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CDEFGHI ABCDEFGHIJKLMNOPQRST AB 12345 Fed Schedule M-3 is attached Qualified Subchapter S Subsidiary Initial Filer Final Return NC-478 CD-479 ABCDEFGHIJKLMNOPQRSTUVWXYZABCDEFGHIJKLMNOP ABCD M3 ABCD A 12345 QSSS 123456789 A IF A A 12 45 78 Federal Employer ID Number 123456789 N.C. Secretary of State ID Number 1234567 Limited Liability Company Amended Return NAICS Code 123456 Has Escheatable Property 1234567 FR DOR Use Only 478 123456789 123456 A EP 479 A LLC A A AR.

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