Project 25 Compliance Assessment Program Summary Test Report XTS 5000 Portable Subscriber STR-MOT-XTS February 12, 2013

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roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber Device Under Test Description Manufacturer Motorola Solutions Manufacturer Contact Debra Brown 847-576-3318 roduct Name XTS 5000 ortable Subscriber Frequency Bands VHF, UHF, 700/800MHz Installed Options Trunking, Encryption Installed Vocoder Baseline Full Rate with Improvements Test Description 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.1 roject 25 hase 1 Common Air Interface Conventional Subscriber Unit erformance. 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit erformance. 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.3.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit Interoperability. (Home Configuration tests are the same as the September 2009 CAB. Inter- and Inter-WACN roaming configurations are not supported on the Motorola infrastructure.) Informative References Date Title March 2010 25-CAB-CAI_TEST_REQ Other Devices Tested with Motorola Solutions XTS 5000 Subscriber Manufacturer roduct Name and Definition Installed Options Release 7.7 Release 7.8 Motorola ASTRO 25 Release 7.9 Solutions Release 7.11 Release 7.13 Harris Harris Master V 25 Station Release R9B Tait/EADS 25 Trunked Radio TaitNet 25/EADS COR 25 Network Cassidian Cassidian COR 25 Infrastructure TB5000i Base Station Model Class owertrunk owertrunk 25 FNE B800014 Release Ver. 9.4.52 EF Johnson Trunking Release 3.1-RC1 Testing Laboratory Information Laboratory Information 25 CA Laboratory Code Motorola erformance CAI Subscriber FL 25CA081014 Date(s) of Test February 3, 4, 6 14, 2011; June 4-29, 2009 Date of Issue February 16, 2011 June 23-July 8, 2009 25 CA Laboratory Code TIMCO Engineering Inc.(Infrastructure used Motorola Solutions) 25CA081016 Date(s) of Test March 3, 2011 Date of Issue March 8, 2011 25 CA Laboratory Code Harris Corp 25CA081017 Date(s) of Test January 20, 2011 Date of Issue January 24, 2011 25 CA Laboratory Code Teltest Laboratories (Infrastructure used TAIT/EADS) 25CA081015 age 1 of 15

roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber Date(s) of Test October 28, 2010 Date of Issue November 15, 2010 25 CA Laboratory Code TIMCO Engineering Inc.(Infrastructure used owertrunk) 25CA081016 Date(s) of Test June 14, 2010 Date of Issue June 28, 2010 25 CA Laboratory Code EF Johnson Technologies 25CA081010 Date(s) of Test October 14, 2009 Date of Issue November 16, 2009 age 2 of 15

erformance Test Cases and Results 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.1 roject 25 hase 1 Common Air Interface Conventional Subscriber Unit erformance roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 25CA081014-25-0002 (136-174MHz) 25CA081014-25-0004 (UHF-R1 380-470MHz) 25CA081014-25-0003 (UHF-R2 450-520MHz) 25CA081014-25-0001 (700/800MHz) ERFORMANCE Conventional Receiver Tests XTS5000 (VHF 136-174, UHF-R1 380-470, UHF-R2 450-520, 700, 800) 2.1.4 Reference Sensitivity -116 dbm 1 2.1.5 Faded Reference Sensitivity -108 dbm 2 2.1.6 Signal Delay Spread Capability 50 µs 3 2.1.7 Adjacent Channel Rejection 60 db 4 2.1.8 Co-Channel Rejection 9 db 2.1.9 Spurious Response Rejection 70 db 2.1.10 Intermodulation Rejection 70 db 2.1.11 Signal Displacement Bandwidth 1000 Hz 2.1.17 Late Entry Unsquelch Delay No Talk Group or Encryption Talk Group Only Encryption Only Both (On Clear or Encrypted Channel) 125 ms 370 ms 370 ms 460 ms 2.1.18 Receiver Throughput Delay 125 ms 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.1 roject 25 hase 1 Common Air Interface Conventional 25CA081014-25-0001 (700/800MHz) Subscriber Unit erformance ERFORMANCE Conventional Transmitter Tests XTS5000 (800MHz) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio 67 db Transmitter ower Attack Time 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation Low Level Signal Deviation 2544 fdev 3111 Hz 848 fdev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 20.0 ms Time Interval t 2 = 50.0 ms Time Interval t 3 = 10.0 ms age 3 of 15

roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.1 roject 25 hase 1 Common Air Interface Conventional 25CA081014-25-0001 (700/800MHz) Subscriber Unit erformance ERFORMANCE Conventional Transmitter Tests XTS5000 (700MHz) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio Offset From Center Frequency (khz) 9.375 15.625, 21.875, 37.5 62.5, 87.5, 150, 250, 350 >400 khz to 12 MHz 12 MHz to paired RX Band In the aired RX Band Transmitter ower Attack Time ACR (db) 40 60 65 75 75 100 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation Low Level Signal Deviation 2544 fdev 3111 Hz 848 fdev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 20.0 ms Time Interval t 2 = 50.0 ms Time Interval t 3 = 10.0 ms 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.1 roject 25 hase 1 Common Air Interface Conventional Subscriber Unit erformance 25CA081014-25-0004 (UHF-R1 380-470MHz) 25CA081014-25-0003 (UHF-R2 450-520MHz) ERFORMANCE - Conventional Transmitter Tests XTS5000 (UHF-R1 380-470MHz; UHF-R2 450-520MHz) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio 67 db Transmitter ower Attack Time 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation Low Level Signal Deviation 2544 f dev 3111 Hz 848 f dev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 10.0 ms Time Interval t 2 = 25.0 ms Time Interval t 3 = 10.0 ms age 4 of 15

roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.1 roject 25 hase 1 Common Air Interface Conventional 25CA081014-25-0002 (136-174MHz) Subscriber Unit erformance ERFORMANCE Conventional Transmitter Tests XTS5000 (VHF 136-174) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio 67 db Transmitter ower Attack Time 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation 2544 fdev 3111 Hz Low Level Signal Deviation 848 fdev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 5.0 ms Time Interval t 2 = 20.0 ms Time Interval t 3 = 5.0 ms 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit erformance 25CA081014-25-0002 (136-174MHz) 25CA081014-25-0004 (UHF-R1 380-470MHz) 25CA081014-25-0003 (UHF-R2 450-520MHz) 25CA081014-25-0001 (700/800MHz) ERFORMANCE Trunked Receiver Tests XTS5000 (VHF 136-174, UHF-R1 380-470, UHF-R2 450-520, 700, 800) 2.1.4 Reference Sensitivity -116 dbm 1 2.1.5 Faded Reference Sensitivity -108 dbm 2 2.1.6 Signal Delay Spread Capability 50 µs 3 2.1.7 Adjacent Channel Rejection 60 db 4 2.1.8 Co-Channel Rejection 9 db 2.1.9 Spurious Response Rejection 70 db 2.1.10 Intermodulation Rejection 70 db 2.1.11 Signal Displacement Bandwidth 1000 Hz age 5 of 15

roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked 25CA081014-25-0001 (700/800MHz) Subscriber Unit erformance ERFORMANCE Trunked Transmitter Tests XTS5000 (800MHz) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio 67 db Transmitter ower Attack Time 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation 2544 fdev 3111 Hz Low Level Signal Deviation 848 fdev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 20.0 ms Time Interval t 2 = 50.0 ms Time Interval t 3 = 10.0 ms 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked 25CA081014-25-0001 (700/800MHz) Subscriber Unit erformance ERFORMANCE Trunked Transmitter Tests XTS5000 (700MHz) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio Offset From Center Frequency (khz) 9.375 15.625, 21.875, 37.5 62.5, 87.5, 150, 250, 350 >400 khz to 12 MHz 12 MHz to paired RX Band In the aired RX Band Transmitter ower Attack Time ACR (db) 40 60 65 75 75 100 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation Low Level Signal Deviation 2544 fdev 3111 Hz 848 fdev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 20.0 ms Time Interval t 2 = 50.0 ms Time Interval t 3 = 10.0 ms age 6 of 15

