%PDF-1.7 % 1 0 obj <> endobj 2 0 obj <> endobj 3 0 obj <> endobj 4 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/TrimBox[ 0 0 612 792]/Type/Page>> endobj 5 0 obj [ 6 0 R 11 0 R 14 0 R 17 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 44 0 R 47 0 R 50 0 R 53 0 R 56 0 R 59 0 R 62 0 R 65 0 R 68 0 R 71 0 R 74 0 R 77 0 R 80 0 R 83 0 R 86 0 R 89 0 R 92 0 R 95 0 R 98 0 R 101 0 R 104 0 R 107 0 R 110 0 R 113 0 R 116 0 R 119 0 R 122 0 R 125 0 R 128 0 R 131 0 R 134 0 R 137 0 R 140 0 R 143 0 R 146 0 R 149 0 R 152 0 R 155 0 R 158 0 R 161 0 R 164 0 R 167 0 R 170 0 R 173 0 R 176 0 R 179 0 R 182 0 R 185 0 R 188 0 R 191 0 R 194 0 R 197 0 R 200 0 R 203 0 R 206 0 R 209 0 R 212 0 R 215 0 R 218 0 R 221 0 R 224 0 R 227 0 R 230 0 R 233 0 R 236 0 R 239 0 R 242 0 R 245 0 R 248 0 R 251 0 R 254 0 R 257 0 R 260 0 R 263 0 R 266 0 R 269 0 R 272 0 R 275 0 R 278 0 R 281 0 R 284 0 R 287 0 R 290 0 R 293 0 R 296 0 R 299 0 R 302 0 R 305 0 R 308 0 R 311 0 R 314 0 R 317 0 R 320 0 R 323 0 R 326 0 R 329 0 R 332 0 R 335 0 R 338 0 R 341 0 R 344 0 R 347 0 R 350 0 R 353 0 R 356 0 R 359 0 R 362 0 R 365 0 R 368 0 R 371 0 R 374 0 R 377 0 R 380 0 R 383 0 R 386 0 R 389 0 R 392 0 R 395 0 R 398 0 R 401 0 R 404 0 R 407 0 R 410 0 R 413 0 R 416 0 R 419 0 R 422 0 R 425 0 R 428 0 R 431 0 R 434 0 R 437 0 R 440 0 R 443 0 R 446 0 R 449 0 R 452 0 R 455 0 R 458 0 R 461 0 R 464 0 R 467 0 R 470 0 R 473 0 R 476 0 R 479 0 R 482 0 R 485 0 R 488 0 R 491 0 R 494 0 R 497 0 R 500 0 R 503 0 R 506 0 R 509 0 R 512 0 R 515 0 R 518 0 R 521 0 R 524 0 R 527 0 R 530 0 R 533 0 R 536 0 R 539 0 R 542 0 R 545 0 R 548 0 R 551 0 R 554 0 R 557 0 R 560 0 R 563 0 R 566 0 R 569 0 R 572 0 R 575 0 R 578 0 R 581 0 R 584 0 R 587 0 R 590 0 R 593 0 R 596 0 R 599 0 R 602 0 R 605 0 R 608 0 R 611 0 R 617 0 R 623 0 R 626 0 R 629 0 R 632 0 R 635 0 R 638 0 R 640 0 R 646 0 R 652 0 R 658 0 R 664 0 R 670 0 R 675 0 R 678 0 R 681 0 R 684 0 R 687 0 R 693 0 R 698 0 R 704 0 R 710 0 R 712 0 R 714 0 R 716 0 R 719 0 R 722 0 R ] endobj 6 0 obj <>/F 4/MK<<>>/P 4 0 R /Parent 6 0 R /Rect[ 47.915 667.736 133.09 681.059]/Subtype/Widget/Type/Annot>> endobj 7 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 8 0 obj <> endobj 9 0 obj <> endobj 10 0 obj <> endobj 11 0 obj <>/F 4/MK<<>>/P 4 0 R /Parent 7 0 R /Rect[ 154.882 667.762 220.151 681.084]/Subtype/Widget/Type/Annot>> endobj 12 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 13 0 obj <> endobj 14 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 239.447 652.69 295.528 666.013]/Subtype/Widget/T(PROVIDER-LICENCE)/TU(Provider licence No.)/Type/Annot>> endobj 15 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 16 0 obj <> endobj 17 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 297.521 652.807 320.934 666.13]/Subtype/Widget/T(PROVIDER-SPEC)/TU(Provider spec.)/Type/Annot>> endobj 18 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 19 0 obj <> endobj 20 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 324.487 652.716 421.913 666.039]/Subtype/Widget/T(PATIENT-ACCOUNT)/TU(Patient office account no.)/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[ 47.8039 640.951 219.752 654.273]/Subtype/Widget/T(ADDRESS-SUBS)/TU(Patient address)/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[ 48.4703 613.169 114.249 626.492]/Subtype/Widget/T(CITY-SUBS)/TU(Patient city)/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[ 123.218 613.216 173.685 626.538]/Subtype/Widget/T(PROVINCE-SUBS)/TU(Patient province)/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[ 175.81 613.124 220.661 626.447]/Subtype/Widget/T(POSTALCODE-SUBS)/TU(Patient postal code)/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[ 316.587 596.592 424.732 609.915]/Subtype/Widget/T(PROVIDER-PHONE)/TU(Provider phone no.)/Type/Annot>> endobj 36 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 37 0 obj <> endobj 38 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 26.9974 534.028 222.936 574.404]/Subtype/Widget/T(PROVIDER-OTHER-INFO)/TU(For provider's use only - for additional information, diagnosis, procedures, or special consideration.)/Type/Annot>> endobj 39 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 40 0 obj <> endobj 41 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 27.2731 501.993 42.52 512.254]/Subtype/Widget/T(SERVICE-DATE-DAY-1)/TU(Date of service \(day\)_row1)/Type/Annot>> endobj 42 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 43 0 obj <> endobj 44 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 45.3832 502.182 60.6301 512.443]/Subtype/Widget/T(SERVICE-DATE-MONTH-1)/TU(Date of service \(month\)_row1)/Type/Annot>> endobj 45 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 46 0 obj <> endobj 47 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 62.4041 502.536 80.7136 512.797]/Subtype/Widget/T(SERVICE-DATE-YEAR-1)/TU(Date of service \(year\)_row1)/Type/Annot>> endobj 48 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 49 0 obj <> endobj 50 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 82.9771 502.871 95.6721 512.621]/Subtype/Widget/T(PROCEDURE-CODE1-1)/TU(Procedure code 1_row1)/Type/Annot>> endobj 51 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 52 0 obj <> endobj 53 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 98.9783 503.225 111.673 512.975]/Subtype/Widget/T(PROCEDURE-CODE2-1)/TU(Procedure code 2_row1)/Type/Annot>> endobj 54 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 55 0 obj <> endobj 56 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 115.999 503.048 128.694 512.798]/Subtype/Widget/T(PROCEDURE-CODE3-1)/TU(Procedure code 3_row1)/Type/Annot>> endobj 57 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 58 0 obj <> endobj 59 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 131.959 502.891 144.654 512.641]/Subtype/Widget/T(PROCEDURE-CODE4-1)/TU(Procedure code 4_row1)/Type/Annot>> endobj 60 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 61 0 obj <> endobj 62 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 147.98 503.225 160.675 512.975]/Subtype/Widget/T(PROCEDURE-CODE5-1)/TU(Procedure code 5_row1)/Type/Annot>> endobj 63 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 64 0 obj <> endobj 65 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 164.448 502.538 204.195 512.798]/Subtype/Widget/T(TOOTH-CODE-1)/TU(Int'l tooth code_row1)/Type/Annot>> endobj 66 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 67 0 obj <> endobj 68 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.955 502.715 249.702 512.975]/Subtype/Widget/T(TOOTH-SURFACES-1)/TU(Tooth surfaces_row1)/Type/Annot>> endobj 69 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 70 0 obj <> endobj 71 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 254.315 502.048 265.989 511.798]/Subtype/Widget/T(PROVIDER-FEE1-1)/TU(Provider's fee 1_row2)/Type/Annot>> endobj 72 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 73 0 obj <> endobj 74 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 267.784 501.891 279.459 511.641]/Subtype/Widget/T(PROVIDER-FEE2-1)/TU(Provider's fee 2_row1)/Type/Annot>> endobj 75 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 76 0 obj <> endobj 77 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 281.743 502.225 293.417 511.975]/Subtype/Widget/T(PROVIDER-FEE3-1)/TU(Provider's fee 3_row1)/Type/Annot>> endobj 78 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 79 0 obj <> endobj 80 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 295.64 502.068 307.314 511.818]/Subtype/Widget/T(PROVIDER-FEE4-1)/TU(Provider's fee 4_row1)/Type/Annot>> endobj 81 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 82 0 obj <> endobj 83 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 309.13 501.891 320.804 511.641]/Subtype/Widget/T(PROVIDER-FEE5-1)/TU(Provider's fee 5_row1)/Type/Annot>> endobj 84 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 85 0 obj <> endobj 86 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 324.489 502.215 336.163 511.965]/Subtype/Widget/T(LAB-CHARGE1-1)/TU(Laboratory charges 1_row1)/Type/Annot>> endobj 87 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 88 0 obj <> endobj 89 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 337.958 502.058 349.632 511.808]/Subtype/Widget/T(LAB-CHARGE2-1)/TU(Laboratory charge 2_row1)/Type/Annot>> endobj 90 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 91 0 obj <> endobj 92 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 351.917 501.88 363.591 511.63]/Subtype/Widget/T(LAB-CHARGE3-1)/TU(Laboratory charge 3_row1)/Type/Annot>> endobj 93 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 94 0 obj <> endobj 95 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 365.814 502.235 377.488 511.985]/Subtype/Widget/T(LAB-CHARGE4-1)/TU(Laboratory charge 4_row1)/Type/Annot>> endobj 96 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 97 0 obj <> endobj 98 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 380.771 502.038 394.997 512.298]/Subtype/Widget/T(TOTAL-CHARGES1-1)/TU(Total charges 1_row1)/Type/Annot>> endobj 99 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 100 0 obj <> endobj 101 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 399.366 501.369 413.592 511.63]/Subtype/Widget/T(TOTAL-CHARGES2-1)/TU(Total charges 2_row1)/Type/Annot>> endobj 102 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 103 0 obj <> endobj 104 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 417.407 501.704 431.633 511.965]/Subtype/Widget/T(TOTAL-CHARGES3-1)/TU(Total charges 3_row1)/Type/Annot>> endobj 105 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 106 0 obj <> endobj 107 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 435.898 501.547 450.124 511.808]/Subtype/Widget/T(TOTAL-CHARGES4-1)/TU(Total charges 4_row1)/Type/Annot>> endobj 108 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 109 0 obj <> endobj 110 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 453.982 501.369 468.208 511.63]/Subtype/Widget/T(TOTAL-CHARGES5-1)/TU(Total charges 5_row1)/Type/Annot>> endobj 111 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 112 0 obj <> endobj 113 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 2/Rect[ 472.201 501.548 531.345 511.808]/Subtype/Widget/T(ALLOWED-AMT-1)/TU(Allowed amount_row1)/Type/Annot>> endobj 114 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 115 0 obj <> endobj 116 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 1/Rect[ 534.65 502.183 566.231 512.954]/Subtype/Widget/T(CODE-1)/TU(Code_row1)/Type/Annot>> endobj 117 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 118 0 obj <> endobj 119 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 27.2681 489.404 42.515 499.665]/Subtype/Widget/T(SERVICE-DATE-DAY-2)/TU(Date of service \(day\)_row2)/Type/Annot>> endobj 120 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 121 0 obj <> endobj 122 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 45.3782 489.104 60.6251 499.365]/Subtype/Widget/T(SERVICE-DATE-MONTH-2)/TU(Date of service \(month\)_row2)/Type/Annot>> endobj 123 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 124 0 obj <> endobj 125 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 62.3991 488.927 80.7086 499.188]/Subtype/Widget/T(SERVICE-DATE-YEAR-2)/TU(Date of service \(year\)_row2)/Type/Annot>> endobj 126 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 127 0 obj <> endobj 128 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 82.9721 490.282 95.6671 500.032]/Subtype/Widget/T(PROCEDURE-CODE1-2)/TU(Procedure code 1_row2)/Type/Annot>> endobj 129 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 130 0 