Figure of a Period BlankThe following is an example of a partially completed page 3 of a Form 3520 and a partial error register. Certain items are circled, these are represented in brackets. The completed line items of the form are listed. Line 15 (a). Name of beneficiary: field contains Janice ShephardLine 15 (b) Address of beneficiary: field contains 213 Pointer Way; Tokyo {1} Japan JALine 15 (c) U.S. beneficiary: checked checkbox NoLine 15 (d) Identification number, if any: field contains none and 2 on the 2nd line to the right of the checkmarkLine 16(a) -- Name of trustee: field contains Diane PointerLine 16 (b) -- Address of trustee: field contains 325 Terrier Dr; Copenhagen {2} Denmark DALine 16 (c) -- Identification number, if any: field contains noneLine 17(a) -- Name of other person with trust powers: field contains Lisa SetterLine 17(b) -- Address of other person: field contains 1 Boxer Ln; Cork {3} Ireland IRLine 17(c) -- Description of powers: field is blankLine 17(d) -- Taxpayer identification number, Tin, if any: field contains noneScreen Shot of Section 07 and 08 of the Error Register6 07 AJANICE SHEPHARD + B213 POINTER WAY + CTOKYO +D.+{1} E + FJA+ G2+ H + I +J + K + L +M + N + O + P + Q + R +S + T + U+V + W + X + Y + Z +AA + BB +6 08 ADIANE POINTER + B325 TERRIER DR + CCOPENHAGEN +D.+{2} E + FDA + G + H + I+JLISA SETTER+ K1 BOXER LN + LCORK+M.{3} + N + OIR+ P + Q + R + S + T + U + V + W + X + Y +