CITADEL BROADCASTING CORPORATION FORM OF RESTRICTED STOCK AGREEMENT FOR USE UNDER THE AMENDED AND RESTATED 2002 STOCK OPTION AND AWARD PLAN (as of October 25, 2005)
EXHIBIT
99.1
CITADEL
BROADCASTING CORPORATION
FORM
OF RESTRICTED STOCK AGREEMENT
FOR
USE UNDER THE
AMENDED
AND RESTATED 2002 STOCK OPTION AND AWARD PLAN
(as
of
October 25, 2005)
THIS
AGREEMENT, dated [GRANT
DATE],
is
entered into between Citadel Broadcasting Corporation, a Delaware Corporation
(together with its subsidiaries and affiliates, including any successor thereto
by merger, consolidation, acquisition of substantially all the assets thereof
or
otherwise, the “Company”),
and
[EMPLOYEE’S
FULL NAME]
(the
“Employee”).
WHEREAS,
the Compensation Committee of the Board of Directors of the Company or its
delegates (the “Committee”)
has
determined that the Employee shall be granted shares of the Company’s common
stock, par value $0.01 per share (the “Common
Stock”),
subject to the restrictions stated below and in accordance with the terms and
conditions of the Citadel Broadcasting Corporation Amended and Restated 2002
Stock Option and Award Plan (also referred to from time to time by the Company
as the Amended and Restated 2002 Long Term Incentive Plan) (as amended from
time
to time, the “Plan”),
a
copy of which can be found as Exhibit 99.1 to the Form 8-K that the Company
filed with the Securities Exchange Commission on May 24, 2005 or can be obtained
by written or telephonic request to the Secretary of the Company. Capitalized
terms not otherwise defined herein have the meaning set forth in the
Plan.
NOW
THEREFORE, the parties hereto hereby agree as follows:
| 1. |
Grant
and Issuance of Stock.
|
Subject
to the terms and conditions of this Agreement and of the Plan, the Company
hereby grants to the Employee (the “Award”)
[INSERT
NO.]
shares
of Common Stock (together with any securities of the Company which may be issued
with respect to the shares by virtue of any stock split, combination, stock
dividend, recapitalization or exchange of stock, which securities shall be
deemed to be “Stock”
hereunder), subject to all the restrictions hereinafter set forth. The Stock
shall be issued in the name of the Employee as soon as reasonably practicable
after the grant is made; provided
that the
Employee has executed and delivered to the Company this Agreement evidencing
the
award, the appropriate blank stock powers (a form of which is attached hereto
as
Exhibit
A)
and, in
the discretion of the Committee, an escrow agreement and any other documents
which the Committee may require as a condition to the issuance of the
Stock.
| 2. |
Vesting
Schedule.
|
Provided
that the
Employee remains in the employ of the Company on a continuous, full-time basis
through the close of business on each of the Vesting Dates set out below, the
interest of the Employee in the specified number of shares of the Stock shall
become fully vested on the specified Vesting Date. The interest of the Employee
in the Stock shall vest as follows: [INSERT
VESTING PROVISION HERE];
|
Vesting
Date
|
Number
of Shares of Stock
|
| 3. |
Restrictions.
|
(a) With
respect to each share of the Stock, the period of time between the date hereof
and the date such share of Stock becomes fully vested in accordance with Section
2
hereof
is referred to herein as the “Restriction
Period.”
(b) Except
as
otherwise provided in this Agreement or permitted by the Committee or the Board
of Directors of the Company, no share of Stock and/or rights or privileges
granted hereunder may be sold, transferred (whether by operation of law or
otherwise) or otherwise disposed of, be pledged or otherwise hypothecated or
be
subject to execution, attachment or similar process until such share of Stock
becomes vested in accordance with Section 2
hereof.
