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BY WHOM PAID DIRECT INQUIRIES M*. Payer's Federal identifying numbe 1 Interest Income not included <br /> { 970-3 in Box3 <br /> III 1111111111i1111 84 4610 1, 490 . 99 <br /> 999 WESTSTAR BANK <br /> PO BOX 1210 Recipient's identifying number 2 Early withdrawal penalty <br /> GYPSUM CO 81637 470-40-8052 . 00 <br /> PAYER'S RTN(OPTIONAL) 3 Interest on U.S.Savings <br /> Bonds and Treas.obligations <br /> 1021-03119 .00 <br /> CORRECTED(if checked)EI <br /> II your taxpayer ountltylnp number le 4 Federal Income tier withheld <br /> not shown or is Incorrectly shown. <br /> pluu lemhh Me correct ttum•er to . 00 <br /> j the payer. <br /> 5 Investment expenses <br /> � TO WHOM PAID <br /> OMB No 1545 0112 <br /> 00 <br /> , <br /> 1 1 ROBERT T LAZIER ASSIGNED TO S Foreign tax paid <br /> 1313 SHERMAN STREET ROOM 215 . 00 <br /> • DENVER CO 60203 <br /> 7 Foreign country or U.S.passession <br /> Copy <br /> e• Recipient <br /> 1099 INTEREST This is important lax mlormation and is being furnished to the Internal Revenue Sawa.It you are required to file a return,a negli enoe <br /> SUBSTITUTE penalty or other sanction may be imposed on you a Nis income Is taxable and the IRS determines that it has not been reported. Keep this copy for your records. <br /> INTEREST STATEMENT FOR 1999 <br /> TYPE ACCOUNT NUMBER I INTEREST EARNED FORFEITURE FEDERAL TAX WITHHELD <br /> PUBLIC FUNDS CERTIFICATE 10804338 860 . 83 10 .00 <br /> PUBLIC FUNDS CERTIFICATE 10804471 630. 16 0 . 00 <br /> I � <br /> I , <br /> oat? <br /> • I II <br /> II <br /> l <br /> l <br /> I <br /> I <br />