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OMB No. 15100057(A) Expiration Date: 03/31/2016 For Paperwork Reduction Act Statement and Burden Estimate Statement: See Last Page of Letter December 31, 2016, Telephone (202) 8746850 ANNUAL LETTER

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1510-0057a is a form used for reporting certain information to the relevant authority.

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The purpose of 1510-0057a is to gather specific information for regulatory or compliance purposes.

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