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r Separate Forms on This Page I I SDNY_GM_02771883 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EF1'A_0025869I EFTA01338195 U.S. Department of Justice United States Attorney Southern District of Florida A. Marie Villafana SOO S. Australian Ave, 4th Floor West Palm Beach, Florida 33401 (561) 82
35487.81 3 3fr5-3-33nr. 92 odoelco so porno*. W-2V1 U.S. Virgin Islands Wage and Tax Statement 2005 DeporentYR of I AS Treavay—Infern31 Revenue Sarno. For PeAvicy Act nd Paperwork Rixtuceon Act Notice and ktstruatIone, see Peon W-395. 12.1 S00 rill3V6S.Sii rftWOOIS r 15.82 a Coned rumble 222
ene Agcnrs signature) I I. Attached isa ccrtificate of exisicnce duly authentiented, not more than 90 <bys prior to delivety of this application to the Department of State, by the Secremry of State or other official having custody of corporate records in the jurisdiction under the luw of which li is incorporated. liy
address: From- (Sute) Mot To: 5. (Street Address) County: PIP Dales you wi be at this address: From: (State) (Zip) To: Mailing Address a Sarno es Permanent O Samna Temporary (Suess Address) County (Gay; (Suite) gel Employment Di on Caner unorepleyed. 1. Employer Florida Science Fou
Receipts. • • 3/C-LIAA —/orm, a — 91 339 eyd,cO1 ec EFTA01688713 December 8, 2006 Summerfield, FL 34491 Re: Case Number 31E-MM-108062 Dea l U.S. Department of Justice Federal Bureau of Investigation FBI - West Palm Beach Suite 500 505 South Flagler Drive West Palm Beach, FL 33401 Phone: (561) 833-7517 Fax: (
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