WILMER EYE INSTITUTE SCHOOL OF MEDICINE THE

Neil M. Bressler, MD The James P. Gills Professor of Ophthalmology – Chief, Retina Division 600 North Wolfe Street, Maumenee 752-A , 21287-9277 Administrative Office: 1-410-955-8342 Fax: 1-410-955-0845 [email protected]

To Whom It May Concern: Clinical Faculty J. Fernando Arévalo, M.D. We would like to offer you the opportunity to support the 35th Annual Current Concepts in Mary Beth Aronow, M.D. Christopher Brady, M.D. Ophthalmology Meeting to be held at the Johns Hopkins University School of Medicine in Baltimore, Neil M. Bressler, M.D. Susan B. Bressler, M.D. Maryland, March 11-16, 2018. We expect an attendance of approximately 100 physicians. If you would Peter A. Campochiaro, M.D. like to exhibit at this activity, an exhibit fee of $2,500 would entitle you to a six-foot table top display. Daniel Finkelstein, M.D. Peter L. Gehlbach, M.D., Ph.D. Johns Hopkins University School of Medicine follows all ACCME guidelines for commercial Morton F. Goldberg, M.D. support. Please visit the course website for more details: James T. Handa, M.D. Catherine B. Meyerle, M.D. https://hopkinscme.cloud-cme.com/aph.aspx?P=5&EID=10918. Hendrik Scholl, M.D. Adrienne Scott, M.D. Syed Mahmood Shah, M.D. This Current Concepts course will highlight the recent developments regarding diagnosis as well as medical Mandeep Singh, M.D., Ph.D and surgical therapy of common eye diseases. The participant should get a comprehensive review of the Akrit Sodhi, M.D., Ph.D. Sharon D. Solomon, M.D. most current concepts in the management of ophthalmology by experts across the breadth of the field. For Adam Wenick, M.D., Ph.D. example, clinical trials and other evidence in the peer-reviewed literature over the past few years have Ingrid Zimmer-Galler, M.D. changed the approach to managing cataract including IOL technology and femtosecond laser cataract The Johns Hopkins Hospital surgery, corneal disease including dry eye disease, keratoplasty, and collagen cross linking, glaucoma and 600 N. Wolfe Street Maumenee 205 minimally invasive glaucoma surgical devices, as well as diabetic retinopathy, macular degeneration, and Baltimore, MD 21287-9277 retinal vein occlusions. Furthermore, the role of optical coherence tomography (OCT) and other imaging 1-410-955-3518 phone 1-410-955-0869 fax advances are expanding the understanding of the anatomy of the anterior and posterior segment of the 1-866-4WILMER toll free eye. This course will address the ongoing pattern of registrants with repeat requests for demonstrations of (1-866-494-5637 toll free) [email protected] the latest surgical techniques and medical therapies, questions regarding practice management issues and clarification of legislative updates. There is a demand for expert education of new techniques and medical Bel Air 620 Boulton Street therapies as well as the need for elucidation of associated clinical trials, and this course provides extensive Bel Air, MD 21014 coverage of that. 1-410-893-0480 phone 1-410-893-9796 fax We look forward to your consideration and funding of this educational meeting. We believe this activity is Bethesda 7315 Wisconsin Avenue a worthwhile educational endeavor that will meet the needs of ophthalmologists by providing information West Tower, Suite 610 Bethesda, MD 20814 that is current, relevant, and clinically useful to their practices. 1-240-482-1100 phone 1-240-482-1105 fax The Johns Hopkins University is a 501(c)3 non-profit organization and our Tax ID # is 52-0595110. All Columbia checks for exhibit fees must be payable to the Johns Hopkins University and sent to 12529 Collections 10700 Charter Drive Suite 205 Center Drive, Chicago, IL 60693 along with an Exhibitor Booth Agreement. Please be sure to reference Columbia, MD 21044-3629 course #80043980 so that the monies are deposited in the appropriate account. More information is 1-410-910-2330 phone 1-410-910-2393 fax available on the Exhibitor Booth Agreement.

