06Form 84-105-23-3-1-000 (Rev. 10/23)07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
04                                                                                                                                  Mississippi                                                                                                                     04
05                                                                                                                                                                                                                                                                  05
                                                                                                            Pass-Through Entity Tax Return
06      841052331000                                                                                                                       2023                                                                                                                     06
07                                                                                                                                                                                                                                                                  07
08Tax Year Beginning           99999999                                                                                                                                                                  Tax Year Ending               99999999                     08
09                                                                                                                                                                                                                                                                  09
10FEIN     999999999                                                                                           Mississippi Secretary of State ID                  9999999999                                NAICS Code              999999                          10
11                                                                                                                                                                                                                                                                  11
  Legal Name and DBA
12                                                                                                                                                                   Partnership / LLC / LLP                                     S Corporation                      12
13 X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                     X           (Federal 1065)                               X     (Federal 1120-S)                      13
14 Address                                                                                                                                                                                                                                                          14
15 X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                     CHECK ALL THAT APPLY                                           CHECK ONE                             15
16                                                                                                                                                                                                                                                                  16
17 X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                     X     Electing Pass-Through                              X     100% Mississippi                      17
18 City                                                                                                     State             Zip +4                                 Entity                                                                                         18
19 X9X9X9X9X9X9X9X9X9X9X9                                                                                   XX                999999999                        X     Composite Return                                   X     Multistate Apportioning               19
20                                                                                                                                                                                                                                                                  20
21 County Code        99                                                            Total Number of Mississippi K-1s                   999                     X     Amended Return                                     X     Multistate Direct                     21
22                                                                                                                                                                                                                            Accounting                            22
23                                                                                                                                                             X     Final Return                                                                                   23
    If issuing 100 or more K-1s, this return must be filed electronically. 
24                                                                                                                                                                                                                                                                  24
25 S CORPORATION FRANCHISE TAX                                                                                                                                                                   (ROUND TO THE NEAREST DOLLAR)                                      25
26                                                                                                                                                                                                                                                                  26
271   Taxable capital (from Form 84-110, line 18)                                                                                                                                         1                                      9999999999                         27
28                                                                                                                                                                                                                                                                  28
292   Franchise tax (minimum tax $25)                                                                                                                 X        Fee-In-Lieu                2                                      9999999999                         29
30                                                                                                                                                                                                                                                                  30
31 3   Franchise tax credit (from Form 84-401, line 1)                                                                                                                                    3                                      9999999999                         31
32                                                                                                                                                                                                                                                                  32
334   Net franchise tax due (line 2 minus line 3)                                                                                                                                         4                                      9999999999                         33
34                                                                                                                                                                                                                                                                  34
35 COMPOSITE / ELECTING PASS-THROUGH ENTITY INCOME TAX                                                                                                                                                                                                              35
36                                                                                                                                                                                                                                                                  36
375   Mississippi net taxable income (from Form 84-122, line 32 (composite) or line 35                                                                                                    5                                      9999999999                         37
     (electing pass-through entity))
38                                                                                                                                                                                                                                                                  38
396   Income tax                                                                                                                                                                          6                                      9999999999                         39
40                                                                                                                                                                                                                                                                  40
417   Income tax credits (from Form 84-401, line 3)                                                                                                                                       7                                      9999999999                         41
42                                                                                                                                                                                                                                                                  42
438   Net income tax due (line 6 minus line 7)                                                                                                                                            8                                      9999999999                         43
44                                                                                                                                                                                                                                                                  44
   PAYMENTS AND TAX DUE
45                                                                                                                                                                                                                                                                  45
46 9   Total franchise tax (S corporations only) and/or income tax (composite or electing                                                                                                 9                                      9999999999                         46
47   pass-through entity), (line 4 plus line 8)                                                                                                                                                                                                                     47
4810   Overpayments from prior year                                                                                                                                                       10                                     9999999999                         48
49                                                                                                                                                                                                                                                                  49
5011   Estimated tax payments and payment with extension                                                                                                                                  11                                     9999999999                         50
51                                                                                                                                                                                                                                                                  51
5212   Credit for tax paid on an electing Pass-Through Entity Tax Return (from Form                                                                                                       12                                     9999999999                         52
     (84-161, line 3D; must attach K-1(s) received from electing pass-through entities)
53                                                                                                                                                                                                                                                                  53
5413   Total payments (line 10 plus line 11 and line 12)                                                                                                                                  13                                     9999999999                         54
55                                                                                                                                                                                                                                                                  55
5614   Net total franchise tax and/or income tax (line 9 minus line 13)                                                                                                                   14                                     9999999999                         56
57                                                                                                                                                                                                                                                                  57
5815   Interest and penalty on underestimated income tax payments (from Form 83-305,                                                                                                                                                                                58
