This exhibit displays a copy of Form 8288-A, Statement of Withholding on Certain Dispositions by Foreign Persons. The left side of the form do not have any box or line numbers. The top left hand corner box is the Withholding Agent's name (Willow Oak), street address (1803 Elm Ave), city (Reno), state (NV), and zip code (89501) entity box.Underneath the withholding agent's entity box is the withholding agent's U.S. TIN (000-00-4321).The box to the right of the withholding agent's TIN (00-00-1234) 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(Balsam Hickory).Under the Name of Person Subject to Withholding is the Foreign Address (number, street, apt. or suite no.) box (4443 Fir Dr.).Under the Foreign Address (number, street, apt. or suite no.) box is the City or town, state or province, country (not U.S.) box (Calgary AB T2A 3H8.)The Date of Transfer appears in Box 1 (09-03-2023).The Gain recognized by a foreign appears in Box 2.The Amount Realized appears in Box 3 (20,000.00).Federal income tax withheld appears in Box 4 ($2,000.00).The description checkboxes of Withholding under section 1445 or 1446(f) appear in box 5 (Box 1445 is checked).The description checkbox of the foreign person subject to withhold appears in Box 6 (individual is checked).To the right of the City, province state, postal code and country (not U.S.) box is Box 7, the Country Code box (CA).Description of property transferred appears in box 8 (1234 No. 4321 E. Tampa FL 33602).