This figure represents the top portion of a Form 1040 (page 1) with the entity section completed:The filing status is single.The taxpayer name is Daniel Prieto.The TIN is 000-00-1584.The street address is URB Cayures 1693 Calle Yauco. URB Cayures is underlined in red because an URB must be shown as the Additional Information Line (AIL).The city is listed as Arecibo, Puerto Rico. Puerto Rico has been circled in red.The state field was empty but has been edited in red with PR (the two character alpha abbreviation for Puerto Rico).There was no ZIP code. All territory returns must have a ZIP Code, so 00612 (from Exhibit 3.21.3-6) has been edited in red