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}\pard \ltrpar\s17\ql \li0\ri360\widctlpar\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin360\lin0\itap0\pararsid1535236 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f0\fs16\lang1036\langfe1033\langnp1036\insrsid2708514\charrsid2762239 SD5E(08/03) \par }\pard \ltrpar\s17\qc \li0\ri0\widctlpar\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16123332 {\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\lang1036\langfe1033\langnp1036\insrsid2708514\charrsid2762239 (aussi disponible en fran\'e7ais) \par }}{\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}} {\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8 \pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ltrpar\s15\qc \li0\ri0\widctlpar\brdrt\brdrs\brdrw30\brsp20 \brdrl\brdrs\brdrw30 \brdrb\brdrs\brdrw30\brsp20 \brdrr\brdrs\brdrw30 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1315193 \shading2000\cbpat8 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\fs20\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \f1\fs28\insrsid89701\charrsid6117281 SOLVENT DEGREASING CONSUMPTION UNIT \par TRANSFER APPLICATION \par }\pard\plain \ltrpar\qc \li0\ri0\widctlpar\brdrt\brdrs\brdrw30\brsp20 \brdrl\brdrs\brdrw30 \brdrb\brdrs\brdrw30\brsp20 \brdrr\brdrs\brdrw30 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1315193 \shading2000\cbpat8 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid89701\charrsid6117281 [See Paragraph 6(3) and Schedule 5 of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\insrsid89701\charrsid6117281 Solvent Degreasing Regulations}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid89701\charrsid6117281 ] \par }\pard \ltrpar\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\insrsid89701\charrsid3083352 \par }\pard \ltrpar\ql \fi-720\li720\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 NOTES:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid9589473\charrsid6117281 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid3083352\charrsid6117281 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid6117281 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 his form }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\ul\cf6\insrsid89701\charrsid6117281 must}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 be used to make a joint application for a consumption unit transfer. \par }\pard \ltrpar\ql \fi-758\li709\ri0\widctlpar\tx90\tx630\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin709\itap0\pararsid3083352 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 \tab \tab \tab }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid6117281 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\ul\cf6\insrsid89701\charrsid6117281 separate joint application }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 for the tran}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid13979945 s}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 fer of consumption units }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\ul\cf6\insrsid89701\charrsid6117281 must}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 be made for a }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\ul\cf6\insrsid89701\charrsid6117281 given solvent}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 and a }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\ul\cf6\insrsid89701\charrsid6117281 specific degreasing process}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid6117281 .}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\cf6\insrsid89701\charrsid6117281 \par }\pard \ltrpar\ql \li720\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin720\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\insrsid89701\charrsid3083352 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid8729548 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt\f39\fs40}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\insrsid89701 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid89701 STEP 1: Transferor Information}{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid89701 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1144703 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid1144703\charrsid15421793 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 Transferor}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid6117281 :}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl \brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl \brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar \s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid6117281 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ame of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid6117281 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ransferor, }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid6117281 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ompany or }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid6117281 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 orporation}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid6117281 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid6117281 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid6117281 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid6117281 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid6117281 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid6117281\charrsid6117281 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 usiness}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid6117281\charrsid6117281 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\insrsid1144703\charrsid6117281 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 Number}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\insrsid1144703\charrsid6117281 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 and}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\insrsid1144703\charrsid6117281 S}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 treet: \par \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 City: \par \cell Province: \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid1144703\charrsid6117281 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 Postal Code:\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs20\insrsid1144703 \trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb \brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb \brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt \brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt \brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 pos}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 tal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 usiness}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid1144703\charrsid733557 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 { \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid733557 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow6\irowband6\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid733557 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 Province:\cell Postal Code:\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl \brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow8\irowband8\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 elephone }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1144703\charrsid6117281 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid733557 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \scaps\fs14\insrsid1144703\charrsid733557 (}{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid1144703\charrsid733557 include area code)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 \par ( )}{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid1144703\charrsid6117281 \cell }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid733557 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ax }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid733557 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid733557 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\fs14\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid733557 (}{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid733557 if any \endash include area code)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 ( )\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow8\irowband8\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow9\irowband9\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt \brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt \brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar \s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid733557 e}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 -mail }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid733557 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ddress}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid733557 : } {\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid733557\charrsid733557 (if any)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid733557 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow9\irowband9\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 Person }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid733557 a}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 uthorized to }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid733557 s}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ubmit }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid733557 a}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid6117281 pplication}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 on }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid733557 b}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ehalf of }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid733557 t}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid11206911\charrsid6117281 ransferor} {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid13335467 :}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b0\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid409244 (}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid409244 if applicable)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b0\scaps0\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb \brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb \brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\row \ltrrow}\trowd \irow11\irowband11\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ame}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow11\irowband11\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 itle}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow12\irowband12\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ame of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ompany}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow13\irowband13\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid409244 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid1144703\charrsid6117281 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid409244 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid1144703\charrsid6117281 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid409244 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid1144703\charrsid6117281 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid409244 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid1144703\charrsid6117281 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid409244 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid1144703\charrsid6117281 usiness:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang1033\langfe1033\langnp1033\insrsid1144703\charrsid6117281 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow14\irowband14\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 Number and Street: \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow15\irowband15\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow16\irowband16\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 City: \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 Province:\cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 Postal Code:\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow16\irowband16\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow17\irowband17\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 usiness}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid409244 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow17\irowband17\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow18\irowband18\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 Province:\cell Postal Code:\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl \brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow20\irowband20\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\pard\plain \ltrpar \s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f40\fs16\lang4105\langfe1033\langnp4105\insrsid409244\charrsid409244 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \f40\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid409244 elephone}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid409244\charrsid409244 (include area code)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 ( )\cell }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244\charrsid409244 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ax }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid409244 (if any \endash include area code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ) \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid6117281 ( )\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid1144703 \trowd \irow20\irowband20\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow21\irowband21\lastrow \ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 e}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 -mail }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 ddress}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid409244 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid409244\charrsid409244 (if any)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid1144703\charrsid6117281 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid1144703 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid1144703\charrsid409244 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid1144703 \trowd \irow21\irowband21\lastrow \ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid8287868\charrsid8287868 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\tx720\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid140297 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid140297 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt \f39\fs40}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid140297 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid140297 STEP 2: Request for Confidentiality}{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid9266036 - Transferor}{ \rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid140297 \par }\pard\plain \ltrpar\s19\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid140297 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\insrsid140297\charrsid13699577 \par }\pard\plain \ltrpar\s1\ql \fi-567\li567\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin567\itap0\pararsid140297 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 NOTE: }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid13327892 i}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 ndicate if a request for confidentiality is being made under }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid13327892 s}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 ection 313 of the }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid13327892 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 anadian }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid13327892 e}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 nvironmental }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid13327892 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 rotection }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid13327892 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 ct }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid13327892 (cepa),}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 1999}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid140297\charrsid409244 and the reason for the request. \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid140297 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid140297\charrsid409244 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 Do you request confidentiality under Section 313 of }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\i\scaps\fs20\insrsid140297\charrsid409244 CEPA 1999}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 ? \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \b\scaps\fs12\insrsid140297\charrsid409244 \par }{\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 {\*\bkmkstart Check18} FORMCHECKBOX }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 {\*\datafield 650000001400000007436865636b313800000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check18}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 {\*\bkmkend Check18} No \par }\pard \ltrpar\ql \fi-851\li851\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin851\itap0\pararsid140297 {\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 {\*\bkmkstart Check17} FORMCHECKBOX }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 {\*\datafield 650000001400000007436865636b313700000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check17} \ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 {\*\bkmkend Check17} Yes \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \scaps\fs12\insrsid140297\charrsid409244 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid140297 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid140297\charrsid409244 Reason}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid140297\charrsid409244 :}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1921475 \page }{\rtlch\fcs1 \af38 \ltrch\fcs0 \f38\fs40\insrsid8729548\charrsid1921475 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt\f39\fs40}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs32\insrsid89701 }{\rtlch\fcs1 \af38 \ltrch\fcs0 \f38\fs32\ul\insrsid89701\charrsid1921475 STEP 3: }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid89701\charrsid9659030 Transferor Facility Information}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid89701\charrsid1921475 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid89701\charrsid8139682 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid5201088 NOTE:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid8806941\charrsid5201088 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid5201088 i}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid5201088 f more than }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid5201088 five}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid5201088 }{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid5201088 (5)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid5201088 facilities attach additional copies of this page.