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A L Z FORM #35803 VERSION: 07/14 <br />WALZ FPOM ._ U.S. PAT. NO. 5,501,393 <br />CERTIFIED <br />MAILER® 1111' III "'I'I1111'IIII'1111111' III "111'1111 "'I'I'I "'111111111 <br />Internal Revenue Service <br />Ogden, UT 84201 <br />Label #1 <br />1111'111 ^'I'1114'Illl'1111111 'III "111'1111 "'19'1 "'111111111 <br />Internal Revenue Service <br />Ogden, UT 84201 <br />Label #2 <br />i <br />Edward J. Rojas <br />Womble Carlyle Sandridge & Rice, LLP <br />I Post Office Box 831 <br />Label #3 1 Raleigh, NC 27602 <br />1 FOLD AND TEAR THIS WAY —I OPTIONAL <br />ZI <br />J: <br />Ni <br />zI <br />o <br />cl <br />a' <br />r <br />9414 7266 9904 2023 8269 45 <br />TO: Internal Revenue Service <br />Ogden, UT 84201 <br />SENDER: Edward J. Rojas <br />REFERENCE: Santa Ana 911 System <br />PS Form 3800, Janua 2005 <br />RETURN Postage <br />RECEIPT Certified Fee <br />SERVICE <br />Return Raceint Fee <br />Restricted Delivery <br />? Total Postage & Fees <br />LISPS® POSTMARK OR DATE <br />Receipt for <br />f; Certified Mail® <br />p No Insurance Coverage Provided <br />B Do Not Use for International Mail <br />_....— ...... ............�.,.......,., .... _ e .,..... <br />I Label #5 Label #6 <br />1111' ul"' I' IIIIr1111 'IIIm1'IU "Ilrl111' ^1.pl ... 111111,11 <br />Internal Revenue Service <br />I Ogden, UT 84201 <br />m _0 Charge <br />M r N Amount: <br />ar' charge 68489.0040.9 <br />To: <br />6111�IIfilGla''�IIIIl�MJllllil <br />9414 7266 9904 2023 8269 i <br />RETURN RECEIPT R <br />PS Form 3811, January 2005 Domestic Return Recelpt <br />Yes <br />No <br />N <br />U <br /><n <br />a <br />U <br />CC <br />C <br />7 <br />(D <br />ir <br />0) <br />C <br />0 <br />a <br />.Y <br />C <br />03 <br />H <br />i2. <br />Article Number <br />1 <br />jI [1 <br />A. Received by (Please Print Clearly) <br />C. Signature <br />0 <br />11 <br />H j <br />9414 7266 9904 2023 8269 45 <br />X <br />O <br />.� <br />en <br />IJl Q I <br />W <br />D. Is delivery address different from Item 1? <br />If YES, enter delivery address below: <br />= <br />CC 1 <br />p. i <br />cn <br />W <br />3. Service Type CERTIFIED MAILe <br />U3 <br />U LU <br />0. <br />4. Restricted Delivery?, (Extra Fee) Yes <br />' <br />R: J 0 <br />1. Article Addressed to: <br />a eC <br />c <br />U z0 I <br />Internal Revenue Service <br />rn Q I <br />Ogden UT 84201 <br />Santa Ana 911 System <br />C <br />CD <br />Z a <br />5 <br />CD <br />a j <br />Edward J. Rojas <br />¢ <br />CD <br />t <br />0 <br />CD <br />E <br />PS Form 3811, January 2005 Domestic Return Recelpt <br />Yes <br />No <br />N <br />U <br /><n <br />a <br />U <br />CC <br />C <br />7 <br />(D <br />ir <br />0) <br />C <br />0 <br />a <br />.Y <br />C <br />03 <br />H <br />