59   line 19 or Form 80-320, line 11 (composite partnerships only), see instructions))                                                                                                    15                                     9999999999                         59
60                                                                                                                                                                                                                                                                  60
6116   Late payment interest                                                                                                                                                              16                                     9999999999                         61
62                                                                                                                                                                                                                                                                  62
63                                                                                                                                                                                                                                                                  63
  06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80

  Form 84-105-23-3-2-000 (Rev. 10/23)06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
04                                                           Mississippi                                                                                                                                                                                              04
05                                                                                                                                                                                                                                                      Page 2        05
                                            Pass-Through Entity Tax Return
06      841052332000                                                                                                                                                                                                                                                  06
07                                                            2023                                                                                                                                                                                                    07
08FEIN  999999999                                                                                                                                                                                                                                                     08
09                                                                                                                                                                                                                                                                    09
10                                                                                                                                                                                                                                                                    10
1117   Late payment penalty                                                                                               17                                                                                                                            9999999999    11
12                                                                                                                                                                                                                                                                    12
1318   Late filing penalty (minimum income tax penalty $100)                                                              18                                                                                                                            9999999999    13
14                                                                                                                                                                                                                                                                    14
1519   Total balance due (if line 9 is larger than line 13, add line 14 through line 18)                                  19                                                                                                                            9999999999    15
16                                                                                                                                                                                                                                                                    16
1720   Total overpayment (if line 13 is larger than line 9 plus line 15, subtract line 9                                  20                                                                                                                            9999999999    17
         and line 15 from line 13)
18                                                                                                                                                                                                                                                                    18
1921   Overpayment credited to next year (from line 20)                                                                   21                                                                                                                            9999999999    19
20                                                                                                                                                                                                                                                                    20
2122   Overpayment to be refunded (line 20 minus line 21)                                                                 22                                                                                                                            9999999999    21
22                                                                                                                                                                                                                                                                    22
23 PART l: ENTITY INFORMATION                                                                                                                                                                                                                                         23
24                                                                                                                                                                                                                                                                    24
251     If final return, enter reason and date effective:                                                                                                              DateX9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                99999999      25
262     If the entity has been sold, merged, incorporated, or elected to become a Qualified Sub-Chapter S Subsidiary (QSSS), or converted to a Single-                                                                                                                26
27       Member LLC (SMLLC), complete the following: Name, address and FEIN of the new existing corporation, parent of QSSS or owner of the SMLLC:                                                                                                                    27
28                                                                                                                                                                                          FEINX9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X 999999999     28
29                                                                                                                                                                                                                                                                    29
303     If amended return, check reason.                  Mississippi Correction              Federal Correction                      OtherX X X                               X9X9X9X9X9X9X9X9                                                                       30
31                                                                                                                                                                                                                                                                    31
324     If a partnership or LLC, has a federal election been made to file as a corporation?                    Yes                NoX X                                                                                                                               32
33                                                                                                                                                                                                                                                                    33
345     Check if the company has been audited by the IRS.              If the company has been audited, what year(s) are involved?X                                                                                                                     X9X9X9X9X9X9X 34
35                                                                                                                                                                                                                                                                    35
366     Principal business activity in Mississippi                                                               6a    County location in Mississippi                                                       X9X9X9X9X9X9X9X XXXXXXXXXXXXXXXX                          36
37                                                                                                                                                                                                                                                                    37
387     Principal product or service in Mississippi                                                                       X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                         38
39                                                                                                                                                                                                                                                                    39
408    Contact person for this return                                                                                8a    Location and phone number    X9X9X9X9X9X9X9X9X9X9X9 9X9X9X9X9X9X9X9X                                                                       40
41                                                                                                                                                                                                                                                                    41
42 PART lI:  PASS-THROUGH ENTITY SCHEDULE                                                                                                                                                                                                                             42
43                                                                                                                                                                                                                                                                    43
  List all pass-through entities in Mississippi that the S corporation / Partnership invested in during the tax year.  Attach additional schedule(s),  
44 Form 84-105, page 4, if needed.                                                                                                                                                                                                                                    44
45                                                                                                                                                                                                                                                                    45
46      ENTITY NAME                     FEIN                                             ADDRESS                                                                                                                                                        ENTITY TYPE   46
47                                                                                                                                                                                                                                                                    47
48X9X9X9X9X9X9X9X9X9X                999999999            9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                                                                XXXXXXXXXXXXX 48
49                                                                                                                                                                                                                                                                    49
50X9X9X9X9X9X9X9X9X9X                999999999            9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                                                                XXXXXXXXXXXXX 50
51                                                                                                                                                                                                                                                                    51
52X9X9X9X9X9X9X9X9X9X                999999999            9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                                                                XXXXXXXXXXXXX 52
