24 . What is the taxable portion of Marks pension from Pine Corporation using the simplified method? $________.

CORRECTED (if checked) 1 Gross distribution PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no. OMB No. 1545-0119 Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAS, Insurance Contracts, etc. 3,200.00 2019 ESSEX BANK, CUSTODIAN FOR ROTH IRA OF MARK MATTHEWS 300 MARIN STREET YOUR CITY, STATE ZIP 2a Taxable amount Form 1099-R 0.00 2b Taxable amount not determined 3 Capital gain (included Copy B Report this income on your federal tax return. If this form shows federal income tax withheld in box 4, attach this copy to your return. Total distribution RECIPIENT'S TIN PAYER'S TIN Federal income tax withheld in box 2a) 48-100XXXX RECIPIENT'S name 317-00-XXXX 5 Employee contributions/ Designated Roth contributions or insurance premiums Net unrealized appreciation in employer's securities MARK MATTHEWS 7 Distribution code(s) IRA SEP/ SIMPLE 8 Other Street address (including apt. no.) This information is being fumished to the IRS. 742 RED ROOSTER City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total emrployee cortributions YOUR CITY, STATE ZIP 10 Amount allocable to IRR within 5 years distribution 13 State/Payer's state no. 14 State distribution 11 1st year of desig. Roth contrib. 12 FATCA filing requirement State tax withheld 16 Name of locality Account number (see instructions) 17 Local distribution 15 Local tax withheld Date of payment Form 1099-R www.irs.gow/Form1099R Department of the Treasury - Internal Revenue Service O CORRECTED (f checked). 1 Gross distribution Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAS, Insurance Contracts, etc. OMB No. 1545-0119 PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no. 22,532.00 2a Taxable amount 2019 PINE CORPORATION 1809 GULF DRIVE YOUR CITY, STATE ZIP Form 1099-R 2b Taxable amount not determined X 3 Capital gain (included Total distribution 4 Federal income tax Copy B Report this income on your federal tax return. If this form shows federal income tax withheld in box 4, attach this copy to your return. RECIPIENT'S TIN PAYER'S TIN in box 2a) withheld 40-100XXXX RECIPIENT'S name 317-00-XXXX 2,253.00 6 Net unrealized appreciation in employer's securities 5 Employee contributions Designated Roth contributions or MARK MATTHEWS insurance premiums 7 Distribution code(s) 8 Other Street address (including apt. no.) IRA SEP/ SIMPLE This information is being fumished to the IRS. 742 RED ROOSTER 7. City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contrbutions YOUR CITY, STATE ZIP $ 14,500.00 13 State/Payer's state no. 14 State distribution distribution FATA ing 12 State tax withheld 11 1st year of desig. Roth contrib. requirement 10 Amount allocable to IRR within 5 years 16 Name of locality Account number (see instructions) 17 Local distribution Date of payment 15 Local tax withheld Fom 1099-R www.irsgov/Form1099R Department of the Treasury - Internal Revenue Service CORRECTED (if checked) 1 Gross distribution PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no. OMB No. 1545-0119 Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAS, Insurance Contracts, etc. 3,200.00 2019 ESSEX BANK, CUSTODIAN FOR ROTH IRA OF MARK MATTHEWS 300 MARIN STREET YOUR CITY, STATE ZIP 2a Taxable amount Form 1099-R 0.00 2b Taxable amount not determined 3 Capital gain (included Copy B Report this income on your federal tax return. If this form shows federal income tax withheld in box 4, attach this copy to your return. Total distribution RECIPIENT'S TIN PAYER'S TIN Federal income tax withheld in box 2a) 48-100XXXX RECIPIENT'S name 317-00-XXXX 5 Employee contributions/ Designated Roth contributions or insurance premiums Net unrealized appreciation in employer's securities MARK MATTHEWS 7 Distribution code(s) IRA SEP/ SIMPLE 8 Other Street address (including apt. no.) This information is being fumished to the IRS. 742 RED ROOSTER City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total emrployee cortributions YOUR CITY, STATE ZIP 10 Amount allocable to IRR within 5 years distribution 13 State/Payer's state no. 14 State distribution 11 1st year of desig. Roth contrib. 12 FATCA filing requirement State tax withheld 16 Name of locality Account number (see instructions) 17 Local distribution 15 Local tax withheld Date of payment Form 1099-R www.irs.gow/Form1099R Department of the Treasury - Internal Revenue Service O CORRECTED (f checked). 1 Gross distribution Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAS, Insurance Contracts, etc. OMB No. 1545-0119 PAYER'S name, street address, city or town, state or province, country, ZIP or foreign postal code, and phone no. 22,532.00 2a Taxable amount 2019 PINE CORPORATION 1809 GULF DRIVE YOUR CITY, STATE ZIP Form 1099-R 2b Taxable amount not determined X 3 Capital gain (included Total distribution 4 Federal income tax Copy B Report this income on your federal tax return. If this form shows federal income tax withheld in box 4, attach this copy to your return. RECIPIENT'S TIN PAYER'S TIN in box 2a) withheld 40-100XXXX RECIPIENT'S name 317-00-XXXX 2,253.00 6 Net unrealized appreciation in employer's securities 5 Employee contributions Designated Roth contributions or MARK MATTHEWS insurance premiums 7 Distribution code(s) 8 Other Street address (including apt. no.) IRA SEP/ SIMPLE This information is being fumished to the IRS. 742 RED ROOSTER 7. City or town, state or province, country, and ZIP or foreign postal code 9a Your percentage of total 9b Total employee contrbutions YOUR CITY, STATE ZIP $ 14,500.00 13 State/Payer's state no. 14 State distribution distribution FATA ing 12 State tax withheld 11 1st year of desig. Roth contrib. requirement 10 Amount allocable to IRR within 5 years 16 Name of locality Account number (see instructions) 17 Local distribution Date of payment 15 Local tax withheld Fom 1099-R www.irsgov/Form1099R Department of the Treasury - Internal Revenue Service