Disclosure by Tax-Exempt Entity Regarding                                                      OMB No. 1545-2078
Form 8886-T                                                                                                                          
  (September 2007)                       Prohibited Tax Shelter Transaction                                                         Open to Public
Department of the Treasury                       As required by section 6033(a)(2) of the Internal Revenue Code                          Inspection
Internal Revenue Service                                                                                                                  
 For calendar year 20     , or tax year beginning                                          , 20       and ending                      20                .
Name of tax-exempt entity                                                                                             Employer identification number 
                                                                                                                           . . . .  
In care of (if applicable)
 
Number, street, and room or suite no. (or P.O. box number if mail is not delivered to street address)
 
City or town, state, and ZIP code
 
 1      Check the applicable box that describes the tax-exempt entity.
         
           An organization described in section 501(c) or 501(d)                                An eligible deferred compensation plan
             A State, a possession of the United States, or the                                 described in section 457(b) which is maintained by
           District of Columbia, a political subdivision of a                                   an employer described in section 457(e)(1)(A)
           State or possession of the United States                                             An   individual retirement account
             An Indian tribal government                                                          An individual retirement annuity
             A plan described in section 401(a) which includes                                  An   Archer MSA
           a trust exempt from tax under section 501(a)                                           A custodial account treated as an annuity 
             An annuity plan described in section 403(a) or                                     contract under section 403(b)(7)(A)
           annuity contract described in section 403(b)                                           A Coverdell education savings account
             A qualified tuition program described in section 529                                A health savings account
                                                                                                 
 2      Identify the type of prohibited tax shelter transaction. Check all the box(es) that apply (see instructions).
         
  a        Listed transaction                    b  Confidential                          c     Contractual protection
                                                                                                 
 3      If the transaction is a listed transaction or substantially similar to a listed transaction, identify the listed transactions 
        (see instructions).
         
 4      Identity of other parties (whether taxable or tax-exempt) to the transaction, if known (attach additional sheets, if necessary):
         
Name of party
 
Number, street, and room or suite no.
 
City or town, state, and ZIP code
 
Name of party
 
Number, street, and room or suite no.
 
City or town, state, and ZIP code
 
                   I declare under penalty of perjury that I am authorized to sign this disclosure, that I have examined this disclosure, including any accompanying
                   attachments, and to the best of my knowledge and belief, it is true, correct, and complete.
                    
  Sign
  Here              Signature of director, trustee, officer, or other authorized official                     Date
                                                                                                               
                    Type or print name of signer                                                              Type or print title or authority of signer
                                                                                                               
For Paperwork Reduction Act Notice, see the separate instructions. Printed on recycled paper          Cat. No. 49103E               Form 8886-T           (09-2007)