This figure contains two graphics. The first graphic represents Form 1040-NR (page 1):The taxpayer name is Richard Bellinger.The TIN is 000-00-7130.The address is 3366 Cooloola St (which is underlined in red) in Melbourne VIC 3000, Australia. A slash is edited before and after Australia, along with a dollar ($) sign.The block letters of AS are edited in red across from the city name in the right margin to indicate the country code.The taxpayer checked the single filing status box; so based on the information provided on the return, a Filing Status Code (FSC) 1 is edited in red in the margin to the left of the filing status boxes.Lines 1a and 1z show 26000.00.The second graphic shows Schedule A, Form 1040-NR:Line 1b (total line of state and local taxes) shows 1600.00.Line 6 shows 900.00 (casualty and theft losses).Line 7 shows 2000.00 (the amount of the valid tax treaty).Line 8 shows 4500.00. A valid tax treaty cannot be claimed on Schedule A; so the amount needs to be transferred to page 1 of Form 1040-NR.Returning to page 1, the amount of 2000 is edited in red to line 1k. Line 1a is adjusted to exclude 2000, placing a red X to the left of 26000.00 and editing 24000 in red on the dotted line to the left.Page 1 also contains a blurb which states, Exhibit 3.21.3-10 was used to verify the treaty before amounts were moved.