}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\cf6\insrsid89701\charrsid5201088 \par }\pard\plain \ltrpar\s19\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7932129 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\insrsid7932129\charrsid13189112 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid8282750 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 Facilities}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7812807 :}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid8282750 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid8282750 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10517904 number of facilities included in this }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid6978264 application}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10517904 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 __________ \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrdb\brdrw15 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10517904 facility 1:}{\rtlch\fcs1 \af1\afs4 \ltrch\fcs0 \b\scaps\fs4\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { \rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrdb\brdrw15 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8282750\charrsid5843003 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 : \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8282750\charrsid5843003 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 : \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh \brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10517904 facility 1:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8282750\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \scaps\fs20\ul\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow6\irowband6\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow8\irowband8\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8282750 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8282750\charrsid10517904 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8282750\charrsid10517904 ddress of facility 2}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\fs16\insrsid8282750\charrsid10517904 :}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs20\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow8\irowband8\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow9\irowband9\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow11\irowband11\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid8282750 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 acility 2}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8282750 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid8282750\charrsid10649403 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow11\irowband11\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow12\irowband12\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow13\irowband13\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow13\irowband13\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow14\irowband14\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10517904 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10517904 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10517904 acility }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 3:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\fs16\insrsid8282750\charrsid10517904 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow14\irowband14\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow15\irowband15\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow16\irowband16\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow16\irowband16\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow17\irowband17\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 acility }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 3: }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8282750\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow17\irowband17\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow18\irowband18\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow20\irowband20\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 acility 4}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 :\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow20\irowband20\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 { \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow21\irowband21\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow22\irowband22\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow22\irowband22\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow23\irowband23\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 acility 4}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8282750\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow23\irowband23\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow24\irowband24\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow25\irowband25\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow25\irowband25\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow26\irowband26\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 acility }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 5:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow26\irowband26\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow27\irowband27\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow28\irowband28\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow28\irowband28\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow29\irowband29\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750\charrsid10649403 acility 5}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8282750 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8282750\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow29\irowband29\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow30\irowband30\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow31\irowband31\lastrow \ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8282750 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8282750\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid8282750 \trowd \irow31\irowband31\lastrow \ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row }\pard \ltrpar \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \f0\fs16\insrsid68696 \par \page }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid6035245 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt\f39\fs40}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid89701 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid89701 STEP 4: Transferee Information}{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid89701 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid68696 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid68696\charrsid15421793 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 Transferee}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid9588636\charrsid9588636 :}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9588636 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ame of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9588636 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ransferee, }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9588636 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ompany or }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9588636 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 orporation}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid5275446 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9588636 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9588636 