%PDF-1.7 % 1 0 obj <> endobj 2 0 obj <> endobj 3 0 obj <> endobj 4 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/TrimBox[ 0 0 612 792]/Type/Page>> endobj 5 0 obj [ 6 0 R 9 0 R 12 0 R 15 0 R 20 0 R 23 0 R 26 0 R 29 0 R 32 0 R 35 0 R 38 0 R 41 0 R 47 0 R 53 0 R 59 0 R 65 0 R 71 0 R 77 0 R 83 0 R 89 0 R 95 0 R 98 0 R 101 0 R 104 0 R 107 0 R 110 0 R 113 0 R 119 0 R 125 0 R 131 0 R 137 0 R 143 0 R 149 0 R 152 0 R 155 0 R 161 0 R 167 0 R 173 0 R 179 0 R 185 0 R 191 0 R 194 0 R 196 0 R 198 0 R 200 0 R 206 0 R 212 0 R 218 0 R 224 0 R 230 0 R 236 0 R 242 0 R 248 0 R 251 0 R 253 0 R 255 0 R 257 0 R 263 0 R 269 0 R 275 0 R 277 0 R 280 0 R 283 0 R ] endobj 6 0 obj <>/BS 8 0 R /CreationDate(D:20121213143417-05'00')/DA(16.25 TL /Cour 12 Tf)/DS(font: Courier 12.0pt; text-align:left; color:#000000 )/F 4/IT/FreeTextTypewriter/M(D:20140304134619-05'00')/NM(b00a9aa0-c5e8-43af-ade2-6607120ce89e)/P 4 0 R /Rect[ 32.0752 1.55629 46.4752 13.5563]/Subj(Typewritten Text)/Subtype/FreeText/T(hersid)/Type/Annot>> endobj 7 0 obj <>/Subtype/Form/Type/XObject>>stream x3P(263062R370W043Q04R(J*2T0B[m8PB:P}9W U endstream endobj 8 0 obj <> endobj 9 0 obj <>/BS 11 0 R /CreationDate(D:20121213143418-05'00')/DA(16.25 TL /Cour 12 Tf)/DS(font: Courier 12.0pt; text-align:left; color:#000000 )/F 4/IT/FreeTextTypewriter/M(D:20140304134619-05'00')/NM(4bd7cf61-c088-4558-bf1e-bcafd28a78d8)/P 4 0 R /Rect[ 12.1022 1.2804 26.5022 13.2804]/Subj(Typewritten Text)/Subtype/FreeText/T(hersid)/Type/Annot>> endobj 10 0 obj <>/Subtype/Form/Type/XObject>>stream x3P(24304R03164T0 F E\y\\ @!s(*7PHj( "v endstream endobj 11 0 obj <> endobj 12 0 obj <>/BS 14 0 R /CreationDate(D:20121213143418-05'00')/DA(16.25 TL /Cour 12 Tf)/DS(font: Courier 12.0pt; text-align:left; color:#000000 )/F 4/IT/FreeTextTypewriter/M(D:20140304134619-05'00')/NM(2d405b1e-cdd2-420b-a79b-2e7a52d57664)/P 4 0 R /Rect[ 12.1022 1.2804 26.5022 13.2804]/Subj(Typewritten Text)/Subtype/FreeText/T(hersid)/Type/Annot>> endobj 13 0 obj <>/Subtype/Form/Type/XObject>>stream x3P(24304R03164T0 F E\y\\ @!s(*7PHj( "v endstream endobj 14 0 obj <> endobj 15 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 15/P 4 0 R /Rect[ 132.019 649.024 297.113 670.149]/Subtype/Widget/T(GSID-ROOT)/Type/Annot>> endobj 16 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 17 0 obj <> endobj 18 0 obj <> endobj 19 0 obj <> endobj 20 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 76.4794 623.779 296.741 645.957]/Subtype/Widget/T(LASTNAME-SUBS)/Type/Annot>> endobj 21 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 22 0 obj <> endobj 23 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 348.233 623.779 567.473 645.956]/Subtype/Widget/T(FIRSTNAME-SUBS)/Type/Annot>> endobj 24 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 25 0 obj <> endobj 26 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 76.4191 599.273 568.473 620.941]/Subtype/Widget/T(ADDRESS-SUBS)/Type/Annot>> endobj 27 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 28 0 obj <> endobj 29 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 48.4191 576.122 167.266 595.007]/Subtype/Widget/T(CITY-SUBS)/Type/Annot>> endobj 30 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 31 0 obj <> endobj 32 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.68 576.123 289.877 597.248]/Subtype/Widget/T(PROVINCE-SUBS)/Type/Annot>> endobj 33 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 34 0 obj <> endobj 35 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 342.68 576.122 437.242 597.248]/Subtype/Widget/T(POSTALCODE-SUBS)/Type/Annot>> endobj 36 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 37 0 obj <> endobj 38 0 obj <>/DA(/Helv 9 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 454.568 576.381 567.065 588.913]/Subtype/Widget/T(PHONE-NUMBER)/Type/Annot>> endobj 39 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 40 0 obj <> endobj 41 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 390.428 549.572 401.595 559.678]/Subtype/Widget/T(EXPENSE-FOR-CHILD)/Type/Annot>> endobj 42 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P043433R043403T(JJ23Ua H.W` r endstream endobj 43 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ A ~bJmbrZFvށ?kqmJ@S1u *=8.FMo.\7Ƅ$٫1IruY59۽k ?9 endstream endobj 44 0 obj <> endobj 45 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P043433R043403T(JJ23Ua H.W`; ; endstream endobj 46 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ 1~bJm[b{hg#;EBPL,b8L[M n{zqoMoX\7(bwd+jro{׬O*N 01 endstream endobj 47 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 264.091 549.303 275.258 559.409]/Subtype/Widget/T(EXPENSE-FOR-ME)/Type/Annot>> endobj 48 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P043433R043403T(JJ23Ua H.W` r endstream endobj 49 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ A ~bJmbrZFvށ?kqmJ@S1u *=8.FMo.