DEUT 348 PARK AVENUE - NEW YORK NY 10154¢ FOR ASSI TANCE CALI HE BANK TRUST CO. AMERIC. NYC20-1409 16 INTEREST INCOME FORM 1099-INT COPY B, FOR RECIPIENT OMB No. 1848-0112 267D0100001163000 {800) 856-4162 PAYER'S PEDERAL IDENTIFICATION NUMBER 13-4941247 PAGE 1 THIS IS IMPORTANT TAX INFORMATION AND IS BEING PURNISHED TO THE INTERNAL REVENUE HAS NOT B YORK NY Account Type NOW Account MAY BE IMPOS IF YOU ARE REQUIRED TO FILE A RETURN, A NEGLIGEN ON YOU IP THIS INCOME IS TAXABLE AND THE IRS DETERMI { REPORTED. 10065 TOTALS: “2 PENALTY OR OTHER RECIPIENT'S IDENTIFICATION NUMBER INTEREST INCOME 16 FORM 1099-IN' Account Number Deposit ID IRS Description Box# Amount 00035267258 0a001 erest income 1 17.15 Interest income 1 17.15 Barly withdrawal penalty 2 0.00 Interest on U.S. Savings Bonds and Treasury obligations 3 0.00 Federal income tax withheld 4 0.00 Investment expenses s 0.00 Foreign tax paid 6 0.00 Tax-exempt interest a 0.00 Specified private activity bond interest Ey 0.00 Market discount 10 0.00 Bond premium 11 0.00 Bond premium on Treasury obligations 12 0.00 Bond premium on tax-exempt bond 13 0.00 State tax withheld 17 0.00 EFTA00520748