ࡱ> O Jbjbjyy Bʋeʋec|&F&FkTkTkTkTkTTTT8T V|Tی0?^?^(g^g^g^_a1bTZ\\\\\\$ kTXc__XcXckTkTg^g^4qqqXckTg^kTg^ZqXcZqqpDg^[hvRd&F0یڄBd&LJkTfb0b"qbbebbbmbbbیXcXcXcXcbbbbbbbbb&F 1S: Eye Conditions Disability Benefits Questionnaire FIRST NAME, LAST NAME, MIDDLE NAME (SUFFIX):SOCIAL SECURITY NUMBER/FILE NUMBER:TODAYS DATE:HOME ADDRESS:EXAMINING LOCATION AND ADDRESS:HOME TELEPHONE: CONTRACTOR:VES NUMBER:VA CLAIM NUMBER:VES IMPORTANT - THE DEPARTMENT OF VETERANS AFFAIRS (VA) WILL NOT PAY OR REIMBURSE ANY EXPENSES OR COST INCURRED IN THE PROCESS OF COMPLETING AND/OR SUBMITTING THIS FORM. PLEASE READ THE PRIVACY ACT AND RESPONDENT BURDEN INFORMATION ON REVERSE BEFORE COMPLETING FORM. NOTE: This examination must be conducted by a licensed ophthalmologist or by a licensed optometrist. The examiner must identify the disease, injury or other pathologic process responsible for any decrease in visual acuity or other visual impairment found. Examinations of visual fields or muscle function should be conducted ONLY when there is a medical indication of disease or injury that may be associated with visual field defect or impaired muscle function. If indicated to address requested claim, and not medically indicated, dilated fundus exam required. Is this questionnaire being completed in conjunction with a VA21-2507, C & P examination Request? X Yes ( No How was the examination completed (check all that apply)? ( In-person examination ( Records reviewed If a record review was completed in conjunction with the exam, please select this option in addition to the correct exam type. ( Examination via approved video Tele-C&P All Tele-C&P exams must be pre-approved with VES and must be completed via HIPAA-compliant video platform. ( Other, please specify in comments box: Comments: ACCEPTABLE CLINICAL EVIDENCE (ACE) INDICATE METHOD USED TO OBTAIN MEDICAL INFORMATION TO COMPLETE THIS DOCUMENT: NOTE: All exams are expected to be completed via an in-person examination unless use of the ACE process or Tele-C&P has been pre-approved with VES. ( Review of available records (without in-person or video Tele-C&P examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the questionnaire and such an examination will likely provide no additional relevant evidence. PLEASE NOTE: You may only complete the exam using this method if the ACE process was pre-approved with VES, the records sufficiently reflect the current condition, and a telephone interview or in-person exam would likely provide no additional relevant evidence. If it was determined a telephone interview was not necessary to complete the exam via the ACE process, please provide the reason: If a phone interview was attempted but could not be completed, please specify the number of attempts made: NOTE: If a phone interview is needed in order to complete the DBQ but the Veteran is unable to be reached after multiple attempts, please notify VES. ( Review of available records in conjunction with an interview with the Veteran (without in-person or Tele-C&P examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the questionnaire and such an examination would likely provide no additional relevant evidence. If the ACE process was pre-approved with VES and the records do not sufficiently reflect the current condition, a telephone interview is required. Please provide the date and time of the phone interview: EVIDENCE REVIEW *NOTE: If you reviewed the records and are unsure which option to select you may select "VA e-folder" and the QA will ensure that the correct option is selected on the final report. Evidence reviewed (check all that apply): ( Not requested ( VA claims file (hard copy paper C-file) ( VA e-folder ( VA Computerized Patient Record System (CPRS) ( Other (please identify other evidence reviewed):( No records were reviewedEvidence comments: ( All available records were reviewed and findings considered when completing this DBQ. NOTE: Selecting this option will auto-generate this statement into the Evidence Comments box in the final report for you, as well as any additional comments made below. Additional evidence comments: SECTION I - DIAGNOSIS NOTE: The diagnosis section should be filled out AFTER the clinician has completed the examination NOTE: VA will not accept incomplete diagnoses such as Glaucoma suspect or Pre-glaucoma. If you suspect glaucoma is beginning to develop but have insufficient evidence to render a firm diagnosis, please state so in the Remarks section and VES will notify the Veteran of the need to seek follow up evaluation with his/her PCP to be monitored for development of the condition. 