\7Ƅ$٫1IruY59۽k ?9 endstream endobj 50 0 obj <> endobj 51 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P043433R043403T(JJ23Ua H.W`; ; endstream endobj 52 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ 1~bJm[b{hg#;EBPL,b8L[M n{zqoMoX\7(bwd+jro{׬O*N 01 endstream endobj 53 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 264.091 537.749 275.258 547.855]/Subtype/Widget/T(Declaration No)/Type/Annot>> endobj 54 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04343W04340S(JJ23UaP&S`V endstream endobj 55 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ A ~bJmbݶ A0+\)De(eP*@S1<0A_|: ;rX%4iwTf~Xm'~ $ endstream endobj 56 0 obj <> endobj 57 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343W04340S(JJ23UaP&S` w endstream endobj 58 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ @~bJm֝9shg#,v&`!DRo`VtJ䙟'Fl׬Vei!Aa ui>wfR1F$+>Td8_WXm׌3~ n~ endstream endobj 59 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 264.091 526.689 275.258 536.795]/Subtype/Widget/T(Other contract No)/Type/Annot>> endobj 60 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04343W04340S(JJ23UaP&S`V endstream endobj 61 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ A ~bJmbݶ A0+\)De(eP*@S1<0A_|: ;rX%4iwTf~Xm'~ $ endstream endobj 62 0 obj <> endobj 63 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343W04340S(JJ23UaP&S` w endstream endobj 64 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ @~bJm֝9shg#,v&`!DRo`VtJ䙟'Fl׬Vei!Aa ui>wfR1F$+>Td8_WXm׌3~ n~ endstream endobj 65 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 264.091 515.952 275.258 526.058]/Subtype/Widget/T(Accident No)/Type/Annot>> endobj 66 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04343W04340S(JJ23UaP&S`V endstream endobj 67 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ A ~bJmbݶ A0+\)De(eP*@S1<0A_|: ;rX%4iwTf~Xm'~ $ endstream endobj 68 0 obj <> endobj 69 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343W04340S(JJ23UaP&S` w endstream endobj 70 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ @~bJm֝9shg#,v&`!DRo`VtJ䙟'Fl׬Vei!Aa ui>wfR1F$+>Td8_WXm׌3~ n~ endstream endobj 71 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 330.603 549.303 341.77 559.409]/Subtype/Widget/T(EXPENSE-FOR-SPOUSE)/Type/Annot>> endobj 72 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P043433R043403T(JJ23Ua H.W` r endstream endobj 73 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ A ~bJmbrZFvށ?kqmJ@S1u *=8.FMo.\7Ƅ$٫1IruY59۽k ?9 endstream endobj 74 0 obj <> endobj 75 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P043433R043403T(JJ23Ua H.W`; ; endstream endobj 76 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ 1~bJm[b{hg#;EBPL,b8L[M n{zqoMoX\7(bwd+jro{׬O*N 01 endstream endobj 77 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 330.603 537.911 341.77 548.016]/Subtype/Widget/T(Declaration Yes)/Type/Annot>> endobj 78 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04343W04340S(JJ23UaP&S`V endstream endobj 79 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ A ~bJmbVw`!?+\De(3'(fbuV~Rد[|iaw _nKvJN%3F$q-̜@uKwvx8'C# endstream endobj 80 0 obj <> endobj 81 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343W04340S(JJ23UaP&S` w endstream endobj 82 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ @~bJm֝xhg#,v&`!DR,o`VtJwfR1F$+>֐ l^ 1pO, endstream endobj 83 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 330.603 528.012 341.77 538.118]/Subtype/Widget/T(Other contract Yes)/Type/Annot>> endobj 84 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04343W04340S(JJ23UaP&S`V endstream endobj 85 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ A ~bJmbVw`!?+\De(3'(fbuV~Rد[|iaw _nKvJN%3F$q-̜@uKwvx8'C# endstream endobj 86 0 obj <> endobj 87 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343W04340S(JJ23UaP&S` w endstream endobj 88 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ @~bJm֝xhg#,v&`!DR,o`VtJwfR1F$+>֐ l^ 1pO, endstream endobj 89 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 330.603 516.598 341.77 526.704]/Subtype/Widget/T(Accident Yes)/Type/Annot>> endobj 90 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04343W04340S(JJ23UaP&S`V endstream endobj 91 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ A ~bJmbVw`!?