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Ass-Through Entity FEIN NMBTIN NAICS o Mark this box if the address is new or changed. CHECK ONE (Required): Address (Number and street name) A. City State If foreign address, enter country Postal/Zip Code Foreign province and/or state B. o Original Return o Amended Return B.(i) Type: B.(ii) Date: B.(iii) 7-1-13(G) Payment Election C. Mark the legal entity type that applies to you o Beginning of Tax Year Last Day of Tax Year Federal Due Date Extended Due (MM/DD/CCYY) State w.

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