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9588636 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9588636 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9588636 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 usiness}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid5275446 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\insrsid68696\charrsid9588636 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Number}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\insrsid68696\charrsid9588636 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 and}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\insrsid68696\charrsid9588636 S}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 treet: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Province: \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid68696\charrsid9588636 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Postal Code:\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs20\insrsid68696 \trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb \brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb \brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt \brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt \brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 { \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid5275446 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid5275446 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid5275446 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid5275446 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid5275446 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 usiness}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid5275446 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid68696\charrsid5275446 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { \rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow6\irowband6\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Province:\cell Postal Code:\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl \brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow8\irowband8\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid12656073 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 elephone }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid12656073 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid68696\charrsid9588636 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid12656073 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \scaps\fs14\insrsid68696\charrsid12656073 (}{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid12656073\charrsid12656073 include area code)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 \par ( )}{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid68696\charrsid9588636 \cell }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ax }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\fs14\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 (}{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 if any \endash include area code)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 ( )\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow8\irowband8\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow9\irowband9\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt \brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt \brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar \s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 e}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 -mail }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ddress}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid12656073\charrsid12656073 (if any)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow9\irowband9\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 Person }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid12656073 a}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 uthorized to }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid12656073 s}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ubmit }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid12656073 a}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2305823\charrsid9588636 pplication}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 on }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid12656073 b}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ehalf of }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid12656073 t}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ransfer}{ \rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2780372\charrsid9588636 ee}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \fs18\lang4105\langfe1033\langnp4105\insrsid12656073\charrsid12656073 :}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b0\fs18\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 (}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 if applicable)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b0\scaps0\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\row \ltrrow}\trowd \irow11\irowband11\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr \brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr \brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ame}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow11\irowband11\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 itle}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow12\irowband12\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ame of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ompany}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow13\irowband13\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid12656073 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid68696\charrsid9588636 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid12656073 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid68696\charrsid9588636 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid12656073 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid68696\charrsid9588636 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid12656073 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid68696\charrsid9588636 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid12656073 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang1033\langfe1033\langnp1033\insrsid68696\charrsid9588636 usiness:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang1033\langfe1033\langnp1033\insrsid68696\charrsid9588636 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow14\irowband14\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 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\li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow15\irowband15\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow16\irowband16\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 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{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 Province:\cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Postal Code:\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow16\irowband16\ltrrow 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\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 {\*\xmlopen\xmlns2{\factoidname address}}{\*\xmlopen\xmlns2{\factoidname Street}}p}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 rincipal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 lace{\*\xmlclose}{\*\xmlclose} of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 usiness}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow17\irowband17\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow18\irowband18\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 Province:\cell Postal Code:\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow20\irowband20\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt \brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt \brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 elephone }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 (include area code)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 ( )\cell }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073\charrsid12656073 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ax }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 umber}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 (if any \endash include area code)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid9588636 ( )\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs28\ul\insrsid68696 \trowd \irow20\irowband20\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw20 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx4709\clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw20 \clbrdrb\brdrs\brdrw20 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth4817\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow21\irowband21\lastrow \ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 