+\De(3'(fbuV~Rد[|iaw _nKvJN%3F$q-̜@uKwvx8'C# endstream endobj 92 0 obj <> endobj 93 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343W04340S(JJ23UaP&S` w endstream endobj 94 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H4ͱ @~bJm֝xhg#,v&`!DR,o`VtJwfR1F$+>֐ l^ 1pO, endstream endobj 95 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 26.7502 436.361 133.186 461.602]/Subtype/Widget/T(SECT3-LASTNAME-1)/Type/Annot>> endobj 96 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 97 0 obj <> endobj 98 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 135.472 436.361 241.398 461.602]/Subtype/Widget/T(SECT3-FIRSTNAME-1)/Type/Annot>> endobj 99 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 100 0 obj <> endobj 101 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 243.86 436.184 350.296 461.935]/Subtype/Widget/T(SECT3-BIRTH-DATE-1)/Type/Annot>> endobj 102 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 103 0 obj <> endobj 104 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 26.7502 409.23 132.675 434.47]/Subtype/Widget/T(SECT3-LASTNAME-2)/Type/Annot>> endobj 105 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 106 0 obj <> endobj 107 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 135.472 409.23 241.909 434.47]/Subtype/Widget/T(SECT3-FIRSTNAME-2)/Type/Annot>> endobj 108 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 109 0 obj <> endobj 110 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 243.86 409.053 349.786 434.804]/Subtype/Widget/T(SECT3-BIRTH-DATE-2)/Type/Annot>> endobj 111 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 112 0 obj <> endobj 113 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 378.012 450.271 390.477 460.726]/Subtype/Widget/T(Gender1 F)/Type/Annot>> endobj 114 0 obj <>/Subtype/Form/Type/XObject>>stream x33754VH2P0P043135T04315U(JJ23UaCC%L n " endstream endobj 115 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ P > endobj 117 0 obj <>/Subtype/Form/Type/XObject>>stream x3TH2P0P043135T04315U(JJ23UaCC%L ( endstream endobj 118 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ A ~bJmbf^+N;+~8@"h*^+wPfn^_>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 378.012 423.174 390.477 433.629]/Subtype/Widget/T(Gender2 F)/Type/Annot>> endobj 120 0 obj <>/Subtype/Form/Type/XObject>>stream x33754VH2P0P043135T04315U(JJ23UaCC%L n " endstream endobj 121 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ P > endobj 123 0 obj <>/Subtype/Form/Type/XObject>>stream x3TH2P0P043135T04315U(JJ23UaCC%L ( endstream endobj 124 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ A ~bJmbf^+N;+~8@"h*^+wPfn^_>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 378.012 396.783 390.477 407.238]/Subtype/Widget/T(Gender3 F)/Type/Annot>> endobj 126 0 obj <>/Subtype/Form/Type/XObject>>stream x33754VH2P0P043135T04315U(JJ23UaCC%L n " endstream endobj 127 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ P > endobj 129 0 obj <>/Subtype/Form/Type/XObject>>stream x3TH2P0P043135T04315U(JJ23UaCC%L ( endstream endobj 130 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ A ~bJmbf^+N;+~8@"h*^+wPfn^_>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 410.059 450.783 422.524 461.238]/Subtype/Widget/T(Gender1 M)/Type/Annot>> endobj 132 0 obj <>/Subtype/Form/Type/XObject>>stream x33754VH2P0P043135T04315U(JJ23UaCC%L n " endstream endobj 133 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ P > endobj 135 0 obj <>/Subtype/Form/Type/XObject>>stream x3TH2P0P043135T04315U(JJ23UaCC%L ( endstream endobj 136 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ A ~bJmbf^+N;+~8@"h*^+wPfn^_>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 410.059 423.783 422.524 434.238]/Subtype/Widget/T(Gender2 M)/Type/Annot>> endobj 138 0 obj <>/Subtype/Form/Type/XObject>>stream x33754VH2P0P043135T04315U(JJ23UaCC%L n " endstream endobj 139 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ P > endobj 141 0 obj <>/Subtype/Form/Type/XObject>>stream x3TH2P0P043135T04315U(JJ23UaCC%L ( endstream endobj 142 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ A ~bJmbf^+N;+~8@"h*^+wPfn^_>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 410.059 396.172 422.524 406.627]/Subtype/Widget/T(Gender3 M)/Type/Annot>> endobj 144 0 obj <>/Subtype/Form/Type/XObject>>stream x33754VH2P0P043135T04315U(JJ23UaCC%L n " endstream endobj 145 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ P > endobj 147 0 obj <>/Subtype/Form/Type/XObject>>stream x3TH2P0P043135T04315U(JJ23UaCC%L ( endstream endobj 148 