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8937Report of Organizational Actions
Affecting Basis of SecuritiesForm
(December 2011)
Department of the Treasury
Internal Revenue Serviceman Ia See separate instructions. Reporting Issuer1 Issuer\'s
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The name of contact for refers to the designated individual who is responsible for communication regarding a specific matter.
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The information that must be reported includes the contact person's name, title, organization, phone number, and email address.
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