Form ID-FTHB
                     Beneficiary and Withdrawal Schedule
                     First-time Home Buyer Savings Account
Account holder names                                         Social Security number

Registration information

         Financial institution name    Account number        Date account opened

                                    Beneficiary information
                                                             Date the beneficiary 
                     Name              Social Security number
                                                             was named

Withdrawals from account

Withdrawal date      Withdrawal amount                     Withdrawal purpose

Financial Institutions: File this schedule with the Idaho State Tax Commission within 90 days of a withdrawal.

                     Mail to: Idaho State Tax Commission, PO Box 36, Boise, ID  83722-0410 

EFO00326 03-31-2022