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream x5̱ A ~bJmbf^+N;+~8@"h*^+wPfn^_>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 135.472 382.021 241.907 407.262]/Subtype/Widget/T(SECT3-FIRSTNAME-3)/Type/Annot>> endobj 150 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 151 0 obj <> endobj 152 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 243.83 381.678 349.755 407.429]/Subtype/Widget/T(SECT3-BIRTH-DATE-3)/Type/Annot>> endobj 153 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 154 0 obj <> endobj 155 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 462.993 450.4 476.012 460.855]/Subtype/Widget/T(Spouse 1)/Type/Annot>> endobj 156 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04304T04315P(JJ23UaC#%\ endstream endobj 157 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<= @~~Ŕڬw׊v6`h@U)9JEQkFSI9U~j_1iH]iw쮷Ý.%%iE4I[gD9; endstream endobj 158 0 obj <> endobj 159 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04304T04315P(JJ23UaC#%\ = Q endstream endobj 160 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<̱ @~bJmlN,@7P*f4\r*YZfU.}`wtqc@'^[f֫3pI M2^8 0q endstream endobj 161 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 462.993 437.011 476.012 447.466]/Subtype/Widget/T(Child 1)/Type/Annot>> endobj 162 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04304T04315P(JJ23UaC#%\ endstream endobj 163 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<= @~~Ŕڬw׊v6`h@U)9JEQkFSI9U~j_1iH]iw쮷Ý.%%iE4I[gD9; endstream endobj 164 0 obj <> endobj 165 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04304T04315P(JJ23UaC#%\ = Q endstream endobj 166 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<̱ @~bJmlN,@7P*f4\r*YZfU.}`wtqc@'^[f֫3pI M2^8 0q endstream endobj 167 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 462.993 423.011 476.012 433.466]/Subtype/Widget/T(Spouse 2)/Type/Annot>> endobj 168 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04304T04315P(JJ23UaC#%\ endstream endobj 169 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<= @~~Ŕڬw׊v6`h@U)9JEQkFSI9U~j_1iH]iw쮷Ý.%%iE4I[gD9; endstream endobj 170 0 obj <> endobj 171 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04304T04315P(JJ23UaC#%\ = Q endstream endobj 172 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<̱ @~bJmlN,@7P*f4\r*YZfU.}`wtqc@'^[f֫3pI M2^8 0q endstream endobj 173 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 462.993 411.011 476.012 421.466]/Subtype/Widget/T(Child 2)/Type/Annot>> endobj 174 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04304T04315P(JJ23UaC#%\ endstream endobj 175 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<= @~~Ŕڬw׊v6`h@U)9JEQkFSI9U~j_1iH]iw쮷Ý.%%iE4I[gD9; endstream endobj 176 0 obj <> endobj 177 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04304T04315P(JJ23UaC#%\ = Q endstream endobj 178 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<̱ @~bJmlN,@7P*f4\r*YZfU.}`wtqc@'^[f֫3pI M2^8 0q endstream endobj 179 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 462.993 396.011 476.012 406.466]/Subtype/Widget/T(Spouse 3)/Type/Annot>> endobj 180 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04304T04315P(JJ23UaC#%\ endstream endobj 181 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<= @~~Ŕڬw׊v6`h@U)9JEQkFSI9U~j_1iH]iw쮷Ý.%%iE4I[gD9; endstream endobj 182 0 obj <> endobj 183 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04304T04315P(JJ23UaC#%\ = Q endstream endobj 184 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<̱ @~bJmlN,@7P*f4\r*YZfU.}`wtqc@'^[f֫3pI M2^8 0q endstream endobj 185 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 462.993 384.268 476.012 394.723]/Subtype/Widget/T(Child 3)/Type/Annot>> endobj 186 0 obj <>/Subtype/Form/Type/XObject>>stream H23754VH2P0P04304T04315P(JJ23UaC#%\ endstream endobj 187 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<= @~~Ŕڬw׊v6`h@U)9JEQkFSI9U~j_1iH]iw쮷Ý.%%iE4I[gD9; endstream endobj 188 0 obj <> endobj 189 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04304T04315P(JJ23UaC#%\ = Q endstream endobj 190 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<̱ @~bJmlN,@7P*f4\r*YZfU.