This is the first page of completed Partial Agreement on Form 870-PT(AD), Settlement Agreement for Partnership Items and Partnership Level Determination as to Penalties, Additions to Tax, and Additional Amounts.There is a note at the top of the page that states the instructions for the form can be found on the Publishing web site.The words Partial Agreement are added at the top of the page.The following fields are completed:In reply refer to:Taxpayer(s) name, address, and zip code:Dottie Sunflower2 Forget-Me-Not-LaneAnytown, US 01234SSN/EIN: 123-45-X78ZName of Partnership: Flower PartnershipEIN: XY-1234567Tax Year(s) Ended: December 31, 2009Name of Tax Matters Partner: Paul PetuniaIn the signature section of the form, the following fields are completed:Signature of Taxpayer: Dottie SunflowerDate Signed: November 15, 2011Phone Number: 71X-28Z-123XIn the For Internal Revenue Use Only portion of signature section, the following fields are completed:Date Accepted for Commissioner: November 23, 2006Office: Anytown AppealsSignature: Julia OrchidTitle: Appeals Team Manager