This figure contains two graphics. The first graphic represents the top portion of Form 1040-NR, page 1:The taxpayer name is Mickey Cobra.The TIN is 000-00-9306.The address is 457 Gator Way in New Orleans, LA, and the ZIP code is 70113. There is no country listed in the entity area. A text box states: No country found on attachments.The entity address is domestic; therefore, XX is edited as the country code.Filing status code 1 is edited in red to the left of the filing status boxes since the single box is checked by the taxpayer.The second graphic is a Schedule OI with no fields completed.