Frederick 87 Thomas Johnson Drive Please contact Kathy Case in the CME office at [email protected] if you are interested in exhibiting at Suite 102 this conference to receive the Exhibitor Booth Agreement and further directions. Frederick, MD 21702-4301 1-301-620-9268 phone 1-301-620-9228 fax Sincerely,

Green Spring Station 10753 Falls Rd Pavilion 2, Suite 455 Lutherville, MD 21093-4543 1-410-583-2800 phone Neil M. Bressler, MD 1-410-583-2842 fax The James P. Gills Professor of Ophthalmology Johns Hopkins University School of Medicine

Chief, Retina Division – Wilmer Eye Institute

www.wilmer.jhu.edu Main Telephone: 1-410-955-3518 or toll free 1-866-4WILMER (1-866-494-5637) • email: [email protected] 24 hour page: 1-410-283-2000

VAIL

PROGRAM

SUNDAY, MARCH 11, 2018

3:30 – 5:30 Early Registration

MONDAY, MARCH 12, 2018

Morning Session

6:00 - 7:00 Registration and Continental Breakfast – Meet the Faculty

6:00 – 11:00 Exhibits Open

Practice Management

6:30 - 6:40 What 25 Years of Working with Ophthalmologists has Taught Us* John Grande, CFP and Traudy Grande, CFP *This Session is not eligible for AMA PRA Category 1 Credit™.

6:40 - 6:55 Washington Legislative Update for Ophthalmology 2018* Nancey McCann *This Session is not eligible for AMA PRA Category 1 Credit™.

6:55 - 7:00 Welcome and Conference Goals Neil Bressler, MD

Anterior Segment • Chairs: Yassine Daoud, MD and Terry Kim, MD

7:00- 7:15 Advances in Cataract Surgery: New Phaco Machines Yassine Daoud, MD

7:15 - 7:30 Comparison of Commercially Available Femtosecond Lasers Ronald Krueger, MD

7:30 - 7:45 FLACS in Complicated Cases William Culbertson, MD

7:45 - 8:00 Same Day Simultaneous Cataract Surgery Richard Kaiser, MD

8:00 - 9:00 Complex Cataract Case Presentations William Culbertson, MD, Yassine Daoud, MD, Richard Davidson, MD, Albert Jun, MD, PhD, Terry Kim, MD, Ronald Krueger, MD, and Rolando Toyos, MD

9:00 - 9:15 Intracameral Medications in Cataract Surgery Richard Kaiser, MD

9:15 - 9:30 Pupil Expansion Devices and Management of Zonule Loss Richard Davidson, MD

9:30 - 9:45 Outcomes of Retained Lens Fragments in Cataract Surgery Terry Kim, MD

9:45 - 10:00 Management of Post-surgical Cystoid Macular Edema Susan Bressler, MD

10:00 - 11:00 ORA Seminar – Intraocular Abberometry Yassine Daoud, MD

Afternoon Session

4:30 - 5:00 Refreshment Break – Meet the Faculty

4:30 – 8:00 Exhibits Open

Refractive Surgery • Chairs: William Culbertson, MD and Ronald Krueger, MD

5:00 - 5:15 Custom Cataract Surgery Rolando Toyos, MD

5:15 - 5:30 Multifocal and Extended Depth of Focus IOLs Yassine Daoud, MD

5:30 - 5:45 Management of Astigmatism Richard Davidson, MD

5:45 - 6:00 Intraoperative Aberrometry for Cataract Surgery Ronald Krueger, MD

6:00 - 6:15 Corneal Inlays: What’s Approved and What’s on the Horizon Christina Prescott, MD, PhD

6:15 - 6:30 ICL and Bioptics Richard Davidson, MD

6:30 - 6:45 Topography Guided Ablation Ronald Krueger, MD

6:45 - 7:00 Starting SMILE Natalie Afshari, MD, FACS

7:00 - 8:00 Welcome Reception

TUESDAY, MARCH 13, 2018

Morning Session

6:30 – 7:00 Continental Breakfast – Meet the Faculty

6:30 – 11:15 Exhibits Open

Practice Management

6:30 - 6:45 Is Giving Up Some of Your Upside Potential Worth Hedging Part of the Downside Risk?* John Grande, CFP and Traudy Grande, CFP *This session is not eligible for AMA PRA Category 1 Credit™.

