<n1:Form109495BTransmittalUpstream xmlns:irs="urn:us:gov:treasury:irs:common" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns="urn:us:gov:treasury:irs:ext:aca:air:ty21" xmlns:n1="urn:us:gov:treasury:irs:msg:form1094-1095Btransmitterupstreammessage" xsi:schemaLocation="urn:us:gov:treasury:irs:msg:form1094-1095Btransmitterupstreammessage IRS-Form1094-1095BTransmitterUpstreamMessage.xsd">
<Form1094BUpstreamDetail>
<SubmissionId>1</SubmissionId>
<TaxYr>2021</TaxYr>
<BusinessName>
<BusinessNameLine1Txt>First National Corp</BusinessNameLine1Txt>
</BusinessName>
<irs:TINRequestTypeCd>BUSINESS_TIN</irs:TINRequestTypeCd>
<irs:EmployerEIN>600000111</irs:EmployerEIN>
<ContactPhoneNum>5551234567</ContactPhoneNum>
<MailingAddressGrp>
<USAddressGrp>
<AddressLine1Txt>1111 Main St</AddressLine1Txt>
<irs:CityNm>Trenton</irs:CityNm>
<USStateCd>NJ</USStateCd>
<irs:USZIPCd>08695</irs:USZIPCd>
</USAddressGrp>
</MailingAddressGrp>
<Form1095BAttachedCnt>5</Form1095BAttachedCnt>
<Form1095BUpstreamDetail lineNum="0" recordType="">
<RecordId>1</RecordId>
<CorrectedInd>0</CorrectedInd>
<TaxYr>2021</TaxYr>
<ResponsibleIndividualGrp>
<ResponsibleIndividualName>
<PersonFirstNm>Amber</PersonFirstNm>
<PersonLastNm>Atkins</PersonLastNm>
</ResponsibleIndividualName>
<PersonNameControlTxt>ATKI</PersonNameControlTxt>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:TIN>655000011</irs:TIN>
<MailingAddressGrp>
<USAddressGrp>
<AddressLine1Txt>11 Main St</AddressLine1Txt>
<irs:CityNm>Trenton</irs:CityNm>
<USStateCd>NJ</USStateCd>
<irs:USZIPCd>08695</irs:USZIPCd>
<irs:USZIPExtensionCd>1616</irs:USZIPExtensionCd>
</USAddressGrp>
</MailingAddressGrp>
</ResponsibleIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Amber</PersonFirstNm>
<PersonLastNm>Atkins</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:SSN>655000011</irs:SSN>
<CoveredIndividualAnnualInd>1</CoveredIndividualAnnualInd>
</CoveredIndividualGrp>
</Form1095BUpstreamDetail>
<Form1095BUpstreamDetail lineNum="0" recordType="">
<RecordId>2</RecordId>
<CorrectedInd>1</CorrectedInd>
<TaxYr>2021</TaxYr>
<ResponsibleIndividualGrp>
<ResponsibleIndividualName>
<PersonFirstNm>Brennan</PersonFirstNm>
<PersonLastNm>Burton</PersonLastNm>
</ResponsibleIndividualName>
<PersonNameControlTxt>BURT</PersonNameControlTxt>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:TIN>655000021</irs:TIN>
<MailingAddressGrp>
<USAddressGrp>
<AddressLine1Txt>22 Main St</AddressLine1Txt>
<irs:CityNm>Trenton</irs:CityNm>
<USStateCd>NJ</USStateCd>
<irs:USZIPCd>08695</irs:USZIPCd>
<irs:USZIPExtensionCd>3317</irs:USZIPExtensionCd>
</USAddressGrp>
</MailingAddressGrp>
</ResponsibleIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Brennan</PersonFirstNm>
<PersonLastNm>Burton</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:SSN>655000021</irs:SSN>
<CoveredIndividualMonthlyIndGrp>
<JuneInd>1</JuneInd>
<JulyInd>1</JulyInd>
<AugustInd>1</AugustInd>
<SeptemberInd>1</SeptemberInd>
<OctoberInd>1</OctoberInd>
<NovemberInd>1</NovemberInd>
<DecemberInd>1</DecemberInd>
</CoveredIndividualMonthlyIndGrp>
</CoveredIndividualGrp>
</Form1095BUpstreamDetail>
<Form1095BUpstreamDetail lineNum="0" recordType="">
<RecordId>3</RecordId>
<CorrectedInd>1</CorrectedInd>
<TaxYr>2021</TaxYr>
<ResponsibleIndividualGrp>
<ResponsibleIndividualName>
<PersonFirstNm>Cory</PersonFirstNm>
<PersonMiddleNm>C</PersonMiddleNm>
<PersonLastNm>Cannon</PersonLastNm>
</ResponsibleIndividualName>
<PersonNameControlTxt>CANN</PersonNameControlTxt>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:TIN>655000031</irs:TIN>
<MailingAddressGrp>
<USAddressGrp>
<AddressLine1Txt>33 Main St</AddressLine1Txt>
<irs:CityNm>Trenton</irs:CityNm>
<USStateCd>NJ</USStateCd>
<irs:USZIPCd>08695</irs:USZIPCd>
<irs:USZIPExtensionCd>1241</irs:USZIPExtensionCd>
</USAddressGrp>
