven, PA 46279
$322,837.92
$300,000
$1,000
$3,773.13
Pinecrest Mortgage Company
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-aaba34214a8277b4be0584ae,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-d68269ee8bd09d88d90d1901,synthetic_programmatic_template,columns,top,False,home_declarations
"Annual Policy Statement - Universal Life
Granite Auto Insurance Co.
Policy number
Insured
Death benefit
Premiums paid this year
Cash value
Cost of insurance charges
UL2657634
Olivia Okafor
$177,483.98
$4,738.90
$36,470.98
$2,189.83",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-6127219d17e3d0d51dd1d733,v11-INSURANCE_DOCUMENT-columns,original,2024,fgen-047f9670a5b7c70d940e3f7c,synthetic_programmatic_template,columns,top,False,life_annual
"Granite Auto Insurance Co.
Policy number
Insured
Death benefit
Premiums paid this year
Cash value
Cost of insurance charges
UL7986989
Priya A. Lindqvist
$616,788.81
$389.80
$37,313.98
$1,216.24
Annual Policy Statement - Universal Life",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-335e601c98a9a04578491c38,v11-INSURANCE_DOCUMENT-columns,original,2022,fgen-d340e941c68c978ceeeb1835,synthetic_programmatic_template,columns,bottom,False,life_annual
"Homeowners Policy Declarations
Granite Auto Insurance Co.
Policy number
Residence premises
Coverage A - Dwelling
Coverage E - Personal liability
All other perils deductible
Annual premium
Mortgagee
HO-688576
4800 Oak Hollow Ct Testville, IL 35604
$222,547.41
$300,000
$1,000
$3,832.07
Keystone Home Loans
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-a6f2ba1150b6215ce0ace805,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-bc623ec2b911b9ef3292a2b0,synthetic_programmatic_template,columns,top,False,home_declarations
"Explanation of Benefits
Harbor Life Assurance
THIS IS NOT A BILL
Member
Claim number
Provider
Date of service
Jordan Adeyemi
6051035751
Sample Family Clinic
01/25/2025
Amount billed
Plan discount
Plan paid
You may owe
3,286.86
986.06
1,643.43
657.37
Deductible met year to date
$2,026.16
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-2ffcd271c357654df4b3766e,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-8b5f00b595f63108b4dec4fe,synthetic_programmatic_template,columns,top,False,eob
"Explanation of Benefits
Harbor Life Assurance
THIS IS NOT A BILL
Member
Claim number
Provider
Date of service
Kwame Nguyen
6640261231
Lakeshore Pharmacy
04/04/2024
Amount billed
Plan discount
Plan paid
You may owe
733.54
220.06
366.77
146.71
Deductible met year to date
$1,401.21",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-296750b13d46bcc5877b6a5b,v11-INSURANCE_DOCUMENT-columns,original,2024,fgen-6c2ad672fbbb1b98ddc658dd,synthetic_programmatic_template,columns,top,False,eob
"Annual Policy Statement - Universal Life
Evergreen Health Plan
Policy number
Insured
Death benefit
Premiums paid this year
Cash value
Cost of insurance charges
UL6322116
Mateo Testcase
$528,751.97
$525.22
$83,190.26
$1,835.50",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-76e231b527d86ed9aae5f458,v11-INSURANCE_DOCUMENT-columns,original,2022,fgen-72ce59a5cd3f62051e5f7a7f,synthetic_programmatic_template,columns,top,False,life_annual
"Granite Auto Insurance Co.
Policy number
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-923989
2025-05-13 to 06/04/2026
Noah Adeyemi
2016 Toyota Corolla
$100,000 / $300,000
$500
$1,475.54",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-6a4983cc02a87e63f21badcb,v11-INSURANCE_DOCUMENT-columns,original,2025,fgen-9e0f539830be078690c09dac,synthetic_programmatic_template,columns,none,False,auto_declarations
"Homeowners Policy Declarations
Evergreen Health Plan
Policy number
Residence premises
Coverage A - Dwelling
Coverage E - Personal liability
All other perils deductible
Annual premium
Mortgagee
HO-411759
1483 Willow Bend Way Lakewood, CO 70923
$863,950.76
$300,000
$1,000
$2,534.85
Riverbend Mortgage Servicing
Health coverage information forms (1095) are issued separately when required.",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-90531674b9ed2348825d6559,v11-INSURANCE_DOCUMENT-columns,original,2022,fgen-56df4dbf58969d70064b0bc8,synthetic_programmatic_template,columns,top,False,home_declarations
"Explanation of Benefits
Harbor Life Assurance
THIS IS NOT A BILL
Member
Claim number
Provider
Date of service
Priya 5. Haddad
2120218512
5ample Family Clinic
May 10, 2022
Amount billed
Plandiscount
Plan paíd
You may owe
558.19
167.46
279.09
111.64
Deductible met year to date
$654.81",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-4df9c9a814cde17ff8a411f0,v11-INSURANCE_DOCUMENT-columns,original,2022,fgen-519f25b05219832cd61d20cd,synthetic_programmatic_template,columns,top,True,eob
"Harbor Life Assurance
Policy number
Policy period
Named insured
Vehicle
Bodily injury liability
Collision deductible
Six-month premium
PA-244706
7/23/2l to 05/09/2022
Sofía Patel
20l7 Ford F-150
$100,000 / $300,000
$500
$393.74
Health coverage information forms (1095)are issued separately when required.
Auto Policy Dedarations",INSURANCE_DOCUMENT,45,INSURANCE_DOCUMENT,fdc-f5f0b76b49f70f917c3260a8,v11-INSURANCE_DOCUMENT-columns,original,2021,fgen-6f49cd261c80289b026d2a46,synthetic_programmatic_template,columns,bottom,True,auto_declarations
"Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
2022
Department of the Treasury Internal Revenue Service
Part I Information About the Estate or Trust: Testcase Family Trust lO78 Lakeshore Blvd Testville, IL 2533l
A Estate's or trust's employer identification number: 27-7202227
Part II Information About the Beneficiary: Hiro K. Romero
C Beneficiary'sidentifying number: XXXXX0232
5treet address (indudingapt. no.): 9l64 Elm Park Pl
City or town, state or province, country, and ZIP orforeign postal code:Maplewood, MN 65340
Account number (see instructions): ****470864
Line l Interest income: 8,427.06
Line 2a Ordinary dividends: 7,412.10
Line 3 Net short-term capital gain: $0.00
Line 4a Net long-term capital gain: 4,073.11
Line 5 0ther portfolio and nonbusiness income
Line 14 Other information: DD 2,706.69
Department of the Treasury - Intemal Revenue 5ervice
Form K-1 (Form 1041) (keep for yourrecords)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-80bb1ac03c7e41b5e6ba8498,v11-K-1-1041-boxed,original,2022,fgen-e3d11009cfe070431652965a,synthetic_programmatic_template,boxed,top,True,
"CORRECTED (if checked)
Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
For calendar year 2021
Part I Information About the Estate or Trust: Estate of R. Walsh 7536 Maple Ridge Dr Fairview, OH 45874
A Estate's or trust's employer identification number: 38-3026015
Part II Information About the Beneficiary: Riley Adeyemi
C Beneficiary's identifying number: ****0846
Street address (including apt. no.): 8447 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code: Bayside, WA 47104
Account number (see instructions): ***-**-486500
Box 1 Interest income: 169.00
Box 2a Ordinary dividends: 154.48
Box 3 Net short-term capital gain: $0.00
Box 4a Net long-term capital gain: $1,470.07
Box 5 Other portfolio and nonbusiness income: $0.00
Box 14 Other information: DD 1,826.73
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-39166e3f5e3f215ff7184a99,v11-K-1-1041-boxed,original,2021,fgen-2ba2df365047a5bdbc0970e8,synthetic_programmatic_template,boxed,top,False,
"Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
For calendar year 2021
Final K-1  Amended K-1
Part I Information About the Estate or Trust: Testcase Family Trust 5774 Harbor View Rd Pinecrest, GA 32184
A Estate's or trust's employer identification number: 46-1652103
Part II Information About the Beneficiary: Amara Fischer
C Beneficiary's identifying number: XXX-XX-6700
Street address (including apt. no.): 2795 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code: Cedar Falls, IA 54419
Box 1 Interest income: $3,485.94
Box 2a Ordinary dividends: $158.74
Box 3 Net short-term capital gain: 0.00
Box 4a Net long-term capital gain: 8,440.80
Box 14 Other information: D 4,016.77
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-b79acbcdb7c7e479523e1cf8,v11-K-1-1041-boxed,original,2021,fgen-a0cba58f701050351ef50728,synthetic_programmatic_template,boxed,top,False,
"From:: Estate of R. Walsh
RECIPIENT:: Avery S. Lindqvist
Line 1 Interest income: 8,116.53
Schedule K-1 (Form 1041) Beneficiary's Share of Income, Deductions, Credits, etc. 2024",K-1,30,K-1,fdc-69fd4bee4f23cf645ba84103,v11-K-1-1041-boxed,original,2024,fgen-a8bf78c10d2659705dcb8f35,synthetic_programmatic_template,boxed,bottom,False,
"Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
OMB No. 1545-0092
Final K-1  Amended K-1
Part I Information About the Estate or Trust: Estate of R. Walsh 2126 Maple Ridge Dr Cedar Falls, IA 99074
A Estate's or trust's employer identification number: 55-4251632
Part II Information About the Beneficiary: Wei R. Larsen
C Beneficiary's identifying number: XXX-XX-2887
Account number (see instructions): XXXXX759849
Box 1 Interest income: $1,749.75
Box 2a Ordinary dividends: 7,124.89
Box 3 Net short-term capital gain: 0.00
Box 4a Net long-term capital gain: $5,938.90
Box 14 Other information: C 8,631.65
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-163f726c23e92dbaf32d57c4,v11-K-1-1041-boxed,original,2024,fgen-2c8d18b948f55f7f65840e74,synthetic_programmatic_template,boxed,top,False,
"Part I Information About the Estate or Trust:: Estate of R. Walsh
RECIPIENT:: Kwame Larsen
2a Ordinary dividends: $6,367.25
4a Net long-term capital gain: 463.64",K-1,30,K-1,fdc-398f4475a856811bc3ee2f33,v11-K-1-1041-boxed,original,2023,fgen-969613a4a0615ae2e4726eff,synthetic_programmatic_template,boxed,none,False,
"☐ CORRECTED
OMB No. 1545-0092
Part I Information About the Estate or Trust: Testcase Family Trust 5892 Willow Bend Way Bayside, WA 26006
A Estate's or trust's employer identification number: 76-2835857
Part II Information About the Beneficiary: Jordan Castillo
C Beneficiary's identifying number: XXX-XX-4854
2a Ordinary dividends: $7,029.65
3 Net short-term capital gain
4a Net long-term capital gain: 2,413.10
5 Other portfolio and nonbusiness income
14 Other information: D 8,472.21
Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.",K-1,30,K-1,fdc-e8e7f4989ad0b8d305ceed31,v11-K-1-1041-boxed,original,2025,fgen-e60cf2ce3f542ca187463d10,synthetic_programmatic_template,boxed,bottom,False,
"Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
For calendar year 2023
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
Part I Information About the Estate or Trust: Testcase Family Trust 9139 Granite St Riverton, WI 59191
A Estate's or trust's employer identification number: 94-9888213
Part II Information About the Beneficiary: Morgan Romero
C Beneficiary's identifying number: XXX-XX-7656
Street address (including apt. no.): 9844 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 47355
Account number (see instructions): XXX-XX-253206
1 Interest income: $5,990.93
2a Ordinary dividends: $7,369.79
3 Net short-term capital gain
5 Other portfolio and nonbusiness income: 0.00
14 Other information: D 421.66
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-e5fac15e1d30139c9d248173,v11-K-1-1041-boxed,original,2023,fgen-320b7c3956c0a13845646b44,synthetic_programmatic_template,boxed,top,False,
"Schedule K-1 (Form 1041) Beneficiary's Share of Income, Deductions, Credits, etc.
From:: Testcase Family Trust
To:: Amara Lindqvist
Box 1 Interest income: $3,599.06
Box 4a Net long-term capital gain: 3,434.32
Box 2a Ordinary dividends: 6,280.70",K-1,30,K-1,fdc-95b10acec7755cee7f84e77a,v11-K-1-1041-boxed,original,2025,fgen-5ad32b16db89518be9b2c3d4,synthetic_programmatic_template,boxed,top,False,
"VOID  CORRECTED
Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
Part I Information About the Estate or Trust: Larsen Irrevocable Trust 442 Harbor View Rd Oak Grove, TX 41145
A Estate's or trust's employer identification number: 91-8902939
Part II Information About the Beneficiary: Hiro Kowalski
C Beneficiary's identifying number: ****7863
Account number (see instructions): ***-**-044187
1 Interest income: $313.81
2a Ordinary dividends: 6,832.85
3 Net short-term capital gain
5 Other portfolio and nonbusiness income: 0.00
14 Other information: V 2,821.79
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-e5c30864244770d374fc66fc,v11-K-1-1041-boxed,original,2025,fgen-0c72b027f7f06b65e9a6cd83,synthetic_programmatic_template,boxed,top,False,
"OMB No. 1545-0092
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
Part I Information About the Estate or Trust: Testcase Family Trust 5527 Maple Ridge Dr Lakewood, CO 91901
A Estate's or trust's employer identification number: 83-5519071
Part II Information About the Beneficiary: Wei Testcase
C Beneficiary's identifying number: XXX-XX-1364
Street address (including apt. no.): 3732 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Cedar Falls, IA 93188
Line 1 Interest income: 1,770.62
Line 2a Ordinary dividends: 4,958.54
Line 3 Net short-term capital gain
Line 4a Net long-term capital gain: 2,669.86
Line 5 Other portfolio and nonbusiness income: 0.00
Line 14 Other information: V 8,011.25
Department of the Treasury - Internal Revenue Service",K-1,30,K-1,fdc-4d003ef8a0813576d6678735,v11-K-1-1041-boxed,original,2022,fgen-b52924bdaa5233633a3d6689,synthetic_programmatic_template,boxed,none,False,
"OMB No. 1545-0092
Final K-1  Amended K-1
Part I Information About the Estate or Trust: Larsen Irrevocable Trust 3470 Harbor View Rd Riverton, WI 17321
A Estate's or trust's employer identification number: 25-5070537
Part II Information About the Beneficiary: Olivia Brennan
C Beneficiary's identifying number: XXX-XX-3177
Street address (including apt. no.): 1496 Harbor View Rd
City or town, state or province, country, and ZIP or foreign postal code: Fairview, OH 21882
Account number (see instructions): ***-**-370033
1 Interest income: $8,036.32
4a Net long-term capital gain: $6,316.83
5 Other portfolio and nonbusiness income
14 Other information: AA 2,970.25",K-1,30,K-1,fdc-730c6cc91590191473d74bd6,v11-K-1-1041-boxed,original,2022,fgen-517eca99a182c8f49572a447,synthetic_programmatic_template,boxed,none,False,
"VOID  CORRECTED
Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
2022
OMB No. 1545-0092
Part I Information About the Estate or Trust: Testcase Family Trust 3721 Prairie Ave Fairview, OH 97983
A Estate's or trust's employer identification number: 57-9412244
Part II Information About the Beneficiary: Hiro C. Walsh
C Beneficiary's identifying number: XXX-XX-0871
Street address (including apt. no.): 6683 Cedar Ln
City or town, state or province, country, and ZIP or foreign postal code: Lakewood, CO 85563
Line 1 Interest income: 2,983.97
Line 2a Ordinary dividends: $7,834.73
Line 3 Net short-term capital gain
Line 4a Net long-term capital gain: 7,842.57
Line 14 Other information: D 779.05
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-8e6034bf9df3f7e0f8f68794,v11-K-1-1041-boxed,original,2022,fgen-219a049385dfc403d9d1320c,synthetic_programmatic_template,boxed,top,False,
"VOID  CORRECTED
Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
2024
OMB No. 1545-0092
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
Part I Information About the Estate or Trust: Estate of R. Walsh 7429 Maple Ridge Dr Fairview, OH 25687
A Estate's or trust's employer identification number: 61-6127699
Part II Information About the Beneficiary: Diego Testcase
C Beneficiary's identifying number: ***-**-4582
Street address (including apt. no.): 8885 Sample Street
City or town, state or province, country, and ZIP or foreign postal code: Testville, IL 38878
Box 1 Interest income: $9,325.88
Box 2a Ordinary dividends: 2,313.86
Box 3 Net short-term capital gain: $0.00
Box 4a Net long-term capital gain: 8,763.07
Box 14 Other information: D 2,079.36
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-9bdef0890d9d5dcd62ad1b9a,v11-K-1-1041-boxed,original,2024,fgen-1b0da6855bd2851c4fe0eb31,synthetic_programmatic_template,boxed,top,False,
"Schedule K-1 (Form 1041) Beneficiary's Share of Income, Deductions, Credits, etc. 2023
From:: Testcase Family Trust
RECIPIENT:: Fatima Testcase
Line 2a Ordinary dividends: $5,408.00
Line 4a Net long-term capital gain: 6,841.23
Line 1 Interest income: 4,233.56",K-1,30,K-1,fdc-946823c3e702a1230ee8008b,v11-K-1-1041-boxed,original,2023,fgen-e614d96dc8f722218b40f52f,synthetic_programmatic_template,boxed,top,False,
"Schedule K-1 (Form 1041)
Beneficiary's Share of Income, Deductions, Credits, etc.
For calendar year 2024
OMB No. 1545-0092
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
Part I Information About the Estate or Trust: Estate of R. Walsh 8876 Granite St Brookhaven, PA 60217
A Estate's or trust's employer identification number: 28-6682294
Part II Information About the Beneficiary: Olivia Rivera
C Beneficiary's identifying number: ***-**-2978
Street address (including apt. no.): 5209 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code: Testville, IL 32947
Line 1 Interest income: 2,559.45
Line 2a Ordinary dividends: $6,126.26
Line 3 Net short-term capital gain: $0.00
Line 5 Other portfolio and nonbusiness income
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1041) (keep for your records)  www.irs.gov/FormScheduleK1Form1041",K-1,30,K-1,fdc-d6d47f875b37d375ef2776c1,v11-K-1-1041-boxed,original,2024,fgen-f87423bdc31f39d2d631dac8,synthetic_programmatic_template,boxed,top,False,
"Schedule K-1 (Form 1065) Partner's Share of Income,
Deductions, Credits, etc. Part I Information About the Partnership'S name: Granite Holdings Partners To: Alex Adeyemi 2 Net rental real estate income (loss) 29,230.55 L Partner's Capital Account Analysis Beginning capital account 99,511.58 1 Ordinary business income
(loss) 17,181.00",K-1,30,K-1,fdc-5aad0860bed840edaac5d049,v11-K-1-1065-flat,original,2022,fgen-9fa733735b0430de4db5af82,synthetic_programmatic_template,flat,top,False,
"Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc. 2026 OMB No. 1545-0123 Part I Information About
the Partnership Granite Holdings Partners 1028 Maple Ridge Dr Fairview, OH 25830 A Partnership's employer identification number 56-8074189 Part II Information About the Partner Casey Romero E Partner's SSN or TIN XXXXX5630 Street address (including apt. no.) 8075 Lakeshore Blvd City or town, state or province, country, and ZIP or foreign postal code Lakewood, CO 29663 Account number (see instructions) XXXXX882360 1 Ordinary business income (loss) -2,544.17 2 Net rental real estate income (loss) 7,141.93 4a Guaranteed payments for services $0.00 5 Interest income 696.80
14 Self-employment earnings (loss) 12,307.01 19 Distributions $4,911.02 L Partner's Capital Account Analysis Beginning capital account $2,788.69 L Ending capital account $55,952.16",K-1,30,K-1,fdc-4ee07b896e672badcac062df,v11-K-1-1065-flat,original,2026,fgen-0976ea54e5ee26744e4aafc2,synthetic_programmatic_template,flat,top,False,
"Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc. OMB No. 1545-0123 Department of the Treasury Internal Revenue Service Part I Information About the Partnership Riverbend Ventures LLC 4036 Willow Bend Way Bayside, WA 56170 A Partnership's employer identification number 45-5815114 Part II Information About the Partner Fatima Castillo E Partner's SSN or TIN XXXXX9619 1 Ordinary business income (loss) 16,064.07 2 Net rental real estate income (loss) 21,851.84 5 Interest income
4,330.39 14 Self-employment earnings (loss) 22,551.69 19 Distributions $2,354.72 L Partner's Capital Account Analysis Beginning capital account $102,429.00
L Ending capital account 75,344.05 Department of the Treasury - Internal Revenue Service Form K-1 (Form 1065) (keep for your records) www.irs.gov/FormScheduleK1Form1065",K-1,30,K-1,fdc-46144d8b6b6503e7a8de6442,v11-K-1-1065-flat,original,2023,fgen-ef9c47aec25885a583caf3af,synthetic_programmatic_template,flat,top,False,
"Part I Information About the Partnership: Granite Holdings PartnersRECIPIENT:
Alex
Brennan 19 Distributions $59.89",K-1,30,K-1,fdc-04caf011058d2bff72381c90,v11-K-1-1065-flat,original,2026,fgen-2aedd22756585ced7e09e966,synthetic_programmatic_template,flat,none,True,
"Schedule K-1 (Form 1065)
Partner's Share of Income, Deductions, Credits, etc. 2026 Part I Information About
the Partnership: Granite Holdings Partners To: Riley Testcase L Partner's Capital Account Analysis Beginning capital account $130,677.32 19 Distributions $5,735.35",K-1,30,K-1,fdc-381a8a5dd5dbd8faa703b7cc,v11-K-1-1065-flat,original,2026,fgen-1a53f79d90f866be8bb0b7c8,synthetic_programmatic_template,flat,top,False,
"Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc. 2025 OMB No. 1545-0123 Department of the Treasury Internal Revenue Service Part I Information About the Partnership Sample Rentals LP 84 Prairie Ave Brookhaven, PA 23199 A Partnership's employer identification number 91-6489714 Part II Information About the Partner Alex Moreau E Partner's SSN or TIN ending in 1408 Account number (see instructions) ***-**-474929 1 Ordinary business income (loss) (743.36) 2 Net rental real estate income (loss) 12,123.75
4a Guaranteed payments for services 5 Interest income $1,689.62 14 Self-employment earnings (loss) -8,836.94 19 Distributions
8,738.69 L Partner's Capital Account Analysis Beginning capital account 12,549.25 L Ending capital account 126,979.42",K-1,30,K-1,fdc-6c252502122e0f2bd9c57acf,v11-K-1-1065-flat,original,2025,fgen-93222a9d3ba3edbffc6dfe76,synthetic_programmatic_template,flat,top,False,
"Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc.2026 Part I Information About the Partnership:
Riverbend Ventures LLC Recipicnt's name:
Tay1or R. Brennan 14 Se1f-employment earnings (loss) (2,355.24)",K-1,30,K-1,fdc-b630234d90826b28f399420d,v11-K-1-1065-flat,original,2026,fgen-8d93e5f38a123182747d767f,synthetic_programmatic_template,flat,top,True,
"From: Granite Holdings Partners RECIPIENT: Olivia Adeyemi 5 Interest income 704.57 L Ending capital account $123,648.54 1 Ordinary business
income (loss) 12,604.09 19 Distributions
$8,349.70",K-1,30,K-1,fdc-1e5ff4ff353c7f0b781cf2d0,v11-K-1-1065-flat,original,2025,fgen-cc2e6cb43c66dbc7da614e62,synthetic_programmatic_template,flat,none,False,
"VOID CORRECTED Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc. 2024 OMB No.1545-0123 Final K-1 Amended K-1 Department ofthe Treasury Internal Revenue Servíce Part I Information About the Partnership Sample Rentals LP 5987 Elm Park Pl Lakewood, CO 7569l A Partnership's employer identification number86-74O3056 Part II Information About the Partner Hiro Castillo E Partner's SSN or TIN ending in 9145 Street address (induding apt. no.) 6397 Oak Hollow Ct City or town, state orprovince, country, and ZIP or
foreign postal codc Lakewood, CO 29627 l Ordinary business income (loss) 5,98O.37 2 Net rental real estate income (loss) (3,O14.70) 4aGuaranteed payments for services 0.00 5 Interest income $7,389.10 14
5elf-employment eamings (loss) (3,778.92) l9 Distributions 426.44 L Partner's Capital Account Analysis Beginning capital account 130,318.91 L Ending capital account 59,115.99",K-1,30,K-1,fdc-e5cc074241d15cc11b1efedc,v11-K-1-1065-flat,original,2024,fgen-a79fa074824a7542ebd67f5c,synthetic_programmatic_template,flat,top,True,
"Schedule K-1 (Form 1065) Partner's 5hare of Income, Deductions, Credits, etc. 2021 Final K-1 Amended K-1 Department of the Treasury Internal Revenue Service PartI
Information About the Partnership Sample Rentals LP 78 Lakeshore Blvd Maplewood, MN 5674O A Partnership's employer identification number 54-9008767 Part IIInformation About the Partner NoahNguyen E Partner's 5SN or TIN XXX-XX-8389 5treet address (induding apt. no.) 2940 Elm Park Pl City or town, state or province, country, and ZIP or foreign postal code Baysidc, WA 33743 Account number (see instructions) ***-**-O38962 1 Ordinary business income (loss) 14,389.O6 2 Net rental real estate income (loss) (6,851.61) 4a Guaranteed payments for services 0.00 14 5elf-employment eamings
(loss) 28,354.63 19 Distributions S1,283.32 L Partner's Capital Account Analysis Beginning capital account $l18,673.95 L Ending capitalaccount 82,174.77 Department of the Treasury- Intemal Revenue Service Form K-1 (Form 1065) (keep for your records) www.irs.gov/FormScheduleK1Form1065",K-1,30,K-1,fdc-6567539f4122b373c0b448fb,v11-K-1-1065-flat,original,2021,fgen-b5c2f4fb93c3072e12f731a5,synthetic_programmatic_template,flat,top,True,
"Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc. 2025 Final K-1 Amended K-1 Department of the Treasury Internal Revenue Service Part I Information About the Partnership Granite Holdings Partners 4764 Oak Hollow Ct Maplewood, MN 78989 A Partnership's employer identification number 20-1362158 Part II Information About the Partner Noah Lindqvist E Partner's SSN or TIN ending in 4867 1 Ordinary business income (loss) 9,035.55 2 Net rental
real estate income (loss) 14,731.48 4a Guaranteed payments for services 0.00 5 Interest income 3,963.30 14 Self-employment earnings (loss) 27,752.10
19 Distributions $7,915.56 L Partner's Capital Account Analysis Beginning capital account $97,305.17 L Ending capital account 127,348.63 Department of the Treasury - Internal Revenue Service Form K-1 (Form 1065) (keep for your records) www.irs.gov/FormScheduleK1Form1065",K-1,30,K-1,fdc-14ff7960949204ef23efd0b7,v11-K-1-1065-flat,original,2025,fgen-76ae44e8f0bbbf7e6921916f,synthetic_programmatic_template,flat,top,False,
"2022 OMB No. 1545-O123 Final K-1 Amended K-1 PartI Information About the Partnership Riverbend Ventures LLC 2840 Cedar Ln Lakewood, C0 67584 A Partnership's employer identification number 86-666O6l5 Part II Information About thc Partner
Taylor Haddad E Partner's 5SN or TIN ***-**-l559 1 Ordinary business income (loss) 25,297.61
4a Guaranteed paymentsfor serviccs 5 Interest income 5,103.36 14 Self-employment earnings (loss) (1,765.10) 19 Distributions 8,149.67 L Partner's Capital Account Analysis Beginning capital account 137,961.35 L Ending capital account S86,490.66 Department of the Treasury- Internal Revenue Service",K-1,30,K-1,fdc-ff020feabf1ebccf77675fd2,v11-K-1-1065-flat,original,2022,fgen-c966553bf2da9a78a2504ad1,synthetic_programmatic_template,flat,none,True,
"Schedule
K-1 (Form 1065) Partner's Shareof Income, Deductíons, Credits, etc. Fina1 K-1 Amended K-1 Department of the Treasury Internal Revenue Service PartI Information About the Partnership Samp1e Rentals LP 6103 Cedar Ln Bayside, WA 34349 A
Partnership's employer identification number 69-5056806Part IIInformation About the Partner Lena L. Tanaka E Partncr's SSN or TIN ending in 7032 Street address (including apt. no.) 447 Cedar Ln City or town, state or province, country, and ZIP or foreígn postal code Oak Grove, TX 65883 1 Ordinary business income (loss) 21,212.01 4a Guaranteed payments for services 14 Self-employment eamings (loss) -5,017.45 L Partner's Capital Account Ana1ysis Beginning capital account $57,l82.96",K-1,30,K-1,fdc-b5f9cdafaeda22708d103224,v11-K-1-1065-flat,original,2026,fgen-5eb9e0bd13b9b39d2d03e3cf,synthetic_programmatic_template,flat,top,True,
"Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc. For calendar year 2022 Part I Information About the Partnership Granite Holdings Partners 5153 Maple Ridge Dr Lakewood, CO 79820 A Partnership's employer identification number 85-3937376 Part II Information About the Partner Morgan Kowalski E Partner's SSN or TIN ***-**-5063 Street address (including apt. no.) 4375 Granite St City or town, state or province, country, and ZIP or foreign postal code Fairview, OH 20909 1 Ordinary business income (loss) 28,931.98 2 Net rental real estate income (loss) (1,286.75) 5 Interest income 1,899.38 14
Self-employment earnings (loss)
23,578.64 19 Distributions 1,594.35 L Partner's Capital Account Analysis Beginning capital account 9,053.34 L Ending capital account $6,643.90",K-1,30,K-1,fdc-e2201d421f7dfaed2dd7da4b,v11-K-1-1065-flat,original,2022,fgen-1f03e1a46d9dbeea15c9bebb,synthetic_programmatic_template,flat,top,False,
"Part I Information About the Partnership'S name: Riverbend
Ventures LLC RECIPIENT: Jamie Romero 14 Self-employment earnings (loss) 11,077.57 L Ending capital account 98,048.46 19 Distributions 9,387.42 5 Interest income
$4,895.41",K-1,30,K-1,fdc-77b1cd5ef757b7515d4d16f6,v11-K-1-1065-flat,original,2021,fgen-124e0fbfd7c5457ab3761fe6,synthetic_programmatic_template,flat,none,False,
"☐ CORRECTED Schedule K-1 (Form 1065) Partner's Share of Income, Deductions, Credits, etc. 2024 OMB No. 1545-0123 Final K-1 Amended K-1 Department of the Treasury Internal Revenue Service Part I Information About the Partnership Granite Holdings Partners 1330 Oak Hollow Ct Brookhaven, PA 68824 A Partnership's employer identification number 53-3212789 Part II Information About the
Partner Priya J. Tanaka E Partner's SSN or TIN ****3705 Street address (including apt. no.) 80 Oak Hollow Ct City or town, state or province, country, and ZIP or foreign postal code Riverton, WI 23588 1
Ordinary business income (loss) 29,327.67 2 Net rental real estate income (loss) 24,951.20 4a Guaranteed payments for services 0.00 5 Interest income $629.71 14 Self-employment earnings (loss) 4,556.28 19 Distributions $9,486.31 L Partner's Capital Account Analysis Beginning capital account 73,882.19 L Ending capital account 117,076.04 Department of the Treasury - Internal Revenue Service Form K-1 (Form 1065) (keep for your records) www.irs.gov/FormScheduleK1Form1065",K-1,30,K-1,fdc-43cad09f6282c93ce53a5b3e,v11-K-1-1065-flat,original,2024,fgen-c1ff143c20154d5392663494,synthetic_programmatic_template,flat,top,False,
"## ☐ CORRECTED
## Schedule K-1 (Form 1120-S)
## Shareholder's Share of Income, Deductions, Credits, etc.
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Maple Street Bakery Inc. 3887 Willow Bend Way Fairview, OH 17354 |
| A Corporation's employer identification number | 37-7174329 |
| Part II Information About the Shareholder | Wei Brennan |
| E Shareholder's identifying number | ****2541 |
| Street address (including apt. no.) | 7572 Willow Bend Way |
| City or town, state or province, country, and ZIP or foreign postal code | Fairview, OH 13666 |
| 1 Ordinary business income (loss) | 7,134.42 |
| 4 Interest income | $920.26 |
| 5a Ordinary dividends |  |
| 17 Other information | D 7,648.65 |
| G Current year allocation percentage | 31.3330 % |
## Department of the Treasury - Internal Revenue Service
## Form K-1 (Form 1120-S) (keep for your records)  www.irs.gov/FormScheduleK1Form1120S",K-1,30,K-1,fdc-b1e6fcda2819708e9abac94f,v11-K-1-1120-S-markdown,original,2026,fgen-aba3ec274048c0e561e8d1bc,synthetic_programmatic_template,markdown,top,False,
"☐ CORRECTED
Schedule K-1 (Form 1120-S)
Shareholder's Share of Income, Deductions, Credits, etc.
2022
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Bluewater Design Studio Inc. 7315 Maple Ridge Dr Brookhaven, PA 73872 |
| A Corporation's employer identification number | 61-2875729 |
| Part II Information About the Shareholder | Alex Walsh |
| E Shareholder's identifying number | XXX-XX-8277 |
| Street address (including apt. no.) | 5268 Lakeshore Blvd |
| City or town, state or province, country, and ZIP or foreign postal code | Pinecrest, GA 34667 |
| Account number (see instructions) | XXX-XX-331428 |
| 1 Ordinary business income (loss) | 3,443.97 |
| 4 Interest income | $6,966.07 |
| 5a Ordinary dividends | $0.00 |
| 17 Other information | AA 2,067.64 |
| G Current year allocation percentage | 34.7866 % |",K-1,30,K-1,fdc-ecbd6855e32e0daab4788e1b,v11-K-1-1120-S-markdown,original,2022,fgen-8986daee6dad757537283fd2,synthetic_programmatic_template,markdown,top,False,
"| Field | Value |
| --- | --- |
| Part I Information About the Corporation: | Maple Street Bakery Inc. |
| RECIPIENT: | Jamie Walsh |
| 4 Interest income | 1,231.70 |
| 17 Other information | D 4,942.42 |
| 1 Ordinary business income (loss) | -8,214.51 |
## Schedule K-1 (Form 1120-S) Shareholder's Share of Income, Deductions, Credits, etc.",K-1,30,K-1,fdc-5114fe338a036473178eafbe,v11-K-1-1120-S-markdown,original,2022,fgen-82ba756fd621184a1adda86b,synthetic_programmatic_template,markdown,bottom,False,
"## CORRECTED (if checked)
## For calendar year 2026
OMB No. 1545-0123
Final K-1  Amended K-1
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Bluewater Design Studio Inc. 6925 Cedar Ln Testville, IL 98226 |
| A Corporation's employer identification number | 77-7161150 |
| Part II Information About the Shareholder | Noah Romero |
| E Shareholder's identifying number | XXXXX5774 |
| Street address (including apt. no.) | 4334 Prairie Ave |
| City or town, state or province, country, and ZIP or foreign postal code | Testville, IL 49155 |
| 1 Ordinary business income (loss) | 6,584.00 |
| 4 Interest income | 7,483.71 |
| 5a Ordinary dividends | 0.00 |
| 16 Items affecting shareholder basis | V 8,742.67 |
| 17 Other information | W 7,639.66 |
| G Current year allocation percentage | 79.2402 % |
Schedule K-1 (Form 1120-S)
Shareholder's Share of Income, Deductions, Credits, etc.",K-1,30,K-1,fdc-d11888e5d2a3463335ceb5f7,v11-K-1-1120-S-markdown,original,2026,fgen-9e8866be2ee4aa4c3170d23d,synthetic_programmatic_template,markdown,bottom,False,
"Schedule K-1 (Form 1120-S) Shareholder's Share of Income, Deductions, Credits, etc. 2023
| Field | Value |
| --- | --- |
| From: | Copperline Consulting Inc. |
| To: | Hiro Patel |
| 1 Ordinary business income (loss) | 29,015.24 |
| 4 Interest income | 7,366.33 |
| 17 Other information | V 5,664.62 |
| 16 Items affecting shareholder basis | AA 7,604.21 |",K-1,30,K-1,fdc-72d9f098ecac3eb3e8129451,v11-K-1-1120-S-markdown,original,2023,fgen-67519e29c4c65eb9fa62f68c,synthetic_programmatic_template,markdown,top,False,
"## VOID  CORRECTED
2024
## Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Maple Street Bakery Inc. 502 Cedar Ln Fairview, OH 93688 |
| A Corporation's employer identification number | 48-4440277 |
| Part II Information About the Shareholder | Casey K. Rivera |
| E Shareholder's identifying number | ending in 6036 |
| 1 Ordinary business income (loss) | (5,521.47) |
| 4 Interest income | 3,630.99 |
| 16 Items affecting shareholder basis | C 4,172.22 |
| 17 Other information | W 1,761.93 |
| G Current year allocation percentage | 11.9630 % |
Department of the Treasury - Internal Revenue Service",K-1,30,K-1,fdc-93045014fd1d0cc23f592bd2,v11-K-1-1120-S-markdown,original,2024,fgen-a1e3d626e73f21429452adaa,synthetic_programmatic_template,markdown,none,False,
"## VOID  CORRECTED
Schedule K-1 (Form 1120-S)
Shareholder's Share of Income, Deductions, Credits, etc.
2021
OMB No. 1545-0123
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Maple Street Bakery Inc. 208 Willow Bend Way Cedar Falls, IA 95111 |
| A Corporation's employer identification number | 19-4419042 |
| Part II Information About the Shareholder | Amara Okafor |
| E Shareholder's identifying number | ending in 0475 |
| Street address (including apt. no.) | 8257 Granite St |
| City or town, state or province, country, and ZIP or foreign postal code | Lakewood, CO 64139 |
| Account number (see instructions) | XXXXX572524 |
| 1 Ordinary business income (loss) | 16,239.72 |
| 4 Interest income | $4,490.07 |
| 5a Ordinary dividends |  |
| 16 Items affecting shareholder basis | C 1,112.82 |
| 17 Other information | AA 2,298.58 |
| G Current year allocation percentage | 7.9737 % |",K-1,30,K-1,fdc-5bc5723e1950ce22d4c06a4f,v11-K-1-1120-S-markdown,original,2021,fgen-d19a99e171f3d92127ec041a,synthetic_programmatic_template,markdown,top,False,
"Schedule K-1 (Form 1120-S)
## Shareholder's Shareof Income, Deductions, Credits,etc.
## 2022
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
| Field| Value |
| --- | --- |
| Part I Information About the Corporation | Copperline Consu1ting Inc. 2718 Sample Street Lakewood, CO 35O00 |
| A Corporatíon's employer identification number | 41-6416834 |
| Part II Information About the Shareholder | Casey Larsen |
| EShareholder's ídentifying number | ***-**-5270 |
| 1 0rdinary business income (loss) | -7,666.32 |
| 4 Interest income | $9,322.71 |
| 5a Ordinary dividends |  |
| 17 Other information | V 2,7l2.68 |
| G Currentyear allocation percentage | 48.3742 % |
## Department of the Treasury - Intemal Revenue 5ervice
Form K-1 (Form 112O-S) (keep for your records)  www.irs.gov/FormScheduleK1Forml120S",K-1,30,K-1,fdc-8e7e35d8d979ea31bb925329,v11-K-1-1120-S-markdown,original,2022,fgen-60e1a178e0938ae9201620c6,synthetic_programmatic_template,markdown,top,True,
"Schedule K-1 (Form 1120-S) Shareholder's Share of Income, Deductions, Credits, etc. 2025
| Field | Value |
| --- | --- |
| Part I Information About the Corporation: | Copperline Consulting Inc. |
| Recipient's name: | Sofia R. Tanaka |
| G Current year allocation percentage | 53.3965 % |
| 4 Interest income | $8,345.25 |",K-1,30,K-1,fdc-33268fed3a5a16b4d1b7b26a,v11-K-1-1120-S-markdown,original,2025,fgen-5833a1d0c22abad85d472b11,synthetic_programmatic_template,markdown,top,False,
"Schedule K-1 (Form 1120-S)
Shareholder's Share of Income, Deductions, Credits, etc.
2022
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Copperline Consulting Inc. 9168 Cedar Ln Lakewood, CO 40596 |
| A Corporation's employer identification number | 62-8137339 |
| Part II Information About the Shareholder | Fatima C. Patel |
| E Shareholder's identifying number | XXXXX1749 |
| Street address (including apt. no.) | 8630 Sample Street |
| City or town, state or province, country, and ZIP or foreign postal code | Riverton, WI 68619 |
| Account number (see instructions) | ending in 999193 |
| 1 Ordinary business income (loss) | (7,052.24) |
| 4 Interest income | 4,032.67 |
| 5a Ordinary dividends |  |
| 16 Items affecting shareholder basis | C 2,328.16 |
| 17 Other information | V 187.45 |
| G Current year allocation percentage | 11.3252 % |
Department of the Treasury - Internal Revenue Service
## Form K-1 (Form 1120-S) (keep for your records)  www.irs.gov/FormScheduleK1Form1120S",K-1,30,K-1,fdc-6a9f5a26c1bac55ccadc2bba,v11-K-1-1120-S-markdown,original,2022,fgen-8e4f65a6ebb562fd04176b66,synthetic_programmatic_template,markdown,top,False,
"For calendar year 2021
OMB No. 1545-0123
## Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Maple Street Bakery Inc. 302 Lakeshore Blvd Lakewood, CO 70475 |
| A Corporation's employer identification number | 59-7623638 |
| Part II Information About the Shareholder | Fatima Larsen |
| E Shareholder's identifying number | ***-**-1712 |
| Street address (including apt. no.) | 5024 Lakeshore Blvd |
| City or town, state or province, country, and ZIP or foreign postal code | Lakewood, CO 76935 |
| Account number (see instructions) | ending in 438635 |
| 5a Ordinary dividends | 0.00 |
| 16 Items affecting shareholder basis | V 7,285.09 |
| 17 Other information | V 6,432.10 |
| G Current year allocation percentage | 82.8606 % |
## Department of the Treasury - Internal Revenue Service
Schedule K-1 (Form 1120-S)
Shareholder's Share of Income, Deductions, Credits, etc.