e}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 -mail }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 ddress}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid12656073 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid68696\charrsid12656073 (if any)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid68696\charrsid9588636 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid68696 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid68696\charrsid12656073 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\f38\fs28\ul\insrsid68696 \trowd \irow21\irowband21\lastrow \ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw30 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid89701\charrsid2305823 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\tx720\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid6035245 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt\f39\fs40}}}{ \rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid89701 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid89701 STEP 5: Request for Confidentiality \endash Transferee \par }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid89701\charrsid2305823 \par }\pard\plain \ltrpar\s1\ql \fi-567\li567\ri0\keepn\widctlpar\tx567\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin567\itap0\pararsid7693193 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 NOTE: }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid16585420\charrsid8812725 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193 i}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193\charrsid409244 ndicate if a request for confidentiality is being made under }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193 s}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193\charrsid409244 ection 313 of the }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193\charrsid409244 anadian }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193 environmental p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193\charrsid409244 rotection }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193\charrsid409244 ct }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193 (cepa),}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \i\fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193\charrsid409244 1999}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid7693193\charrsid409244 and the reason for the request.}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\cf6\lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8729548 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid8729548\charrsid8812725 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid8729548\charrsid8812725 Do you request confidentiality under }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid8812725 s}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid8729548\charrsid8812725 ection 313 of }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\i\scaps\fs20\insrsid8729548\charrsid8812725 CEPA, 1999}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\scaps\fs20\insrsid8729548\charrsid8812725 ? \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \b\scaps\fs12\insrsid8729548\charrsid8812725 \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0\pararsid8729548 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 FORMCHECKBOX }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 {\*\datafield 650000001400000007436865636b313800000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check18}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect \psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 No \par }\pard \ltrpar\s1\ql \fi-851\li851\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin851\itap0\pararsid7472567 {\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 FORMCHECKBOX }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 {\*\datafield 650000001400000007436865636b313700000000000000000000000000} {\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check17}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7472567\charrsid8812725 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 Yes}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7472567\charrsid8812725 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7341666 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid7341666\charrsid8812725 \par }\pard\plain \ltrpar\s1\ql \fi-630\li630\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin630\itap0\pararsid8729548 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8729548\charrsid8812725 Reason:}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid9660424\charrsid8812725 \par }\pard \ltrpar\s1\ql \fi-630\li630\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin630\itap0\pararsid13578594 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid9660424 \page }{\rtlch\fcs1 \af38 \ltrch\fcs0 \f38\fs40\insrsid6035245\charrsid13578594 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt\f39\fs40}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs32\lang1033\langfe1033\langnp1033\insrsid89701\charrsid13578594 }{\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \b0\f38\fs32\ul\lang1033\langfe1033\langnp1033\insrsid89701\charrsid13578594 STEP 6: Transferee Facility Information}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs32\lang1033\langfe1033\langnp1033\insrsid89701\charrsid13578594 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid89701\charrsid13899638 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid7812807 NOTE:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid4222593\charrsid7812807 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid7812807 i}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid7812807 f more than }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid7812807 five (5}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\cf6\insrsid89701\charrsid7812807 ) facilities attach additional copies of this page.}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\cf6\insrsid89701\charrsid7812807 \par }\pard\plain \ltrpar\s19\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13899638 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs20\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\insrsid13899638\charrsid13189112 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid8792357 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 Facilities}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8792357 :}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid8792357\charrsid10649403 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid8792357 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10517904 number of facilities included in this }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid6978264 application}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10517904 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 __________ \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid8792357\charrsid10649403 \trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrdb\brdrw15 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10517904 facility 1:}{\rtlch\fcs1 \af1\afs4 \ltrch\fcs0 \b\scaps\fs4\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { \rtlch\fcs1 \af1\afs4 \ltrch\fcs0 \b\scaps\fs4\insrsid8792357\charrsid10649403 \trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrdb\brdrw15 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \trowd \irow4\irowband4\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10517904 facility 1:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8792357\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \scaps\fs20\ul\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \scaps\fs20\ul\insrsid8792357\charrsid10649403 \trowd \irow5\irowband5\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \trowd \irow6\irowband6\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps\fs16\ul\insrsid8792357\charrsid5843003 \trowd \irow7\irowband7\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow8\irowband8\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8792357 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8792357\charrsid10517904 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\f40\fs16\insrsid8792357\charrsid10517904 ddress of facility 2}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\fs16\insrsid8792357\charrsid10517904 :}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs20\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs20\insrsid8792357\charrsid10649403 \trowd \irow8\irowband8\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid5843003 \trowd \irow9\irowband9\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow10\irowband10\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow11\irowband11\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid8792357 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 acility 2}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid8792357 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid8792357\charrsid10649403 \cell }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 \trowd \irow11\irowband11\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow12\irowband12\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow13\irowband13\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow13\irowband13\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow14\irowband14\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10517904 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10517904 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10517904 acility }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 3:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\fs16\insrsid8792357\charrsid10517904 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\fs16\insrsid8792357\charrsid10517904 \trowd \irow14\irowband14\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow15\irowband15\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow16\irowband16\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow16\irowband16\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow17\irowband17\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 acility }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 3: }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8792357\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \trowd \irow17\irowband17\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow18\irowband18\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow19\irowband19\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow20\irowband20\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 acility 4}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 :\cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \trowd \irow20\irowband20\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 { \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow21\irowband21\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow22\irowband22\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow22\irowband22\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow23\irowband23\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 acility 4}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8792357\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \trowd \irow23\irowband23\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow24\irowband24\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow25\irowband25\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow25\irowband25\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow26\irowband26\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ivic }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 acility }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 5:}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \trowd \irow26\irowband26\ltrrow \ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow27\irowband27\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow28\irowband28\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow28\irowband28\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl \brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row \ltrrow }\trowd \irow29\irowband29\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ostal }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 ddress of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 f}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357\charrsid10649403 acility 5}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid8792357 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \fs14\insrsid8792357\charrsid3888096 (if different from the civic address)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 \trowd \irow29\irowband29\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 Number and Street: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow30\irowband30\ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow31\irowband31\lastrow \ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt\brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid10649403 City: \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Province}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid9659030 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030 Postal Code}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid9659030\charrsid10649403 : \par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8792357 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \cell }\pard \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid8792357\charrsid5843003 \trowd \irow31\irowband31\lastrow \ltrrow\ts11\trgaph108\trleft-108\trkeep\trbrdrt \brdrs\brdrw30 \trbrdrl\brdrs\brdrw30 \trbrdrb\brdrs\brdrw30 \trbrdrr\brdrs\brdrw30 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt \brdrs\brdrw10 \clbrdrl\brdrs\brdrw30 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx3103\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3211\clshdrawnil \cellx6314\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrdb\brdrw15 \clbrdrr\brdrs\brdrw30 \cltxlrtb\clftsWidth3\clwWidth3212\clshdrawnil \cellx9526\row }\pard \ltrpar \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\cf1\insrsid16724227 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16724227 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16724227 \page }{\rtlch\fcs1 \af38 \ltrch\fcs0 \f38\fs40\insrsid6035245\charrsid16724227 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt\f39\fs40}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs32\lang1033\langfe1033\langnp1033\insrsid89701\charrsid9589473 }{\rtlch\fcs1 \af38 \ltrch\fcs0 \f38\fs32\ul\insrsid89701\charrsid16724227 STEP 7: }{\rtlch\fcs1 \af0\afs32 \ltrch\fcs0 \scaps\f38\fs32\ul\lang1033\langfe1033\langnp1033\insrsid89701\charrsid9659030 Solvent and Degreasing Process Information}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs32\insrsid89701 \par }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid89701\charrsid16724227 \par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid89701 Solvent and }{\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid9974266 d}{ \rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid89701 egreasing }{\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid9974266 p}{\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid89701 rocess} {\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid9974266 :}{\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid89701 \cell }\pard\plain \ltrpar \ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\scaps\f38\fs16\cf1\insrsid89701 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth9634\clcbpatraw8\clshdngraw2000 \cellx9526\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid7544760\charrsid9974266 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ame of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 s}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 olvent for }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1835288\charrsid9974266 w}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 hich }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 onsumption }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nits were }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 i}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ssued}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 (select one only)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid7544760\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 TCE }{\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkstart Check1} FORMCHECKBOX }{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}} }{\fldrslt }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkend Check1} }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid7544760\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 PERC }{\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkstart Check2} FORMCHECKBOX }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\datafield 650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkend Check2} \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid7544760 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid7544760\charrsid9974266 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f38\fs16\cf1\insrsid89701 \trowd \irow1\irowband1\ltrrow \ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trrh287\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 { \rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid7544760\charrsid9974266 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 n}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ame of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 d}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 egreasing }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 p}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 rocess for }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid1835288\charrsid9974266 w}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 