Upon any attempt to effect any such disposition, or upon the levy of any such
process, the Award shall immediately become null and void and the Stock shall
be
forfeited.
| 4. |
Legend.
|
All
certificates representing any Stock of the Company subject to the provisions
of
this Agreement shall have endorsed thereon, (i) any
appropriate legends that may be, in the judgment of the Company, necessary
or
desirable in order to achieve compliance with the Securities Act of 1933, as
amended, or the securities laws of any state or any other law and (ii)
the
following legend:
“The
shares represented by this certificate are subject to an agreement between
Citadel Broadcasting Corporation and the registered holder, a copy of which
is
on file at the principal office of Citadel Broadcasting
Corporation.”
| 5. |
Escrow.
|
(a) The
certificate or certificates evidencing the Stock subject hereto shall be
delivered to and deposited with the Secretary of the Company as Escrow Agent
in
this transaction. The Stock may also be held in a restricted book entry account
in the name of the Employee. Such certificates or such book entry shares are
to
be held by the Escrow Agent until termination of the Restriction Period with
respect to the shares of Stock to which such certificates relate, at which
time
they shall be released by said Escrow Agent; provided,
however,
that a
portion of such Stock shall be surrendered in payment of required withholding
taxes in accordance with Section 9
hereto,
unless alternative procedures for the payment of required withholding taxes
are
established by the Company.
(b) Upon
the
termination of the Restriction Period and subject to the satisfaction of all
terms and conditions contained herein and in the Plan, the Committee shall
cause
the Escrow Agent to, and the Escrow Agent shall deliver a stock certificate
in
respect of the vested Stock to the Employee, free and clear of all restrictions
hereunder.
| 6. |
The
Employee’s Stockholder Rights.
|
Upon
the
Employee's execution and delivery to the Company of this Agreement and the
delivery of the Stock to the Escrow Agent, during the Restriction Period the
Employee shall have all the rights of a holder of Common Stock with respect
to
the Stock except for the right to transfer the Stock, as set forth in Section
3
hereto.
Accordingly, the Employee shall have the right to vote the Stock at any meeting
of the stockholders of the Company at which a holder of Common Stock is entitled
to vote and to receive any dividends or other distributions paid to or made
with
respect to the Stock, less applicable withholding taxes (it being understood
that any cash dividends will generally be taxable as ordinary compensation
income during the Restriction Period unless the Employee makes an election
under
Section 83(b) of the Code as provided in Section 9(e)
of this
Agreement). It
is the
Committee’s intent that, for purposes of Section 409A of the Code, (i) the Stock
shall not be treated as a payment of deferred compensation and (ii) the right
to
receive dividends with respect to the Stock shall be treated as deferred
compensation payable at a specified time or pursuant to a specified schedule,
and that any ambiguities in construction be interpreted to effectuate such
intent.
Any
payment of dividends hereunder shall be made no later than the end of the
calendar year in which the dividends are paid to other stockholders of the
Common Stock or,
if
later, the fifteenth day of the third month following the date the dividends
are
paid to such other stockholders.
| 7. |
Lapse
of Restriction By Death or Disability.
|
The
Restriction shall lapse and have no further force or effect upon termination
of
the Employee’s employment with the Company by reason of [his/her]
death,
permanent disability or adjudicated incompetency. For purposes of this
Agreement, the term “disability” shall mean the Employee’s Disability as defined
in Section 2.12 of the Plan. Once the Employee has been disabled as defined
in
this Section for a period of at least 180 consecutive days, the disability
shall
be deemed to have occurred on the first day of such 180-day period. In the
event
of the Employee’s death after a vesting date but prior to the delivery to the
Employee of the vested shares of Stock, said Stock shall be delivered to the
Employee’s estate or designated beneficiary.
| 8. |
Forfeiture
of Shares.
|
Except
as
otherwise provided for in this Agreement, if the Employee’s employment with the
Company is terminated at any time for any reason (including but not limited
to
the Employee’s voluntary resignation or involuntary discharge for Cause, as
defined in Section 2.5 of the Plan) prior to the lapse of the Restriction Period
for any share of Stock granted hereunder, such Stock shall be forfeited by
the
Employee, and ownership of such Stock transferred back to the Company, without
consideration to the Employee or [his/her]
executor, administrator, personal representative or heirs (“Representative”).
In
any such event, the Employee or [his/her]
Representative
shall promptly deliver any documents requested by the Company necessary to
effectuate such transfer.
| 9. |
Taxes.
|
(a) The
grant
of the Stock and the lapse of the Restriction on the Stock pursuant to Section
2
or
7
hereof
shall be conditioned on the Employee or the Representative having made
appropriate arrangements with the Company to provide for the withholding of
any
taxes required to be withheld by federal, state or local law with respect to
such grant or lapse.