obj <> endobj 131 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 98.9732 490.125 111.668 499.875]/Subtype/Widget/T(PROCEDURE-CODE2-2)/TU(Procedure code 2_row2)/Type/Annot>> endobj 132 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 133 0 obj <> endobj 134 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 115.484 490.459 128.179 500.209]/Subtype/Widget/T(PROCEDURE-CODE3-2)/TU(Procedure code 3_row2)/Type/Annot>> endobj 135 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 136 0 obj <> endobj 137 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 131.443 490.302 144.138 500.052]/Subtype/Widget/T(PROCEDURE-CODE4-2)/TU(Procedure code 4_row2)/Type/Annot>> endobj 138 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 139 0 obj <> endobj 140 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 147.464 490.125 160.159 499.875]/Subtype/Widget/T(PROCEDURE-CODE5-2)/TU(Procedure code 5_row2)/Type/Annot>> endobj 141 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 142 0 obj <> endobj 143 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 163.933 489.949 203.68 500.209]/Subtype/Widget/T(TOOTH-CODE-2)/TU(Int'l tooth code_row2)/Type/Annot>> endobj 144 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 145 0 obj <> endobj 146 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.439 489.615 249.186 499.875]/Subtype/Widget/T(TOOTH-SURFACES-2)/TU(Tooth surfaces_row2)/Type/Annot>> endobj 147 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 148 0 obj <> endobj 149 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 253.8 489.459 265.474 499.209]/Subtype/Widget/T(PROVIDER-FEE1-2)/TU(Provider's fee 1_row2)/Type/Annot>> endobj 150 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 151 0 obj <> endobj 152 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 267.78 489.302 279.454 499.052]/Subtype/Widget/T(PROVIDER-FEE2-2)/TU(Provider's fee 2_row2)/Type/Annot>> endobj 153 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 154 0 obj <> endobj 155 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 281.738 489.125 293.412 498.875]/Subtype/Widget/T(PROVIDER-FEE3-2)/TU(Provider's fee 3_row2)/Type/Annot>> endobj 156 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 157 0 obj <> endobj 158 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 295.125 489.479 306.799 499.229]/Subtype/Widget/T(PROVIDER-FEE4-2)/TU(Provider's fee 4_row2)/Type/Annot>> endobj 159 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 160 0 obj <> endobj 161 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 308.614 489.302 320.288 499.052]/Subtype/Widget/T(PROVIDER-FEE5-2)/TU(Provider's fee 5_row2)/Type/Annot>> endobj 162 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 163 0 obj <> endobj 164 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 323.973 489.116 335.647 498.866]/Subtype/Widget/T(LAB-CHARGE1-2)/TU(Laboratory charges 1_row2)/Type/Annot>> endobj 165 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 166 0 obj <> endobj 167 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 337.443 489.469 349.117 499.219]/Subtype/Widget/T(LAB-CHARGE2-2)/TU(Laboratory charge 2_row2)/Type/Annot>> endobj 168 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 169 0 obj <> endobj 170 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 351.401 489.292 363.075 499.042]/Subtype/Widget/T(LAB-CHARGE3-2)/TU(Laboratory charge 3_row2)/Type/Annot>> endobj 171 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 172 0 obj <> endobj 173 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 365.298 489.135 376.972 498.885]/Subtype/Widget/T(LAB-CHARGE4-2)/TU(Laboratory charge 4_row2)/Type/Annot>> endobj 174 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 175 0 obj <> endobj 176 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 380.787 488.938 395.013 499.199]/Subtype/Widget/T(TOTAL-CHARGES1-2)/TU(Total charges 1_row2)/Type/Annot>> endobj 177 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 178 0 obj <> endobj 179 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 398.85 488.781 413.076 499.042]/Subtype/Widget/T(TOTAL-CHARGES2-2)/TU(Total charges 2_row2)/Type/Annot>> endobj 180 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 181 0 obj <> endobj 182 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 416.892 488.605 431.118 498.866]/Subtype/Widget/T(TOTAL-CHARGES3-2)/TU(Total charges 3_row2)/Type/Annot>> endobj 183 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 184 0 obj <> endobj 185 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 435.383 488.958 449.609 499.219]/Subtype/Widget/T(TOTAL-CHARGES4-2)/TU(Total charges 4_row2)/Type/Annot>> endobj 186 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 187 0 obj <> endobj 188 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 453.466 488.781 467.692 499.042]/Subtype/Widget/T(TOTAL-CHARGES5-2)/TU(Total charges 5_row2)/Type/Annot>> endobj 189 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 190 0 obj <> endobj 191 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 2/Rect[ 472.196 488.959 531.34 499.219]/Subtype/Widget/T(ALLOWED-AMT-2)/TU(Allowed amount_row2)/Type/Annot>> endobj 192 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 193 0 obj <> endobj 194 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 1/Rect[ 534.603 488.594 566.184 499.365]/Subtype/Widget/T(CODE-2)/TU(Code_row2)/Type/Annot>> endobj 195 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 196 0 obj <> endobj 197 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 27.2682 476.28 42.5151 486.541]/Subtype/Widget/T(SERVICE-DATE-DAY-3)/TU(Date of service \(day\)_row3)/Type/Annot>> endobj 198 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 199 0 obj <> endobj 200 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 45.3782 476.51 60.6251 486.771]/Subtype/Widget/T(SERVICE-DATE-MONTH-3)/TU(Date of service \(month\)_row3)/Type/Annot>> endobj 201 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 202 0 obj <> endobj 203 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 62.3991 475.823 80.7086 486.084]/Subtype/Widget/T(SERVICE-DATE-YEAR-3)/TU(Date of service \(year\)_row3)/Type/Annot>> endobj 204 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 205 0 obj <> endobj 206 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 82.9721 477.178 95.6672 486.928]/Subtype/Widget/T(PROCEDURE-CODE1-3)/TU(Procedure code 1_row3)/Type/Annot>> endobj 207 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 208 0 obj <> endobj 209 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 98.9733 476.511 111.668 486.261]/Subtype/Widget/T(PROCEDURE-CODE2-3)/TU(Procedure code 2_row3)/Type/Annot>> endobj 210 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 211 0 obj <> endobj 212 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 115.484 477.355 128.179 487.105]/Subtype/Widget/T(PROCEDURE-CODE3-3)/TU(Procedure code 3_row3)/Type/Annot>> endobj 213 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 214 0 obj <> endobj 215 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 131.443 476.687 144.138 486.437]/Subtype/Widget/T(PROCEDURE-CODE4-3)/TU(Procedure code 4_row3)/Type/Annot>> endobj 216 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 217 0 obj <> endobj 218 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 147.464 476.511 160.159 486.261]/Subtype/Widget/T(PROCEDURE-CODE5-3)/TU(Procedure code 5_row3)/Type/Annot>> endobj 219 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 220 0 obj <> endobj 221 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 163.933 476.334 203.68 486.594]/Subtype/Widget/T(TOOTH-CODE-3)/TU(Int'l tooth code_row3)/Type/Annot>> endobj 222 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 223 0 obj <> endobj 224 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.439 476.001 249.186 486.261]/Subtype/Widget/T(TOOTH-SURFACES-3)/TU(Tooth surfaces_row3)/Type/Annot>> endobj 225 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 226 0 obj <> endobj 227 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 253.8 475.844 265.474 485.594]/Subtype/Widget/T(PROVIDER-FEE1-3)/TU(Provider's fee 1_row3)/Type/Annot>> endobj 228 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 229 0 obj <> endobj 230 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 267.779 475.687 279.454 485.437]/Subtype/Widget/T(PROVIDER-FEE2-3)/TU(Provider's fee 2_row3)/Type/Annot>> endobj 231 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 232 0 obj <> endobj 233 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 281.738 475.511 293.412 485.261]/Subtype/Widget/T(PROVIDER-FEE3-3)/TU(Provider's fee 3_row3)/Type/Annot>> endobj 234 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 235 0 obj <> endobj 236 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 295.125 475.864 306.799 485.614]/Subtype/Widget/T(PROVIDER-FEE4-3)/TU(Provider's fee 4_row3)/Type/Annot>> endobj 237 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 238 0 obj <> endobj 239 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 308.614 475.687 320.288 485.437]/Subtype/Widget/T(PROVIDER-FEE5-3)/TU(Provider's fee 5_row3)/Type/Annot>> endobj 240 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 241 0 obj <> endobj 242 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 323.973 475.501 335.647 485.251]/Subtype/Widget/T(LAB-CHARGE1-3)/TU(Laboratory charges 1_row3)/Type/Annot>> endobj 243 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 244 0 obj <> endobj 245 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 337.443 475.854 349.117 485.604]/Subtype/Widget/T(LAB-CHARGE2-3)/TU(Laboratory charge 2_row3)/Type/Annot>> endobj 246 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 247 0 obj <> endobj 248 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 351.401 475.677 363.075 485.427]/Subtype/Widget/T(LAB-CHARGE3-3)/TU(Laboratory charge 3_row3)/Type/Annot>> endobj 249 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 250 0 obj <> endobj 251 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 365.298 475.521 376.972 485.271]/Subtype/Widget/T(LAB-CHARGE4-3)/TU(Laboratory charge 4_row3)/Type/Annot>> endobj 252 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 253 0 obj <> endobj 254 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 380.787 475.324 395.013 485.585]/Subtype/Widget/T(TOTAL-CHARGES1-3)/TU(Total charges 1_row3)/Type/Annot>> endobj 255 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 256 0 obj <> endobj 257 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 398.85 475.167 413.076 485.428]/Subtype/Widget/T(TOTAL-CHARGES2-3)/TU(Total charges 2_row3)/Type/Annot>> endobj 258 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 259 0 obj <> endobj 260 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 416.892 474.99 431.118 485.251]/Subtype/Widget/T(TOTAL-CHARGES3-3)/TU(Total charges 3_row3)/Type/Annot>> endobj 261 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 262 0 obj <> endobj 263 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 435.383 475.343 449.609 485.604]/Subtype/Widget/T(TOTAL-CHARGES4-3)/TU(Total charges 4_row3)/Type/Annot>> endobj 264 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 265 0 obj <> endobj 266 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 453.466 475.167 467.692 485.428]/Subtype/Widget/T(TOTAL-CHARGES5-3)/TU(Total charges 5_row3)/Type/Annot>> endobj 267 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 268 0 obj <> endobj 269 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 2/Rect[ 472.196 475.344 531.34 485.604]/Subtype/Widget/T(ALLOWED-AMT-3)/TU(Allowed