Form Dr-601cs - Schedules B,c,d,e Page 2

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DR-601CS
R. 01/01
Stocks, Mutuals, Money Market Funds, Limited Partnership Interests, and Beneficial Interest in
D
Schedule
any Trust
The law provides for a specific penalty of 10% for omitted and/or undervalued stock.
Class
Number
Just Value
Total Just Value
Name of Company Issuing Stocks
C = Common
January 1, 2001
of Shares
Per Share
(List Alphabetically — Do not Abbreviate)
P = Preferred
(C)
(D)
(E)
(A)
(B)
Example: X,Y,Z Corporation
X,Y,Z Corporation
X,Y,Z Corporation
X,Y,Z Corporation
X,Y,Z Corporation
C C C C C
1 0 0
1 0 0
1 0 0
1 0 0
1 0 0
8.875
8.875
8.875
8.875
8.875
(C) X (D) = $887.50
(C) X (D) = $887.50
(C) X (D) = $887.50
(C) X (D) = $887.50
(C) X (D) = $887.50
19.
Total of Schedule D (Enter on Schedule A, Line 4.)
19.
E
Corporations Only — Paying as Agent for Florida Stockholders
Schedule
Value of
Total Number of Shares
No. of Taxable Shares
Just Value
Total Taxable Amount
Class of
January 1, 2001
(All shares held by Florida residents)
Outstanding
Per Share
Shares Outstanding
Stock
(4)
(1)
(2)
(3)
(5)
Common
Preferred
Other
LOANS and ADVANCES FROM FLORIDA STOCKHOLDERS
20.
Total of Schedule E (Enter on Schedule A, Line 5.)
20.
Include additional schedules if necessary. Photocopies of all schedules are acceptable. You may use your broker's
statement if all required information is listed and the totals are transferred to the appropriate schedule(s).

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