%PDF-1.7 % ò¤ô 1 0 obj << /Type /Catalog /Pages 2 0 R /AcroForm << /Fields [6 0 R 7 0 R 8 0 R 12 0 R] >> >> endobj 2 0 obj << /Type /Pages /Count 1 /Kids [3 0 R] >> endobj 3 0 obj << /Type /Page /Parent 2 0 R /MediaBox [0 0 300 300] /Resources << /ProcSet [/PDF /Text /ImageB /ImageC /ImageI] /Font << /F1 4 0 R >> >> /Contents 5 0 R /Annots [6 0 R 7 0 R 9 0 R 10 0 R 11 0 R 13 0 R 14 0 R 15 0 R] >> endobj 4 0 obj << /Type /Font /Subtype /Type1 /Name /F1 /BaseFont /Courier >> endobj 5 0 obj << /Length 1411 >> stream q 1 0 0 1 0 0 cm BT /F1 12 Tf 14.4 TL ET BT 1 0 0 1 85.2 170 Tm (This form contains) Tj T* ET BT 1 0 0 1 49.2 155 Tm (checkboxes and radio buttons) Tj T* ET BT /F1 14 Tf 16.8 TL ET q 1 w 1 0 1 RG 1 .752941 .796078 rg n 135.5 250.5 19 19 re B* Q q 2 w .1 .1 .1 RG .8 .843 1 rg n 136 211 18 18 re B* Q q 2 w 0 .501961 0 RG 0 0 1 rg n 104 110 m 104 114.9706 99.97056 119 95 119 c 90.02944 119 86 114.9706 86 110 c 86 105.0294 90.02944 101 95 101 c 99.97056 101 104 105.0294 104 110 c B* Q q 2 w 0 .501961 0 RG 0 0 1 rg n 154 110 m 154 114.9706 149.9706 119 145 119 c 140.0294 119 136 114.9706 136 110 c 136 105.0294 140.0294 101 145 101 c 149.9706 101 154 105.0294 154 110 c B* Q q 2 w 0 .501961 0 RG 0 0 1 rg n 204 110 m 204 114.9706 199.9706 119 195 119 c 190.0294 119 186 114.9706 186 110 c 186 105.0294 190.0294 101 195 101 c 199.9706 101 204 105.0294 204 110 c B* Q q 2 w 0 .501961 0 RG 0 0 1 rg n 104 60 m 104 64.97056 99.97056 69 95 69 c 90.02944 69 86 64.97056 86 60 c 86 55.02944 90.02944 51 95 51 c 99.97056 51 104 55.02944 104 60 c B* Q q 2 w 0 .501961 0 RG 0 0 1 rg n 154 60 m 154 64.97056 149.9706 69 145 69 c 140.0294 69 136 64.97056 136 60 c 136 55.02944 140.0294 51 145 51 c 149.9706 51 154 55.02944 154 60 c B* Q q 2 w 0 .501961 0 RG 0 0 1 rg n 204 60 m 204 64.97056 199.9706 69 195 69 c 190.0294 69 186 64.97056 186 60 c 186 55.02944 190.0294 51 195 51 c 199.9706 51 204 55.02944 204 60 c B* Q Q endstream endobj 6 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /Ff 1 /P 3 0 R /Rect [135 250 155 270] /T (readOnlyCheckbox) /TU (readOnlyCheckbox) /AP << /N << /Yes 16 0 R /Off 17 0 R >> /D << /Yes 18 0 R /Off 19 0 R >> /R << /Yes 20 0 R /Off 21 0 R >> >> /AS /Yes /BS << /S /S /W 1 >> /H /N /MK << /BC [1 0 1] /BG [1 .752941 .796078] /CA (4) >> /V /Yes >> endobj 7 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /Ff 2 /P 3 0 R /Rect [135 210 155 230] /T (checkbox) /TU (checkbox) /AP << /N << /Yes 22 0 R /Off 23 0 R >> /D << /Yes 24 0 R /Off 25 0 R >> /R << /Yes 26 0 R /Off 27 0 R >> >> /AS /Off /BS << /S /S /W 2 >> /H /N /MK << /BC [.1 .1 .1] /BG [.8 .843 1] /CA (5) >> /V /Off >> endobj 8 0 obj << /FT /Btn /Ff 49153 /T (readOnlyRadioButton) /TU (readOnlyRadioButton1) /Kids [9 0 R 10 0 R 11 0 R] /V /value3 >> endobj 9 