6:45 - 7:00 ASCRS Update* Nancey McCann *This session is not eligible for AMA PRA Category 1 Credit™.

Cornea (Refractive) • Chairs: Kathryn Colby, MD, PhD and Mark Terry, MD

7:00 - 7:15 Social Media for Ophthalmologists Rolando Toyos, MD

7:15 - 7:30 SMILE versus LASIK Terry Kim, MD

7:30 - 7:45 Use of Fibrin Adhesives for Epithelial Ingrowth Management Terry Kim, MD

7:45 - 8:00 Amniotic Membrane Transfer for SJS and TENS Darren Gregory, MD

Cornea (Surgical) • Chairs: Kathryn Colby, MD, PhD and Mark Terry, MD

8:00 - 8:15 Descemet’s Stripping Without Keratoplasty Kathryn Colby, MD, PhD

8:15 - 8:30 Starting DMEK Mark Terry, MD

8:30 - 8:45 DMEK Complications Mark Terry, MD

8:45 - 9:00 When to Perform DSAEK versus DMEK Mark Terry, MD

9:00 - 9:15 Trends in Corneal Transplantation Natalie Afshari, MD, FACS

9:15 - 9:30 Intraoperative OCT for Corneal Surgery William Culbertson, MD

9:30 - 9:45 DALK for Keratoconus Samar Al-Swailem, MD

9:45 - 10:00 Keratoprosthesis: How Has Technology Changed? Kathryn Colby, MD, PhD

10:00 - 10:15 Endothelial Graft Inserters Mark Terry, MD

10:15 - 11:15 Endothelial Keratoplasty Graft (DMEK) Inserters Seminar Yassine Daoud, MD

Afternoon Session

4:00 - 4:30 Refreshment Break – Meet the Faculty

4:00 – 7:00 Exhibits Open

Practice Management

4:30 - 5:00 The Confidence of a Life Well Planned* John Grande, CFP and Traudy Grande, CFP *This Session is not eligible for AMA PRA Category 1 Credit™.

Cornea (Medical) • Chairs: Marguerite McDonald, MD, FACS and Christina Prescott, MD, PhD

5:00 - 5:15 Dry Eye with Stem Cell Deficiency: What are the Options? Christina Prescott, MD, PhD

5:15 - 5:30 Diagnostics and Therapeutics for Dry Eye Marguerite McDonald, MD, FACS

5:30 - 5:45 Dry Eye Masqueraders Richard Davidson, MD

5:45 - 6:00 Management of Dry Eye in Surgical Patients Marguerite McDonald, MD, FACS

6:00 - 6:15 Updates in Ocular Allergy Michael Raizman, MD

6:15 - 6:30 Refractive Changes with Cross Linking Michael Raizman, MD

6:30 - 6:45 Long Term Effects of Cross Linking Samar Al-Swailem, MD

6:45 - 7:00 How to Evaluate Keratoconus Progression and Cross Linking Success Stephen Klyce, PhD, FARVO

WEDNESDAY, MARCH 14, 2018 Morning Session

6:30 - 7:00 Continental Breakfast – Meet the Faculty

6:30 – 10:35 Exhibits Open

Practice Management

6:40 - 7:00 Smart Strategies for Claiming Social Security Benefits* John Grande, CFP and Traudy Grande, CFP *Practice Management Session is not eligible for AMA PRA Category 1 Credit™.