amount_row3)/Type/Annot>> endobj 270 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 271 0 obj <> endobj 272 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 1/Rect[ 534.093 475.49 565.674 486.261]/Subtype/Widget/T(CODE-3)/TU(Code_row3)/Type/Annot>> endobj 273 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 274 0 obj <> endobj 275 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 26.9761 463.342 42.223 473.603]/Subtype/Widget/T(SERVICE-DATE-DAY-4)/TU(Date of service \(day\)_row4)/Type/Annot>> endobj 276 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 277 0 obj <> endobj 278 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 45.5341 463.062 60.781 473.323]/Subtype/Widget/T(SERVICE-DATE-MONTH-4)/TU(Date of service \(month\)_row4)/Type/Annot>> endobj 279 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 280 0 obj <> endobj 281 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 62.5758 463.397 80.8853 473.657]/Subtype/Widget/T(SERVICE-DATE-YEAR-4)/TU(Date of service \(year\)_row4)/Type/Annot>> endobj 282 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 283 0 obj <> endobj 284 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 82.6384 463.73 95.3334 473.481]/Subtype/Widget/T(PROCEDURE-CODE1-4)/TU(Procedure code 1_row4)/Type/Annot>> endobj 285 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 286 0 obj <> endobj 287 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 99.1499 463.573 111.845 473.324]/Subtype/Widget/T(PROCEDURE-CODE2-4)/TU(Procedure code 2_row4)/Type/Annot>> endobj 288 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 289 0 obj <> endobj 290 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 115.15 464.417 127.845 474.167]/Subtype/Widget/T(PROCEDURE-CODE3-4)/TU(Procedure code 3_row4)/Type/Annot>> endobj 291 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 292 0 obj <> endobj 293 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 131.109 464.26 143.804 474.01]/Subtype/Widget/T(PROCEDURE-CODE4-4)/TU(Procedure code 4_row4)/Type/Annot>> endobj 294 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 295 0 obj <> endobj 296 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 147.172 463.042 159.867 472.792]/Subtype/Widget/T(PROCEDURE-CODE5-4)/TU(Procedure code 5_row4)/Type/Annot>> endobj 297 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 298 0 obj <> endobj 299 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 164.172 462.907 203.919 473.167]/Subtype/Widget/T(TOOTH-CODE-4)/TU(Int'l tooth code_row4)/Type/Annot>> endobj 300 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 301 0 obj <> endobj 302 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.106 462.574 248.853 472.834]/Subtype/Widget/T(TOOTH-SURFACES-4)/TU(Tooth surfaces_row4)/Type/Annot>> endobj 303 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 304 0 obj <> endobj 305 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 253.976 463.417 265.651 473.167]/Subtype/Widget/T(PROVIDER-FEE1-4)/TU(Provider's fee 1_row4)/Type/Annot>> endobj 306 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 307 0 obj <> endobj 308 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 267.935 462.749 279.61 472.5]/Subtype/Widget/T(PROVIDER-FEE2-4)/TU(Provider's fee 2_row4)/Type/Annot>> endobj 309 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 310 0 obj <> endobj 311 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 281.914 462.573 293.589 472.324]/Subtype/Widget/T(PROVIDER-FEE3-4)/TU(Provider's fee 3_row4)/Type/Annot>> endobj 312 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 313 0 obj <> endobj 314 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 294.791 463.437 306.465 473.187]/Subtype/Widget/T(PROVIDER-FEE4-4)/TU(Provider's fee 4_row4)/Type/Annot>> endobj 315 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 316 0 obj <> endobj 317 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 308.28 463.26 319.954 473.01]/Subtype/Widget/T(PROVIDER-FEE5-4)/TU(Provider's fee 5_row4)/Type/Annot>> endobj 318 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 319 0 obj <> endobj 320 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 323.639 463.074 335.313 472.824]/Subtype/Widget/T(LAB-CHARGE1-4)/TU(Laboratory charges 1_row4)/Type/Annot>> endobj 321 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 322 0 obj <> endobj 323 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 338.109 463.427 349.783 473.177]/Subtype/Widget/T(LAB-CHARGE2-4)/TU(Laboratory charge 2_row4)/Type/Annot>> endobj 324 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 325 0 obj <> endobj 326 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 351.068 463.25 362.742 473]/Subtype/Widget/T(LAB-CHARGE3-4)/TU(Laboratory charge 3_row4)/Type/Annot>> endobj 327 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 328 0 obj <> endobj 329 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 364.964 463.094 376.638 472.844]/Subtype/Widget/T(LAB-CHARGE4-4)/TU(Laboratory charge 4_row4)/Type/Annot>> endobj 330 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 331 0 obj <> endobj 332 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 380.453 462.897 394.679 473.158]/Subtype/Widget/T(TOTAL-CHARGES1-4)/TU(Total charges 1_row4)/Type/Annot>> endobj 333 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 334 0 obj <> endobj 335 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 398.517 462.74 412.743 473.001]/Subtype/Widget/T(TOTAL-CHARGES2-4)/TU(Total charges 2_row4)/Type/Annot>> endobj 336 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 337 0 obj <> endobj 338 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 416.558 462.563 430.784 472.824]/Subtype/Widget/T(TOTAL-CHARGES3-4)/TU(Total charges 3_row4)/Type/Annot>> endobj 339 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 340 0 obj <> endobj 341 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 435.049 462.916 449.275 473.177]/Subtype/Widget/T(TOTAL-CHARGES4-4)/TU(Total charges 4_row4)/Type/Annot>> endobj 342 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 343 0 obj <> endobj 344 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 453.132 462.74 467.358 473.001]/Subtype/Widget/T(TOTAL-CHARGES5-4)/TU(Total charges 5_row4)/Type/Annot>> endobj 345 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 346 0 obj <> endobj 347 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 2/Rect[ 472.372 462.917 531.516 473.177]/Subtype/Widget/T(ALLOWED-AMT-4)/TU(Allowed amount_row4)/Type/Annot>> endobj 348 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 349 0 obj <> endobj 350 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 1/Rect[ 533.759 462.553 565.34 473.324]/Subtype/Widget/T(CODE-4)/TU(Code_row4)/Type/Annot>> endobj 351 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 352 0 obj <> endobj 353 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 26.7577 450.268 42.0046 460.529]/Subtype/Widget/T(SERVICE-DATE-DAY-5)/TU(Date of service \(day\)_row5)/Type/Annot>> endobj 354 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 355 0 obj <> endobj 356 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 45.3782 449.947 60.6251 460.208]/Subtype/Widget/T(SERVICE-DATE-MONTH-5)/TU(Date of service \(month\)_row5)/Type/Annot>> endobj 357 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 358 0 obj <> endobj 359 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 62.4199 450.281 80.7294 460.542]/Subtype/Widget/T(SERVICE-DATE-YEAR-5)/TU(Date of service \(year\)_row5)/Type/Annot>> endobj 360 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 361 0 obj <> endobj 362 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 82.9721 450.635 95.6671 460.386]/Subtype/Widget/T(PROCEDURE-CODE1-5)/TU(Procedure code 1_row5)/Type/Annot>> endobj 363 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 364 0 obj <> endobj 365 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 99.4837 450.989 112.179 460.739]/Subtype/Widget/T(PROCEDURE-CODE2-5)/TU(Procedure code 2_row5)/Type/Annot>> endobj 366 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 367 0 obj <> endobj 368 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 115.994 450.323 128.689 460.073]/Subtype/Widget/T(PROCEDURE-CODE3-5)/TU(Procedure code 3_row5)/Type/Annot>> endobj 369 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 370 0 obj <> endobj 371 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 131.954 450.166 144.649 459.916]/Subtype/Widget/T(PROCEDURE-CODE4-5)/TU(Procedure code 4_row5)/Type/Annot>> endobj 372 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 373 0 obj <> endobj 374 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 147.464 449.989 160.159 459.739]/Subtype/Widget/T(PROCEDURE-CODE5-5)/TU(Procedure code 5_row5)/Type/Annot>> endobj 375 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 376 0 obj <> endobj 377 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 164.443 449.813 204.19 460.073]/Subtype/Widget/T(TOOTH-CODE-5)/TU(Int'l tooth code_row5)/Type/Annot>> endobj 378 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 379 0 obj <> endobj 380 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.95 450.479 249.697 460.739]/Subtype/Widget/T(TOOTH-SURFACES-5)/TU(Tooth surfaces_row5)/Type/Annot>> endobj 381 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 382 0 obj <> endobj 383 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 254.31 450.323 265.984 460.073]/Subtype/Widget/T(PROVIDER-FEE1-5)/TU(Provider's fee 1_row5)/Type/Annot>> endobj 384 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 385 0 obj <> endobj 386 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 268.269 450.166 279.943 459.916]/Subtype/Widget/T(PROVIDER-FEE2-5)/TU(Provider's fee 2_row5)/Type/Annot>> endobj 387 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 388 0 obj <> endobj 389 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 282.249 449.989 293.923 459.739]/Subtype/Widget/T(PROVIDER-FEE3-5)/TU(Provider's fee 3_row5)/Type/Annot>> endobj 390 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 391 0 obj <> endobj 392 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 295.635 450.343 307.309 460.093]/Subtype/Widget/T(PROVIDER-FEE4-5)/TU(Provider's fee 4_row5)/Type/Annot>> endobj 393 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 394 0 obj <> endobj 395 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 310.146 449.655 321.82 459.406]/Subtype/Widget/T(PROVIDER-FEE5-5)/TU(Provider's fee 5_row5)/Type/Annot>> endobj 396 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 397 0 obj <> endobj 398 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 324.484 449.979 336.158 459.729]/Subtype/Widget/T(LAB-CHARGE1-5)/TU(Laboratory charges 1_row5)/Type/Annot>> endobj 399 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 400 0 obj <> endobj 401 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 338.953 450.333 350.627 460.083]/Subtype/Widget/T(LAB-CHARGE2-5)/TU(Laboratory charge 2_row5)/Type/Annot>> endobj 402 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 403 0 obj <> endobj 404 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 351.912 450.156 363.586 459.906]/Subtype/Widget/T(LAB-CHARGE3-5)/TU(Laboratory charge 3_row5)/Type/Annot>> endobj 405 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 406 0 obj <> endobj 407 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 365.808 449.999 377.482 459.749]/Subtype/Widget/T(LAB-CHARGE4-5)/TU(Laboratory charge 4_row5)/Type/Annot>> endobj 408 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 409 0 obj <> endobj 410 