}`wtqc@'^[f֫3pI M2^8 0q endstream endobj 191 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 25/P 4 0 R /Rect[ 26.7502 382.021 133.186 407.262]/Subtype/Widget/T(SECT3-LASTNAME-3)/Type/Annot>> endobj 192 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 193 0 obj <> endobj 194 0 obj <>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 30.283 306.569 166.363 316.409]/Subtype/Widget/T(Nom et prnom du dtenteur de)/Type/Annot>> endobj 195 0 obj <>/Subtype/Form/Type/XObject>>stream xPpurb& endstream endobj 196 0 obj <>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.323 306.569 340.003 316.409]/Subtype/Widget/T(Nom de lassureur)/Type/Annot>> endobj 197 0 obj <>/Subtype/Form/Type/XObject>>stream xPpurb& endstream endobj 198 0 obj <>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 382.843 306.569 513.643 316.409]/Subtype/Widget/T(N de certificat de ladhrent)/Type/Annot>> endobj 199 0 obj <>/Subtype/Form/Type/XObject>>stream xPpurb& endstream endobj 200 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 171.002 268.411 181.198 277.878]/Subtype/Widget/T(COVERAGE-STATUS-FAMILY)/Type/Annot>> endobj 201 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 202 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 203 0 obj <> endobj 204 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 205 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 206 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 171.002 257.875 181.198 267.342]/Subtype/Widget/T(COVERAGE-STATUS-INDIVIDUAL)/Type/Annot>> endobj 207 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 208 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 209 0 obj <> endobj 210 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 211 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 212 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 171.002 247.055 181.198 256.522]/Subtype/Widget/T(COVERAGE-STATUS-SPARENT)/Type/Annot>> endobj 213 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 214 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 215 0 obj <> endobj 216 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 217 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 218 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 171.002 236.594 181.198 246.061]/Subtype/Widget/T(COVERAGE-STATUS-COUPLE)/Type/Annot>> endobj 219 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 220 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 221 0 obj <> endobj 222 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 223 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 224 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 377.442 267.574 387.638 277.041]/Subtype/Widget/T(BENEFIT-TYPE-DRUG)/Type/Annot>> endobj 225 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 226 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 227 0 obj <> endobj 228 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 229 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 230 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 377.442 256.875 387.638 266.342]/Subtype/Widget/T(BENEFIT-TYPE-DE)/Type/Annot>> endobj 231 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 232 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 233 0 obj <> endobj 234 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 235 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 236 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 377.442 246.415 387.638 255.882]/Subtype/Widget/T(BENEFIT-TYPE-VISUAL)/Type/Annot>> endobj 237 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 238 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 239 0 obj <> endobj 240 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 241 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 242 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 377.442 235.594 387.638 245.061]/Subtype/Widget/T(BENEFIT-TYPE-OTHERS)/Type/Annot>> endobj 243 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04343T3137T(JJs*%D.]`Q  endstream endobj 244 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJm%wF8MB?xb2*)6#JS1.KCPi9WqnH+\#eЈ` ь(٪zoC? endstream endobj 245 0 obj <> endobj 246 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04343T3137T(JJs*%D.]`SD endstream endobj 247 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ @~bJmsIZI;EH!