Glaucoma Chair: E. Randy Craven, MD

7:00 – 7:10 Laser Updates Leonard Seibold, MD

7:10 – 7:20 New Glaucoma Medications Releases Jeffrey Soohoo, MD

7:20 – 7:30 Managing Perimetry in the EHR Era E. Randy Craven, MD

7:30 – 7:40 Issues with IOP Leonard Seibold, MD

7:40 – 7:50 Ab-Interno Prodedures Jeffrey Soohoo, MD

7:50 – 8:00 Questions and Answers

8:00 – 8:10 How to Pick the Right MIGS E. Randy Craven, MD

8:10 – 8:20 Trabeculectomy Steven Gedde, MD

8:20 – 8:30 Deep Sclerectomy E. Randy Craven, MD

8:30 – 8:40 Secondary Glaucomas Steven Gedde, MD

8:40 – 8:50 Pseudoexfoliation Syndrome Leonard Seibold, MD

8:50 – 9:00 Questions and Answers

9:00 – 9:10 When to NOT Operate Steven Gedde, MD

9:10 – 9:20 Medicolegal issues with Glaucoma Care E. Randy Craven, MD

9:20 – 9:30 Cataract Surgery in Glaucoma Patients Jeffrey Soohoo, MD

9:30 – 9:40 Valve Update Steven Gedde, MD

9:40 – 9:50 Difficult Cases Leonard Seibold, MD and Jeffrey Soohoo, MD

9:50 – 10:00 Questions and Answers

10:00 – 10:35 MIGS Seminar E. Randy Craven, MD, Steven Gedde, MD, Leonard Seibold, MD, and Jeffrey Soohoo, MD

Afternoon Session

3:50 - 4:20 Refreshment Break – Meet the Faculty

3:50 – 7:00 Exhibits Open

Retina Chairs: Susan Bressler, MD and Akrit Sodhi, MD, PhD

4:20 - 4:40 Teleretinal Screening for Macular Disease Christina Weng, MD

4:40 - 5:00 Initial Treatment of Diabetic Macular Edema: Why Anti-VEGF Instead of Laser or Corticosteroids? How Many Initial Doses? Susan Bressler, MD

5:00 - 5:20 What to Do about Persistent Diabetic Macular Edema: Laser? Corticosteroids? Other? Neil Bressler, MD

5:20 - 5:40 Common Questions on Intravitreous Injections: (1) Role of Pre- or Post-Injection Topical Antibiotics (2) Impact of Injections on IOP (3) Impact of Vitrectomy Prior to Injections Anat Loewenstein, MD, MHA

5:40 - 6:00 Update on Management of Choroidal Neovascularization in Age-related Macular Degeneration Susan Bressler, MD

6:00 - 6:20 Proliferative Diabetic Retinopathy: Panretinal Photocoagulation (PRP) or Anti-VEGF Agents or Both Neil Bressler, MD

6:20 - 6:40 Managing the Intermediate Stage of AMD: (1) Dietary Supplements (2) Home Monitoring Anat Loewenstein, MD, MHA

6:40 - 7:00 Questions and Answers

THURSDAY, MARCH 15, 2018 Morning Session

7:00 - 7:30 Continental Breakfast – Meet the Faculty

7:00 – 11:30 Exhibits Open

Surgical Retina for the Comprehensive Ophthalmologist Chairs: J. Fernando Arevalo, MD, FACS and Anat Loewenstein, MD, MHA

7:30 - 7:45 Pseudoholes, Lamellar Holes, Epiretinal Membranes – What’s the Difference? Scott Oliver, MD

7:45 - 8:00 What’s New in Uveal Melanoma? Scott Oliver, MD

8:10 - 8:30 Endophthalmitis After Cataract Surgery in 2018 Christina Weng, MD

8:30 - 8:50 Heads-Up Displays – Possible Future of Retina Surgery Anat Loewenstein, MD, MHA

8:50 - 9:10 3D Visualization Systems J. Fernando Arevalo, MD, FACS

9:10 - 9:30 Macular Hole Surgery: What’s the Latest? J. Fernando Arevalo, MD, FACS

9:30 - 9:50 Vitreomacular Traction: What Do We Know about Ocriplasmin? Christina Weng, MD

9:50 - 10:10 Managing Macular Edema When an ERM is Present Anat Loewenstein, MD, MHA

10:10 - 10:30 The Lens Went South: What Should the Cataract Surgeon Do? Christina Weng, MD

10:30 - 11:30 Retina OCT Seminar (or 3D Surgical Seminar) J. Fernando Arevalo, MD and Christina Weng, MD

Afternoon Session

4:00 - 4:30 Refreshment Break – Meet the Faculty

4:30 – 7:00 Exhibits Open

Practice Management

4:00 - 4:30 Washington Legislative Update for Ophthalmology 2018* Nancey McCann *This session is not eligible for AMA PRA Category 1 Credit™.