Form K-1 (Form 1120-S) (keep for your records)  www.irs.gov/FormScheduleK1Form1120S",K-1,30,K-1,fdc-5f91cc0edba33c5b8bdb432a,v11-K-1-1120-S-markdown,original,2021,fgen-2c01ec7c5498b0cc0cb22996,synthetic_programmatic_template,markdown,bottom,False,
"2024
## OMB No. 1545-0123
## Fina1 K-1  Amended K-1
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Information About thc Corporation | Maple Street Bakery Inc. 6994 Sample Street Oak Grove, TX 35921 |
| A Corporation's employer identificationnumber | 47-2O49223|
| PartII Information About the Shareholder | Sofia Okafor |
|E Shareholder's identifying number | XXX-XX-2411 |
| Street address (induding apt. no.) | 6488 Oak Hollow Ct |
| City or town, state or province, country, and ZIP or foreign postal code | Pinecrest, GA 40428 |
| Account number (see instructions) | ending in 546768 |
| l Ordinary business income (loss) | (l,O59.16) |
| 4 Interest income | 5,828.08 |
| 5a Ordinary dividends |  |
| l6 Items affecting shareholderbasis | D 676.42 |
| 17 Other information | AA 1,934.75 |",K-1,30,K-1,fdc-04584a077af2b36d00c6038c,v11-K-1-1120-S-markdown,original,2024,fgen-c593b30e16a39428d64ae0f1,synthetic_programmatic_template,markdown,none,True,
"## Schedule K-1 (Form 1120-S) Shareholder's Share of Income, Deductions, Credits, etc. 2022
| Field | Value |
| --- | --- |
| Part I Information About the Corporation'S name: | Bluewater Design Studio Inc. |
| RECIPIENT: | Taylor C. Patel |
| 17 Other information | AA 2,110.84 |
| 16 Items affecting shareholder basis | AA 1,823.24 |
| 4 Interest income | 580.71 |
| 1 Ordinary business income (loss) | 1,711.70 |",K-1,30,K-1,fdc-5a8b804b6b45c53eb1d401b7,v11-K-1-1120-S-markdown,original,2022,fgen-67425173959007e2c7656fdc,synthetic_programmatic_template,markdown,top,False,
"## Schedule K-1 (Form 1120-S) Shareholder's Share of Income, Deductions, Credits, etc. 2022
| Field | Value |
| --- | --- |
| Part I Information About the Corporation: | Copperline Consulting Inc. |
| RECIPIENT: | Jordan Castillo |
| 17 Other information | DD 7,364.58 |
| 16 Items affecting shareholder basis | W 7,592.41 |",K-1,30,K-1,fdc-5fc09eba1349e4dffd1381fd,v11-K-1-1120-S-markdown,original,2022,fgen-3fd53dc017bd83ebb1e2114c,synthetic_programmatic_template,markdown,top,False,
"## ☐ CORRECTED
Schedule K-1 (Form 1120-S)
Shareholder's Share of Income, Deductíons, Credits, etc.
## OMB No. 1545-0123
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part IInformation About the Corporation | Bluewater Design 5tudio Inc. 9368 Maple Ridge Dr Bayside, WA 39218 |
| A Corporation's employer identification number | 66-2O21O56 |
| Part II Information About the Shareholder | MorganOkafor |
| E Sharcholder'sidentifying number | ending in 5O72 |
| 1 Ordinary business income (loss) | 27,318.82 |
| 4 Interest income | S8,988.45 |
| 5a Ordinary dividends | O.O0 |",K-1,30,K-1,fdc-6465aef02400cb163271e6fd,v11-K-1-1120-S-markdown,original,2024,fgen-3ecb073d246c3ff884bdc86a,synthetic_programmatic_template,markdown,top,True,
"Schedule K-1 (Form 1120-S)
## Shareholder's Share of Income, Deductions, Credits, etc.
OMB No. 1545-0123
Final K-1  Amended K-1
Department of the Treasury Internal Revenue Service
| Field | Value |
| --- | --- |
| Part I Information About the Corporation | Copperline Consulting Inc. 3731 Lakeshore Blvd Cedar Falls, IA 69962 |
| A Corporation's employer identification number | 88-9568466 |
| Part II Information About the Shareholder | Wei Rivera |
| E Shareholder's identifying number | XXXXX6508 |
| Account number (see instructions) | ending in 032962 |
| 1 Ordinary business income (loss) | 2,443.02 |
| 4 Interest income | 748.03 |
| 5a Ordinary dividends |  |
| 16 Items affecting shareholder basis | DD 1,562.66 |
| 17 Other information | C 4,657.40 |
| G Current year allocation percentage | 13.2469 % |
Department of the Treasury - Internal Revenue Service
Form K-1 (Form 1120-S) (keep for your records)  www.irs.gov/FormScheduleK1Form1120S",K-1,30,K-1,fdc-e6079dd51a508eaa1e5b0e1c,v11-K-1-1120-S-markdown,original,2023,fgen-7b10d74fe24198943b45ba4a,synthetic_programmatic_template,markdown,top,False,
"HELOC Billing Statement
Harbor Personal Lending
Account number
ending in 189065
Statement period
03/01/2025 - 03/30/2025
Outstanding principal
$86,816.01
Interest rate
8.65%
Monthly payment
$853.13
Due date
January 16, 2025
Credit limit
$104,755.28
Available credit
$58,256.91
Tax reminder: amounts on this statement may differ from your Form 1098.",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-cd88fab5ed5c7b32bbf45419,v11-LOAN_STATEMENT-stacked,original,2025,fgen-ae37ce6c366b84a6518fcb40,synthetic_programmatic_template,stacked,top,False,heloc
"Northwind Auto Credit
Account number
ending in 023662
Statement period
09/01/2022 - 09/30/2022
Principal balance
$68,906.78
APR
8.90%
Payment due
$912.42
Due date
6/26/22
Vehicle
2020 Subaru Outback
Payments remaining
8",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-1bb715ac381c55c9d34cfd13,v11-LOAN_STATEMENT-stacked,original,2022,fgen-2e52cc0fe05a25348c8ab7ed,synthetic_programmatic_template,stacked,none,False,auto
"Your loan bill
Harbor Personal Lending
Account number
ending in 218092
Statement period
03/01/2024 - 03/31/2024
Outstanding principal
$89,966.72
Fixed rate
6.80%
Amount due
$1,323.34
Due date
02/08/2024",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-a713a8241c4f7eae4b48bb07,v11-LOAN_STATEMENT-stacked,original,2024,fgen-67cd2ec9290110faa460eb84,synthetic_programmatic_template,stacked,top,False,personal
"Posted  Type  Amount  To Principal  To Interest  Outstanding Balance
01/07/2023
INTEREST ACCRUAL
74.74
375.89
276.29
71386.49
2023-04-15
PAYMENT
139.78
1038.98
117.56
24209.42
10/03/2023
PAYMENT
1181.18
856.31
200.98
41878.16
2023-05-15
INTEREST ACCRUAL
834.93
19.62
1.45
89510.06
05/01/2023
INTEREST ACCRUAL
1253.44
369.31
94.09
73762.60
2023-07-14
PAYMENT
423.46
368.02
148.36
81746.77
2023-02-17
DISBURSEMENT
728.79
837.07
104.35
69290.35
06/11/2023
DISBURSEMENT
506.43
1118.98
294.73
10387.59
12/17/2023
INTEREST ACCRUAL
723.83
637.85
257.76
8924.21
Loan 6225 payment history",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-991a56f9eb35ccb253f2841b,v11-LOAN_STATEMENT-stacked,original,2023,fgen-afa8129de16b92d855311c90,synthetic_programmatic_template,stacked,bottom,False,raw_export
"Cedar Valley Credit Union
Account number
endíng in 151365
Statement period
12/01/2023- 12/31/2023
Outstanding principal
$6,916.48
Interest rate
11.12%
Payment due
$118.39
Due date
1O/9/23
Personal Loan Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-37e0acdc53dccbb41cdd0f18,v11-LOAN_STATEMENT-stacked,original,2023,fgen-d296095b8ab6b3ce388bc686,synthetic_programmatic_template,stacked,bottom,True,personal
"Billing Statement - Student Loans
Summit Student Loan Servicing
Account number
****318686
Statement period
04/01/2024 - 04/30/2024
Principal balance
$26,828.63
Fixed rate
5.22%
Monthly payment
$1,220.39
Payment due date
08/03/2024
Loan type
Direct Subsidized
Interest paid this year
$976.37
Repayment plan
Income-Driven Repayment
IRS Form 1098-E information for 2024 will be mailed separately.",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-33b27d86781db337c84461b7,v11-LOAN_STATEMENT-stacked,original,2024,fgen-eed21d8c40ab88facdd2ae2a,synthetic_programmatic_template,stacked,top,False,student
"Your loan bill
Granite Auto Finance
Account number
***-**-700931
Statement period
05/01/2021 - 05/28/2021
Outstanding principal
$48,412.14
Fixed rate
9.40%
Monthly payment
$1,111.67
Due by
01/16/2021",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-7cd4feb9da54eafd5ce736ed,v11-LOAN_STATEMENT-stacked,original,2021,fgen-315d614e2bd0b4d45d87de97,synthetic_programmatic_template,stacked,top,False,personal
"Cedar Valley Credit Union
Account number
****514205
Statement period
12/01/2023 - 12/30/2023
Outstanding principal
$0.00
APR
5.49%
Current amount due
$237.90
Due by
August 9, 2023
Loan status: Paid in full
Installment Loan Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-9f5f99d4c9fbe3243b409356,v11-LOAN_STATEMENT-stacked,original,2023,fgen-823eddf4ea11064c906f5832,synthetic_programmatic_template,stacked,bottom,False,personal
"Personal Loan History
Payment Date  Amount Paid  Principal Paid  Interest Paid  Late Fee  Loan Balance
2025-10-03
848.19
809.24
148.02
0.00
55417.24
2025-10-13
374.81
692.02
166.53
0.00
15088.03
17/10/2025
1056.35
447.30
229.42
0.00
41992.17
12/09/2025
1068.33
395.89
12.68
0.00
59883.03
08/19/2025
957.38
162.68
103.66
0.00
13659.10
2025-03-27
284.18
304.35
109.84
0.00
36315.56
2025-02-06
616.45
278.94
360.82
0.00
22424.37
01/19/2025
933.39
111.12
94.11
0.00
83251.54
05/08/2025
161.21
645.89
44.40
0.00
45596.93",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-a768611947d4f1da4d008bdb,v11-LOAN_STATEMENT-stacked,original,2025,fgen-ae378ffbd046c296c8f61e1f,synthetic_programmatic_template,stacked,top,False,raw_export
"Installment Loan Statement
Summit Student Loan Servicing
Account number
XXX-XX-449535
Statement period
03/01/2022 - 03/28/2022
Principal balance
$86,027.15
Interest rate
7.98%
Amount due
$360.17
Due by
12/9/22",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-ab9a33f09233bfb7b3c8fc31,v11-LOAN_STATEMENT-stacked,original,2022,fgen-7061923b72cae8a2ae100980,synthetic_programmatic_template,stacked,top,False,personal
"Vehicle Loan Billing Statement
Northwind Auto Credit
Account number
ending in 857196
Statement period
05/01/2023 - 05/30/2023
Principal balance
$40,325.30
Interest rate
9.42%
Payment due
$1,241.91
Due date
May 6, 2023
Vehicle
2018 Ford F-150
Payments remaining
28",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-73c2b96f2b3e4ed114a0ba66,v11-LOAN_STATEMENT-stacked,original,2023,fgen-659e56380242fbca252e420c,synthetic_programmatic_template,stacked,top,False,auto
"Payment Date  Amount Paíd  Principal Paid  Interest Paid  Late Fee  LoanBalance
09/14/2022
1166.43
609.16
137.61
0.00
58497.31
02/04/2022
794.36
1014.95
6.85
0.00
68012.07
04/16/2022
1222.12
261.29
234.55
0.00
33771.63
04/02/2022
l358.55
95.55
144.22
0.00
72373.57",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-71a5ede49277dc050241bf8e,v11-LOAN_STATEMENT-stacked,original,2022,fgen-ed1b2f102341c38ea56c8242,synthetic_programmatic_template,stacked,none,True,raw_export
"Northwind Auto Credit
Account number
XXX-XX-571515
Statement period
06/01/2021 - 06/31/2021
Principal balance
$6,252.90
Interest rate
11.64%
Monthly payment
$1,348.62
Due by
5/15/21
Loan type
Direct Subsidized
Interest paid this year
$1,706.61
Repayment plan
Graduated",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-2c859005ab84a806632c9602,v11-LOAN_STATEMENT-stacked,original,2021,fgen-4afce81788d02228227da76f,synthetic_programmatic_template,stacked,none,False,student
"Date  Description  Payment  Principal  Interest  Balance
15/12/2025
Personal loan installment
603.29
360.52
152.64
74862.57
28/10/2025
Autopay
444.84
104.03
220.29
23640.61
18/07/2025
Loan payment
1200.37
1141.40
134.89
82319.61
2025-10-10
Auto1oan payment
1026.99
875.43
66.85
32031.77",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-dfcf9f53eb9ca5aa488aa8a7,v11-LOAN_STATEMENT-stacked,original,2025,fgen-8e3c074a0fcbaf56458137cf,synthetic_programmatic_template,stacked,top,True,raw_export
"Granite AutoFinance
Account number
XXXXX429037
Statement period
09/01/2023 - 09/28/2023
Principal balance
$49,301.50
APR
9.29%
Payment due
$953.67
Payment due date
8/18/23
Vehic1e
2023 Toyota Corolla
Payments remaíning
60
Your auto loan bill",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-3f766f14ae52d9a8546c7215,v11-LOAN_STATEMENT-stacked,original,2023,fgen-8bc0e196baef246b891331b7,synthetic_programmatic_template,stacked,bottom,True,auto
"Summit Student LoanServicing
Account number
ending in 125730
Statement period
02/0l/2023 - 02/28/2023
Outstanding principal
$4,939.51
APR
2.92%
Month1y payment
$379.55
Due by
08/14/2023
Vehicle
2019 Ford F-150
Payments rcmaining
8
Your auto loan bill",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-1f4320f61b2bf6ca60872590,v11-LOAN_STATEMENT-stacked,original,2023,fgen-b72639133d087c1db9c680cd,synthetic_programmatic_template,stacked,bottom,True,auto
"Personal Loan Statement
Cedar Valley CreditUnion
Account number
****411784
Statement period
01/01/2023 - 01/31/2023
Remaining balance
$1,741.31
APR
6.92%
Current amount due
$125.82
Due date
02/12/2023",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-ea9ae18815cbdbc9500a437d,v11-LOAN_STATEMENT-stacked,original,2023,fgen-874b89f22b6d39b3825264a9,synthetic_programmatic_template,stacked,top,True,personal
"Harbor Personal Lending
Account number
***-**-208337
Statement period
05/01/2025 - 05/28/2025
Current principal
$14,788.98
Interest rate
10.75%
Monthly payment
$589.10
Payment due date
2025-11-12
Credit limit
38,419.48
Available credit
$18,701.93",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-4e0af132baf40b461445a494,v11-LOAN_STATEMENT-stacked,original,2025,fgen-94611c659f38b843bb21f9bc,synthetic_programmatic_template,stacked,none,False,heloc
"Payment Date  Amount Paid  Principal Paid  Interest Paid  Late Fee  Loan Balance
10/12/2022
1383.44
436.81
382.60
0.00
40330.68
2022-09-07
956.40
271.80
183.70
0.00
61847.51
15/03/2022
1218.70
1068.61
123.98
0.00
34523.69
2022-08-13
182.24
1139.96
335.06
0.00
9694.95",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-387c0f3e5a749c07245cd872,v11-LOAN_STATEMENT-stacked,original,2022,fgen-dfdc5e9ed2ec0f533f84dfbc,synthetic_programmatic_template,stacked,top,False,raw_export
"Student Loan Statement
Summit Student Loan Servicing
Account number
ending in 103199
Statement period
12/01/2022 - 12/28/2022
Unpaid principal balance
$55,385.46
Interest rate
8.59%
Monthly payment
$1,086.48
Due by
9/20/22
Loan type
Direct Unsubsidized
Interest paid this year
1,003.74
Repayment plan
Income-Driven Repayment
IRS Form 1098-E information for 2022 will be mailed separately.",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-8fef2c4fd0b826958b1e0fe6,v11-LOAN_STATEMENT-stacked,original,2022,fgen-6951c3e81513dfb1e3e3d5cf,synthetic_programmatic_template,stacked,top,False,student
"Harbor Personal Lending
Account number
XXX-XX-166338
Statement period
07/01/2024 - 07/28/2024
Current principal
$47,890.54
Fixed rate
6.00%
Amount due
$590.25
Due date
12/01/2024
Installment Loan Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-ce882e1c97a600e0bf8241ba,v11-LOAN_STATEMENT-stacked,original,2024,fgen-29de84c1ea0e6ebfb6f1398a,synthetic_programmatic_template,stacked,bottom,False,personal
"Home Equity Line of Credit Statement
Northwind Auto Credit
Account number
***-**-940159
Statement period
04/01/2026 - 04/28/2026
Remaíning ba1ance
$85,228.82
Fixed rate
6.60%
Payment due
$295.97
Due by
June 9,2026
Credit limit
$56,499.82
Available credit
$30,298.46
Your 2026 Form l098 will be available online by January 3l, 2027.",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-fb5b068d30146fe9aa58af5e,v11-LOAN_STATEMENT-stacked,original,2026,fgen-c85dd9d47eebc55b7821b68d,synthetic_programmatic_template,stacked,top,True,heloc
"Vehicle Loan Billing Statement
Summit Student Loan Servicing
Account number
XXX-XX-298749
Statement period
05/01/2026 - 05/31/2026
Current principal
$30,136.92
APR
4.72%
Payment due
$971.05
Due by
December 28, 2026
Vehicle
2023 Honda Civic
Payments remaining
27",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-7abd7d538fad4b4171668ecf,v11-LOAN_STATEMENT-stacked,original,2026,fgen-e63b1c137bf34c4522973b2b,synthetic_programmatic_template,stacked,top,False,auto
"Your monthly student loan bill
Harbor Personal Lending
Account number
ending in 255612
5tatcment period
03/01/2025 - 03/28/2025
Principal balance
$60,100.20
Interest rate
11.78%
Monthly payment
$205.73
Due date
January8, 2025
Loan type
Direct Unsubsidized
Interest paid this year
$2,429.O3
Repaymcnt plan
Standard
Your 2025 Form lO98-E will be available online by January 31, 2026.",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-1ef60e0ca823ab23e7357e71,v11-LOAN_STATEMENT-stacked,original,2025,fgen-4cbfdae1c5c896d727f9443e,synthetic_programmatic_template,stacked,top,True,student
"Vehicle Loan Billing Statement
Northwind Auto Credit
Account number
****299790
Statement period
02/01/2025 - 02/28/2025
Principal balance
$9,418.06
Fixed rate
8.47%
Amount due
$136.48
Due date
2025-07-24
Vehicle
2023 Honda Civic
Payments remaining
42",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-d41d0a9fe97e8bdcf52e3208,v11-LOAN_STATEMENT-stacked,original,2025,fgen-042dea3635ecb0d36927e9db,synthetic_programmatic_template,stacked,top,False,auto
"Home Equity Line of Credit Statement
Cedar Valley Credit Union
Account number
ending in 446358
Statement period
07/01/2022 - 07/28/2022
Current principal
$55,361.29
APR
6.80%
Payment due
$616.87
Payment due date
2022-12-04
Credit limit
115,116.32
Available credit
$13,089.11
This statement is not a Form 1098. Keep it for your records.",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-86e37673c1100e5a8ed73230,v11-LOAN_STATEMENT-stacked,original,2022,fgen-1d6d05ff6f4845557fb0be2d,synthetic_programmatic_template,stacked,top,False,heloc
"Auto Loan Activity
Payment Date  Amount Paid  Principal Paid  Interest Paid  Late Fee  Loan Balance
09/10/2026
1287.88
408.08
130.72
0.00
71782.30
13/04/2026
796.62
394.26
215.64
0.00
32150.58
11/11/2026
179.60
226.84
284.10
0.00
35002.06
01/21/2026
1012.62
788.53
33.42
0.00
41299.41
11/03/2026
899.17
157.71
154.73
0.00
61696.09
2026-12-06
462.18
661.45
342.58
0.00
89750.74",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-e98d98bfe79c91345c58d864,v11-LOAN_STATEMENT-stacked,original,2026,fgen-452b806ee27dd4ad6e4b6bfe,synthetic_programmatic_template,stacked,top,False,raw_export
"Student Loan Transactions
Downloaded 2026-09-01
Posted  Type  Amount  To Principal  To Interest  Outstanding Balance
05/04/2026
INTEREST ACCRUAL
1329.84
808.41
363.42
58326.51
2026-11-10
INTEREST CAPITALIZATION
331.78
1052.99
139.18
30643.24
2026-07-09
INTEREST CAPITALIZATION
1284.14
865.38
294.55
22204.32
13/08/2026
PAYMENT
953.93
363.19
4.04
5517.28
15/12/2026
INTEREST CAPITALIZATION
921.86
831.29
223.80
65316.11
03/08/2026
PAYMENT
716.19
382.52
239.14
22458.21",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-aade4b75fe956683f5a81ef3,v11-LOAN_STATEMENT-stacked,original,2026,fgen-2f425220645d6ff1d11fd14a,synthetic_programmatic_template,stacked,top,False,raw_export
"SummitStudent Loan Servicing
Account number
****968299
Statement period
07/01/2025 - 07/30/2025
Outstanding principal
S52,692.50
Interest rate
8.10%
Amount due
$137.49
Payment due date
2/5/25
Credit 1imit
$148,142.78
Available credit
54,900.99
IR5 Form 1098 information for 2025 will be mailed separately.
Home Equity Line of Credit Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-c3a529529d46c0efdab1f89e,v11-LOAN_STATEMENT-stacked,original,2025,fgen-9f68582574f5e295bcd0f4ac,synthetic_programmatic_template,stacked,bottom,True,heloc
"Your auto loan bill
Harbor Personal Lending
Account number
****172376
Statement period
12/01/2023 - 12/30/2023
Unpaid principal balance
$18,052.95
Fixed rate
13.33%
Amount due
$699.98
Due date
2023-02-28
Vehicle
2018 Toyota Corolla
Payments remaining
52",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-b0b4591b64c5e42b6c741a84,v11-LOAN_STATEMENT-stacked,original,2023,fgen-acf76c27306932a79598263b,synthetic_programmatic_template,stacked,top,False,auto
"Installment Loan Statement
Cedar Valley Credit Union
Account number
ending in 198928
Statement period
03/01/2021 - 03/28/2021
Outstanding principal
$41,728.46
APR
7.38%
Payment due
$461.70
Due by
May 14, 2021",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-2aa1e6a03d599e74a76361c0,v11-LOAN_STATEMENT-stacked,original,2021,fgen-1cb0cd2d8b334ff3d818ca9c,synthetic_programmatic_template,stacked,top,False,personal
"Your monthly student loan bill
Northwind Auto Credit
Account number
***-**-300154
Statement period
04/01/2022 - 04/31/2022
0utstanding principal
$39,750.25
Fixed rate
11.11%
Current amount due
$1,149.30
Due date
10/24/22
Loan type
Direct Unsubsidized
Interest paid this year
$2,169.64
Repayment p1an
Income-Driven Repayment
Thís statement is not a Form1098-E. Keep it for your records.",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-2afb1f5ecd3a572afc7901b6,v11-LOAN_STATEMENT-stacked,original,2022,fgen-beb5d6129ae204b806599e2d,synthetic_programmatic_template,stacked,top,True,student
"Dental Visit Receipt
Sample Family Clinic
Patient Riley Romero
Date of service  9/3/22
CPT Description Charge
80053 Cleaning 1,359.68
Insurance adjustment      -543.87
Insurance paid -543.87
Patient paid  271.94
Balance due      $0.00
Payment method      Cash",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-46026bae797fab743f644ff5,v11-MEDICAL_RECEIPT-inline,original,2022,fgen-1f14e8218ce8269efc9ac961,synthetic_programmatic_template,inline,top,False,dental
"Sample Family Clinic
Patient  Priya Brennan
Date of service   11/17/2021
CPT      Description      Charge
80053 Cleaning 85.15
Insurance adjustment   -34.06
Insurance paid -34.06
Patient paid      17.03
Balance due $0.00
Payment method Visa ****2674",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-0dd359e44ad50e9840ca85f9,v11-MEDICAL_RECEIPT-inline,original,2021,fgen-a049c35108b4afd2a60fc892,synthetic_programmatic_template,inline,none,False,dental
"Patient Receipt
Brightsmile Dental Group
Patient Amara B. Romero
Date of service      4/28/21
CPT      Description      Charge
36415  Lab panel  1,225.07
Insurance adjustment -490.03
Insurance paid -490.03
Patient paid  245.01
Balance due      $0.00
Payment method HSA card",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-1ac242b397736195fd3dbf1b,v11-MEDICAL_RECEIPT-inline,original,2021,fgen-76b928fe36c70f8bf768b925,synthetic_programmatic_template,inline,top,False,clinic
"Patient Receipt
Sample Family Clinic
Patient  Avery Haddad
Date of service      06/01/2025
CPT   Description   Charge
1110   Office visit   983.97
Insurance adjustment   -393.59
Insurance paid   -393.59
Patient paid      196.79
Balance due $0.00
Payment method   HSA card",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-69aca63e1aa3a0cb39debbb2,v11-MEDICAL_RECEIPT-inline,original,2025,fgen-026fac22a071c02a69ad48d7,synthetic_programmatic_template,inline,top,False,clinic
"Brightsmile Dental Group
Patient Lena Haddad
Date of service 8/6/22
Rx #   374087
Drug Amoxicillin 500mg
Qty   30
Insurance paid  1,452.98
Your copay     622.71
Paymcnt method      Visa ****2174
Prescription Rcceipt",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-f08bee078b0fdc373756fd11,v11-MEDICAL_RECEIPT-inline,original,2022,fgen-117e31d823f4baae4d39c013,synthetic_programmatic_template,inline,bottom,True,pharmacy
"Brightsmile Dental Group
Patient Priya Haddad
Date of service      10/26/26
CPT   Description   Charge
1110 Lab panel 1,718.07
Insurance adjustment   -687.23
Insurance paid  -687.23
Patient paid      343.61
Balance due $0.00
Payment method  Visa ****7827",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-d3b2381e0b5dbf665463fecc,v11-MEDICAL_RECEIPT-inline,original,2026,fgen-3be6f0ad4edeeb2f3da4ac8d,synthetic_programmatic_template,inline,none,False,hospital_statement
"Prescription Receipt
Brightsmile Dental Group
Patient   Morgan C. Adeyemi
Date of service   9/24/22
Rx # 367922
Drug Amoxicillin 500mg
Qty 90
Insurance paid  1,932.00
Your copay 828.00
Payment method   HSA card",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-d6c830e914e4da7a183e95f9,v11-MEDICAL_RECEIPT-inline,original,2022,fgen-7dd0c821fb257f1432d8ccf3,synthetic_programmatic_template,inline,top,False,pharmacy
"Prescription Receipt
Brightsmile Dental Group
Patient      Avery Okafor
Date of service January 14, 2026
Rx # 825180
Drug  Atorvastatin 20mg
Qty 90
Insurance paid      1,134.61
Your copay   486.26
Payment method   HSA card",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-86858abfef9c8b7205daf7d9,v11-MEDICAL_RECEIPT-inline,original,2026,fgen-5abc9fde20b9d2d19cae47ba,synthetic_programmatic_template,inline,top,False,pharmacy
"Patient Account Statement
Riverside Urgent Care
Patient Lena Lindqvist
Date of service  November 4, 2026
CPT Description Charge
99213   Cleaning   1,063.20
Insurance adjustment   -425.28
Insurance paid   -425.28
Patient paid 212.64
Balance due $0.00
Payment method Visa ****7464",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-4ba5e83a1cd73bfe8d03a4e4,v11-MEDICAL_RECEIPT-inline,original,2026,fgen-f2c671d9aa5aca6d6a45c4e9,synthetic_programmatic_template,inline,top,False,hospital_statement
"Prescription Receipt
Sample Family Clinic
Patient      Jordan Fischer
Date of service  August 20, 2022
Rx # 852753
Drug   Amoxicillin 500mg
Qty   60
Insurance paid 1,259.68
Your copay   539.86
Payment method   Visa ****2099",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-5c2812e6cd21bb7440073bd8,v11-MEDICAL_RECEIPT-inline,original,2022,fgen-3e7ebfd7f80c450aebcdc4e5,synthetic_programmatic_template,inline,top,False,pharmacy
"Patient Account Statement
Riverside Urgent Care
Patient   Fatima Brennan
Date of service 2/23/23
CPT      Description      Charge
99214 Lab panel 1,291.64
Insurance adjustment   -516.66
Insurance paid  -516.66
Patient paid      258.33
Balance due  $0.00
Payment method Cash",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-f30854c2c5fe675cd9734b85,v11-MEDICAL_RECEIPT-inline,original,2023,fgen-733bb8946627c20d6426d1ad,synthetic_programmatic_template,inline,top,False,hospital_statement
"Prescription Receipt
Brightsmile Dental Group
Patient   Olivia E. Kowalski
Date of service   02/17/2022
Rx # 627150
Drug  Amoxicillin 500mg
Qty      30
Insurance paid 557.61
Your copay 238.98
Payment method      Cash",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-846c384518fb1899fddcaafc,v11-MEDICAL_RECEIPT-inline,original,2022,fgen-f94acbe9657d9982ed253889,synthetic_programmatic_template,inline,top,False,pharmacy
"Patient Account Statement
Brightsmile Dental Group
Patient   Noah Rivera
Date of service  5/25/25
CPT Description Charge
1110  Filling  2,753.60
Insurance adjustment -1,101.44
Insurance paid  -1,101.44
Patient paid 550.72
Balance due   $0.00
Payment method  HSA card",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-8988d8f2455b35d073c903f1,v11-MEDICAL_RECEIPT-inline,original,2025,fgen-0662585ca36f32711875823f,synthetic_programmatic_template,inline,top,False,hospital_statement
"Patient Receipt
Brightsmile Dental Group
Patient Olivia Testcase
Date of service   10/19/2021
CPT      Description      Charge
2391   Office visit   442.02
Insurance adjustment   -176.81
Insurance paid  -176.81
Patient paid   88.40
Balance due      $0.00
Payment method  Visa ****1130",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-439024f0a1adb79a7d184a71,v11-MEDICAL_RECEIPT-inline,original,2021,fgen-8c633516a0a9dd1bd889f770,synthetic_programmatic_template,inline,top,False,clinic
"Brightsmile Dental Group
Patient Hiro Adeyemi
Date of service 2025-06-16
CPT Description Charge
1110      Office visit      54.37
Insurance adjustment   -21.75
Insurance paid  -21.75
Patient paid  10.87
Balance due  $0.00
Payment method HSA card",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-2e93c4d04c6bcf6ad5d82abf,v11-MEDICAL_RECEIPT-inline,original,2025,fgen-36a1695b79dcb259aa93d819,synthetic_programmatic_template,inline,none,False,clinic
"Dental Visit Receipt
Sample Family Clinic
Patient Sofia Haddad
Date of service May 15, 2024
CPT      Description      Charge
36415 Cleaning 40.44
Insurance adjustment -16.18
Insurance paid -16.18
Patient paid      8.09
Balance due  $0.00
Payment method  HSA card",MEDICAL_RECEIPT,31,MEDICAL_RECEIPT,fdc-bddf1dfed5afcd9da1bb1d7a,v11-MEDICAL_RECEIPT-inline,original,2024,fgen-be0b88fb6afec6cff713a734,synthetic_programmatic_template,inline,top,False,dental
"Annual Escrow Account Disclosure Statement
Keystone Home Loans
Loan number
Property address
Projected property taxes
Projected homeowners insurance
Escrow shortage
New monthly escrow payment
New total monthly payment effective
***-**-2812O3
2137 Harbor View Rd Bayside, WA 27486
7,495.93
3,845.46
$946.75
238.27
March 4, 2O27
This is anattempt to collect a debt. NML5 ID 876949",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-3efe526bff51bf8c3fd5d46b,v11-MORTGAGE_STATEMENT-columns,original,2026,fgen-8835e71b214f25a441132879,synthetic_programmatic_template,columns,top,True,escrow_analysis
"Lakeshore Home Lending
Statement date
Loan number
Property address
Payment due date
Amount due
12/18/2026
XXX-XX-832247
8551 Prairie Ave Pinecrest, GA 15264
November 22, 2026
$3,738.72
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
2,278.97
2,522.37
$1,431.03
$3,685.74
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
30,268.42
$343,882.52
$4,649.65
2.546%
This is an attempt to collect a debt. NMLS ID 564248",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-f9ed7c86ebdb2043d3ea37a3,v11-MORTGAGE_STATEMENT-columns,original,2026,fgen-1fd6f2da20a3f2d160989102,synthetic_programmatic_template,columns,none,False,monthly
"Annual Escrow Account Disclosure Statement
Lakeshore Home Lending
Loan number
Property address
Projected property taxes
Projected homeowners insurance
Escrow shortage
New monthly escrow payment
New total monthly payment effective
****926581
8928 Lakeshore Blvd Cedar Falls, IA 41230
4,243.81
$3,468.46
$446.24
$565.31
12/27/23
IRS Form 1098 information for 2022 will be mailed separately.
This is an attempt to collect a debt. NMLS ID 182530",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-ce97dd611d52c3b267443c10,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-0b0d5a463d458ee9f4baeed4,synthetic_programmatic_template,columns,top,False,escrow_analysis
"Home Loan Statement
Lakeshore Home Lending
Statement date
Loan number
Property address
Payment due date
Amount due
03/04/2022
***-**-772584
2942 Oak Hollow Ct Riverton, WI 86253
June 26, 2022
$3,562.13
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
1,156.46
2,970.15
$725.39
3,791.23
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
20,791.05
$386,110.57
$3,831.25
4.101%
IRS Form 1098 information for 2022 will be mailed separately.
This is an attempt to collect a debt. NMLS ID 349091",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-62f853cbf8c6ef8ae106b072,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-ea6dfd8eb906cc87e2d6faec,synthetic_programmatic_template,columns,top,False,monthly
"Mortgage Statement
Keystone Home Loans
Statement date
Loan number
Property address
Payment due date
Amount due
August 5, 2024
***-**-927470
2144 Granite St Cedar Falls, IA 11602
11/09/2024
$1,720.97
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
1,541.84
2,643.18
150.87
4,475.86
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
31,718.19
$436,128.30
$5,300.87
5.202%
If you are experiencing financial difficulty, call a HUD-approved housing counselor.
This is an attempt to collect a debt. NMLS ID 960712",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-4751404985edf2135226e9dc,v11-MORTGAGE_STATEMENT-columns,original,2024,fgen-8f19b6e3fae447ef36f8a485,synthetic_programmatic_template,columns,top,False,monthly
"Payment Date
Total Payment
Principal
Interest
Escrow
Principal Balance
26/03/2023
3931.15
1033.00
800.20
558.26
61031.43
2023-06-11
2689.88
557.21
1904.13
735.24
245430.52
25/05/2023
3670.51
922.63
2286.50
753.63
394586.58
11/13/2023
1555.82
1438.00
2335.12
431.33
259322.29
01/05/2023
1416.68
675.39
2276.30
607.85
465195.18
2023-02-12
1671.42
393.14
2388.21
578.27
398550.03
07/11/2023
1966.90
987.41
1507.87
1168.19
223578.69
2023-05-07
2323.03
488.02
432.79
454.09
438490.80
Mortgage loan 1917 - payment history",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-830bf41d968917f7e4cd4543,v11-MORTGAGE_STATEMENT-columns,original,2023,fgen-1606dd76b715d6c00e826e0d,synthetic_programmatic_template,columns,bottom,False,raw_export
"Bluewater Loan Servicing
Statement date
Loan number
Property address
Payment due date
Amount due
6/16/23
ending in 995250
8929 Sample Street Pinecrest, GA 73278
10/06/2023
$4,506.91
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
$1,323.70
1,451.84
318.84
3,806.26
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
17,422.07
$602,331.81
$5,718.08
2.729%
If you are experiencing financial difficulty, call a HUD-approved housing counselor.
Late fee of $75.00 will be charged if payment is received after the 16th.
This is an attempt to collect a debt. NMLS ID 520904
Monthly Mortgage Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-8a557f11e795ebb56193ab55,v11-MORTGAGE_STATEMENT-columns,original,2023,fgen-fe05c7437bb5e64a0d204c68,synthetic_programmatic_template,columns,bottom,False,monthly
"Due Date
Amount Paid
Principal Applied
Interest Applied
Escrow Deposit
RemainingBalance
23/l0/2024
3614.91
1251.09
989.75
497.42
495362.96
03/14/2024
4255.01
709.45
1355.76
598.00
373218.81
2024-03-06
1935.54
1070.91
1910.39
372.58
342723.79",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-cd7aa2e3a231d4588f0173ed,v11-MORTGAGE_STATEMENT-columns,original,2024,fgen-b2d82e811b728cabaa766970,synthetic_programmatic_template,columns,bottom,True,raw_export
"Pinecrest Mortgage Company
Statement date
Loan number
Property address
Payment due date
Amount due
03/25/2021
ending in 928528
7218 Cedar Ln Oak Grove, TX 90404
April 8, 2021
$1,306.78
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
$650.27
1,535.36
$1,110.03
$2,069.08
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
15,353.58
$563,399.37
$324.57
6.160%
If you are experiencing financial difficulty, call a HUD-approved housing counselor.
Late fee of $75.00 will be charged if payment is received after the 16th.
This is an attempt to collect a debt. NMLS ID 839297
Mortgage Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-a9a2580d5009f3bca05b6db7,v11-MORTGAGE_STATEMENT-columns,original,2021,fgen-68ad5f8d3ed1b1cb47173c20,synthetic_programmatic_template,columns,bottom,False,monthly
"Pinecrest Mortgage Company
Statement date
Loan number
Property address
Payment due date
Amount due
2026-03-02
XXXXX771479
458 Harbor View Rd Lakewood, CO 68597
2/18/26
$2,470.39
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
1,252.78
674.19
1,331.77
3,529.04
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
4,719.36
$602,063.11
$3,631.30
4.134%
Late fee of $75.00 will be charged if payment is received after the 16th.
This is an attempt to collect a debt. NMLS ID 95458",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-1047e0ae1259b46a848455a9,v11-MORTGAGE_STATEMENT-columns,original,2026,fgen-240e3ab563de0e1bdff54d4c,synthetic_programmatic_template,columns,none,False,monthly
"Keystone Home Loans
Loan number
Good through date
Unpaid principal balance
Interest from last paid date
Recording fee
Total amount to pay off loan
****806846
2024-12-23
$503,097.81
$1,098.35
$45.00
$504,389.26
This is an attempt to collect a debt. NMLS ID 73712",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-b9227281646a614778217306,v11-MORTGAGE_STATEMENT-columns,original,2024,fgen-267ba8357307015a65e17d79,synthetic_programmatic_template,columns,none,False,payoff
"Mortgage loan 9730 - payment history
Due Date
Amount Paid
Principal Applied
Interest Applied
Escrow Deposit
Remaining Balance
2024-07-13
2824.76
1154.45
515.75
299.85
425060.23
18/07/2024
3412.95
1448.33
2248.27
936.23
473473.50
2024-04-17
1324.34
1147.46
1300.36
1015.65
155299.90
2024-01-06
3428.06
771.49
1331.32
509.25
584756.18
09/06/2024
2350.35
1553.39
1085.78
474.38
250591.18",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-055fdd2dcaea67e21d265d6a,v11-MORTGAGE_STATEMENT-columns,original,2024,fgen-6f2e56d241cf8c2a3e1e5bf3,synthetic_programmatic_template,columns,top,False,raw_export
"Downloaded 2023-10-25
Date
Transaction
Amount
Principal
Interest
Escrow
Fees
Unpaid Principal
13/12/2023
Hazard insurancc disbursement
1544.66
18.93
224.22
230.22
0.00
429088.75
22/04/2023
Hazard ínsurance disbursement
3802.16
1221.15
1120.70
1071.19
0.00
375243.42
04/07/2023
Additional principal
1602.02
1515.29
2475.56
522.12
0.00
523682.49
06/15/2023
Hazard insurance disbursement
1420.58
1366.70
2022.05
793.55
0.00
548049.82
02/12/2023
Regu1armonthly payment
895.22
970.38
1863.03
302.05
0.00
311161.04
06/05/2023
Hazard insurance disbursement
1407.31
979.94
1687.59
447.88
0.00
407223.16
22/10/2023
Additiona1 principa1
1056.75
1431.40
1029.72
834.43
0.00
599186.37
2023-01-21
Additiona1 principal
2272.66
29.86
1759.13
570.39
0.00
495828.76",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-594c850010ba744e1b6b3551,v11-MORTGAGE_STATEMENT-columns,original,2023,fgen-7ffec1d09e550cf2dafcfee3,synthetic_programmatic_template,columns,bottom,True,raw_export
"Home Loan Statement
Pinecrest Mortgage Company
Statement date
Loan number
Property address
Payment due date
Amount due
01/17/2022
****638248
7200 Lakeshore Blvd Brookhaven, PA 73052
March 28, 2022
$2,741.34
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
$2,161.02
354.41
749.91
$1,296.16
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
1,417.63
$616,303.56
$4,404.17
4.485%
Late fee of $75.00 will be charged if payment is received after the 16th.