1A. Does the Veteran currently have an eye condition (other than congenital or developmental errors of refraction)? ( Yes ( No (If Yes, provide only diagnoses that pertain to eye conditions:) Diagnosis #1:ICD code:Date of diagnosis: Diagnosis #2:ICD code:Date of diagnosis: Diagnosis #3:ICD code:Date of diagnosis:1B. If there are additional diagnoses that pertain to eye conditions, list using above format: SECTION II - MEDICAL HISTORY *NOTE: PLEASE PROVIDE AS MANY SPECIFIC DETAILS REGARDING THE HISTORY OF THE VETERANS CLAIMED CONDITION AS POSSIBLE. 2. Describe the history (including onset and course) of the Veterans current eye condition(s) (brief summary). Date of onset: Details of onset: Course of the condition since onset: If multiple options are selected, please explain your reasoning in the Other textbox below. ( Progressed/Worsened ( Stayed the same ( Improved ( Resolved ( Other, please describe: Current symptoms (or state if the condition has resolved): Any treatment, medications or surgery? Any previous x-rays/labs/testing (If not available for review, simply state so)? ( Yes ( No ( Not available for review NOTE: If yes, please address any previous testing that was reviewed in the Remarks section. SECTION III - PHYSICAL EXAMINATION 1. VISUAL ACUITY Visual acuity should be reported according to the lines on the Snellen chart or its equivalent. If assessment of the Veteran's visual acuity falls between two lines on the Snellen chart, round up to the higher (worse) level (poorer vision) for answers a-d below. (For example, 20/60 would be reported as 20/70; 20/80 would be reported as 20/100, etc.) Examination of visual acuity must include central uncorrected and corrected visual acuity for distance and near vision. Evaluate visual acuity on the basis of corrected distance vision with central fixation. Visual acuity should not be determined with eccentric fixation or viewing. If refraction is needed in order to evaluate visual acuity please do so. A Veterans lack of up-to-date corrective lenses is not a valid reason for being unable to determine whether corrected visual acuity is 20/20 or better. a. Uncorrected distance: RIGHT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterLEFT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterb. Corrected distance: RIGHT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterLEFT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterc. Uncorrected Near (Reading): RIGHT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterLEFT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterd. Corrected Near (Reading): RIGHT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterLEFT: ( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or better2. DIFFERENCE IN CORRECTED VISUAL ACUITY FOR DISTANCE AND NEAR VISION a. Does the Veteran have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse? ( Yes ( No (If Yes, complete items 2b thru 2d) b. Provide a second recording of corrected distance and near vision Second recording of corrected distance vision: RIGHT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterLEFT: ( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterSecond recording of corrected near vision: RIGHT:( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or betterLEFT: ( 5/200 or worse( 10/200( 15/200( 20/200( 20/100( 20/70( 20/50( 20/40( 20/20 or better . Explain reason for the difference between distance and near corrected vision: d. Does the lens required to correct distance vision in the poorer eye differ by more than 3 diopters from the lens required to correct distance vision in the better eye? ( Yes ( No (If Yes, explain reason for the difference): 3. PUPILS a. Pupil diameter: Right:mmLeft:mmb. Pupils are round and reactive to light? ( Yes ( No c. Is an afferent pupillary defect present? ( Yes ( No (If Yes, indicate