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 381.297 449.802 395.523 460.063]/Subtype/Widget/T(TOTAL-CHARGES1-5)/TU(Total charges 1_row5)/Type/Annot>> endobj 411 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 412 0 obj <> endobj 413 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 399.361 449.645 413.587 459.906]/Subtype/Widget/T(TOTAL-CHARGES2-5)/TU(Total charges 2_row5)/Type/Annot>> endobj 414 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 415 0 obj <> endobj 416 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 417.402 449.468 431.628 459.729]/Subtype/Widget/T(TOTAL-CHARGES3-5)/TU(Total charges 3_row5)/Type/Annot>> endobj 417 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 418 0 obj <> endobj 419 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 435.893 449.822 450.119 460.083]/Subtype/Widget/T(TOTAL-CHARGES4-5)/TU(Total charges 4_row5)/Type/Annot>> endobj 420 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 421 0 obj <> endobj 422 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 453.977 449.645 468.203 459.906]/Subtype/Widget/T(TOTAL-CHARGES5-5)/TU(Total charges 5_row5)/Type/Annot>> endobj 423 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 424 0 obj <> endobj 425 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 2/Rect[ 472.217 449.823 531.361 460.083]/Subtype/Widget/T(ALLOWED-AMT-5)/TU(Allowed amount_row5)/Type/Annot>> endobj 426 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 427 0 obj <> endobj 428 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 1/Rect[ 534.603 449.968 566.184 460.739]/Subtype/Widget/T(CODE-5)/TU(Code_row5)/Type/Annot>> endobj 429 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 430 0 obj <> endobj 431 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 26.9135 437.331 42.1604 447.592]/Subtype/Widget/T(SERVICE-DATE-DAY-6)/TU(Date of service \(day\)_row6)/Type/Annot>> endobj 432 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 433 0 obj <> endobj 434 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 45.5341 437.031 60.781 447.292]/Subtype/Widget/T(SERVICE-DATE-MONTH-6)/TU(Date of service \(month\)_row6)/Type/Annot>> endobj 435 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 436 0 obj <> endobj 437 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 63.0862 436.854 80.8853 447.115]/Subtype/Widget/T(SERVICE-DATE-YEAR-6)/TU(Date of service \(year\)_row6)/Type/Annot>> endobj 438 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 439 0 obj <> endobj 440 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 83.1279 437.719 95.8229 447.469]/Subtype/Widget/T(PROCEDURE-CODE1-6)/TU(Procedure code 1_row6)/Type/Annot>> endobj 441 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 442 0 obj <> endobj 443 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 99.6395 437.562 112.335 447.312]/Subtype/Widget/T(PROCEDURE-CODE2-6)/TU(Procedure code 2_row6)/Type/Annot>> endobj 444 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 445 0 obj <> endobj 446 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 115.129 437.896 127.824 447.646]/Subtype/Widget/T(PROCEDURE-CODE3-6)/TU(Procedure code 3_row6)/Type/Annot>> endobj 447 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 448 0 obj <> endobj 449 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 132.109 437.739 144.804 447.489]/Subtype/Widget/T(PROCEDURE-CODE4-6)/TU(Procedure code 4_row6)/Type/Annot>> endobj 450 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 451 0 obj <> endobj 452 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 147.62 437.562 160.315 447.312]/Subtype/Widget/T(PROCEDURE-CODE5-6)/TU(Procedure code 5_row6)/Type/Annot>> endobj 453 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 454 0 obj <> endobj 455 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 164.599 437.386 204.346 447.646]/Subtype/Widget/T(TOOTH-CODE-6)/TU(Int'l tooth code_row6)/Type/Annot>> endobj 456 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 457 0 obj <> endobj 458 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 210.106 437.052 249.853 447.312]/Subtype/Widget/T(TOOTH-SURFACES-6)/TU(Tooth surfaces_row6)/Type/Annot>> endobj 459 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 460 0 obj <> endobj 461 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 254.466 437.896 266.14 447.646]/Subtype/Widget/T(PROVIDER-FEE1-6)/TU(Provider's fee 1_row6)/Type/Annot>> endobj 462 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 463 0 obj <> endobj 464 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 267.915 437.739 279.589 447.489]/Subtype/Widget/T(PROVIDER-FEE2-6)/TU(Provider's fee 2_row6)/Type/Annot>> endobj 465 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 466 0 obj <> endobj 467 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 282.404 437.562 294.078 447.312]/Subtype/Widget/T(PROVIDER-FEE3-6)/TU(Provider's fee 3_row6)/Type/Annot>> endobj 468 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 469 0 obj <> endobj 470 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 295.791 437.916 307.465 447.666]/Subtype/Widget/T(PROVIDER-FEE4-6)/TU(Provider's fee 4_row6)/Type/Annot>> endobj 471 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 472 0 obj <> endobj 473 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 309.79 437.739 321.465 447.489]/Subtype/Widget/T(PROVIDER-FEE5-6)/TU(Provider's fee 5_row6)/Type/Annot>> endobj 474 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 475 0 obj <> endobj 476 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 324.639 437.552 336.313 447.302]/Subtype/Widget/T(LAB-CHARGE1-6)/TU(Laboratory charges 1_row6)/Type/Annot>> endobj 477 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 478 0 obj <> endobj 479 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 338.109 437.906 349.783 447.656]/Subtype/Widget/T(LAB-CHARGE2-6)/TU(Laboratory charge 2_row6)/Type/Annot>> endobj 480 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 481 0 obj <> endobj 482 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 352.068 437.729 363.742 447.479]/Subtype/Widget/T(LAB-CHARGE3-6)/TU(Laboratory charge 3_row6)/Type/Annot>> endobj 483 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 484 0 obj <> endobj 485 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 365.964 437.572 377.638 447.322]/Subtype/Widget/T(LAB-CHARGE4-6)/TU(Laboratory charge 4_row6)/Type/Annot>> endobj 486 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 487 0 obj <> endobj 488 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 381.453 437.375 395.679 447.636]/Subtype/Widget/T(TOTAL-CHARGES1-6)/TU(Total charges 1_row6)/Type/Annot>> endobj 489 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 490 0 obj <> endobj 491 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 399.517 437.218 413.743 447.479]/Subtype/Widget/T(TOTAL-CHARGES2-6)/TU(Total charges 2_row6)/Type/Annot>> endobj 492 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 493 0 obj <> endobj 494 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 417.558 437.041 431.784 447.302]/Subtype/Widget/T(TOTAL-CHARGES3-6)/TU(Total charges 3_row6)/Type/Annot>> endobj 495 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 496 0 obj <> endobj 497 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 436.049 437.395 450.275 447.656]/Subtype/Widget/T(TOTAL-CHARGES4-6)/TU(Total charges 4_row6)/Type/Annot>> endobj 498 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 499 0 obj <> endobj 500 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 454.132 437.218 468.358 447.479]/Subtype/Widget/T(TOTAL-CHARGES5-6)/TU(Total charges 5_row6)/Type/Annot>> endobj 501 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 502 0 obj <> endobj 503 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 2/Rect[ 472.372 436.885 531.516 447.145]/Subtype/Widget/T(ALLOWED-AMT-6)/TU(Allowed amount_row6)/Type/Annot>> endobj 504 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 505 0 obj <> endobj 506 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 1/Rect[ 534.759 436.52 566.34 447.291]/Subtype/Widget/T(CODE-6)/TU(Code_row6)/Type/Annot>> endobj 507 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 508 0 obj <> endobj 509 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 27.2681 424.825 42.515 435.086]/Subtype/Widget/T(SERVICE-DATE-DAY-7)/TU(Date of service \(day\)_row7)/Type/Annot>> endobj 510 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 511 0 obj <> endobj 512 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 45.3782 425.035 60.6251 435.296]/Subtype/Widget/T(SERVICE-DATE-MONTH-7)/TU(Date of service \(month\)_row7)/Type/Annot>> endobj 513 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 514 0 obj <> endobj 515 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 62.399 424.348 80.1981 434.609]/Subtype/Widget/T(SERVICE-DATE-YEAR-7)/TU(Date of service \(year\)_row7)/Type/Annot>> endobj 516 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 517 0 obj <> endobj 518 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 82.9721 424.703 95.6671 434.453]/Subtype/Widget/T(PROCEDURE-CODE1-7)/TU(Procedure code 1_row7)/Type/Annot>> endobj 519 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 520 0 obj <> endobj 521 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 98.9732 425.057 111.668 434.807]/Subtype/Widget/T(PROCEDURE-CODE2-7)/TU(Procedure code 2_row7)/Type/Annot>> endobj 522 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 523 0 obj <> endobj 524 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 115.484 424.88 128.179 434.63]/Subtype/Widget/T(PROCEDURE-CODE3-7)/TU(Procedure code 3_row7)/Type/Annot>> endobj 525 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 526 0 obj <> endobj 527 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 131.443 424.723 144.138 434.473]/Subtype/Widget/T(PROCEDURE-CODE4-7)/TU(Procedure code 4_row7)/Type/Annot>> endobj 528 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 529 0 obj <> endobj 530 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 147.464 425.057 160.159 434.807]/Subtype/Widget/T(PROCEDURE-CODE5-7)/TU(Procedure code 5_row7)/Type/Annot>> endobj 531 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 532 0 obj <> endobj 533 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 164.444 423.839 204.191 434.099]/Subtype/Widget/T(TOOTH-CODE-7)/TU(Int'l tooth code_row7)/Type/Annot>> endobj 534 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 535 0 obj <> endobj 536 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 209.439 423.526 249.186 433.786]/Subtype/Widget/T(TOOTH-SURFACES-7)/TU(Tooth surfaces_row7)/Type/Annot>> endobj 537 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 538 0 obj <> endobj 539 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 254.31 424.37 265.984 434.12]/Subtype/Widget/T(PROVIDER-FEE1-7)/TU(Provider's fee 1_row7)/Type/Annot>> endobj 540 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 541 0 obj <> endobj 542 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 268.27 424.723 279.944 434.473]/Subtype/Widget/T(PROVIDER-FEE2-7)/TU(Provider's fee 2_row7)/Type/Annot>> endobj 543 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 544 0 obj <> endobj 545 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 281.738 425.057 293.412 434.807]/Subtype/Widget/T(PROVIDER-FEE3-7)/TU(Provider's fee 3_row7)/Type/Annot>> endobj 546 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 547 0 obj <> endobj 548 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 295.125 424.9 306.799 434.65]/Subtype/Widget/T(PROVIDER-FEE4-7)/TU(Provider's