This statement is not a Form 1098. Keep it for your records.
This is an attempt to collect a debt. NMLS ID 512045",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-71514c9d84ff34d39bc27386,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-c48f3b53c44f6a160532d314,synthetic_programmatic_template,columns,top,False,monthly
"Mortgage loan 2064 - payment history
Date
Transaction
Amount
Principal
Interest
Escrow
Fees
Unpaid Principal
07/19/2025
Additional principal
2519.14
116.98
559.06
861.48
0.00
622671.57
2025-07-13
Hazard insurance disbursement
1596.78
1144.27
1725.19
844.89
0.00
220630.47
2025-08-12
Regular monthly payment
173.06
195.91
1337.19
471.35
0.00
233782.11
08/24/2025
Regular monthly payment
2846.64
22.59
628.49
1177.19
0.00
296681.07",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-85a7f38671cc5bd25837af28,v11-MORTGAGE_STATEMENT-columns,original,2025,fgen-ed8a93013552d5e5670e81dc,synthetic_programmatic_template,columns,top,False,raw_export
"Downloaded 23/07/2022
Payment Date
Total Payment
Principal
Interest
Escrow
Principal Balance
05/05/2022
3273.13
1007.42
1862.88
746.59
466810.53
05/12/2022
3779.51
962.62
365.01
511.67
241726.88
02/05/2022
3598.62
700.12
1313.59
1076.82
240872.83
11/06/2022
3070.12
406.51
2120.13
190.45
302002.38
09/04/2022
2273.33
1097.95
660.97
1161.66
628939.27
07/10/2022
2136.12
1001.98
2140.63
722.14
353086.68",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-437f09c539e2de56cba0aa36,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-3269c1a1a95ae15b5cb8274e,synthetic_programmatic_template,columns,bottom,False,raw_export
"Mortgage Payoff Statement
Lakeshore Home Lending
Loan number
Good through date
Unpaid principal balance
Interest from last paid date
Recording fee
Total amount to pay off loan
***-**-568759
September 24, 2022
$124,527.53
$2,071.59
$45.00
$125,427.24
This statement is not a Form 1098. Keep it for your records.
This is an attempt to collect a debt. NMLS ID 57348",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-42d1a520b2bbc73e9e40739c,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-66524d4fb720a5ffc7f3175a,synthetic_programmatic_template,columns,top,False,payoff
"Date
Transaction
Amount
Principal
Interest
Escrow
Fees
Unpaid Principal
10/01/2022
Additional principal
943.28
627.41
1958.03
890.93
0.00
626689.38
12/11/2022
Additional principal
3465.97
127.76
42.72
522.65
0.00
295816.22
26/07/2022
Escrow disbursement - county tax
3073.28
1462.82
2120.67
777.46
0.00
239938.26
2022-04-18
Escrow disbursement - county tax
3596.58
1251.25
1569.80
1099.39
0.00
603109.61
03/26/2022
Escrow disbursement - county tax
1041.65
272.09
1439.85
833.33
0.00
563173.42",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-a3a7df785332bec5d980541c,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-4fe5ba8eef5d41e1a16bcacf,synthetic_programmatic_template,columns,top,False,raw_export
"Mortgage Statement
Riverbend Mortgage Servicing
Statement date
Loan number
Property address
Payment due date
Amount due
5/27/26
ending in 805026
2447 Cedar Ln Riverton, WI 27050
September 22, 2026
S4,l30.95
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regu1ar monthly payment
2,262.98
2,626.91
$531.19
$3,462.36
Pastpayments breakdown  Paid last month  Paid year to date
Interest paid year to date
0utstandíngprincipal
Escrow balance
Interest rate
10,507.65
$437,440.09
$5,709.33
4.908%
This is an attempt to collect a debt. NMLS ID 252033",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-dbcba13fc8b12f13b726d02d,v11-MORTGAGE_STATEMENT-columns,original,2026,fgen-90754009426846fe81043226,synthetic_programmatic_template,columns,top,True,monthly
"Pinecrest Mortgage Company
Statement date
Loan number
Property address
Payment due date
Amount due
04/16/2022
****256598
3319 Granite St Lakewood, CO 79507
September 22, 2022
$3,449.18
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
821.30
2,828.59
491.10
$1,472.85
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
31,114.45
$537,341.93
$4,842.96
4.957%
IRS Form 1098 information for 2022 will be mailed separately.
This is an attempt to collect a debt. NMLS ID 896704",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-8daf453b63c7df383beb530c,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-5b3d7043aeddb8864374c8d9,synthetic_programmatic_template,columns,none,False,monthly
"Lakeshore Home Lending
Loan number
Good through date
Unpaid principal balance
Interest from last paid date
Recording fee
Total amount to pay off loan
XXXXX454031
2025-05-19
$622,605.42
$319.35
$45.00
$624,900.30
IRS Form 1098 information for 2025 will be mailed separately.
This is an attempt to collect a debt. NMLS ID 892179
Mortgage Payoff Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-656277c22a18df49cd507398,v11-MORTGAGE_STATEMENT-columns,original,2025,fgen-4831c341f8ff5be28b656cec,synthetic_programmatic_template,columns,bottom,False,payoff
"Bluewater Loan Servicing
Statement date
Loan number
Property address
Payment due date
Amount due
2022-02-20
***-**-910421
4359 Maple Ridge Dr Pinecrest, GA 96031
04/07/2022
$1,475.94
Explanation of amount due
Principal
Intcrest
Escrow (for taxes and insurance)
Regular monthly payment
1,377.05
2,673.66
$880.20
1,793.56
Past paymentsbreakdown  Paid last month  Paid year to date
Interest paid year to date
0utstanding principa1
Escrow balance
Interest rate
32,083.96
$30l,828.86
$4,222.69
4.856%
If you are experiencing financial difficulty, call a HUD-approved housíngcounselor.
This is an attempt to collect a debt. NMLS ID 720506",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-8770e422529e41c6405d4084,v11-MORTGAGE_STATEMENT-columns,original,2022,fgen-4bc1f756898ab8b237eb43be,synthetic_programmatic_template,columns,none,True,monthly
"Due Date
Amount Paid
Principal Applied
Interest Applied
Escrow Deposit
Remaining Balance
10/24/2026
1494.42
268.84
969.33
533.34
618496.17
2026-12-03
2695.49
461.72
1091.86
816.61
450562.95
05/02/2026
1785.47
1004.91
1221.89
552.14
441717.02
01/01/2026
3193.02
579.15
937.92
792.64
345183.87
02/16/2026
1417.97
859.40
2298.40
655.78
306212.36
07/01/2026
3039.39
1352.29
2398.90
914.65
603785.49",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-ebe044633421fb7cdaec1210,v11-MORTGAGE_STATEMENT-columns,original,2026,fgen-41d5c7e63a9348014dd59248,synthetic_programmatic_template,columns,top,False,raw_export
"Home Loan Activity
Downloaded 2024-08-11
Due Date
Amount Paid
Principal Applied
Interest Applied
Escrow Deposit
Remaining Balance
20/04/2024
1881.94
1367.96
589.75
229.98
107265.50
2024-10-15
2347.98
584.77
641.02
1095.64
585833.17
2024-11-20
1816.81
1121.28
1506.48
494.47
296502.62
25/01/2024
1488.86
1578.97
1383.38
1182.97
370498.45
2024-05-12
2580.08
725.73
2256.25
653.19
524145.22
27/07/2024
2001.20
1407.43
1418.27
1170.40
501648.57",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-3a4698f6323b5f8fed3bdeea,v11-MORTGAGE_STATEMENT-columns,original,2024,fgen-b14a4b65a27cc306f98bc4f6,synthetic_programmatic_template,columns,top,False,raw_export
"Mortgage Statement
Riverbend Mortgage Servicing
Statement date
Loan number
Property address
Payment due date
Amount due
10/08/2023
XXX-XX-632998
9336 Cedar Ln Oak Grove, TX 17147
11/02/2023
$1,748.51
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
$2,163.59
2,825.41
$719.35
$2,165.56
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
25,428.71
$553,804.75
$222.08
3.535%
If you are experiencing financial difficulty, call a HUD-approved housing counselor.
This is an attempt to collect a debt. NMLS ID 619683",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-ff4ab1bcdf95fa6999ec069b,v11-MORTGAGE_STATEMENT-columns,original,2023,fgen-9e98542abb49b8348b929724,synthetic_programmatic_template,columns,top,False,monthly
"Home Loan Statement
Riverbend Mortgage Servicing
Statement date
Loan number
Property address
Payment due date
Amount due
March 1, 2021
***-**-030385
5843 Cedar Ln Testville, IL 36783
September 3, 2021
$4,250.37
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
$1,807.78
2,123.96
$1,415.19
$3,920.79
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
4,247.91
$218,932.07
$5,588.28
6.691%
IRS Form 1098 information for 2021 will be mailed separately.
This is an attempt to collect a debt. NMLS ID 801552",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-d79034717c97639fbb5bd710,v11-MORTGAGE_STATEMENT-columns,original,2021,fgen-e7c537bb284b59cad3fe79c6,synthetic_programmatic_template,columns,top,False,monthly
"Home Loan Activity
Payment Date
Total Payment
Principal
Interest
Escrow
Principal Balance
2023-02-23
1696.49
655.21
2412.46
1090.48
564772.65
2023-02-17
4202.59
406.96
831.73
954.92
414679.08
2023-09-03
3811.99
720.56
2355.21
476.81
363506.70
20/08/2023
2187.38
307.71
1885.59
1028.72
398148.20",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-daa44dff1c8f7ead8630d268,v11-MORTGAGE_STATEMENT-columns,original,2023,fgen-37bc227723fd7c1156ee5395,synthetic_programmatic_template,columns,top,False,raw_export
"Mortgage Statement
Lakeshore Home Lending
Statement date
Loan number
Property address
Payment due date
Amount due
October 12, 2021
ending in 523339
2245 Harbor View Rd Oak Grove, TX 39651
4/11/21
$1,807.86
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
1,179.87
733.49
1,434.45
4,545.58
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
2,933.94
$363,793.30
$495.72
3.900%
If you are experiencing financial difficulty, call a HUD-approved housing counselor.
This is an attempt to collect a debt. NMLS ID 943791",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-df998d1fe7889eb4815292e4,v11-MORTGAGE_STATEMENT-columns,original,2021,fgen-c6c65b0c1de7da02388c978c,synthetic_programmatic_template,columns,top,False,monthly
"Mortgage Payoff Statement
Pinecrest Mortgage Company
Loan number
Good through date
Unpaid principal balance
Interest from last paid date
Recording fee
Total amount to pay off loan
****098910
07/14/2023
$423,152.59
$289.89
$45.00
$425,515.58
This is an attempt to collect a debt. NMLS ID 680380",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-b9cef15f97ea8a25756381cd,v11-MORTGAGE_STATEMENT-columns,original,2023,fgen-d1db4c7a9c4cdb0724d44082,synthetic_programmatic_template,columns,top,False,payoff
"Mortgage Statement
Riverbend Mortgage Servicing
Statement date
Loan number
Property address
Payment due date
Amount due
June 5, 2023
***-**-660017
2259 Harbor View Rd Lakewood, CO 13473
5/22/23
$5,030.24
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
2,368.73
1,298.67
$1,438.72
$3,299.12
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
6,493.34
$341,326.90
$4,351.35
2.725%
If you are experiencing financial difficulty, call a HUD-approved housing counselor.
This is an attempt to collect a debt. NMLS ID 84475",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-0b17bdbfd42ef4165798ac3c,v11-MORTGAGE_STATEMENT-columns,original,2023,fgen-5bce5bacc93cfe1eca3f716a,synthetic_programmatic_template,columns,top,False,monthly
"Home Loan Statement
Keystone Home Loans
Statement date
Loan number
Property address
Payment due date
Amount due
05/15/2024
XXXXX880738
341 Oak Hollow Ct Oak Grove, TX 70641
April 27, 2024
$4,793.36
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
1,954.12
1,013.72
$645.03
$912.42
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
12,164.68
$367,882.11
$3,308.19
7.415%
Late fee of $75.00 will be charged if payment is received after the 16th.
Tax reminder: amounts on this statement may differ from your Form 1098.
This is an attempt to collect a debt. NMLS ID 380770",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-339a6d221516a80ac3f563b9,v11-MORTGAGE_STATEMENT-columns,original,2024,fgen-231b6704422acb0bfe6ce1fb,synthetic_programmatic_template,columns,top,False,monthly
"Bluewater Loan Servicing
Statement date
Loan number
Property address
Payment due date
Amount due
1/16/25
***-**-102481
2203 Maple Ridge Dr Bayside, WA 42703
11/9/25
$3,118.04
Explanation of amount due
Principal
Interest
Escrow (for taxes and insurance)
Regular monthly payment
$1,163.70
388.51
$1,305.09
$3,826.02
Past payments breakdown  Paid last month  Paid year to date
Interest paid year to date
Outstanding principal
Escrow balance
Interest rate
1,165.54
$343,327.12
$1,419.28
6.705%
If you are experiencing financial difficulty, call a HUD-approved housing counselor.
Late fee of $75.00 will be charged if payment is received after the 16th.
This statement is not a Form 1098. Keep it for your records.
This is an attempt to collect a debt. NMLS ID 523904
Mortgage Statement",LOAN_STATEMENT,42,LOAN_STATEMENT,fdc-bf05a15f6dcdd2e4969d0152,v11-MORTGAGE_STATEMENT-columns,original,2025,fgen-4810a7ecd4dad26a97af62c6,synthetic_programmatic_template,columns,bottom,False,monthly
"Form 3922
## Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
Department of the Treasury - Internal Revenue Service
| Field | Value |
| --- | --- |
| Recipient's name | Alex C. Tanaka |
| SSN | XXX-XX-6290 |
| 1 Date option granted | 26,246.29 |
| 2 Date option exercised | $22,327.97 |
| 3 Fair market value per share on grant date | 4,461.40 |
| 5 Exercise price paid per share | 12,237.79 |
| 6 Number of shares transferred | 10/24/2021 |",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-c30eebc318afa1704df986d6,v11-OTHER_TAX_FORM-kind05,original,2021,fgen-abed069c10017895e63e1542,synthetic_programmatic_template,markdown,top,False,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
2026
Department of Revenue
Taxpayer name
Noah Rivera
Recipient's TIN
****4919
1 Date option granted
18,580.28
2 Date option exercised
2,581.23
3 Fair market value per share on grant date
27,591.69
5 Exercise price paid per share
2026-10-04
6 Number of shares transferred
$24,917.92",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-74ab7ee0f113a0969375a7be,v11-OTHER_TAX_FORM-kind05,original,2026,fgen-23c5631c67a4da4d77b8b9fa,synthetic_programmatic_template,stacked,top,False,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
Department of Revenue
Taxpayer name Olivia M. Okafor
Recipient's TIN      ending in 2665
1 Date option granted  17,364.29
2 Date option exercised 24,930.14
3 Fair market value per share on grant date  9/27/26
5 Exercise price paid per share      $21,404.42
6 Number of shares transferred   $19,520.88",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-04c49cab31a7a5ecfa3956fd,v11-OTHER_TAX_FORM-kind05,original,2026,fgen-b8919fcfb0f20061ef808e61,synthetic_programmatic_template,inline,top,False,3922
"Form 3922
Transfer of Stock Acquired Through an EmployceStock Purchase Plan Under Section 423(c)
2025
Department of Revenue
Name
Identification number
1 Date option granted
2 Date option exercised
3 Fair market va1ue per share on grant date
5 Exercise price paid per share
6 Number of sharcs transferred
Mateo Brennan
XXX-XX-8107
$27,657.13
2025-10-24
3,218.78
$9,206.10
22,134.80",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-3d57eef022a5f6d01a1a3a88,v11-OTHER_TAX_FORM-kind05,original,2025,fgen-2c406754cbfe8a76e9f6fc2c,synthetic_programmatic_template,columns,top,True,3922
"Copy B For Recipient
Taxpayer name,Alex Haddad
SSN,****1220
1 Date option granted,""$29,909.53""
2 Date option exercised,""29,496.40""
3 Fair market value per share on grant date,""27,007.65""
5 Exercise price paid per share,""$1,079.34""
6 Number of shares transferred,04/22/2022
Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-7cb123f575416ec9bf7a9cd1,v11-OTHER_TAX_FORM-kind05,original,2022,fgen-af4c41e8a59428f9dea6fc83,synthetic_programmatic_template,csv,bottom,False,3922
"Department
of the Treasury - Internal Revenue Service Recipient's name Hiro Okafor SSN ****0515 1 Date option granted 1/1/23 2 Date option exercised 8/10/23 3 Fair market value per share on grant date 27,177.61 5 Exercise price paid per share
14,875.82 6 Number of shares transferred 15,707.15",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-df910a875a05faf7bda36f4b,v11-OTHER_TAX_FORM-kind05,original,2023,fgen-857952d8bc4937ca3d80739c,synthetic_programmatic_template,flat,none,False,3922
"## Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
Department of Revenue
| Field | Value |
| --- | --- |
| Recipient's name | Jordan Fischer |
| Recipient's TIN | ***-**-7703 |
| 1 Date option granted | $21,458.69 |
| 2 Date option exercised | $3,746.85 |
| 3 Fair market value per share on grant date | $20,458.26 |
| 5 Exercise price paid per share | 2,062.63 |
| 6 Number of shares transferred | 9,782.31 |",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-5d98b6033f3ff0d2fc201be8,v11-OTHER_TAX_FORM-kind05,original,2026,fgen-4169b7e605abda370cb072f9,synthetic_programmatic_template,markdown,top,False,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
2021
Department of Revenue
Taxpayer name
Hiro Brennan
SSN
****1460
1 Date optíon granted
4,268.05
2 Date option exercised
$28,909.40
3 Fair market va1ue per share on grant date
l2/03/2021
5 Exercise price paidper share
9,682.20
6 Number of shares transferred
7,538.35",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-45f41a1f92478977d5d67106,v11-OTHER_TAX_FORM-kind05,original,2021,fgen-3b0c059fc3d1e17cb12e8d1d,synthetic_programmatic_template,stacked,top,True,3922
"2024
Department of the Treasury - Internal Revenue Service
Taxpayer name  Diego Larsen
Recipient's TIN      XXXXX0005
1 Date option granted   11,684.45
2 Date option exercised 17,070.72
3 Fair market value per share on grant date   10,128.88
5 Exercise price paid per share December 11, 2024
6 Number of shares transferred  22,989.14
Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-02076269f3ecf5c3860449ff,v11-OTHER_TAX_FORM-kind05,original,2024,fgen-e950ee69392c4e471309b3ba,synthetic_programmatic_template,inline,bottom,False,3922
"Form 3922
Transferof Stock Acquired Through an Employee Stock Purchase P1an Under Section 423(c)
2025
Department of Revenue
Recipient's name
Recipient's TIN
1 Date option granted
2 Date option exercised
3 Fair market va1ue per share on grant date
5 Exercise price paid per share
6 Number of shares transferred
5ofia Rivera
ending in 8980
9/24/25
12,861.81
24,148.69
9,320.04
07/02/2025",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-080913ac5f75a524757587e8,v11-OTHER_TAX_FORM-kind05,original,2025,fgen-bf2f9600e842a5c59924d866,synthetic_programmatic_template,columns,top,True,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
2025
Department of Revenue
Taxpayer name,Wei Tanaka
Recipient's TIN,****3689
1 Date option granted,""29,750.33""
2 Date option exercised,""22,811.81""
3 Fair market value per share on grant date,""1,721.42""
5 Exercise price paid per share,03/25/2025
6 Number of shares transferred,""9,785.91""",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-e9af611bbf3d577cef0544e7,v11-OTHER_TAX_FORM-kind05,original,2025,fgen-bb4fd63021caa68c6cda4fe1,synthetic_programmatic_template,csv,top,False,3922
"Form
3922 Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c) Department of the Treasury - Internal Revenue Service Recipient's name Hiro Larsen Identificationnumber ****7989 1 Date option granted S23,573.1O 2 Date option exercised September 12, 2025 3 Fair market value per share ongrant date 925.81 5 Exercise price paid per share 06/05/2025 6 Number of
shares transferred 11,414.16",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-80b40a9414fc30c14f67c008,v11-OTHER_TAX_FORM-kind05,original,2025,fgen-2d9912b8e02bccac0b1c76fe,synthetic_programmatic_template,flat,top,True,3922
"## 2024
## Department of the Treasury - Internal Revenue Service
| Field | Value |
| --- | --- |
| Recipient's name | Amara Moreau |
| Identification number | ***-**-1011 |
| 1 Date option granted | $9,256.20 |
| 2 Date option exercised | 3,508.38 |
| 3 Fair market value per share on grant date | 25,379.32 |
| 5 Exercise price paid per share | 12,540.64 |
| 6 Number of shares transferred | $7,783.65 |
Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-f2dcc4069586bf08c9c4d3bd,v11-OTHER_TAX_FORM-kind05,original,2024,fgen-f5ce7191716784adcdd38e76,synthetic_programmatic_template,markdown,bottom,False,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
2026
Department of Revenue
Recipient's name
Jordan K. Haddad
Recipient's TIN
ending in 0762
1 Date option granted
$16,673.82
2 Date option exercised
5,985.89
3 Fair market value per share on grant date
2026-07-25
5 Exercise price paid per share
05/07/2026
6 Number of shares transferred
6,877.85",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-297c6da4247a2a1b06c64186,v11-OTHER_TAX_FORM-kind05,original,2026,fgen-96478a5bd513eaf6058a2fed,synthetic_programmatic_template,stacked,top,False,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
2023
Copy B For Recipient
Taxpayer name Lena Romero
Identification number  XXX-XX-4606
1 Date option granted $10,805.66
2 Date option exercised      3,101.59
3 Fair market value per share on grant date 3,066.79
5 Exercise price paid per share      14,351.55
6 Number of shares transferred 12/20/23",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-bbddfb817a549a646597a6b0,v11-OTHER_TAX_FORM-kind05,original,2023,fgen-198ca97261b85226cea737f3,synthetic_programmatic_template,inline,top,False,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
Department of the Treasury - Internal Revenue Service
Recipient's name
Recipient's TIN
1 Date option granted
2 Date option exercised
3 Fair market value per share on grant date
5 Exercise price paid per share
6 Number of shares transferred
Hiro J. Walsh
XXXXX8958
23.89
07/28/2022
21,057.94
$14,661.20
11/04/2022",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-a2f0deeb35ff9f2b2e67911f,v11-OTHER_TAX_FORM-kind05,original,2022,fgen-fc0ddf00b50a8e7962d69ff3,synthetic_programmatic_template,columns,top,False,3922
"Form 3922
Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)
2021
Keep for your records
Name,Amara Tanaka
Identification number,***-**-8559
1 Date option granted,""10,190.41""
2 Date option exercised,""14,016.29""
3 Fair market value per share on grant date,""26,878.70""
5 Exercise price paid per share,""13,747.54""
6 Number of shares transferred,""18,146.31""",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-2ce358264cae2a7291ef3c78,v11-OTHER_TAX_FORM-kind05,original,2021,fgen-27d38db9f9920882658a0264,synthetic_programmatic_template,csv,top,False,3922
"Form 3922 Transfer of
Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c) 2024 Department of the Treasury - Internal Revenue Service Recipient's name Alex A. Nguyen Recipient's TIN ending in 2277 1 Date option granted $22,935.88 2 Date option exercised 16,733.00 3 Fair market value per share on grant date $9,544.32 5 Exercise price paid per share 8,690.65 6 Number of shares transferred
29,385.93",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-055cbaac1d44756f2e107dad,v11-OTHER_TAX_FORM-kind05,original,2024,fgen-f501a8e1d428c78e559d10a4,synthetic_programmatic_template,flat,top,False,3922
"Keep for your records
| Field | Value |
| --- | --- |
| Name | Diego Moreau |
| Identification number | XXX-XX-3230 |
| 1 Annuity start date | $23,053.55 |
| 2 Amount of premiums | 5/26/23 |
| 4 Fair market value of QLAC | 2023-11-06 |
Form 1098-Q
Qualifying Longevity Annuity Contract Information",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-f9f03fab66ee95ec59ea1622,v11-OTHER_TAX_FORM-kind11,original,2023,fgen-41c53c4659640cd55b38bed3,synthetic_programmatic_template,markdown,bottom,False,1098-Q
"2026
Copy B For Recipient
Recipient's name
Jordan E. Nguyen
Identification number
XXXXX2048
1 Annuity start date
29,629.41
2 Amount of premiums
October 11, 2026
4 Fair market value of QLAC
16,449.14",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-0b058eacd413947c9b5aaf58,v11-OTHER_TAX_FORM-kind11,original,2026,fgen-4d0b87e2730ca24edadb3364,synthetic_programmatic_template,stacked,none,False,1098-Q
"Department of the Treasury - Internal Revenue Service
Taxpayer name  Wei D. Brennan
Identification number ***-**-3176
1 Annuity start date   11,066.76
2 Amount of premiums 22,200.50
4 Fair market value of QLAC 29,976.78",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-1921ccc5c0703545e14ff37b,v11-OTHER_TAX_FORM-kind11,original,2024,fgen-f525f513c3b86542072e7ea2,synthetic_programmatic_template,inline,none,False,1098-Q
"Form 1098-Q
Qualifying Longevity Annuity Contract Information
2022
Department of Revenue
Taxpayer name
Identification number
1 Annuity start date
2 Amount of premiums
4 Fair market value of QLAC
Jamie Sato
XXX-XX-2753
$21,556.72
11,086.74
2022-05-03",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-d8d4ccb58d527c03690c0f8f,v11-OTHER_TAX_FORM-kind11,original,2022,fgen-f61b1750cd7d09e5b5399b87,synthetic_programmatic_template,columns,top,False,1098-Q
"2024
Department of the Treasury - Internal Revenue Service
Taxpayer name,Wei Larsen
Identification number,ending in 9777
1 Annuity start date,""24,121.93""
2 Amount of premiums,2024-11-28
4 Fair market value of QLAC,""$29,913.35""",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-8e1f8eea1a01e7f143ed7d6e,v11-OTHER_TAX_FORM-kind11,original,2024,fgen-ccfa18dcc1a11441c4fd5c01,synthetic_programmatic_template,csv,none,False,1098-Q
"Form 1098-Q Qualifying Longevity Annuity Contract Information 2024 Department of Revenue Recipient's name Avery Brennan SSN
****5617 1 Annuity start date 14,829.37 2 Amount of premiums10,001.43 4 Fair market
value of QLAC 27,431.45",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-2bf2c7485834d08a194b009f,v11-OTHER_TAX_FORM-kind11,original,2024,fgen-86d8d9ec021ee7021f2e7eef,synthetic_programmatic_template,flat,top,True,1098-Q
"2023
Keep for your records
| Field | Value |
| --- |--- |
| Recipient's name | Wei Kowa1ski |
| SSN |ending in 3843 |
| l Annuity start date | 26,717.30 |
| 2 Amount of premiums | 27,506.36 |
| 4 Fair market va1ue of QLAC | S10,015.78 |
Form 1098-Q
Qualifying Longevity Annuity Contract Information",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-b0d0cbfa6db75611c8e44de9,v11-OTHER_TAX_FORM-kind11,original,2023,fgen-4b33735d3db02e3b113432c7,synthetic_programmatic_template,markdown,bottom,True,1098-Q
"Form 1098-Q
Qualifying Longevity Annuity Contract Information
2024
Keep for your records
Name
Avery Castillo
Identification number
****5295
1 Annuity start date
14,900.08
2 Amount of premiums
25,655.55
4 Fair market value of QLAC
5/5/24",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-a142f28d717b24d1e22c32e9,v11-OTHER_TAX_FORM-kind11,original,2024,fgen-f72382b41072aba8799ea8e4,synthetic_programmatic_template,stacked,top,False,1098-Q
"Form 1098-Q
Qualifying Longevity Annuity Contract Information
2026
Copy B For Recipient
Taxpayer name Fatima Romero
Identification number ***-**-5051
1 Annuity start date $13,437.00
2 Amount of premiums  $26,287.14
4 Fair market value of QLAC $22,857.76",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-015c5153cabae23a6ca20808,v11-OTHER_TAX_FORM-kind11,original,2026,fgen-0989053c0eda6a44e39c6642,synthetic_programmatic_template,inline,top,False,1098-Q
"Form 1098-Q
Qualifying Longevity Annuity Contract Information
Copy B For Recipient
Taxpayer name
SSN
1 Annuity start date
2 Amount of premiums
4 Fair market value of QLAC
Kwame B. Patel
****4070
$27,324.19
$15,526.21
2,024.18",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-f2f4089d67482015bfd345c5,v11-OTHER_TAX_FORM-kind11,original,2021,fgen-2972054dbcbecaeee759984e,synthetic_programmatic_template,columns,top,False,1098-Q
"Keep for your records
Taxpayer name,Taylor Lindqvist
SSN,****1445
1 Annuity start date,""8,737.28""
2 Amount of premiums,""17,450.12""
4 Fair market value of QLAC,""22,637.50""",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-7a5725c892347025981dd0a8,v11-OTHER_TAX_FORM-kind11,original,2024,fgen-3ee0914173cb0f69b7a61ab7,synthetic_programmatic_template,csv,none,False,1098-Q
"Form 1098-Q Qualifying Longevity Annuity Contract Information 2026 Department of
the Treasury - Internal Revenue Service Recipient's name Mateo A. Romero Identification number ***-**-2149 1 Annuity
start date 14,133.34 2 Amount of premiums 21,354.47 4 Fair market value of QLAC March 17, 2026",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-a5c1e3b9a57c207661586477,v11-OTHER_TAX_FORM-kind11,original,2026,fgen-c1f16183e973850af6b3c482,synthetic_programmatic_template,flat,top,False,1098-Q
"Form 1098-Q
## Qualifying Longevity Annuity Contract Information
## Department of Revenue
| Field | Value |
| --- | --- |
| Recipient's name | Diego Okafor |
| SSN | ****5030 |
| 1 Annuity start date | $18,709.37 |
| 2 Amount of premiums | 10/22/2023 |
| 4 Fair market value of QLAC | 10/15/23 |",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-2ad0a41aef817e2af363d9da,v11-OTHER_TAX_FORM-kind11,original,2023,fgen-1f30013624de09d9c1fb04a5,synthetic_programmatic_template,markdown,top,False,1098-Q
"Form 1098-Q
Qualifying Longevity Annuity Contract Information
Keep for your records
Recipient's name
Olivia Lindqvist
Identification number
ending in 6490
1 Annuity start date
7,633.04
2 Amount of premiums
$3,357.86
4 Fair market value of QLAC
10/10/25",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-62c888647562a79fb9578230,v11-OTHER_TAX_FORM-kind11,original,2025,fgen-b7f55ce965b2c504381279c8,synthetic_programmatic_template,stacked,top,False,1098-Q
"Form 1098-Q
Qualifying Longevity Annuity Contract Information
2026
Copy B For Recipient
Name Olivia J. Fischer
Recipient's TIN  ending in 4563
1 Annuity start date 05/21/2026
2 Amount of premiums 26,692.16
4 Fair market value of QLAC $3,078.22",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-8952946ee6650598c7a2f95b,v11-OTHER_TAX_FORM-kind11,original,2026,fgen-d2392a1bcef63c9010a77814,synthetic_programmatic_template,inline,top,False,1098-Q
"Form 1098-Q
Qualifying Longevity Annuity Contract Information
2021
Keep for your records
Recipient's name
Recipient's TIN
1 Annuity start date
2 Amount of premiums
4 Fair market value of QLAC
Noah Lindqvist
****4417
July 27, 2021
6/24/21
23,013.96",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-d4db51085013cb431fb2fbeb,v11-OTHER_TAX_FORM-kind11,original,2021,fgen-5972c8eef0013924b4d3dbbc,synthetic_programmatic_template,columns,top,False,1098-Q
"2023
Copy B For Recipient
Recipient's name,DiegoA. Okafor
SSN,XXX-XX-6373
1 Annuity start date,""24,807.97""
2 Amount of premiums,""2,251.89""
4 Fair market value of QLAC,""$19,605.02""",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-95ad1c8f0e561f464185dcad,v11-OTHER_TAX_FORM-kind11,original,2023,fgen-218e852df787c48c10138554,synthetic_programmatic_template,csv,none,True,1098-Q
"2021
Keep for your records Recipient's name Lena Lindqvist Recipient's TIN ending in 9475 1 Annuity start date $6,055.37 2 Amount of premiums 10,283.00 4 Fair market
value of QLAC 12,076.62 Form 1098-Q Qualifying Longevity Annuity Contract Information",OTHER_TAX_FORM,48,OTHER_TAX_FORM,fdc-3a327b3869abb46264d50664,v11-OTHER_TAX_FORM-kind11,original,2021,fgen-ca5d518d7a64b8c9f3a131a4,synthetic_programmatic_template,flat,bottom,False,1098-Q
"Payroll Advice Tri-County School District 6728 Harbor View Rd Fairview, OH 47139 Employee Morgan A. Rivera Employee ID 33840 Pay period 01/01/2025 - 01/28/2025 Pay date 03/05/2025 Earnings Rate Hours Current YTD Regular 70.38 40.00 2,815.05 45,040.74 Overtime 105.56 6.00 23.04 8,402.79 Deductions
Current YTD Federal Income Tax 309.66 4,954.48 Social Security 174.53 2,792.53 State Income Tax 112.60 1,801.63 401(k) 168.90 2,702.44 Medical Pre-Tax 84.45
1,351.22 Gross pay 2,815.05 Net pay 1,914.23 Direct deposit to checking ending in 2028",PAYSTUB,44,PAYSTUB,fdc-c2d7eac63a0485a5fcf933a1,v11-PAYSTUB-flat,original,2025,fgen-58ce5a45c99733bc2399fc2f,synthetic_programmatic_template,flat,top,False,semimonthly
"Earnings Statement Riverside Regional Hospital 8033 Oak Hollow Ct Oak Grove, TX 58355 Employee Taylor Kowalski Employee ID 17555 Pay period 09/01/2023 - 09/28/2023 Pay date 2023-09-02 Earnings Rate Hours Current YTD Regular 40.69 75.00 3,052.12 70,198.71 Overtime 61.04 1.00 385.23 824.44 Deductions Current YTD Federal Income Tax 335.73 7,721.86 Social Security 189.23 4,352.32 Medicare 44.26 1,017.88 State Income
Tax 122.08 2,807.95 Gross pay 3,052.12 Net
pay 2,075.44 Direct deposit to checking ****7792",PAYSTUB,44,PAYSTUB,fdc-be1996dba2fe5306046d61b5,v11-PAYSTUB-flat,original,2023,fgen-275a89a0075ee05ef00f2f39,synthetic_programmatic_template,flat,top,False,semimonthly
"Tri-County School District 9389 Willow Bend
Way Fairview, OH 38352 Employee Lena D. Sato Employee ID 96407 Pay period 06/01/2026 - 06/28/2026 Pay date 09/10/2026 Earnings Rate Hours Current YTD Regular 84.89 86.67 7,357.10 14,714.20 Overtime 127.33 4.00 385.72 5,628.13 Deductions Current YTD Federal Income Tax 809.28 1,618.56 Social Security 456.14 912.28 Medicare 106.68 213.36 State Income Tax 294.28 588.57 401(k) 441.43 882.85 Medical Pre-Tax 220.71 441.43 Gross pay 7,357.10 Net pay
5,002.83 Direct deposit to checking ****9509 Earnings Statement",PAYSTUB,44,PAYSTUB,fdc-fd81cd5372788f6cfeb67573,v11-PAYSTUB-flat,original,2026,fgen-fa2db51f15a03cb650422d8e,synthetic_programmatic_template,flat,bottom,False,biweekly
"Pay Statement Copperline Software
Inc. 8282Sample Street Fairview, OH 84793 Emp1oyee Taylor Rivera Employee ID 90496 Pay period l2/01/2023 - 12/30/2023 Pay date 2023-08-02 Eamings Rate HoursCurrent YTD Regular 18.50 75.00 1,387.44 15,261.85 Overtime 27.75 3.00 0.91 7,887.52 Deductions Current YTD Federal Income Tax 152.62 l,678.80 Medicare 20.12 221.30 State Income Tax 55.50 610.47 40l(k) 83.25 915.71 Medical Pre-Tax 41.62 457.86 Gross pay
1,387.44 Net pay 943.46 Direct deposit to checking ***-**-9097",PAYSTUB,44,PAYSTUB,fdc-632499e156fff194c8d0456d,v11-PAYSTUB-flat,original,2023,fgen-e616043100c335d6b2539373,synthetic_programmatic_template,flat,top,True,biweekly
"Earnings Statement Maple Street Dental PC 9554 Harbor View Rd Cedar Falls,
IA 35646 Employee Wei Patel Employee ID 50373 Pay period 05/01/2024 - 05/31/2024 Pay date 2024-04-25 Earnings Rate
Hours Current YTD Regular 65.19 75.00 4,889.21 107,562.67 Overtime 97.78 4.00 386.67 4,394.47 Deductions Current YTD Federal Income Tax 537.81 11,831.89 Social Security 303.13 6,668.89 Medicare 70.89 1,559.66 State Income Tax 195.57 4,302.51 401(k) 293.35 6,453.76 Medical Pre-Tax 146.68 3,226.88 Gross pay 4,889.21 Net pay 3,324.66 Direct deposit to checking ending in 7473",PAYSTUB,44,PAYSTUB,fdc-e6baab68bddc5f60fb096aab,v11-PAYSTUB-flat,original,2024,fgen-e76d2978a61578340939ca25,synthetic_programmatic_template,flat,top,False,semimonthly
"Riverside Regional Hospital 467 Willow Bend Way Testville, IL 97324 Employee
Kwame A. Fischer Employee ID 99382 Pay period 07/01/2025 - 07/31/2025 Pay date 2025-04-05 Earnings Rate Hours Current YTD Regular 27.21 80.00 2,177.16 41,366.00 Overtime 40.82 1.00 319.64 6,399.97 Deductions Current YTD Social Security 134.98 2,564.69 Medicare 31.57 599.81