53                                                                                                                                                                                                                                                                    53
54X9X9X9X9X9X9X9X9X9X                999999999            9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                                                                XXXXXXXXXXXXX 54
55                                                                                                                                                                                                                                                                    55
56 X9X9X9X9X9X9X9X9X9X               999999999            9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                                                                XXXXXXXXXXXXX 56
57                                                                                                                                                                                                                                                                    57
58 X9X9X9X9X9X9X9X9X9X               999999999            9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                                                                XXXXXXXXXXXXX 58
59                                                                                                                                                                                                                                                                    59
60 X9X9X9X9X9X9X9X9X9X               999999999            9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                                                                                                XXXXXXXXXXXXX 60
61                                                                                                                                                                                                                                                                    61
62                                                                                                                                                                                                                                                                    62
63                                                                                                                                                                                                                                                                    63
  06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80

  06Form 84-105-23-3-3-000 (Rev. 10/23)07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
04                                                                                                                                  Mississippi                                                                                                                     04
05                                                                                                                                                                                                                                              Page 3              05
                                                                                                               Pass-Through Entity Schedule
06     841052333000                                                                                                                           2023                                                                                                                  06
07                                                                                                                                                                                                                                                                  07
08                                                                                                                                                                                                                                                                  08
09FEIN    999999999                                                                                                                                                                                                                                                 09
10                                                                                                                                                                                                                                                                  10
11                                                                                                                                                                                                                                                                  11
12 PART lII                                                                                                        Q-SUBS/DISREGARDED ENTITY SCHEDULE                                                                                                               12
13List all qualified subchapter S subsidiaries (Q-Subs) and/or disregarded entities.  Attach additional schedule(s), Form 84-105, page 4, if needed.                                                                                                                13
14                                                                                                                                                                                                                                                                  14
15                 ENTITY NAME                                                                           FEIN                                                     ADDRESS                                               MISSISSIPPI OPERATIONS                      15
16                                                                                                                                                                                                                                        (Y/N)                     16
17                                                                                                                                                                                                                                                                  17
18 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      18
19                                                                                                                                                                                                                                                                  19
20 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      20
21                                                                                                                                                                                                                                                                  21
22 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      22
23                                                                                                                                                                                                                                                                  23
24 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      24
25                                                                                                                                                                                                                                                                  25
26 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      26
27                                                                                                                                                                                                                                                                  27
28 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      28
29                                                                                                                                                                                                                                                                  29
30 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      30
31                                                                                                                                                                                                                                                                  31
32 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      32
33                                                                                                                                                                                                                                                                  33
34 X9X9X9X9X9X9X9X9X9X                                                                          999999999                     9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      34
35                                                                                                                                                                                                                                                                  35
36 X9X9X9X9X9X9X9X9X9X                                                                       999999999                        9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                                 X                      36
37                                                                                                                                                                                                                                                                  37
38 PART IV                                                                                                                  ENTITY OFFICER INFORMATION                                                                                                              38
39List the owners, officers, directors, or partners who have a responsibility in the fiscal management of the organization.                                                                                                                                         39
40                                                                                                                                                                                                                                                                  40
41     OFFICER NAME AND TITLE                                                                            SSN                                                      ADDRESS                                                           OWNERSHIP                       41
42                                                                                                                                                                                                                               PERCENTAGE                         42
43                                                                                                                                                                                                                                                                  43
44X9X9X9X9X9X9X9X9X9X                                                                        999999999                        9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                           999.9999                     44
45                                                                                                                                                                                                                                                                  45
46X9X9X9X9X9X9X9X9X9X                                                                        999999999                        9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                           999.9999                     46
47                                                                                                                                                                                                                                                                  47
48X9X9X9X9X9X9X9X9X9X                                                                        999999999                        9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                           999.9999                     48
49                                                                                                                                                                                                                                                                  49
50X9X9X9X9X9X9X9X9X9X                                                                        999999999                        9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                                                           999.9999                     50
51                                                                                                                                                                                                                                                                  51
52 X      Check box if return may be discussed with preparer.                                                                                                                                                                                                       52
53                                                                                                                                                                                                                                                                  53
54I declare, under penalties of perjury, that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief,                                                                                                    54
  this is a true, correct and complete return.  Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. 