</MailingAddressGrp>
</ResponsibleIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Cory</PersonFirstNm>
<PersonMiddleNm>C</PersonMiddleNm>
<PersonLastNm>Cannon</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:SSN>655000031</irs:SSN>
<CoveredIndividualAnnualInd>1</CoveredIndividualAnnualInd>
</CoveredIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Christine</PersonFirstNm>
<PersonMiddleNm>C</PersonMiddleNm>
<PersonLastNm>Cannon</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:SSN>655000032</irs:SSN>
<CoveredIndividualAnnualInd>1</CoveredIndividualAnnualInd>
</CoveredIndividualGrp>
</Form1095BUpstreamDetail>
<Form1095BUpstreamDetail lineNum="0" recordType="">
<RecordId>4</RecordId>
<CorrectedInd>0</CorrectedInd>
<TaxYr>2021</TaxYr>
<ResponsibleIndividualGrp>
<ResponsibleIndividualName>
<PersonFirstNm>Dawn</PersonFirstNm>
<PersonLastNm>Duncan</PersonLastNm>
</ResponsibleIndividualName>
<PersonNameControlTxt>DUNC</PersonNameControlTxt>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:TIN>655000041</irs:TIN>
<MailingAddressGrp>
<USAddressGrp>
<AddressLine1Txt>44 Main St</AddressLine1Txt>
<irs:CityNm>Trenton</irs:CityNm>
<USStateCd>NJ</USStateCd>
<irs:USZIPCd>08695</irs:USZIPCd>
<irs:USZIPExtensionCd>1121</irs:USZIPExtensionCd>
</USAddressGrp>
</MailingAddressGrp>
</ResponsibleIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Dawn</PersonFirstNm>
<PersonLastNm>Duncan</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:SSN>655000041</irs:SSN>
<CoveredIndividualMonthlyIndGrp>
<MarchInd>1</MarchInd>
<AprilInd>1</AprilInd>
<MayInd>1</MayInd>
<JuneInd>1</JuneInd>
<JulyInd>1</JulyInd>
<AugustInd>1</AugustInd>
<SeptemberInd>1</SeptemberInd>
<OctoberInd>1</OctoberInd>
<NovemberInd>1</NovemberInd>
<DecemberInd>1</DecemberInd>
</CoveredIndividualMonthlyIndGrp>
</CoveredIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Daniel</PersonFirstNm>
<PersonLastNm>Duncan</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:SSN>655000042</irs:SSN>
<CoveredIndividualMonthlyIndGrp>
<MarchInd>1</MarchInd>
<AprilInd>1</AprilInd>
<MayInd>1</MayInd>
<JuneInd>1</JuneInd>
<JulyInd>1</JulyInd>
<AugustInd>1</AugustInd>
<SeptemberInd>1</SeptemberInd>
<OctoberInd>1</OctoberInd>
<NovemberInd>1</NovemberInd>
<DecemberInd>1</DecemberInd>
</CoveredIndividualMonthlyIndGrp>
</CoveredIndividualGrp>
</Form1095BUpstreamDetail>
<Form1095BUpstreamDetail lineNum="0" recordType="">
<RecordId>5</RecordId>
<CorrectedInd>1</CorrectedInd>
<TaxYr>2021</TaxYr>
<ResponsibleIndividualGrp>
<ResponsibleIndividualName>
<PersonFirstNm>Emma</PersonFirstNm>
<PersonLastNm>Ellison</PersonLastNm>
</ResponsibleIndividualName>
<PersonNameControlTxt>ELLI</PersonNameControlTxt>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:TIN>655000051</irs:TIN>
<MailingAddressGrp>
<USAddressGrp>
<AddressLine1Txt>55 Main St</AddressLine1Txt>
<irs:CityNm>Trenton</irs:CityNm>
<USStateCd>NJ</USStateCd>
<irs:USZIPCd>08695</irs:USZIPCd>
<irs:USZIPExtensionCd>4818</irs:USZIPExtensionCd>
</USAddressGrp>
</MailingAddressGrp>
</ResponsibleIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Emma</PersonFirstNm>
<PersonLastNm>Ellison</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<irs:SSN>655000051</irs:SSN>
<CoveredIndividualAnnualInd>1</CoveredIndividualAnnualInd>
</CoveredIndividualGrp>
<CoveredIndividualGrp>
<CoveredIndividualName>
<PersonFirstNm>Erin</PersonFirstNm>
<PersonLastNm>Ellison</PersonLastNm>
</CoveredIndividualName>
<irs:TINRequestTypeCd>INDIVIDUAL_TIN</irs:TINRequestTypeCd>
<BirthDt>2019-10-02</BirthDt>
<CoveredIndividualMonthlyIndGrp>
<OctoberInd>1</OctoberInd>
<NovemberInd>1</NovemberInd>
<DecemberInd>1</DecemberInd>
</CoveredIndividualMonthlyIndGrp>
</CoveredIndividualGrp>
</Form1095BUpstreamDetail>
</Form1094BUpstreamDetail>
</n1:Form109495BTransmittalUpstream>