(b) The
Employee shall be liable for any and all taxes, including withholding taxes,
arising out of this grant or the vesting of Stock hereunder. The Employee shall
surrender a sufficient number of whole shares of Stock as necessary to cover
all
applicable required withholding taxes and required social security contributions
at the time of grant or the time that the restrictions on the Stock lapse,
unless alternative procedures for such payment are established by the Company.
The Employee will receive a cash refund for any fraction of a surrendered share
of Stock not necessary for required withholding taxes and required social
insurance contributions. To the extent that any surrender of Stock or
alternative procedure for such payment is insufficient, the Employee authorizes
the Company, its affiliates and subsidiaries, which are qualified to deduct
tax
at source, to deduct all applicable required withholding taxes and social
security contributions from the Employee’s compensation. The Employee agrees to
pay any amounts that cannot be satisfied from wages or other cash compensation,
to the extent permitted by law.
(c) Regardless
of any action the Company takes with respect to any or all income tax, social
insurance, payroll tax, payment on account or other tax-related withholding
(“Tax-Related
Items”),
the
Employee acknowledges and agrees that the ultimate liability for all Tax-Related
Items legally due by [him/her]
is and
remains the Employee’s responsibility and that the Company (i) makes no
representations nor undertakings regarding the treatment of any Tax-Related
Items in connection with any aspect of this grant of Stock, including the grant,
vesting or release, the subsequent sale of Stock and receipt of any dividends
and (ii) does not commit to structure the terms or any aspect of this grant
of
Stock to reduce or eliminate the Employee’s liability for Tax-Related Items. The
Employee shall pay the Company any amount of Tax-Related Items that the Company
or the Employer may be required to withhold as a result of the Employee’s
participation in the Plan or the Employee’s receipt of Stock that cannot be
satisfied by the means previously described. The Company may refuse to deliver
the Stock if the Employee fails to comply with the Employee’s obligations in
connection with the Tax-Related Items.
(d) It
is the
Committee’s intent that the Stock shall not be treated as a payment of deferred
compensation for purposes of Section 409A of the Internal Revenue Code, as
amended from time to time, and that any ambiguities in construction be
interpreted to effectuate such intent.
(e) Section
83(a) of the Code provides that on the vesting date of the Stock, the Employee
must
include in [his/her]
taxable
income as compensation an amount equal to the fair market value (determined
as
of the vesting date of such Stock) of the Stock over the amount (if any) paid
for such Stock.
If the
Employee chooses, the Employee may make an election under Section 83(b) of
the
Code, which would cause the Employee to recognize compensation income for
[his/her]
taxable
year in which the Stock is granted, in the amount of the excess (if any) of
the
Fair Market Value of the Stock acquired (determined as of the date of grant
of
the Stock) over the amount (if any) paid for such Stock. A Section 83(b)
election must be filed with the Internal Revenue Service within thirty (30)
days
after the date of grant. The form for making a Section 83(b) election is
attached as Exhibit
B.
The
Employee acknowledges that it is the Employee's sole responsibility (i)
to
determine whether making an election under Section 83(b) of the Code is
appropriate in [his/her]
particular circumstances, and (ii) if he so chooses,
to file
timely the Section 83(b) election, and further acknowledges that failure to
file
a Section 83(b) election within the applicable thirty (30) day period may result
in the recognition of ordinary compensation income when the Restriction Period
lapses.
| 10. |
Data
Privacy Consent.
|
The
Employee hereby explicitly and unambiguously consents to the collection, use
and
transfer, in electronic or other form, of the Employee’s personal data as
described in this document by and among, as applicable, the Company and its
subsidiaries and affiliates for the exclusive purpose of implementing,
administering and managing the Employee’s participation in the Plan. The
Employee understands that the Company, its affiliates and its subsidiaries
hold
certain personal information about the Employee, including, but not limited
to,
the Employee’s name, home address and telephone number, date of birth, social
security number or other identification number, salary, nationality, job title,
any shares of stock or directorships held in the Company, details of all options
or any other entitlement to shares of stock awarded, canceled, purchased,
exercised, vested, unvested or outstanding in the Employee’s favor for the
purpose of implementing, managing and administering the Plan (the “Data”).