^"b籌8"0P1[lZP#՜V qnhWU>G뭻[NXYhIENz7qK; 0F endstream endobj 248 0 obj <>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 158.742 209.397 310.062 218.116]/Subtype/Widget/T(Nom de la personne accidente)/Type/Annot>> endobj 249 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 250 0 obj <> endobj 251 0 obj <>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 163.243 198.209 212.203 208.049]/Subtype/Widget/T(Date de laccident AAAAMMJJ)/Type/Annot>> endobj 252 0 obj <>/Subtype/Form/Type/XObject>>stream xPpurb& endstream endobj 253 0 obj <>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 214.363 198.209 267.763 208.049]/Subtype/Widget/T(undefined)/Type/Annot>> endobj 254 0 obj <>/Subtype/Form/Type/XObject>>stream xPpurb& endstream endobj 255 0 obj <>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 269.923 198.209 318.883 208.049]/Subtype/Widget/T(undefined_2)/Type/Annot>> endobj 256 0 obj <>/Subtype/Form/Type/XObject>>stream xPpurb& endstream endobj 257 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 109.541 185.419 121.37 195.631]/Subtype/Widget/T(ACCIDENT-TYPE-WORK)/Type/Annot>> endobj 258 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04Գ04T043242T(JJJs*0P._` H endstream endobj 259 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<1 @ 7k{JE8mAP?!CGTT4DP*$b4`}br8B2-PV/A^ႷWg+vxg:!PJ(b@l.Mڲp8/u endstream endobj 260 0 obj <> endobj 261 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04Գ04T043242T(JJJs*0P._`f endstream endobj 262 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<1 @ 7/wzEnAP?!CGUĪ QpB8@]e+^p0nmD}=dM=,E]  endstream endobj 263 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 167.213 184.361 179.859 196.186]/Subtype/Widget/T(ACCIDENT-TYPE-AUTO)/Type/Annot>> endobj 264 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04331S04Գ021Q(JJs*0P,o/0 # endstream endobj 265 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<ͱ A ~bJmdN;W\#D`UBͩd3~?BR6?|V5 \ ;zGXR[@D.pG^ٚq_ endstream endobj 266 0 obj <> endobj 267 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04331S04Գ021Q(JJs*0P,o/0\ endstream endobj 268 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H<1 @ 7r&GZ-8:tHཏ Psjj*ٌϐ԰N_(VU n錓0KY ckw?# #lOcp\0%0 endstream endobj 269 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 5 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 269.13 183.807 280.959 195.631]/Subtype/Widget/T(ACCIDENT-TYPE-OTHER)/Type/Annot>> endobj 270 0 obj <>/Subtype/Form/Type/XObject>>stream H237402VH2P0P04Գ0P&& E\i@qw.=S64勹 ' endstream endobj 271 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H< AC|EJmƙYFX Ap+BH!*CSJ)fs灡de:s]o1X3^m9b[\w7fLdQXp魑׬O+N 0 endstream endobj 272 0 obj <> endobj 273 0 obj <>/Subtype/Form/Type/XObject>>stream H2TH2P0P04Գ0P&& E\i@qw.=S64勹 ] endstream endobj 274 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream H< `>/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 309.523 187.529 434.083 197.369]/Subtype/Widget/T(autre)/Type/Annot>> endobj 276 0 obj <>/Subtype/Form/Type/XObject>>stream xPpurb& endstream endobj 277 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Q 1/Rect[ 315.83 109.785 362.034 121.244]/Subtype/Widget/T(AUTHORIZATION-DATE-YEAR)/Type/Annot>> endobj 278 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 279 0 obj <> endobj 280 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Q 1/Rect[ 368.003 109.784 414.208 121.244]/Subtype/Widget/T(AUTHORIZATION-DATE-MONTH)/Type/Annot>> endobj 281 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 282 0 obj <> endobj 283 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Q 1/Rect[ 423.306 109.785 469.511 121.244]/Subtype/Widget/T(AUTHORIZATION-DATE-DAY)/Type/Annot>> endobj 284 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 285 0 obj <> endobj 286 0 obj <>stream x][sH~w:#ME }:Όsb;هxk#$̥Ώ?$eJIœ)KH4}=fqƲEzg|^6|6?-۶l/|'\ |}y{_M}ǡ=l3ZBZ q9ǶٿY 7q |x.1I_zR[^_mfsaL& x`N6#C ]g䖯3zt6t;>`W7H+=08 |.@ZcicسGۮmbYX,Zl%iOטXI/ȼ#tdzF /ݏ4]Km̖$g@XpQ*ɰ)lox*Z[3vلoNeYE*Z&1pFdϧyjMf@=t{gYIxUIJ(͑x)|KnSºѺ%ψMV >/WlV$yTw]{_ lq 9VvXyrC zHqWJ뛀xǝH# |Pԁ_]B@s`.0(x_bK)INpKoxpqИ( ]~~8!iY [i78kk6Ċ Dx9P?_6)qANAp7YKBф;V o DX m R5YJPz c;D^3xD$=!n=at=x+hjbӆhϵuII3l$䄭"w[#S2Z-h!;m%FKHp9\RHH":2IR!aCehsI&u p!Ez11e:nzz>w+0 ˠSwB,P'ltu!RiIE+GeΌS(W4d':8 yI4V9:f8hM@Z^#+֏dKLɧQ6#qWʞp+|PebA@W'Qa+g4$ia AҐ66AY8|̀ItXr)G4*=O=P)ϡiE Mh!t^]L,p!α齥AA=@AҠ0Ah),< pl2dOؤX',!Ic;Lc%wҶՇƢu?_i}YWڷϭq7n$haO\aҊ'ָN?,jq!L~|">gXwDr-yK\%N^P^6/֢͋h`b-ؼT 6xiؼX6/֢͋h`rR%li4Ӥ} h^9i&V ^g} jc϶c< G"⺷!Z{vޞ~i u ng+ S4 }o-ujK9O]Ҕ4%.>uINRqԈ/+]{T6sXGivNAԔR mo]Ω@XC~9>S\{]m-R,sw'7O'S;}hMZa%Yk,8vjƻ\]M޽p{D9w5eQʡ5 5wmт&5gK v`E벃sbp/=+j7[Hyqj(p{xp!A ,PvY y*_Z~HRm`?>]V¡7|%Kz·ba |eq" ^q& n' }Mڰ0ԤE;'=`G\qv2t'h_C=%n)q I<'e#=%zJn@Dr):{5/| Ck疔Rl0ֺ=qeqK~r,:S6pxG8=}Q,^mQ[Ɋ(bDtY3&PP`GmmxU x36O^"@5}pC)o3%V%Q՘œ#\-z{!{Hk!Yaeo9G;lph#$ۇE;AeAjΜK6;ƚ3kA IU; !lށ纆Pm~[]_Kt-wx,]⌸ aNaK+C}>3lۨ59ʅ'OCSbՕ^3ʶ=QQ<~[=Jd \mFmvT-_`9PM]5ZC|;@Qi>z=Hy| upyX!0, R pNsi-:Y%"S>ٯjoQW7d\ 07h¤$O@k R)œٓ([_iaa4 JyĻj^[,⪌DJ T'JM.DAA5e[}%lX$aށރX'Tt6 D KY B,b8dw.ж26Xe`G "*w -_ؾ5, @>mAYG`9 }$g6g`џogOא,;8[pfaA(jKCf-)dߒzdC&ʐpgvz <#ux8!Bk|6_upZjV`R%2U]Oʞn)j5)s=pisvI]nP'E)!"h#dߠ$ -,p qNgp`qqK6U>dY!