State Income Tax 87.09 1,654.64 401(k) 130.63 2,481.96 Medical Pre-Tax 65.31 1,240.98 Gross pay 2,177.16 Net pay 1,480.47 Direct deposit to checking ****9613 Payroll Advice",PAYSTUB,44,PAYSTUB,fdc-9e014f32e2caf20f3b006aec,v11-PAYSTUB-flat,original,2025,fgen-876d60993103e11f3b2a5dc8,synthetic_programmatic_template,flat,bottom,False,biweekly
"Earnings Statement Granite Peak Manufacturing Co. 3592 Elm Park Pl Maplewood, MN 97823 Employee Kwame
Rivera Employee ID 61840 Pay period 10/01/2025 - 10/28/2025 Pay date 03/23/2025 Earnings Rate Hours Current YTD Regular 47.54 75.00 3,565.17 81,998.94 Overtime 71.30 3.00 202.96 4,827.09 Deductions Current YTD Federal Income Tax 392.17 9,019.88 Medicare 51.69 1,188.98 State
Income Tax 142.61 3,279.96 401(k) 213.91 4,919.94 Medical Pre-Tax 106.96 2,459.97 Gross pay 3,565.17 Net pay 2,424.32 Direct deposit to checking ***-**-7105",PAYSTUB,44,PAYSTUB,fdc-f5d7c819d4f40e01c9e92b01,v11-PAYSTUB-flat,original,2025,fgen-9cf4f17d055e176c4909e624,synthetic_programmatic_template,flat,top,False,biweekly
"Acme Test Corp 4884 Elm Park Pl Fairview,0H
46820 Employee Kwame Okafor Employee ID 43225 Pay period 08/01/2026 - 08/28/2026 Pay date 11/10/26 EarningsRate Hours Current YTD Regular 39.04 86.67 3,383.42 50,751.34 Overtime 58.56 8.00 326.53 6,686.45 Deductions Current YTD Federal Income Tax 372.18 5,582.65 5ocíal Security 209.77 3,146.58 Medicare 49.06 735.89 State Income Tax 135.34 2,030.05 Medical Pre-Tax 101.50
1,522.54 Gross pay 3,383.42 Net pay 2,300.73 Direct deposit to checking XXXXX9449 Statement of Earnings andDeductions",PAYSTUB,44,PAYSTUB,fdc-5979aec57129b62d965ad6f9,v11-PAYSTUB-flat,original,2026,fgen-c2365883b464b0d33a582ad0,synthetic_programmatic_template,flat,bottom,True,biweekly
"Statement of Earnings and Deductions Riverside Regional Hospital 3995 Willow Bend Way Fairview, OH 63077 Employee Jamie Adeyemi Employee ID
88080Pay period 03/01/2026 - 03/31/2026 Pay date 09/09/2026 Earnings Rate Hours Current YTD Regular 83.96 86.67 7,276.81 101,875.29 Overtime 125.94 0.00 336.48 8,609.05 Deductions Current
YTD Federa1 Income Tax 800.45 11,206.285ocial Security 451.16 6,316.27 Medicare 105.51 1,477.19 State Income Tax 291.07 4,075.01 Medical Pre-Tax 218.30 3,056.26 Grosspay 7,276.81 Net pay 4,948.23 Dírect deposít to checking ***-**-5119",PAYSTUB,44,PAYSTUB,fdc-5bb10522402158e2c3b4570c,v11-PAYSTUB-flat,original,2026,fgen-96a0ce6a04377ffb6b61257f,synthetic_programmatic_template,flat,top,True,biweekly
"Tri-County School District 8271 Granite St Pinecrest, GA 66832 Employee Wei Brennan Employee ID 70954 Pay period
12/01/2021 - 12/30/2021 Pay date January 9, 2021 Earnings Rate Hours Current YTD Regular 19.57 80.00 1,565.47 6,261.89 Overtime 29.35 3.00 376.74 5,762.61 Deductions Current YTD Federal Income
Tax 172.20 688.81 Social Security 97.06 388.24 Medicare 22.70 90.80 Medical Pre-Tax 46.96 187.86 Gross pay 1,565.47 Net pay 1,064.52 Direct deposit to checking ****2328 Pay Statement",PAYSTUB,44,PAYSTUB,fdc-2561d5ab8dad3f7e2defa84a,v11-PAYSTUB-flat,original,2021,fgen-6e0b063a70597048b5d2ccb0,synthetic_programmatic_template,flat,bottom,False,semimonthly
"Pay Statement Maple Street Dental PC 5963 Cedar Ln Testville, IL 94879 Employee Mateo Haddad Employee ID 21125 Pay period 06/01/2021 -
06/30/2021
Pay date 12/31/2021 Earnings Rate Hours Current YTD Regular 51.92 75.00 3,894.12 101,247.13 Overtime 77.88 0.00 404.33 271.43 Deductions Current YTD Federal Income Tax 428.35 11,137.18 Social Security 241.44 6,277.32 Medicare 56.46 1,468.08 State Income Tax 155.76 4,049.89 401(k) 233.65 6,074.83 Medical Pre-Tax 116.82 3,037.41 Gross pay 3,894.12 Net pay 2,648.00 Direct deposit to checking XXX-XX-0164 Your 2021 Form W-2 will be available in the employee portal by January 31.",PAYSTUB,44,PAYSTUB,fdc-b1352b14c2c3c59cf7314e19,v11-PAYSTUB-flat,original,2021,fgen-e71af1da94a65baeb9149705,synthetic_programmatic_template,flat,top,False,final_of_year
"Pay Statement Maple Street Dental PC 5139 Granite St Riverton, WI 57684 Employee Kwame Haddad Employee ID 67097 Pay period 06/01/2021 - 06/28/2021 Pay date 04/10/2021 Earnings Rate Hours Current YTD Regular 71.83 86.67
6,225.62 99,610.00 Overtime 107.75 3.00 470.35 188.66 Deductions Current YTD Federal Income Tax 684.82 10,957.10 Social Security 385.99
6,175.82 Medicare 90.27 1,444.34 State Income Tax 249.02 3,984.40 401(k) 373.54 5,976.60 Medical Pre-Tax 186.77 2,988.30 Gross pay 6,225.62 Net pay 4,233.42 Direct deposit to checking ending in 1531",PAYSTUB,44,PAYSTUB,fdc-53a4b7101117ba5cd0da0a92,v11-PAYSTUB-flat,original,2021,fgen-9d453f0bf13f32a1c7eb6b9a,synthetic_programmatic_template,flat,top,False,semimonthly
"Payroll Advice Acme Test Corp 144 Maple Ridge Dr Oak
Grove, TX 57934 Employee Noah Sato Employee ID 65362 Pay period 05/01/2026 - 05/30/2026 Pay date 7/10/26 Earnings Rate Hours Current YTD Regular 60.45 75.00 4,533.88 81,609.84 Overtime 90.68 5.00 537.97 3,762.39 Deductions Current YTD Social Security 281.10 5,059.81 Medicare 65.74 1,183.34 State Income Tax 181.36 3,264.39 Medical Pre-Tax 136.02 2,448.30 Gross
pay 4,533.88 Net pay 3,083.04 Direct deposit to checking ****7096",PAYSTUB,44,PAYSTUB,fdc-88cffca76a3dfdd4ef08e6ab,v11-PAYSTUB-flat,original,2026,fgen-60f436da9f75234308236f24,synthetic_programmatic_template,flat,top,False,semimonthly
"Statement of Earnings and Deductions Copperline Software Inc. 3699 Oak Hollow Ct Bayside, WA 92784 Employee Lena Testcase Employee ID
19368 Pay period 09/01/2023 - 09/28/2023 Pay date 06/27/2023 Earnings Rate Hours Current YTD Regular 64.05 86.67 5,550.99 38,856.93 Overtime 96.07 0.00 594.15 5,110.60 Deductions Current YTD Federal Income Tax 610.61 4,274.26 Social
Security 344.16 2,409.13 Medicare 80.49 563.43 State Income Tax 222.04 1,554.28 401(k) 333.06 2,331.42 Medical Pre-Tax 166.53 1,165.71 Gross pay 5,550.99 Net pay 3,774.67 Direct deposit to checking XXX-XX-0468",PAYSTUB,44,PAYSTUB,fdc-a05b17bdd90c38fe06c246de,v11-PAYSTUB-flat,original,2023,fgen-fcdd1c752a9baf0260dbc8a1,synthetic_programmatic_template,flat,top,False,biweekly
"Granite Peak Manufacturing Co. 9052 Harbor View Rd Oak Grove, TX 11848
Employee Hiro D. Brennan Employee ID 55549 Pay period 06/01/2024 - 06/31/2024
Pay date 2024-07-03 Earnings Rate Hours Current YTD Regular 92.64 40.00 3,705.69 37,056.91 Overtime 138.96 7.00 70.86 68.78 Deductions Current YTD Federal Income Tax 407.63 4,076.26 Social Security 229.75 2,297.53 Medicare 53.73 537.33 State Income Tax 148.23 1,482.28 Gross pay 3,705.69 Net pay 2,519.87 Direct deposit to checking ****3278",PAYSTUB,44,PAYSTUB,fdc-7842b4bf20a3da8af4805343,v11-PAYSTUB-flat,original,2024,fgen-3738f8cb0d0396ea49118d40,synthetic_programmatic_template,flat,none,False,biweekly
"Acme Test Corp 7336 Prairie Ave Maplewood, MN 32511
Employee Mateo Testcase Employee ID 28186 Pay period 11/01/2023 - 11/31/2023 Pay date 2023-02-04 Earnings
Rate Hours Current YTD Regular 94.83 86.67 8,218.65 131,498.33 Overtime 142.24 0.00 496.11 1,266.90 Deductions Current YTD Social Security 509.56 8,152.90 Medicare 119.17 1,906.73 State Income Tax 328.75 5,259.93 401(k) 493.12 7,889.90 Medical Pre-Tax 246.56 3,944.95 Gross pay 8,218.65 Net pay 5,588.68 Direct deposit to checking ending in 2941",PAYSTUB,44,PAYSTUB,fdc-596e7bf4f02e56070d1dc540,v11-PAYSTUB-flat,original,2023,fgen-2525ba683a19bd1831777607,synthetic_programmatic_template,flat,none,False,biweekly
"Earnings Statement Riverside Regional Hospital 5972 Harbor View Rd Cedar Falls, IA 98770 Employee Lena Nguyen Employee ID 16535 Pay period 01/01/2023
- 01/31/2023 Pay date 2023-01-05 Earnings Rate Hours Current YTD Regular 34.20 86.67 2,964.43 20,751.03 Overtime 51.31 3.00 157.48 4,396.83 Deductions Current YTD Federal Income Tax
326.09 2,282.61 Social Security 183.79 1,286.56 401(k) 177.87 1,245.06 Gross pay 2,964.43 Net pay 2,015.81 Direct deposit to checking ****8563",PAYSTUB,44,PAYSTUB,fdc-72b270f0b6a0a64dfe6535be,v11-PAYSTUB-flat,original,2023,fgen-9a7375c9065c61263ce94b93,synthetic_programmatic_template,flat,top,False,semimonthly
"Granite
Peak Manufacturing Co. 4210 Lakeshore Blvd Testville, IL 58381 Employee Casey Lindqvist Employee ID 10360 Pay period 04/01/2026 - 04/28/2026 Pay date 2026-09-20 Earnings Rate Hours Current YTD Regular 55.28 75.00 4,146.28 33,170.23 Overtime 82.93 1.00 230.93 48.24 Deductions Current YTD Social Security 257.07 2,056.55 Medicare 60.12 480.97 State Income Tax 165.85 1,326.81 401(k) 248.78 1,990.21 Medical Pre-Tax 124.39 995.11 Gross pay 4,146.28 Net pay 2,819.47 Direct deposit to checking
XXX-XX-2085",PAYSTUB,44,PAYSTUB,fdc-c581852b034ebfe70d96604e,v11-PAYSTUB-flat,original,2026,fgen-066b67ecf3568e474aa42e77,synthetic_programmatic_template,flat,none,False,biweekly
"Statement of Earnings and Deductions Granite Peak Manufacturing Co. 7469 Lakeshore Blvd Fairview, OH 49633 Employee Taylor Tanaka Employee ID
18232 Pay period 06/01/2025 - 06/30/2025 Pay date 11/22/2025 Earnings Rate Hours Current YTD Regular 75.36 40.00 3,014.30 72,343.11 Overtime 113.04 4.00 543.23 907.86 Deductions Current YTD Federal Income Tax 331.57 7,957.74 Social Security 186.89 4,485.27 Medicare 43.71 1,048.98 State
Income Tax 120.57 2,893.72 401(k) 180.86 4,340.59 Medical Pre-Tax 90.43 2,170.29 Gross pay 3,014.30 Net pay 2,049.72 Direct deposit to checking XXXXX8690",PAYSTUB,44,PAYSTUB,fdc-73061d9dfc465c9cd8d02dc8,v11-PAYSTUB-flat,original,2025,fgen-e2bc6e30d3bf4489c7270666,synthetic_programmatic_template,flat,top,False,semimonthly
"Granite Peak Manufacturing Co. 3027 Cedar Ln Riverton, WI 37993 Employee Morgan Okafor Employee ID 15002 Pay period 10/01/2024 - 10/30/2024 Pay date 2024-12-04 Earnings Rate Hours Current YTD Regular 92.41 75.00 6,931.03 110,896.48 Overtime 138.62 9.00 70.62 5,480.89 Deductions
Current YTD Federal Income Tax 762.41 12,198.61 Social Security 429.72 6,875.58 Medicare 100.50 1,608.00 State Income Tax 277.24 4,435.86 401(k) 415.86 6,653.79 Medical Pre-Tax 207.93 3,326.89 Gross pay 6,931.03 Net
pay 4,713.10 Direct deposit to checking ending in 9367",PAYSTUB,44,PAYSTUB,fdc-b252d40f517410897a7186fb,v11-PAYSTUB-flat,original,2024,fgen-22ea42f51b37083a5b3263db,synthetic_programmatic_template,flat,none,False,biweekly
"Statement of Earnings
and Deductions Tri-County School District 6811 Elm Park Pl Bayside, WA 49735 Employee Amara Kowalski Employee ID 89449 Pay period 12/01/2025
- 12/28/2025 Pay date 03/14/2025 Earnings Rate Hours Current YTD Regular 85.30 40.00 3,411.82 68,236.34 Overtime 127.94 2.00 566.57 1,942.77 Deductions Current YTD Federal Income Tax 375.30 7,506.00 Social Security 211.53 4,230.65 Medicare 49.47 989.43 State Income Tax 136.47 2,729.45 401(k) 204.71 4,094.18 Medical Pre-Tax 102.35 2,047.09 Gross pay 3,411.82 Net pay 2,320.04 Direct deposit to checking ****0529",PAYSTUB,44,PAYSTUB,fdc-96344e601b0ab22bdcd0ce58,v11-PAYSTUB-flat,original,2025,fgen-f134b895ae5020938c651dc9,synthetic_programmatic_template,flat,top,False,biweekly
"Earnings Statement Tri-County SchoolDistrict 3138 Sample Street Riverton, WI 47657 Employee Taylor Patel Employee ID 76133 Pay period 02/01/2025
- 02/28/2025 Pay date 05/10/2025 Earníngs RatcHours Current YTD Regular 63.22 40.00 2,528.86 12,644.29 Overtime 94.83 0.00 257.19 1,845.47 Deductions Current YTD Federal Income Tax 278.17 1,390.87 Social Security 156.79 783.95 Medicare 36.67 l83.34 State Income Tax 101.15 505.77 401(k)151.73 758.66 Medical Pre-Tax 75.87 379.33
Gross pay 2,528.86 Net pay 1,719.62 Direct deposit to checking ***-**-2986",PAYSTUB,44,PAYSTUB,fdc-da0327cfb247a985f0a818bc,v11-PAYSTUB-flat,original,2025,fgen-7bbab2cb8f4f060b7c44895b,synthetic_programmatic_template,flat,top,True,semimonthly
"Copperline Software Inc. 1047 Harbor View Rd Oak Grove, TX 40043 Employee Taylor Rivera Employee ID 70452 Pay period 06/01/2026 - 06/31/2026
Pay date 2026-09-09 Earnings Rate Hours Current YTD Regular 16.08 75.00 1,206.29 14,475.52 Overtime 24.13 3.00 341.95 7,773.81 Deductions Current YTD Federal Income Tax 132.69 1,592.31 Social Security 74.79 897.48 Medicare 17.49 209.90 State Income Tax 48.25 579.02 401(k) 72.38 868.53 Medical
Pre-Tax 36.19 434.27 Gross pay 1,206.29 Net pay 820.28 Direct deposit to checking ****4366",PAYSTUB,44,PAYSTUB,fdc-ff34415ca216f833c9a52f51,v11-PAYSTUB-flat,original,2026,fgen-e0ea3f2a5f9a155c0f140c1a,synthetic_programmatic_template,flat,none,False,biweekly
"Payroll Advice Blue Heron Logistics LLC 941 Granite St Riverton, WI 72677 Employee Jamie Haddad Employee ID 54139 Pay period 01/01/2023 - 01/30/2023 Pay date 2023-06-17 Earnings
Rate Hours Current YTD
Regular 53.73 86.67 4,656.52 18,626.09 Overtime 80.59 1.00 284.17 4,270.59 Deductions Current YTD Federal Income Tax 512.22 2,048.87 Social Security 288.70 1,154.82 Medicare 67.52 270.08 State Income Tax 186.26 745.04 401(k) 279.39 1,117.57 Medical Pre-Tax 139.70 558.78 Gross pay 4,656.52 Net pay 3,166.44 Direct deposit to checking ****4695",PAYSTUB,44,PAYSTUB,fdc-8a4d98c176beb458af1e962e,v11-PAYSTUB-flat,original,2023,fgen-f66fbae391a781f8748e6be4,synthetic_programmatic_template,flat,top,False,semimonthly
"Granite Peak Manufacturing Co. 1365 Willow Bend Way Maplewood, MN 49388 Employee Jordan Moreau Employee ID 81095 Pay period 12/01/2021 - 12/28/2021 Pay date 05/03/2021 Earnings Rate Hours
Current YTD Regular 57.92 86.67 5,019.95 25,099.77 Overtime 86.88 0.00 248.89 7,407.30 Deductions Current YTD Federal Income Tax 552.19 2,760.97
Social Security 311.24 1,556.19 Medicare 72.79 363.95 State Income Tax 200.80 1,003.99 401(k) 301.20 1,505.99 Gross pay 5,019.95 Net pay 3,413.57 Direct deposit to checking ****0304 Earnings Statement",PAYSTUB,44,PAYSTUB,fdc-0fa1416ef9f7af87d570235c,v11-PAYSTUB-flat,original,2021,fgen-c8a75d6ecbe66330621239a6,synthetic_programmatic_template,flat,bottom,False,semimonthly
"Earnings Statement Maple Street Dental PC 7107 Lakeshore Blvd Maplewood, MN 53799 Employee Wei Castillo Employee ID 80445
Pay period 06/01/2026 - 06/28/2026 Pay date 04/09/2026 Earnings Rate Hours Current YTD Regular 40.86 75.00 3,064.45 52,095.60
Overtime 61.29 2.00 585.91 4,407.81 Deductions Current YTD Federal Income Tax 337.09 5,730.52 Social Security 190.00 3,229.93 Medicare 44.43 755.39 State Income Tax 122.58 2,083.82 401(k) 183.87 3,125.74 Gross pay 3,064.45 Net pay 2,083.82 Direct deposit to checking ending in 6519",PAYSTUB,44,PAYSTUB,fdc-2f642f1fc9a6c94117460575,v11-PAYSTUB-flat,original,2026,fgen-f25a10b4026feca9c5162454,synthetic_programmatic_template,flat,top,False,biweekly
"Blue Heron Logistics LLC 945 Maple Ridge Dr Brookhaven, PA 25382 Employee Mateo Sato Employee ID 57298 Pay period 01/01/2026 - 01/30/2026
Pay date 06/06/2026 Earnings Rate Hours Current YTD Regular 90.92 40.00 3,636.69 65,460.48 Overtime 136.38 2.00 379.55 5,225.51 Deductions Current YTD Federal Income Tax 400.04 7,200.65 Social Security 225.47 4,058.55 Medicare 52.73 949.18 State Income Tax 145.47
2,618.42 401(k) 218.20 3,927.63 Medical Pre-Tax 109.10 1,963.81 Gross pay 3,636.69 Net pay 2,472.95 Direct deposit to checking XXXXX5150",PAYSTUB,44,PAYSTUB,fdc-357be1122a5016b6cbe5899d,v11-PAYSTUB-flat,original,2026,fgen-9c980faaf412a57d32049809,synthetic_programmatic_template,flat,none,False,biweekly
"Acme Test Corp 5674 Prairie Ave Riverton, WI 89719 Employee Jamie S. Nguyen Employee ID 29985 Pay period 11/01/2025 - 11/31/2025 Pay date 06/05/2025 Earnings Rate Hours Current YTD Regular 57.59 75.00 4,318.95 51,827.40 Overtime 86.38 4.00 91.64 5,765.71 Deductions Current YTD Federal Income Tax 475.08 5,701.01 Social Security 267.77 3,213.30 State Income Tax 172.76 2,073.10 401(k) 259.14 3,109.64 Medical
Pre-Tax
129.57 1,554.82 Gross pay 4,318.95 Net pay 2,936.89 Direct deposit to checking ending in 2255",PAYSTUB,44,PAYSTUB,fdc-dadc689a23fb07083e981af1,v11-PAYSTUB-flat,original,2025,fgen-16e9541978f7e45ed7e672c7,synthetic_programmatic_template,flat,none,False,semimonthly
"Pay Statement Tri-County School District 8944 0ak Hollow Ct Tcstville, IL 59682 Employee Taylor 0kafor Employee ID 65929 Pay period 12/O1/2024 - 12/30/2024 Pay date 12/31/2024 Earnings Rate Hours Current
YTD Regular 94.00 40.00 3,760.18 97,764.64 Overtime 141.01 7.00410.03 1,810.44 Deductions Current YTD Federa1 Income Tax 413.62 1O,754.11Social Security 233.13 6,061.41 Medicare 54.52 1,417.59 State Income Tax 150.41 3,910.59 Gross pay 3,760.18 Net pay 2,556.92 Direct deposit to checking XXX-XX-6795 Your 2024 FormW-2 wi1l be available in the employee
portal by January 31.",PAYSTUB,44,PAYSTUB,fdc-f2c92a0b802b8d1d42a1eb7d,v11-PAYSTUB-flat,original,2024,fgen-62d9b9625674bd6dc5292a91,synthetic_programmatic_template,flat,top,True,final_of_year
"Granite Peak Manufacturing Co. 2752 Elm Park Pl Oak Grove, TX 34827 Employee Jordan L. Fischer Employee ID 79848 Pay period 03/01/2024 - 03/30/2024 Pay date 06/26/2024 Earnings Rate Hours Current YTD Regular 67.10 40.00 2,684.11 48,313.94 Overtime 100.65 2.00 450.52 4,122.18 Deductions Current YTD Federal Income Tax 295.25 5,314.53 Social Security 166.41 2,995.46 Medicare 38.92 700.55 State Income Tax 107.36 1,932.56 401(k) 161.05 2,898.84 Medical Pre-Tax 80.52 1,449.42 Gross pay 2,684.11 Net pay
1,825.19
Direct deposit to checking XXX-XX-3660 Pay Statement",PAYSTUB,44,PAYSTUB,fdc-d88c2613f8c1b24e59f59e27,v11-PAYSTUB-flat,original,2024,fgen-9807508977d076e993a069c0,synthetic_programmatic_template,flat,bottom,False,biweekly
"Statement of Earnings
and Deductions Copperlíne Software Inc. 761 Willow Bend Way Lakewood, CO 57310 Employee Sofía R. Rivera Emp1oyee ID 53465 Pay period 05/01/2026 - 05/31/2026 Pay
date 12/31/2026 Earnings Rate Hours Current YTD Regular 57.89 75.00 4,342.01 112,892.23 Overtime 86.84 7.00 334.89 5,639.65 Deductions Current YTD Federal Income Tax 477.62 12,418.15 SocialSecurity 269.20 6,999.32 Medicare 62.96 1,636.94 5tate Income Tax 173.68 4,515.69 401(k) 260.52 6,773.53 Medica1 Pre-Tax 130.26 3,386.77 Grosspay 4,342.O1 Net pay 2,952.57 Direct depositto checking ending in 1627",PAYSTUB,44,PAYSTUB,fdc-4d05d836c64270ab815ebc96,v11-PAYSTUB-flat,original,2026,fgen-abf86bfd9db9e7dcd18115f3,synthetic_programmatic_template,flat,top,True,final_of_year
"Earnings Statement Maple Street Dental PC 2531 Granite St Bayside, WA 40979 Employee Riley J. Kowalski Employee ID
11693 Pay period 08/01/2021 - 08/30/2021 Pay date June 13, 2021 Earnings Rate Hours Current YTD Regular 19.80 40.00 792.03 15,048.52 Overtime 29.70 9.00 403.36 710.93 Deductions Current YTD Federal Income Tax 87.12 1,655.34 Medicare 11.48 218.20 State Income Tax 31.68 601.94 401(k) 47.52 902.91 Medical Pre-Tax 23.76 451.46 Gross pay 792.03 Net pay 538.58 Direct deposit to
checking ***-**-7898",PAYSTUB,44,PAYSTUB,fdc-7bb3639bc8a9c0cb772bbccf,v11-PAYSTUB-flat,original,2021,fgen-d2f19c487e9d04bf5e586f42,synthetic_programmatic_template,flat,top,False,biweekly
"Bright PixelDesign LLC
## March 2023
Accrual Basis
Incomc
| Field | Value |
| --- | --- |
| Sales | 144,149.O6|
| Total Income | 144,149.O6 |
| Cost of Goods Sold | 33,694.76 |
| Gross Profit | 110,454.30 |
| Expenses | Total |
| --- | --- |
| Insurance | 3,081.86 |
| Rcnt or Lease | 11,695.04 |
| Software Subscriptions | 1,075.80 |
| Travel | 1,803.90 |
| Field | Value |
| --- | --- |
| Total Expenses | 17,656.60 |
| Nct 0perating Income | 92,797.70 |
| Net Income |92,797.70 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ad0d0cbd3211be76be444bca,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2023,fgen-ee5f4a55a9598e5526e2fb65,synthetic_programmatic_template,markdown,none,True,monthly
"Profit and Loss
Riverbend Landscaping
January - December 2026
Cash Basis
Income
| Field | Value |
| --- | --- |
| Sales | 474,065.87 |
| Total Income | 474,065.87 |
| Cost of Goods Sold | 143,037.79 |
| Gross Profit | 331,028.08 |
| Expenses | Total |
| --- | --- |
| Contract Labor | 48,224.47 |
| Insurance | 12,725.25 |
| Office Supplies | 4,764.96 |
| Rent or Lease | 41,108.86 |
| Utilities | 3,349.94 |
| Field | Value |
| --- | --- |
| Total Expenses | 110,173.48 |
| Net Operating Income | 220,854.60 |
| Net Income | 220,854.60 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-c3edde5aeca6251df4bb3932,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2026,fgen-7124102d4b23a315cb2c701a,synthetic_programmatic_template,markdown,top,False,cash_basis
"Income Statement
Riverbend Landscaping
January - December 2023
Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 234,680.45 |
| Total Income |234,680.45 |
| Cost of Goods Sold | 34,698.69 |
| Gross Profit | 199,981.76 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 7,462.66 |
| Insurance| 3,503.64 |
| Rent or Lease | 16,647.35 |
| Travel | 5,247.62 |
| Utilities | l,969.36 |
| Field | Value |
| --- | --- |
| Total Expenses | 34,830.63 |
| Net 0perating Income | l65,151.13 |
|Net Income | 165,151.13 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-e6bca287791a1727834309a7,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2023,fgen-b46b4b9157ec2c9b522092e7,synthetic_programmatic_template,markdown,top,True,annual
"Profit & Loss Statement
Maple Street Bakery
## October 2024
Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 139,577.04 |
| Total Income | 139,577.04 |
| Cost of Goods Sold | 41,827.54 |
| Gross Profit | 97,749.50 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 3,259.35 |
| Insurance | 2,137.91 |
| Office Supplies | 1,649.74 |
| Rent or Lease | 9,424.05 |
| Software Subscriptions | 1,045.71 |
| Travel | 3,382.46 |
| Field | Value |
| --- | --- |
| Total Expenses | 20,899.22 |
| Net Operating Income | 76,850.28 |
| Net Income | 76,850.28 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-79bbbafbd070338785407874,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2024,fgen-d97d8f8f416318234e4a8c48,synthetic_programmatic_template,markdown,top,False,monthly
"Bright Pixel Design LLC
March 2026
Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 80,267.85 |
| Total Income | 80,267.85 |
| Cost of Goods Sold | 12,907.25 |
| Gross Profit | 67,360.60 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 1,259.86 |
| Contract Labor | 5,318.33 |
| Insurance | 2,334.28 |
| Office Supplies | 1,189.20 |
| Rent or Lease | 7,178.56 |
| Software Subscriptions | 782.04 |
| Travel | 1,900.44 |
| Utilities | 847.34 |
| Field | Value |
| --- | --- |
| Total Expenses | 20,810.05 |
| Net Operating Income | 46,550.55 |
| Net Income | 46,550.55 |
Profit and Loss",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-4498f2314c61446331505fa6,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2026,fgen-2630e16a7b7d9b4e43481702,synthetic_programmatic_template,markdown,bottom,False,monthly
"## Profit and Loss
## Bright Pixel Design LLC
January - December 2023
Cash Basis
Income
| Field | Value |
| --- | --- |
| Sales | 355,844.34 |
| Total Income | 355,844.34 |
| Cost of Goods Sold | 85,815.02 |
| Gross Profit | 270,029.32 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 6,939.63 |
| Contract Labor | 30,249.24 |
| Insurance | 6,719.77 |
| Rent or Lease | 14,198.41 |
| Software Subscriptions | 3,222.61 |
| Utilities | 3,430.02 |
| Field | Value |
| --- | --- |
| Total Expenses | 64,759.68 |
| Net Operating Income | 205,269.64 |
| Net Income | 205,269.64 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-6a188ec80a622ee200bfb87b,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2023,fgen-0296f67e48231ccb1b648a11,synthetic_programmatic_template,markdown,top,False,cash_basis
"| Category | Jan | Feb | Mar | YTD |
| --- | --- | --- | --- | --- |
| Income | 27496.92 | 3250.66 | 5412.57 | 24152.01 |
| COGS | 4489.39 | 8561.85 | 10988.73 | 17568.92 |
| Software | 28687.66 | 29769.34 | 18962.67 | 26301.70 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-832c649c86c009b450ece2db,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2025,fgen-fe3804d1f7c4c221c2a2c013,synthetic_programmatic_template,markdown,top,False,raw_export
"Copperline Consulting - Profit and Loss - 2022
| Account | Q1 | Q2 | Q3 | Q4 | Total |
| --- | --- | --- | --- | --- | --- |
| Gross Profit | 965.17 | 21017.72 | 83414.28 | 4515.19 | 85983.75 |
| Total Revenue | 45211.41 | 41370.48 | 30525.27 | 43921.06 | 83114.21 |
| Gross Profit | 47170.43 | 47288.29 | 81744.00 | 46185.98 | 85517.48 |
| Rent | 45523.33 | 48940.61 | 31156.07 | 7558.57 | 82521.89 |
| Cost of Goods Sold | 47242.28 | 32040.67 | 1878.59 | 34789.47 | 23863.87 |
| Rent | 5486.10 | 68535.63 | 57356.67 | 62200.54 | 37812.06 |
| Net Income | 56955.29 | 35563.36 | 27901.89 | 12274.90 | 31221.83 |
| Payroll Expenses | 77262.96 | 62823.28 | 3659.45 | 85348.24 | 59954.21 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-9b18b8c32cfa97811434e2f6,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2022,fgen-d48caf5149caf20ba96848a2,synthetic_programmatic_template,markdown,top,False,raw_export
"Income Statement
Bright Pixel Design LLC
## January - December 2021
Cash Basis
Income
| Field | Value |
| --- | --- |
| Sales | 348,641.34 |
| Total Income | 348,641.34 |
| Cost of Goods Sold | 49,071.11 |
| Gross Profit | 299,570.23 |
| Expenses | Total |
| --- | --- |
| Contract Labor | 32,347.93 |
| Office Supplies | 2,997.95 |
| Rent or Lease | 19,014.81 |
| Software Subscriptions | 3,373.78 |
| Travel | 4,222.79 |
| Field | Value |
| --- | --- |
| Total Expenses | 61,957.26 |
| Net Operating Income | 237,612.97 |
| Net Income | 237,612.97 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-2455e6319c2aadd757700ee4,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2021,fgen-b51da1b9aa3d6643e6049b21,synthetic_programmatic_template,markdown,top,False,cash_basis
"Income Statement
Riverbend Landscaping
June 2023
## Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 496,577.78 |
| Total Income | 496,577.78 |
| Cost of Goods Sold | 131,407.90 |
| Gross Profit | 365,169.88 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 21,254.18 |
| Contract Labor | 25,960.25 |
| Office Supplies | 6,644.68 |
| Rent or Lease | 25,390.48 |
| Software Subscriptions | 6,611.05 |
| Utilities | 6,491.83 |
| Field | Value |
| --- | --- |
| Total Expenses | 92,352.47 |
| Net Operating Income | 272,817.41 |
| Net Income | 272,817.41 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ddfd181f9f8b81e5e3fa363e,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2023,fgen-61d4d401130cb27a439f1c9d,synthetic_programmatic_template,markdown,top,False,monthly
"Bright Pixel Design LLC
January - December 2025
Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 394,473.87 |
| Total Income | 394,473.87 |
| Cost of Goods Sold | 195,681.67 |
| Gross Profit | 198,792.20 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 6,126.85 |
| Contract Labor | 28,799.82 |
| Insurance | 8,445.52 |
| Office Supplies | 3,563.54 |
| Rent or Lease | 21,465.23 |
| Field | Value |
| --- | --- |
| Total Expenses | 68,400.96 |
| Net Operating Income | 130,391.24 |
| Net Income | 130,391.24 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-be947cdee18465f7c83a04e6,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2025,fgen-db47a6c941788acab71d177b,synthetic_programmatic_template,markdown,none,False,annual
"## Income statement by month
| Category | Jan | Feb | Mar | YTD |
| --- | --- | --- | --- | --- |
| Service revenue | 2535.23 | 13689.76 | 25233.62 | 1706.06 |
| Contractors | 18019.82 | 22341.63 | 17049.56 | 29609.06 |
| Contractors | 4378.73 | 8931.40 | 21314.11 | 29664.49 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-90426b5824449b5134250ba2,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2021,fgen-cd1c777bbd2ee924b657fd39,synthetic_programmatic_template,markdown,top,False,raw_export
"Income Statement
## Maple Street Bakery
January - December 2022
## Cash Basis
Income
| Field | Value |
| --- | --- |
| Sales | 77,136.67 |
| Total Income | 77,136.67 |
| Cost of Goods Sold | 21,704.30 |
| Gross Profit | 55,432.37 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 2,314.30 |
| Contract Labor | 7,024.25 |
| Office Supplies | 790.56 |
| Rent or Lease | 5,702.14 |
| Software Subscriptions | 1,139.28 |
| Utilities | 891.28 |
| Field | Value |
| --- | --- |
| Total Expenses | 17,861.81 |
| Net Operating Income | 37,570.56 |
| Net Income | 37,570.56 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-8c0ee55906f2aee705f1d140,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2022,fgen-a04f7274619eece1730a3192,synthetic_programmatic_template,markdown,top,False,cash_basis
"Profit & Loss Statement
Maple Street Bakery
January - December 2026
CashBasis
Income
|Field | Value |
| --- | --- |
|Sales | 237,050.13 |
| Total Income | 237,050.l3 |
| Cost of Goods Sold | 34,421.75 |
| Gross Profit | 202,628.38 |
| Expcnses | Total |
| --- | --- |
| Advertising & Marketing | 8,728.98 |
| Contract Labor | 26,318.56 |
| Officc Supplies | 1,695.12 |
| Rcnt or Lease | 8,117.6O |
| Uti1ities | 2,531.49 |
| Field | Value |
| --- | --- |
| Total Expenses | 47,391.75 |
| Nct Operating Income | 155,236.63 |
| Net Income | 155,236.63 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ea650b69b3dd0f0bca9a2466,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2026,fgen-e7fb2b44c47562be63510f05,synthetic_programmatic_template,markdown,top,True,cash_basis
"Copperline Consulting
January - December 2022
Cash Basis
## Income
| Field | Value |
| --- | --- |
| Sales | 158,271.57 |
| Total Income | 158,271.57 |
| Cost of Goods Sold | 68,754.67 |
| Gross Profit | 89,516.90 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 5,112.64 |
| Contract Labor | 15,432.68 |
| Insurance | 3,623.04 |
| Office Supplies | 1,636.65 |
| Rent or Lease | 6,215.63 |
| Software Subscriptions | 2,151.14 |
| Travel | 3,350.57 |
| Utilities | 2,358.12 |
| Field | Value |
| --- | --- |
| Total Expenses | 39,880.47 |
| Net Operating Income | 49,636.43 |
| Net Income | 49,636.43 |
## Profit and Loss",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-fbd942c31a7264e6c851d765,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2022,fgen-a34ba7c5b65ff6a93bfeb307,synthetic_programmatic_template,markdown,bottom,False,cash_basis
"| Account | Q1 | Q2 | Q3 | Q4 | Total |
| --- | --- | --- | --- | --- | --- |
| Gross Profit | 47695.93 | 27670.81 | 15446.29 | 45349.44 | 69635.98 |
| Total Revenue | 33243.57 | 17421.32 | 51426.30 | 14684.32 | 23011.29 |
| Payroll Expenses | 66848.82 | 56033.00 | 21604.63 | 10258.69 | 85660.99 |
| Cost of Goods Sold | 68829.96 | 66318.81 | 13785.07 | 57228.62 | 66291.52 |
| Gross Profit | 31585.50 | 28156.67 | 84505.30 | 60519.18 | 27675.79 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-47bcd43d3faa6ebae911d59b,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2021,fgen-89a3b269c9ecefdc9c376f62,synthetic_programmatic_template,markdown,none,False,raw_export
"## Income Statement
Maple Street Bakery
January - December 202l
CashBasis
Income
| Field | Value |
| --- | --- |
| Sales | 394,174.11 |
| Total Incomc | 394,174.11 |
| Costof Goods Sold | 116,189.86 |
| Gross Profit | 277,984.25 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 17,488.93 |
| Contract Labor| 33,974.l0 |
| Insurance | 5,369.49 |
| Rent or Lease | 23,174.53 |
| Travel | 4,176.22 |
| Utilities | 3,606.10 |
| Field | Value |
| --- | --- |
| Total Expenses | 87,789.37 |
| Net 0perating Income | 190,194.88 |
| Net Income | 190,194.88 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-0d7b9717f34376ef5f91433a,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2021,fgen-f5ea3bcc9cdb7a27240a1fc7,synthetic_programmatic_template,markdown,top,True,cash_basis
"Profit and Loss
Copperline Consulting
March 2021
Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 145,347.90 |
| Total Income | 145,347.90 |
| Cost of Goods Sold | 21,036.49 |
| Gross Profit | 124,311.41 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 3,067.71 |
| Contract Labor | 6,412.78 |
| Insurance | 1,654.91 |
| Software Subscriptions | 1,364.33 |
| Travel | 3,895.19 |
| Utilities | 1,904.47 |
| Field | Value |
| --- | --- |
| Total Expenses | 18,299.39 |
| Net Operating Income | 106,012.02 |
| Net Income | 106,012.02 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-0be1144aa8ac247ca1643954,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2021,fgen-5989f091f3e8df24daefd0f9,synthetic_programmatic_template,markdown,top,False,monthly
"## Profit & Loss Statement
Maple Street Bakery
October 2025
Accrual Basis
## Income
|Field | Value |
| --- | --- |
| Sales | 357,572.56 |
| Total Income | 357,572.56 |
| Cost of Goods Sold | 41,545.90 |
| Gross Profit | 316,026.66 |
| Expenses | Total |
| --- | --- |
| Contract Labor | 29,453.15 |
| Office 5upplies | 2,143.41 |
| Rent or Lease| 28,226.88 |
| Trave1 | 8,642.16 |
| Utilities | 4,143.22|
| Field | Value |
| --- | --- |
| Total Expenses | 72,608.82 |
| Net Operating Income | 243,417.84 |
| Net Income | 243,417.84 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-8d600af2ac53f24480d23a74,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2025,fgen-1662aa57e4c00270606a2561,synthetic_programmatic_template,markdown,top,True,monthly
"P&L Summary 2025
| Category | Jan | Feb | Mar | YTD |
| --- | --- | --- | --- | --- |
| Service revenue | 15466.20 | 24786.37 | 22385.23 | 6037.79 |
| Service revenue | 11095.86 | 20510.65 | 4809.44 | 28105.99 |
| Net operating income | 5289.99 | 8407.72 | 4690.22 | 13810.72 |
| Service revenue | 10943.88 | 19695.91 | 13956.98 | 28978.07 |
| Operating expenses | 17240.64 | 11099.45 | 15922.87 | 7013.46 |
| Net operating income | 26309.30 | 22095.53 | 14120.72 | 5647.91 |
| Software | 21644.17 | 29611.61 | 11610.25 | 10061.54 |
| Net operating income | 20584.29 | 24568.21 | 7994.75 | 10338.92 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-e2cad52b05e1ff8eb5103ad7,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2025,fgen-bfb448721ba42936a03ca462,synthetic_programmatic_template,markdown,top,False,raw_export
"Profit and Loss
## Maple Street Bakery
January - December 2022
## Cash Basis
Income
| Field | Value |
| --- | --- |
| Sales | 310,558.28 |
| Total Income | 310,558.28 |
| Cost of Goods Sold | 51,588.49 |
| Gross Profit | 258,969.79 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 8,721.32 |
| Contract Labor | 19,437.06 |
| Insurance | 3,541.87 |
| Office Supplies | 3,334.54 |
| Rent or Lease | 13,167.09 |
| Software Subscriptions | 1,987.00 |
| Travel | 4,293.99 |
| Utilities | 3,329.25 |
| Field | Value |
| --- | --- |
| Total Expenses | 57,812.12 |
| Net Operating Income | 201,157.67 |
| Net Income | 201,157.67 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-d38133801355500c07724cac,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2022,fgen-a6960f1b69edf90262047ba1,synthetic_programmatic_template,markdown,top,False,cash_basis
"Profit & Loss Statement
Riverbend Landscaping
January - December 2025
Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales| 598,7l9.23 |
| Total Income | 598,719.23 |
| Cost ofGoods Sold | 173,898.31 |
| Gross Profít | 424,82O.92 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing |19,653.34 |
|Contract Labor | 44,982.55 |
| Insurance | 8,884.19 |
