Page 1 of 3
Fidelity Institutional (CUST-FI-001) Statement Date:
as agent for Fidelity Institutional Tax Information
Menlo Park, CA 94025 Account 2024
Customer Service: 800-555-0199
PAYER'S EIN: 61-4327891 RECIPIENT'S SSN: XXX-XX-4444 / XXX-XX-8888
RECIPIENT: Alex & Sam Chen Household ID: HH-CHEN-001
3215 Lakeview Circle, Wayzata, MN 55391 Account: ACCT-TX01 ...7412
DIVIDENDS AND DISTRIBUTIONS 2024 1099-DIV INTEREST INCOME 2024 1099-INT
1a- Total ordinary dividends 1,340.52 1- Interest income 868.10
1b- Qualified dividends 1,072.42 3- Interest on U.S. Savings Bonds 0.00
2a- Total capital gain distributions 0.00 4- Federal income tax withheld 0.00
5- Section 199A dividends 0.00 8- Tax-exempt interest 0.00
12- Exempt-interest dividends 878.40 11- Bond premium 0.00
14- State tax withheld 0.00
SUMMARY OF PROCEEDS, GAINS & LOSSES, AND WITHHOLDING
Term Proceeds Cost basis Market discount Wash sale loss disallowed Net gain or loss(-)
Long 104,942.00 90,444.00 0.00 0.00 14,498.00
Grand total 104,942.00 90,444.00 0.00 0.00 14,498.00
Withholding
Federal income tax withheld 0.00
*This is important tax information and is being furnished to the Internal Revenue Service.
If you are required to file a return, a negligence penalty or other sanction may be imposed on
you if this income is taxable and the IRS determines that it has not been reported.
Fidelity Institutional (Synthetic) — Chen Household HH-CHEN-001 | CONFIDENTIAL | Synthetic Demo Data Only — Not Investment or Tax Advice | Page 1

Page 2 of 3
FORM 1099-DIV — DIVIDENDS & DISTRIBUTIONS
PAYER: Fidelity Institutional (CUST-FI-001) RECIPIENT: Alex & Sam Chen
EIN: 61-4327891 SSN: XXX-XX-4444 / XXX-XX-8888
Account: ACCT-TX01 ...7412 Tax Year: 2024
Securities: UECIY, IDEIY, UCBIX, UTIPX, MUNIX
Box Detail
Box 1a — Total Ordinary Dividends $1,340.52
Box 1b — Qualified Dividends (subset of 1a) $1,072.42
Box 2a — Total Capital Gain Distributions $0.00
Box 5 — Section 199A Dividends $0.00
Box 12 — Exempt-Interest Dividends (state/local tax-exempt) $878.40
Box 14 — State Tax Withheld $0.00
Qualified dividend eligibility based on required holding periods met for all equity index positions.
Exempt-interest dividends from MUNIX (MN Municipal Bond Fund) are exempt from federal and MN state income tax.
Fidelity Institutional (Synthetic) — Chen Household HH-CHEN-001 | CONFIDENTIAL | Synthetic Demo Data Only — Not Investment or Tax Advice | Page 2

Page 3 of 3
FORM 1099-B — PROCEEDS FROM BROKER TRANSACTIONS
Payer: Fidelity Institutional (CUST-FI-001) EIN: 61-4327891 Account: ACCT-TX01 ...7412
LONG-TERM Transactions — Basis Reported to IRS
Security Qty Date Sold Proceeds Cost Basis Gain / (Loss) Notes
UECIY 2,500 2024-03-14 $37,500.00 $32,750.00 $4,750.00 Q1 equity rebalancing — trim post-rally
IDEIY 1,800 2024-05-22 $22,500.00 $19,440.00 $3,060.00 Q2 international trim
UCBIX 1,500 2024-08-19 $15,150.00 $13,710.00 $1,440.00 Q3 bond portfolio adjustment
MUNIX 1,200 2024-10-02 $12,360.00 $10,872.00 $1,488.00 Q4 muni trim — estate cash planningn(RecID...
UTIPX 800 2024-11-15 $8,360.00 $5,584.00 $2,776.00 TIPS reduce — rate environment shift
STBIX 900 2024-12-20 $9,072.00 $8,088.00 $984.00 Year-end rebalancing
LONG-TERM Subtotal $104,942.00 $90,444.00 $14,498.00
NET REALIZED GAIN / (LOSS): $14,498.00
All transactions in ACCT-TX01 (Joint Taxable Brokerage). Covered security — cost basis reported to IRS.
Noncovered transactions: none for this account in this tax year. Wash sale rules applied where applicable.
Synthetic demo data — consult your tax advisor.
Fidelity Institutional (Synthetic) — Chen Household HH-CHEN-001 | CONFIDENTIAL | Synthetic Demo Data Only — Not Investment or Tax Advice | Page 3