@A=-u' A!ZOjޛ^7R[)no*K|&TH6Q_?X+w c\q(ޫ% \=S^z p?dVE9PY05z-X*ؗQCDԷ*L"<~&R3x]ev8:o&EvhB\nf<ݕ)FԝsPG1\Nw,Ṯ"}C~`q V?!.g*`RD5n>(-R\T>?vpm endstream endobj 287 0 obj [/Separation/Black 288 0 R 290 0 R ] endobj 288 0 obj [/ICCBased 289 0 R ] endobj 289 0 obj <>stream hޜwTTϽwz0z.0. Qf Ml@DEHb!(`HPb0dFJ|yyǽgs{.$O./ 'z8WGбx0Y驾A@$/7z HeOOҬT_lN:K"N3"$F/JPrb[䥟}Qd[Sl1x{#bG\NoX3I[ql2$ 8xtrp/8 pCfq.Knjm͠{r28?.)ɩL^6g,qm"[Z[Z~Q7%" 3R`̊j[~: w!$E}kyhyRm333: }=#vʉe tqX)I)B>== <8Xȉ9yP:8p΍Lg kk Ѐ$t!0V87`ɀ2A. @JPA#h'@8 .: ``a!2D!UH 2 dA>P ECqB**Z:]B=h~L2  5pN:|ó@ QC !H,G6 H9R ]H/r Aw( Q(OTJCm@*QGQ-(j MF+ 6h/*t:].G7Зw7 Xa<1:L1s3bXyeb~19 vGĩp+5qy^ oó|= ?'Htv`Ba3BDxHxE$Չ"XAP44077&9$An0;T2421t.54ld+s;# V]=iY9FgM֚k&=%Ō:nc1gcbcfX.}lGv{c)LŖN퉛w/p+/<j$.$%&㒣OdxTԂԑ4i3|o~C:&S@L u[Uo3C3OfIgwdO|;W-wsz 17jl8c͉̈́3+{%lKWr[ $ llGmnacOkE&EEY׾2⫅;K,KhtiN=e²{^-_V^Oo§s]?TWީrjVQ=w}`嚢zԶiו8>k׍ E  [ly邟~_Y53rW򯎼^{7so}x>|쇊z>yz endstream endobj 290 0 obj <>stream hĿþ½~}|~|}{}z|z{~yz}xz|wy{wx{vwzuwytvxtuxstwrtvqsuprtpqtopsnprmoqmnplmpklojknikmijlhikghkfgjegidfhdegcdfbcfabe`ad`ac_`b^_a]^`\]`[\_[\^Z[]YZ\XY[WXZVWYUVXTUWSTVSSURRTQQSPPROOQNNPMMOLLNKKMJJLIIKHHJHGIGFHFFGEEFDDECCDBBCAAB@@A?>@>=?=<><;<:9;98:8787576454343132011/00-..,--*,,)*+()*'((%&'$%&#$%""$ !#  H endstream endobj 291 0 obj <> endobj 292 0 obj <> endobj 293 0 obj <> endobj 294 0 obj <> endobj 295 0 obj <> endobj 296 0 obj <> endobj 297 0 obj <>stream Adobed     $$''$$53335;;;;;;;;;;  %% ## ((%%((22022;;;;;;;;;;Y"?   3!1AQa"q2B#$Rb34rC%Scs5&DTdE£t6UeuF'Vfv7GWgw5!1AQaq"2B#R3$brCScs4%&5DTdEU6teuFVfv'7GWgw ?TI%)$<ޯD @7A jtn$wv,wnWۣH}~[)*}C9mm+ eQs\$|G:cY@ni@niIs~YѲ\ꚜxM!hvQc04FI=z@a&cӣTa q[);:߯= ,yLӺ5á@I$I$RI$I%)$IJI$RI$I%)$lv)>dvX {p⸋,}6X8D~V]V<R3#g#llM~.&/b~Ƥ\}_\GVu'\qcwXW:Cqےb3Qdu;JrZΪ5{ƻ踈 ^8wDUPqiT5scޏGG]F[p-quh5Kqe;"*ipW n ֜dDi!ϝXfpA̴ݓa>ɒ᫤5R_Sku *3=C\OCu,6 F_܏l]_]:F#Hd#C*i %tI[[\D)#w}s^uVrk5<.0xdz#@x+>(I+ZыqU:|=Pk#>so9S&SN/%ʈ$nD/}L̳k yRԊz^3j?vQ|i4fV#!doaհrŬ ē:W^s.յ@..o⾁@><]r%"W:;}wG~l1+n`CnZĮ?EY8yx@>x Ȁ0z+3m?;wIO}s]>Ϫt{ DPPno^OoQZoJx̼^3Ycnh2 cI0~(}'?eu}tWH{^@i-4.֏W6ʲ1vljFC;b.&o'q!% qok4'ikGeQʫ2}&ۛc5];tLUS1kώ<ˉ\MP>~n&0{AwyIMw1^NUfk^\:M ,hRI$~sG=.d}e.}4̀e@v|o}LWնk}%a]k7G5 `KH-$*q<2 H[W2ZgMHjs88O(xYY֊qk68GQ3H䝁Ofvq Y{r| w_f|5N[-.ߧ|TF1exe u/7^O%X\eyl-kkB aŗ$QoTɳ=?yihBmm0׈ ܷp,~E.`/U [9 v۪t{d,GI"=nc5cXʲjXLJ8/EfV[M q eI}nŎ)zX,xpXzԗV?3V՛r \>kWgUPkN2Ԍl'"1ׁ]c2 ==L 4>JD&&;$X]nyးssTnXn~):y `gO5JҺU-ȭ6;m9ڛZc}X-A/VXA-?"Jtr^M}c3tέWzQr1 V{k;[qur񻼙zs_u>ֳ2Eځ:w%;3QΫޜܵ:fN)[H]Y=eٗf:_em-ŕُcPAic,/h+tUCZ v7U7A [sNѦ0K*cU52/mU]h r[:?cՉT96S\W>_ h4/Sͳ P-s?[pݍo iv8skd$duL|Vv5$ѰVWP 9~$Lf_R87DIJL$;;M-{z5UR:C$L"wiN§wE;O+_V;4B2HlPF(x-pi$\}U./4ow.fCi$N8 8O]졮xj \"–PnnX{8J"HɳC8k~tgװ}~Xq|/T&Ŷښ!h p9%ܱ}vP P|ams% TS6+]tv2o6u>:aYx.v&#*v`# IN^'ծ~6#*0~:[Kq0\Ƒ1jjwJӼ\I;JѷC36F;# 5k -DSUa=A7 xu_Wn=N Jqn:Yƥ۫uVB]K Y6*I)_T~tMl㧩˾DӾ~vN3h'eβRIJI$RI$I%)$IJI$RI$I%)$IJI$RI$I%)$IJI$RI$I%)$IJI$RI$ endstream endobj 298 0 obj <>>>/Subtype/Form/Type/XObject>>stream xK0 D9N>}ΐ*5ߤ!ѴD<G` mhmTȵT~پ׷PD)d0?L.%Z#+dNr5lDCXCADH>ȸޒ+SbA,=R-[2Q=| Ր uteq2g]-DGR 榁I;N"@`Z)q1 $Y ԖtGW9ЮS#9d+5eCˀJBƆ%Ҁr 5"v4oʄ\! D$y"L%>Ru:I QN!ւVoBMj$+fk#:YCD ]f4w\Ot'W}eaHxgtaIxR| B(2(-L .0B8_oAQXw7 <9}B..;YtZp[kkt]Un:;S:GKŭˤ֭:; & QTx@syDcg@g5ݠłe \;|p&bOJiVƄV8t%2͟謥a6D}G0/ 461]g- A1{nvUo߮s0ĺ pع 1TNn(}y gR̓~=\[SZY|Rㆪ} 5Y ϻ65 endstream endobj 299 0 obj [ 286 0 R 300 0 R ] endobj 300 0 obj <>stream x+T0T0BbM+ endstream endobj xref 0 301 0000000000 65535 f 0000000017 00000 n 0000000066 00000 n 0000000122 00000 n 0000000209 00000 n 0000000589 00000 n 0000001153 00000 n 0000001526 00000 n 0000001798 00000 n 0000001825 00000 n 0000002199 00000 n 0000002473 00000 n 0000002501 00000 n 0000002876 00000 n 0000003150 00000 n 0000003178 00000 n 0000003353 00000 n 0000003538 00000 n 0000003575 00000 n 0000003669 00000 n 0000004865 00000 n 0000005034 00000 n 0000005218 00000 n 0000005255 00000 n 0000005425 00000 n 0000005608 00000 n 0000005645 00000 n 0000005813 00000 n 0000005997 00000 n 0000006034 00000 n 0000006199 00000 n 0000006383 00000 n 0000006420 00000 n 0000006588 00000 n 0000006771 00000 n 0000006808 00000 n 0000006978 00000 n 0000007161 00000 n 0000007198 00000 n 0000007365 00000 n 0000007549 00000 n 0000007586 00000 n 0000007836 00000 n 0000008080 00000 n 0000008417 00000 n 0000008497 00000 n 0000008735 00000 n 0000009067 00000 n 0000009314 00000 n 0000009558 00000 n 0000009895 00000 n 0000009975 00000 n 0000010213 00000 n 0000010545 00000 n 0000010773 00000 n 0000011013 00000 n 0000011349 00000 n 0000011429 00000 n 0000011663 00000 n 0000011995 00000 n 0000012226 00000 n 0000012466 00000 n 0000012802 00000 n 0000012882 00000 n 0000013116 00000 n 0000013448 00000 n 0000013673 00000 n 0000013913 00000 n 0000014249 00000 n 