Anterior Segment and Uveitis Chairs: Susan Lightman, MBBS, PhD and Michael Raizman, MD

4:30 - 4:45 New Regional Therapies for the Uveitides Susan Lightman, MBBS, PhD

4:45 - 5:00 Diagnosis of Posterior Uveitides Douglas Jabs, MD, MBA

5:00 - 5:15 Uveitis: What’s the Work-Up? Susan Lightman, MBBS, PhD

5:15 - 5:30 Questions and Answers

5:30 - 5:45 Acute Retinal Necrosis – Can We Use Oral Valcyclovir Rather Than Oral Acyclovir? Susan Lightman, MBBS, PhD

5:45 - 6:00 Dry Eye Diagnostic Testing Michael Raizman, MD

6:00 - 6:15 Questions and Answers

6:15 - 6:30 Anti-Inflammatory Therapy of the Non-infectious Posterior Uveitides Douglas Jabs, MD, MBA

6:30 - 6:45 Treatment Options for Keratoconus: Crosslinking and Beyond Michael Raizman, MD

6:45 - 7:00 Questions and Answers

FRIDAY, MARCH 17, 2018 Morning Session

7:00 - 7:30 Continental Breakfast – Meet the Faculty

7:00 – 10:00 Exhibits Open

Uveitis Chairs: Douglas Jabs, MD, MBA and Susan Lightman, MBBS, PhD

7:00 - 7:20 The MUST Trial: 7-Year Results Douglas Jabs, MD, MBA

7:20 - 7:40 Other Biologics for the Uveitides Susan Lightman, MBBS, PhD

7:40 - 8:00 Anti-TNF-α Monoclonal Antibody Therapy for the Uveitides Douglas Jabs, MD, MBA

8:00 - 8:20 Toxoplasmic Retinochoroiditis Susan Lightman, MBBS, PhD

8:20 - 8:40 Uveitic Macular Edema Douglas Jabs, MD, MBA

8:40 – 9:00 Questions and Answers

Oculoplastics and Orbit Chair: Sophie Liao, MD

9:15 – 9:30 Update on Non-Ablative Laser Applications Sophie Liao, MD

9:30 – 9:45 Orbital Tumor Update Sophie Liao, MD

9:45 - 10:00 Questions and Answers

10:00 Adjourn You will receive an email notification to complete the evaluation form and to attest to the number of hours in attendance. The registration desk will remain open during conference hours.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality and scientific integrity of this CME activity.

This schedule is subject to change.

Today’s Date:

EXHIBIT BOOTH AGREEMENT

The Wilmer Eye Institute's 35th Annual Current Concepts in Ophthalmology Vail Marriott, Vail, Colorado March 11-16, 2018 * 80043980 COMPANY: ______CONTACT NAME: ______ADDRESS: ______CITY: ______STATE: ______ZIP: ______PHONE: ______FAX: ______EMAIL: ______DISPLAY FEE: $2,500 NAME AND EMAIL OF REPRESENTATIVES TO BE PRESENT AT CONFERENCE: REP 1: ______REP 1 EMAIL: ______REP 2: ______REP 2 EMAIL: ______

Exhibitor representatives who would like to attend educational sessions are required to register separately for the conference.

Exhibit space includes: One 6'x30" table and 2 chairs will be provided. # Outlets Needed: ______Exhibits will be held at the Vail Marriott, Vail, Colorado. Access to the exhibit area will be available for set-up on March 11, 2018 beginning at 12:00 p.m. Registration will begin at 3:30 p.m. on Sunday, March 11, 2018 and 6:00 a.m. on Monday, March 12, 2018. Due to lack of storage space, please do not ship display to arrive prior to March 8, 2018. It is your company’s responsibility to make arrangements with a courier service to have the display picked up immediately following the last day of the activity.

