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["Form 13976","Itemized Statement Component of Advisee List"]
[]
["Section I","Material Advisor Information"]
[]
["Name (Last/Company)","First Name","Street Address","City","State","Zip Code","Telephone Number","Identifying Number","Person to Contact"]
[]
["Section II","Reportable Transaction Information"]
[]
["Name of Reportable Transaction",null,"Type(s) of ReportableTransaction",null,"Reportable Transaction #",null,null,"Published Guidance # (TOI or Listed Transactions)"]
[]
["Section III","Other Material Advisors to the Reportable Transaction"]
[]
["Name (Last/Company)","First Name","Street Address","City","State","Zip Code","Identifying Number","Signed Designation Agreement (Yes or No)"]
[]
[]
[]
["Section IV","Advisee Information"]
[]
["Name (Last/Company)","First Name","Street Address","City","State","Zip Code","Identifying Number","Date Entered into Transaction","Amount Invested"]

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["Form 13976","Itemized Statement Component of Advisee List"]
["Section V","Schedule of Tax Treatment"]
["Name (Last/Company)","First Name","Identifying Number","Summary or Schedule of the Tax Treatment that Advisee is Expected or Intended to Derive from Participation in Reportable Transaction ",{"$nulls":7},"Associated Documents, such as Exhibit and/or Bates Numbers   Optional"]