0000014329 00000 n 0000014563 00000 n 0000014895 00000 n 0000015145 00000 n 0000015389 00000 n 0000015726 00000 n 0000015806 00000 n 0000016044 00000 n 0000016376 00000 n 0000016604 00000 n 0000016844 00000 n 0000017180 00000 n 0000017260 00000 n 0000017494 00000 n 0000017827 00000 n 0000018058 00000 n 0000018298 00000 n 0000018634 00000 n 0000018714 00000 n 0000018948 00000 n 0000019281 00000 n 0000019506 00000 n 0000019746 00000 n 0000020082 00000 n 0000020162 00000 n 0000020396 00000 n 0000020729 00000 n 0000020911 00000 n 0000021095 00000 n 0000021132 00000 n 0000021315 00000 n 0000021500 00000 n 0000021538 00000 n 0000021723 00000 n 0000021909 00000 n 0000021947 00000 n 0000022129 00000 n 0000022314 00000 n 0000022352 00000 n 0000022535 00000 n 0000022720 00000 n 0000022758 00000 n 0000022943 00000 n 0000023129 00000 n 0000023167 00000 n 0000023395 00000 n 0000023636 00000 n 0000023971 00000 n 0000024052 00000 n 0000024287 00000 n 0000024618 00000 n 0000024846 00000 n 0000025087 00000 n 0000025422 00000 n 0000025503 00000 n 0000025738 00000 n 0000026069 00000 n 0000026297 00000 n 0000026538 00000 n 0000026873 00000 n 0000026954 00000 n 0000027189 00000 n 0000027520 00000 n 0000027748 00000 n 0000027989 00000 n 0000028324 00000 n 0000028405 00000 n 0000028640 00000 n 0000028971 00000 n 0000029199 00000 n 0000029440 00000 n 0000029775 00000 n 0000029856 00000 n 0000030091 00000 n 0000030422 00000 n 0000030650 00000 n 0000030891 00000 n 0000031226 00000 n 0000031307 00000 n 0000031542 00000 n 0000031873 00000 n 0000032058 00000 n 0000032244 00000 n 0000032282 00000 n 0000032467 00000 n 0000032653 00000 n 0000032691 00000 n 0000032916 00000 n 0000033161 00000 n 0000033501 00000 n 0000033582 00000 n 0000033821 00000 n 0000034157 00000 n 0000034383 00000 n 0000034628 00000 n 0000034968 00000 n 0000035049 00000 n 0000035288 00000 n 0000035624 00000 n 0000035851 00000 n 0000036096 00000 n 0000036436 00000 n 0000036517 00000 n 0000036756 00000 n 0000037092 00000 n 0000037318 00000 n 0000037563 00000 n 0000037903 00000 n 0000037984 00000 n 0000038223 00000 n 0000038559 00000 n 0000038786 00000 n 0000039031 00000 n 0000039371 00000 n 0000039452 00000 n 0000039691 00000 n 0000040027 00000 n 0000040253 00000 n 0000040498 00000 n 0000040838 00000 n 0000040919 00000 n 0000041158 00000 n 0000041494 00000 n 0000041678 00000 n 0000041864 00000 n 0000041902 00000 n 0000042068 00000 n 0000042268 00000 n 0000042422 00000 n 0000042622 00000 n 0000042788 00000 n 0000042987 00000 n 0000043255 00000 n 0000043502 00000 n 0000043844 00000 n 0000043925 00000 n 0000044165 00000 n 0000044502 00000 n 0000044774 00000 n 0000045021 00000 n 0000045363 00000 n 0000045444 00000 n 0000045684 00000 n 0000046021 00000 n 0000046290 00000 n 0000046537 00000 n 0000046879 00000 n 0000046960 00000 n 0000047200 00000 n 0000047537 00000 n 0000047805 00000 n 0000048052 00000 n 0000048394 00000 n 0000048475 00000 n 0000048715 00000 n 0000049052 00000 n 0000049315 00000 n 0000049562 00000 n 0000049904 00000 n 0000049985 00000 n 0000050225 00000 n 0000050562 00000 n 0000050823 00000 n 0000051070 00000 n 0000051412 00000 n 0000051493 00000 n 0000051733 00000 n 0000052070 00000 n 0000052335 00000 n 0000052582 00000 n 0000052924 00000 n 0000053005 00000 n 0000053245 00000 n 0000053582 00000 n 0000053847 00000 n 0000054094 00000 n 0000054436 00000 n 0000054517 00000 n 0000054757 00000 n 0000055094 00000 n 0000055261 00000 n 0000055447 00000 n 0000055485 00000 n 0000055649 00000 n 0000055848 00000 n 0000055995 00000 n 0000056193 00000 n 0000056342 00000 n 0000056541 00000 n 0000056804 00000 n 0000057053 00000 n 0000057396 00000 n 0000057477 00000 n 0000057719 00000 n 0000058058 00000 n 0000058322 00000 n 0000058569 00000 n 0000058909 00000 n 0000058990 00000 n 0000059230 00000 n 0000059565 00000 n 0000059829 00000 n 0000060072 00000 n 0000060410 00000 n 0000060491 00000 n 0000060727 00000 n 0000061061 00000 n 0000061204 00000 n 0000061404 00000 n 0000061596 00000 n 0000061781 00000 n 0000061819 00000 n 0000062013 00000 n 0000062197 00000 n 0000062235 00000 n 0000062427 00000 n 0000062612 00000 n 0000062650 00000 n 0000067753 00000 n 0000067811 00000 n 0000067852 00000 n 0000070548 00000 n 0000071512 00000 n 0000071593 00000 n 0000071673 00000 n 0000072377 00000 n 0000072610 00000 n 0000073321 00000 n 0000073548 00000 n 0000078189 00000 n 0000079985 00000 n 0000080026 00000 n trailer << /Root 1 0 R /Info 3 0 R /Size 301/ID[<335B63EE10CB3EC37F7AA66D96EBCFAA><335B63EE10CB3EC37F7AA66D96EBCFAA>]>> startxref 80128 %%EOF