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /P 3 0 R /Parent 8 0 R /Rect [85 100 105 120] /AP << /N << /value1 28 0 R /Off 29 0 R >> /D << /value1 30 0 R /Off 31 0 R >> /R << /value1 32 0 R /Off 33 0 R >> >> /AS /Off /BS << /S /S /W 2 >> /H /N /MK << /BC [0 .501961 0] /BG [0 0 1] /CA (5) >> >> endobj 10 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /P 3 0 R /Parent 8 0 R /Rect [135 100 155 120] /AP << /N << /value2 28 0 R /Off 29 0 R >> /D << /value2 30 0 R /Off 31 0 R >> /R << /value2 32 0 R /Off 33 0 R >> >> /AS /Off /BS << /S /S /W 2 >> /H /N /MK << /BC [0 .501961 0] /BG [0 0 1] /CA (5) >> >> endobj 11 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /P 3 0 R /Parent 8 0 R /Rect [185 100 205 120] /AP << /N << /value3 28 0 R /Off 29 0 R >> /D << /value3 30 0 R /Off 31 0 R >> /R << /value3 32 0 R /Off 33 0 R >> >> /AS /value3 /BS << /S /S /W 2 >> /H /N /MK << /BC [0 .501961 0] /BG [0 0 1] /CA (5) >> >> endobj 12 0 obj << /FT /Btn /Ff 49154 /T (radioButton) /TU (radioButton1) /Kids [13 0 R 14 0 R 15 0 R] /V /value3 >> endobj 13 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /P 3 0 R /Parent 12 0 R /Rect [85 50 105 70] /AP << /N << /value1 28 0 R /Off 29 0 R >> /D << /value1 30 0 R /Off 31 0 R >> /R << /value1 32 0 R /Off 33 0 R >> >> /AS /Off /BS << /S /S /W 2 >> /H /N /MK << /BC [0 .501961 0] /BG [0 0 1] /CA (5) >> >> endobj 14 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /P 3 0 R /Parent 12 0 R /Rect [135 50 155 70] /AP << /N << /value2 28 0 R /Off 29 0 R >> /D << /value2 30 0 R /Off 31 0 R >> /R << /value2 32 0 R /Off 33 0 R >> >> /AS /Off /BS << /S /S /W 2 >> /H /N /MK << /BC [0 .501961 0] /BG [0 0 1] /CA (5) >> >> endobj 15 0 obj << /Type /Annot /Subtype /Widget /FT /Btn /F 4 /P 3 0 R /Parent 12 0 R /Rect [185 50 205 70] /AP << /N << /value3 28 0 R /Off 29 0 R >> /D << /value3 30 0 R /Off 31 0 R >> /R << /value3 32 0 R /Off 33 0 R >> >> /AS /value3 /BS << /S /S /W 2 >> /H /N /MK << /BC [0 .501961 0] /BG [0 0 1] /CA (5) >> >> endobj 16 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 901 >> stream q 1 g 1 G 1 .752941 .796078 rg 0 0 20 20 re f 1 0 1 RG 1 w 0.5 0.5 19 19 re s Q q 0 0 1 rg 0 0 1 RG 11.90655 14.48997 m 13.73412 16.72368 l 14.54638 17.62618 16.37396 18.07744 17.59234 18.07744 c 17.75028 17.71643 l 15.65195 15.23454 l 10.95891 9.029805 l 7.709889 3.998329 l 6.920195 2.644568 l 6.807382 2.418942 6.672006 2.148189 6.446379 2.012813 c 6.153064 1.877437 5.476184 1.877437 5.160306 1.877437 c 4.438301 1.877437 4.280362 1.877437 4.122423 1.990251 c 3.896797 2.148189 3.783983 2.464067 3.626045 2.779944 c 3.129666 3.817827 2.249721 6.074095 2.249721 7.202228 c 2.249721 7.585794 2.475348 7.766295 2.768663 7.969359 c 3.242479 8.307799 3.919359 8.691365 4.505989 8.691365 c 4.957242 8.691365 5.002368 8.307799 5.137744 