Exhibit 3.11.106-5 - Form 706-GS(D), Page 1Summary: This is an example of a Form 706-GS(D), Generation-Skipping Transfer Tax Return For Distributions, showing transcription lines. The following items are transcribed:Computer Condition CodeTax PeriodPenalty and Interest (P&I) CodeUnder Part 1 - General Information:1a. Name of skip person distributee1b. Social security number of individual distributee (SSN Code)1c. Employer identification number (EIN) of trust distributee2a. Name and title of person filing return (if different from 1a)2b. Address of distributee or person filing return (number and street or PO Box, city, town, or post office, state and ZIP code)Under Part 2 - Distributions:3. Total transfers (add amounts in column c)Under Part 3 - Tax Computation:4. Adjusted allowable expenses)5. Taxable amount (subtract line 4 from line 3)6. Maximum Federal estate tax rate (%)7. Gross GST tax (multiply line 5 by line 6)8. Creditable state GST tax (if any)9. Multiply line 7 by 5%10. Allowable credit (enter the smaller of line 8 or line 9) (received date)11. Net GST tax (subtract line 10 from line 7)12. Payment, if any, made with Form 700413. Tax due (if line 11 is larger than line 12, enter amount owed) (Remittance)14. Overpayment (If line 12 is larger than line 11, enter amount to be refunded)