fee 4_row7)/Type/Annot>> endobj 549 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 550 0 obj <> endobj 551 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 310.145 424.723 321.82 434.473]/Subtype/Widget/T(PROVIDER-FEE5-7)/TU(Provider's fee 5_row6)/Type/Annot>> endobj 552 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 553 0 obj <> endobj 554 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 323.973 425.047 335.647 434.797]/Subtype/Widget/T(LAB-CHARGE1-7)/TU(Laboratory charges 1_row7)/Type/Annot>> endobj 555 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 556 0 obj <> endobj 557 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 337.443 424.89 349.117 434.64]/Subtype/Widget/T(LAB-CHARGE2-7)/TU(Laboratory charge 2_row6)/Type/Annot>> endobj 558 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 559 0 obj <> endobj 560 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 351.401 424.713 363.075 434.463]/Subtype/Widget/T(LAB-CHARGE3-7)/TU(Laboratory charge 3_row6)/Type/Annot>> endobj 561 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 562 0 obj <> endobj 563 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 365.298 425.067 376.972 434.817]/Subtype/Widget/T(LAB-CHARGE4-7)/TU(Laboratory charge 4_row7)/Type/Annot>> endobj 564 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 565 0 obj <> endobj 566 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 380.787 424.359 395.013 434.62]/Subtype/Widget/T(TOTAL-CHARGES1-7)/TU(Total charges 1_row7)/Type/Annot>> endobj 567 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 568 0 obj <> endobj 569 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 398.85 424.202 413.076 434.463]/Subtype/Widget/T(TOTAL-CHARGES2-7)/TU(Total charges 2_row7)/Type/Annot>> endobj 570 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 571 0 obj <> endobj 572 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 416.892 424.536 431.118 434.797]/Subtype/Widget/T(TOTAL-CHARGES3-7)/TU(Total charges 3_row7)/Type/Annot>> endobj 573 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 574 0 obj <> endobj 575 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 435.893 424.379 450.119 434.64]/Subtype/Widget/T(TOTAL-CHARGES4-7)/TU(Total charges 4_row6)/Type/Annot>> endobj 576 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 577 0 obj <> endobj 578 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 1/P 4 0 R /Q 1/Rect[ 453.466 424.202 467.692 434.463]/Subtype/Widget/T(TOTAL-CHARGES5-7)/TU(Total charges 5_row6)/Type/Annot>> endobj 579 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 580 0 obj <> endobj 581 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 2/Rect[ 472.237 424.38 531.381 434.64]/Subtype/Widget/T(ALLOWED-AMT-7)/TU(Allowed amount_row7)/Type/Annot>> endobj 582 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 583 0 obj <> endobj 584 0 obj <>/DA(/Helv 6.5 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Q 1/Rect[ 535.155 424.015 566.736 434.786]/Subtype/Widget/T(CODE-7)/TU(Code_row7)/Type/Annot>> endobj 585 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 586 0 obj <> endobj 587 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 361.57 404.784 531.566 418.432]/Subtype/Widget/T(TOTAL-FEE-SUBMITTED)/TU(Total fee submitted)/Type/Annot>> endobj 588 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 589 0 obj <> endobj 590 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 478.983 392.154 559.653 402.739]/Subtype/Widget/T(PART1-DATE)/TU(Date)/Type/Annot>> endobj 591 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 592 0 obj <> endobj 593 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 28.1634 307.073 127.631 320.396]/Subtype/Widget/T(PARTICIPANT-LASTNAME)/TU(Participant's last name)/Type/Annot>> endobj 594 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 595 0 obj <> endobj 596 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 196.382 306.609 282.068 319.932]/Subtype/Widget/T(PARTICIPANT-FIRSTNAME)/TU(Participant's first name)/Type/Annot>> endobj 597 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 598 0 obj <> endobj 599 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 300.621 307.086 445.006 320.409]/Subtype/Widget/T(GSID-PART-A)/TU(SSQ certificate number)/Type/Annot>> endobj 600 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 601 0 obj <> endobj 602 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 459.96 302.741 482.864 313.512]/Subtype/Widget/T(PARTICIPANT-BIRTHDATE-Y)/TU(Participant's date of birth \(year\))/Type/Annot>> endobj 603 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 604 0 obj <> endobj 605 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 487.727 302.44 506.037 313.211]/Subtype/Widget/T(PARTICIPANT-BIRTHDATE-M)/TU(Participant's date of birth \(month\))/Type/Annot>> endobj 606 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 607 0 obj <> endobj 608 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 511.978 302.753 530.287 313.013]/Subtype/Widget/T(PARTICIPANT-BIRTHDATE-D)/TU(Participant's date of birth \(day\))/Type/Annot>> endobj 609 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 610 0 obj <> endobj 611 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 5 0 R /Rect[ 379.586 264.625 389.929 273.948]/Subtype/Widget/Type/Annot>> endobj 612 0 obj <>/Subtype/Form/Type/XObject>>stream HdA ＂@AKChҦ .%-F!!SE-eõ.ukfvA?/잒jG>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HdO B1 uMZUts-OB ˑ\5' XH8qM* $* 5WCqUb;3vJڧͻ> wuP4I<]r_< pY!28 endstream endobj 614 0 obj <> endobj 615 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzF 9\z&Fpk!d%$0!P!hiv@ endstream endobj 616 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1y-ߥlN s)Ͱ3|kM ql]iuI֤ y$,m1Q;š3vRVGbK:>ө=#>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 5 0 R /Rect[ 414.295 264.625 424.638 273.948]/Subtype/Widget/Type/Annot>> endobj 618 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HdO B1 uMZUts-OB ˑ\5' XH8qM* $* 5WCqUb;3vJڧͻ> wuP4I<]r_< pY!28 endstream endobj 619 0 obj <> endobj 620 0 obj <>/Subtype/Form/Type/XObject>>stream HdA ＂@AKChҦ .%-F!!SE-eõ.ukfvA?/잒jG>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1y-ߥlN s)Ͱ3|kM ql]iuI֤ y$,m1Q;š3vRVGbK:>ө=#>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzF 9\z&Fpk!d%$0!P!hiv@ endstream endobj 623 0 obj <>/F 4/MK<<>>/P 4 0 R /Parent 6 0 R /Rect[ 27.5798 251.568 128.579 264.891]/Subtype/Widget/Type/Annot>> endobj 624 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 625 0 obj <> endobj 626 0 obj <>/F 4/MK<<>>/P 4 0 R /Parent 7 0 R /Rect[ 196.375 251.463 281.55 264.786]/Subtype/Widget/Type/Annot>> endobj 627 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 628 0 obj <> endobj 629 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 459.447 245.181 482.35 255.952]/Subtype/Widget/T(YEAR-PART-A)/TU(Patient's date of birth \(year\))/Type/Annot>> endobj 630 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 631 0 obj <> endobj 632 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 487.255 245.391 505.565 256.162]/Subtype/Widget/T(MONTH-PART-A)/TU(Patientt's date of birth \(month\))/Type/Annot>> endobj 633 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 634 0 obj <> endobj 635 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 512.016 245.193 530.325 255.454]/Subtype/Widget/T(DAY-PART-A)/TU(Partient's date of birth \(day\))/Type/Annot>> endobj 636 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 637 0 obj <> endobj 638 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 144.287 226.957 283.996 239.526]/Subtype/Widget/T(PATIENT-REL-PM)/TU(Patient's relationship to Plan Member)/Type/Annot>> endobj 639 0 obj <>/Subtype/Form/Type/XObject>>stream xPpuVru endstream endobj 640 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 8 0 R /Rect[ 140.893 205.738 151.236 215.061]/Subtype/Widget/Type/Annot>> endobj 641 0 obj <>/Subtype/Form/Type/XObject>>stream HdA ＂@AKChҦ .%-F!!SE-eõ.ukfvA?/잒jG>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HdO B1 uMZUts-OB ˑ\5' XH8qM* $* 5WCqUb;3vJڧͻ> wuP4I<]r_< pY!28 endstream endobj 643 0 obj <> endobj 644 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzF 9\z&Fpk!d%$0!P!hiv@ endstream endobj 645 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1y-ߥlN s)Ͱ3|kM ql]iuI֤ y$,m1Q;š3vRVGbK:>ө=#>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 8 0 R /Rect[ 230.728 205.228 241.071 214.551]/Subtype/Widget/Type/Annot>> endobj 647 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HdO B1 uMZUts-OB ˑ\5' XH8qM* $* 5WCqUb;3vJڧͻ> wuP4I<]r_< pY!28 endstream endobj 648 0 obj <> endobj 649 0 obj <>/Subtype/Form/Type/XObject>>stream HdA ＂@AKChҦ .%-F!!SE-eõ.ukfvA?/잒jG>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1y-ߥlN s)Ͱ3|kM ql]iuI֤ y$,m1Q;š3vRVGbK:>ө=#>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzF 9\z&Fpk!d%$0!P!hiv@ endstream endobj 652 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 9 0 R /Rect[ 484.078 223.427 495.952 232.749]/Subtype/Widget/Type/Annot>> endobj 653 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hl A D|ŔڬIn춢 )zr' c2v#k Dר<.eޓ@0f $\IJgQv+W?']tڮ- H36qjG:AϑI 4 endstream endobj 654 0 obj <> endobj 655 0 obj <>/Subtype/Form/Type/XObject>>stream Hl10 /Ph@BŲO9\Ytb0DliQ5+5j75ry6nL Q!#y endstream endobj 656 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hl 1y-{ml` r'_v>vf.4tИ5F5a誷S`gAR@Ek٪z\˓U*G n'aJ='qjtȅmCiR:c]G0f endstream endobj 657 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzFF 9\z&K7Bf4.=sS#Kqs $DT#,q endstream endobj 658 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 9 0 R /Rect[ 542.777 223.427 554.652 232.749]/Subtype/Widget/Type/Annot>> endobj 659 0 obj <>/Subtype/Form/Type/XObject>>stream Hd1 /@IhxPa)K?BZu|meֈJ HH#JA<>I[ =/7aNBg;n p endstream endobj 660 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd1 1 Ԥ\WEn YP\y/!']$0!!B*iFƩhl4'翦,ߕY0ӹ; KZau> endobj 662 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzFF 9\zp%g!@d% d0!H0 14.H endstream endobj 663 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1D-Yws _ 'DStPgݡ} ?LFCnr,%M)-7<#Z}]R嫌> (M.vJ\el9|&c"-[ endstream endobj 664 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 10 0 R /Rect[ 483.803 205.267 495.226 214.139]/Subtype/Widget/Type/Annot>> endobj 665 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hl1 B1 uI[۾Uts -{jq9Xy;6`(CPBLT7>p3v0}v=ꢩ߻yVmw^MqۻVۮ"- ˆ寲ADs tqK3;G&Ҏ 4 endstream endobj 666 0 obj <> endobj 667 0 obj <>/Subtype/Form/Type/XObject>>stream Hl;0 C'Ps څ. b'r :1"!PBɒԌwiv'ӓmմټwc9O/?׍#O endstream endobj 668 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hl B1D-yl`hW/Ov;3KrNx 6R NV@M{٪ \Sv~;b 3fbO” D(DDP N)X.0: endstream endobj 669 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0Tzf 9\z&FfK 7Bf4.=sS#Kqs $DT#,q endstream endobj 670 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 10 0 R /Rect[ 543.013 205.267 553.985 214.59]/Subtype/Widget/Type/Annot>> endobj 671 0 obj <>/Subtype/Form/Type/XObject>>stream Hd10w^ " *YB"bq6=bBBb*Vjx vFڦ}ejcKԅKB=9<5kJD!K endstream endobj 672 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HdO 1 Wdԥ]{]E7! )ڂ XdS%KΚ)r#GP:4g]b;3-iUl9S3^/7newHt>Mړ<`l2U endstream endobj 673 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzF 9\zFFpk"d%$0!P!hiv@, endstream endobj 674 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1D-ٍI.hg#,v _&(60ֻ@g01 Jخ>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 481.82 193.902 502.466 204.673]/Subtype/Widget/T(YEAR-PLACEMENT-A)/TU(Date of prior placement \(year\))/Type/Annot>> endobj 676 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 677 0 obj <> endobj 678 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 505.84 194.112 524.15 204.883]/Subtype/Widget/T(MONTH-PLACEMENT-A)/TU(Date of prior placement \(month\))/Type/Annot>> endobj 679 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 680 0 obj <> endobj 681 0 obj <>/DA(/Helv 8 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 527.132 193.914 545.441 204.175]/Subtype/Widget/T(DAY-PLACEMENT-A)/TU(Date of prior placement \(day\))/Type/Annot>> endobj 682 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 683 0 obj <> endobj 684 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 102.674 183.032 283.217 195.602]/Subtype/Widget/T(STUDENT-SCHOOL)/TU(If student, indicate school.)/Type/Annot>> endobj 685 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 686 0 obj <> endobj 687 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 11 0 R /Rect[ 483.921 179.687 495.796 189.01]/Subtype/Widget/Type/Annot>> endobj 688 0 obj <>/Subtype/Form/Type/XObject>>stream Hl10 /P)h@BŲO9Y :1"X.iQ5+5Zo$ jd{6nL Q!c#r endstream endobj 689 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hl A D|ŔڬIvܵ )zr' c2v:V Zh9jx\O| `J>p1VЕ>~OTB;ODt&+|Yۮ"- ˆ3qjM@<#niWDS4 endstream endobj 690 0 obj <> endobj 691 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzFF 9\z&K7Bf4.=sS#Kqs $DT#,q endstream endobj 692 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hl 1y-{l`h _v>vf:AHh(ڹFըwSfqMo Qk٪2U*\F n'aJ͓8S:¶O)LX.0_ endstream endobj 693 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 11 0 R /Rect[ 543.13 180.08 554.102 188.951]/Subtype/Widget/Type/Annot>> endobj 694 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HlO B1 uI^_n.B@pS =P\qKEH:,@HR M/8Ʀ!5̇ĿF1̶]~Ɖb3Opg5>/Subtype/Form/Type/XObject>>stream Hl10 /A ]@D(Y9ZYtb0S5UTL2jTp Γ_V]g6&(os`P" endstream endobj 696 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hl 1D-YwsҊv6‚`h Cla歰Mz$Nѹhp.}h0y-5NLKm_WkxڜI,CP,^٥ vIvְ[5/ endstream endobj 697 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0Tzf 9\zFFo0d%4T͹0!P!hi4.q endstream endobj 698 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 12 0 R /Rect[ 44.5982 152.857 54.9409 162.18]/Subtype/Widget/Type/Annot>> endobj 699 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HdO B1 uMZUts-OB ˑ\5' XH8qM* $* 5WCqUb;3vJڧͻ> wuP4I<]r_< pY!28 endstream endobj 700 0 obj <> endobj 701 0 obj <>/Subtype/Form/Type/XObject>>stream HdA ＂@AKChҦ .%-F!!SE-eõ.ukfvA?/잒jG>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1y-ߥlN s)Ͱ3|kM ql]iuI֤ y$,m1Q;š3vRVGbK:>ө=#>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzF 9\z&Fpk!d%$0!P!hiv@ endstream endobj 704 0 obj <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 12 0 R /Rect[ 91.0473 152.857 101.39 162.18]/Subtype/Widget/Type/Annot>> endobj 705 0 obj <>/Subtype/Form/Type/XObject>>stream HdA ＂@AKChҦ .%-F!!SE-eõ.ukfvA?/잒jG>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream HdO B1 uMZUts-OB ˑ\5' XH8qM* $* 5WCqUb;3vJڧͻ> wuP4I<]r_< pY!28 endstream endobj 707 0 obj <> endobj 708 0 obj <>/Subtype/Form/Type/XObject>>stream H235045VH2T0TzF 9\z&Fpk!d%$0!P!hiv@ endstream endobj 709 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Hd 1y-ߥlN s)Ͱ3|kM ql]iuI֤ y$,m1Q;š3vRVGbK:>ө=#>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 141.518 146.045 273.697 158.614]/Subtype/Widget/T(OTHER-INSURING-AGENT)/TU(Name of other insuring Agency or Plan)/Type/Annot>> endobj 711 0 obj <>/Subtype/Form/Type/XObject>>stream xPpuVru endstream endobj 712 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 80.4073 126.245 144.335 138.814]/Subtype/Widget/T(POLICY-NO)/TU(If Yes, Policy No)/Type/Annot>> endobj 713 0 obj <>/Subtype/Form/Type/XObject>>stream xPpuVru endstream endobj 714 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/P 4 0 R /Rect[ 205.807 126.245 273.548 138.814]/Subtype/Widget/T(SPOUSE-BIRTHDATE)/TU(Spouse Date of Birth)/Type/Annot>> endobj 715 0 obj <>/Subtype/Form/Type/XObject>>stream xPpuVru endstream endobj 716 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 474.078 117.292 500.337 129.861]/Subtype/Widget/T(PART3-DATE-Y)/TU(Date \(year\))/Type/Annot>> endobj 717 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 718 0 obj <> endobj 719 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 2/P 4 0 R /Rect[ 504.017 117.467 522.618 130.037]/Subtype/Widget/T(PART3-DATE-M)/TU(Date \(month\))/Type/Annot>> endobj 720 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 721 0 obj <> endobj 722 0 obj <>/DA(/Helv 10 Tf 0 g)/F 4/FT/Tx/MK<<>>/MaxLen 4/P 4 0 R /Rect[ 537.832 117.334 556.434 129.904]/Subtype/Widget/T(PART3-DATE-D)/TU(Date \(day\))/Type/Annot>> endobj 723 0 obj <>/Subtype/Form/Type/XObject>>stream x+  endstream endobj 724 0 obj <> endobj 725 0 obj <>stream HWێ$ }ovmt;[5KkH@Ax @~?H]/3.zJH"ح>>ӗ˧ge+z{^c. Z)SvWlJ-?i+@{?7G *Vkޯ5_-"ٚthv#;YvTAz KG_wۿiJAw^:ap:\wu@ՠ% L#@vQh[>}^=~/u,:# kYwJ{IYxý¸7 Kl.>]~8-~߲'#@+3v^Ay$>6CVp@Nb&[NΠ.t6`_@~_u;Hf˷73yQJZtA뛔 vs&Du7540z:G238a>$ԯV`)վEA෶5J9ے1Ń$#$T&՚..靈"R³3.®Iȕ62(?ᱷʴٳ'f8I|uּX6DՎe׉vɮXD:1iP]LN/rk(D۔unvYū!=*FXRi~}%*ޤpBewn %cŦ T~#~Nctʗ3I;39ZdQ+'j&ɹ&qqb7 x[M?3zdS!s7Y4NZ*ƦڂĆ@OΣfܬCeI*nlm|UzzřJRRFLK8ԂX\, =t4vdTN"M|Ygz0GL2EI2>ZBbs aiSfPUo>]KTY%kB%5yHy 153K;N[yE"\t.[feUx1m^.LID-1[Ď$RG7+1p No1A5p2< yĎsq~=F ">|b~H5f֏ JKЄ%ZB)Ȥ%B3fn6ǣ&{b9abP(fjW]8(:lܲϲԸ^(d*l2%¡Дi=k)tW1KUeI&=I-sћ4>rJgQm׹bSUR@j>TK-oߚv%=Nsp+l,9$u͛5́ ٹ^]"~菃TtI⍵<fZbju\套XoP^!\BԞtc`$t.օk")bOs۶+&ASk3ґ?Sy(+jIMA9^P!Y\G4Sl%& D$KnQn_Ui68uP՜iLP~?gM΂&/J6Lۈ|R.( t!q MU:OܠK!=d<%I#yEWb8CkbV^Ycل>stream HM6@6fC)^ [⠇9͡ΈDݕ ^Ҥïgr [hi(k ߚߛ]խچLK*D@iO~&>Tc]`LS8d G3cȠ cSHJB!| yi1jǥQj4lr$[F%2$F5Q5Q7kD D aUQ5o {ָkEij30P{ޜ`̝noDho5_Ο>~֋җ.DO$_;hwzF?_cGh$R;Iܟ$QC?>g9ŊD+ т]/rO#> tcH>( Pl(g2تicZZssuke氅2eev923iϖ6B. j3W[Lu+x+< 3}̼l{/#&/U竴\Ї^8Lq~č&_ͬ6GmN"nh&l2#,z*$֡ iTK#ؠ}.2nS}~N6a<v\\n endstream endobj 727 0 obj <>stream HK[1 @YE6P!GtI嗟.ĵ!"0\@˯K~5cH+sHׯ?ɔ`zp^#R\WD, m^),ᴓ&m[AhV)?U8Y%}tN;eɭ=hF* #F%i8HEHBp9C&1P7@7iUtNQ&U)%/ZJ1Je2'XO%锈Vf+С )Bk3$nSh3Ҩݚցq]&=+zF% t[ժi45֋k۴inITFcx$-EDz@EepUެ$e4lSEO~; HaCve:Dun}.(qt2s OxpϲѰ<ͳj@#xV#xơ7pwE/fWCk{^|5zUIW^<<>stream HM0 u .P8?>ƜY,q (:iRJ@><8ǯǿ@~~ \F8Qɮ@Hekmr{bEDp::1Epz 7Ol.c 4a\7:y Bp9ċEL?lG= X{% {D-.p1 trĨF3n8&T_[A*%څP\ڥT0"A6>yu _{^=G蹜>&DznԭF9# =d*E7$+_rv HV;XZ}ut:T7ImT(VS6mXmE۰6a55jU@"W(c+Z e- eŒ7Ɠd -nM9?4 3)sʋsNڑꜥVH2dH4ɺYkq(vYZbul# YX|fZ;w0kkڑ](\ev Vf]ծajWڧ 5 endstream endobj 729 0 obj <>stream HMN0yV `8]k# vЄ^4B̫oC/ޖsV_ۺSYS܃Y5c|?U͋[y/ԞǓog޺R =u=*[hm<BKca=k5YGX6 u߱?>>jxZ5Ÿq鲐ur9.Tr^>Z qQdю!vXsȢD h|,{cТ"V-Z!hТ".e>L؎gl3a0zV cI^vvkW ]1vjieڕkW]-vk }6Kvp펢kw\F0vŨ|mp:<$$ $$ $ $p9ӆJb+ߊ`m|iE)vkW ]1vKtE[N](t;ZTuto(_)t endstream endobj 730 0 obj <>stream HWMo6 P 753&@E-P@~2'EΛ78 fy0G{ ݧ1+^I[ZtaE c^X83琐TbN8n ,s@Ƶ-8P~2K%z%$C< 8j UW T^uWUٍnVWx#ۀ-( VBq͸ ZTk`^`V{ZXkSVjI7NV;jv \ X+kδ0񅬱 RsR'P͕N `5JRK2[ 2'Hu[PXUe.6Xu˼ ւϱJbU(Gm/L2_RPky.%>U7˻P] ~{Uρ Qwo,Ʋ+, E,-1 "~KE!ȲxNT2įѵ2V,eR;b`qV}gC[ ^B\1nhh g{P C>MLhO %B)&+Z-KGP9ss2D*T-)?=x>|\q=c0(űYn}N׷h#80nnv~lt5EXt:fpxx[hi,E:Mp d\p֊0x X7r&"F:"ŧnmiё1H #G2mIx9n7ah Hi4Vw64rwHebcw*fy1bFӦ}Nb-soxE,@. qQ]J`}7}`]g`$&D?+w)(Ii3>G,$;ǵcx=ơU > .2o o~0Oܤ3~UrvBwtx.16"!w -UFYϚ$%z29<)2q1!UYݧ M\^?UGM۔'>R 1lO!1ѵ?Qo ZB繛ƛBȁ*l$+9itCjw`#D|-LNSɘ:/ID&} endstream endobj 731 0 obj <>stream HWK6P Ә;.z@E͡Hv?:ÇLIl")9@וrVXoi.%w2>>~]hl>}ݿW1Xjf.=w-4%{IK hyy%!IVZuAX@m޼9l6oin JpUvOsTB@d3:ӥ/+>XTZȃ~xUq]Jc\agXHGVہ^:mN8!c(mP҆`z ]18(4EF5 WiO0MyJE% E \6͠Qå 7*lDHI]$1^a&ҽKŁWi ;b!X8:M(cЮtЏFA+nu3NL4=rz!Gƙ/1 V^v)UMĘ 9Fx&ppv?GAEj?idj"`S>)JOI6| lޔ2Bo2 >S S*] FD>#&і5(k1-h1ǟ.! |%4"x!L4Z$*3F8Iʚ(%]%S&m;rR,fy G9!,: ouu:F;uZѦB{jֵPXMOUnzQ@ըSEBad5qS =GM-It &p6=J ? HC2;y:aOʼdʊ(J/wYjatnWUPPgEMHz̦J=Ց?@w@{_J6apJ^+g6-~}a+T省jnbVI״'mn(`Pt!%:]]i)}Zn hwŕdr!E:1q|xb<֙ 3S~=U _ &F" >)qc6R^JNu8Uvg4DABdd>uX1xN Q#뿮-|Qnb]}s{]Uk%&.Nҕ'(':[9%ѳ,1<GUk 5^tj]u]ϒvs&,|,],% HD\M lt͞K"Z&SkZtYfz|aUrTHXGSLP]Ӌ^3ǜ;a\̓D!M(qLRfEE0r'$e( endstream endobj 732 0 obj <>stream HW[o\ ~70ıݙ"#nM> OQ`CLA?JQ\|If8>sF(ǏQA+]>]W0hNь7N.h˗ m;PFTcg.Uk؟W'Zel=֓+G2c×Q#?W?:g 1n0 59cs&B=~T Œ%KY3KO\K!=x68>Vݚp d5*g\@"R-}F_75& 0`A%9tqϻ9h4o)"r(&}!ߩ*5s7H{btv&c=w+ ~- afK[2!$_ODہ)ǂo]  gHMjn4zeVd_)6>q#F=FROsV[*@ pzwR)+!ʃ!FnlA6zuڗK}Y3/\`:\.:V.Σt-eT;ox3e9,gʾ:d bW`.4ȤD " w Bν24EjHa|lYCθϐ4R3ZTA?bˮZ5ܢnaJ<By/8U 5Kd,T-M#:dQMZxx T"nČ)d]1`|6o6BۦTWABj1tp{C-kKY\}pZZּPZ;cyM*ner7I '+ڰl4x]ϩ1 慀p0"s߮Թ\H&r&p1:rǚZVr2YZYLv;u CwM3Z'!!9M/e?+mg1z_ݜm!7yyhaSE`AAۧr`i<%tH>5Bޔ cVjDؚIW" ni;C:. Hss~4tW~SMnfK[O)qzQf-B0BB ]g]Ϡ0vߧ2!^#C ė"4g8?Quum&|ͻon5.{\IS^F|(JB86_OEgaU1hFeA+m}q,?]7m?'WuD…UQxLX%8/0_RUl)i 1}p<ƾ}A; ']W&@ATfف+=~CB @/ endstream endobj 733 0 obj [/Separation/Black 734 0 R 736 0 R ] endobj 734 0 obj [/ICCBased 735 0 R ] endobj 735 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 736 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 737 0 obj [/Indexed 734 0 R 1 738 0 R ] endobj 738 0 obj <>stream x?# endstream endobj 739 0 obj <> endobj 740 0 obj <> endobj 741 0 obj <> endobj 742 0 obj [ 743 0 R ] endobj 743 0 obj <> endobj 744 0 obj <> endobj 745 0 obj <> endobj 746 0 obj <>stream Hj0 endstream endobj 747 0 obj <>stream H\U xW~sso!bq $b$$ŌڍD$bv,iZPt>-vT !J)Qg\}{oy@TBhv 8\9wP{w dOqJn;J`.8';o 1tj@r! NiNH[5ȉ33N-8͘=%pp"XIYo/< peO5eBR mVDWaFC/#^-V((͈澾'I>7|Ck-mM@E},{2x|"Mqp #H1tBo0HxiA*(D[|-X$h~-"\q($GR @3x%%P:-L8Kf טdc0n&a>c+!1,:~8ʰʞoՇA<9bs`P&}5 ˳F5H̓Bd3l9eEmKOW`;>I6Ģ fŢ;1*T4,h.3)8Pܗ*wOi$6L%]X2Odl?V|)ܖ' JP=QFRFLHT{(g%uURtM]K7u+tޣ/:͜'řv3ˌ2fjssXb=w;=нg!5 hN<-ӳF;*_*fG Z+?ӀYA`*G{[#8]b%)J'ioȇku:6P;;KMPnUH(*3R9MVץ@}Rخa K:һ1؋gxKh#'o+Tt jaoR\ψAOY+S|'v?w05/ЋJ`9%ד*y4DYpF0\WoAޡ*?sӱXvse %L$Ny<<{>]]2%%: MvNއN)u BSޮ٣۹/BCt2E!ƩqmDT Uҋ!}=i\fv' ]:)cؘvmD:U͛E46 4n԰Azu넼\VAիU vG+AT79S,iMIi]9fp!g E.%RȓWR3B3R]ZGy3^O 0ՉޡrW8<wtk~PrY{m'b{ dץ,ZE*J\L5%-j"ԧiõK;BȕATFiRJ$RH$DU~g&Vgf<Μ朹OH W .leul=֖H.[RmeQcEXZy7tR*3F| z{KA[g V1yfmX6W1 v\5cjK$Uhs`XzNljӱ|4XRa%GҌc'1-j= nG UkD;#oCztMI/#ء9N;;#%ѝKMIJlBXzK"T?;.C7E%zp"ژvo>7ܺ9iEj'V01ܵ8))ʳٴ!>v+~?ɑܡbu)<kOhc|&'}wUXҼ7M-=l6OeISF\)ɹЂۓZj uψVI| ,4bʣx81ӪNWNO3k*0X͗;Ls4]="iz3;G.C(+p,q#'s(6K[e2-C!x[GdԇaYkc5ѡ%EFuh\ӹ'0}XUh_hU #6OM9m+wXr>rSEY#'4\BD5.+u乍}W=jݩQ F?RJue~EHWHLAkOWdO:w}M=щ5;`G5 ӓ>wb*'O3r)`.§R`3yNVdoRAqe7ǀ? 53~z|mlrQ.T2ڀP2ݧVD=_=7>2!hcl3dszQ%{;S r3kо z)QC9lv>*1 vX7r9}R@?ȯFm^4F/l\n\;5|lW*UT <|{n% ׿!>0OtoEZu`¦; ]P{}IR4}>=B23 ?/3OQ n|Ke,Y[B;?DB&;R R*s1)qOI9 1&l=PKjP,ğ)^ϾNk(G$5F× ibuBr7\q$ʩQHcqKFm _u(ݙӜ#K+=!> Et+>pCTSfQ~ }p 09Dob_)R%_Ex~M)<ƹ$d3Ƞ%!ψk:=Gކ,' 87p|1ؐkT ٔ')S>,v*IQ7Ѯ &n?-QnSzEysPbTcaJw=K~_ٟ8_Arۯu \{Eb>FJĦ4b,n갨:Ԝ4sij9ϣ=L/һ压n>Ń)";ݯ>]ۈ뾇wﾱ=%5%Gdnj></kɫ0B.mGyf!tQ<(I^x %~G=;myq)E~em|Al|_Jʯ?A|Ȧr7&ixU*S~ٓ|:8q?ӡ }~ /|jש][?1K4Fi1??<'$ۚ63[Τ3sb)'+˩^1:,d)ᜤ~CZp@UO K ?&%/ئ;='gZ_$q26: L0M%q ؙ`N;M+k]F`hw@iSҢi+[ Jvkʺ=uHCh?ks;{܅!ҰM\"3inFy+u2۞R\:)2uvl||u˱'J=!Q4ޛyǛIw`|`smR'dm*y9N?"9ㇹ/dqFdA< o#/Xh{ޱ"Jm977Ñ[`oF `z~rзs89Y+yE~1>y;>KﱿKr6}ߒ7sbkke2?K` ^T<s8FqVeZAt-It^W!_Q+G gWهzR;>ޗ 枒K]|=-m}D[SLsLr=&9{Do|=:{vf0޹40=^ysYqG ;\s>3%ݴݶ:թĸ鲵25а0޳ۖոѹϊDc,' (Αuq=O]BY: %qϋl'l' !tQl$<(oQ'1D:'#Ok$J_LFSWGM}QD@y%ҔSɡ,3u=@g6LQRP BR Hۅ;FAŒRi8t ,"Tx"_m>ڱ)$uR+4!2<І@y NlDʹST-bbP1~޺Fq_vCoѦfԚm-QaYFJ"JsE}~PAZTj8޽a{AZ2( mhKDL*XFvA.R/ zOЗ O%RH_T/I+rmW Y!Et.Bp Ć)Iˮ]3S4K@NvzL1v@FzB^{(ph. <%a{2LCw|z墴bfju4!7;y'䋐w@@v>m8]Z;lC3l/Va,vFw9|lieߦECj7{-w d޾wu4vTDG Et۴v_!kv[hDOQ;h:C4 ga}} KA}OU\9^=Nv=~Q1wFU7 B0 bh14h C{~jav$tEу'R{COwvo>xg:=Td45cL-n̜3Y뾛 dǠEO<$zy9DQX%1A1<WP;i `7N;!2UVZ}lPwaԱZэבKjnV+^VwI) nݞ<"^j@wsݱFR?رjQ5Jf1&Q@@j0'[wZL)0_H+Ap W<ہ=]xzAh\yQO9+l`(2 iLkDnJOxk$κI9ɒJrRҕ,2-R<-6;{v沫v+իTAxm5UϊmyrP*0I.X.X.~ַ|`rY_@P?+(*g^zAIqKiT')[X%A\P&LUqgbcq1o˱@};6ch{\0؀TBmRYjbH MGp|:j!OeiUڦUE[%U3N$~Oמygg~'B֐ jB ]rh6TYO'~ X{n66Ecd8)gUR#o{[#֯NIVG  c#I4޲6DZVDQF^F̍Ur^U9*N#4V{nҿ! p!<}eX{c%awA}N$ ÂX }a8zQqЫˆ+ࠗtN8gA]дH\yeao=%vQraZC U!p\ZȗI\HYa-)$5YZHv˃MѢb 0bNo>#MıǴCa>`ܤQ!¸&Pp29EYZKai8*b+߈aD(V)HGtK8w_@z; _wN܀j?36Ş >c7" s~Qވa%F180 U@3+S|˜/|$~DˇØ3懌]U|5d'sN/߉ Tenn![ 7tiks@ ߛ́`m&*2X  akK IZ믑䯐X& $yk|Yݛr;l)n3ngH4떟$ف^D2}LFN On%zu\;CwFy ԁ$*C%4*)Yc1DrbRRlAP)ews_WmTCc0t8 ~=391TN '#bOI>4q=.vIw.\f_Ӣ]~"ssm;`dm2׮G{5*s\]*W7E=b}ϰP|f$'Wz̼ROt$[҅GZVazUrGsuzqUzg-Dž=.cfF!5.