7.946797 c 5.588997 6.886351 l 5.656685 6.70585 5.859749 6.074095 6.107939 6.074095 c 6.333565 6.074095 6.604318 6.593036 6.694568 6.750975 c 11.90655 14.48997 l h f Q endstream endobj 17 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 80 >> stream q 1 g 1 G 1 .752941 .796078 rg 0 0 20 20 re f 1 0 1 RG 1 w 0.5 0.5 19 19 re s Q endstream endobj 18 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 906 >> stream q 1 g 1 G .9 .677647 .716471 rg 0 0 20 20 re f .9 0 .9 RG 1 w 0.5 0.5 19 19 re s Q q 0 0 .9 rg 0 0 .9 RG 11.90655 14.48997 m 13.73412 16.72368 l 14.54638 17.62618 16.37396 18.07744 17.59234 18.07744 c 17.75028 17.71643 l 15.65195 15.23454 l 10.95891 9.029805 l 7.709889 3.998329 l 6.920195 2.644568 l 6.807382 2.418942 6.672006 2.148189 6.446379 2.012813 c 6.153064 1.877437 5.476184 1.877437 5.160306 1.877437 c 4.438301 1.877437 4.280362 1.877437 4.122423 1.990251 c 3.896797 2.148189 3.783983 2.464067 3.626045 2.779944 c 3.129666 3.817827 2.249721 6.074095 2.249721 7.202228 c 2.249721 7.585794 2.475348 7.766295 2.768663 7.969359 c 3.242479 8.307799 3.919359 8.691365 4.505989 8.691365 c 4.957242 8.691365 5.002368 8.307799 5.137744 7.946797 c 5.588997 6.886351 l 5.656685 6.70585 5.859749 6.074095 6.107939 6.074095 c 6.333565 6.074095 6.604318 6.593036 6.694568 6.750975 c 11.90655 14.48997 l h f Q endstream endobj 19 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 83 >> stream q 1 g 1 G .9 .677647 .716471 rg 0 0 20 20 re f .9 0 .9 RG 1 w 0.5 0.5 19 19 re s Q endstream endobj 20 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 906 >> stream q 1 g 1 G 1 .777647 .816471 rg 0 0 20 20 re f 1 .1 1 RG 1 w 0.5 0.5 19 19 re s Q q .1 .1 1 rg .1 .1 1 RG 11.90655 14.48997 m 13.73412 16.72368 l 14.54638 17.62618 16.37396 18.07744 17.59234 18.07744 c 17.75028 17.71643 l 15.65195 15.23454 l 10.95891 9.029805 l 7.709889 3.998329 l 6.920195 2.644568 l 6.807382 2.418942 6.672006 2.148189 6.446379 2.012813 c 6.153064 1.877437 5.476184 1.877437 5.160306 1.877437 c 4.438301 1.877437 4.280362 1.877437 4.122423 1.990251 c 3.896797 2.148189 3.783983 2.464067 3.626045 2.779944 c 3.129666 3.817827 2.249721 6.074095 2.249721 7.202228 c 2.249721 7.585794 2.475348 7.766295 2.768663 7.969359 c 3.242479 8.307799 3.919359 8.691365 4.505989 8.691365 c 4.957242 8.691365 5.002368 8.307799 5.137744 7.946797 c 5.588997 6.886351 l 5.656685 6.70585 5.859749 6.074095 6.107939 6.074095 c 6.333565 6.074095 6.604318 6.593036 6.694568 6.750975 c 11.90655 14.48997 l h f Q endstream endobj 21 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 81 >> stream q 1 g 1 G 1 .777647 .816471 rg 0 0 20 20 re f 1 .1 1 RG 1 w 0.5 0.5 19 19 re s Q endstream endobj 22 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 303 >> stream q 1 g 1 G .8 .843 1 rg 0 0 20 20 re f .1 .1 .1 