Exhibit 3.12.263- 12 (Cont. 4) - Form 709-NA, United States Gift (and Generation-Skipping Transfer) Tax Return of Nonresident Not a Citizen of the United States, Page 5Summary: This is an example of Page 5 (Schedule A) of a Form 709-NA with field designators. Part 4 -Taxable Gift Reconciliation (Lines below):1. Total value of gifts of donor; field contains 02012. Total annual exclusions for gifts listed on line 1; field contains 02023. Total included amount of gifts. Subtract line 2 from line 1; field contains 02034. Gifts of interest to spouse; field contains 02045. Exclusions attributable to gifts on line 4; field contains 0205 6. Marital deduction. Subtract line 5 from line 4; field contains 02067. Charitable deduction; field contains 02078. Total deductions. Add lines 6 and 7; field contains 02089. Subtract line 8 from line 3; field contains 020910. GST taxes payable with form 709, field contains 021011. Taxable gifts. Add lines 9 and 10; field contains 0211