| Office 5upp1ies | 4,986.88 |
| Rent or Lease | 28,185.89 |
| Software Subscriptions | 7,281.77 |
| Trave1 | 12,037.12 |
| Field | Value |
| --- | --- |
| Total Expenses | 126,011.74 |
| Net Operating Income | 298,8O9.18 |
| Net Income | 298,8O9.18 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-d330b73121916760bda7c8af,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2025,fgen-5d0f5901fdc6687a0c2c6da7,synthetic_programmatic_template,markdown,top,True,annual
"## Income statement by month
| Account | Q1 | Q2 | Q3 | Q4 | Total |
| --- | --- | --- | --- | --- | --- |
| Total Revenue | 81787.29 | 79093.41 | 8192.35 | 27600.63 | 50493.15 |
| Payroll Expenses | 81060.02 | 11301.19 | 9633.92 | 53550.68 | 15539.64 |
| Gross Profit | 34671.34 | 60861.54 | 28850.86 | 29418.33 | 20627.55 |
| Marketing | 21344.98 | 53398.86 | 38837.83 | 30826.22 | 85277.50 |
| Sales | 65663.58 | 48526.45 | 63319.04 | 73183.86 | 42319.03 |
| Net Income | 26760.74 | 62382.70 | 41887.47 | 67351.65 | 28895.01 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-4ad524e30c6358bebb81c114,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2026,fgen-be0b2b275a3a776d47a3532a,synthetic_programmatic_template,markdown,top,False,raw_export
"Bright Pixel Design LLC
January - December 2024
## Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 360,860.95 |
| Total Income |360,860.95 |
| Cost of Goods Sold | 16O,736.56 |
| Gross Profit | 200,124.39 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 13,546.58 |
| Contract Labor | 18,804.96 |
| Insurance | 6,109.68 |
| 0ffice Supplies | 3,504.11 |
| Rent or Lease | 27,857.95 |
| Software Subscriptions |4,276.29 |
| Travel | 9,360.11 |
| Utilities | 4,613.61 |
| Field | Value |
| --- | --- |
| Total Expenses | 88,073.29 |
| Net 0perating Income | 112,051.10|
| Net Income | 112,051.10 |
## Profit & LossStatement",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ee95253be00769647f42efce,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2024,fgen-1c2f24cb50d7dbd370b9128d,synthetic_programmatic_template,markdown,bottom,True,annual
"Maple Street Bakery - Profit and Loss - 2026
| Account | Q1 | Q2 | Q3 | Q4 | Total |
| --- | --- | --- | --- | --- | --- |
| Payroll Expenses | 88123.61 | 60191.51 | 19004.21 | 10845.52 | 19496.95 |
| Rent | 28800.67 | 42793.74 | 73176.89 | 39174.22 | 18091.13 |
| Net Income | 21464.79 | 60341.74 | 78105.86 | 5449.10 | 36531.10 |
| Marketing | 82394.42 | 36703.07 | 58007.17 | 4439.29 | 86044.49 |
| Net Income | 72966.20 | 14727.12 | 51774.77 | 21747.19 | 43338.03 |
| Gross Profit | 84652.75 | 18865.42 | 22983.06 | 34995.85 | 23009.71 |
| Total Revenue | 2399.67 | 36112.36 | 84875.80 | 45044.34 | 5484.35 |
| Net Income | 63206.38 | 52410.09 | 80522.04 | 13650.53 | 17306.82 |
| Cost of Goods Sold | 611.53 | 64198.03 | 38666.92 | 8509.26 | 51461.66 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-9869b2c8bb92c6cead3c21e3,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2026,fgen-5ec02522170c02a846f04d7a,synthetic_programmatic_template,markdown,top,False,raw_export
"Income Statement
Bright Pixel Design LLC
## January - December 2026
Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 364,060.47 |
| Total Income | 364,060.47 |
| Cost of Goods Sold | 78,985.48 |
| Gross Profit | 285,075.00 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 12,945.79 |
| Contract Labor | 30,996.58 |
| Rent or Lease | 17,401.28 |
| Utilities | 4,495.75 |
| Field | Value |
| --- | --- |
| Total Expenses | 65,839.40 |
| Net Operating Income | 219,235.60 |
| Net Income | 219,235.60 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-d8b23d220a520a6852454c09,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2026,fgen-28a9fc744e9eea23f38f4e39,synthetic_programmatic_template,markdown,top,False,annual
"## Profit and Loss
## Bright Pixel Design LLC
January - December 2022
## Cash Basis
Income
| Field | Value |
| --- | --- |
| Sales | 467,145.75 |
| Total Income | 467,145.75 |
| Cost of Goods Sold | 52,670.74 |
| Gross Profit | 414,475.01 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 17,970.61 |
| Contract Labor | 30,489.62 |
| Insurance | 4,838.28 |
| Office Supplies | 5,034.70 |
| Rent or Lease | 29,051.12 |
| Software Subscriptions | 6,047.00 |
| Field | Value |
| --- | --- |
| Total Expenses | 93,431.33 |
| Net Operating Income | 321,043.68 |
| Net Income | 321,043.68 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ff7ebaaea0c454daeee953ce,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2022,fgen-afc7e081d33c5af9ffeb4c22,synthetic_programmatic_template,markdown,top,False,cash_basis
"Maple Street Bakery
January - December 2023
Cash Basis
Income
| Field | Value |
| --- | --- |
| Sales | 141,097.34 |
| Total Income | 141,097.34 |
| Cost of Goods Sold | 63,503.58 |
| Gross Profit | 77,593.76 |
| Expenses | Total |
| --- | --- |
| Insurance | 1,843.28 |
| Office Supplies | 1,420.20 |
| Rent or Lease | 9,125.17 |
| Software Subscriptions | 1,284.50 |
| Travel | 2,902.97 |
| Utilities | 1,858.13 |
| Field | Value |
| --- | --- |
| Total Expenses | 18,434.25 |
| Net Operating Income | 59,159.51 |
| Net Income | 59,159.51 |
Profit and Loss",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-3daa9aa5c42e717eb0504cc5,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2023,fgen-49936ac6647eb810472d4104,synthetic_programmatic_template,markdown,bottom,False,cash_basis
"## Bright Pixel Design LLC
January - December 2024
## Accrual Basis
Income
| Field | Value |
| --- | --- |
| Sales | 338,936.36 |
| Total Income | 338,936.36 |
| Cost of Goods Sold | 37,154.41 |
| Gross Profit | 301,781.94 |
| Expenses | Total |
| --- | --- |
| Advertising & Marketing | 7,542.97 |
| Contract Labor | 30,742.78 |
| Rent or Lease | 23,828.27 |
| Travel | 7,008.28 |
| Utilities | 2,728.32 |
| Field | Value |
| --- | --- |
| Total Expenses | 71,850.62 |
| Net Operating Income | 229,931.32 |
| Net Income | 229,931.32 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-1a6868a63c990aaabc9f4e91,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2024,fgen-275ccfe8d38db6dd8fd80dd1,synthetic_programmatic_template,markdown,none,False,annual
"| Category | Jan | Feb | Mar | YTD |
| --- |--- | --- | --- | --- |
| Service revenue | 24972.40 | l5147.82 | 8820.62 | 27357.57 |
| COGS | 10783.40 | 16899.88 | 20300.89 | 4843.82 |
| Software | 12916.06 | 16825.78 | 8602.53 | 11209.16 |
| Net operating income | 20498.18 | 18213.55 | 17917.59 | 9392.47 |
|Income | 3133.38 | 16613.59 | 23281.37 | 24282.36|
| Software | 6955.72 | 373.88 | 28904.16 | 21614.87 |
| C0GS | 20229.85 | 10413.28 | 7762.21 | 14434.81 |
| Software | 19113.64 | 29976.67 |19321.24 | 1000.88 |
| Contractors | 7142.86 | 445.37 | 17083.07 | 20867.29 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-60b65e544c1e9724d012b7d6,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2023,fgen-2c95b74409900bfc1eb1d731,synthetic_programmatic_template,markdown,top,True,raw_export
"Riverbend Landscaping
June 2024
Accrual Basis
## Income
| Field | Value |
| --- |--- |
| Sales | 297,838.30 |
| Total Income | 297,838.30 |
| Cost of Goods Sold | 148,238.17|
| Gross Profít | 149,600.13 |
| Expenses | Total |
| --- | --- |
| Advertísing &Marketing | 12,600.01 |
| Contract Labor | 25,828.48 |
| Rent or Lease | 25,530.60 |
| Software Subscriptions | 1,693.95 |
| Trave1 | 7,641.71 |
| Uti1ities | 2,401.01 |
| Fie1d | Value |
| --- | --- |
| Total Expenses | 75,695.76 |
| Net Operating Income | 73,904.37 |
| Net Income | 73,9O4.37 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-ee6af84d53cb5fcc3a457ae3,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2024,fgen-aee59833be8cc7a02f6c2c59,synthetic_programmatic_template,markdown,none,True,monthly
"Profit & Loss Statement
Bright Pixel Design LLC
March 2O22
Accrual Basis
Income
| Field | Value |
| ---| --- |
| Sales | 58,184.34 |
| Total Income | 58,184.34 |
| Cost of Goods Sold | 19,787.09 |
| Gross Profit | 38,397.26|
| Expenses |Total |
| --- | --- |
| Contract Labor | 4,293.24 |
| 0ffice Supplies | 861.42 |
| Rent or Lease | 2,199.69 |
| Software Subscriptions | 649.89 |
| Travel | 584.13 |
| Field | Value |
| --- | --- |
| Tota1 Expenses | 8,588.37 |
| Net Operating Income | 29,808.89 |
| Net Income | 29,808.89 |",BUSINESS_RECORD,25,BUSINESS_RECORD,fdc-fd7198ff923f928097675fb7,v11-PROFIT_AND_LOSS_STATEMENT-markdown,original,2022,fgen-a94c04c95c5390b93292357c,synthetic_programmatic_template,markdown,top,True,monthly
"Second Installment Property Tax Notice
Harbor County Treasurer
Parcelnumber
77-29-57l-55
Property location
6273 Oak Hollow Ct Riverton, WI 64759
Owner
Kwame C. Haddad
Assessed value
S439,348.27
Homestead exemption
$7,366.22
Tax rate
3.922l%
Taxing district  Amount
County General
1,043.10
Community Co1lege 502
876.02
Park District
2,359.06
School Dístrict 204
3,625.93
Total tax
$10,722.91
Fírst installment due
November 22, 2021
Second installment due
05/16/2021",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-f4258d6d6f99f84c300031d0,v11-PROPERTY_TAX_BILL-stacked,original,2021,fgen-28822707ee4dd72e971a712d,synthetic_programmatic_template,stacked,top,True,installment_notice
"2023 Real Estate Property Tax Bill
Harbor County Treasurer
Parcel number
95-63-991-89
Property location
4118 Elm Park Pl Brookhaven, PA 42269
Owner
Avery Walsh
Assessed value
$358,247.33
Homestead exemption
$3,325.46
Tax rate
3.5968%
Taxing district  Amount
School District 204
185.84
County General
2,033.80
Community College 502
4,282.22
City of Testville
442.70
Total tax
$6,715.99
First installment due
09/19/2023
Second installment due
10/7/23
If your taxes are paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-aa3f600b71d763a645f7e05c,v11-PROPERTY_TAX_BILL-stacked,original,2023,fgen-f3aae862c294e05afa8265f5,synthetic_programmatic_template,stacked,top,False,annual_bill
"Property Tax Payment Receipt
Cedar County Tax Office
Parcel number
99-53-861-28
Property location
156 Maple Ridge Dr Bayside, WA 45189
Owner
Avery Rivera
Assessed value
$108,607.07
Homestead exemption
$1,678.37
Tax rate
8.8490%
Taxing district  Amount
County General
3,655.83
Park District
3,377.14
City of Testville
4,603.09
Library District
664.30
Total tax
$7,958.61
First installment due
10/21/2022
Second installment due
March 23, 2022
Amount paid
$3,979.30",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-a649b687d0b74862fdbc6995,v11-PROPERTY_TAX_BILL-stacked,original,2022,fgen-90617efb49d34d6e39b0eeb3,synthetic_programmatic_template,stacked,top,False,paid_receipt
"Property Tax Payment Receipt
Marion County Treasurer
Parcel number
34-62-380-91
Property location
4449 Prairie Ave Cedar Falls, IA 88888
Owner
Olivia S. Moreau
Assessed value
$595,529.09
Homestead exemption
$2,133.28
Tax rate
3.2815%
Taxing district  Amount
Community College 502
3,252.57
School District 204
4,248.59
Library District
562.92
County General
451.44
Total tax
$4,178.18
First installment due
2022-07-09
Second installment due
2022-12-08
Amount paid
$2,089.09",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-336cbd6e5ecc50d3f3fb1f56,v11-PROPERTY_TAX_BILL-stacked,original,2022,fgen-051229e8d600bd1f25614107,synthetic_programmatic_template,stacked,top,False,paid_receipt
"Marion County Treasurer
Parcel number
72-37-374-93
Property location
2530 Elm Park Pl Riverton, WI 82019
Owner
Jamie Fischer
Assessed value
$598,249.46
Homestead exemption
$8,884.31
Tax rate
1.1073%
Taxing district  Amount
School District 204
3,108.57
Library District
427.08
Community College 502
2,196.44
City of Testville
2,035.03
Total tax
$3,582.33
First installment due
February 16, 2021
Second installment due
06/01/2021
If your taxes are paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-3d8c9ea9fcd8e28c083102a0,v11-PROPERTY_TAX_BILL-stacked,original,2021,fgen-607edb2616cd0549737c2917,synthetic_programmatic_template,stacked,none,False,installment_notice
"Property Tax Payment Receipt
Harbor County Treasurer
Parcel number
40-72-858-88
Property location
4796 Willow Bend Way Pinecrest, GA 18775
Owner
Taylor S. Brennan
Assessed value
$572,293.01
Homestead exemption
$6,883.68
Tax rate
7.5409%
Taxing district  Amount
City of Testville
1,754.90
School District 204
1,139.56
Community College 502
3,404.63
Park District
4,738.08
Total tax
$11,646.71
First installment due
2025-04-19
Second installment due
2025-10-12
Amount paid
$5,823.36",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-22483d3fc57c615d5180c647,v11-PROPERTY_TAX_BILL-stacked,original,2025,fgen-f99b80adc359d0a2fafd6ddf,synthetic_programmatic_template,stacked,top,False,paid_receipt
"Second Installment Property Tax Notice
Marion County Treasurer
Parcel number
74-61-447-12
Property location
6532 Maple Ridge Dr Lakewood, CO 80082
Owner
Jamie Patel
Assessed value
$515,051.20
Homestead exemption
$7,718.35
Tax rate
8.2272%
Taxing district  Amount
County General
2,377.25
City of Testville
3,598.80
School District 204
3,646.32
Park District
577.91
Total tax
$5,642.20
First installment due
2022-10-26
Second installment due
8/16/22",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-efa9af7ab09f2d71e6c4f0e3,v11-PROPERTY_TAX_BILL-stacked,original,2022,fgen-76ad398dee3986c6c28d73d9,synthetic_programmatic_template,stacked,top,False,installment_notice
"Second Installment Property Tax Notice
Cedar County Tax Office
Parcel number
91-94-258-99
Property location
7365 Willow Bend Way Cedar Falls, IA 89401
Owner
Diego Lindqvist
Assessed value
$380,233.10
Homestead exemption
$5,914.42
Tax rate
1.1622%
Taxing district  Amount
Library District
761.77
County General
2,457.70
Community College 502
3,395.32
City of Testville
3,324.06
Total tax
$8,983.10
First installment due
02/05/2025
Second installment due
8/19/25
If your taxes are paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-ba06d2fb2ce76aca02266d7c,v11-PROPERTY_TAX_BILL-stacked,original,2025,fgen-6681c1a16c356c01070f4190,synthetic_programmatic_template,stacked,top,False,installment_notice
"Lake County Collector
Parcel number
58-38-165-74
Property location
7703 Elm Park Pl Fairview, OH 18164
Owner
Wei Moreau
Assessed value
$62,049.46
Homestead exemption
$4,249.02
Tax rate
3.5051%
Taxing district  Amount
School District 204
2,444.23
City of Testville
2,020.85
Park District
1,488.31
Library District
1,651.69
Total tax
$15,670.50
First installment due
July 20, 2023
Second installment due
4/18/23",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-0670162ecb6a403746d0454e,v11-PROPERTY_TAX_BILL-stacked,original,2023,fgen-f72c0433a138fe83a535075b,synthetic_programmatic_template,stacked,none,False,annual_bill
"Second Installment Property Tax Notice
Lake County Collector
Parcel number
36-25-125-14
Property location
4728 Lakeshore Blvd Bayside, WA 3l079
0wner
Jamie B. Kowalski
Assessed value
$165,410.65
Homestead exemption
$134.80
Tax rate
1.7786%
Taxing district  Amount
City of Testville
749.33
Library District
4,354.78
Park District
772.51
Community College 502
138.30
Total tax
$2,352.53
First installment due
07/26/2022
5econd installment duc
2022-04-01
If your taxes are paid through an cscrow account, forward this bill to yourmortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-62acab20ad0e73dc24e8dcbb,v11-PROPERTY_TAX_BILL-stacked,original,2022,fgen-f293d220655a2b529e4e6d88,synthetic_programmatic_template,stacked,top,True,installment_notice
"Property TaxPayment Receipt
Marion County Treasurer
Parcel number
24-54-252-34
Property location
133 Cedar Ln Pinecrest, GA 23808
Owner
Mateo A. Nguyen
Assessed value
$108,280.01
Homcstead exemption
$3,220.89
Tax rate
7.1913%
Taxing district  Amount
Communíty Co1lege 502
2,853.57
County General
2,967.33
City of Testville
1,921.7O
Park District
598.80
Total tax
$6,467.24
First installment due
03/16/2023
Second installment due
9/26/23
Amount paid
$3,233.62",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-e7ca61182bb11485d18dfa0b,v11-PROPERTY_TAX_BILL-stacked,original,2023,fgen-a1063091b24b126162e4c691,synthetic_programmatic_template,stacked,top,True,paid_receipt
"Lake County Collector
Parcel number
22-33-175-51
Property location
106 Lakeshore Blvd Testville, IL 34925
Owner
Noah A. Nguyen
Assessed value
$176,156.59
Homestead exemption
$3,555.36
Tax rate
8.7967%
Taxing district  Amount
Library District
1,497.96
City of Testville
4,779.97
County General
2,757.03
Park District
1,998.89
Total tax
$14,002.81
First installment due
11/07/2023
Second installment due
04/04/2023
Amount paid
$7,001.41
Property Tax Payment Receipt",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-b708fabd27b5be3cf33d8d10,v11-PROPERTY_TAX_BILL-stacked,original,2023,fgen-f1b2f095c0ccc0c45d2c78bb,synthetic_programmatic_template,stacked,bottom,False,paid_receipt
"Second Installment Property Tax Notice
Harbor County Treasurer
Parcel number
31-53-134-69
Property location
6497 Willow Bend Way Cedar Falls, IA 88544
Owner
Jordan Castillo
Assessed value
$68,486.26
Homestead exemption
$7,645.83
Tax rate
6.0833%
Taxing district  Amount
Library District
2,806.50
Park District
4,729.13
City of Testville
131.25
County General
600.48
Total tax
$14,649.03
First installment due
1/28/24
Second installment due
2024-06-22",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-82c8e7d1eacd1b2860dedb19,v11-PROPERTY_TAX_BILL-stacked,original,2024,fgen-f0464287105e4181aa60c1ec,synthetic_programmatic_template,stacked,top,False,installment_notice
"Lake County Collector
Parcel number
91-79-217-27
Property location
2751 Lakeshore Blvd Lakewood, CO 44491
Owner
Diego Larsen
Assessed value
$599,995.59
Homestead exemption
$9,806.05
Tax rate
2.2836%
Taxing district  Amount
Library District
461.42
Community College 502
159.70
City of Testville
1,990.78
County General
4,019.23
Total tax
$8,408.94
First installment due
2026-05-17
Second installment due
01/25/2026
Amount paid
$4,204.47
Property Tax Payment Receipt",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-0d36008fdf7bb6ee6d55e0ce,v11-PROPERTY_TAX_BILL-stacked,original,2026,fgen-341814c8023187a078ba88db,synthetic_programmatic_template,stacked,bottom,False,paid_receipt
"2021 Real Estate Property Tax Bíll
Cedar County TaxOffice
Parcel number
17-49-940-63
Property location
765 Lakeshore Blvd Cedar Falls, IA 70020
0wner
Riley Sato
Assessed value
$l46,769.3O
Homestead exemption
$2,63l.16
Tax rate
2.9107%
Taxing district  Amount
Community College 502
4,427.01
School District 204
3,525.53
Library District
3,735.31
County General
3,284.88
Total tax
$13,593.65
First insta1lment due
April 15, 2021
Second installment due
2021-07-09
If your taxesare paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-43342869b059fb3a6f1e5995,v11-PROPERTY_TAX_BILL-stacked,original,2021,fgen-f25133998f31c744a808ad84,synthetic_programmatic_template,stacked,top,True,annual_bill
"Second Installment Property Tax Notice
Lake County Collector
Parcel number
16-92-952-14
Property location
6970 Granite St Brookhaven, PA 79267
Owner
Diego L. Romero
Assessed value
$640,953.71
Homestead exemption
$2,852.88
Tax rate
9.0780%
Taxing district  Amount
School District 204
177.25
Park District
1,589.97
Community College 502
691.08
City of Testville
4,555.64
Total tax
$5,604.39
First installment due
11/02/2024
Second installment due
September 21, 2024
If your taxes are paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-a1bb60299d76fc0061cba71e,v11-PROPERTY_TAX_BILL-stacked,original,2024,fgen-903ffd8480aab480df4a9ac7,synthetic_programmatic_template,stacked,top,False,installment_notice
"Second Installment Property Tax Notice
Harbor County Treasurer
Parcel number
35-10-687-94
Property location
7070 Willow Bend Way Fairview, OH 67011
Owner
Amara L. Sato
Assessed value
$609,625.70
Homestead exemption
$2,660.71
Tax rate
3.3175%
Taxing district  Amount
County General
676.01
Community College 502
4,258.54
School District 204
3,599.36
Park District
1,802.54
Total tax
$5,381.96
First installment due
03/25/2021
Second installment due
01/24/2021",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-362b854e535393c942ee15aa,v11-PROPERTY_TAX_BILL-stacked,original,2021,fgen-29b6ae53d87d23a265aa0974,synthetic_programmatic_template,stacked,top,False,installment_notice
"2021 Real Estate Property Tax Bill
Lake County Collector
Parcel number
48-19-743-79
Property location
7717 Maple Ridge Dr Cedar Falls, IA 57629
Owner
Avery Patel
Assessed value
$584,362.26
Homestead exemption
$112.80
Tax rate
7.3523%
Taxing district  Amount
Park District
2,298.30
Library District
3,824.88
School District 204
3,903.86
County General
898.52
Total tax
$1,462.97
First installment due
May 14, 2021
Second installment due
6/26/21",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-441e45307633f86549f8127d,v11-PROPERTY_TAX_BILL-stacked,original,2021,fgen-e9f74345b1ee9bedcdd70d8e,synthetic_programmatic_template,stacked,top,False,annual_bill
"Harbor County Treasurer
Parcel number
17-40-834-29
Property location
2311 Harbor View Rd Bayside, WA 55674
Owner
Olivia Sato
Assessed value
$620,635.42
Homestead exemption
$9,790.14
Tax rate
4.1303%
Taxing district  Amount
Park District
3,788.21
Library District
506.10
School District 204
2,334.73
City of Testville
2,065.17
Total tax
$13,325.51
First installment due
2022-01-16
Second installment due
06/05/2022
Amount paid
$6,662.76",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-f48725e27266ba469b7d22b0,v11-PROPERTY_TAX_BILL-stacked,original,2022,fgen-87992993e4b57fb2137953b0,synthetic_programmatic_template,stacked,none,False,paid_receipt
"Cedar County Tax Office
Parcel number
84-23-735-50
Property location
4473 Sample Street Riverton, WI 59785
Owner
Priya Patel
Assessed value
$415,111.40
Homestead exemption
$4,862.77
Tax rate
6.2373%
Taxing district  Amount
Community College 502
2,595.27
County General
2,968.17
Library District
3,555.09
City of Testville
3,803.56
Total tax
$14,587.16
First installment due
11/19/2025
Second installment due
05/10/2025
Second Installment Property Tax Notice",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-6c060c98b52116aaa9bd8f65,v11-PROPERTY_TAX_BILL-stacked,original,2025,fgen-57d1aef61954e8ac0b1d7e02,synthetic_programmatic_template,stacked,bottom,False,installment_notice
"Lake County Collector
Parcel number
98-98-735-97
Property location
8388 Elm Park Pl Bayside, WA 36602
Owner
Sofia Haddad
Assessed value
$585,688.38
Homestead exemption
$9,276.75
Tax rate
7.5807%
Taxing district  Amount
Library District
1,084.97
County General
3,282.51
City of Testville
324.78
School District 204
2,189.53
Total tax
$9,826.49
First installment due
2026-03-04
Second installment due
05/08/2026
Amount paid
$4,913.24
If your taxes are paid through an escrow account, forward this bill to your mortgage company.
Property Tax Payment Receipt",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-3224672a6e38f1965f2d5513,v11-PROPERTY_TAX_BILL-stacked,original,2026,fgen-08bc7f332c8a8ec177bc6f20,synthetic_programmatic_template,stacked,bottom,False,paid_receipt
"Second Installment Property Tax Notice
Cedar County Tax Office
Parcel number
99-47-852-74
Property location
7862 Ccdar Ln Maplewood, MN 74764
Owner
Avery Romero
Assessed value
$29l,909.86
Homestead exemption
$5,566.19
Tax rate
4.2280%
Taxíng district  Amount
5chool District 204
2,098.92
Park District
4,545.21
CommunityCollege 502
938.72
City of Testville
222.18
Total tax
$5,289.57
First installment due
12/16/2023
5econd installment due
5/6/23",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-1eff1d23ba64dd31cde68f38,v11-PROPERTY_TAX_BILL-stacked,original,2023,fgen-bd2c3718117c310946c2450a,synthetic_programmatic_template,stacked,top,True,installment_notice
"2025 Real Estate Property Tax Bill
Harbor County Treasurer
Parcel number
47-36-894-65
Property location
734 Willow Bend Way Fairview, OH 13477
Owner
Alex J. Patel
Assessed value
$71,823.35
Homestead exemption
$6,021.36
Tax rate
3.3750%
Taxing district  Amount
School District 204
4,116.25
County General
3,017.80
Library District
4,569.79
City of Testville
1,870.87
Total tax
$3,534.56
First installment due
11/02/2025
Second installment due
12/01/2025
If your taxes are paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-5d521ecf1cb589962528a467,v11-PROPERTY_TAX_BILL-stacked,original,2025,fgen-b1e41c7583bdd1d4fcf241aa,synthetic_programmatic_template,stacked,top,False,annual_bill
"Marion County Treasurer
Parcel number
87-65-170-54
Property location
4773 Cedar Ln Riverton, WI 19412
Owner
Fatima S. Romero
Assessed value
$74,529.95
Homestead exemption
$4,443.45
Tax rate
1.5385%
Taxing district  Amount
Library District
3,652.93
City of Testville
2,847.67
Park District
4,197.94
School District 204
2,218.18
Total tax
$12,864.98
First installment due
05/05/2024
Second installment due
9/18/24",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-da1608a16645a40691b4b23a,v11-PROPERTY_TAX_BILL-stacked,original,2024,fgen-5a01444d3207bd1ef854af1f,synthetic_programmatic_template,stacked,none,False,installment_notice
"2024 Real Estate Property Tax Bill
Cedar County Tax Office
Parcelnumber
l4-29-825-85
Property location
3209 Cedar Ln Fairview, OH 92532
Owner
Mateo Líndqvist
Assessed value
$442,690.06
Homestcad exemption
$6,496.83
Tax rate
7.2977%
Taxingdistrict  Amount
County Gcneral
976.55
Community College 502
3,737.66
Library District
3,783.28
Park District
2,l57.10
Total tax
$3,235.92
First installment due
March 27, 2024
Second installment due
2024-09-02
If your taxes are paid through an cscrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-b759e80f1ef632da7e00b367,v11-PROPERTY_TAX_BILL-stacked,original,2024,fgen-81ee34c37805d07db97d2a3c,synthetic_programmatic_template,stacked,top,True,annual_bill
"Property Tax Payment Receipt
Harbor County Trcasurer
Parcel number
82-86-327-28
Property location
6799 Cedar Ln Pinecrest, GA 57l86
Owner
Sofia Patel
Assessed value
$405,402.59
Homestead exemption
$6,559.75
Tax rate
9.2367%
Taxing district  Amount
Park District
500.62
Community Co1lege 502
3,421.00
Library District
4,570.92
County General
2,729.96
Total tax
$10,091.46
First installment due
November 13, 2023
5econd installment due
2023-08-18
Amount paid
$5,045.73
If yourtaxes are paid through an escrow account, forward this bi1l to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-9577d503eff6d109477240cf,v11-PROPERTY_TAX_BILL-stacked,original,2023,fgen-f13d39e785bce789869476b6,synthetic_programmatic_template,stacked,top,True,paid_receipt
"Property Tax Payment Receipt
Cedar County Tax Office
Parcel number
18-67-272-46
Property location
3793 Lakeshore Blvd Testville, IL 72079
Owner
Jordan Kowalski
Assessed value
$555,594.92
Homestead exemption
$5,289.67
Tax rate
8.8348%
Taxing district  Amount
County General
4,234.79
City of Testville
3,185.24
Library District
2,571.73
Community College 502
4,203.38
Total tax
$15,533.79
First installment due
2023-03-03
Second installment due
10/6/23
Amount paid
$7,766.90
If your taxes are paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-ee81ec78a8152c61cfb22e1d,v11-PROPERTY_TAX_BILL-stacked,original,2023,fgen-f6da59c4e82ead7a530aa362,synthetic_programmatic_template,stacked,top,False,paid_receipt
"2021 Real Estate Property Tax Bill
Marion County Treasurer
Parce1 number
37-95-212-57
Property location
2896 Sample StreetBayside, WA 29143
0wner
Noah Testcase
Assessed value
$578,l23.82
Homestead exemption
$306.07
Tax rate
3.5413%
Taxing district  Amount
County General
4,905.91
5chool District 204
3,672.88
Park District
3,769.34
Community College 502
3,073.04
Total tax
$2,227.11
Fírst installment due
09/17/2021
Second installment due
July 16, 2021",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-3639754965ad9299c62d3402,v11-PROPERTY_TAX_BILL-stacked,original,2021,fgen-7a708c50563fb8d93f4f44b8,synthetic_programmatic_template,stacked,top,True,annual_bill
"Property Tax Payment Receipt
Lake County Co1lector
Parcel number
34-62-457-10
Property location
202 Granite St OakGrove, TX 59l97
Owner
Taylor E. Fischer
Assessed value
S315,416.27
Homestead exemption
$2,440.40
Tax rate
4.8434%
Taxing district  Amount
School District 204
4,690.36
County General
1,036.71
City of Testville
1,321.47
Library District
476.67
Total tax
$6,127.81
First installment duc
09/27/2022
Second insta1lment due
2022-12-18
Amount paid
$3,063.90",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-b827097fe362575738c2fe7a,v11-PROPERTY_TAX_BILL-stacked,original,2022,fgen-2c0b3e420a793be92ec06ecb,synthetic_programmatic_template,stacked,top,True,paid_receipt
"Lake County Collector
Parcel number
83-33-806-39
Property location
2995 Oak Hollow Ct Oak Grove, TX 90855
Owner
Avery Haddad
Assessed value
$95,208.58
Homestead exemption
$348.38
Tax rate
8.8322%
Taxing district  Amount
City of Testville
4,615.99
School District 204
4,289.43
Library District
4,419.94
County General
1,729.09
Total tax
$13,403.78
First installment due
6/2/25
Second installment due
April 4, 2025
Amount paid
$6,701.89
If your taxes are paid through an escrow account, forward this bill to your mortgage company.",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-97afc9eb8c45b7c2e9f23355,v11-PROPERTY_TAX_BILL-stacked,original,2025,fgen-2f45b1ba5628201f18f19a54,synthetic_programmatic_template,stacked,none,False,paid_receipt
"Lake CountyCollector
Parcel number
36-34-592-94
Property location
2566 Lakeshore Blvd Bayside, WA 81691
Owner
Lena Okafor
Assessed value
S349,094.00
Homestead exemptíon
$603.76
Tax rate
7.4711%
Taxing district  Amount
5chool District 204
1,726.14
County Gcneral
1,887.77
Community College 502
1,314.58
Library District
3,684.64
Total tax
$5,220.20
First installment due
February 16, 2024
Second installment due
8/5/24
Second Installmcnt Property Tax Notice",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-bb26d0b1867e31b366fe1870,v11-PROPERTY_TAX_BILL-stacked,original,2024,fgen-bc6bbaaceb273ee9ffb06150,synthetic_programmatic_template,stacked,bottom,True,installment_notice
"Second Installment Property Tax Notice
Harbor County Treasurer
Parcel number
74-40-773-50
Property location
7479 Sample Street Riverton, WI 36474
Owner
Morgan Okafor
Assessed value
$486,844.46
Homestead exemption
$1,433.53
Tax rate
5.3865%
Taxing district  Amount
Library District
1,345.05
County General
1,521.82
City of Testville
2,332.36
Community College 502
4,447.09
Total tax
$7,181.62
First installment due
02/28/2022
Second installment due
2022-12-05",PROPERTY_TAX_BILL,47,PROPERTY_TAX_BILL,fdc-9fbce7905b2f57020c81473a,v11-PROPERTY_TAX_BILL-stacked,original,2022,fgen-7686d135fcb395bb543ff93d,synthetic_programmatic_template,stacked,top,False,installment_notice
"1580 Cedar Ln Maplewood, MN 75646
06/20/2022 3:41 PM  Store 023
Item      Qty      Price
Monitor 27in      2      347.13
USB-C Cable  3  206.69
LED Bulbs 4pk 1 165.92
Subtotal  719.74
Sales tax   50.38
Total  770.12
Visa ending in 0875
Thank you for shopping! Returns within 30 days with receipt.
Cedar Office Supply",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-45673aa9e451a7b6ebea3e3c,v11-PURCHASE_RECEIPT-inline,original,2022,fgen-6ad26782a642318370015a30,synthetic_programmatic_template,inline,bottom,False,retail
"Cedar Office Supply
1418 Oak Hollow Ct Fairview, OH 47821
May 22, 2026 3:41 PM  Store 014
Item   Qty   Price
USB-C Cable 1 125.56
Drill Bit Set      2      292.51
Monitor 27in 1 152.37
Organic Apples  3  72.00
USB-C Cable      2      306.52
Subtotal  948.96
Sales tax 66.43
Total 1,015.39
Visa   ending in 5404
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-06fba6e081498017947f3c72,v11-PURCHASE_RECEIPT-inline,original,2026,fgen-0175c14a070e854be0fa0e8e,synthetic_programmatic_template,inline,top,False,retail
"1718 Elm Park Pl Riverton, WI94872
2026-0l-13 3:41 PM  Store 023
Item  Qty Price
USB-C Cable  3  333.94
Drill Bit Set 2 398.63
Organic Apples      2      11.51
Monitor 27in  3  209.98
Monitor 27in  1  259.99
5ubtotal   1,214.O5
Sales tax   84.98
Total   1,299.03
Visa XXX-XX-2972
Thank you for shopping! Returns within 3O days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-3a652546d14e6d2893767b9d,v11-PURCHASE_RECEIPT-inline,original,2026,fgen-7df0b3e6a17714d5ac353209,synthetic_programmatic_template,inline,none,True,retail
"Maple Market
1636 Elm Park Pl Fairview, OH 77666
April 21, 2021 3:41 PM  Store 065
Item  Qty  Price
USB-C Cable  3  277.88
Monitor 27in 2 245.31
Drill Bit Set 3 268.00
Monitor 27in 2 146.44
LED Bulbs 4pk 1 342.97
USB-C Cable 1 83.29
Subtotal   1,363.89
Sales tax 95.47
Total 1,459.36
Visa   ***-**-7283
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-656acffb9fb95c4e79603066,v11-PURCHASE_RECEIPT-inline,original,2021,fgen-215bb946b7c50948dff6f2a9,synthetic_programmatic_template,inline,top,False,retail
"9722 Sample Street Fairview, OH 17699
February 14, 2024 3:41 PM  Store 099
Item      Qty      Price
Drill Bit Set  3   263.68
Monitor 27in3 23.12
Subtotal 286.80
Sales tax      20.08
Total      306.88
Visa   ending in 5282
Thank you for shoppíng! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-267af36b03c1f9f2dda2d545,v11-PURCHASE_RECEIPT-inline,original,2024,fgen-445f1510149c18aa9c7c5551,synthetic_programmatic_template,inline,none,True,retail
"Harbor Hardware
9329 Oak Hollow Ct Maplewood, MN 52093
2026-06-23 3:41 PM  Store 050
Item  Qty  Price
LED Bulbs 4pk 2 97.89
Organic Apples 3 124.77
LED Bulbs 4pk  2  327.79
Subtotal  550.45
Sales tax   38.53
Total 588.98
Visa  ****2648
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-f95f0ae2e267ce88d747f02b,v11-PURCHASE_RECEIPT-inline,original,2026,fgen-06032ca5e6ae7b1421c6eb9e,synthetic_programmatic_template,inline,top,False,retail
"1712 Oak Hollow Ct Lakewood, CO 76949
October 24, 2022 3:41 PM  Store 095
Item Qty Price
Monitor 27in  1  221.73
Printer Paper 10pk      3      164.80
Printer Paper 10pk      1      272.97
Organic Apples      3      20.60
Drill Bit Set 3 30.78
Subtotal   710.88
Sales tax      49.76
Total      760.64
Visa ending in 6160
Thank you for shopping! Returns within 30 days with receipt.
Maple Market",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-6d15c5d8a6a1befc79de3ed6,v11-PURCHASE_RECEIPT-inline,original,2022,fgen-0fc42e66bbd15836e67b2d7a,synthetic_programmatic_template,inline,bottom,False,retail
"Northwind Electronícs
6816 Willow Bend Way Riverton, WI 52895
O9/08/2023 3:4l PM  Store 016
Item  Qty  Price
0rganic Apples 1 21.55
OrganicApples 3 240.53
Monitor 27in 1 263.34
Subtotal 525.42
Sales tax  36.78
Total  562.20
Visa      XXX-XX-5451
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-aa66576caa4b51bd98d5c29d,v11-PURCHASE_RECEIPT-inline,original,2023,fgen-79a5fe4eb11d2bf87201a0a4,synthetic_programmatic_template,inline,top,True,retail
"3798 Prairie Ave Brookhaven, PA 41546
2024-12-17 3:41 PM  Store 041
Item Qty Price
Drill Bit Set      1      121.59
USB-C Cable      1      137.23
USB-C Cable  3  176.53
USB-C Cable 1 384.12
USB-C Cable 1 246.61
Monitor 27in  2  90.05
Subtotal 1,156.13
Sales tax   80.93
Total 1,237.06
Visa   ****4152
Thank you for shopping! Returns within 30 days with receipt.