hich }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 onsumption }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nits were }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 i}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ssued}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 (select one only)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid7544760 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid7544760\charrsid9974266 \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid13964676\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid13964676\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 VAPOUR DEGREASER }{\field\flddirty\fldpriv{\*\fldinst { \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkstart Check3} FORMCHECKBOX }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\datafield 650000001400000006436865636b3300000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check3}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkend Check3} }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid13964676\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 COLD DEGREASER }{\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkstart Check4} FORMCHECKBOX }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\datafield 650000001400000006436865636b3400000000000000000000000000} {\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check4}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 {\*\bkmkend Check4} \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid7544760 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid7544760\charrsid9974266 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f38\fs16\cf1\insrsid89701 \trowd \irow2\irowband2\ltrrow \ts11\trgaph108\trrh287\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \b\scaps\fs8\insrsid12282557\charrsid9974266 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9974266 y}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid89701\charrsid9974266 ear to }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid1835288\charrsid9974266 w}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid89701\charrsid9974266 hich the }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9974266 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid89701\charrsid9974266 onsumption }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9974266 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid89701\charrsid9974266 nits }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9974266 a}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid89701\charrsid9974266 pply}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid9974266 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b\scaps\fs16\insrsid89701\charrsid9974266 ___________ \par }{\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \b\fs8\insrsid12282557\charrsid9974266 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f38\fs16\cf1\insrsid89701 \trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid12282557\charrsid9974266 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 e}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ffective }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 d}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ate of }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 c}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 onsumption }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nit }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ransfer}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 : }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 (dd/mm/yy)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid14576823\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid12282557\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid11548664\charrsid9974266 _______}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid12282557\charrsid9974266 /}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid11548664\charrsid9974266 ________}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid12282557\charrsid9974266 /}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid11548664\charrsid9974266 _______}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid12282557 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid12282557\charrsid9974266 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f38\fs16\cf1\insrsid89701 \trowd \irow4\irowband4\ltrrow \ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid12282557\charrsid9974266 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 onsumption }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nits }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 i}{ \rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ssued to the }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ransferor }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 efore }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ransfer}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid11548664\charrsid9974266 _______________}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 Kg}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 . \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid12282557 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid12282557\charrsid9974266 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\scaps\f38\fs16\cf1\insrsid89701 \trowd \irow5\irowband5\ltrrow \ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid12282557\charrsid9974266 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ransferor\rquote s }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nexpended }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 onsumption }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nits }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 b}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 efore }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid9974266 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ransfer}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid3879472 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid3879472 }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid11548664\charrsid9974266 _______________}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 Kg. \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid12282557 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid12282557\charrsid9974266 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f38\fs16\cf1\insrsid89701 \trowd \irow6\irowband6\ltrrow \ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row \ltrrow}\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\lang4105\langfe1033\langnp4105\insrsid12282557\charrsid9974266 \par }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid3879472 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nexpended }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid3879472 c}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 onsumption }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid3879472 u}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 nits to be }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid3879472 t}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ransferred}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid3879472 :}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 ___}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid11548664\charrsid9974266 _____}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \b0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 _______}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \scaps0\fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid9974266 Kg. \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid12282557 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs8 \ltrch\fcs0 \fs8\insrsid12282557\charrsid9974266 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \b\scaps\f38\fs16\cf1\insrsid89701 \trowd \irow7\irowband7\lastrow \ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth9634\clshdrawnil \cellx9526\row }\pard \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\cf1\insrsid89701\charrsid4219669 \par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid6035245 {\field{\*\fldinst SYMBOL 242 \\f "Monotype Sorts" \\s 20}{\fldrslt\f39\fs40}}}{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs40\insrsid89701 }{\rtlch\fcs1 \af0 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid89701 STEP 8: Signatures \par }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\ul\insrsid89701 \par }{\rtlch\fcs1 \af38\afs32 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid14310638 Transferor:}{\rtlch\fcs1 \af38\afs32 \ltrch\fcs0 \scaps\f38\fs32\ul\insrsid4219669 \par }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \scaps\f0\fs12\insrsid14310638\charrsid14310638 \par \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 I, _____________________}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4219669\charrsid6775270 ___}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 ________, }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 (print name of transferor or person who is authorized to act on behalf of transferor)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 the transferor}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b0\scaps0\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 declare that the information provided in this solvent degreasing consumptio n unit transfer application is correct. \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 Date: }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4154591\charrsid6775270 _____________________}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 Place: ___________________}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4154591\charrsid6775270 _}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 Total number of pages in this application: }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4154591\charrsid6775270 _____}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4154591 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid4154591\charrsid6775270 \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4154591\charrsid6775270 _______________________________________________}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par Signature\~of transferor, or of person who is authorized to act on behalf of the transferor.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid89701 \par }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\lang4105\langfe1033\langnp4105\insrsid4154591 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14310638 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\insrsid14310638\charrsid14310638 \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\lang4105\langfe1033\langnp4105\insrsid4154591\charrsid4154591 \par }{\rtlch\fcs1 \af38\afs32 \ltrch\fcs0 \b0\f38\fs32\ul\lang4105\langfe1033\langnp4105\insrsid14310638 Transferee:}{\rtlch\fcs1 \af38\afs32 \ltrch\fcs0 \b0\f38\fs32\ul\lang4105\langfe1033\langnp4105\insrsid4154591\charrsid14310638 \par }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\lang4105\langfe1033\langnp4105\insrsid4154591 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid14310638 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\insrsid14310638\charrsid14310638 \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 I, __________________________}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4154591\charrsid6775270 ____}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 ___, }{\rtlch\fcs1 \af1\afs14 \ltrch\fcs0 \b0\scaps0\fs14\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 (print name of transferee or person who is authorized to act on behalf of transferee)}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 the transferee}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b0\scaps0\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 undertake to use each transferred consumption unit in the same year and in the same degreasing process for which the transferor\rquote s consumption unit was issued; and, \par I declare that the information provided in this solvent degreasing consumption unit transfer application is correct. \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 Date: }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4154591\charrsid6775270 ____________________}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 Place: ___________________ \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4154591 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang1033\langfe1033\langnp1033\insrsid4154591\charrsid6775270 \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang1033\langfe1033\langnp1033\insrsid4525116\charrsid6775270 \par }\pard\plain \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4154591\charrsid6775270 ___________________________________________________}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid6775270 \par Signature\~of transferee, or of person who is authorized to act on behalf of the transferee.}{\rtlch\fcs1 \af0 \ltrch\fcs0 \f0\lang4105\langfe1033\langnp4105\insrsid8222557 \par }\pard \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\itap0\pararsid8222557 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\lang1033\langfe1033\langnp1033\insrsid4525116\charrsid2762239 \page }{ \rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\lang1033\langfe1033\langnp1033\insrsid6035245\charrsid2762239 \par \ltrrow}\trowd \irow0\irowband0\lastrow \ltrrow\ts11\trgaph108\trleft-108\trbrdrt\brdrs\brdrw15 \trbrdrl\brdrs\brdrw15 \trbrdrb\brdrs\brdrw15 \trbrdrr\brdrs\brdrw15 \trbrdrh\brdrs\brdrw15 \trbrdrv\brdrs\brdrw15 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw15 \clbrdrl\brdrs\brdrw15 \clbrdrb\brdrs\brdrw15 \clbrdrr\brdrs\brdrw15 \clcbpat8\clshdng2000\cltxlrtb\clftsWidth3\clwWidth10190\clcbpatraw8\clshdngraw2000 \cellx10082\pard \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid89701\charrsid9589473 \page }{\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \f0\fs12\lang1033\langfe1033\langnp1033\insrsid4741667\charrsid4741667 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 This solvent degreasing consumption unit tran}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1254672\charrsid11548766 s}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 fer application}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4741667\charrsid11548766 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 must be submitted}{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid4741667\charrsid11548766 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 for approval}{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid4741667\charrsid11548766 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid9660424\charrsid11548766 befo}{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 re the transfer {\*\xmlopen\xmlns2{\factoidname address}} {\*\xmlopen\xmlns2{\factoidname Street}}takes }{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid4741667\charrsid11548766 place}{\rtlch\fcs1 \af1 \ltrch\fcs0 \ul\lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 {\*\xmlclose}{\*\xmlclose} \par }{\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 Submit the completed and signed solvent degreasing consumption unit tran}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid1254672\charrsid11548766 s}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 fer application}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4741667\charrsid11548766 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid4741667\charrsid11548766 by mail to:}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid89701\charrsid11548766 \par }\pard\plain \ltrpar\qc \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\insrsid89701\charrsid11548766 \par }\pard\plain \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid2762239 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \b\scaps\f1\fs20\lang3084\langfe1033\cgrid\langnp3084\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid2762239\charrsid12454701 Solvent Degreasing Coordinator \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1036\langfe1033\langnp1036\insrsid2762239\charrsid2762239 products division, chemicals sector directorate \par Environment Canada \par }\pard \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid7078438 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7078438 351 St. Joseph Blvd \par Gatineau, Quebec}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid7078438 \par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang2058\langfe1033\langnp2058\insrsid7078438 K1A 0H3 \par }\pard \ltrpar\s1\ql \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid7078438 {\rtlch\fcs1 \af1\afs12 \ltrch\fcs0 \fs12\lang2058\langfe1033\langnp2058\insrsid7078438 \par \par \par }\pard \ltrpar\s1\qc \li0\ri0\keepn\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0\pararsid7078438 {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7078438 For assistance, call: }{\rtlch\fcs1 \af0 \ltrch\fcs0 \lang1033\langfe1033\langnp1033\insrsid7078438 1-888-391-3426}{\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7078438 or email: }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af0\afs19 \ltrch\fcs0 \fs19\lang1033\langfe1033\langnp1033\insrsid7078438\charrsid7078438 HYPERLINK "mailto:products.produits@ec.gc.ca" }}{\fldrslt {\rtlch\fcs1 \af0\afs19 \ltrch\fcs0 \cs21\fs19\ul\cf2\lang1033\langfe1033\langnp1033\insrsid7078438 products.produits@ec.gc.ca} }}\sectd \ltrsect\psz1\linex0\headery706\footery706\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \lang4105\langfe1033\langnp4105\insrsid7078438 \par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid11420188 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \f1\fs24\lang4105\langfe1033\cgrid\langnp4105\langfenp1033 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 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