The
Employee understands that the Data may be transferred to any third parties
assisting in the implementation, administration and management of the Plan,
that
these recipients may be located in the Employee’s country or elsewhere and that
the recipient country may have different data privacy laws and protections
than
the Employee’s country. The Employee understands that [he/she]
may
request a list with the names and addresses of any potential recipients of
the
Data by contacting the local human resources representative. The Employee
authorizes the recipients to receive, possess, use, retain and transfer the
Data, in electronic or other form, for the purposes of implementing,
administering and managing the Employee’s participation in the Plan, including
any requisite transfer of such Data, as may be required to a broker or other
third party with whom the Employee may elect to deposit any shares of Common
Stock acquired under the Plan. The Employee understands that Data will be held
only as long as is necessary to implement, administer and manage participation
in the Plan. The Employee understands that
[he/she]
may, at
any time, view Data, request additional information about the storage and
processing of the Data, require any necessary amendments to the Data or refuse
or withdraw the consents herein, in any case without cost, by contacting the
Company’s Director of Human Resources in writing. The Employee understands that
refusing or withdrawing consent may affect the Employee’s ability to participate
in the Plan. For more information on the consequences of refusing to consent
or
withdrawing consent, the Employee understands that [he/she]
may
contact the Company’s Director of Human Resources.
| 11. |
Plan
Information.
|
The
Employee acknowledges that
[he/she]
has
received copies of the Plan, the Plan prospectus and other Plan information
and
acknowledges that additional copies of and any updates to the Plan, Plan
prospectus, Plan information and stockholder information are available upon
written or telephonic request to the Secretary of the Company.
| 12. |
Acknowledgment
and Waiver.
|
By
accepting this grant of Stock, the Employee acknowledges and agrees that: (i)
the Plan is established voluntarily by the Company, it is discretionary in
nature and may be modified, amended, suspended or terminated by the Company
at
any time unless otherwise provided in the Plan or this Agreement; (ii) the
grant
of Stock is voluntary and occasional and does not create any contractual or
other right to receive future grants of Stock, or benefits in lieu of Stock,
even if Stock has been granted repeatedly in the past; (iii) all decisions
with
respect to future grants, if any, will be at the sole discretion of the
Committee and/or the Board of Directors of the Company; (iv) the Employee’s
participation in the Plan shall not create a right to further employment with
the Company and shall not interfere with the ability of the Company to terminate
the Employee’s employment relationship at any time with or without cause and it
is expressly agreed and understood that employment is terminable at the will
of
either party, insofar as permitted by law; (v) the Employee is participating
voluntarily in the Plan; (vi) stock and stock grants are an extraordinary item
that is outside the scope of the Employee’s employment contract, if any; (vii)
stock and stock grants are not part of normal or expected compensation or salary
for any purposes, including, but not limited to calculating any severance,
resignation, termination, redundancy, end of service payments, bonuses,
long-service awards, pension or retirement benefits or similar payments insofar
as permitted by law; (viii) in the event that the Employee is not an employee
of
the Company, this grant of Stock will not be interpreted to form an employment
contract or relationship with the Company or any subsidiary or affiliate of
the
Company; (ix) the future value of the underlying Stock is unknown and cannot
be
predicted with certainty; (x) in consideration of this grant of Stock, no claim
or entitlement to compensation or damages shall arise from termination of this
grant of Stock or diminution in value of this grant of Stock resulting from
termination of the Employee’s employment by the Company (for any reason
whatsoever and whether or not in breach of local labor laws) and the Employee
irrevocably releases the Company from any such claim that may arise; if,
notwithstanding the foregoing, any such claim is found by a court of competent
jurisdiction to have arisen, then, by accepting the terms of this Agreement,
the
Employee shall be deemed irrevocably to have waived any entitlement to pursue
such claim; and (xi) notwithstanding any terms or conditions of the Plan to
the
contrary, in the event of involuntary termination of the Employee’s employment
(whether or not in breach of local labor laws), the Employee’s right to receive
Stock and vest in Stock under the Plan, if any, will terminate effective as
of
the date that the Employee is no longer actively employed and will not be
extended by any notice period mandated under local law (e.g., active employment
would not include a period of “garden leave” or similar period pursuant to local
law); furthermore, in the event of involuntary termination of employment
(whether or not in breach of local labor laws), the Employee’s right to vest in
this Stock after termination of employment, if any, will be measured by the
date
of termination of the Employee’s active employment and will not be extended by
any notice period mandated under local law; the Committee shall have the
exclusive discretion to determine when the Employee is no longer actively
employed for purposes of this Stock grant.
| 13. |
Miscellaneous.
|
(a) The
Company shall not be required (i) to transfer on its books any shares of Stock
of the Company which shall have been sold or transferred in violation of any
of
the provisions set forth in this agreement, or (ii) to treat as owner of such
Stock or to accord the right to vote as such owner or to pay dividends to any
transferee to whom such Stock shall have been so transferred.