(aVPK12|%;WLpy6b^B$ȉU~:u~~ mA8Ϣ-+'f _ٞ={{ᶯ2۲X@ST3nIjպ3 \G{)G<Qse9o|WUe endstream endobj 748 0 obj <>stream H\j0 ~ C]C`t rZ[I l琷&AO/- ua縰Cq ޕM6)-ps>xT9Kw-)}ㄔ@ӀAn']SEy= \BUo=:dK#H5PJ5 wrq?ۘq=xr );(A#o endstream endobj 749 0 obj <> endobj 750 0 obj <> endobj 751 0 obj <> endobj 752 0 obj <>stream hެ mT_&0Ӯ"U@<L $8MlƸݭՋRiM -TUKk{6f1a2ayye&9yS=9SCƜɼ3jokY|rغuں5vS7\gŋڥՖ|_o7/{`ks1[szd۷wHSK[bw}?DZ)FƧfN:s+׭2`\ҸƸfqjU+6W5Zgܸ޸qqF*㺵 ׮2nZm\ڸqq&FZ kkW3nkk׭37^m\ɸvq-vq-jqyq#d\_1— 671nx杻=7Xs'$䷔;0$-$66o Ơq?0^p^[#*H5"x oqqT݊}!*M\"qb5N1cҰ N'c7ɞul)a弔٬/e&Y]2c;t *0<}W5C?~ܤ~S?Xx{i-W-·ؕ}(G-kѯ39Cn+pML9?c".ؾ:_;3v RP$G1zQվBg:Ǵg5}7 D9ce-<ۚy1s"_a8;Oq% iw\ǎ{$e?݆!_LT_cuHwT Zȹ ;[;qa9bb>{ic'gzG o¶L;G ILl f4B lepqy.rŒ^“dr2GS3i<2-UIJcY,2t/_Jr.$sP$ 1E)W_w_c2~9YB h8:EH$JsIoʛ:]+ͻZt8+X)X\!q1.€3`D"O{^00aRBQ$$C',P{6lNMWP1u k1{ڈ޾c~` t7O$2|Wܟ(}E85Hm)zE8:>>LrJɧATaBq9|pxwٗe4!$dd4 Y$dp(zV]kо3XZ;;Z;v?-(8PaF.TB9LJ`,(R:.;-SE+I'SRAH(\vJ6zh1  @4!!*BpO,4/}mm^av+m6J{pwZ X>K$d"΢).Ntc$R ӊPR'FhÖ6Ct@lE{eBRS* >ّq \$ʠlhw v&Ej(aE"Q91!2Q)E6Ge d)v@"P|@vT+ >/YCPZ b& &P7HMSCpe!EĘՒHkʳ8uqKT2q2\(Mj* cEB&߀՞@:6XX%?Zm c8z U7#< ,P}R7g1;}EhYջ ~y\CtF`Fc-Ljc-ûNє}u6Ruԡw%DE)'5[lk>>J6]pH-ci).ǀ(lB]X'JgCݳ=x_YmS k2Mb^s!y#ۦ.Pj/S*L[S0u}=O{;lv*^%Fsda"mN/:IWDL%Fw<6ڍ9ˏJ"%)XRp"Ql 6u>g1EW%oM AAݱx,s[ Bm=h 08 1 LTD r<25Uar4(IvV'mwcvuHߠ:vThaA)/'|nH熥9Ev@⣔S&WO|_5?j,DRȄaF}(XP*j5oՇtiDᢐd'vi?zp塷'w!^ٲa⯱[7oBh V@Kt A0̣> UU fu9N*D>hjIľ˴h?Hz}$k~%d0AC/6r1ū7B X0߇1X(?mI{ Y#rӳypKg8Z'}O&+0* ///Lelr NM'Ob lG`z;ȫe[Ʋ4`ZAt$BoWiM7n ݙW>Z+1Ӵ ȓ闱3|8?>ꗐ@&cIQ D*|Tl*% -&{PK#yH2HaeXKSY@eaq^|&uO' S|R]j\kR@>M"'0 Ɔia>~4jnnVߥRPZBb GEQD>:uR?ȱW曫[Ub1WmhRa6]/S(PzAeTTo^{m>ʨYMvcEeCE ժ/)7Ɗ~y)Y'd"\H%Ib2)`EEYT4؟c? Ö{[G Gf`f0Q 玃ܴ SOŁx) R<-6#Pڒul "R*LE; ߂jG {Y9na@4[ْ;oS@b65zCL_l0cPC`Ő&?YPǀ;D(Ad"XgS:De, {{YMe8ˤb8RB |֛^*怮`(3aqtvKK7elF}!_ۥ-ӦϪ\LYDŰ Dij2hoH1SiĹ8-%w7\x&j7osL5 Nc$f"z zy2]iqQѫ׾n\.WjgptE,)RLţz". KfCL$t?ګ+jF|mw{B V3Rԉw2VMNʸk;fr eOD9R*Ucgz!^Oi!x2BӅV1b,]AnP@ù7̂\ԧ;c]س2VncJι wX@_ͥx>X>PqE!O2 .ѨMzpOo+wmSvže"q$3@"W"x p3,>s[vƼq*0ט\#|^{ӹr}~iX(ML4'Wu*:~ZYu Эڷ򈸐|aB>Ք\5ݹj9T>%Ε٤ɮ:ǨϷXc9ʫ֫ר޴:ڊ=ې1ܴ՗0"Ʋ3װ3ѳA׮n44mߝڜ;软5.>)Գ:2<^!/l1"ƠO? xtU#d>3-,4`mØI=YDžڿ.ΎS5=A"á\P4+(IZL&drEa)R"uax,"_2>JgpU(>G$~9T ,wh;t͙78 XbS!AipIͥ> a~F c-٣nvLݩ!=G󅽿*xVٙw99Ϟ#-T^x=ᛴ jw%7 2Hr&ᮖ!QWO a4u6w8;>;y`>Ƿ.$uw@<-$Dzcb[̊gרKg=V$Ŵַf 8>}MWS bM}k=zo[waNwX .Dh-\}e!~;s.G)ŪXm{vNGt {׿jΡw~f-]bMz+"0#pb@)XFm q&SRg>_z~瘽;Obn 0!2#M6.!l/)W3ī8ML92M͠{s:.$9+N>: O3/k W fbT2P{j7{͵bCx%ǗC6"[" mD~C{JƟ(O`OO6r0u Yk%&67 ]!2e8zx]9R)NwTNWDM,DЫRE.ږ-:Xĥ@ $.Ҩ޵|@N5zϺGh,b  ƾv+Fm'YFEpEDQoUCd\#ujIBH)OΜ@EGLڣg&ln 1G{O{&}+xŋ0>>["(+0_ 1וVF/-1뱘07c *-0U@OΊ\s8x$M ֫mP o'Y^!M[n$\(q Eh7JLYGY #hHNz.`'(9amCӾaNXD K3d8ID T=WmkϩkԯM9sNG922[&TҸ3=jdó,rN^D5ꃕ)3Bk#ޥ[ul7dq 5lG?iXo'}n߰hK4|5^+a&,tsC9']wWI$JD\ć8)<* p>c9dL8H}g}i b ȃ> >'pv1F7`y@P;Lx0*8L\dSz[*slj,^&F ő ̈yv5S֑"(m $fpI{nm0,So( f*uv!z)T{e8SN@EٓD[}/z: &kj; NYPdR3S`JX e3D6#Jh)83xIbcg52]e\܄_H_ }yp=˾S;ie<-VJ%PB}hw^&w?%.럶\w#cd٦+#Azx=琣Y|wʅ,m-L mCER.b< K 2Q )$Dx6POs8q|,(%S€ O Q4O".sC>.Iܙa氹q9?H 攊4bdZѪ߶^֫]W,fܭ48LGN:P[K-~Q[ \r*!K#[z-V ğ3eJХmE<-BB &WesO IB$i|:@>)[!54<"4 0tmP endstream endobj 753 0 obj <> endobj 754 0 obj <> endobj 755 0 obj <> endobj 756 0 obj <>stream hޔyx4"0Ti2k i2}mҤ$vR'o[D(7 @Rާ,ۊ}lL;Ӵ'Oݧfv6iwyG/Xv-7ߴl2-mXq04x[=޹]лP~}ݞsM,[vn3(v~++׬#~=}{,v7@8'HB6269s|֮խmX۰Zqn&ݦպu6ZU+u76et6mXߤ۸QinFUt 5uU+ukn**:*`njڍkuWրѭ^[IznJ5uVmب[A||Nvמܶmg=G{z4n pᇖ-硛 {ӊL7Y=߹o츧cR'oO[ ?RgV?M~oOy;~'hiyg?=\|n}+q{ᅽvsȈ)qqŷ9Vu ,\pƍڭIe+dn@e).N)6I)8Nv! wmPi(ӛHQ8ɅXFjVy>HȐYe ͈ɴIIFLJD87z^N v P;Y)iF]M&;^PYX/yy.@|0~^жYD'|#xc@>l`ŀ& r'N{2eCܴ~mG L͌[jW] #JG#`Gә>M- 9|r6eT =e2eMC) ~ΰYTp:dE,M\BU^y^H NbiX S RvМEkPLt{@Zڠ !ejuG#na8Bh3}Tazi".Y3q8T7fc8d9")81-dU#UI|r֦z>JAGϩhtu >0|#s8! N0&x8۠8]¨Q-#eEز lmR6 kSvM) 2t( 7i~xTPX7sEIGY; Ӈ`BxXGөרUt=G˔CӾ䍫QdtD @_#˅obtz,Ȧpca2 }7=;piP'B{p/|ú\= ֯=i ~<,r1.i _.1qNbn#0d:"!,L: ӄ7F B5!l翝 D s`"ti_,WJ)lfxXB^nنlG߹ ޢ9|FK\`IY5wg[#,|j T;Xےlvzm%?;'c{/}T[1oP[k Q[`^~ wUލ X dD$9C3Rbٝ¬ DTL_BRL#`ŪFԏꃮA[o=m9Lba2JD$:Jإqz,%(gLyV2 :`G7Յl+:8tXƧ*͉\ZN W<Nc|\z\–-A3#3f|&p-7%`R#[,HX,֚pSz=&vHz` K$V/53h9RR+JR4Hg2f(# }Ռ!=CG#/<|(Ey|~b/f^QV\fQs &B4GɋH+k@O\c1%j r7eig7޵3⮹.kZrbB#} P&3 o!oΏOa#y`e-SVАoLu\DrI3 ޭYFYպ#] d-> u6 jXEa?>):|D b" 4X*%&d4[T{5J]Ɔl:nj)jqxA8xُd %u4fy.9u?ԕvɮtU8 W\A"J}<R9'. Jm.P0m?lg)GQ l-ҏ4ʥ}[z[GYst!% J|UQ/.n`əvӿ1Qk;:}A xdIɟ6a.hh偎%8DJMO48(71M|A%wj$geG[nSބ3q)h1Zy ݬyv+"d;x약cӪunGN9bʞ"d;S+HH&U#:Q2ZR*'JG=؀qHQfshN$ DN!9V&ELx4N{׾ {"& L0ځ}|]݇mF6U_|K}Ry?ݜ?5 pGtz7{ej=xO8: NS_E~ V>U΍ 4zqgsbTuvD#}&9io H7>vTL$tcMm})ݺ'6 ?4 yɟ}f'[:tݣŕ.nW;ڇm}zlr//^NϞq~hm_Y ЖA@Rp޴ݶӧ{]Ea{Qw] iLYoI$,6;.O/`Qub&tv΢&KJsI$̒JPFP./sS& X؊ƳS,ra")ժRoU9s,Eŭ3pP`Vz򯪷:*LDa@t* HJ*TƱ_ BGh&!"G=b$)n:~BYsz^Z|?_tCta  Հ6\%Fp+<#Hqqb\ t҂UNMi:Q6}A[LL#㡆X+mG=>  ),(fJ)$Gx"clfPڧF^ShxG&Ѥf0y}]+rU}C==,_{yR~<).Al+PXÞ 3e{& ǭ/ovoExئK,zzKs\n +DB(4LQM5bpC sT®G퐃mal ՕŻ֋"?ߙsͩrs.(=bɛ3Iܖ'sչcta[)|g_}|/Mʁ=uMֲٚDeкܱݏE:BC7iӘnBdz#ZQݪQj://GhPTqA$a<1(^꿃w!%tVC{yd:1B90sH&=bf#.(K堑KU"JaK֔Ō fD~%:E"ā B( 4! !"Obd~93 j19j]y "c䨣 ;::-~Aů!ܔ+H~ FדpwX?taQZ5Skr>>;i92K }^1H}.mW0㦉k lbd27V, AHaޟpY~/ +ӊg.O,5z!&mؼqo4C^C/bM$?dZFtRp{ > XJ\^|C'W qFc\k B& .iX79f8I|lB _WaniAes`aS;T%dyI1^[+nMFFRxSBHeU:\ڿع]cr!e/Ok 9夀Eۖw*̻oW^ѯw\ µݏH_@ڇJcƍ ٣Qoin 7;w6[#c ?*?Zp}ئ>7n"v!E͔v.m`)qRhϵ/i;TŢk4ɽ_ш="OM  M`t8>"JRld8?9jx4“Sk3\ٯ9S 7+Z0)!G:܇hJK_i\s4rƽft?~@hFӓGLrdOc:vPEE \}8 Ke8Ak0̰Y2dqx2: '~,Bo;fǪq2.NN!s㘭ҟ? gXb#c)I|”E,-g%aCݞX̋b8ܒI\ e y:0Okx4zf4p0M{#iIvC>0tZg6㛟6勴z8г9ϸ'/./pڛ<;<ԝ_+ W[vU(;2O?oN`sc,x ;5{ :?M9'Οѓz@'2i|16_W_Xoy#{P 0=.ض|Qduљ-ؕ֝ZZ.Kb-YRKޜ9[E>O?ۆQ~{] ϹqU\I^Mu6^ۨxСC]l;aNⅭ&yylpb޷}i>Xp9Gxf1{8Y7GFFf)ϤO%W5-taHo챛0lw 9/nxƉYc'fb6u -,wdi'kQV ti?ov~$a,3 OSI3c!jSXC$ ~_`K\U8N> endobj 758 0 obj <> endobj 759 0 obj <>stream xcd`ab`ddquM-K-M  IJ!#2~5~"##[pHeABJj@ R(缟b?Yee?O8G-SM3m3fϙ4[zζ)[5L[0zrG)ӥN4I~)Ӥfh%0jz)++ 39cLΖЖX/WXZ*]Ysn[c݄)MZ'uLhڹh7-$?cB{oG_koeF̎Fڦlssz*&4Mh־hw] %]ҿt endstream endobj 760 0 obj <> endobj 761 0 obj <> endobj 762 0 obj <>stream hbd`ab`ddquM-K-M uI !#CGϡe/;`B L|*n!  )i8L\j[?/+_Ey'ǁy?n]2a܄Sg̜1iguN"$(U?~Z\˔ ̙8}gΖ6a\œ9gK$6UɧWUpT4'EHD}-E{-9'u[)w'sj:気Nl:}*?cf0\r endstream endobj 763 0 obj <>stream Adobed     $$''$$53335;;;;;;;;;;  %% ## ((%%((22022;;;;;;;;;;Y"?   3!1AQa"q2B#$Rb34rC%Scs5&DTdE£t6UeuF'Vfv7GWgw5!1AQaq"2B#R3$brCScs4%&5DTdEU6teuFVfv'7GWgw ?TM))t(Na][Op Z$3pɁ}dCD#%jI&R&.I0rsp`X>Ұ 3}n> XR&%.Ɖq aҰN 2^a18Y ZI2tI%)$IJI$RI$I%)$IJI$R;^mynˊsZ\xu :Rc\[PhQrecsn_jey)Wcv3C0 Z13JP{LB8!it=OX]Ŝ?[ç_ItD \ȀhKT,6eSÇ>׷̗ o2>0aA\n]vZe8xȓ$| sM7vˉ'ĥ>K܌l#X J(LaEߛƴ%Z'?Q4X~<$Vvm,˺ͭ 9㖆V^;2)2-XX>S\q+UI_UnqS+\}Ymù%q䒦S+rFi mfu~֘o22u).!Ը;7n]n6xB2VXf9Ť;YN[ĀKg sA c@Hal2Nо[52 ȩ6>΋_n Q\wV&=/=YK;^h'W@dhOt:=S`mѩo^J~>*~ꫳs@q8n]ImOQ-ݼjG`tll,a{-2}V;wՖ r<ޭz} ɮ_⪟?Ws1(l'JuUqF]̢͏ C ?C~uOq@QS~Si>:yL7E?oՖ[;coa%O`j.ƶu#h~ O9ǜӯ"Nw2)v=o- }^1c9 +zQ6ܓ82|纷լ>f˘_2,xtks8WAs?즜l--%ҳ[S@ iFS+ؽ_MXm9XBsOVnK/^만,KNB?Yɯ1{Nr|2:=0, qZ-p>Ɏ,]yVi: 쾕kI5>' kvL D !Q{s0ۇkfLx 'dG *!#a h|^+H/~WLk-s9s| 6^,enŎuU[ޟUiU|pOmŔԇQO551o sh91$>*vg3Ҩ7,j{O+.Ee!q?SzoT E}vά6IHHÉ<zHtT?=5#ľѨ?Lƫa]Lc@N@` v|{Ywb0 a ]tղP9\iat_}^XsQa%kfG@<w_;@U2Y3Jg/ys1dXA85 WPuI 0a}JEꛓQkI$43So=/XuŎ#b>wNītKz{|חs:!wZ>u,﫝' OL`m3ďqxΡ+X8ݎ߱9S[@cFDdnE:ZKCo/+^ᗔo\]}cg}@Qmm|sΆjTu:kdDrgwpWe`v⺞k՞:Mm: Ou7^ocXe \]zռtK?;9olccÜ82 `9;iv^-spXXC; ۱o}g>}{ƱݓBӧ|g͓2Rn[:>S,ul!dp踽9db#Y 3zFS+`=^æEKܞk_cEuW+>h :|BXjZWz3\%J>imlH=& @$@l[6f52f?V>#oWAɿhh d'-s:}%t#&C+}wgY ^3=6m;)):=m{K[Q^4'S3_UUX&=#Ou M[;QtzumX֍vIObR/ŹT=GQɵQ{-[^M/,KMue0Ut_OkO))ޯ[綸ʻ&=;ƥyՇԬS- }M_󷜷5Π! 7撟f`ZIp~~qs{VHi]JY$$NJCNM.q}K>]Os{ŵr+vK2XķcɊ}_/[b?N=r1\H鰒g;^3Eyp6}&wccQKi@hEH1ٞ=?c;!p|Bs*N!~h5ߔ cFL0 {\i:irGٍcDp&{a>_j{m6 Ku7W]uXƈp(RF;3`*"Kb,s<fEέZku Ж8td 1|T?SnwV~ a7g[;,a0,2Fɚ1%4]O˯-޵v V?T^S2ldsf]uv oպ>t{0,w`;^8+i%an@3b``hvunGt]KhH'ho%z% )}X}W=+6v7r8?T~}^~fG4ًaѨu d%>stream hK .UJ l\8$B4Ȍf˽ou9G]=ƌ3f̘1cƌ3f̘1cƌ3f̘1cƌ3f̘1cƌ3f̘1cƌ3f̘1cƌ3f̘1cC\!C endstream endobj 765 0 obj <>>>/Subtype/Form/Type/XObject>>stream x[K% uH}ƀRWnTl;-&$ˮ0^rUJj,׿_-5!Mdi"HJ5_7}"] {@PCJ/} LF"A-WI9'0 `R S"2rkL ~Zf;嚞n6+WF~j?v&=)W5?^^ v/iA)_Eg7 L0eH-t`Pj; ?-Қ`Po@8v:N[Bfyޅ%"t*6 *ؔ"M5̬ 6/HL[!s(D/ "oJD& aBD+"1LO 1~\c0cGMT#.G9& eH@lHHԨ2$DO)(B(D68 "Y#V{ځw( Kh,[Ɵdҙ&!,r34 * gT~\&pVrAIg)[ `C[frC0r5Y9?䄹S gU(hd}!K *r8 VˀBgvAJ>nl -!2 6Q#ij*DOL\(dW}NNlLSqSi q&Rָ-@f&D\:ӑ#EPZ/V0i hQ`-->ƜLǪ`D:-lC1n"U{(tqU~jz8XU=?'LST:З4"w?fLdU}?>3zCp` U! ]*r3L*rO1ҦtІs\>#ޜCl:&4 h:UL<,CJ-Mָ $"2 /K\sƚlwA%-RW1I De ߎֈ9߽ցTnD[ZPŮqPF5 َoAU;TL.-n=" i n) 5 6y1-˴ 19 *qxC_cdysfª~чamJ*/ o,scL23DMyV>G>ch1eOĢ7x(s`Ϙ>082ɘO[Ĕ!>y+Օk飆}JyO+UO.Ϥ)n4:\䴇h@cfg-iLyeoWw>:G9*c|\)xY9eth33ek0f':>JokVUp/#fG=-YP :89=ΑOK{t~29W*<_lh+E0hynMuTZ jrA)kf h>S. 'cS692B9e0yso~cV:e8*gIH%|JycJ MYΒpf}J, kJe JRm?^Sc~ɳn'z8d]91{HY, kJ`hvkUc+6HbB2E_&7Z!G:*D9McV|bd@`;LeĦ⛑unѱ@IpesdLlc}Vv1#ͭR53;O-2`*ƾ*+#>z;}Led631hq_s^Wl>./>b.eˆ?Ģ¼GqxnA`o1gg,FU4A/323=du-9uCs|?Xo#ϝ}7~ R@O{n($:W{Prݷ,R?cGwk'dX#X(.y1Qg^d/m>J>$+RĦRT`ϴ}@H 1`S endstream endobj 766 0 obj [ 725 0 R 726 0 R 727 0 R 728 0 R 729 0 R 730 0 R 731 0 R 732 0 R 767 0 R ] endobj 767 0 obj <>stream x+T0T0BbM+ endstream endobj xref 0 768 0000000000 65535 f 0000000017 00000 n 0000000066 00000 n 0000000122 00000 n 0000000209 00000 n 0000000666 00000 n 0000002716 00000 n 0000002852 00000 n 0000003034 00000 n 0000003069 00000 n 0000003162 00000 n 0000004358 00000 n 0000004498 00000 n 0000004681 00000 n 0000004717 00000 n 0000004913 00000 n 0000005096 00000 n 0000005132 00000 n 0000005319 00000 n 0000005502 00000 n 0000005538 00000 n 0000005740 00000 n 0000005923 00000 n 0000005959 00000 n 0000006147 00000 n 0000006331 00000 n 0000006367 00000 n 0000006549 00000 n 0000006734 00000 n 0000006770 00000 n 0000006960 00000 n 0000007143 00000 n 0000007179 00000 n 0000007373 00000 n 0000007556 00000 n 0000007592 00000 n 0000007785 00000 n 0000007969 00000 n 0000008005 00000 n 0000008287 00000 n 0000008471 00000 n 0000008507 00000 n 0000008722 00000 n 0000008906 00000 n 0000008942 00000 n 0000009163 00000 n 0000009347 00000 n 0000009383 00000 n 0000009602 00000 n 0000009786 00000 n 0000009822 00000 n 0000010035 00000 n 0000010219 00000 n 0000010255 00000 n 0000010468 00000 n 0000010653 00000 n 0000010689 00000 n 0000010902 00000 n 0000011086 00000 n 0000011122 00000 n 0000011335 00000 n 0000011519 00000 n 0000011555 00000 n 0000011767 00000 n 0000011951 00000 n 0000011987 00000 n 0000012182 00000 n 0000012364 00000 n 0000012400 00000 n 0000012597 00000 n 0000012779 00000 n 0000012815 00000 n 0000013026 00000 n 0000013207 00000 n 0000013243 00000 n 0000013454 00000 n 0000013638 00000 n 0000013674 00000 n 0000013885 00000 n 0000014066 00000 n 0000014102 00000 n 0000014312 00000 n 0000014493 00000 n 0000014529 00000 n 0000014739 00000 n 0000014923 00000 n 0000014959 00000 n 0000015172 00000 n 0000015356 00000 n 0000015392 00000 n 0000015604 00000 n 0000015785 00000 n 0000015821 00000 n 0000016031 00000 n 0000016215 00000 n 0000016251 00000 n 0000016463 00000 n 0000016647 00000 n 0000016683 00000 n 0000016894 00000 n 0000017077 00000 n 0000017114 00000 n 0000017326 00000 n 0000017511 00000 n 0000017548 00000 n 0000017761 00000 n 0000017946 00000 n 0000017983 00000 n 0000018196 00000 n 0000018381 00000 n 0000018418 00000 n 0000018630 00000 n 0000018815 00000 n 0000018852 00000 n 0000019052 00000 n 0000019236 00000 n 0000019273 00000 n 0000019455 00000 n 0000019642 00000 n 0000019679 00000 n 0000019897 00000 n 0000020083 00000 n 0000020120 00000 n 0000020343 00000 n 0000020529 00000 n 0000020566 00000 n 0000020787 00000 n 0000020973 00000 n 0000021010 00000 n 0000021225 00000 n 0000021408 00000 n 0000021445 00000 n 0000021660 00000 n 0000021844 00000 n 0000021881 00000 n 0000022096 00000 n 0000022282 00000 n 0000022319 00000 n 0000022534 00000 n 0000022717 00000 n 0000022754 00000 n 0000022969 00000 n 0000023152 00000 n 0000023189 00000 n 0000023385 00000 n 0000023569 00000 n 0000023606 00000 n 0000023805 00000 n 0000023989 00000 n 0000024026 00000 n 0000024237 00000 n 0000024423 00000 n 0000024460 00000 n 0000024672 00000 n 0000024855 00000 n 0000024892 00000 n 0000025105 00000 n 0000025288 00000 n 0000025325 00000 n 0000025538 00000 n 0000025721 00000 n 0000025758 00000 n 0000025971 00000 n 0000026154 00000 