Cedar Office Supply",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-986cb69db8d5af34f6b011e1,v11-PURCHASE_RECEIPT-inline,original,2024,fgen-6f8bcd43147122424a680bba,synthetic_programmatic_template,inline,bottom,False,retail
"Harbor Hardware
2308 Cedar Ln Riverton, WI 77057
04/07/2025 3:41 PM  Store 041
Item Qty Price
Monitor 27in 2 390.59
Drill Bit Set   2   29.91
Printer Paper 10pk   3   181.60
Organic Apples   3   294.21
Monitor 27in 1 252.02
Monitor 27in  2  90.42
Subtotal      1,238.75
Sales tax      86.71
Total      1,325.46
Visa   XXX-XX-2209
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-206c7a31fef270828eebc937,v11-PURCHASE_RECEIPT-inline,original,2025,fgen-fb214bfdcdadf4eeb6bb0262,synthetic_programmatic_template,inline,top,False,retail
"7449 Granite St Maplewood, MN 87367
1/21/22 3:4l PM  Store 024
Item      Qty      Price
Drill Bit Set 3 241.65
Monitor 27in      3     367.34
LED Bulbs 4pk 2 101.63
Subtotal  710.62
Salestax 49.74
Total  760.36
Vísa XXX-XX-9653
Thank you for shopping! Rcturns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-861f225f8665c7fbce10d5e7,v11-PURCHASE_RECEIPT-inline,original,2022,fgen-7b6f96cd72dd4392c027bad0,synthetic_programmatic_template,inline,none,True,retail
"Maple Market
3679 Harbor View Rd Cedar Falls, IA 29338
09/27/2024 3:41 PM  Store 097
Item Qty Price
Drill Bit Set      3      125.98
Monitor 27in      2      146.49
Monitor 27in      1      324.28
Monitor 27in   1   393.83
Monitor 27in   3   249.10
Subtotal 1,239.68
Sales tax  86.78
Total 1,326.46
Visa XXXXX7276
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-f2a28adec7f6be4e63559a3d,v11-PURCHASE_RECEIPT-inline,original,2024,fgen-aff0be8a45c302aee1e6f9f2,synthetic_programmatic_template,inline,top,False,retail
"Harbor Hardware
2391 Oak Hollow Ct Brookhaven, PA 74842
2025-09-24 3:41 PM  Store 048
Item   Qty   Price
Monitor 27in      3      346.06
Printer Paper 10pk   2   221.45
Drill Bit Set  3  310.53
Organic Apples  2  81.82
USB-C Cable  1  314.95
Drill Bit Set  3  397.81
Subtotal   1,672.62
Sales tax      117.08
Total      1,789.70
Visa      ****7864
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-3884328542b95fd1e5d8fddf,v11-PURCHASE_RECEIPT-inline,original,2025,fgen-8e560086bdc989b866d2ac59,synthetic_programmatic_template,inline,top,False,retail
"Northwind Electronics
7843 Cedar Ln Pinecrest, GA 30728
5/24/24 3:41 PM  Store 048
Item   Qty   Price
Printer Paper 10pk  1  397.76
Printer Paper 10pk      3      14.73
USB-C Cable 1 141.07
Drill Bit Set   3   137.65
Printer Paper 10pk 2 43.87
Monitor 27in   2   89.67
Subtotal  824.75
Sales tax   57.73
Total 882.48
Visa ***-**-7026
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-52244bc14abe070845b4cfac,v11-PURCHASE_RECEIPT-inline,original,2024,fgen-18671bc687bb48a699d61714,synthetic_programmatic_template,inline,top,False,retail
"Harbor Hardware
9882 Granite St Testville, IL 98727
9/3/23 3:41 PM  Store 044
Item  Qty  Price
Monitor 27in 3 363.12
Printer Paper 10pk 1 3.62
LED Bulbs 4pk   3   48.11
Organic Apples 3 273.75
Subtotal  688.60
Sales tax      48.20
Total   736.80
Visa ***-**-1112
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-00b09271421bb03ad5077247,v11-PURCHASE_RECEIPT-inline,original,2023,fgen-503e08781b12475bb372bde4,synthetic_programmatic_template,inline,top,False,retail
"Harbor Hardware
4058 Lakeshore Blvd Riverton, WI 17176
2024-10-05 3:41 PM  Store 020
Item Qty Price
Organic Apples 1 216.87
LED Bulbs 4pk 3 196.33
Printer Paper 10pk 2 210.02
Organic Apples   3   180.39
Printer Paper 10pk   3   271.09
Organic Apples 2 49.08
Subtotal   1,123.78
Sales tax   78.66
Total   1,202.44
Visa   XXX-XX-8235
Thank you for shopping! Returns within 30 days with receipt.",PURCHASE_RECEIPT,33,PURCHASE_RECEIPT,fdc-41c85e620da4081b866e6165,v11-PURCHASE_RECEIPT-inline,original,2024,fgen-2f4db64eed1f09f79c5ce4b8,synthetic_programmatic_template,inline,top,False,retail
"Northstar Retirement Plan Services
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Maple Street Dental PC 401(k) Savings Plan
Priya Rivera
10/01/2022 - 10/30/2022
482,903.48
$21,701.33
$4,240.15
$7,632.23
2,099.57
$374,240.84
538,522.95
-7.7%
Investment
Allocation
Balance
Stable Value Fund
58%
109,094.40
Total Bond Index
34%
172,810.58
Target Retirement 2050 Fund
11%
187,178.55
IRS Form 1099-R information for 2022 will be mailed separately.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-f57f5125b5224ebecfcb5b3c,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2022,fgen-e72280e54a641fa3372c0a1b,synthetic_programmatic_template,columns,none,False,401k_quarterly
"Annual Benefit Statement
Summit Retirement Trust
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Granite Peak Manufacturing Co. 403(b) Plan
Amara Sato
05/01/2024 - 05/31/2024
291,291.00
6,099.38
3,845.51
3,303.35
50,902.79
$275,925.02
$225,644.89
-2.1%
Investment
Allocation
Balance
Stable Value Fund
60%
117,151.36
S&P 500 Index Fund
48%
129,674.18
Target Retirement 2050 Fund
55%
197,506.60",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-8f437d5c63a3427ab0445b35,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-83935cf3a0fda67afe4269c6,synthetic_programmatic_template,columns,top,False,403b_annual
"Retirement Account Statement
Clearwater 401(k) Administration
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Riverside Regional Hospital 401(k) Savings Plan
Hiro Moreau
01/01/2021 - 01/30/2021
$136,329.15
8,448.96
1,652.96
$2,311.01
-7,377.34
$511,628.88
259,474.65
-7.2%
Investment
Allocation
Balance
Total Bond Index
69%
97,446.61
Target Retirement 2050 Fund
31%
80,468.02
S&P 500 Index Fund
18%
144,766.05",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-bf1ebc352d99bdcc8b18c153,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2021,fgen-2240a2d69e084a4ff3ada194,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Rollover IRA Statement
Northstar Retirement Plan Services
Account
Statement period
2021 contributions
2020 contributions made in 2021
Account value
Required minimum distribution for 2021
XXX-XX-1583
11/01/2021 - 11/30/2021
$936.49
663.82
38,182.15
$2,503.37
Your 2021 Form 5498 will be available online by January 31, 2022.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-3670de6fd4186d5b7e1c192f,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2021,fgen-dedc0baabf162af23459dd1c,synthetic_programmatic_template,columns,top,False,ira_statement
"Summit Retirement Trust
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Maple Street Dental PC 401(k) Savings Plan
Olivia K. Tanaka
03/01/2021 - 03/28/2021
$48,495.26
16,875.40
343.38
8,348.93
-17,310.78
121,417.07
$499,584.82
12.4%
Investment
Allocation
Balance
Total Bond Index
39%
2,051.40
Target Retirement 2050 Fund
66%
164,849.77
S&P 500 Index Fund
5%
148,608.57
Retirement Account Statement",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-4486e93e4ecb1ae71a45b265,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2021,fgen-b2f9edb98e27ffb6ef2f3e2b,synthetic_programmatic_template,columns,bottom,False,401k_quarterly
"Rollover IRA Statement
Northstar Retirement Plan Services
Account
Statement period
2024 contributions
2023 contributions made in 2024
Account value
Required minimum distribution for 2024
***-**-5834
08/01/2024 - 08/30/2024
$6,677.34
6,790.14
$181,765.99
28,880.47",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-42bb60ed88c70e62a70acf73,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-f15cbbeec9a900dec526cc6f,synthetic_programmatic_template,columns,top,False,ira_statement
"Annual Benefit Statement
Summit Retirement Trust
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Copperline Software Inc. 403(b) Plan
Morgan Kowalski
12/01/2024 - 12/31/2024
$471,936.55
2,701.71
$516.47
7,022.80
22,136.39
212,625.39
$111,513.38
3.4%
Investment
Allocation
Balance
Total Bond Index
63%
38,544.04
S&P 500 Index Fund
78%
65,907.51
Stable Value Fund
21%
545.56
Tax reminder: amounts on this statement may differ from your Form 1099-R.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-cb18bcd4d569f81b00398500,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-1a0f43f51caa81bed43bc7e9,synthetic_programmatic_template,columns,top,False,403b_annual
"Traditional IRA Statement
Summit Retirement Trust
Account
Statement period
2024 contributions
2023 contributions made in 2024
Account value
Required minimum distribution for 2024
***-**-3550
06/01/2024 - 06/28/2024
$6,394.94
$4,855.13
293,306.17
Not applicable",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-7c72366cc5a90bebd66d15ad,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-b8402b0893c739897b2b6112,synthetic_programmatic_template,columns,top,False,ira_statement
"Retirement Account Statement
Summit Retirement Trust
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Granite Peak Manufacturing Co. 401(k) Savings Plan
Alex Adeyemi
10/01/2022 - 10/31/2022
31,612.16
22,541.20
$340.42
244.74
56,897.95
224,409.22
562,130.33
-0.2%
Investment
Allocation
Balance
Target Retirement 2050 Fund
54%
54,058.82
S&P 500 Index Fund
9%
54,585.71
Total Bond Index
42%
171,096.99",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-bdb67893d59c05f0a9628f42,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2022,fgen-5e99cf507da74f659db1c717,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Traditional IRA Statement
Clearwater 401(k) Administration
Account
Statement period
2022 contributions
2021 contributions made in 2022
Account value
Required minimum distribution for 2022
XXXXX7301
06/01/2022 - 06/30/2022
4,783.09
3,943.50
$176,053.48
22,879.10
IRS Form 5498 information for 2022 will be mailed separately.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-88ac344f4658bec14461493e,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2022,fgen-d750f5b37e27aa766d142d1a,synthetic_programmatic_template,columns,top,False,ira_statement
"Account
Account Type
Symbol
Quantity
Value
Contributions YTD
...9014
Roth IRA
VTI
211.53
144494.04
3548.05
...1787
Roth IRA
BND
17.06
187426.21
2519.87
...3490
Roth IRA
BND
300.81
100929.75
1447.47
...7364
Rollover IRA
VTI
216.13
151649.59
6490.23",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-afe6df8ceea96eded41c266c,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-9fb86cba138951fde78745ac,synthetic_programmatic_template,columns,top,False,raw_export
"Summit Retirement Trust
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Tri-County School District 403(b) Plan
Riley B. Kowalski
02/01/2024 - 02/28/2024
202,034.41
$15,017.18
4,586.27
$2,473.55
-7,413.62
86,676.04
411,923.78
10.6%
Investment
Allocation
Balance
Stable Value Fund
33%
17,704.53
S&P 500 Index Fund
9%
9,025.42
Total Bond Index
80%
187,710.29",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-26d1690f0b17fc0a5d9a24b8,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-e5395b60b10bee964df8cb17,synthetic_programmatic_template,columns,none,False,403b_annual
"Retirement Account Statement
Northstar Retirement Plan Services
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Copperline Software Inc. 401(k) Savings Plan
Noah Testcase
08/01/2025 - 08/28/2025
145,894.81
$10,128.58
190.23
3,984.98
43,875.54
$482,518.31
$353,939.47
11.9%
Investment
Allocation
Balance
S&P 500 Index Fund
69%
166,412.01
Stable Value Fund
46%
93,030.70
Total Bond Index
47%
186,340.73",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-70e087644c1b11a9f2f66f88,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2025,fgen-0c06def2b2b59a8cec24fe7a,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Roth IRA Statement
Clearwater 401(k)Admínístration
Account
Statement períod
2024 contributions
2023 contributions made in 2O24
Account va1ue
Required minimum distribution for 2024
***-**-6427
08/01/2024 - 08/31/2024
S3,097.02
3,453.82
418,074.83
Not applicable
Tax reminder: amounts on this statement may differ from your Form 5498.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-f73e8754652a5a6b94221b5c,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-1fdaa42c558ba0f636a1cf29,synthetic_programmatic_template,columns,top,True,ira_statement
"IRA ...7492 Positions
Downloaded 03/09/2023
Pay Date
Source
Investment
Amount
Units
Unit Price
2023-09-23
Profit Sharing
Target Retirement 2050
1251.52
7.69
285.36
21/09/2023
Profit Sharing
Target Retirement 2050
1452.29
58.31
219.75
19/09/2023
Employee Pre-Tax
Stable Value Fund
1202.66
23.11
52.14",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-c065de7a02c4302e4d7ec240,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2023,fgen-2c8ce7d7595346e394a1a72b,synthetic_programmatic_template,columns,top,False,raw_export
"Retirement Account Statement
Northstar Retirement Plan Services
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Granite Peak Manufacturing Co. 401(k) Savings Plan
Morgan Moreau
04/01/2025 - 04/31/2025
$125,113.88
$2,325.48
4,731.48
7,654.83
5,861.09
382,764.22
219,333.56
5.6%
Investment
Allocation
Balance
S&P 500 Index Fund
23%
16,691.55
Stable Value Fund
41%
185,924.74
Total Bond Index
55%
187,231.14",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-95fcc68c0d9b842b080a9b50,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2025,fgen-5d7a319b6b2441454048a695,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Retirement Account Statement
Northstar Retirement Plan Services
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Tri-County School District 401(k) Savings Plan
Priya B. Brennan
07/01/2023 - 07/30/2023
145,269.44
$4,281.43
$2,694.31
$3,241.29
51,021.11
330,852.82
$364,787.02
-7.3%
Investment
Allocation
Balance
S&P 500 Index Fund
14%
181,551.97
Stable Value Fund
20%
109,673.90
Total Bond Index
56%
84,697.66",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-d0b5c0c51448e41b077013b7,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2023,fgen-0af4fcb5a85b77caf510de1c,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Retirement Account Statement
Clearwater 401(k) Administration
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Tri-County School District 401(k) Savings Plan
Kwame Walsh
07/01/2021 - 07/30/2021
343,616.05
14,569.33
1,486.29
$4,474.01
56,520.04
204,246.95
$209,471.89
8.3%
Investment
Allocation
Balance
Target Retirement 2050 Fund
64%
42,816.28
S&P 500 Index Fund
40%
58,099.19
Total Bond Index
12%
105,576.98",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-7698c9977d2b1d28f0b8d0fc,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2021,fgen-8597150c99f7e4e3c66b61be,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Retirement Account Statement
Clearwater 401(k) Administration
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Copperline Software Inc. 401(k) Savings Plan
Alex Haddad
04/01/2021 - 04/31/2021
$287,521.90
$7,158.78
4,225.66
6,552.12
23,121.54
$284,197.70
442,421.97
18.5%
Investment
Allocation
Balance
Stable Value Fund
53%
126,696.65
Total Bond Index
41%
115,684.56
S&P 500 Index Fund
42%
83,113.12
Your 2021 Form 1099-R will be available online by January 31, 2022.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-90ed635c05be48e9c7a54679,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2021,fgen-b119d78fd3fb8cc7973b38c0,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Retirement Account Statement
Clearwater 401(k) Administration
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Acme Test Corp 401(k) Savings Plan
Sofia Moreau
03/01/2024 - 03/28/2024
$142,008.96
11,476.78
701.70
7,231.22
38,699.08
253,900.57
142,976.66
5.4%
Investment
Allocation
Balance
Stable Value Fund
56%
92,047.62
Target Retirement 2050 Fund
52%
2,283.19
Total Bond Index
32%
132,980.22
IRS Form 1099-R information for 2024 will be mailed separately.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-7ca1c793564278aa3a2d3b13,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-38722e9855fb1cf7d0adeac2,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Pay Date
Source
Investment
Amount
Units
Unit Price
20/03/2024
Roth 401(k)
Target Retirement 2050
122.93
36.99
131.80
27/07/2024
Rollover
Stable Value Fund
174.93
19.87
288.82
08/05/2024
Rollover
Target Retirement 2050
376.84
30.60
290.63
13/01/2024
Employee Pre-Tax
Target Retirement 2050
619.00
5.69
119.00
20/02/2024
Roth 401(k)
Large Cap Index
1153.05
10.33
142.43
2024-10-17
Roth 401(k)
Stable Value Fund
346.92
30.61
108.55
2024-10-23
Safe Harbor Match
Stable Value Fund
590.84
3.35
141.28
05/04/2024
Rollover
Stable Value Fund
1387.53
1.62
271.55
09/09/2024
Rollover
Stable Value Fund
947.49
5.56
233.89",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-d879c93c36c513511272e3e9,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-bfaaacd3dd663f59294347a9,synthetic_programmatic_template,columns,none,False,raw_export
"Clearwater 401(k) Administration
Account
Statement period
2024 contributions
2023 contributions made in 2024
Account value
Required minimum distribution for 2024
***-**-6250
06/01/2024 - 06/31/2024
3,633.68
5,175.02
$199,901.80
Not applicable
IRS Form 5498 information for 2024 will be mailed separately.
Traditional IRA Statement",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-10a42e84c2d5c1b1eaea7ce7,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-9214e58964bd5745cf631130,synthetic_programmatic_template,columns,bottom,False,ira_statement
"Annual Benefit Statement
Summit Retirement Trust
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Tri-County School District 403(b) Plan
Fatima L. Moreau
06/01/2024 - 06/31/2024
319,816.88
$14,404.55
$309.53
$729.27
40,359.14
348,149.64
$441,594.87
16.7%
Investment
Allocation
Balance
S&P 500 Index Fund
35%
141,783.70
Target Retirement 2050 Fund
10%
61,137.05
Total Bond Index
11%
127,292.52
Tax reminder: amounts on this statement may differ from your Form 1099-R.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-b1b1e301a48c46316a99100d,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-05e6b8798a6cf0ed5317cdd3,synthetic_programmatic_template,columns,top,False,403b_annual
"Rollover IRA Statement
Evergreen Retirement Services
Account
Statement period
2021 contributions
2020 contributions made in 2021
Account value
Required minimum distribution for 2021
XXX-XX-6097
10/01/2021 - 10/30/2021
2,819.55
$3,709.57
$418,507.67
$21,952.96
This statement is not a Form 5498. Keep it for your records.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-b13c2979048280e07a19ac86,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2021,fgen-04611a7f9b4172db9b6e699b,synthetic_programmatic_template,columns,top,False,ira_statement
"Pay Date
Source
Investment
Amount
Units
Unit Price
06/15/2024
Roth 401(k)
Stable Value Fund
1014.49
18.17
98.09
06/02/2024
Roth 401(k)
Stable Value Fund
1106.23
40.10
254.93
2024-11-10
Profít Sharing
Large Cap Index
958.42
50.63
137.53
11/21/2024
Profit Sharing
Target Retirement2050
451.22
41.83
18.68
2O24-11-02
Profit Sharing
Large Cap Index
1402.11
10.44
145.18
2024-05-14
Roth 401(k)
Large Cap Index
110.90
58.06
66.68
2024-09-22
Roth 40l(k)
Stab1e Value Fund
1218.88
7.85
238.09
24/05/2024
Ro1lover
Target Retírement 2050
1004.86
17.94
251.70
03/26/2024
Profit Sharing
Large Cap Index
1468.18
26.32
149.39",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-ed3fe028fa360b694816e367,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-7566a5657a26f6d47d56c796,synthetic_programmatic_template,columns,bottom,True,raw_export
"Traditional IRA Statement
Northstar Retirement Plan Services
Account
Statement period
2021 contributions
2020 contributions made in 2021
Account value
Required minimum distribution for 2021
XXXXX4490
12/01/2021 - 12/30/2021
3,124.55
5,354.52
$545,852.76
5,731.93",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-cf8b46dfcec515f8817b4875,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2021,fgen-15b6edaad8396b79b0bb07e6,synthetic_programmatic_template,columns,top,False,ira_statement
"Retirement Account Statement
Clearwater 401(k) Administration
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Tri-County School District 401(k) Savings Plan
Kwame Adeyemi
03/01/2024 - 03/31/2024
42,511.86
6,900.78
3,890.51
5,289.03
25,939.35
318,498.64
$564,774.20
8.7%
Investment
Allocation
Balance
Total Bond Index
64%
42,819.64
Stable Value Fund
13%
150,238.68
S&P 500 Index Fund
49%
125,095.80",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-076c572361d17a495152b88b,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2024,fgen-767f2f7615bc53c5d73a2d68,synthetic_programmatic_template,columns,top,False,401k_quarterly
"Roth IRA Statement
Evergreen Retirement Services
Account
Statement period
2022 contributions
2021 contributions made in 2022
Account value
Required minimum distribution for 2022
XXXXX0945
04/01/2022 - 04/31/2022
3,753.22
$217.04
$562,181.93
13,184.34",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-75631172cc5cac2b44aacbaa,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2022,fgen-b970f085e92865872c888510,synthetic_programmatic_template,columns,top,False,ira_statement
"Northstar Retirement Plan Services
Account
Statement period
2026 contributions
2025 contributions made in 2026
Account value
Required minimum distribution for 2026
ending in 8273
08/01/2026 - 08/30/2026
$1,373.79
663.58
59,807.36
1,641.55
IRS Form 5498 information for 2026 will be mailed separately.
Roth IRA Statement",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-9488f5ad4b568905d75c9e24,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2026,fgen-8656eafe9541be383484d7f0,synthetic_programmatic_template,columns,bottom,False,ira_statement
"Rollover IRA Statement
Clearwater 401(k) Administration
Account
Statement period
2026 contributions
2025 contributions made in 2026
Account value
Required minimum distribution for 2026
XXX-XX-7868
08/01/2026 - 08/31/2026
5,113.77
5,197.83
378,676.28
$15,121.11",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-978606363d23ad62035f6f1b,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2026,fgen-bab3947eb137be903e68f345,synthetic_programmatic_template,columns,top,False,ira_statement
"Rollover IRA Statement
Clearwater 401(k) Administration
Account
Statement period
2026 contributions
2025contributíons made in 2026
Account value
Required minimum distribution for 2026
****3921
06/01/2026 - 06/31/2026
$3,125.27
1,991.43
531,873.03
$28,496.09
IRS Form 5498 information for 2026 wíll bc mailed separately.",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-f95c520519c65e43dfba9e38,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2026,fgen-c9f372ede2d9d39c4aee2462,synthetic_programmatic_template,columns,top,True,ira_statement
"Annual Benefit Statement
Northstar Retirement Plan Services
Plan
Participant
Statement period
Beginning balance
Employee contributions (pre-tax)
Roth contributions
Employer match
Investment gain/loss
Ending balance
Vested balance
Personal rate of return
Maple Street Dental PC 403(b) Plan
Noah Castillo
06/01/2026 - 06/30/2026
$233,674.84
$22,011.35
$2,477.59
$2,829.23
18,556.64
373,906.16
$61,839.51
4.8%
Investment
Allocation
Balance
Stable Value Fund
35%
185,642.10
S&P 500 Index Fund
66%
71,524.83
Target Retirement 2050 Fund
8%
116,121.66",INVESTMENT_STATEMENT,43,INVESTMENT_STATEMENT,fdc-29cba430ddd70c337345e70e,v11-RETIREMENT_ACCOUNT_STATEMENT-columns,original,2026,fgen-94765a018231bd30e9fffd9f,synthetic_programmatic_template,columns,top,False,403b_annual
"CORRECTED (if checked)
2023
OMB No. 1545-0074
Name of proprietor: Olivia Lindqvist
Social security number (SSN): 80 Elm Park Pl Cedar Falls, IA 67845
A Principal business or profession, including product or service: ***-**-7789
C Business name. If no separate business name, leave blank.
1 Gross receipts or sales: 82,341.05
7 Gross income: 89,279.34
8 Advertising: 7,796.27
9 Car and truck expenses: 7,261.18
18 Office expense: 6,664.35
28 Total expenses before expenses for business use of home: $49,542.16
31 Net profit or (loss): -543.83
Department of the Treasury - Internal Revenue Service
SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForm1040",SCHEDULE,34,SCHEDULE,fdc-a1926f293b61f96b438db78b,v11-SCHEDULE-C-boxed,original,2023,fgen-69956b7ab3ba5c34b76f0512,synthetic_programmatic_template,boxed,bottom,False,
"SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
2026
Department of the Treasury Internal Revenue Service
Name of proprietor: Priya L. Okafor
Social security number (SSN): 5671 Lakeshore Blvd Bayside, WA 81644
A Principal business or profession, including product or service: ***-**-9277
C Business name. If no separate business name, leave blank.
Line 1 Gross receipts or sales: $117,715.04
Line 7 Gross income: $99,615.87
Line 8 Advertising: $8,095.09
Line 9 Car and truck expenses: 3,070.27
Line 28 Total expenses before expenses for business use of home: 48,463.79
Line 31 Net profit or (loss): (7,607.61)
Department of the Treasury - Internal Revenue Service
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForm1040",SCHEDULE,34,SCHEDULE,fdc-d8bd46430c134d89b3e035b8,v11-SCHEDULE-C-boxed,original,2026,fgen-69a670c61f60b5d931274666,synthetic_programmatic_template,boxed,top,False,
"SCHEDULE C (Form 1040) Profit or Loss From Business (Sole Proprietorship)
Name:: Jordan Walsh
Line 1 Gross receipts or sales: $139,597.98
Line 31 Net profit or (loss): 11,001.88
Line 18 Office expense: 8,408.69
Line 28 Total expenses before expenses for business use of home: 114,539.00",SCHEDULE,34,SCHEDULE,fdc-aaa8aebae472fc05fed85204,v11-SCHEDULE-C-boxed,original,2021,fgen-df5b05990af5db6995d674af,synthetic_programmatic_template,boxed,top,False,
"SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
OMB No. 1545-0074
Name of proprietor: Fatima Sato
Social security number (SSN): 3487 Cedar Ln Maplewood, MN 97207
A Principal business or profession, including product or service: XXXXX6914
C Business name. If no separate business name, leave blank.
Box 8 Advertising: 5,396.41
Box 9 Car and truck expenses: $9,296.57
Box 18 Office expense: $3,375.39
Box 28 Total expenses before expenses for business use of home: 66,375.56
Department of the Treasury - Internal Revenue Service
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForm1040",SCHEDULE,34,SCHEDULE,fdc-6f8067e74680ebb177755c2e,v11-SCHEDULE-C-boxed,original,2024,fgen-7e2116accc6655da59d180d1,synthetic_programmatic_template,boxed,top,False,
"☐ CORRECTED
2022
Department of the Treasury Internal Revenue Service
Name of proprietor: Morgan Brennan
Social security number (SSN): 1473 Prairie Ave Oak Grove, TX 73469
A Principal business or profession, including product or service: ****1972
C Business name. If no separate business name, leave blank.
1 Gross receipts or sales: 75,313.66
7 Gross income: 89,493.10
8 Advertising: 3,754.77
9 Car and truck expenses: $2,288.30
18 Office expense: $4,550.60
SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)",SCHEDULE,34,SCHEDULE,fdc-f2af5c292b22522289b5ad45,v11-SCHEDULE-C-boxed,original,2022,fgen-ae73b08cac42a2929625465f,synthetic_programmatic_template,boxed,bottom,False,
"SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
2025
Name of proprietor: Jamie Moreau
Social security number (SSN): 599 Willow Bend Way Fairview, OH 62154
A Principal business or profession, including product or service: XXXXX9887
C Business name. If no separate business name, leave blank.
Box 7 Gross income: 14,467.97
Box 8 Advertising: 975.39
Box 9 Car and truck expenses: 8,467.81
Box 28 Total expenses before expenses for business use of home: $46,250.58",SCHEDULE,34,SCHEDULE,fdc-2bcad64d3b60d2b3b36c3db7,v11-SCHEDULE-C-boxed,original,2025,fgen-2a60de4edf31603f3ed40308,synthetic_programmatic_template,boxed,top,False,
"☐ CORRECTED
SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
2022
OMB No. 1545-0074
Attach to Form 1040, 1040-SR, 1040-SS, 1040-NR, or 1041; partnerships must generally file Form 1065.
Name of proprietor: Mateo Okafor
Social security number (SSN): 7562 Lakeshore Blvd Pinecrest, GA 46226
A Principal business or profession, including product or service: XXX-XX-4701
C Business name. If no separate business name, leave blank.
Box 1 Gross receipts or sales: 119,039.83
Box 7 Gross income: 120,315.70
Box 8 Advertising: 6,698.35
Box 9 Car and truck expenses: 4,690.72
Box 18 Office expense: $2,824.05
Box 28 Total expenses before expenses for business use of home: 95,703.57
Box 31 Net profit or (loss): 18,841.53
Department of the Treasury - Internal Revenue Service
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForm1040",SCHEDULE,34,SCHEDULE,fdc-ed16b07f9d12808424d616a7,v11-SCHEDULE-C-boxed,original,2022,fgen-2e5b9f58923a4e127754272d,synthetic_programmatic_template,boxed,top,False,
"SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
2022
Nameof proprietor: Hiro S. Patel
Social security number (SSN): 7487 Maple Ridge Dr Testville, IL 55574
A Principal businessor profession, including product or service: XXX-XX-3014
C Business name. If no separate business name, lcave blank.
1 Gross receipts or sales: $43,059.84
7 Grossincome: $120,540.42
8 Advertising: 5,609.73
9 Car and truck expenses: l,490.10
18 0fficc expense: 5,411.32
28 Total expenses before expenses for business use of home: 11,522.53
31 Net profit or (loss): -5,162.90
Department of the Treasury - Intemal Revenue 5ervíce
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForml040",SCHEDULE,34,SCHEDULE,fdc-6aa233d7ec3ba37974a60c4e,v11-SCHEDULE-C-boxed,original,2022,fgen-b0d75e4a47f1bf5ed3c9de6b,synthetic_programmatic_template,boxed,top,True,
"SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
For calendar year 2023
OMB No. 1545-0074
Attach to Form 1040, 1040-SR, 1040-SS, 1040-NR, or 1041; partnerships must generally file Form 1065.
Department of the Treasury Internal Revenue Service
Name of proprietor: Sofia Larsen
Social security number (SSN): 3499 Lakeshore Blvd Maplewood, MN 26111
A Principal business or profession, including product or service: ending in 4055
C Business name. If no separate business name, leave blank.
Box 8 Advertising: $4,384.42
Box 9 Car and truck expenses: $8,861.72
Box 18 Office expense: 428.60
Box 28 Total expenses before expenses for business use of home: 3,497.30
Department of the Treasury - Internal Revenue Service
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForm1040",SCHEDULE,34,SCHEDULE,fdc-250f893fe4b6a84f5b1bfa57,v11-SCHEDULE-C-boxed,original,2023,fgen-e48be145014b9e624aff38b6,synthetic_programmatic_template,boxed,top,False,
"SCHEDULE C (Form 1040) Profit or Loss From Business (Sole Proprietorship) 2024
Name:: Noah Sato
Box 28 Total expenses before expenses for business use of home: $885.24",SCHEDULE,34,SCHEDULE,fdc-b4affdff93adeac95a7e5739,v11-SCHEDULE-C-boxed,original,2024,fgen-fae3e9a0a64f8df5da8788b0,synthetic_programmatic_template,boxed,top,False,
"CORRECTED (if checked)
SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
2025
OMB No. 1545-0074
Attach to Form 1040, 1040-SR, 1040-SS, 1040-NR, or 1041; partnerships must generally file Form 1065.
Name of proprietor: Jordan Brennan
Social security number (SSN): 8427 Granite St Riverton, WI 71754
A Principal business or profession, including product or service: ****8973
C Business name. If no separate business name, leave blank.
Line 1 Gross receipts or sales: 71,118.43
Line 7 Gross income: 76,171.04
Line 9 Car and truck expenses: 4,149.10
Line 18 Office expense: 5,676.38
Line 28 Total expenses before expenses for business use of home: 6,057.84
Department of the Treasury - Internal Revenue Service
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForm1040",SCHEDULE,34,SCHEDULE,fdc-90f8aaaf831b16154f9d4ed5,v11-SCHEDULE-C-boxed,original,2025,fgen-7669a5487bef40a3741ccb3c,synthetic_programmatic_template,boxed,top,False,
"CORRECTED (if checked)
SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
2022
Attach to Form 1040, 1040-SR, 1040-SS, 1040-NR, or 1041;partnerships must generally file Form 1065.
Department of the Treasury Intemal Revenue Service
Name ofproprictor: Jamie Castillo
Social security number (SSN): 3605 Wí1low Bend Way Maplewood, MN 95578
A Principal business or profession, including product or service: ***-**-4465
C Business name. If no separate business name, leave blank.
1 Gross receipts or sales: 45,103.97
7 Gross income: $64,997.72
8 Advertising: 2,488.49
9 Car and truck expenses: $9,326.44
18 Office expense: 6,124.41
28 Tota1expenses before expenses for business use of home: $67,794.33
3l Net profit or (1oss): 4,366.41",SCHEDULE,34,SCHEDULE,fdc-918315db36daa94b03659034,v11-SCHEDULE-C-boxed,original,2022,fgen-af6f39964b23ee865df9bf68,synthetic_programmatic_template,boxed,top,True,
"☐ CORRECTED
SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
For calendar year 2026
OMB No. 1545-0074
Department of the Treasury Internal Revenue Service
Name of proprietor: Lena Rivera
Social security number (SSN): 8029 Maple Ridge Dr Pinecrest, GA 60631
A Principal business or profession, including product or service: ****4435
C Business name. If no separate business name, leave blank.
Box 1 Gross receipts or sales: $53,162.56
Box 7 Gross income: 77,611.39
Box 8 Advertising: $9,191.96
Box 9 Car and truck expenses: 6,033.11
Box 18 Office expense: 8,133.41
Box 28 Total expenses before expenses for business use of home: 137,062.00
Box 31 Net profit or (loss): 21,216.86",SCHEDULE,34,SCHEDULE,fdc-94f7852f2122374c4be6ad81,v11-SCHEDULE-C-boxed,original,2026,fgen-6997cac20ae3e161f58992c6,synthetic_programmatic_template,boxed,top,False,
"SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
OMB No. 1545-0074
Department of the Treasury Internal Revenue Service
Name of proprietor: Wei Romero
Social security number (SSN): 3999 Lakeshore Blvd Bayside, WA 74644
A Principal business or profession, including product or service: XXXXX6340
C Business name. If no separate business name, leave blank.
1 Gross receipts or sales: 114,379.59
7 Gross income: $107,082.06
8 Advertising: 6,938.26
9 Car and truck expenses: 9,056.69
18 Office expense: 8,050.74
28 Total expenses before expenses for business use of home: $110,714.52
Department of the Treasury - Internal Revenue Service
Form C (Form 1040) (keep for your records)  www.irs.gov/FormSCHEDULECForm1040",SCHEDULE,34,SCHEDULE,fdc-d8f702e11db328fce8edf0ef,v11-SCHEDULE-C-boxed,original,2026,fgen-decbaab50e3f7e5fb999d9ca,synthetic_programmatic_template,boxed,top,False,
"OMB No. 1545-0074
Attach to Form 1040, 1040-SR, 1040-SS, 1040-NR, or 1041; partnerships must generally file Form 1065.
Department of the Treasury Internal Revenue Service
Name of proprietor: Morgan Patel
Social security number (SSN): 2408 Elm Park Pl Riverton, WI 15865
A Principal business or profession, including product or service: ***-**-8105
C Business name. If no separate business name, leave blank.
Box 1 Gross receipts or sales: $62,869.27
Box 7 Gross income: 41,821.81
Box 8 Advertising: 6,723.42
Box 9 Car and truck expenses: 142.17
Box 18 Office expense: 1,371.48
Box 28 Total expenses before expenses for business use of home: 85,022.85
Box 31 Net profit or (loss): 25,053.55",SCHEDULE,34,SCHEDULE,fdc-3893b16aa9d2856f0b98a6fa,v11-SCHEDULE-C-boxed,original,2023,fgen-4086597f766895b72cc2ab0a,synthetic_programmatic_template,boxed,none,False,
"SCHEDULE C (Form 1040)
Profit or Loss From Business (Sole Proprietorship)
For calendar year 2021
Attach to Form 1040, 1040-SR, 1040-SS, l040-NR, or 1041; partncrshíps must generally file Form 1065.
Namc of proprietor: Amara Lindqvist
5ocial security number (SSN): 8004 Cedar Ln Brookhaven, PA 61623
A Principal business or profession, induding product or service: ending in 0759
C Business name. If no separate business name, 1eave blank.
Line 8 Advertising: $4,062.59
Line 9Car and truck expenses: 6,226.78
Line18 Office expense: 5,078.02
Line 31Net profit or (loss): (5,189.26)",SCHEDULE,34,SCHEDULE,fdc-87b23925d92b404201c0bd20,v11-SCHEDULE-C-boxed,original,2021,fgen-2f5c31cab0c220b0e4f30a7a,synthetic_programmatic_template,boxed,top,True,
"2023 OMB No. 1545-0074 (From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.) Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Name(s) shown on return Morgan Walsh Your social security number 2613 Sample Street Fairview, OH 80389 Part I Income or Loss From Rental Real Estate and Royalties ****5791 1a Physical address of each property 1b Type of Property (from list below) 359 2 Fair Rental Days / Personal Use Days 516 3 Rents received 71,466.73
9 Insurance $5,428.94 12 Mortgage interest paid to banks, etc. $1,822.72 16 Taxes $8,467.10 18 Depreciation expense or depletion 1,051.66 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties) -688.99 26 Total rental
real estate and royalty income or (loss) 4,576.54 Department of the Treasury - Internal Revenue Service SCHEDULE E (Form 1040) Supplemental Income and Loss Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-9129d2131c1c6c6ffab53d73,v11-SCHEDULE-E-flat,original,2023,fgen-ba83ab29bea789fa37b8f9d9,synthetic_programmatic_template,flat,bottom,False,
"☐ CORRECTED SCHEDULE E (Form 1040) Supplemental Income and Loss For calendar year 2021 Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Name(s) shown on return Wei B. Tanaka Your social security number 6161 Maple Ridge Dr Pinecrest,
GA 62647 Part I Income or Loss From Rental Real Estate and Royalties XXX-XX-3880 1a Physical address of each property 1b Type of Property (from list below) 382 2
Fair Rental Days / Personal Use Days 143 3 Rents received $75,302.02 9 Insurance $6,247.67 16 Taxes 7,213.17 18 Depreciation expense or depletion $6,166.55 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties) 21,958.20 26 Total rental real estate and royalty income or (loss) 15,851.95 Department of the Treasury - Internal Revenue Service Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-3f189f936eea9d3b790dd8b6,v11-SCHEDULE-E-flat,original,2021,fgen-b54e72d20b4d3f82ae8d08c8,synthetic_programmatic_template,flat,top,False,
"CORRECTED (if checked) SCHEDULE E (Form 1040) Supp1emental Income and Loss For calendar year 2025 OMB No. 1545-0074 (From rcntal real estate, royalties, partnerships,S corporations, estates, trusts, REMICs, etc.) Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Name(s) shown on return Casey Romero Yoursocia1security number 9548 Sample Street Cedar Falls, IA 92059 Part I Income or Loss From Rental Real Estate and Royalties ****3509 1a Physical address of each propertylb Type of Property (from list below) 753 2 Fair Rental Days / Personal Use Days 6763
Rents receíved 100,367.04 9 Insurance l,429.87 12 Mortgage interest paid to banks, etc. 923.07 16 Taxes $9,463.18 18
Depreciation expense or depletion $1,376.51 2l Subtract line 20 from line 3 (rents) and/or 4 (royalties) 21,485.78 26 Tota1 rental real estate and royalty income or (loss) 28,448.72",SCHEDULE,34,SCHEDULE,fdc-18c26d893bde6716bf767af8,v11-SCHEDULE-E-flat,original,2025,fgen-5a45815311c86591ae5c9f17,synthetic_programmatic_template,flat,top,True,
"☐ CORRECTED For calendar year 2021 Name(s) shown on return Jordan Walsh Your social security number 6893 Cedar
Ln Lakewood, CO 96347 Part I Income or Loss From Rental Real Estate and Royalties ending in 1233
1a Physical address of each property 1b Type of Property (from list below) 628 3 Rents received $68,648.20 9 Insurance $8,660.56 12 Mortgage interest paid to banks, etc. 5,420.43 16 Taxes 5,846.09 26 Total rental real estate and royalty income or (loss) 12,958.42 Department of the Treasury - Internal Revenue Service SCHEDULE E (Form 1040) Supplemental Income and Loss Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-de07db57ff89b1c6048d2482,v11-SCHEDULE-E-flat,original,2021,fgen-6bfc75c20d20b63654dd00a2,synthetic_programmatic_template,flat,bottom,False,
"SCHEDULE E (Form 1040) Supplemental Income and Loss 2022 Name: Hiro Rivera 18
Depreciation expenseor depletion
8,583.44",SCHEDULE,34,SCHEDULE,fdc-84e7b6497ae5400dee54b93f,v11-SCHEDULE-E-flat,original,2022,fgen-504aae88cb3d2ad19a3a9c99,synthetic_programmatic_template,flat,top,True,
"SCHEDULE E (Form 1040) Supplemental Income and Loss (From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.) Name(s) shown on return Jamie Romero Your social security number 3500 Cedar Ln Bayside, WA 36550 Part I Income or Loss From Rental Real Estate and Royalties ending in
0559 1a Physical address of each property 1b Type of Property (from list
below) 646 2 Fair Rental Days / Personal Use Days 906 3 Rents received 50,244.78 9 Insurance 6,504.47 12 Mortgage interest paid to banks, etc. $8,533.18 16 Taxes $2,688.78 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties) 21,977.69",SCHEDULE,34,SCHEDULE,fdc-a7c79ea777fededfa30a5434,v11-SCHEDULE-E-flat,original,2023,fgen-91308a4f4f235cafe4c67aa0,synthetic_programmatic_template,flat,top,False,
"CORRECTED (if checked) SCHEDULE E (Form 1040) Supplemental
Income and Loss For calendar year 2026 OMB No. l545-0074 (From
rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.) Attach to Form l040, 1040-SR, 1040-NR,or 1041. Name(s) shown on retum Mateo Walsh Your social security number 8547 Cedar Ln Cedar Falls, IA 92159 Part I Income or Loss From Rental Real Estate and Royalties ****7939 1a Physical addressof each property 1b Type of Property (from list below) 74 2 Fair Rental Days / Personal Use Days 677 3 Rents received 50,0l9.16 9 Insurance 8,790.11 12 Mortgage interest paid to banks, etc. $1,712.2416 Taxcs $1,073.91 21 5ubtract line20 from line 3 (rents) and/or 4 (royalties) l1,144.3926 Total rental real estate and royalty income or (loss) -5,368.74",SCHEDULE,34,SCHEDULE,fdc-d5cb593361168d6455702cd5,v11-SCHEDULE-E-flat,original,2026,fgen-90045ca3f2b418ea96f98e68,synthetic_programmatic_template,flat,top,True,
"SCHEDULE E (Form 1040) Supplemental Income and Loss 2021
(From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.) Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Name(s) shown on return Wei Walsh Your social security number 1040 Granite St Cedar Falls, IA 37752 Part I Income or Loss From Rental Real Estate and Royalties ****9302 1a Physical address of each property 2 Fair Rental Days
/ Personal Use Days 351 3 Rents received $84,832.22 9 Insurance 1,294.11 12 Mortgage interest paid to banks, etc. 4,406.71 16 Taxes 1,914.27 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties) 15,266.30 26 Total rental real estate and royalty income or (loss) 8,443.91 Department of the Treasury - Internal Revenue Service Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-e3930ee7184acff8dc219475,v11-SCHEDULE-E-flat,original,2021,fgen-38e89820b2256926d0362aa6,synthetic_programmatic_template,flat,top,False,
"SCHEDULE E (Form
1040) Supplemental Income and Loss
Name:Fatima B. Kowalski 16 Taxes S3,456.55 26 Total rental real estate and royalty income or (loss) (3,948.72)",SCHEDULE,34,SCHEDULE,fdc-2893b7651f88003926b7fa9c,v11-SCHEDULE-E-flat,original,2021,fgen-93ee34ac25f9ea756dd9324c,synthetic_programmatic_template,flat,top,True,
"SCHEDULE E (Form 1040) Supplemental Income and Loss 2022 OMB No. 1545-0074 (From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.) Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Name(s) shown on return Hiro J. Patel Your social security number
7198 Maple Ridge Dr Cedar Falls, IA 22459 Part I Income or Loss From Rental Real Estate and Royalties ****3209 1a Physical address of each property 1b Type of Property (from list below) 221 2 Fair Rental Days / Personal Use Days 927 3 Rents received 76,593.38 9 Insurance $1,136.11 12 Mortgage interest paid to banks, etc. 6,315.61
16 Taxes $7,150.45 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties) 10,566.49 26 Total rental real estate and royalty income or (loss) 11,387.44 Department of the Treasury - Internal Revenue Service Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-fec6ce0a8e59373397459442,v11-SCHEDULE-E-flat,original,2022,fgen-a607a1eb876c12b345a94d24,synthetic_programmatic_template,flat,top,False,
"☐ CORRECTED SCHEDULE E (Form 1040) Supplemental Income and Loss 2O22 OMB No. 1545-0074 Attach to Form 1040, 1040-SR, 1040-NR,or l041. Name(s)
shown on return Jordan Líndqvist Your social security number 3654 Lakeshore Blvd 0ak Grove, TX 40789 Part I Income or Loss From Rental Real Estate and Royalties ending in 8981 1a Physica1 address of each property 1b Type of Property (from listbelow) 974 2Fair Rental Days / Personal Use Days 437 3 Rents receíved 132,654.59 12 Mortgage interest paid to banks, etc. 6,653.51 16 Taxes 749.74 18 Depreciation
expense or depletion S1,335.20 26 Total rental real estate and royalty income or (loss) 9,726.77Department of the Treasury - Intemal Revenue 5ervice Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm104O",SCHEDULE,34,SCHEDULE,fdc-463c50152ee871beddc65a6a,v11-SCHEDULE-E-flat,original,2022,fgen-d92d400ae4b8911f6fd3b4f1,synthetic_programmatic_template,flat,top,True,
"VOID CORRECTED SCHEDULE E (Form 1040) Supplemental Income and Loss 2025 Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Name(s) shown on return Sofia Haddad Your social security number 404 Cedar Ln Bayside, WA 17649 Part I Income or Loss From Rental Real Estate and Royalties ***-**-4410 1a Physical address of each property 1b Type of Property (from list below) 89 2 Fair Rental Days /
Personal Use Days 604 3 Rents received $75,196.95 9 Insurance 6,042.95 18 Depreciation expense or depletion 9,112.94 21 Subtract line 20 from line 3 (rents) and/or 4 (royalties) 25,416.58 Department of the Treasury
- Internal Revenue Service Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-c72f58ebeac3420711b18b50,v11-SCHEDULE-E-flat,original,2025,fgen-d13cc1ef803b65ffbcb18b7b,synthetic_programmatic_template,flat,top,False,
"SCHEDULE E (Form 1040) Supplemental Income and Loss 2025 (From rental real estate, royalties, partnerships, S corporations, estates, trusts, REMICs, etc.) Attach to Form 1040, 1040-SR, 1040-NR, or 1041.Name(s) shown on return Jamíe K. Sato Your social security number 1487 Elm Park Pl Lakewood, C0 53348 Part I Income or Loss From Rental Real
Estate and Royalties ****2613 1a Physical address of each property 1b Type of Property (from list below) 811 2 Fair RentalDays / Personal Use Days l80 9 Insurance $6,573.00 12 Mortgagc ínterestpaid to banks, etc.8,292.01 16 Taxes $1,578.76 18 Depreciation
expense or depletion $4,854.98 21 Subtract line 20 from 1ine 3 (rents) and/or 4 (royalties) l1,263.55 26 Total rental real estate and royalty income or (loss)19,699.21 Department of the Treasury - Internal Revenue 5ervice Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-68d0ca823b06d4e911ba21b0,v11-SCHEDULE-E-flat,original,2025,fgen-606453965961d6ff78a9e3ad,synthetic_programmatic_template,flat,top,True,
"Name: Alex Haddad 18 Depreciation expense or depletion 9,257.94
SCHEDULE E (Form 1040) Supplemental
Income and Loss 2024",SCHEDULE,34,SCHEDULE,fdc-49e93533afd799ef6f8641ea,v11-SCHEDULE-E-flat,original,2024,fgen-b1ad9b4d6e811c04e87b07e7,synthetic_programmatic_template,flat,bottom,False,
"SCHEDULE E (Form 1040) Supplemental Income and Loss For calendar year 2025 OMB No. 1545-0074 Attach to Form 1040, 1040-SR, 1040-NR, or 1041. Name(s) shown on return Priya Patel Your social security number 8302 Maple Ridge Dr Pinecrest, GA 58556 Part I Income or Loss From Rental Real Estate and Royalties XXX-XX-8611 1a Physical address of each property 1b Type of Property (from list below) 749
3 Rents received 3,802.92 9 Insurance 325.52 12 Mortgage interest paid to banks, etc. $421.80 21 Subtract
line 20 from line 3 (rents) and/or 4 (royalties) 2,498.89 Department of the Treasury - Internal Revenue Service Form E (Form 1040) (keep for your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-d131977f976c52885340a7e6,v11-SCHEDULE-E-flat,original,2025,fgen-f4acb4cb900961b051c4ddbf,synthetic_programmatic_template,flat,top,False,
"SCHEDULE E (Form 1040) Supplemental Income and Loss 2022 OMB No. 1545-0074 Name(s) shown on return Sofia Adeyemi Your social security number 6260 Elm Park Pl Lakewood, CO 16976 Part I Income or Loss From Rental Real Estate and Royalties ***-**-9661 1a Physical address of each property
2 Fair Rental Days / Personal Use Days 341 3 Rents received $40,715.31 9 Insurance 1,692.28 12 Mortgage interest paid to banks, etc. $5,346.16 16 Taxes $5,099.35 18 Depreciation expense or depletion $4,248.79 Department of the Treasury - Internal Revenue Service Form E (Form 1040) (keep for
your records) www.irs.gov/FormSCHEDULEEForm1040",SCHEDULE,34,SCHEDULE,fdc-a92d76d88ef44b9bdcc3e78f,v11-SCHEDULE-E-flat,original,2022,fgen-cdc1c1511a05f621544098a4,synthetic_programmatic_template,flat,top,False,
"Understanding your Form 8949
This guideexplains each box on the Form 8949 you receive.