(b) Certain
Definitions. Generally, for purposes of this Agreement,
(i) “Affiliate”shall
mean, with respect to any Person, any other Person which, directly or
indirectly, is in control of, or is controlled by, or is under common control
with, such Person.
(ii) “Code”
shall
mean the United States Internal Revenue Code of 1986, as amended.
(iii) "Fair
Market Value"
on
any
date means (a) the closing price in the primary trading session for a share
of
Common Stock on such date on the stock exchange, if any, on which Common Stock
is primarily traded (or if no shares were traded on such date, then on the
most
recent previous date on which any shares were so traded), (b) if clause (a)
is
not applicable, the closing price of the shares of Common Stock on such date
on
The Nasdaq Stock Market at the close of the primary trading session (or if
no
shares were traded on such date, then on the most recent previous date on which
any shares were so traded) or (c) if neither clause (a) nor clause (b) is
applicable, the value of a share for such date as established by the Committee,
using any reasonable method of valuation.
(iv) "FL
& CO. COMPANIES"
shall
mean the collective reference to Forstmann Little & Co. Equity
Partnership-VI, L.P.. Forstmann Little & Co. Subordinated Debt and Equity
Management Buyout Partnership-VII, L.P., Forstmann Little & Co. Equity
Partnership-VII, L.P., and Forstmann Little & Co. Subordinated Debt and
Equity Management Buyout Partnership-VIII, L.P., each a Delaware limited
partnership.
(v) "Person"
shall
mean an individual, a corporation, a partnership, an association, a trust or
any
other entity or organization, including a government or political subdivision
or
an agency or instrumentality thereof.
(vi) "Subsidiary"
shall
mean any Person (other than the Company) in an unbroken chain of Persons
beginning with the Company, if each of the Persons other than the last Person
in
the unbroken chain owns stock possessing fifty percent (50%) or more of the
total combined voting power of all classes of stock in one of the other Persons
in such chain. A Person that attains the status of a Subsidiary on a date after
the execution of this Agreement shall be considered a Subsidiary commencing
as
of such date.
(c) Further
Assurances.
The
parties hereto hereby agree to execute such further instruments and to take
such
action as may reasonably be necessary to carry out the intent of this Agreement.
(d) The
Plan is incorporated herein by reference.
The
Plan and this Agreement (and any documents or certificates executed in
connection herewith) constitute the entire agreement of the parties hereto
with
respect to the subject matter hereof and supersede in their entirety all prior
undertakings and agreements of the Company and the Employee with respect to
the
subject matter hereof, and may not be modified adversely to the Employee’s
interest except by means of a writing signed by the Company and the Employee.
To
the extent any provision of this Agreement is inconsistent or in conflict with
any term or provision of the Plan, the Plan shall govern.
(e) Notice.
Any
notice required or permitted hereunder shall be given in writing and shall
be
deemed effectively given upon delivery to the Employee at [his/her]
address
then on file with the Company.
(f) Successors
and Assigns.
This
Agreement shall be binding upon and operate for the benefit of the Company
and
its successors and assigns, and the Employee, the heirs and legatees of the
Employee's estate and [his/her]
Representative,
whether
or not any such person shall have become a party to this Agreement and have
agreed in writing to be joined herein and be bound by the terms hereof. Neither
this Agreement nor any of the rights, interests or obligations hereunder shall
be assigned by the Employee without the prior written consent of the Company.
In
addition, each of the FL & Co. Companies shall be a third party beneficiary
of this Agreement and shall be entitled directly to enforce this
Agreement.