n 0000026191 00000 n 0000026406 00000 n 0000026592 00000 n 0000026629 00000 n 0000026843 00000 n 0000027029 00000 n 0000027066 00000 n 0000027280 00000 n 0000027463 00000 n 0000027500 00000 n 0000027714 00000 n 0000027900 00000 n 0000027937 00000 n 0000028150 00000 n 0000028335 00000 n 0000028372 00000 n 0000028584 00000 n 0000028769 00000 n 0000028806 00000 n 0000029019 00000 n 0000029204 00000 n 0000029241 00000 n 0000029454 00000 n 0000029639 00000 n 0000029676 00000 n 0000029889 00000 n 0000030074 00000 n 0000030111 00000 n 0000030310 00000 n 0000030494 00000 n 0000030531 00000 n 0000030714 00000 n 0000030900 00000 n 0000030937 00000 n 0000031155 00000 n 0000031341 00000 n 0000031378 00000 n 0000031600 00000 n 0000031786 00000 n 0000031823 00000 n 0000032044 00000 n 0000032230 00000 n 0000032267 00000 n 0000032482 00000 n 0000032669 00000 n 0000032706 00000 n 0000032921 00000 n 0000033105 00000 n 0000033142 00000 n 0000033357 00000 n 0000033543 00000 n 0000033580 00000 n 0000033795 00000 n 0000033978 00000 n 0000034015 00000 n 0000034230 00000 n 0000034413 00000 n 0000034450 00000 n 0000034646 00000 n 0000034830 00000 n 0000034867 00000 n 0000035066 00000 n 0000035250 00000 n 0000035287 00000 n 0000035498 00000 n 0000035681 00000 n 0000035718 00000 n 0000035931 00000 n 0000036114 00000 n 0000036151 00000 n 0000036364 00000 n 0000036547 00000 n 0000036584 00000 n 0000036797 00000 n 0000036983 00000 n 0000037020 00000 n 0000037233 00000 n 0000037416 00000 n 0000037453 00000 n 0000037668 00000 n 0000037851 00000 n 0000037888 00000 n 0000038102 00000 n 0000038288 00000 n 0000038325 00000 n 0000038539 00000 n 0000038725 00000 n 0000038762 00000 n 0000038976 00000 n 0000039162 00000 n 0000039199 00000 n 0000039412 00000 n 0000039597 00000 n 0000039634 00000 n 0000039846 00000 n 0000040031 00000 n 0000040068 00000 n 0000040280 00000 n 0000040465 00000 n 0000040502 00000 n 0000040715 00000 n 0000040900 00000 n 0000040937 00000 n 0000041150 00000 n 0000041335 00000 n 0000041372 00000 n 0000041571 00000 n 0000041755 00000 n 0000041792 00000 n 0000041974 00000 n 0000042159 00000 n 0000042196 00000 n 0000042414 00000 n 0000042600 00000 n 0000042637 00000 n 0000042859 00000 n 0000043045 00000 n 0000043082 00000 n 0000043303 00000 n 0000043488 00000 n 0000043525 00000 n 0000043739 00000 n 0000043925 00000 n 0000043962 00000 n 0000044177 00000 n 0000044364 00000 n 0000044401 00000 n 0000044615 00000 n 0000044798 00000 n 0000044835 00000 n 0000045048 00000 n 0000045231 00000 n 0000045268 00000 n 0000045483 00000 n 0000045666 00000 n 0000045703 00000 n 0000045900 00000 n 0000046084 00000 n 0000046121 00000 n 0000046320 00000 n 0000046504 00000 n 0000046541 00000 n 0000046754 00000 n 0000046937 00000 n 0000046974 00000 n 0000047184 00000 n 0000047370 00000 n 0000047407 00000 n 0000047620 00000 n 0000047806 00000 n 0000047843 00000 n 0000048056 00000 n 0000048239 00000 n 0000048276 00000 n 0000048486 00000 n 0000048669 00000 n 0000048706 00000 n 0000048921 00000 n 0000049107 00000 n 0000049144 00000 n 0000049358 00000 n 0000049544 00000 n 0000049581 00000 n 0000049790 00000 n 0000049973 00000 n 0000050010 00000 n 0000050224 00000 n 0000050407 00000 n 0000050444 00000 n 0000050657 00000 n 0000050842 00000 n 0000050879 00000 n 0000051091 00000 n 0000051276 00000 n 0000051313 00000 n 0000051526 00000 n 0000051711 00000 n 0000051748 00000 n 0000051961 00000 n 0000052146 00000 n 0000052183 00000 n 0000052395 00000 n 0000052580 00000 n 0000052617 00000 n 0000052817 00000 n 0000053001 00000 n 0000053038 00000 n 0000053220 00000 n 0000053405 00000 n 0000053442 00000 n 0000053661 00000 n 0000053847 00000 n 0000053884 00000 n 0000054107 00000 n 0000054293 00000 n 0000054330 00000 n 0000054551 00000 n 0000054737 00000 n 0000054774 00000 n 0000054989 00000 n 0000055175 00000 n 0000055212 00000 n 0000055427 00000 n 0000055614 00000 n 0000055651 00000 n 0000055866 00000 n 0000056052 00000 n 0000056089 00000 n 0000056304 00000 n 0000056487 00000 n 0000056524 00000 n 0000056739 00000 n 0000056925 00000 n 0000056962 00000 n 0000057158 00000 n 0000057342 00000 n 0000057379 00000 n 0000057577 00000 n 0000057761 00000 n 0000057798 00000 n 0000058010 00000 n 0000058196 00000 n 0000058233 00000 n 0000058446 00000 n 0000058629 00000 n 0000058666 00000 n 0000058879 00000 n 0000059065 00000 n 0000059102 00000 n 0000059315 00000 n 0000059498 00000 n 0000059535 00000 n 0000059747 00000 n 0000059933 00000 n 0000059970 00000 n 0000060185 00000 n 0000060368 00000 n 0000060405 00000 n 0000060619 00000 n 0000060802 00000 n 0000060839 00000 n 0000061053 00000 n 0000061236 00000 n 0000061273 00000 n 0000061487 00000 n 0000061673 00000 n 0000061710 00000 n 0000061923 00000 n 0000062108 00000 n 0000062145 00000 n 0000062358 00000 n 0000062543 00000 n 0000062580 00000 n 0000062793 00000 n 0000062978 00000 n 0000063015 00000 n 0000063228 00000 n 0000063413 00000 n 0000063450 00000 n 0000063663 00000 n 0000063848 00000 n 0000063885 00000 n 0000064085 00000 n 0000064269 00000 n 0000064306 00000 n 0000064489 00000 n 0000064675 00000 n 0000064712 00000 n 0000064931 00000 n 0000065117 00000 n 0000065154 00000 n 0000065376 00000 n 0000065562 00000 n 0000065599 00000 n 0000065820 00000 n 0000066006 00000 n 0000066043 00000 n 0000066258 00000 n 0000066444 00000 n 0000066481 00000 n 0000066696 00000 n 0000066880 00000 n 0000066917 00000 n 0000067132 00000 n 0000067318 00000 n 0000067355 00000 n 0000067570 00000 n 0000067756 00000 n 0000067793 00000 n 0000068007 00000 n 0000068190 00000 n 0000068227 00000 n 0000068424 00000 n 0000068608 00000 n 0000068645 00000 n 0000068844 00000 n 0000069028 00000 n 0000069065 00000 n 0000069277 00000 n 0000069463 00000 n 0000069500 00000 n 0000069713 00000 n 0000069899 00000 n 0000069936 00000 n 0000070149 00000 n 0000070332 00000 n 0000070369 00000 n 0000070582 00000 n 0000070765 00000 n 0000070802 00000 n 0000071014 00000 n 0000071200 00000 n 0000071237 00000 n 0000071452 00000 n 0000071635 00000 n 0000071672 00000 n 0000071886 00000 n 0000072069 00000 n 0000072106 00000 n 0000072320 00000 n 0000072503 00000 n 0000072540 00000 n 0000072754 00000 n 0000072940 00000 n 0000072977 00000 n 0000073190 00000 n 0000073375 00000 n 0000073412 00000 n 0000073625 00000 n 0000073810 00000 n 0000073847 00000 n 0000074060 00000 n 0000074245 00000 n 0000074282 00000 n 0000074495 00000 n 0000074680 00000 n 0000074717 00000 n 0000074930 00000 n 0000075115 00000 n 0000075152 00000 n 0000075352 00000 n 0000075536 00000 n 0000075573 00000 n 0000075754 00000 n 0000075939 00000 n 0000075976 00000 n 0000076194 00000 n 0000076380 00000 n 0000076417 00000 n 0000076640 00000 n 0000076826 00000 n 0000076863 00000 n 0000077083 00000 n 0000077269 00000 n 0000077306 00000 n 0000077521 00000 n 0000077707 00000 n 0000077744 00000 n 0000077959 00000 n 0000078143 00000 n 0000078180 00000 n 0000078393 00000 n 0000078579 00000 n 0000078616 00000 n 0000078831 00000 n 0000079014 00000 n 0000079051 00000 n 0000079266 00000 n 0000079449 00000 n 0000079486 00000 n 0000079683 00000 n 0000079867 00000 n 0000079904 00000 n 0000080103 00000 n 0000080287 00000 n 0000080324 00000 n 0000080534 00000 n 0000080717 00000 n 0000080754 00000 n 0000080966 00000 n 0000081149 00000 n 0000081186 00000 n 0000081399 00000 n 0000081582 00000 n 0000081619 00000 n 0000081829 00000 n 0000082012 00000 n 0000082049 00000 n 0000082261 00000 n 0000082444 00000 n 0000082481 00000 n 0000082696 00000 n 0000082879 00000 n 0000082916 00000 n 0000083128 00000 n 0000083314 00000 n 0000083351 00000 n 0000083565 00000 n 0000083751 00000 n 0000083788 00000 n 0000084002 00000 n 0000084185 00000 n 0000084222 00000 n 0000084434 00000 n 0000084619 00000 n 0000084656 00000 n 0000084868 00000 n 0000085053 00000 n 0000085090 00000 n 0000085303 00000 n 0000085488 00000 n 0000085525 00000 n 0000085737 00000 n 0000085922 00000 n 0000085959 00000 n 0000086172 00000 n 0000086357 00000 n 0000086394 00000 n 0000086592 00000 n 0000086776 00000 n 0000086813 00000 n 0000086996 00000 n 0000087182 00000 n 0000087219 00000 n 0000087419 00000 n 0000087605 00000 n 0000087642 00000 n 0000087818 00000 n 0000088002 00000 n 0000088039 00000 n 0000088245 00000 n 0000088431 00000 n 0000088468 00000 n 0000088676 00000 n 0000088861 00000 n 0000088898 00000 n 0000089094 00000 n 0000089280 00000 n 0000089317 00000 n 0000089546 00000 n 0000089731 00000 n 0000089768 00000 n 0000089998 00000 n 0000090182 00000 n 0000090219 00000 n 0000090448 00000 n 0000090633 00000 n 0000090670 00000 n 0000090893 00000 n 0000091172 00000 n 0000091538 00000 n 0000091619 00000 n 0000091888 00000 n 0000092246 00000 n 0000092467 00000 n 0000092833 00000 n 0000092914 00000 n 0000093193 00000 n 0000093551 00000 n 0000093820 00000 n 0000093962 00000 n 0000094148 00000 n 0000094185 00000 n 0000094326 00000 n 0000094511 00000 n 0000094548 00000 n 0000094761 00000 n 0000094946 00000 n 0000094983 00000 n 0000095200 00000 n 0000095384 00000 n 0000095421 00000 n 0000095634 00000 n 0000095819 00000 n 0000095856 00000 n 0000096070 00000 n 0000096275 00000 n 0000096498 00000 n 0000096777 00000 n 0000097143 00000 n 0000097224 00000 n 0000097493 00000 n 0000097851 00000 n 0000098072 00000 n 0000098438 00000 n 0000098519 00000 n 0000098798 00000 n 0000099156 00000 n 0000099425 00000 n 0000099646 00000 n 0000100018 00000 n 0000100099 00000 n 0000100381 00000 n 0000100744 00000 n 0000101016 00000 n 0000101239 00000 n 0000101518 00000 n 0000101882 00000 n 0000101963 00000 n 0000102230 00000 n 0000102586 00000 n 0000102808 00000 n 0000103178 00000 n 0000103259 00000 n 0000103541 00000 n 0000103900 00000 n 0000104171 00000 n 0000104394 00000 n 0000104672 00000 n 0000105037 00000 n 0000105305 00000 n 0000105663 00000 n 0000105881 00000 n 0000106066 00000 n 0000106103 00000 n 0000106322 00000 n 0000106506 00000 n 0000106543 00000 n 0000106760 00000 n 0000106945 00000 n 0000106982 00000 n 0000107187 00000 n 0000107372 00000 n 0000107409 00000 n 0000107632 00000 n 0000107914 00000 n 0000108286 00000 n 0000108367 00000 n 0000108639 00000 n 0000109001 00000 n 0000109219 00000 n 0000109589 00000 n 0000109870 00000 n 0000110232 00000 n 0000110503 00000 n 0000110724 00000 n 0000111090 00000 n 0000111171 00000 n 0000111450 00000 n 0000111808 00000 n 0000112077 00000 n 0000112299 00000 n 0000112578 00000 n 0000112944 00000 n 0000113025 00000 n 0000113294 00000 n 0000113652 00000 n 0000113872 00000 n 0000114077 00000 n 0000114266 00000 n 0000114473 00000 n 0000114672 00000 n 0000114877 00000 n 0000115074 00000 n 0000115259 00000 n 0000115296 00000 n 0000115494 00000 n 0000115678 00000 n 0000115715 00000 n 0000115911 00000 n 0000116096 00000 n 0000116133 00000 n 0000118592 00000 n 0000119834 00000 n 0000120606 00000 n 0000121478 00000 n 0000122088 00000 n 0000123540 00000 n 0000125509 00000 n 0000127931 00000 n 0000127989 00000 n 0000128030 00000 n 0000130726 00000 n 0000131690 00000 n 0000131741 00000 n 0000131828 00000 n 0000131909 00000 n 0000131993 00000 n 0000132141 00000 n 0000132173 00000 n 0000139124 00000 n 0000139197 00000 n 0000139488 00000 n 0000139572 00000 n 0000148595 00000 n 0000148896 00000 n 0000149312 00000 n 0000149622 00000 n 0000150078 00000 n 0000157893 00000 n 0000158291 00000 n 0000158589 00000 n 0000159028 00000 n 0000166627 00000 n 0000166800 00000 n 0000167004 00000 n 0000167446 00000 n 0000167624 00000 n 0000167833 00000 n 0000168257 00000 n 0000173071 00000 n 0000173364 00000 n 0000179560 00000 n 0000179664 00000 n trailer << /Root 1 0 R /Info 3 0 R /Size 768/ID[<335B63EE10CB3EC3CAABBB69674BFB1A><335B63EE10CB3EC3CAABBB69674BFB1A>]>> startxref 179766 %%EOF