## Box l shows the amount rcported to the IRS.
Boxes 15 through 17 show state information.
This page is an explanation only; your actual form is attached separately.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-bc39f69dee76a5a8cf963ae7,v11-TAX_INSTRUCTIONS-markdown,instruction,2023,fgen-ea610b25d9dfa2c7775e089e,synthetic_programmatic_template,markdown,top,True,employer_guide
"Please bring the following documents:
## ☐ All Forms W-2 and 1099
☐ Form 1098 mortgage interest statements
☐ Property tax bills and charitable receipts
☐ Last year's federal and state returns",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-5be17203890184c4f0035739,v11-TAX_INSTRUCTIONS-markdown,instruction,2025,fgen-d62be91b0592fc377bacd2e3,synthetic_programmatic_template,markdown,none,False,preparer_checklist
"This guide explains each box on the Form Schedule C you receive.
## Box 1 shows the amount reported to the IRS.
Boxes 15 through 17 show state information.
This page is an explanation only; your actual form is attached separately.
Understanding your Form Schedule C",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-455ed463d49ef67492698666,v11-TAX_INSTRUCTIONS-markdown,instruction,2026,fgen-c03b4132caf97999d1735071,synthetic_programmatic_template,markdown,bottom,False,employer_guide
"## (Rev. January 2025)
Section references are to the Internal Revenue Code unless otherwise noted.
## What's New
## Future developments. For the latest information about developments related to Form 1099-R, go to IRS.gov.
## General Instructions
## Specific Instructions
Box 1. Enter the amount reported to you. Do not include amounts reported on another form.
## Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws.
Instructions for Form 1099-R",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-297930e96f5b61b5652fe9a0,v11-TAX_INSTRUCTIONS-markdown,instruction,2025,fgen-b2f0fb866d27bd521b2d458e,synthetic_programmatic_template,markdown,bottom,False,irs_instructions
"## Understanding your Form 1099-R
## This guide explains each box on the Form 1099-R you receive.
## Box 1 shows the amount reported to the IRS.
Boxes 15 through 17 show state information.
This page is an explanation only; your actual form is attached separately.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-5737f6cb4a12cccc2080138a,v11-TAX_INSTRUCTIONS-markdown,instruction,2021,fgen-95e8ffa04dcfe248277a4914,synthetic_programmatic_template,markdown,top,False,employer_guide
"## Instructions for Form 1099-R
(Rev. January 2026)
Section references are to theInternal RevenueCode unless otherwise noted.
What's New
Future developments. For the latest ínformation about developments related to Form 1099-R, go to IRS.gov.
General Instructions
## Specific Instructions
Box 1. Enter the amount reported to you. Do not inc1ude amounts reported on another form.
Papcrwork Reduction Act Notice. We ask for the information on this form to carry out the Interna1 Revenue laws.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-252dc2f2d340bef8b6183ce6,v11-TAX_INSTRUCTIONS-markdown,instruction,2026,fgen-96edc90a4eb4f851e4d8b945,synthetic_programmatic_template,markdown,top,True,irs_instructions
"(Rev. January 2021)
## Section references are to the Internal Revenue Code unless otherwise noted.
What's New
Future developments. For the latest information about developments related to Form Schedule C, go to IRS.gov.
## General Instructions
Specific Instructions
Box 1. Enter the amount reported to you. Do not include amounts reported on another form.
## Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws.
Instructions for Form Schedule C",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-c5fbe54649c6b8092bab2f25,v11-TAX_INSTRUCTIONS-markdown,instruction,2021,fgen-57106e340179b06af7bf3d69,synthetic_programmatic_template,markdown,bottom,False,irs_instructions
"## Understanding your Form 1099-R
This guide explains each box on the Form 1099-R you receive.
Box 1 shows the amount reported to the IRS.
## Boxes 15 through 17 show state information.
This page is an explanation only; your actual form is attached separately.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-e2ad4687e9b996d5a4a631e7,v11-TAX_INSTRUCTIONS-markdown,instruction,2022,fgen-30097101d6ce5196fc348a44,synthetic_programmatic_template,markdown,top,False,employer_guide
"Instructions for Form 1099-R
(Rev. January 2023)
Section references are to the Internal Revenue Code unless otherwise noted.
What's New
Future developments. For the latest information about developments related to Form 1099-R, go to IRS.gov.
## General Instructions
Specific Instructions
## Box 1. Enter the amount reported to you. Do not include amounts reported on another form.
Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-85fcdbf6fe873bf783e5d9c6,v11-TAX_INSTRUCTIONS-markdown,instruction,2023,fgen-68e71ad113c4d13d54c90357,synthetic_programmatic_template,markdown,top,False,irs_instructions
"## 2021 Tax 0rganizer Checklist
## Please bríng thefollowing documents:
☐ All Forms W-2 and 1099
☐ Form 1098 mortgage interest statements
☐ Property tax bills and charitable receipts
## ☐ Last year's federal and state returns",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-6e25d26126dbcbd9b4310289,v11-TAX_INSTRUCTIONS-markdown,instruction,2021,fgen-4f4bb0547b09ab8ed8ea9f96,synthetic_programmatic_template,markdown,top,True,preparer_checklist
"Please bring the following documents:
## ☐ All Forms W-2 and 1099
☐ Form 1098 mortgage interest statements
☐ Property tax bills and charitable receipts
☐ Last year's federal and state returns
## 2024 Tax Organizer Checklist",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-f707c8b04f25985922d704a3,v11-TAX_INSTRUCTIONS-markdown,instruction,2024,fgen-05be609fb54e555f1206d9bc,synthetic_programmatic_template,markdown,bottom,False,preparer_checklist
"Understanding your Form 8949
This guide explains each box on the Form 8949 you receive.
Box 1 shows the amount reported to the IRS.
## Boxes 15 through 17 show state information.
This page is an explanation only; your actual form is attached separately.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-d46fcff9448c41d366139ae0,v11-TAX_INSTRUCTIONS-markdown,instruction,2026,fgen-4905ab67d7c01d4f984e92e6,synthetic_programmatic_template,markdown,top,False,employer_guide
"## Instructions for Form 1099-INT
(Rev. January 2026)
Section references are to the Internal Revenue Code unless otherwise noted.
## What's New
Future developments. For the latest information about developments related to Form 1099-INT, go to IRS.gov.
## General Instructions
Specific Instructions
Box 1. Enter the amount reported to you. Do not include amounts reported on another form.
Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-02d0915c219885767c3a6bc2,v11-TAX_INSTRUCTIONS-markdown,instruction,2026,fgen-559055053a43c9ee64d1fb93,synthetic_programmatic_template,markdown,top,False,irs_instructions
"Understanding your Form W-2
This guide explains each box on the Form W-2 you receive.
## Box 1 shows the amount reported to the IRS.
Boxes 15 through 17 show state information.
## This page is an explanation only; your actual form is attached separately.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-ba3ca9864a7db7537042a096,v11-TAX_INSTRUCTIONS-markdown,instruction,2022,fgen-288a9024c92ca3cb7609ee98,synthetic_programmatic_template,markdown,top,False,employer_guide
"Instructions for Form 1099-INT
(Rev. January 2026)
## 5ection references are to the Internal Rcvenue Code unlcss otherwise noted.
## What's New
## Future developments. For the latest information about deve1opments related to Form 1099-INT, go to IRS.gov.
General Instructions
Specific Instructíons
Box 1. Enter theamountreportcd to you. Do not include amounts reported on another form.
Paperwork Reduction Act Notice. We ask for the ínformation on this form to carry out the Intemal Revenue laws.",TAX_INSTRUCTIONS,35,TAX_INSTRUCTIONS,fdc-8989db7a8c6d2fe437f5fe2a,v11-TAX_INSTRUCTIONS-markdown,instruction,2026,fgen-58b70c9a0fbed4b98f1a4e06,synthetic_programmatic_template,markdown,top,True,irs_instructions
"Lakeshore State University Family Newsletter
## Picture day reminder
Cafeteria menu updates",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-522f7e26cb6ee5ae8210aa2d,v11-UNKNOWN_DOCUMENT-kind05,unknown,2021,fgen-b25a5635f7737d5c97b74f67,synthetic_programmatic_template,markdown,top,False,school_newsletter
"Upcoming events: Science fair on December 26,2025
Picture day reminder
Rivcrside Community College Family Newsletter",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-9e0137b9ec8e41a8c925b208,v11-UNKNOWN_DOCUMENT-kind05,unknown,2025,fgen-057dcb4d4daade20ee3e3858,synthetic_programmatic_template,stacked,bottom,True,school_newsletter
"Northwind Technical Institute Family Newsletter
Upcoming events: Science fair on 2025-10-25
Picture dayreminder
Cafeteria menu updates
Volunteer sign-up for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-229244b627b7b2777d539511,v11-UNKNOWN_DOCUMENT-kind05,unknown,2025,fgen-85a5ff4d79e5f31e9dfa7419,synthetic_programmatic_template,inline,top,True,school_newsletter
"Northwind Technical Institute Family Newsletter
Upcoming events: Science fair on 05/26/2022
Picture day reminder
Cafeteria menu updates",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-90d11f1391dfa9abdd73d0d3,v11-UNKNOWN_DOCUMENT-kind05,unknown,2022,fgen-bcce1a5ff8f9795d93e1e873,synthetic_programmatic_template,columns,top,False,school_newsletter
"Upcoming events: Science fair on July 3, 2025
Cafeteria menu updates
Volunteer sign-up for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-15383d08cef8c64f458d8e7b,v11-UNKNOWN_DOCUMENT-kind05,unknown,2025,fgen-efb27b5988b655890d938cb4,synthetic_programmatic_template,csv,none,False,school_newsletter
"Lakeshore State University Family Newsletter Upcoming events: Science
fair on 01/13/2022 Picturc day reminder
Cafeteria menu updates Volunteer sign-up for thefall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-03297c9df5b02ea2f317e327,v11-UNKNOWN_DOCUMENT-kind05,unknown,2022,fgen-892b51871a301be195d12877,synthetic_programmatic_template,flat,top,True,school_newsletter
"## Lakeshore State University Family Newsletter
Upcoming events: Science fair on 1/24/26
Picture day reminder
Cafeteria menu updates
## Volunteer sign-up for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-dd37640b30850a1e1abbb89d,v11-UNKNOWN_DOCUMENT-kind05,unknown,2026,fgen-c3be6fe2ff0e3451ce5e96f4,synthetic_programmatic_template,markdown,top,False,school_newsletter
"Lakeshore State University Family Newsletter
Upcoming events: Science fair on 11/16/22
Picture day reminder
Cafeteria menu updates
Volunteer sign-up for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-83e01b3180aa377f3acdd79f,v11-UNKNOWN_DOCUMENT-kind05,unknown,2022,fgen-ed4cab5410c7e5c77bf46ce5,synthetic_programmatic_template,stacked,top,False,school_newsletter
"Northwind Technical Institute Family Newsletter
Cafeteria menu updates
Volunteer sign-up for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-18605d03212cdeb02f71324c,v11-UNKNOWN_DOCUMENT-kind05,unknown,2024,fgen-16c1bddfb3b4c2e8dec80290,synthetic_programmatic_template,inline,top,False,school_newsletter
"Lakeshore State University Family Newsletter
Upcoming events: Science fair on l0/12/2021
Pictureday reminder
Cafeteria menu updates
Volunteer sign-up for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-87ced93362583a2e7d3ddb94,v11-UNKNOWN_DOCUMENT-kind05,unknown,2021,fgen-8c02c8133e25b1c8295d191d,synthetic_programmatic_template,columns,top,True,school_newsletter
"Northwind Technical Institute Family Newsletter
Upcoming events: Science fair on May 11, 2026
Picture day reminder
Cafeteria menu updates
Volunteer sign-up for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-45615f6e2a9fde25920b7f71,v11-UNKNOWN_DOCUMENT-kind05,unknown,2026,fgen-319535b0eecfd2238dabb334,synthetic_programmatic_template,csv,top,False,school_newsletter
"Lakeshore State University Family Newsletter Upcoming events: Science fair on
05/07/2022 Picture day reminder Cafeteria menu updates Volunteer sign-up
for the fall festival",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-96480d7f11703538150ebb10,v11-UNKNOWN_DOCUMENT-kind05,unknown,2022,fgen-1d45d0db65a3dfa3551db35e,synthetic_programmatic_template,flat,top,False,school_newsletter
"Evergreen Health Plan
Prior authorization decision
Request received 11/19/21
## Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-d055e8f7a890de7210f2e7f7,v11-UNKNOWN_DOCUMENT-kind11,unknown,2021,fgen-5f110bccae5e547fc7f2727a,synthetic_programmatic_template,markdown,top,False,medical_eob_letter
"Sample MutualInsurance
Prior authorization decision
Member: Avery Walsh
Request received 2022-09-04
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-02ab2627c4d54e7e84379048,v11-UNKNOWN_DOCUMENT-kind11,unknown,2022,fgen-08b71be6113a13e6d3709d88,synthetic_programmatic_template,stacked,top,True,medical_eob_letter
"Evergreen Health Plan
Prior authorization decision
Member: Riley Kowalski
Request received 07/26/2026
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-3ec4b1d1c11a420349bbd96f,v11-UNKNOWN_DOCUMENT-kind11,unknown,2026,fgen-1a481dd0c490081f145ca3a7,synthetic_programmatic_template,inline,top,False,medical_eob_letter
"Evergreen Health Plan
Prior authorization decision
Member: Wei Adeyemi
Request received 8/25/22
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-145b3b441a12d40baa5573c1,v11-UNKNOWN_DOCUMENT-kind11,unknown,2022,fgen-760f4c904ac99f5c70bdafea,synthetic_programmatic_template,columns,top,False,medical_eob_letter
"Harbor Life Assurance
Prior authorization decision
Member: Sofia Sato
Request received October 7, 2024
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-59d2747ca542ef4113440821,v11-UNKNOWN_DOCUMENT-kind11,unknown,2024,fgen-183aaaa155dc01c224cdfdaa,synthetic_programmatic_template,csv,top,False,medical_eob_letter
"Harbor Life Assurance Prior authorization decision
Member: Jordan Walsh Request received
August 27, 2021 Your request for an MRI has been approved.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-e1cc158ab97a93951640ed0b,v11-UNKNOWN_DOCUMENT-kind11,unknown,2021,fgen-bb842e198be8e88df9d81261,synthetic_programmatic_template,flat,top,False,medical_eob_letter
"Member: Alex Testcase
Request received 2023-05-12
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-a096fe93406f43003e9603f8,v11-UNKNOWN_DOCUMENT-kind11,unknown,2023,fgen-d0ef19aa36327dec2f6180f6,synthetic_programmatic_template,markdown,none,False,medical_eob_letter
"Granite Auto Insurance Co.
Prior authorization decision
Member: Alex L. Okafor
Request received 2026-01-18
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-29541ce38df791ca6fc1fa78,v11-UNKNOWN_DOCUMENT-kind11,unknown,2026,fgen-65575fb4e1226b52a91a8a35,synthetic_programmatic_template,stacked,top,False,medical_eob_letter
"Granite Auto Insurance Co.
Prior authorization decision
Member: Jamie Romero
Request received 2023-05-25
Your request for an MRIhas been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-cf6059831751a4cf0e3d143b,v11-UNKNOWN_DOCUMENT-kind11,unknown,2023,fgen-6456990cb36401306e0cf448,synthetic_programmatic_template,inline,top,True,medical_eob_letter
"Sample Mutual Insurance
Prior authorization decision
Member: Casey Romero
Request received 11/18/23
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-8d2f69ffd39d16a6919a6712,v11-UNKNOWN_DOCUMENT-kind11,unknown,2023,fgen-3e84da6cf972d838d9e98afa,synthetic_programmatic_template,columns,top,False,medical_eob_letter
"Evergreen Health Plan
Prior authorization decision
Member: Wei C. Fischer
Your request for an MRI has been approved.
This letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-965c2fbe51bbba27cc77c3cb,v11-UNKNOWN_DOCUMENT-kind11,unknown,2026,fgen-31f92a4394a8336c2f5734b1,synthetic_programmatic_template,csv,top,False,medical_eob_letter
"Evergreen Health Plan Prior authorization decision Member: Amara Sato Request
received 12/20/2024 This
letter is not a bill.",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-0a3b810fd9a9a079a432a2b5,v11-UNKNOWN_DOCUMENT-kind11,unknown,2024,fgen-9d055377930f6a658833bc09,synthetic_programmatic_template,flat,top,False,medical_eob_letter
"Jamie Larsen
Resume
Experience: Senior Ana1yst, Riverside Regional Hospital (2019–present)
## Education: B.S. Accounting
## Skills: Excel, SQL,reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-2eddcc09dcf642d89dff7680,v11-UNKNOWN_DOCUMENT-kind17,unknown,2025,fgen-76750986ddfb05c9431a8bc9,synthetic_programmatic_template,markdown,top,True,resume
"Experience: Senior Analyst, Maple Street Dental PC (2019–present)
Education: B.S. Accounting
Skills: Excel, SQL, reconciliations
Amara A. Lindqvist
Resume",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-60e447a3a2fe603fc81218ac,v11-UNKNOWN_DOCUMENT-kind17,unknown,2026,fgen-ff0b0a34568bf9f112c878e2,synthetic_programmatic_template,stacked,bottom,False,resume
"Sofia R. Testcase
Resume
Experience: Senior Analyst, Acme Test Corp (2019–present)
Education: B.S.Accounting
Skills: Excel, SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-95e4a6f0d96f0e6518f8a813,v11-UNKNOWN_DOCUMENT-kind17,unknown,2021,fgen-b292093f6fe4785a980dee74,synthetic_programmatic_template,inline,top,True,resume
"Hiro J. Moreau
Resume",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-d2b10acd92e257291018646a,v11-UNKNOWN_DOCUMENT-kind17,unknown,2021,fgen-52e485feae2f994777cf7daf,synthetic_programmatic_template,columns,top,False,resume
"Noah Lindqvist
Resume
Experience: Senior Analyst, Maple Street Dental PC (2019–present)
Education: B.S. Accounting
Skills: Excel, SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-4bdf4ae937f3010ea8be7e10,v11-UNKNOWN_DOCUMENT-kind17,unknown,2025,fgen-e16431cf4f4782ffa252689a,synthetic_programmatic_template,csv,top,False,resume
"Morgan Patel Resume Experience: Senior Analyst,
Copperline Software Inc. (2019–present)Education: B.S. Accounting Skills: Exccl,
SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-5a20ccf6ccccdb0d62892a3e,v11-UNKNOWN_DOCUMENT-kind17,unknown,2023,fgen-0e61cbbdc16230330182f788,synthetic_programmatic_template,flat,top,True,resume
"Experience: Senior Analyst, Tri-County School District (2019–present)
## Education: B.S. Accounting
Skills: Excel, SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-75b925290ec0c2804d4912be,v11-UNKNOWN_DOCUMENT-kind17,unknown,2024,fgen-f260232c315d53c90d1786ca,synthetic_programmatic_template,markdown,none,False,resume
"Experience: Senior Analyst, Blue Heron Logistics LLC (2019–present)
Education: B.S. Accounting
Skills: Excel, SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-4026b5cea02c7f7ea52fc386,v11-UNKNOWN_DOCUMENT-kind17,unknown,2021,fgen-7914d635eee3779b03c69b78,synthetic_programmatic_template,stacked,none,False,resume
"Diego Haddad
Resume
Experience: Senior Analyst, Blue Heron Logistics LLC (2019–present)
Education: B.S. Accounting
Skills: Excel, SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-001132dc6155fa960308eded,v11-UNKNOWN_DOCUMENT-kind17,unknown,2025,fgen-90faa03cce62532e2d06279f,synthetic_programmatic_template,inline,top,False,resume
"Diego D. Fischer
Resume
Experience: Senior Analyst, Maple Street Dental PC (2019–present)
Education: B.S. Accounting
Skills: Excel, SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-69591faf82d7e5e2c02553a3,v11-UNKNOWN_DOCUMENT-kind17,unknown,2021,fgen-2c4f79865a8fe669ceee7157,synthetic_programmatic_template,columns,top,False,resume
"Morgan Sato
Resume
Experience: Senior Analyst, Tri-County School District (2019–present)
Education: B.S. Accounting
Skills: Excel, SQL, reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-4b98b51196560af1a549183d,v11-UNKNOWN_DOCUMENT-kind17,unknown,2025,fgen-ac4e6fd2c59957303a247676,synthetic_programmatic_template,csv,top,False,resume
"Kwame S. Tanaka Resume Experience: Senior Analyst, Maple Street Dental
PC (2019–present) Education: B.S. Accounting Skills: Excel, SQL,
reconciliations",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-1b6a409e6ece28ab6a3dfae0,v11-UNKNOWN_DOCUMENT-kind17,unknown,2023,fgen-96f4689b808ae8e91d0c6b31,synthetic_programmatic_template,flat,top,False,resume
"Student,Assignment,Score,Max
Noah Haddad,Quiz 3,184,100
Kwame Brennan,Essay 1,477,100
Amara Adeyemi,Lab 2,561,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-9216129e4aab55d9814cdbcd,v11-UNKNOWN_DOCUMENT-kind23,unknown,2021,fgen-31e288550f26f5891205b040,synthetic_programmatic_template,markdown,none,False,gradebook
"Student,Assignment,Score,Max
Noah E. Lindqvist,Essay 1,460,100
Alex Fischer,Lab 2,141,100
Gradebook export",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-87ef8b7ad08f52bd998a88f4,v11-UNKNOWN_DOCUMENT-kind23,unknown,2023,fgen-c85ffdf6e9dbe2c62ac7ef95,synthetic_programmatic_template,stacked,bottom,False,gradebook
"Student,Assignment,Score,Max
Jordan Patel,Quiz 3,289,100
Kwame Larsen,Essay 1,483,100
Kwame L. Okafor,Lab 2,349,100
Gradebook export",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-bbfed57f719d560609060d7e,v11-UNKNOWN_DOCUMENT-kind23,unknown,2026,fgen-6b5222bebfa8401399cc349f,synthetic_programmatic_template,inline,bottom,False,gradebook
"Student,Assignment,Score,Max
Diego C. Patel,Quiz 3,177,100
Sofia Lindqvist,Essay 1,501,100
Jordan Tanaka,Lab 2,163,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-4a9085a95c9d2f7d44da06f9,v11-UNKNOWN_DOCUMENT-kind23,unknown,2025,fgen-39716af6f64362b18087259d,synthetic_programmatic_template,columns,none,False,gradebook
"Gradebook export
Student,Assignment,Score,Max
Fatima E. Moreau,Quiz 3,247,100
Avery Nguyen,Essay 1,53,100
Fatima L. Fischer,Lab 2,418,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-abe399fa3404081d08fd4ea5,v11-UNKNOWN_DOCUMENT-kind23,unknown,2022,fgen-27627eb2461cf7d557d8d812,synthetic_programmatic_template,csv,top,False,gradebook
"Gradebook
export Student,Assignment,Score,Max Jamie Okafor,Quiz 3,426,100 Fatima Patel,Essay 1,310,100 Jordan J. Okafor,Lab
2,146,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-ee72a4652170fff6255c0c97,v11-UNKNOWN_DOCUMENT-kind23,unknown,2021,fgen-8ede6b9fb9541cb357009631,synthetic_programmatic_template,flat,top,False,gradebook
"## Gradebook export
Avery Tanaka,Quiz 3,181,100
Alex Okafor,Essay 1,359,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-60ab974da3e8f41f67bddd9b,v11-UNKNOWN_DOCUMENT-kind23,unknown,2021,fgen-2afb9ec3ac8dcafeb5cdec07,synthetic_programmatic_template,markdown,top,False,gradebook
"Gradebook export
Student,Assignment,Score,Max
Jordan Haddad,Quiz 3,341,100
Lena Adeyemi,Essay 1,253,100
Alex C. Larsen,Lab 2,558,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-82172ea5a0703fbc02c9cd83,v11-UNKNOWN_DOCUMENT-kind23,unknown,2026,fgen-dc93ab945afb5a506f589529,synthetic_programmatic_template,stacked,top,False,gradebook
"Student,Assignment,Score,Max
Casey A. Nguyen,Quiz 3,388,100
Alex D. Romero,Essay 1,102,100
Wei Brennan,Lab 2,512,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-ab95c9aafc51a93d32ca6645,v11-UNKNOWN_DOCUMENT-kind23,unknown,2024,fgen-28277228661243415a68755d,synthetic_programmatic_template,inline,none,False,gradebook
"Gradebook export
Student,Assignment,Score,Max
Jamie Sato,Quiz 3,486,100
Kwame Okafor,Essay 1,36,100
Diego Larsen,Lab 2,584,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-89b031a5d40577adeb94f1ad,v11-UNKNOWN_DOCUMENT-kind23,unknown,2025,fgen-d39c82b8772a044ddb08dfc6,synthetic_programmatic_template,columns,top,False,gradebook
"Gradebook export
Student,Assignment,Score,Max
Amara A. Larsen,Essay 1,375,100
Jamie B. Testcase,Lab 2,584,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-3d2b180160ba3f668deb3d6c,v11-UNKNOWN_DOCUMENT-kind23,unknown,2022,fgen-0c935737a87ff66fb8fb12ad,synthetic_programmatic_template,csv,top,False,gradebook
"Gradebook
export Student,Assignment,Score,Max Priya Rivera,Essay 1,298,100
Jamie Larsen,Lab 2,66,100",UNKNOWN_DOCUMENT,37,UNKNOWN_DOCUMENT,fdc-9909f743d06dd380c3b81778,v11-UNKNOWN_DOCUMENT-kind23,unknown,2022,fgen-02c06da99f190c5fd257ace8,synthetic_programmatic_template,flat,top,False,gradebook
"Form W-2
Wage and Tax Statement
For calendar year 2023
OMB No. 1545-0029
Copy 2—To Be Filed With Employee's State, City, or Local Income Tax Return
c Employer's name, address, and ZIP code      Maple Street Dental PC 6988 Maple Ridge Dr Testville, IL 59734
b Employer identification number (EIN) 34-2145625
e Employee's first name and initial  Last name  Noah Brennan
a Employee's social security number XXXXX4964
Street address (including apt. no.) 2488 Elm Park Pl
City or town, state or province, country, and ZIP or foreign postal code Pinecrest, GA 18971
Account number (see instructions) ****871497
1 Wages, tips, other compensation 37,647.99
2 Federal income tax withheld $3,696.91
3 Social security wages      109,555.73
4 Social security tax withheld 4,369.58
5 Medicare wages and tips $69,311.58
6 Medicare tax withheld  $86.72
12a See instructions for box 12      D 3,594.94
13 Retirement plan
16 State wages, tips, etc.   114,760.14
17 State income tax   $8,286.22
d Control number 490
Department of the Treasury - Internal Revenue Service
Form W-2 (keep for your records)  www.irs.gov/FormW2",W-2,38,W-2,fdc-e7097ff1debc46b3f6409a53,v11-W-2-inline,original,2023,fgen-e06d4f8d587fce7844acc79a,synthetic_programmatic_template,inline,top,False,
"Form W-2
Wage and Tax Statement
2022
OMB No. 1545-0029
Copy C—For EMPLOYEE'S RECORDS
Copy 2—To Be Filed With Employee's State, City, or Local Income Tax Return
c Employer's name, address, and ZIP code   Acme Test Corp 4930 Sample Street Oak Grove, TX 32771
b Employer identification number (EIN) 60-7204642
e Employee's first name and initial  Last name   Priya Brennan
a Employee's social security number      XXX-XX-3867
Street address (including apt. no.)  7529 Granite St
City or town, state or province, country, and ZIP or foreign postal code  Cedar Falls, IA 11342
Account number (see instructions)   ***-**-986539
1 Wages, tips, other compensation $3,439.11
2 Federal income tax withheld   $6,055.16
3 Social security wages  8,276.15
5 Medicare wages and tips  66,502.43
6 Medicare tax withheld      $3,719.88
12a See instructions for box 12      D 8,022.62
13 Retirement plan X
15 State  Employer's state ID number      PA 8130252
16 State wages, tips, etc.  53,417.93
d Control number  743
Department of the Treasury - Internal Revenue Service
Form W-2 (keep for your records)  www.irs.gov/FormW2",W-2,38,W-2,fdc-f9e883b44f3c724971352c8b,v11-W-2-inline,original,2022,fgen-8752310a4ebdc8bcdcf0d690,synthetic_programmatic_template,inline,top,False,
"VOID  CORRECTED
Form W-2
Wage and Tax Statement
For calendar year 2025
OMB No. 1545-0029
Copy 2—To Be Filed With Employee's State, City, or Local Income Tax Return
c Employer's name, address, and ZIP code Acme Test Corp 5094 Oak Hollow Ct Brookhaven, PA 10129
b Employer identification number (EIN)   36-5424388
e Employee's first name and initial  Last name   Amara Larsen
a Employee's social security number XXXXX3261
Street address (including apt. no.)   3912 Elm Park Pl
City or town, state or province, country, and ZIP or foreign postal code   Pinecrest, GA 95521
1 Wages, tips, other compensation   124,546.32
2 Federal income tax withheld   6,899.46
3 Social security wages      5,563.61
4 Social security tax withheld      5,286.07
5 Medicare wages and tips 103,568.51
6 Medicare tax withheld  1,231.62
12a See instructions for box 12 D 8,199.84
13 Retirement plan ☒
15 State  Employer's state ID number   IL 2451459
16 State wages, tips, etc. 116,256.59
17 State income tax 2,484.65
d Control number 968
Department of the Treasury - Internal Revenue Service
Form W-2 (keep for your records)  www.irs.gov/FormW2",W-2,38,W-2,fdc-93ef52ad54e0f7a17142e23d,v11-W-2-inline,original,2025,fgen-9acf97966bd5ce2372e4b3e5,synthetic_programmatic_template,inline,top,False,
"Form W-2 Wage andTax Statement 2022
c Employer:  Riverside Regional Hospital
Recipient's name: Avery Fischer
16 State wages, tips, etc. 44,872.92
2 Federal íncome tax withheld   S5,939.26
3 Social securíty wages $3,654.13",W-2,38,W-2,fdc-228d8e8465a919648b221cdf,v11-W-2-inline,original,2022,fgen-602a7ac7e152f9adb4612746,synthetic_programmatic_template,inline,top,True,
"Form W-2
Wage and Tax Statement
For calendar year2024
Copy B—To BeFiled With Employee's FEDERAL Tax Return.
Copy C—For EMPL0YEE'5 RECORDS
Copy 2—To Be Filed With Employee's State, City, or Local Income Tax Return
c Employer's name, address, and ZIP code      BlueHeron Logistics LLC 1822 Willow Bend Way 0ak Grove, TX 40777
b Employer identification number (EIN) 85-1222340
e Employee's first name and initial  Last name   Alex Tanaka
a Employee's social security number      ***-**-5314
Street address (induding apt. no.)      6062 Elm Park Pl
Cíty or town, state or province, country, and ZIP or foreign postal code   Brookhaven, PA 45279
1 Wages, tips, other compensation      $88,445.26
2 Federal income tax withheld   6,784.66
3 Socialsecurity wages l11,859.92
4 5ocíal security tax withheld  $983.19
5 Medicare wages and tips  $108,717.82
6 Medícare tax wíthheld $5,246.64
12a See instructions for box 12  W 2,856.08
13 Retirement plan  ☐
16 State wages, tips,etc.     $131,178.18
17 5tateíncomc tax  $8,173.98
d Contro1 number 511
Department of the Treasury - Internal Revenue Service
Form W-2 (keep for your records)  www.irs.gov/FormW2",W-2,38,W-2,fdc-9a6d9d7b264e00931ced590b,v11-W-2-inline,original,2024,fgen-18d50f8a29ccd822ed8de1a5,synthetic_programmatic_template,inline,top,True,
"c Employer'S name: Riverside Regional Hospital
Recipient's name: Kwame D. Rivera
2 Federal incometax withheld 125.29
16 State wages, tips, etc. 80,576.13
13 Retirement p1an X
Form W-2 Wage and Tax Statement 2022",W-2,38,W-2,fdc-8dbcde9d8c8058c7d9ddd331,v11-W-2-inline,original,2022,fgen-2eee9ea22f3a2b49eebf57b9,synthetic_programmatic_template,inline,bottom,True,
"Form W-2
Wage and Tax Statement
2024
Copy C—For EMPLOYEE'S RECORDS
c Employer's name, address, and ZIP code   Blue Heron Logistics LLC 8389 Maple Ridge Dr Lakewood, CO 28280
b Employer identification number (EIN)      80-7024045
e Employee's first name and initial  Last name  Alex A. Romero
a Employee's social security number   ****5239
Street address (including apt. no.)   503 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code   Brookhaven, PA 97618
1 Wages, tips, other compensation 48,962.18
2 Federal income tax withheld      $1,459.98
3 Social security wages $44,926.20
4 Social security tax withheld   $7,244.92
5 Medicare wages and tips      $124,225.04
6 Medicare tax withheld      $3,405.57
12a See instructions for box 12 W 8,580.05
13 Retirement plan ☐
15 State  Employer's state ID number      CO 9180662
d Control number 778",W-2,38,W-2,fdc-66de9e1dd74a4de23d005a84,v11-W-2-inline,original,2024,fgen-766427c7487df22135016d88,synthetic_programmatic_template,inline,top,False,
"From: Granite Peak Manufacturing Co.
Recipient's name: Jordan R. Romero
12a See instructions for box 12   V 1,880.19
3 Social security wages      $18,570.39
6 Medicare tax withheld  $8,094.43",W-2,38,W-2,fdc-8e3ca0008a843f92959468ce,v11-W-2-inline,original,2022,fgen-36a4d63ff8c3669691b8d4ca,synthetic_programmatic_template,inline,none,False,
"VOID  CORRECTED
Form W-2
Wage and Tax Statement
For calendar year 2022
OMB No. 1545-0029
Copy B—To Be Filed With Employee's FEDERAL Tax Return.
Copy C—For EMPLOYEE'S RECORDS
c Employer's name, address, and ZIP code   Acme Test Corp 3566 Harbor View Rd Oak Grove, TX 68257
b Employer identification number (EIN)   18-9618606
e Employee's first name and initial  Last name   Jamie Okafor
a Employee's social security number  ending in 1728
Street address (including apt. no.)  9530 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code   Testville, IL 71647
Account number (see instructions) ending in 613099
1 Wages, tips, other compensation      $133,000.61
2 Federal income tax withheld 1,964.30
3 Social security wages  121,527.51
4 Social security tax withheld   $1,842.35
6 Medicare tax withheld $7,234.99
12a See instructions for box 12   D 3,423.70
13 Retirement plan  ☒
15 State  Employer's state ID number      OH 7772783
16 State wages, tips, etc.      $86,670.10
17 State income tax $3,458.69",W-2,38,W-2,fdc-0cd736f7536543a274e71e5a,v11-W-2-inline,original,2022,fgen-c75c13e3ec55e3e121fbf770,synthetic_programmatic_template,inline,top,False,
"Form W-2 Wage and Tax Statement 2024
c Employer:      Tri-County School District
RECIPIENT: Riley Okafor
4 Social security tax withheld $6,576.50
5 Medicare wages and tips  29,155.16
13 Retirement plan  ☐",W-2,38,W-2,fdc-16aef2146567d5a3171fae1d,v11-W-2-inline,original,2024,fgen-f97de800afad2e415dbc5d56,synthetic_programmatic_template,inline,top,False,
"Form W-2 Wage and TaxStatement
From: Riverside Regional Hospital
RECIPIENT: Taylor Haddad
d Control number 218
15 State  Employer's state ID number      GA 9655652
17 State income tax $5,620.91",W-2,38,W-2,fdc-54ed002d43e5ed25d23c21fb,v11-W-2-inline,original,2025,fgen-438f9c0076c7f357b0c1a7fc,synthetic_programmatic_template,inline,top,True,
"Form W-2
Wage and Tax Statement
2023
OMB No. 1545-0029
Copy B—To Be Filed With Employee's FEDERAL Tax Return.
Copy C—For EMPLOYEE'5 RECORDS
Copy 2—To Be Filed With Employee's State, City, or Local Income Tax Return
c Employer's name, address, and ZIP code Maple Street Dental PC 5884 Harbor View Rd Lakewood, CO 23441
b Employerídentification number (EIN) 68-9372204
e Employee's first name and initial  Last name      Noah D. Testcase
a Employee's social security number   XXX-XX-6248
5treet address (induding apt. no.) 8l19 Maple RidgeDr
City or town, state orprovince, country, and ZIP or foreign postal code      Lakewood, CO 15029
1 Wages,tips, other compensation      115,345.59
2 Federal income tax withheld  1,853.46
3 Social security wages  72,O80.21
5 Medícare wages and tips23,078.09
6 Medicare tax withheld   $3,248.59
12a See instructions for box 12  W 3,942.90
13 Retirement plan [X]
15 State  Employer's state ID number MN 5758353
l6 State wages, tips, etc.   64,261.34
17 State íncome tax $3,451.87
Department of the Treasury- Internal Revenue Service
Form W-2 (keep for your records)  www.irs.gov/FormW2",W-2,38,W-2,fdc-e7c0ca35edbd3028fb1b4132,v11-W-2-inline,original,2023,fgen-3e66bbd536b7b4c18b80584c,synthetic_programmatic_template,inline,top,True,
"VOID  CORRECTED
2026
OMB No. 1545-0029
Copy B—To Be Filed With Employee's FEDERAL Tax Return.