(g) Adjustment
upon Certain Changes in Capitalization. To the extent permitted by Sections
11
and 12 of the Plan, in the event of any Change in Control (as defined in Section
2.7 of the Plan), share exchange, reorganization, consolidation,
recapitalization, reclassification, distribution, stock dividend, stock split,
reverse stock split, split-up, spin-off, issuance of rights or warrants or
other
similar transaction or event affecting the Common Stock after the date of this
Agreement, the Committee or the Board of Directors of the Company is authorized,
to the extent it deems appropriate, to make adjustments to the number and kind
of shares of stock subject to this Agreement, including the substitution of
equity interests in other entities involved in such transactions, to provide
for
cash payments in lieu of restricted or unrestricted shares, and to determine
whether continued employment with any entity resulting from such a transaction
will or will not be treated as continued employment by the Company or a
subsidiary or affiliate. Unless otherwise determined by the Committee or the
Board of Directors of the Company, such stock, securities, cash, property or
other consideration shall remain subject to all of the conditions, restrictions
and other criteria contained herein which were applicable to the Stock being
adjusted prior to such adjustment.
(h) Governing
Law.
This
Agreement is governed by the laws of the state of Delaware.
(i) Severability;
Counterparts.
The
provisions of this Agreement are severable and if any one or more provisions
are
determined to be illegal or otherwise unenforceable, in whole or in part, the
remaining provisions shall nevertheless be binding and enforceable. If
any
provision of this Agreement is held unlawful or unenforceable in any respect,
such provision shall be revised or applied in a manner that renders it lawful
and enforceable to the fullest extent possible. This
Agreement may be executed in one or more counterparts, each of which shall
be
deemed an original for all purposes, and together shall constitute one and
the
same approval.
K&E
10761454.6
IN
WITNESS WHEREOF, the parties have executed this Agreement, as of the date first
above written.
CITADEL
BROADCASTING CORPORATION
By:
[____]
[TITLE]
By:
[EMPLOYEE’S
FULL NAME]
RETAIN
THIS AGREEMENT FOR YOUR RECORDS
K&E
10761454.6
EXHIBIT
A
STOCK
POWER
FOR
VALUE
RECEIVED the undersigned hereby sell(s), assign(s) and transfer(s) unto Citadel
Broadcasting Corporation (the "Company"),
_________________ (_____) shares of the Common Stock, par value $0.01 per share,
of the Company standing in his/her/their/its name on the books of the Company
represented by Certificate No. ________________ herewith and do(es) hereby
irrevocably constitute and appoint ________________________
his/her/their/its attorney-in-fact, with full power of substitution, to transfer
such shares on the books of the Company.
Dated:
__________________ Signature: _________________________________
Print
Name and Mailing Address
_________________________________
_________________________________
_________________________________
_________________________________
INSTRUCTIONS:
Please do not fill in any blanks other than the signature line and printed
name
and mailing address. Please print your name exactly as you would like your
name
to appear on the issued stock certificate.
K&E
10761454.6
EXHIBIT
B
SECTION
83(b) ELECTION
This
statement is being made under Section 83(b) of the Internal Revenue Code,
pursuant to Treas. Reg. Section 1.83-2.
| 14. |
The
taxpayer who performed the services
is:
|
Name: _______________________________________
Address: ____________________________________________________
Social
Security Number: _______________________________________
| 15. |
The
property with respect to which the election is being made is _________
shares of the Common Stock, par value $0.01 per share, of Citadel
Broadcasting Corporation
(“Citadel”).
|
| 16. |
The
property was issued on
_________________.
|
| 17. |
The
taxable year in which the election is being made is the calendar
year ___________.
|
| 18. |
The
property is subject to forfeiture if the taxpayer ceases to be employed
by
Citadel under certain circumstances, at any time prior to
the applicable vesting date. The forfeiture provision lapses in a
series
of installments over a _____________-year period ending on ____________________,
200__.
|
| 19. |
The
fair market value at the time of transfer (determined without regard
to any restriction other than a restriction which by its terms
will never lapse) is $___________ per
share.
|
| 20. |
The
amount paid for such property is $0.00 per share.
|
| 21. |
A
copy of this statement was furnished to the company for whom taxpayer
rendered the services underlying the transfer of property.
|
| 22. |
This
statement is executed on __________________________________.
|
Taxpayer: _______________________________________
Spouse
(if any): _______________________________________
This
election must be filed with the Internal Revenue Service Center with which
taxpayer files his or her Federal income tax returns and must be made within
thirty (30) days after the grant of Stock. This filing should be made by
registered or certified mail, return receipt requested. You should retain two
(2) copies of the completed form for filing with your Federal and state tax
returns for the current tax year and an additional copy for your
records.