Shipments should be addressed as follows:

Vail Marriott 715 West Lionshead Circle Vail, CO 81657 ATTN: Kathy Case PLEASE HOLD FOR THE Current Concepts in Ophthalmology CONFERENCE, held March 11-16, 2018. ------I agree to abide by the ACCME Standards for Commercial Support: Specifically 4.2 states: “Product-promotion material or product-specific advertisement of any type is prohibited in or during CME activities. The juxtaposition of editorial and advertising material on the same products or subjects must be avoided. Live (staffed exhibits, presentations) or enduring (printed or electronic advertisements) promotional activities must be kept separate from CME.” “For live, face-to-face CME, advertisements and promotional materials cannot be displayed or distributed in the educational space immediately before, during, or after a CME activity. Providers cannot allow representatives of Commercial Interests to engage in sales or promotional activities while in the space or place of the CME activity.” (Refer to ACCME standards at www.accme.org)

It is the Johns Hopkins Medicine policy that faculty and staff, employees, students, trainees, and volunteers may not accept gifts or entertainment, regardless of value, from pharmaceutical companies or medical device manufacturers or suppliers with respect to any activity at any JHM member organization site and any activity conducted under the auspices of or using the name of any JHM member organization. This policy extends to all exhibitors of this activity. To adhere to this policy no pens, pads, candy, etc. may be offered at your exhibit table.

By signing below the above company acknowledges and agrees to the following (1) The required exhibit fee is for the sole purchase of exhibit space and two complimentary registrations for exhibiting personnel. These personnel must complete and submit a registration form prior to the activity. (2) If more than two personnel wish to attend they must register separately and pay the full registration fee. (3) Payment is required by the company prior to the activity. (4) Each of the costs subsidized by the fee is incremental to the exhibit space and not standard institutional or organizational overhead, and (5) any payment to exhibit is not intended to influence planning of any CE/CME activity or interfere with presentations at any associated CE/CME activity.

PRINT OR TYPE NAME AUTHORIZED SIGNATURE DATE

CHECK MUST BE MADE PAYABLE TO The Johns Hopkins University/80043980 Johns Hopkins University Federal Tax ID: 52 0595110 Kindly return this form with payment upon receipt to Kathy Case, Conference Coordinator, Johns Hopkins University, Office of Continuing Medical Education, Johns Hopkins University Central Lockbox, Bank of America, 12529 Collections Center Drive, Chicago, IL 60693.

Kathy Case PHONE: 410-614-0150 FAX: 443-224-9540 Email: [email protected] Program information will be available at www.Hopkinscme.edu three months prior to activity.

The Johns Hopkins University INVOICE School of Medicine Invoice Number: 80043980 Office of Continuing Medical Education Date: Turner 20, 720 Rutland Avenue Baltimore, MD 21205-2195 Phone: 410-614-0150 Fax: 443-224-9540

The Wilmer Eye Institute's 35th Annual Current Concepts in Ophthalmology March 11-16, 2018 * 80043980 Vail Marriott, Vail, Colorado

TO: Company Name:______FOR: Exhibit Fee AMOUNT: $ 2,500 DUE: Payment is due 5 business days prior to start of activity.

The Johns Hopkins University Federal Tax ID: 52 0595110 NOTE: Activity budget number 80043980 on the check.

