Wage and Income Transcript. Form 1099-B Proceeds From Broker and Barter Exchange Transactions

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Sharyl Randall
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1 This Product Contains Sensitive Taxpayer Data Wage and Income Transcript Request Date: Response Date: Tracking Number: SSN Provided: Tax Period Requested: December, 2012 & Date of Sale or Exchange: Federal Income Stocks and Bonds: $2, Description: 67 SHARES GABELLI SMALL CAP GROWTH Quantity Sold: & Date of Sale or Exchange: Federal Income Stocks and Bonds: $117.00

2 Description: 3 SHARES GABELLI SMALL CAP GROWTH Quantity Sold: & Date of Sale or Exchange: Federal Income Stocks and Bonds: $2, Description: 64 SHARES GABELLI SMALL CAP GROWTH Quantity Sold: Form SSA-1099 Benefits Statement Payer's Federal Identification Number (FIN): SOCIAL SECURITY ADMINISTRATION Payee: Payee's Identification Number: N/A Pensions and Annuities (Total Benefits Paid): $21, Repayments: 0.00 Workman's Compensation Offset: 0.00 TY 2011 Payments: 0.00 TY 2010 Payments: 0.00 TY 2009 Payments: 0.00 TY 2008 Payments: 0.00 Trust Fund Indicator: Retirement SSA/RRB Payments: Either RRB or SSA payments Form 1099-G Payer's Federal Identification Number (FIN): SOUTH CAROLINA DEPARTMENT OF REVENUE PO BOX 125 COLUMBIA, SC ROUSH RICHARD

3 GREENWOOD, SC ATAA Payments: 0.00 Taxable Grants: 0.00 Unemployment Compensation: 0.00 Agricultural Subsidies: 0.00 Prior Year Refund: $3, Market gain on Commodity Credit Corporation loans repaid on or after January 1, 2007: 0.00 Year of Refund: G Offset: Not Refund, Credit, or Offset for Trade or Business Form 1099-DIV Payer's Federal Identification Number (FIN): PRUDENTIAL FINANCIAL INC TA> C O COMPUTERSHARE P O BOX PROVIDENCE, RI PRU C Capital Gains: 0.00 Non-Dividend Distribution : 0.00 Cash Liquidation Distribution: 0.00 Non-Cash Liquidation Distribution: 0.00 Investment Expense: 0.00 Ordinary Dividend: $99.00 Collectibles (28%) Gain: 0.00 Unrecaptured Section 1250 Gain: 0.00 Section 1202 Gain: 0.00 Foreign Tax Paid: 0.00 Qualified Dividends: $99.00 No Second Notice Exempt Interest Dividends: 0.00 Specified Private Activity Bond Interest Dividend: 0.00 Form 1099-INT & Interest: 0.00 Savings Bonds: 0.00 Investment Expense: 0.00 Interest Forfeiture: 0.00 Foreign Tax Paid: 0.00 Tax-Exempt Interest: 0.00 Specified Private Activity Bond Interest: 0.00 No Second Notice Foreign Country or US Possession:

4 Payer's Federal Identification Number (FIN): PRESIDENTIAL LIFE INSURANCE COMPANY 69 LYDECKER STREET NYACK, NY A 7 IRA/SEP/SIMP box not checked Tax Withheld: $79.00 Gross Distribution: $ Taxable Amount: $ Payer's Federal Identification Number (FIN): METROPOLITAN LIFE INSURANCE CO METLIFE R S PO BOX LEXINGTON, KY RICK ROUSH GREENWOOD, SC A IRA/SEP/SIMP box not checked Gross Distribution: $2, Taxable Amount: $2,

5 7 Tax amount not determined IRA/SEP/SIMP box checked Tax Withheld: $8, Gross Distribution: $39, Taxable Amount: $39, This Product Contains Sensitive Taxpayer Data

Tax Return Transcript

Page 1 of 5 This Product Contains Sensitive Taxpayer Data Tax Return Transcript Request Date: 11-23-2009 Response Date: 11-23-2009 Tracking Number: 100056151738 SSN Provided: 563-43-0684 Tax Period Ending: