%PDF-1.3 % 3 0 obj <>/F 4/Subtype/Widget/DV()/T(Text1)/BS<>/Ff 0/Rect[162 671.75 540 690.5]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 6 0 obj <>/F 4/Subtype/Widget/DV()/T(Text2)/BS<>/Ff 0/Rect[120.75 647 429.75 665]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 8 0 obj <>/F 4/Subtype/Widget/DV()/T(Text3)/BS<>/Ff 0/Rect[443.25 647 478.5 662]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 10 0 obj <>/F 4/Subtype/Widget/DV()/T(Text4)/BS<>/Ff 0/Rect[498.75 647 540 662]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 12 0 obj <>/F 4/Subtype/Widget/DV()/T(Text5)/BS<>/Ff 0/Rect[120.75 622.25 540 641]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 14 0 obj <>/F 4/Subtype/Widget/DV()/T(Text6)/BS<>/Ff 0/Rect[374.25 599.75 540 618.5]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 16 0 obj <>/F 4/Subtype/Widget/DV()/T(Text7)/BS<>/Ff 0/Rect[57.75 573.5 540 592.25]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 18 0 obj <>/F 4/Subtype/Widget/DV()/T(Text8)/BS<>/Ff 0/Rect[119.25 548.75 540 565.25]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 20 0 obj <>/F 4/Subtype/Widget/DV()/T(Text9)/BS<>/Ff 0/Rect[92.25 500 147 520.25]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 22 0 obj <>/F 4/Subtype/Widget/DV()/T(Text10)/BS<>/Ff 0/Rect[199.5 500 257.25 518]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 24 0 obj <>/F 4/Subtype/Widget/DV()/T(Text11)/BS<>/Ff 0/Rect[324 500 388.5 518]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 26 0 obj <>/F 4/Subtype/Widget/DV()/T(Text12)/BS<>/Ff 0/Rect[92.25 476.75 147.75 495.5]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 28 0 obj <>/F 4/Subtype/Widget/DV()/T(Text13)/BS<>/Ff 0/Rect[198.75 476.75 257.25 495.5]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 30 0 obj <>/F 4/Subtype/Widget/DV()/T(Text14)/BS<>/Ff 0/Rect[324 476.75 388.5 495.5]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 32 0 obj <>/F 4/Subtype/Widget/DV()/T(Text15)/BS<>/Ff 0/Rect[205.5 452.75 540 471.5]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 34 0 obj <>/F 4/Subtype/Widget/DV()/T(Text16)/BS<>/Ff 0/Rect[96.75 428 320.25 446]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 36 0 obj <>/F 4/Subtype/Widget/DV()/T(Text17)/BS<>/Ff 0/Rect[351 428 403.5 446]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 38 0 obj <>/F 4/Subtype/Widget/DV()/T(Text18)/BS<>/Ff 0/Rect[420 428 540 446]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 40 0 obj <>/F 4/Subtype/Widget/DV()/T(Text19)/BS<>/Ff 0/Rect[119.25 402.5 540 425]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 42 0 obj <>/F 4/Subtype/Widget/DV()/T(Text20)/BS<>/Ff 0/Rect[96.75 377.75 372.75 401]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 44 0 obj <>/F 4/Subtype/Widget/DV()/T(Text21)/BS<>/Ff 0/Rect[403.5 379.25 540 401]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 46 0 obj <>/F 4/Subtype/Widget/DV()/T(Text22)/BS<>/Ff 0/Rect[120.75 329.75 540 347.75]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 50 0 obj <