RG 2 w 1.0 1.0 18 18 re s Q q .1 .1 .1 rg .1 .1 .1 RG 17.2 15.95145 m 11.20694 10 l 17.2 4.027746 l 15.97225 2.8 l 10 8.793064 l 4.027746 2.8 l 2.8 4.027746 l 8.813873 10 l 2.8 15.97225 l 4.027746 17.2 l 10 11.20694 l 15.97225 17.2 l 17.2 15.95145 l h f Q endstream endobj 23 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 75 >> stream q 1 g 1 G .8 .843 1 rg 0 0 20 20 re f .1 .1 .1 RG 2 w 1.0 1.0 18 18 re s Q endstream endobj 24 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 315 >> stream q 1 g 1 G .72 .7587 .9 rg 0 0 20 20 re f .09 .09 .09 RG 2 w 1.0 1.0 18 18 re s Q q .09 .09 .09 rg .09 .09 .09 RG 17.2 15.95145 m 11.20694 10 l 17.2 4.027746 l 15.97225 2.8 l 10 8.793064 l 4.027746 2.8 l 2.8 4.027746 l 8.813873 10 l 2.8 15.97225 l 4.027746 17.2 l 10 11.20694 l 15.97225 17.2 l 17.2 15.95145 l h f Q endstream endobj 25 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 81 >> stream q 1 g 1 G .72 .7587 .9 rg 0 0 20 20 re f .09 .09 .09 RG 2 w 1.0 1.0 18 18 re s Q endstream endobj 26 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 314 >> stream q 1 g 1 G .82 .8587 1 rg 0 0 20 20 re f .19 .19 .19 RG 2 w 1.0 1.0 18 18 re s Q q .19 .19 .19 rg .19 .19 .19 RG 17.2 15.95145 m 11.20694 10 l 17.2 4.027746 l 15.97225 2.8 l 10 8.793064 l 4.027746 2.8 l 2.8 4.027746 l 8.813873 10 l 2.8 15.97225 l 4.027746 17.2 l 10 11.20694 l 15.97225 17.2 l 17.2 15.95145 l h f Q endstream endobj 27 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 80 >> stream q 1 g 1 G .82 .8587 1 rg 0 0 20 20 re f .19 .19 .19 RG 2 w 1.0 1.0 18 18 re s Q endstream endobj 28 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 573 >> stream q 1 g 1 G 0 0 1 rg 1 0 0 1 10 10 cm 10 0 m 10 5.5231 5.5231 10 0 10 c -5.5231 10 -10 5.5231 -10 0 c -10 -5.5231 -5.5231 -10 0 -10 c 5.5231 -10 10 -5.5231 10 0 c f Q q 0 .501961 0 RG 2 w 1 0 0 1 10 10 cm 9 0 m 9 4.97079 4.97079 9 0 9 c -4.97079 9 -9 4.97079 -9 0 c -9 -4.97079 -4.97079 -9 0 -9 c 4.97079 -9 9 -4.97079 9 0 c s Q q 1 .752941 .796078 rg 1 .752941 .796078 RG 17.2 15.95145 m 11.20694 10 l 17.2 4.027746 l 15.97225 2.8 l 10 8.793064 l 4.027746 2.8 l 2.8 4.027746 l 8.813873 10 l 2.8 15.97225 l 4.027746 17.2 l 10 11.20694 l 15.97225 17.2 l 17.2 15.95145 l h f Q endstream endobj 29 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 327 >> stream q 1 g 1 G 0 0 1 rg 1 0 0 1 10 10 cm 10 0 m 10 5.5231 5.5231 10 0 10 c -5.5231 10 -10 5.5231 -10 0 c -10 -5.5231 -5.5231 -10 0 -10 c 5.5231 -10 10 -5.5231 10 0 c f Q q 0 .501961 0 RG 2 w 1 0 0 1 10 10 cm 9 0 m 9 4.97079 4.97079 9 0 9 c -4.97079 9 -9 4.97079 -9 0 c -9 -4.97079 -4.97079 -9 0 -9 c 4.97079 -9 9 -4.97079 9 0 c s Q endstream endobj 30 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 576 >> stream q 1 g 1 G 0 0 .9 rg 1 0 0 1 10 10 cm 10 0 m 10 5.5231 5.5231 10 0 10 