25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit erformance roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 25CA081014-25-0004 (UHF-R1 380-470MHz) 25CA081014-25-0003 (UHF-R2 450-520MHz) ERFORMANCE Trunked Transmitter Tests XTS5000 (UHF-R1 380-470MHz; UHF-R2 450-520MHz) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio 67 db Transmitter ower Attack Time 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation Low Level Signal Deviation 2544 f dev 3111 Hz 848 f dev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 10.0 ms Time Interval t 2 = 25.0 ms Time Interval t 3 = 10.0 ms 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked 25CA081014-25-0002 (136-174MHz) Subscriber Unit erformance ERFORMANCE Trunked Transmitter Tests XTS5000 (VHF 136-174) 2.2.8 Unwanted Emissions: Adjacent Channel ower Ratio 67 db Transmitter ower Attack Time 2.2.14 Transmitter Throughput Delay 125 ms High Level signal Deviation Low Level Signal Deviation 2544 fdev 3111 Hz 848 fdev 1037 Hz 2.2.16 Modulation Fidelity 5% Time Interval t 1 = 5.0 ms Time Interval t 2 = 20.0 ms Time Interval t 3 = 5.0 ms age 7 of 15

roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked 25CA081014-25-0001 (700/800MHz) Subscriber Unit erformance ERFORMANCE Trunked Subscriber Tests XTS5000 (700/800MHz) 2.3.1 Trunking Control Channel Slot Time (45 ms slot) Encode Attack Time RF ower Attack Time RF ower Turn Off Time 2.00ms t 11.65ms 0.00ms t 11.65ms 1.57 ms 2.3.2 Trunking Request Time 167.5 ms 2.3.3 Trunking Voice Access Time 680 ms 5 2.3.5 Transmit Time to Key on Traffic Channel 150.0 ms 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit erformance 25CA081014-25-0004 (UHF-R1 380-470MHz) 25CA081014-25-0003 (UHF-R2 450-520MHz) ERFORMANCE Trunked Subscriber Tests XTS5000 (UHF-R1 380-470MHz; UHF-R2 450-520MHz) 2.3.1 Trunking Control Channel Slot Time (45 ms slot) Encode Attack Time RF ower Attack Time RF ower Turn Off Time 2.00ms t 11.65ms 0.00ms t 11.65ms 1.57 ms 2.3.2 Trunking Request Time 167.5 ms 2.3.3 Trunking Voice Access Time 490 ms 5 2.3.5 Transmit Time to Key on Traffic Channel 150.0 ms 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.1.2 roject 25 hase 1 Common Air Interface Trunked 25CA081014-25-0002 (136-174MHz) Subscriber Unit erformance ERFORMANCE Trunked Subscriber Tests XTS5000 (VHF 136-174) 2.3.1 Trunking Control Channel Slot Time (45 ms slot) Encode Attack Time RF ower Attack Time RF ower Turn Off Time 2.00ms t 11.65ms 0.00ms t 11.65ms 1.57 ms 2.3.2 Trunking Request Time 167.5 ms 2.3.3 Trunking Voice Access Time 480 ms 5 2.3.5 Transmit Time to Key on Traffic Channel 150.0 ms age 8 of 15

Interoperability Test Cases and Results 25-CAB-CAI_TEST_REQ March 2010, Section 2.1.3.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit Interoperability Motorola Solutions Model Class XTS5000 Subscriber roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 16 XTS Motorola Astro 25 25CA08 1017-1110120 M01 Harris 25CA081 015-3206 Tait/EADS COR 25 Network 25CA081 015-3212 Cassidian COR 25 TB5000i 16 XTS5000 ower Trunk25 25CA081 010-09111601 Test Case Description Results 2.2.1 Full Registration 2.2.1.4.1 Test Case 1 - Valid Registration Home Configuration 2.2.1.4.2 Test Case 2 Denied or Refused Registration Home Configuration 2.2.1.4.3 Test Case 3 Unverified Registration Home Configuration 2.2.2 Group Voice Call 2.2.2.4.1 Test Case 1 - Group Call Granted Home Configuration 2.2.2.4.2 Test Case 2 - Group Call Denied Home Configuration 2.2.2.4.3 Test Case 3 - Group Call Request Queued Home Configuration EFJ age 9 of 15