> endobj 51 0 obj <>>>/F 4/V/Off/AS/Off/Subtype/Widget/Parent 50 0 R/BS<>/Rect[232.5 352.25 246.75 365]/DR<>>>/FT/Btn/MK<>/DA(/ZaDb 10 Tf 0 0 0 rg )>> endobj 54 0 obj <> endobj 55 0 obj <>>>/F 4/V/Off/AS/Off/Subtype/Widget/Parent 54 0 R/BS<>/Rect[382.5 352.25 397.5 365]/DR<>>>/FT/Btn/MK<>/DA(/ZaDb 10 Tf 0 0 0 rg )>> endobj 57 0 obj <>/F 4/Subtype/Widget/DV()/T(Text23)/BS<>/Ff 0/Rect[216 306.5 282 325.25]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 59 0 obj <>/F 4/Subtype/Widget/DV()/T(Text24)/BS<>/Ff 0/Rect[229.13 281.75 282 299]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 61 0 obj <>/F 4/Subtype/Widget/DV()/T(Text25)/BS<>/Ff 0/Rect[219 257.75 282 274.25]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 63 0 obj <>/F 4/Subtype/Widget/DV()/T(Text26)/BS<>/Ff 0/Rect[241.5 233 298.87 250.25]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 65 0 obj <>/F 4/Subtype/Widget/DV()/T(Text27)/BS<>/Ff 0/Rect[239.25 208.25 306 226.25]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 67 0 obj <>/F 4/Subtype/Widget/DV()/T(Text28)/BS<>/Ff 0/Rect[326.25 184.25 372.75 203]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 69 0 obj <>/F 4/Subtype/Widget/DV()/T(Text29)/BS<>/Ff 0/Rect[201 160.25 246.75 179.75]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 71 0 obj <>/F 4/Subtype/Widget/DV()/T(Text30)/BS<>/Ff 0/Rect[139.5 113.75 216 137.75]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 73 0 obj <>/F 4/Subtype/Widget/DV()/T(Text31)/BS<>/Ff 0/Rect[153.75 87.5 234.75 107]/DR<>>>/FT/Tx/DA(/Verdana 10 Tf 0 0 0 rg )>> endobj 74 0 obj <> endobj 75 0 obj <> endobj 2 0 obj <> endobj 48 0 obj <> endobj 29 0 obj <>>>/Subtype/Form/BBox[0 0 64.5 18.75]>>stream x+TTPpuVpb # endstream endobj 35 0 obj <>>>/Subtype/Form/BBox[0 0 52.5 18]>>stream x+TTPpuVpb # endstream endobj 27 0 obj <>>>/Subtype/Form/BBox[0 0 58.5 18.75]>>stream x+TTPpuVpb # endstream endobj 68 0 obj <>>>/Subtype/Form/BBox[0 0 45.75 19.5]>>stream x+TTPpuVpb # endstream endobj 70 0 obj <>>>/Subtype/Form/BBox[0 0 76.5 24]>>stream x+TTPpuVpb # endstream endobj 5 0 obj <>>>/Subtype/Form/BBox[0 0 309 18]>>stream x+TTPpuVpb # endstream endobj 33 0 obj <>>>/Subtype/Form/BBox[0 0 223.5 18]>>stream x+TTPpuVpb # endstream endobj 39 0 obj <>>>/Subtype/Form/BBox[0 0 420.75 22.5]>>stream x+TTPpuVpb # endstream endobj 21 0 obj <>>>/Subtype/Form/BBox[0 0 57.75 18]>>stream x+TTPpuVpb # endstream endobj 47 0 obj <>>>/Subtype/Form/BBox[0 0 14.25 12.75]>>stream x+TT(T0A#=#SC=sSTp<0,JWp QЏJtIJ+ M,LBr4,4C\C !S endstream endobj 53 0 obj <>/Subtype/Form/BBox[0 0 15 12.75]>>stream x+TT endstream endobj 62 0 obj <>>>/Subtype/Form/BBox[0 0 57.37 17.25]>>stream x+TTPpuVpb # endstream endobj 41 0 obj <>>>/Subtype/Form/BBox[0 0 276 23.25]>>stream x+TTPpuVpb # endstream endobj 13 0 obj <>>>/Subtype/Form/BBox[0 0 165.75 18.75]>>stream x+TTPpuVpb # endstream endobj 56 0 obj <>>>/Subtype/Form/BBox[0 0 66 18.75]>>stream x+TTPpuVpb # endstream endobj 49 0 obj <>/Subtype/Form/BBox[0 0 14.25 12.75]>>stream x+TT endstream endobj 25 0 obj <>>>/Subtype/Form/BBox[0 0 55.5 18.75]>>stream x+TTPpuVpb # endstream endobj 37 0 obj <>>>/Subtype/Form/BBox[0 0 120 18]>>stream x+TTPpuVpb # endstream endobj 11 0 obj <>>>/Subtype/Form/BBox[0 0 419.25 18.75]>>stream x+TTPpuVpb # endstream endobj 7 0 obj <>>>/Subtype/Form/BBox[0 0 35.25 15]>>stream x+TTPpuVpb # endstream endobj 31 0 obj <>>>/Subtype/Form/BBox[0 0 334.5 18.75]>>stream x+TTPpuVpb # endstream endobj 1 0 obj <>>>/Subtype/Form/BBox[0 0 378 18.75]>>stream x+TTPpuVpb # endstream endobj 23 0 obj <>>>/Subtype/Form/BBox[0 0 64.5 18]>>stream x+TTPpuVpb # endstream endobj 58 0 obj <>>>/Subtype/Form/BBox[0 0 52.88 17.25]>>stream x+TTPpuVpb # endstream endobj 9 0 obj <>>>/Subtype/Form/BBox[0 0 41.25 15]>>stream x+TTPpuVpb # endstream endobj 15 0 obj <>>>/Subtype/Form/BBox[0 0 482.25 18.75]>>stream x+TTPpuVpb # endstream endobj 60 0 obj <>>>/Subtype/Form/BBox[0 0 63 16.5]>>stream x+TTPpuVpb # endstream endobj 17 0 obj <>>>/Subtype/Form/BBox[0 0 420.75 16.5]>>stream x+TTPpuVpb # endstream endobj 72 0 obj <>>>/Subtype/Form/BBox[0 0 81 19.5]>>stream x+TTPpuVpb # endstream endobj 66 0 obj <>>>/Subtype/Form/BBox[0 0 46.5 18.75]>>stream x+TTPpuVpb # endstream endobj 45 0 obj <>>>/Subtype/Form/BBox[0 0 419.25 18]>>stream x+TTPpuVpb # endstream endobj 52 0 obj <>>>/Subtype/Form/BBox[0 0 15 12.75]>>stream x+TT(T0AcC=sSTp<0,JWp QЏJtIJ+U L ,LBr4,4C\C 4 endstream endobj 43 0 obj <>>>/Subtype/Form/BBox[0 0 136.5 21.75]>>stream x+TTPpuVpb # endstream endobj 64 0 obj <>>>/Subtype/Form/BBox[0 0 66.75 18]>>stream x+TTPpuVpb # endstream endobj 19 0 obj <>>>/Subtype/Form/BBox[0 0 54.75 20.25]>>stream x+TTPpuVpb # endstream endobj 76 0 obj <>stream x+ * ,R endstream endobj 77 0 obj <>stream xS* R endstream endobj 78 0 obj <>>>/DA(/Helv 0 Tf 0 g )>>/Pages 79 0 R>> endobj 80 0 obj <> endobj 79 0 obj <> endobj 81 0 obj <>stream xc` endstream endobj 82 0 obj <>stream xkh D endstream endobj 83 0 obj <> endobj 4 0 obj <>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]/Font<>>>/CropBox[0 0 595 842]/Annots[3 0 R 6 0 R 8 0 R 10 0 R 12 0 R 14 0 R 16 0 R 18 0 R 20 0 R 22 0 R 24 0 R 26 0 R 28 0 R 30 0 R 32 0 R 34 0 R 36 0 R 38 0 R 40 0 R 42 0 R 44 0 R 46 0 R 51 0 R 55 0 R 57 0 R 59 0 R 61 0 R 63 0 R 65 0 R 67 0 R 69 0 R 71 0 R 73 0 R]/Rotate 0/MediaBox[0 0 595 842]>> endobj 84 0 obj <>stream x]Y .mk/9su8+yKyUy7DzT%!n{q;;Ҳ WM˸ho^^}mz8&E,t̛e{Lsoi̋ɝ;5O&gY=Y-wzg56v ϬVEн77ʉSuB=PyIa2̴җk[a\h-d\` s|99 9UD 34к 8(j3x&Vk[iF'%\:eU.e<6xo觔6(Z){@j"? .$'04OV!SVLA̭Hin3u<_t ]*;A0gW+RmpFmt'+4]=X/{{w`j{ H+8s#-0i V\H;GZWWz)!MÍyV5a^vet