c -5.5231 10 -10 5.5231 -10 0 c -10 -5.5231 -5.5231 -10 0 -10 c 5.5231 -10 10 -5.5231 10 0 c f Q q 0 .451765 0 RG 2 w 1 0 0 1 10 10 cm 9 0 m 9 4.97079 4.97079 9 0 9 c -4.97079 9 -9 4.97079 -9 0 c -9 -4.97079 -4.97079 -9 0 -9 c 4.97079 -9 9 -4.97079 9 0 c s Q q .9 .677647 .716471 rg .9 .677647 .716471 RG 17.2 15.95145 m 11.20694 10 l 17.2 4.027746 l 15.97225 2.8 l 10 8.793064 l 4.027746 2.8 l 2.8 4.027746 l 8.813873 10 l 2.8 15.97225 l 4.027746 17.2 l 10 11.20694 l 15.97225 17.2 l 17.2 15.95145 l h f Q endstream endobj 31 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 328 >> stream q 1 g 1 G 0 0 .9 rg 1 0 0 1 10 10 cm 10 0 m 10 5.5231 5.5231 10 0 10 c -5.5231 10 -10 5.5231 -10 0 c -10 -5.5231 -5.5231 -10 0 -10 c 5.5231 -10 10 -5.5231 10 0 c f Q q 0 .451765 0 RG 2 w 1 0 0 1 10 10 cm 9 0 m 9 4.97079 4.97079 9 0 9 c -4.97079 9 -9 4.97079 -9 0 c -9 -4.97079 -4.97079 -9 0 -9 c 4.97079 -9 9 -4.97079 9 0 c s Q endstream endobj 32 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 577 >> stream q 1 g 1 G .1 .1 1 rg 1 0 0 1 10 10 cm 10 0 m 10 5.5231 5.5231 10 0 10 c -5.5231 10 -10 5.5231 -10 0 c -10 -5.5231 -5.5231 -10 0 -10 c 5.5231 -10 10 -5.5231 10 0 c f Q q .1 .551765 .1 RG 2 w 1 0 0 1 10 10 cm 9 0 m 9 4.97079 4.97079 9 0 9 c -4.97079 9 -9 4.97079 -9 0 c -9 -4.97079 -4.97079 -9 0 -9 c 4.97079 -9 9 -4.97079 9 0 c s Q q 1 .777647 .816471 rg 1 .777647 .816471 RG 17.2 15.95145 m 11.20694 10 l 17.2 4.027746 l 15.97225 2.8 l 10 8.793064 l 4.027746 2.8 l 2.8 4.027746 l 8.813873 10 l 2.8 15.97225 l 4.027746 17.2 l 10 11.20694 l 15.97225 17.2 l 17.2 15.95145 l h f Q endstream endobj 33 0 obj << /Type /XObject /Subtype /Form /FormType 1 /BBox [0 0 20 20] /Resources << /ProcSet [/PDF] >> /Length 331 >> stream q 1 g 1 G .1 .1 1 rg 1 0 0 1 10 10 cm 10 0 m 10 5.5231 5.5231 10 0 10 c -5.5231 10 -10 5.5231 -10 0 c -10 -5.5231 -5.5231 -10 0 -10 c 5.5231 -10 10 -5.5231 10 0 c f Q q .1 .551765 .1 RG 2 w 1 0 0 1 10 10 cm 9 0 m 9 4.97079 4.97079 9 0 9 c -4.97079 9 -9 4.97079 -9 0 c -9 -4.97079 -4.97079 -9 0 -9 c 4.97079 -9 9 -4.97079 9 0 c s Q endstream endobj xref 0 34 0000000000 65535 f 0000000015 00000 n 0000000127 00000 n 0000000190 00000 n 0000000457 00000 n 0000000543 00000 n 0000002007 00000 n 0000002479 00000 n 0000002930 00000 n 0000003073 00000 n 0000003496 00000 n 0000003921 00000 n 0000004349 00000 n 0000004478 00000 n 0000004901 00000 n 0000005325 00000 n 0000005752 00000 n 0000006815 00000 n 0000007056 00000 n 0000008124 00000 n 0000008368 00000 n 0000009436 00000 n 0000009678 00000 n 0000010143 00000 n 0000010379 00000 n 0000010856 00000 n 0000011098 00000 n 0000011574 00000 n 0000011815 00000 n 0000012550 00000 n 0000013039 00000 n 0000013777 00000 n 0000014267 00000 n 0000015006 00000 n trailer << /Root 1 0 R /Size 34 >> startxref 15499 %%EOF