Sample Form 870-LT - Agreement for Partnership Items & Partnership Level Determinations as to Penalties, Additions to Tax, and Additional Amounts and Agreement for Affected Items, Schedule of Adjustments, Page 3The sample form is an example of Page 3 of Form 870-LT, which contains the heading Schedule of Adjustments. The sample form is an example of a completed form reflecting the partnership's name and a list of proposed adjustments, but the details are not relevant to this exhibit.