25-CAB-CAI_TEST_REQ March 2010, Section 2.1.3.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit Interoperability Motorola Solutions Model Class XTS5000 Subscriber roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 16 XTS Motorola Astro 25 25CA08 1017-1110120 M01 Harris 25CA081 015-3206 Tait/EADS COR 25 Network 25CA081 015-3212 Cassidian COR 25 TB5000i 16 XTS5000 ower Trunk25 25CA081 010-09111601 Test Case Description Results 2.2.3 Unit-to-Unit Voice Call 2.2.3.4.1 Test Case 1 - Unit-to-Unit Call with Target Availability Check Home Configuration 2.2.3.4.2 Test Case 2 - Unit-to-Unit Call with Target Availability Check Denied by Target Home Configuration 2.2.3.4.3 Test Case 3 - Unit-to-Unit Call Queued with Target Availability Check Traffic Channel Assignment After Target Availability Check Home Configuration N/A2 N/A2 N4 2.2.3.4.4 Test Case 4 - Unit-to-Unit Call Queued with Target Availability Check Traffic Channel Assignment Before Target Availability Check Home Configuration N/A1 N/A1 N/A1 EFJ age 10 of 15

25-CAB-CAI_TEST_REQ March 2010, Section 2.1.3.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit Interoperability Motorola Solutions Model Class XTS5000 Subscriber roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 16 XTS Motorola Astro 25 25CA08 1017-1110120 M01 Harris 25CA081 015-3206 Tait/EADS COR 25 Network 25CA081 015-3212 Cassidian COR 25 TB5000i 16 XTS5000 ower Trunk25 25CA081 010-09111601 Test Case Description Results 2.2.3.4.5 Test Case 5 - Unit-to-Unit Call without Target Availability Check Home Configuration N1 N1 N1 N1 N5 N1 2.2.3.4.6 Test Case 6 - Unit-to-Unit Call Queued without Target Availability Check Home Configuration N1 N1 N1 N1 N5 N1 2.2.3.4.7 Test Case 7 - Unit-to-Unit Call Denied Home Configuration 2.2.4 Broadcast Voice Call 2.2.4.4.1 Test Case 1 - Broadcast Voice Call Home Configuration 2.2.5 Affiliation 2.2.5.4.1 Test Case 1 - Radio ermitted to Affiliate with New Group Home Configuration EFJ age 11 of 15

25-CAB-CAI_TEST_REQ March 2010, Section 2.1.3.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit Interoperability Motorola Solutions Model Class XTS5000 Subscriber roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 16 XTS Motorola Astro 25 25CA08 1017-1110120 M01 Harris 25CA081 015-3206 Tait/EADS COR 25 Network 25CA081 015-3212 Cassidian COR 25 TB5000i 16 XTS5000 ower Trunk25 25CA081 010-09111601 Test Case Description Results 2.2.5.4.2 Test Case 2 - Radio Denied Affiliation to New Group Home Configuration 2.2.6 Announcement Group Call 2.2.6.4.1 Test Case 1 - Collection of Talk Groups Receive Call Home Configuration N6 2.2.7 Emergency Alarm 2.2.7.4.1 Test Case 1 - Emergency Alarm Home Configuration 2.2.8 Emergency Group Call 2.2.8.4.1 Test Case 1 - Emergency Call Home Configuration EFJ age 12 of 15

25-CAB-CAI_TEST_REQ March 2010, Section 2.1.3.2 roject 25 hase 1 Common Air Interface Trunked Subscriber Unit Interoperability Motorola Solutions Model Class XTS5000 Subscriber roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber 16 XTS Motorola Astro 25 25CA08 1017-1110120 M01 Harris 25CA081 015-3206 Tait/EADS COR 25 Network 25CA081 015-3212 Cassidian COR 25 TB5000i 16 XTS5000 ower Trunk25 25CA081 010-09111601 Test Case Description Results 2.2.10 Encryption 2.2.10.4.1 Test Case 1 - Call rivacy for Encrypted Call Home Configuration 2.2.11 Intra-Location Registration Area Roaming 2.2.11.4.1 Test Case 1 - Idle Radio Home Configuration EFJ age 13 of 15

roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber Model Class: XTS5000 ortable Subscriber roduct Name, Definition and Unique ID Model Number and Installed Options 700/800 MHz XTS5000 700/800MHz ortable; Firmware/DS: R12 thru R19 VHF XTS5000 VHF ortable; Firmware/DS: R12 thru R19 UHF-R1 XTS5000 UHF R1 ortable; Firmware/DS: R12 thru R19 UHF-R2 XTS5000 UHF R2 ortable; Firmware/DS: R12 thru R19 H18UCC9W5-N, H18UCF9W6-N, H18UCH9W7-N Options: Trunking and Encryption H18KEC9W5-N, H18KEF9W6-N, H18KEH9W7-N Options: Trunking and Encryption H18QDC9W5-N, H18QDF9W6-N, H18QDH9W7-N Options: Trunking and Encryption H18SDC9W5-N, H18SDF9W6-N, H18SDH9W7-N Options: Trunking and Encryption Model Class: ASTRO 25 roduct Name, Definition and Unique ID Model Number and Installed Options Motorola ASTRO 25 Trunked Release 7.7 Motorola ASTRO 25 Trunked Release 7.8 Motorola ASTRO 25 Trunked Release 7.9 Motorola ASTRO 25 Trunked Release 7.11 Motorola ASTRO 25 Trunked Release 7.13 Test Case Result Definitions No Test erformed --- Test Does Not Apply to the Test Object N/A Test Object Meets Requirements (ass) Test Object Does Not Meet Requirements F (Fail) Test Object is Not Conclusive I (Inconclusive) Comments 1: Motorola subscriber passes Reference Sensitivity ( -116 dbm) specification for C4FM (Non-Simulcast) and Simulcast modulations. 2: Motorola subscriber passes Faded Reference Sensitivity ( -108 dbm) specification for C4FM (Non-Simulcast) and Simulcast modulations. 3: Motorola subscriber passes Signal Delay Spread Capability specification for C4FM (Non-Simulcast) ( 50 µs) and Simulcast ( 80 µs) modulations. 4: Motorola subscriber passes Adjacent Channel Rejection ( 60 db) specification for C4FM (Non-Simulcast) and Simulcast modulations. 5: Trunking Voice Access Time will vary dependent on actual system design and implementation. N1: Motorola Subscribers do not support unit-to-unit call without target availability check. N2: Motorola, Harris, Tait/EADS Infrastructures and Motorola Subscribers do not support the Inter- Roaming Configuration. N3: Motorola, Harris, Tait/EADS Infrastructures and Motorola Subscribers do not support Inter-WACN Roaming Configurations. N4: owertrunk25 FNE does not support checking for destination availability if no channel traffic resources are available. N5: owertrunk25 FNE does not support unit to unit call without target availability check. N6: owertrunk25 FNE does not support announcement group call. N/A1: Test Case 2.2.3.4.4 is not applicable for Motorola subscribers on Motorola, Harris and EFJ infrastructures; see results of test case 2.2.3.4.3. age 14 of 15

roject 25 Compliance Assessment rogram XTS 5000 ortable Subscriber N/A2: Test Case 2.2.3.4.3 is not applicable for Motorola subscribers on Tait/EADS, Cassidian, owertrunk infrastructures; see results of test case 2.2.3.4.4. The information contained herein has been provided by the manufacturer of the product with permission to make the information publically available. The Department of Homeland Security (DHS) is making this information available as a public service; however, DHS IS ROVIDING THE INFORMATION AS IS. DHS MAKES NO EXRESS OR IMLIED WARRANTIES AND SECIFICALLY, DHS MAKES NO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A ARTICULAR UROSE, REGARDING THE ACCURACY OR USE OF THIS INFORMATION. Reference to any specific commercial products, processes, or services by trade name, trademark, manufacturer, or otherwise does not constitute an endorsement by or recommendation from DHS. OMB NO: 1640-0015 EXIRATION DATE: 07/31/2015 Burden Statement An agency may not conduct or sponsor information collection and a person is not required to respond to this information collection unless it displays a current valid Office of Management and Budget control number and an expiration date. The control number for this collection is 1640-0015 and this form will expire on 07/31/2015. The estimated average time to complete this form is 60 minutes per respondent. If you have any comments regarding the burden estimate you can write to Department of Homeland Security, Science and Technology Directorate, Washington, DC 20528. DHS FORM 10056 June 2009 ICR REFERENCE NUMBER: 201204-1640-001 July 2012 age 15 of 15