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NORTH ORANGE COUNTY PEDIATRICS UNMEET GALA al-Walid, M.D. DANIEL ADANA, M.D. CHARLES J. BACH, M.D. DAN W. CHILE, M.D. NANCY CHUNG, M.D. JEFF GILL, M.D., M.B.A. ELIGIBILITY GUARANTEE FORM I, hereby

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Daniel Aldana M is a form used for reporting foreign financial accounts to the IRS.

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Any U.S. person who has a financial interest in or signature authority over foreign financial accounts exceeding certain thresholds.

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