PAYMENT TYPE:

[ ]CHECK PAYABLE TO: The Johns Hopkins University/80043980

[ ]Via WIRE TRANSFER TO JOHNS HOPKINS: BANK NAME: Bank of America ACCOUNT NAME: Johns Hopkins University Central Lockbox ACCOUNT NUMBER: 003936830516 ABA NUMBER: 052001633 REFERENCE: Continuing Medical Education; 80043980; Company Name:______

[ ]CREDIT CARD: [ ]VISA [ ]MASTERCARD [ ]DISCOVER [ ]AMEX

Card # Exp. Date

Name on Card Signature and Date

MAIL TO: Kathy Case, CME Conference Coordinator The Johns Hopkins University School of Medicine Office of Continuing Medical Education Johns Hopkins University Central Lockbox Bank of America 12529 Collections Center Drive Chicago, IL 60693

Form W-9 Request for Taxpayer Give Form to t he (Rev. December 2014) requester. Do not Department of the Treasury Identification Number and Certification send to the IRS. Internal Revenue Service 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Johns Hopkins University 2 Business name/disregarded entity name, if different from above ~ Q) Ol J HU School of Medicine a. "'c: 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to 0 certain entities, not indivi duals; see D lndividuaVsole proprietor or D C Corporation D S Corporation D Partnership D TrusVestate instructions on page 3): Q) "' single-member LLC c. 5 Exempt payee code (if any) ~.-::: D Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) .,.. ... 0 Exemption from FATCA reporting 0 2 Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for ..c"' .. the tax classification of the single-member owner . code (if any) ·c: .5 (Applies to accounts maintained outside the U.S.) Q. 0 [!'.'.] Other (see instructions) .,.. 501 (c)non-stock Corporation :;:::: 5 Address (number, street, and apt. or suite no.) "(j Requester's name and address (optional) Q) 12529 Collection Center Drive rnc. Q) 6 City, state, and ZIP code Q) (/) Chicago IL 60693 7 List account number(s) here (optional)

•:m ,.. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The T IN p rovided must match the name given on line 1 to avoid I Social security number I . . .. ' . . backup w1thhold1ng. For 1nd1v1duals, this IS generally your social security number (SSN). However, for a [IlJ I I I I I resident alien, sole p roprietor, or disregarded entity, see the Part I instructions on page 3. For other - rn - entities, it is your employer identification number (EIN). If you do not have a number, see How to get a . . . . . TIN on page 3. ~o_r ______~ Note. If t he account is in more than one name, see the instructions for line 1 and the chart on page 4 for I Employer identification number guidelines on whose number to enter. 52 - 059 5 0 Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by t he Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification in structions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate t ransactions , item 2 does not ap p ly. For mortgage interest paid , acquisition or abandonment of secured property, cancellation of debt, contrib utions to an individual retirement arrangement (I RA), and generally, payments other than interest and ·vid ends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3 . Sign Signature of Here u.s. person.,.. Date.,.. (~

• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T General Instructions (tuition) Section references are to the Internal Revenue Code unless otherwise noted. • Form 1099-C (canceled debt) Future developments. Information about developments affecting Form W-9 (such • Form 1099-A (acquisition or abandonment of secured property) as legislation enacted after we release it) is at www.irs.gov/fw9. Use Form W-9 only if you are a U.S. person (including a resident alien), to Purpose of Form provide your correct TIN . An individual or entity (Form W-9 requester) who is required to file an information If you do not return Form W-9 to the requester with a TIN, you might be subject return with the IRS must obtain your correct taxpayer identification number (TIN) to backup withholding. See What is backup withholding? on page 2. which may be your social security number (SSN). individual taxpayer identification By signing the filled-out form, you: number (ITIN), adoption taxpayer identification number (ATIN), or employer 1. Certify that the TIN you are giving is correct (or you are waiting for a number identification number (EIN), to report on an information return the amount paid to to be issued), you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: 2. Certify that you are not subject to backup withholding, or • Form 1099-INT (i nterest earned or paid) 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of • Form 1099-DIV (dividends, including those from stocks or mutual funds) any partnership income from a U.S. trade or business is not subject to the • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) withholding tax on foreign partners' share of effectively connected income, and • Form 1099-B (stock or mutual fund sales and certain other transactions by 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are brokers) exempt from the FATCA reporting, is correct. See What is FATCA reporting? on • Form 1099-S (proceeds from real estate transactions) page 2 for further information. • Form 1099-K (merchant card and third party network transactions)

Cat. No. 10231X Form W-9 (Rev. 12-2014)