55                                                                                                                                                                                                                                                                  55
56                                                                                                                                                                                                                                                                  56
57     Officer Signature and Title                                                                                                                          Date                                Business Phone                                                      57
58                                                                                                                                                                                                                                                                  58
59     Paid Preparer Signature                                                                                       Date                                   Paid Preparer Address                                                                                   59
60 9X9X9X9X9                                                                                                                                                                                                                                                        60
61     Paid Preparer PTIN                                                                                            Paid Preparer Phone                    City                                               State             Zip Code                           61
62                                                                                                                                                                                                                                                                  62
63                                                                                Mail Return To: Department of Revenue  P.O. BOX 23191 Jackson, MS 39225-3191                                                                                                      63
  06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80

  Form 84-105-23-3-4-000 (Rev. 10/23)06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
04                                             Mississippi                                                                                                                                                                                                           04
05                                                                                                                     Page 4                                                                                                                                        05
                                     Supplemental Pass-Through Entity Schedule
06 841052334000                                 2023                                                                                                                                                                                                                 06
07                                                                                                                                                                                                                                                                   07
08                                                                                                                                                                                                                                                                   08
09FEIN 999999999                                                                                                                                                                                                                                                     09
10                                                                                                                                                                                                                                                                   10
11                                         PASS-THROUGH ENTITY SCHEDULE                                                                                                                                                                                              11
12 List all pass-through entities in Mississippi that the S corporation / Partnership invested in during the tax year, continued from page 2, part II.                                                                                                               12
13                                                                                                                                                                                                                                                                   13
14     ENTITY NAME                   FEIN            ADDRESS                                                           ENTITY TYPE                                                                                                                                   14
15                                                                                                                                                                                                                                                                   15
16X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 16
17                                                                                                                                                                                                                                                                   17
18X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 18
19                                                                                                                                                                                                                                                                   19
20X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 20
21                                                                                                                                                                                                                                                                   21
22X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 22
23                                                                                                                                                                                                                                                                   23
24 X9X9X9X9X9X9X9X9X9X               999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 24
25                                                                                                                                                                                                                                                                   25
26 X9X9X9X9X9X9X9X9X9X               999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 26
27                                                                                                                                                                                                                                                                   27
28X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 28
29                                                                                                                                                                                                                                                                   29
30X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 30
31                                                                                                                                                                                                                                                                   31
32X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 32
33                                                                                                                                                                                                                                                                   33
34X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          XXXXXXXXXXXXX                                                                                                                                 34
35                                                                                                                                                                                                                                                                   35
36                                    Q-SUBS/DISREGARDED ENTITY SCHEDULE                                                                                                                                                                                             36
37 List all qualified subchapter S subsidiaries (Q-Subs) and/or disregarded entities, continued from page 3, part III.                                                                                                                                               37
38                                                                                                                                                                                                                                                                   38
                                                                                                                       MISSISSIPPI OPERATIONS 
39     ENTITY NAME                   FEIN            ADDRESS                                                            (Y/N)                                                                                                                                        39
40                                                                                                                                                                                                                                                                   40
41                                                                                                                                                                                                                                                                   41
42X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             42
43                                                                                                                                                                                                                                                                   43
44X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             44
45                                                                                                                                                                                                                                                                   45
46X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             46
47                                                                                                                                                                                                                                                                   47
48X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             48
49                                                                                                                                                                                                                                                                   49
50X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             50
51                                                                                                                                                                                                                                                                   51
52X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             52
53                                                                                                                                                                                                                                                                   53
54X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             54
55                                                                                                                                                                                                                                                                   55
56X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             56
57                                                                                                                                                                                                                                                                   57
58X9X9X9X9X9X9X9X9X9X                999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             58
59                                                                                                                                                                                                                                                                   59
60 X9X9X9X9X9X9X9X9X9X               999999999 9X9X9X9X9X9X9X9X9X9X9X9X9X9X9X                                          X                                                                                                                                             60
61                                                                                                                                                                                                                                                                   61
62                                                                                                                     Supplemental Page          of99 99                                                                                                            62
63                                                                                                                                                                                                                                                                   63
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