Copy C—For EMPLOYEE'S RECORDS
c Employer's name, address, and ZIP code   Tri-County School District 7980 Prairie Ave Lakewood, CO 79400
b Employer identification number (EIN)      78-3353838
e Employee's first name and initial  Last name Kwame Sato
a Employee's social security number XXX-XX-4788
Street address (including apt. no.)  1116 Maple Ridge Dr
City or town, state or province, country, and ZIP or foreign postal code   Testville, IL 70641
1 Wages, tips, other compensation $43,095.71
3 Social security wages $110,565.33
5 Medicare wages and tips      80,162.51
6 Medicare tax withheld      $6,205.62
12a See instructions for box 12   V 6,224.98
13 Retirement plan      ☐
15 State  Employer's state ID number  MN 6583072
16 State wages, tips, etc.      43,661.04
17 State income tax   6,247.96
Form W-2
Wage and Tax Statement",W-2,38,W-2,fdc-1f7597a06ce2c6edb9fce199,v11-W-2-inline,original,2026,fgen-33eaa9fd053ccbe2ebe248ff,synthetic_programmatic_template,inline,bottom,False,
"From: Maple Street Dental PC
Recipient's name:      Mateo S. Brennan
17 State income tax 168.60
2 Federal income tax withheld $7,902.32
12a See instructions for box 12   W 5,248.21
Form W-2 Wage and Tax Statement 2022",W-2,38,W-2,fdc-33ab661c9bcb4560daf74bd5,v11-W-2-inline,original,2022,fgen-4cdef4f2ecb5476380dad6ec,synthetic_programmatic_template,inline,bottom,False,
"2025
OMB No. 1545-0029
Copy C—For EMPLOYEE'S RECORDS
c Employer's name, address, and ZIP code Riverside Regional Hospital 7663 Maple Ridge Dr Cedar Falls, IA 91219
b Employer identification number (EIN)  34-9695449
e Employee's first name and initial  Last name Jordan Moreau
a Employee's social security number ending in 0114
Street address (including apt. no.) 9240 Oak Hollow Ct
City or town, state or province, country, and ZIP or foreign postal code  Testville, IL 57088
1 Wages, tips, other compensation 32,125.28
2 Federal income tax withheld 9,379.63
3 Social security wages  $8,713.07
4 Social security tax withheld      $8,357.66
5 Medicare wages and tips   84,136.53
6 Medicare tax withheld  $7,739.95
12a See instructions for box 12  D 632.15
15 State  Employer's state ID number CO 2063493
16 State wages, tips, etc.   $109,686.14
d Control number   361
Department of the Treasury - Internal Revenue Service",W-2,38,W-2,fdc-51a22647407f627eeec3d0b8,v11-W-2-inline,original,2025,fgen-d15eaff6d6ae268316e49cc6,synthetic_programmatic_template,inline,none,False,
"2025
OMB No. 1545-0029
Copy B—To Be Filed With Employee's FEDERAL Tax Return.
Copy C—For EMPLOYEE'S RECORDS
c Employer's name, address, and ZIP code  Blue Heron Logistics LLC 5561 Cedar Ln Oak Grove, TX 31474
b Employer identification number (EIN)  17-7651710
e Employee's first name and initial  Last name      Noah Walsh
a Employee's social security number   ***-**-3784
1 Wages, tips, other compensation      $138,379.76
2 Federal income tax withheld 2,185.04
3 Social security wages 32,788.43
4 Social security tax withheld 6,317.88
5 Medicare wages and tips   $28,911.46
12a See instructions for box 12 W 4,153.53
15 State  Employer's state ID number      CO 4198772
16 State wages, tips, etc.  52,531.24
17 State income tax   8,321.52
d Control number 904
Department of the Treasury - Internal Revenue Service
Form W-2
Wage and Tax Statement
Form W-2 (keep for your records)  www.irs.gov/FormW2",W-2,38,W-2,fdc-0cc40566c934b007e615ee43,v11-W-2-inline,original,2025,fgen-084ab061e6ba0640a55f93e9,synthetic_programmatic_template,inline,bottom,False,
"VOID  CORRECTED
Form W-2c
Corrected Wage and Tax Statement
For calendar year 2026
Copy B—To Be Filed With Employee's Federal Tax Return
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Account number (see instructions)
a Tax year/Form corrected
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Correct information
Riverside Regional Hospital 1803 Oak Hollow Ct Bayside, WA 31437
75-6589560
Casey Testcase
XXXXX0746
****718404
2026
$70,328.56
$38,109.42
3,769.80
8,103.90
82,341.02
Department of the Treasury - Internal Revenue Service
Form W-2c (keep for your records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-e6ab474b672f4180e7162b17,v11-W-2C-columns,corrected,2026,fgen-24857f67521b8a39d5bb577f,synthetic_programmatic_template,columns,top,False,
"VOID  CORRECTED
OMB No. 1545-0008
Copy B—To Be Filed With Employee's Federal Tax Return
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Correct information
3 Social security wages  Correct information
Blue Heron Logistics LLC 9854 Maple Ridge Dr Riverton, WI 66568
91-2992763
Olivia D. Okafor
****8308
1214 Sample Street
Pinecrest, GA 12464
***-**-122120
119,763.45
$86,382.64
$2,754.36
99,856.57
Form W-2c
Corrected Wage and Tax Statement",W-2,38,W-2,fdc-d7600f8d325f8e90785e3736,v11-W-2C-columns,corrected,2021,fgen-604905bc3e9e19f0f0895fe5,synthetic_programmatic_template,columns,bottom,False,
"For calendar ycar 2026
OMB No. 1545-0008
Copy B—To Be Filed With Employee's Federa1 Tax Return
Copy C—For Employee's Records
c Employer's name, address,and ZIP code
bEmployer's Federal EIN
f Employee's first name and initial Last name
d Employee's correct SSN
Street address (induding apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
a Tax year/Form corrected
l Wages, tips, other compensation  Previously reported
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 5ocial security wages  Previously reported
3 5ocial security wages  Correct information
Granite PeakManufacturing Co. 5975 Granite St Cedar Fa1ls, IA 249O9
40-9092652
Casey Lindqvist
ending in 9016
5226 Maple Ridge Dr
Pinecrest, GA 11195
XXXXX301031
2026
$1,395.42
$1,103.54
$1,822.89
134,754.35
8,457.83
Form W-2c
Corrected Wage and Tax Statement",W-2,38,W-2,fdc-b2e01d2a4b417e1681deacf7,v11-W-2C-columns,corrected,2026,fgen-3f88bbb7a0d53255f94ae289,synthetic_programmatic_template,columns,bottom,True,
"Form W-2c
Corrected Wage and Tax Statement
For calendar year 2024
Copy B—To Be Filed With Employee's Federal Tax Return
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
a Tax year/Form corrected
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Copperline Software Inc. 5250 Lakeshore Blvd Cedar Falls, IA 73273
54-8160174
Casey Kowalski
ending in 2857
7061 Cedar Ln
Riverton, WI 78989
****513796
2024
$83,300.45
$130,813.23
8,622.77
5,261.40
80,533.79
105,040.83
Department of the Treasury - Internal Revenue Service
Form W-2c (keep for your records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-1ed4e48d6f507e6816d88e82,v11-W-2C-columns,corrected,2024,fgen-7ca734493de501ff28bc42c0,synthetic_programmatic_template,columns,top,False,
"For calendar year 2024
0MB No. 1545-0008
Copy B—To Be Filed With Employee's Federal Tax Return
Copy C—For Employce's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct 5SN
Street address (induding apt. no.)
City or town,state or province, country, and ZIP or foreign postal code
Account number (see instructions)
l Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Correct information
3 5ocial security wages  Previously reported
3Socialsecurity wages Correct information
Blue Heron Logistics LLC 7Ol9 Willow Bend Way Cedar Falls, IA 92148
14-4941473
Priya Adeyemi
***-**-4054
1116 Harbor View Rd
Bayside, WA 824O0
XXXXX421222
S76,l72.08
36,839.53
$2,259.09
$121,999.72
97,636.01
Department of the Treasury - Internal Revenue 5ervice",W-2,38,W-2,fdc-335d5f3633f97f35bce52650,v11-W-2C-columns,corrected,2024,fgen-510ca60494c979de33501be4,synthetic_programmatic_template,columns,none,True,
"Form W-2c
Corrected Wage and Tax Statement
2021
OMB No. 1545-0008
Copy B—To Be Filed With Employee's Federal Tax Return
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
a Tax year/Form corrected
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Copperline Software Inc. 2512 Lakeshore Blvd Lakewood, CO 76916
38-5169793
Morgan Larsen
****8698
2016 Lakeshore Blvd
Bayside, WA 68049
2021
$139,640.65
20,973.42
$3,272.60
$7,599.49
35,832.93
89,570.45
Department of the Treasury - Internal Revenue Service
Form W-2c (keep for your records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-ea3f89078bbe4f2ab3faee92,v11-W-2C-columns,corrected,2021,fgen-89ed6656923fdb35d0ddc42a,synthetic_programmatic_template,columns,top,False,
"Form W-2c
Corrected Wage and Tax Statement
Forca1endar year 2021
OMB No. 1545-0008
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employcr's Federal EIN
f Employee's first name and initial Lastname
d Employee's correct 5SN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreígn postal code
a Tax year/Form corrected
l Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
3 5ocial security wages  Previously reported
3 Social security wages  Correct information
Acme Test Corp 7938 Harbor View Rd Fairview, 0H 32295
3l-7715842
Híro D. Fischer
XXXXX6516
3869 Lakeshore B1vd
Testville, IL 95619
2021
133,146.91
652.22
119,462.06
$98,949.12",W-2,38,W-2,fdc-cb2c7f6e779af7d4c26ef013,v11-W-2C-columns,corrected,2021,fgen-327d42e4313c3e32e95ef65a,synthetic_programmatic_template,columns,top,True,
"2023
Copy B—To Be Filed With Employee's Federal Tax Return
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
a Tax year/Form corrected
1 Wages, tips, other compensation  Previously reported
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Tri-County School District 3562 Lakeshore Blvd Lakewood, CO 65938
47-7311665
Riley Patel
ending in 1275
7054 Elm Park Pl
Cedar Falls, IA 43299
2023
$80,251.46
$7,767.37
$1,966.26
$85,809.81
$20,466.29
Form W-2c
Corrected Wage and Tax Statement",W-2,38,W-2,fdc-5bbc518384315cdbc6d44c42,v11-W-2C-columns,corrected,2023,fgen-f7d87691e8fba08ae16030b0,synthetic_programmatic_template,columns,bottom,False,
"Form W-2c
Corrected Wage and Tax Statement
For calendar year 2024
OMB No. 1545-0008
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
a Tax year/Form corrected
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Acme Test Corp 7738 Elm Park Pl Pinecrest, GA 68444
88-1311296
Kwame Romero
XXXXX4046
9433 Willow Bend Way
Oak Grove, TX 63109
2024
59,962.51
$133,649.58
$4,243.20
5,919.39
$101,522.59
76,743.12
Department of the Treasury - Internal Revenue Service
Form W-2c (keep for your records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-6928f54e0d0c41f1f8cf1464,v11-W-2C-columns,corrected,2024,fgen-ce5bd12b073eb68a52e82e54,synthetic_programmatic_template,columns,top,False,
"VOID  CORRECTED
OMB No.1545-0008
c Employer's name, address, and ZIP code
b Employer's FederalEIN
f Employee's first name and initial  Last name
dEmployee's correct SSN
Street address (induding apt. no.)
City or town, state or province, country, and ZIP or foreign posta1 code
a Tax year/Form corrected
l Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
Blue Heron Logístics LLC 1771 Elm Park Pl Cedar Falls, IA 653O3
69-1097580
Wci Walsh
ending in 5147
1751 Granite St
Testville, IL 36573
2026
16,707.71
99,725.74
$2,041.29
$1,681.82
$12,152.14
Department of the Treasury - Internal Revenue Service
Form W-2c
Corrected Wage and Tax Statement
Form W-2c (keep foryour records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-ae6089d9506f36b261a70d5f,v11-W-2C-columns,corrected,2026,fgen-0b186c10ab72043c27ab77c1,synthetic_programmatic_template,columns,bottom,True,
"Form W-2c Corrected Wage and Tax Statement 2026
From:
Recipient's name:
a Tax year/Form corrected
2 Federal income tax withheld  Correct information
3 Social security wages  Correct information
Granite Peak Manufacturing Co.
Morgan Adeyemi
2026
$1,574.85
122,756.83",W-2,38,W-2,fdc-63b39b484fd8cb646bacc09f,v11-W-2C-columns,corrected,2026,fgen-5b402d26325e3027bbcd5ce6,synthetic_programmatic_template,columns,top,False,
"Form W-2c
Corrected Wage and Tax Statement
2025
OMB No. 1545-0008
Copy B—To Be Filed With Employee's Federal Tax Return
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
a Tax year/Form corrected
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Copperline Software Inc. 3441 Oak Hollow Ct Lakewood, CO 90662
10-7170505
Avery M. Brennan
XXX-XX-9401
2025
90,136.94
7,216.36
2,561.57
$67,382.45
68,882.40
Department of the Treasury - Internal Revenue Service
Form W-2c (keep for your records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-059752fa2695f93efd292369,v11-W-2C-columns,corrected,2025,fgen-5c38f838900489ed3b649c23,synthetic_programmatic_template,columns,top,False,
"Form W-2c
Corrected Wage and Tax Statement
OMB No. 1545-0008
Copy B—To Be Filed With Employee's Federal Tax Return
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
a Tax year/Form corrected
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Tri-County School District 8544 Oak Hollow Ct Lakewood, CO 28295
49-7952894
Lena R. Adeyemi
XXXXX0301
3074 Prairie Ave
Bayside, WA 54174
XXX-XX-705699
2026
113,716.30
$86,552.52
9,093.23
408.76
14,873.60
8,691.95",W-2,38,W-2,fdc-584cab1a21bf8b130d6adeba,v11-W-2C-columns,corrected,2026,fgen-5a9ac34a61a3d0f7a2cb05d8,synthetic_programmatic_template,columns,top,False,
"Form W-2c
Corrected Wage and Tax Statement
2021
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Account number (see instructions)
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Tri-County School District 957 Harbor View Rd Fairview, OH 60926
43-5955037
Noah M. Sato
ending in 0265
ending in 476779
20,629.88
$7,265.04
802.62
33,314.73
116,992.09
Department of the Treasury - Internal Revenue Service
Form W-2c (keep for your records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-2993922aa2ccba88a942e12b,v11-W-2C-columns,corrected,2021,fgen-8652537f7f5e0b25f206ca7b,synthetic_programmatic_template,columns,top,False,
"☐ CORRECTED
Form W-2c
Corrected Wage and Tax Statement
2026
OMB No. 1545-0008
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Street address (including apt. no.)
City or town, state or province, country, and ZIP or foreign postal code
Account number (see instructions)
a Tax year/Form corrected
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Granite Peak Manufacturing Co. 5877 Harbor View Rd Pinecrest, GA 90142
44-9880078
Kwame Lindqvist
***-**-4723
9793 Granite St
Lakewood, CO 93921
XXX-XX-806358
2026
$67,178.22
$84,316.26
$2,224.07
$2,267.70
112,075.36
130,794.80
Department of the Treasury - Internal Revenue Service
Form W-2c (keep for your records)  www.irs.gov/FormW2c",W-2,38,W-2,fdc-0395a2a54879598a2bd4c062,v11-W-2C-columns,corrected,2026,fgen-9331cd35eb5bfa62cc92c79e,synthetic_programmatic_template,columns,top,False,
"Copy B—To Be Filed With Employee's Federal Tax Return
Copy C—For Employee's Records
c Employer's name, address, and ZIP code
b Employer's Federal EIN
f Employee's first name and initial  Last name
d Employee's correct SSN
Account number (see instructions)
1 Wages, tips, other compensation  Previously reported
1 Wages, tips, other compensation  Correct information
2 Federal income tax withheld  Previously reported
2 Federal income tax withheld  Correct information
3 Social security wages  Previously reported
3 Social security wages  Correct information
Blue Heron Logistics LLC 774 Lakeshore Blvd Brookhaven, PA 74099
55-6622893
Kwame Haddad
***-**-6804
XXXXX894775
$100,148.02
$20,064.03
$8,832.31
4,236.58
36,057.64
$96,260.90
Department of the Treasury - Internal Revenue Service",W-2,38,W-2,fdc-5cd27599217616c88c945a53,v11-W-2C-columns,corrected,2024,fgen-204dadd3e87267ffb7558bf0,synthetic_programmatic_template,columns,none,False,
"Form W-2G Certain Gambling Winnings
PAYER'S name:: Harbor Lights Gaming Resort
Recipient's name:: Jordan Sato
4 Federal income tax withheld: 8,832.80
10 Window: 496
3 Type of wager: Horse race
8 Cashier: 976",W-2G,39,W-2G,fdc-800dd444664f0e4a797664b5,v11-W-2G-boxed,original,2026,fgen-1d8a6950dbb752e562e6a509,synthetic_programmatic_template,boxed,top,False,
"☐ CORRECTED
Form W-2G
Certain Gambling Winnings
OMB No. 1545-0238
Copy C For Winner's Records
PAYER'S name, street address, city or town, province or state, country, and ZIP: Lucky River Casino 3281 Maple Ridge Dr Maplewood, MN 44016
PAYER'S federal identification number: 72-5321339
WINNER'S name: Jordan Walsh
WINNER'S taxpayer identification no.: XXX-XX-6084
Account number (see instructions): XXXXX189843
Line 1 Reportable winnings: $18,744.86
Line 2 Date won: 2026-04-20
Line 3 Type of wager: Slots
Line 5 Transaction: 635
Line 7 Winnings from identical wagers: $4,896.85
Line 8 Cashier: 95
Line 10 Window: 375
Line 14 State winnings: 30,448.83
Line 15 State income tax withheld: 6,628.52",W-2G,39,W-2G,fdc-522db08b323bf99d783714ca,v11-W-2G-boxed,original,2026,fgen-6b254db00963bc2e05d5e24c,synthetic_programmatic_template,boxed,top,False,
"Form W-2G
Certain Gambling Winnings
2022
OMB No. 1545-0238
Copy B Report this income on your federal tax return.
PAYER'S name, street address, city or town, province or state, country, and ZIP: Prairie Downs Racetrack 1327 Harbor View Rd Lakewood, CO 44391
PAYER'S federal identification number: 71-9095854
WINNER'S name: Avery L. Romero
WINNER'S taxpayer identification no.: ***-**-2112
Street address (including apt. no.): 1898 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Fairview, OH 87127
Account number (see instructions): ending in 407084
Line 1 Reportable winnings: 66,709.99
Line 2 Date won: 4/24/19
Line 4 Federal income tax withheld: 3,751.62
Line 5 Transaction: 850
Line 7 Winnings from identical wagers: 7,742.86
Line 8 Cashier: 441
Line 10 Window: 710
Line 14 State winnings: 56,820.14
Line 15 State income tax withheld: $7,469.81",W-2G,39,W-2G,fdc-5d6e4e27182ee6bbc57f6032,v11-W-2G-boxed,original,2022,fgen-fcc2131615b7c29ce5a411ae,synthetic_programmatic_template,boxed,top,False,
"Form W-2G Certain Gambling Winnings 2021
PAYER'S name:: Prairie Downs Racetrack
To:: Wei J. Brennan
Line 10 Window: 155",W-2G,39,W-2G,fdc-ae715c964c60162ddf0456bb,v11-W-2G-boxed,original,2021,fgen-005be13eb9e138461039414a,synthetic_programmatic_template,boxed,top,False,
"2025
OMB No. 1545-0238
Copy B Report this income on your federal tax return.
Copy C For Winner's Records
PAYER'S name, street address, city or town, province or state, country, and ZIP: Harbor Lights Gaming Resort 9373 Harbor View Rd Brookhaven, PA 95004
PAYER'S federal identification number: 85-3809767
WINNER'S name: Mateo M. Romero
WINNER'S taxpayer identification no.: XXXXX1477
1 Reportable winnings: 74,895.58
2 Date won: April 28, 2025
3 Type of wager: Keno
4 Federal income tax withheld: $7,582.50
5 Transaction: 845
7 Winnings from identical wagers: $3,343.78
8 Cashier: 213
10 Window: 623
14 State winnings: 20,862.24
15 State income tax withheld: $2,503.63
Department of the Treasury - Internal Revenue Service",W-2G,39,W-2G,fdc-7afd78428b3083c07bbe146f,v11-W-2G-boxed,original,2025,fgen-fdef35ec477f370c1dfb01bc,synthetic_programmatic_template,boxed,none,False,
"CORRECTED (if checked)
OMB No. 1545-0238
PAYER'S name, street address, city or town, province or state, country, and ZIP: Prairie Downs Racetrack 3444 Maple Ridge Dr Cedar Falls, IA 26678
PAYER'S federal identification number: 43-6238039
WINNER'S name: Noah Sato
WINNER'S taxpayer identification no.: ending in 9835
Street address (including apt. no.): 573 Granite St
City or town, state or province, country, and ZIP or foreign postal code: Cedar Falls, IA 32390
Account number (see instructions): ****818566
2 Date won: 07/20/2019
3 Type of wager: Poker tournament
5 Transaction: 672
7 Winnings from identical wagers: $1,210.01
8 Cashier: 219
10 Window: 330
14 State winnings: $62,464.93
15 State income tax withheld: $5,659.89
Department of the Treasury - Internal Revenue Service",W-2G,39,W-2G,fdc-7ddc698227da4a8cfa6767ca,v11-W-2G-boxed,original,2022,fgen-c2e2f59fece06afbb9936d1f,synthetic_programmatic_template,boxed,none,False,
"For calendar year 2025
OMB No. 1545-0238
Copy B Report this income on your federal tax return.
PAYER'S name, street address, city or town, province or state, country, and ZIP: Harbor Lights Gaming Resort 2511 Elm Park Pl Oak Grove, TX 19907
PAYER'S federal identification number: 34-7184821
WINNER'S name: Wei Adeyemi
WINNER'S taxpayer identification no.: ending in 8291
Street address (including apt. no.): 8877 Granite St
City or town, state or province, country, and ZIP or foreign postal code: Pinecrest, GA 91081
Account number (see instructions): XXXXX357557
1 Reportable winnings: 53,622.87
3 Type of wager: Horse race
4 Federal income tax withheld: 634.54
7 Winnings from identical wagers: 1,267.55
8 Cashier: 416
10 Window: 475
15 State income tax withheld: $8,258.75
Department of the Treasury - Internal Revenue Service",W-2G,39,W-2G,fdc-bd849380c74bbad5d4cbc4ea,v11-W-2G-boxed,original,2025,fgen-e4433a89ed57d36c97134b98,synthetic_programmatic_template,boxed,none,False,
"From:: Lucky River Casino
To:: Riley Moreau
Box 10 Window: 342
Box 8 Cashier: 998
Box 4 Federal income tax withheld: $1,595.27",W-2G,39,W-2G,fdc-963bc8fde2ce6997ae59d637,v11-W-2G-boxed,original,2021,fgen-e99aa57640d3ab699f7ed0cb,synthetic_programmatic_template,boxed,none,False,
"VOID  CORRECTED
Form W-2G
Certain Gambling Winnings
Copy B Report this income on your federal tax return.
PAYER'S name, streetaddress, city or town, province or state, country, and ZIP: Prairie Downs Racetrack 7594 Harbor View Rd Maplewood, MN 374O2
PAYER'S federal identification number: 23-543O733
WINNER'S name: Olivia Testcase
WINNER'S taxpayer identification no.: ***-**-6426
Street address (induding apt. no.): 638l Oak HollowCt
Cíty or town, state or province, country, and ZIP or foreign postal code: Maplewood, MN 38829
Box l Rcportable winnings: 79,O70.79
Box 2 Date won: 07/26/2022
Box 3 Type of wager: Keno
Box 4 Federal income tax withheld:l,645.88
Box 5 Transaction: 470
Box 7 Winnings from idcntical wagers: 5,212.17
Box 8 Cashier: 678
Box 10 Window: 710
Box 14 State winnings: 45,454.92
Box 15 State income tax withheld: S9,314.13
Department ofthe Treasury -Intemal Revenue Service
Form W-2G (keep for your records)  www.irs.gov/FormW2G",W-2G,39,W-2G,fdc-afd218200a6c9c9db393016b,v11-W-2G-boxed,original,2025,fgen-b13f4cdb6f5187cbd5a0cb4f,synthetic_programmatic_template,boxed,top,True,
"Form W-2G Certain Gambling Winnings 2024
PAYER:: Prairie Downs Racetrack
Recipient's name:: Kwame A. Rivera
7 Winnings from identical wagers: $1,664.85
4 Federal income tax withheld: 2,097.39
1 Reportable winnings: 36,726.13",W-2G,39,W-2G,fdc-0e6c63a0ae6470b8adf2eb1d,v11-W-2G-boxed,original,2024,fgen-6ab6c073cd52057c6ad1ff90,synthetic_programmatic_template,boxed,top,False,
"Form W-2G Certain Gambling Winnings 2021
PAYER'S name:: Lucky River Casino
Recipient's name:: Sofia L. Larsen
5 Transaction: 411
1 Reportable winnings: 106,408.85",W-2G,39,W-2G,fdc-18bdae009f4a202d1dd948ab,v11-W-2G-boxed,original,2021,fgen-aac17f790883ee55cbd0495e,synthetic_programmatic_template,boxed,top,False,
"☐ CORRECTED
Form W-2G
Certain Gambling Winnings
2024
OMB No. 1545-0238
Copy B Report this income on your federal tax return.
Copy C For Winner's Records
PAYER'S name, street address, city or town, province or state, country, and ZIP: Prairie Downs Racetrack 8717 Prairie Ave Oak Grove, TX 82746
PAYER'S federal identification number: 92-6325185
WINNER'S name: Avery Walsh
WINNER'S taxpayer identification no.: XXX-XX-6344
1 Reportable winnings: 76,639.35
2 Date won: 3/6/21
4 Federal income tax withheld: $4,839.69
5 Transaction: 785
7 Winnings from identical wagers: 2,079.47
8 Cashier: 629
14 State winnings: $86,944.02",W-2G,39,W-2G,fdc-566bfea130b6b5a16ad91da0,v11-W-2G-boxed,original,2024,fgen-1a842d914450429bc0620d5d,synthetic_programmatic_template,boxed,top,False,
"CORRECTED (if checked)
Form W-2G
Certain Gambling Winnings
2022
OMB No. 1545-0238
Copy C For Winncr's Records
PAYER'5 namc, street address, city or town, province or state, country, and ZIP: Prairie Downs Racetrack 9384 Sample 5treet Fairview, 0H 78190
PAYER'S federa1 identification number: 73-1637247
WINNER'S name: Jamie R. Moreau
WINNER'S taxpayer identification no.: XXX-XX-4653
Street address (induding apt. no.):6099 Cedar Ln
Cityor town, state or province, country, and ZIP or foreign postal code: Oak Grove, TX61967
Box 1Reportable winnings: 38,947.36
Box 2 Date won: May 9, 2022
Box 3 Type of wager: Poker toumament
Box 5 Transaction: 895
Box 7 Winnings from identical wagers: 269.89
Box 8 Cashier: 951
Box 10 Window: 840
Box 14 5tatc winnings: $28,001.45
Box 15 State income tax withheld: $2,837.78",W-2G,39,W-2G,fdc-ead712d0049255f7abcaf7ab,v11-W-2G-boxed,original,2022,fgen-95dc995b3849d3f3443899a4,synthetic_programmatic_template,boxed,top,True,
"CORRECTED (if checked)
For calendar year 2025
OMB No. 1545-0238
Copy C For Winner's Records
PAYER'S name, street address, city or town, province or state, country, and ZIP: Lucky River Casino 4402 Maple Ridge Dr Brookhaven, PA 13654
PAYER'S federal identification number: 90-5795337
WINNER'S name: Kwame Testcase
WINNER'S taxpayer identification no.: XXX-XX-9809
Street address (including apt. no.): 4420 Lakeshore Blvd
City or town, state or province, country, and ZIP or foreign postal code: Pinecrest, GA 65639
Account number (see instructions): ****955025
Box 1 Reportable winnings: 31,678.89
Box 2 Date won: April 8, 2022
Box 3 Type of wager: Slots
Box 5 Transaction: 340
Box 8 Cashier: 849
Box 10 Window: 116
Box 14 State winnings: 61,733.19
Box 15 State income tax withheld: 2,089.22
Form W-2G
Certain Gambling Winnings",W-2G,39,W-2G,fdc-e3aaeae5e71e718956740878,v11-W-2G-boxed,original,2025,fgen-2a1d50d28d4afced80a83d18,synthetic_programmatic_template,boxed,bottom,False,
"Form W-2G
Certain Gambling Winnings
2021
OMB No. 1545-0238
Copy B Report this income on your federal tax return.
PAYER'S name, street address, city or town, province or state, country, and ZIP: Lucky River Casino 4134 Maple Ridge Dr Bayside, WA 96510
PAYER'S federal identification number: 77-4183186
WINNER'S name: Alex A. Fischer
WINNER'S taxpayer identification no.: XXXXX8542
Box 2 Date won: 2021-12-25
Box 4 Federal income tax withheld: $2,390.92
Box 7 Winnings from identical wagers: $7,667.07
Box 10 Window: 729
Box 14 State winnings: $127,128.44
Box 15 State income tax withheld: 5,328.06",W-2G,39,W-2G,fdc-cc4badbf93daa21bfdbc0e2f,v11-W-2G-boxed,original,2021,fgen-e22cb6ec15183c403fbcdcc9,synthetic_programmatic_template,boxed,top,False,
"Form W-2G
Certain Gambling Winnings
For calendar year 2022
OMB No. 1545-0238
PAYER'S name, street address, city or town, province or state, country, and ZIP: Lucky River Casino 2547 Harbor View Rd Fairview, OH 71852
PAYER'S federal identification number: 32-6639706
WINNER'S name: Amara Adeyemi
WINNER'S taxpayer identification no.: ending in 5456
Street address (including apt. no.): 1079 Prairie Ave
City or town, state or province, country, and ZIP or foreign postal code: Riverton, WI 64962
Line 1 Reportable winnings: 127,721.49
Line 2 Date won: 07/19/2019
Line 3 Type of wager: Keno
Line 4 Federal income tax withheld: $9,456.37
Line 5 Transaction: 87
Line 7 Winnings from identical wagers: $5,958.59
Line 8 Cashier: 75
Line 10 Window: 171
Line 14 State winnings: 50,158.03
Line 15 State income tax withheld: 3,251.48
Department of the Treasury - Internal Revenue Service
Form W-2G (keep for your records)  www.irs.gov/FormW2G",W-2G,39,W-2G,fdc-d49f543e8de453047ad2cf79,v11-W-2G-boxed,original,2022,fgen-9628bd600fe9de0670f14ca7,synthetic_programmatic_template,boxed,top,False,
"Form W-9 Request for Taxpayer Identification Number and Certification 2025 Give form to the requester. Do not send to the IRS. 1 Name of entity/individual. An entry is required. Jordan Walsh 2 Business name/disregarded entity name, if different from above. 2087 Granite St Fairview, OH 70163 Part I Taxpayer Identification Number
(TIN) ending in 8614 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ Individual/sole proprietor 5 Address (number, street, and apt. or suite no.) 8054 Prairie Ave Maplewood, MN 14904 Under penalties of perjury, I certify
that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person Department of the Treasury - Internal Revenue Service Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-206029b734182c88660ea7e8,v11-W-9-flat,original,2025,fgen-0bfcc156700e073a358e2663,synthetic_programmatic_template,flat,top,False,
"CORRECTED (if checked) Form W-9 Request for Taxpayer IdentificationNumber and
Certification 1 Name of entity/individual. An entry is required. Alex C. Sato 2 Business name/disregarded entity namc, if different fromabove.
4611 Sample Street Cedar Falls, IA 399O9 Part I Taxpayer Identificatíon Number(TIN) ****0862 Part II Certification 3a Check the appropriate box for federa1 tax c1assification of the entity/individual whose name isentered on line l ☒ Limited liability company P 5 Address (number, street, and apt. or suite no.) 3776 5ample Street Maplewood, MN 74059 Under penaltíes of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature ofU.S. person Department of the Treasury - Intemal Revenue Service Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-25840edd1d5d6396054d806a,v11-W-9-flat,original,2022,fgen-aadaeb075ddfa8421d3e60ca,synthetic_programmatic_template,flat,top,True,
"Form W-9 Request for Taxpayer Identification Number
and Certification Give form to the requester. Do not send to the IRS. (Rev. March 2024) 1 Name of entity/individual. An entry is required. Kwame Rivera 2 Business name/disregarded entity name, if different from above. 7775 Elm Park Pl Maplewood, MN 93926 Part I Taxpayer Identification Number (TIN) ending in 0819 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ Individual/sole proprietor 5 Address (number, street, and apt. or suite no.) 7885 Elm Park Pl Riverton, WI 79306
Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person Department of the Treasury - Internal Revenue Service Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-fc1a91584e0cfd76beddede0,v11-W-9-flat,original,2023,fgen-bcc0cf9f3e04a5f3f6452864,synthetic_programmatic_template,flat,top,False,
"Form W-9 Request for Taxpayer Identification Number and Certification 2026 Give form to the requester. Do not send to the IRS. (Rev. March 2024) 1 Name of entity/individual. An entry is required. Diego S. Romero 2 Business name/disregarded entity name, if different from above. 5947 Prairie Ave Fairview, OH 82043 Part I Taxpayer Identification Number (TIN) XXXXX6664 Part II Certification 3a Check the appropriate
box for federal tax
classification of the entity/individual whose name is entered on line 1 ☒ C corporation 5 Address (number, street, and apt. or suite no.) 7337 Granite St Cedar Falls, IA 35192 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person",W-9,41,W-9,fdc-d49f417639f862a1220b8dd1,v11-W-9-flat,original,2026,fgen-b93285cd8b859ade93585f6d,synthetic_programmatic_template,flat,top,False,
"Name: Diego Okafor 3a Check the appropriate box for federal tax classification of the
entity/individual whose name is entered on line 1
☒ Individual/sole proprietor 5 Address (number, street, and apt. or suite no.) 2495 Granite St Testville, IL 95305 Form W-9 Request for Taxpayer Identification Number and Certification",W-9,41,W-9,fdc-47243e368e3657d9a57deb15,v11-W-9-flat,original,2025,fgen-b0d4b1c47621a24c6520354f,synthetic_programmatic_template,flat,bottom,False,
"☐ CORRECTED Form W-9 Request for Taxpayer Identification Number and Certification 2023 Give form to the requester. Do not send to the IRS. 1 Name of entity/individual.
An entry is required. Mateo Patel 2 Business name/disregarded entity name, if different from above. 2104 Willow Bend Way Brookhaven, PA 25229 Part I Taxpayer Identification Number (TIN) ending in 7197 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ Limited liability
company P Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person Department of the Treasury - Internal Revenue Service Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-cfc335def2276da478f15d8a,v11-W-9-flat,original,2023,fgen-1d389b4971ee61ceb00fe0ee,synthetic_programmatic_template,flat,top,False,
"Give form to the requester. Do not send to the IRS. 1 Name of entity/individual. An entry is required. Hiro L. Nguyen 2 Business name/disregarded entity name, if different from above. 5853 Prairie Ave Brookhaven, PA 79915 Part I Taxpayer Identification Number (TIN) XXXXX7091 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ S corporation 5 Address (number, street, and apt. or suite no.) 6293 Harbor View
Rd Oak Grove, TX 45255 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person Department of the Treasury - Internal
Revenue Service",W-9,41,W-9,fdc-3cf2377bf8f67d6746b95450,v11-W-9-flat,original,2024,fgen-c47218293b76c7361668b4de,synthetic_programmatic_template,flat,none,False,
"Form W-9 Request for
Taxpayer Identification Number and Certification For calendar year 2023 (Rev. March 2024) 1 Name of entity/individual. An entry is required. Alex Tanaka
2 Business name/disregarded entity name, if different from above. 76 Granite St Testville, IL 76426 Part I Taxpayer Identification Number (TIN) ****0240 Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person",W-9,41,W-9,fdc-81f15d7f10d74a97aee82508,v11-W-9-flat,original,2023,fgen-d9231d97cd09227a95fa6f97,synthetic_programmatic_template,flat,top,False,
"Form
W-9 Request for Taxpayer Identification Number and Certification Give form to the requester. Do not send to the IRS. 1 Name of entity/individual. An entry is required. Diego Kowalski 2 Business name/disregarded entity name, if different from above. 8152 Granite St Testville, IL 12916 Part I Taxpayer Identification Number (TIN) XXXXX7385 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ Limited liability company P 5 Address (number, street, and apt. or suite no.) 5025 Lakeshore Blvd Testville, IL 56838 Signature
of U.S. person Department of the Treasury - Internal Revenue Service Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-48dea12589698940da51f8b0,v11-W-9-flat,original,2021,fgen-ea6d021dc7a9e417a63ec832,synthetic_programmatic_template,flat,top,False,
"2021 Give form to the requester. Do not send to the IRS.
(Rev. March 2024) 1 Name of entíty/individual. An entry is required. Kwame L. Moreau 2 Business name/disregarded entity name, if different from above. 7269E1m Park Pl Riverton, WI 99413 Part ITaxpayer Identification Number (TIN) XXX-XX-4114 Part II Certification 3a Check the appropriate box for federal tax dassification of the entity/individual whose name is entered online 1 ☒Individual/sole proprietor 5 Address (number, street, and apt. or suíte no.) 2399 Oak Ho1low Ct Maplewood, MN 49O90 Under pcnalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer ídentification number 5ignature
of U.5. person Department of the Treasury - Intemal Revenue Service Form W-9 Requestfor Taxpayer Identification Number and Certification Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-02711b5e814f2213edae8eb4,v11-W-9-flat,original,2021,fgen-5b63ec74db8c82b0a5d8eaeb,synthetic_programmatic_template,flat,bottom,True,
"Give form to the requester. Do not send to the IRS. 1 Name of entity/individual. An entry is required. Lena M. Kowalski 2 Business name/disregarded entity name, if different from above. 8494 Harbor View Rd Testville, IL 67206 Part I Taxpayer Identification Number (TIN) ending in 2710 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name
is entered on line 1 ☒ Limited liability company P 5 Address (number, street, and apt. or suite no.) 1351 Granite St Testville, IL
93488 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person Department of the Treasury - Internal Revenue Service Form W-9 Request for Taxpayer Identification Number and Certification Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-75b34e7f79e4fabb8068a113,v11-W-9-flat,original,2026,fgen-6f612357bc40f89fada34441,synthetic_programmatic_template,flat,bottom,False,
"Form W-9 Request for Taxpayer Identification Number and Certification 2022 1 Name of entity/individual. An entry is required. Amara J. Moreau 2 Business name/disregarded entity name, if different from above. 3072 Sample Street
Cedar Falls, IA 61939 Part I Taxpayer Identification Number (TIN) ending in 8883 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line
1 ☒ C corporation 5 Address (number, street, and apt. or suite no.) 4477 Elm Park Pl Pinecrest, GA 74491 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person Department of the Treasury - Internal Revenue Service Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-c26c634da33b74155496570b,v11-W-9-flat,original,2022,fgen-2e474d21c1707a00e522d211,synthetic_programmatic_template,flat,top,False,
"☐ CORRECTED For calendar year 2022 Give form to the requester. Do not send to
the IRS. (Rev. March 2024) 1 Name of entity/individual. An entry is required. Lena Kowalski 2 Business name/disregarded entity
name, if different from above. 5828 Willow Bend Way Pinecrest, GA 62482 Part I Taxpayer Identification Number (TIN) ***-**-8112 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ Individual/sole proprietor 5 Address (number, street, and apt. or suite no.) 6250 Oak Hollow Ct Riverton, WI 49565 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Signature of U.S. person Form W-9 Request for Taxpayer Identification Number and Certification",W-9,41,W-9,fdc-7898f020853f250bec433432,v11-W-9-flat,original,2022,fgen-2387dafa2eb9fd618dd9de2c,synthetic_programmatic_template,flat,bottom,False,
"Form W-9 Request for Taxpayer Identification Number and Certification 2022 Name: Fatima Lindqvist 5 Address (number, street, and apt. or suite no.)
1885 Granite
St Oak Grove, TX 51605 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ S corporation",W-9,41,W-9,fdc-42661a133076faa9d3ba1597,v11-W-9-flat,original,2022,fgen-342a3d09887c38c1844008b3,synthetic_programmatic_template,flat,top,False,
"Form W-9 Request
for Taxpayer Identification Number and Certification 2022 Name: Jamie Larsen 5 Address (number, street, and apt. or suite
no.) 9510 Sample Street Riverton, WI 93669 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1 ☒ C corporation",W-9,41,W-9,fdc-c2ba64a750173610c06cec98,v11-W-9-flat,original,2022,fgen-766be1edfb92e78d58984dd1,synthetic_programmatic_template,flat,top,False,
"2024 1 Name of entity/individual. An entry is required. Fatima Moreau 2 Business name/disregarded entity name, if different from above. 9735 Oak Hollow Ct Pinecrest, GA 93946 Part I Taxpayer Identification Number (TIN) ***-**-6402 Part II Certification 3a Check the appropriate box for federal tax classification of the entity/individual whose name is
entered on line 1 ☒ Individual/sole proprietor 5 Address (number, street, and apt. or suite no.) 3437
Sample Street Bayside, WA 22261 Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number Department of the Treasury - Internal Revenue Service Form W-9 Request for Taxpayer Identification Number and Certification Form W-9 (keep for your records) www.irs.gov/FormW9",W-9,41,W-9,fdc-4d1aae1cd65c4ddb24994199,v11-W-9-flat,original,2024,fgen-4ca89721a7e133ad57f3a845,synthetic_programmatic_template,flat,bottom,False,