This exhibit contains a sample Form 3210 that is used to send executed agreement forms to the CTF.The Form 3210 is addressed to:Key Case CTFThe remarks section has the following text: TEFRA Partnership and Agreement forms received to date. All forms haven not been returned at this time.The Form 3210 contains the following information:Name of Partnership:EIN:Year(s):MFT:Form:One-Year statute Date is:Enclosures:Forms 870-PT(AD) or 870-LT(AD) for the following partners:Name of PartnerTINSmall return envelopeThe following copies of forms are marked Information Only - Do Not Mail to Taxpayer:Form 5402Appeals Case MemorandumForm 886-Z with agreed written beside those partners who signed agreement formsForm 4605-ANecessary Actions:Return a copy of Form 3210 within 10 days in the envelope.Input one-year statute date for each partner listed above and process agreement formsInclude instructions to CTF for handling penalties and affected items, if applicableSection 6404(g) Notice Date: ______ Section 6404(g) Notice: Type of NoticeThe From field at the bottom left of the Form 3210 contains the following information: Appeals Office AddressThe Releasing Official field contains the following information: Appeals Officer or other Releasing Official