This exhibit displays a blank copy of Form 8288-A, Statement of Withholding on Dispositions by Foreign Persons of U. S. Real Property Interests. The left side of the form do not have any box or line numbers. The description of this data will be contained in the first four bullets. The following are the names of the lines on the form. In the top left hand corner box will appear the Withholding Agent's name, street address, city, state, and zip code entity box.The first box underneath the withholding agent's entity box appears the withholding agent's Taxpayer Identifying Number (TIN).The box to the right of the withholding agent's TIN is the Identification Number of the Foreign Person subject to withholding.Under the TIN boxes (bottom left hand corner box) appears the box for the Name of Person Subject to Withholding.Under the Name of Person Subject to Withholding is the Foreign Address (number, street, apt. or suite no.) box.Under the Foreign Address (number, street, apt. or suite no.) box is the City, province state, postal code and country (not U.S.) box.To the right of the City, province state, postal code and country (not U.S.) box is Box 7, the Country Code box.The Date of Transfer appears in Box 1.The Federal Income Tax Withheld appears in Box 2.The Amount Realized appears in Box 3.The Gain recognized by a Foreign Corporation appears in Box 4.The Description of the property transferred appears in Box 5.The description checkbox of the foreign person subject to withhold appears in Box 6.Underneath Box 6 appears a box which may have an alternate mailing address for the foreign person subject to withholding.