9

TLS, have you I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING

transmitted all R Action Date Signature
text files for this INSTRUCTIONS TO PRINTERS
cycle update? Form 8886, PAGE 1 of 2
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES. PRINTS: HEAD TO FOOT O.K. to print
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (8 1⁄2 ") x 559 mm (22") FOLD TO: 216 mm (8 1⁄2 ") x 279 mm (11")
Date PERFORATE: (ON FOLD) Revised proofs
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT requested

Form 8886
(Rev. December 2005)
Reportable Transaction Disclosure Statement


OMB No. 1545-1800

Attachment
Attach to your tax return.
Department of the Treasury Sequence No. 137

See separate instructions.
Internal Revenue Service
Name(s) shown on return Identifying number

Number, street, and room or suite no.

City or town, state, and ZIP code

A Enter the form number of the tax return that this form is attached to

Enter the year of the tax return with which this form is filed

B Check the box(es) that apply (see instructions).

Initial year filer

Protective disclosure

1a Name of reportable transaction

1b Initial year participated in transaction 1c Material advisor or tax shelter registration number
(9 digits or 11 digits)

2 Identify the type of reportable transaction. Check all the box(es) that apply (see instructions).

a Listed transaction d Loss

b Confidential e Significant book-tax difference

c Contractual protection f Brief asset holding period

3 If the transaction is a “listed transaction” or substantially similar to a listed transaction, identify the listed transaction (see
instructions)

4 Enter the number of transactions reported on this form

5 If you invested in the transaction through another entity, such as a partnership, an S corporation, or a foreign
corporation, provide the information below for the entity.

a Name

b Type of entity

c Form number of tax return filed

d Employer identification number (EIN)

6 Enter below, the name and address of each person to whom you paid a fee with regard to the transaction if that person
promoted, solicited, or recommended your participation in the transaction, or provided tax advice related to the transaction.
(Attach additional sheet, if necessary.)
a Name

Number, street, and room or suite no.

City or town, state, and ZIP code

b Name

Number, street, and room or suite no.

City or town, state, and ZIP code

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 34654G Form 8886 (Rev. 12-2005)
 9
I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8886, PAGE 2 of 2
MARGINS: TOP 13 mm (1⁄2 "), CENTER SIDES. PRINTS: HEAD to HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216 mm (81⁄2 ")
279 mm (11")
PERFORATE: (NONE)
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 8886 (Rev. 12-2005) Page 2

7 Facts. Describe the facts of the transaction that relate to the expected tax benefits, including your participation
in the transaction. For listed transactions identified in item 2a, also provide the complete name, address, and
nature of involvement of all parties to the transaction (see instructions).

8 Expected tax benefits. Describe the expected tax benefits, including deductions, exclusions from gross income,
nonrecognition of gain, tax credits, adjustments (or the absence of adjustments) to the basis of property, etc.
(see instructions for more details).

9 Estimated tax benefits. Provide a separate estimate of the amount of each of the expected tax benefits
described above for each affected tax year (including prior and future years).

Form 8886 (Rev. 12-2005)

Printed on recycled paper