affected eye): ( Right ( Left ( Both d. ( Other (Describe): Eye affected: ( Right ( Left ( Both 4. ANATOMICAL LOSS, LIGHT PERCEPTION ONLY, EXTREMELY POOR VISION OR BLINDNESS a. Does the Veteran have anatomical loss, light perception only, extremely poor vision or blindness of either eye? ( Yes ( No (If Yes, complete items 4b thru 4f) b. Does the Veteran have anatomical loss of either eye? ( Yes ( No If Yes, indicate affected eye: ( Right ( Left ( Both If Yes, is the Veteran able to wear an ocular prosthesis? ( Yes ( No If No, provide reason: c. Is the Veterans vision limited to no more than light perception only in either eye? ( Yes ( No If Yes, indicate for which eye(s) the Veterans vision is limited to no more than light perception: ( Right ( Left ( Both d. Is the Veteran able to recognize test letters at 1 foot or closer? ( Yes ( No If No, indicate with which eye(s) the Veteran is unable to recognize test letters at 1 foot or closer: ( Right ( Left ( Both e. Is the Veteran able to perceive objects, hand movements, or count fingers at 3 feet? ( Yes ( No If No, indicate with which eye(s) the Veteran is unable to perceive objects, hand movements, or count fingers at 3 feet: ( Right ( Left ( Both f. Does the Veteran have visual acuity of 20/200 or less in the better eye with use of a correcting lens based upon visual acuity loss (i.e. USA statutory blindness with bilateral visual acuity of 20/200 or less)? ( Yes ( No 5. ASTIGMATISM a. Does the Veteran have a corneal irregularity that results in severe irregular astigmatism? ( Yes ( No (If Yes, complete items 5b and 5c) b. Does the Veteran customarily wear contact lenses to correct for the above corneal irregularity? ( Yes ( No If Yes, does using contact lenses result in more visual improvement than using the standard spectacle correction? ( Yes ( No c. Was the corrected visual acuity determined using contact lenses? ( Yes ( No If No, explain: 6. DIPLOPIA a. Does the Veteran have diplopia (double vision)? ( Yes ( No (If Yes, complete items 6b thru 6e) b. Provide etiology (such as traumatic injury, thyroid eye disease, myasthenia gravis, etc.): NOTE: For VA purposes, examiners must use either a Goldmann perimeter chart or the Tangent Screen method identifying the four major quadrants (upward, downward, left lateral, and right lateral) and the central fields (20 degrees or less). c. Indicate the areas where diplopia is present (the fields in which the Veteran sees double using binocular vision): ( Central 20 degrees ( 21 to 30 degrees ( Down ( Lateral ( Up ( 31 to 40 degrees ( Down ( Lateral ( Up ( Greater than 40 degrees ( Down ( Lateral ( Up d. Indicate frequency of the diplopia: ( Constant ( Occasional If occasional, indicate frequency of diplopia and most recent occurrence: e. Is the diplopia correctable with standard spectacle correction? ( Yes ( No If No, is the diplopia correctable with standard spectacle correction that includes a special prismatic correction? ( Yes ( No 7. TONOMETRY a. If tonometry was performed, provide results: Right eye pressure:Left eye pressure:b. Tonometry method used: ( Goldmann applanation ( Other (Describe): 8. SLIT LAMP AND EXTERNAL EYE EXAM Please address all abnormal findings via an appropriate diagnosis in Section I above. a. Slit lamp: ( Normal bilaterally ( Abnormal (If Abnormal, complete items 8b thru 8g) b. External exam/lids/lashes: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):c. Conjunctiva/sclera: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):d. Cornea: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):e. Anterior chamber: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe): f. Iris: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):g. Lens: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):9. INTERNAL EYE EXAM (FUNDUS) Please address all abnormal findings via an appropriate diagnosis in Section I above. a. Fundus: ( Normal bilaterally ( Abnormal (If Abnormal, complete items 9b thru 9f) b. Optic disc: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):c. Macula: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):d. Vessels: Right ( Normal ( Other (Describe)::Left( Normal ( Other (Describe):e. Vitreous: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):f. Periphery: Right ( Normal ( Other (Describe):Left( Normal ( Other (Describe):10. VISUAL FIELDS Please note visual field testing is only required when a visual field defect is documented or suspected based on the eye conditions present, or in order to document diplopia in Section III.6 above. If testing reveals a visual field defect, please complete this section and submit a copy of the results to VES. If no visual field defect is suspected or found on exam, this section should be answered No and a VFT is not required unless otherwise directed by section III.6 above (i.e. if diplopia is present). a. Does the Veteran have a documented visual field defect? ( Yes ( No (If Yes, complete items 10b thru 10f) NOTE: For VA purposes, examiners must perform visual field testing using either Goldmann kinetic perimetry or automated perimetry using Humphrey Model 750, Octopus Model 101, or later versions of these perimetric devices with simulated kinetic Goldmann testing capability. The results must be documented for at least 16 meridians 22-degrees apart for each eye. If additional testing is necessary to evaluate visual fields, it must be conducted using either a tangent screen or a 30-degree threshold visual field with the Goldmann III stimulus size, and the results must be documented on the examination report. b. Was visual field testing performed? ( Yes ( No Results: ( Using Goldmanns equivalent III/4e target ( Using Goldmanns equivalent IV/4e target (used for aphakic individuals not well adapted to contact lens correction or pseudophakic individuals not well adapted to intraocular lens implant) ( Other (Describe): c. Does the Veteran have contraction of a visual field? ( Yes ( No (If Yes, complete the following chart): MeridianNormal DegreesRight Eye (OD) Actual Degrees (Cannot exceed the normal degrees)Left Eye (OS) Actual Degrees (Cannot exceed the normal degrees)Up (90 OD/90 OS)45Up Temporally (45 OD/135 OS)55Temporally (0 OD/180 OS)85Down Temporally (315 OD/225 OS)85Down (270 OD/270 OS)65Down Nasally (225 OD/315 OS)50Nasally (180 OD/0 OS)60Up Nasally (135 OD/45 OS)55d. Does the Veteran have loss of a visual field? ( Yes ( No (If Yes, check all that apply and indicate eye affected) ( Homonymous hemianopsia( Right( Left( Both( Loss of temporal half of visual field( Right( Left( Both( Loss of nasal half of visual field( Right( Left( Both( Loss of inferior half of visual field( Right( Left( Both( Loss of superior half of visual field( Right( Left( Both( Other (Specify):e. Does the Veteran have a scotoma? ( Yes ( No (If Yes, check all that apply and indicate eye affected) ( Scotoma affecting at least 1/4 of the visual field( Right( Left( Both( Centrally located scotoma( Right( Left( Bothf. Does the Veteran have legal (statutory) blindness based upon visual field loss (visual field diameter of 20 degrees or less in the better eye, even if the corrected visual acuity is 20/20)? ( Yes ( No SECTION IV - EYE CONDITIONS Does the Veteran have any of the following eye conditions? ( Yes ( No (If No, proceed to Section V) (If Yes, check all that apply): ( External Eye Condition, including the eyelash, eyelid, and eyebrow(Complete item 2 below)( Lacrimal System Conditions, including Dry Eye Syndrome(Complete item 3 below)( Cornea/Conjunctiva Conditions(Complete item 4 below)( Glaucoma(Complete item 5 below)( Uveal Tract Conditions(Complete item 6 below)( Lens Conditions, including Cataracts(Complete item 7 below)( Retina, Macula, or Vitreous Conditions(Complete item 8 below)( Neuro-Ophthalmic Conditions(Complete item 9 below)( Ocular Neoplasms(Complete item 10 below)( Trauma/Hemorrhage(Complete item 11 below)( Other Eye Conditions(Complete item 12 below)2. EXTERNAL EYE CONDITION, INCLUDING THE EYELASH, EYELID, AND EYEBROW a. Indicate the Veterans condition and side affected (check all that apply): ( Ectropion( Right( Left( Both( Entropian( Right( Left( Both( Lagophthalmos( Right( Left( Both( Complete loss of eyebrows ( Right( Left( Both( Complete loss of eyelashes( Right( Left( Both( Partial or complete loss of eyelid( Right( Left( Both( Pterygium( Right( Left( Both( Pinguecula( Right( Left( Both( Symblepharon( Right( Left( Both( Other (Describe):( Right( Left( Bothb. Is the Veterans decrease in visual acuity or other visual impairment, if present, attributable to an external eye condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify the external condition(s) responsible for visual impairment: If No, explain: 3. LACRIMAL SYSTEM CONDITIONS, INCLUDING DRY EYE SYNDROME a. Does the Veteran have a disorder of the lacrimal apparatus, to include epiphora, dacryocystitis, etc.? ( Yes ( No If Yes, specify condition and side affected: ( Right ( Left ( Both b. Is the Veterans decrease in visual acuity or other visual impairment attributable to a lacrimal system condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify the lacrimal system condition(s) responsible for visual impairment: If No, explain: c. Does the Veteran have dry eye syndrome? ( Yes ( No (If Yes, please complete items 3d through 3h) d. Indicate the eye affected by dry eye syndrome: ( Right ( Left ( Both e. Date dry eye syndrome began:f. Has the Veteran ever had elective procedures, such as laser eye surgery (e.g. LASIK)? ( Yes ( No If Yes, specify which eye, procedure and date: ( Right ( Left ( Both Name or description of procedure:   Date(s) of procedure:Did dry eye syndrome begin after the elective procedure? ( Yes ( No g. Indicate the types of treatment used to treat dry eye syndrome: ( No treatment ( Over-the-counter artificial tear drops ( Prescription medications ( Special contact lenses ( Plugs to block the tear ducts through which tears drain ( Surgical procedures Name or description of surgical procedure:  Date(s) of surgery:( Other (Describe):  h. Is the Veterans decrease in visual acuity or other visual impairment attributable to dry eye syndrome? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify the dry eye syndrome condition(s) responsible for visual impairment:  If No, explain:  4. CORNEA/CONJUNCTIVA CONDITIONS a. Indicate the Veterans condition and side affected: ( Keratopathy( Right( Left( Both ( Trachomatous conjunctivitis (Indicate if it is active or inactive for each eye)( Right ( Left( Active ( Active( Inactive ( Inactive ( Chronic conjunctivitis (non trachomatous) (Indicate if it is active or inactive for each eye)( Right ( Left( Active ( Active( Inactive ( Inactive ( Keratoconus( Right( Left( Both ( Corneal transplant( Right( Left( Both ( Other (Describe):( Right( Left( Bothb. Is the Veterans decrease in visual acuity or other visual impairment attributable to a corneal condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify the corneal condition(s) responsible for visual impairment:  If No, explain:  c. If the Veteran had a corneal transplant, please indicate the current residual(s): (Check all that apply): ( No current residuals( Right( Left( Both( Pain( Right( Left( Both( Photophobia( Right( Left( Both( Glare sensitivity( Right( Left( Both( Other (Describe):( Right( Left( Both5. GLAUCOMA a. Specify the type of glaucoma: ( Angle-closure Eye affected: ( Right ( Left ( Both ( Open-angle Eye affected: ( Right ( Left ( Both ( Other, specify type (For example, neovascular, phakolytic, etc.) Eye affected: ( Right ( Left ( Both b. Does the glaucoma require continuous medication for treatment? ( Yes ( No If Yes, list medication(s) used for treatment of glaucoma: c. Is the Veteran's decrease in visual acuity or other visual impairment, if present, attributable to glaucoma? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If No, explain: 6. UVEAL TRACT CONDITIONS a. Indicate the Veterans condition and eye affected: ( Choroidopathy (including uveitis, iritis, cyclitis, or choroiditis)( Right( Left( Both( Scleritis( Right( Left( Both( Tuberculosis of the eye (indicate if it is active or inactive for each eye)( Right( Active( Inactive( Left( Active( Inactive ( Other (Describe):( Right( Left( Bothb. Is the Veterans decrease in visual acuity or other visual impairment, if present, attributable to an uveal tract eye condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify uveal tract condition(s) responsible for visual impairment: If No, explain: 7. LENS CONDITIONS, INCLUDING CATARACTS a. Indicate cataract condition: ( Preoperative (cataract is present) Eye affected: ( Right ( Left ( Both ( Postoperative (cataract has been removed) Eye affected: ( Right ( Left ( Both Is there a replacement intraocular lens? (pseudophakia) ( Yes ( No If Yes, indicate eye: ( Right ( Left ( Both b. Is there aphakia or dislocation of the crystalline lens? ( Yes ( No If Yes, indicate eye: ( Right ( Left ( Both c. Is the Veterans decrease in visual acuity or other visual impairment, if present, attributable to any of the eye conditions checked above in this section? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify condition in this section responsible for visual impairment: If No, explain: 8. RETINA, MACULA, OR VITREOUS CONDITIONS a. Indicate retina, macula, or vitreous condition and eye affected: ( Diabetic retinopathy (including proliferative and nonproliferative types)( Right( Left( Both( Retinopathy, not otherwise specified( Right( Left( Both( Maculopathy, not otherwise specified( Right( Left( Both( Localized retinal scars, atrophy, or irregularities, that are centrally located and result in irregular, duplicated, enlarged, or diminished image( Right( Left( Both( Detachment of retina( Right( Left( Both( Retinal dystrophy (including retinitis pigmentosa, wet or dry macular degeneration, early-onset macular degeneration, rod and/or cone dystrophy)( Right( Left( Both( Other (Describe):( Right( Left( Bothb. Is the Veterans decrease in visual acuity or other visual impairment attributable to a retina, macula, or vitreous condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify the retina, macula, or vitreous condition(s) responsible for visual impairment: If No, explain: 9. NEURO-OPHTHALMIC CONDITIONS a. Indicate the Veterans condition and side affected: ( Ptosis( Right( Left( Both( Optic neuropathy( Right( Left( Both( Paralysis of accommodation due to neuropathy of the oculomotor nerve (3rd cranial nerve)( Right( Left( Both( Post-chiasmal disorders( Right( Left( BothIf there is a post-chiasmal disorder, indicate the underlying cause: ( Cerebrovascular accident (CVA) ( Demyelinating disease ( Intracranial mass/tumor ( Traumatic Brain Injury (TBI) ( Alzheimers Disease ( Other Specify the underlying neurologic condition (for example: Jakob-Creutzfeldt disease, etc.): b. Does the Veteran have nystagmus? ( Yes ( No If Yes, is it central? ( Yes ( No c. Is the Veterans decrease in visual acuity or other visual impairment attributable to a neuro-ophthalmic condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment: If Yes, specify the neuro-ophthalmic condition(s) responsible for visual impairment: If No, explain: 10. OCULAR NEOPLASMS a. Indicate the Veterans condition and eye affected: ( Malignant neoplasm of the eye, orbit, or adnexa (excluding skin)( Right( Left( Both( Benign neoplasm of the eye, orbit, or adnexa (excluding skin)( Right( Left( Both( Other (Describe):( Right( Left( Bothb. Is the Veterans decrease in visual acuity or other visual impairment attributable to an eye neoplasm condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify the neoplasm condition responsible for visual impairment: If No, explain: c. Is the neoplasm active or in remission? ( Active ( Remission d. Has the Veteran completed treatment or is the Veteran currently undergoing treatment for a benign or malignant neoplasm of the eye, orbit, or adnexa (excluding skin) or metastases? ( Yes ( No, watchful waiting If Yes, indicate type of treatment the Veteran is currently undergoing or has completed (check all that apply): ( Treatment completed; currently in watchful waiting status ( Surgery (more extensive than enucleation) Name or description of surgical procedure: Date(s) of surgery:( Radiation therapy (to include, but not limited to x-ray therapy more extensive than to the area of the eye) Date of most recent treatment:Date of completion of treatment or anticipated date of completion:( Systemic chemotherapy Date of most recent treatment:Date of completion of treatment or anticipated date of completion:( Other therapeutic procedure Name or description of procedure: Date of most recent procedure:e. Does the Veteran currently have any residual conditions or complications due to the neoplasm (including metastases) or its treatment, other than those already documented in the report above? ( Yes ( No If Yes, list residual conditions and complication (brief summary): 11. TRAUMA/HEMORRHAGE a. Indicate condition, and eye affected: ( Intraocular hemorrhage( Right( Left( Both( Unhealed eye injury, inclusive of orbital trauma as well as penetrating and non-penetrating eye injury( Right( Left( Both( Other (Describe):( Right( Left( Bothb. Is the Veteran's decrease in visual acuity or other visual impairment attributable to an eye hemorrhage or trauma? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify the hemorrhage or trauma condition responsible for visual impairment: If No, explain: 12. OTHER EYE CONDITION(S) NOT COVERED BY ITEMS 2 THROUGH 11 Please use this section to document any diagnosed eye conditions not addressed in the specific subsections above. a. Does the Veteran have any other eye conditions, pertinent physical findings, complications, signs, and/or symptoms related to a current eye diagnosis? ( Yes ( No If Yes, describe: b. Is the Veterans decrease in visual acuity or other visual impairment attributable to this condition? ( Yes ( No ( There is no decrease in visual acuity or other visual impairment If Yes, specify condition(s) responsible for visual impairment:  If No, explain: SECTION V - SCARRING AND DISFIGUREMENT 1. Does the Veteran have scarring or disfigurement attributable to any eye condition? ( Yes ( No (If Yes, complete appropriate dermatological DBQ) *NOTE: Only visible scars on the actual eye itself require the addition on the Scar DBQ. SECTION VI - INCAPACITATING EPISODES NOTE: For the purposes of evaluation under 38 CFR 4.79, an incapacitating episode is an eye condition serious enough to require a clinic visit to a provider specifically for treatment purposes. Examples of treatment may include but are not limited to: Systematic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions. 1. During the past 12 months, has the Veteran had any incapacitating episodes attributable to any eye condition? ( Yes ( No If Yes, specify the eye condition(s) causing incapacitating episodes: Indicate the number of DOCUMENTED medical visits for treatment of any eye condition over the past 12 months: ( At least 1 but less than 3 ( At least 3 but less than 5 ( At least 5 but less than 7 ( 7 or more Indicate the type of intervention that occurred during the incapacitating episode (Check all that apply): ( Systemic immunosuppressant or biologic agent (name of medication): ( Intravitreal or periocular injections (name of medication): ( Laser treatments ( Surgical intervention (Describe): ( Other (Describe): SECTION VII - FUNCTIONAL IMPACT 1. Does the Veterans eye condition(s) impact his or her ability to work? ( Yes ( No If Yes, describe the impact of each of the Veterans eye condition(s), providing one or more examples: *NOTE: If the Veteran is retired, please respond to this question as though the Veteran was not retired (to the greatest extent possible). SECTION VIII - REMARKS 1. Remarks (If any): Is there a need for the Veteran to follow up with his/her primary care provider regarding any life threatening findings in this examination (not limited to claimed condition(s))? ( Yes ( No If Yes, was the Veteran notified to follow up with his/her primary care provider? ( Yes ( No Was a copy of the test result identifying the life threatening condition/findings provided to the Veteran or Veterans primary care provider? ( Yes ( No SECTION IX - OPTOMETRIST/PHYSICIAN'S CERTIFICATION AND SIGNATURE CERTIFICATION - To the best of my knowledge, the information contained herein is accurate, complete and current. 9A. OPTOMETRIST/PHYSICIANS SIGNATURE:9B. OPTOMETRIST/PHYSICIANS PRINTED NAME:9C. DATE SIGNED:9D. OPTOMETRIST/PHYSICIANS PHONE NUMBER:1-877-637-83879E. OPTOMETRIST/NATIONAL PROVIDER IDENTIFIER (NPI) NUMBER AND MEDICAL LICENSE NUMBER AND STATE:9F. OPTOMETRIST/PHYSICIANS ADDRESS:, , 9G. OPTOMETRIST/PHYSICIANS SPECIALTY:     Eye Conditions Disability Benefits Questionnaire Name: VA Form 21-0960N-2VA Claim Number: Page  PAGE \* Arabic \* MERGEFORMAT 9 of  NUMPAGES \* Arabic \* MERGEFORMAT 17Contractor: VES 345;AFXax    G S W `    ! M O ȿȿοοοΞzne_ h(-aJh(-h(-aJh(-h(-5\aJ hC8h(-hhC8h0J[ hC8hhC8h0J h(-0Jh`5h0J[6] h0JSh`5h0J[h`5h0JS h6?0JS h`5hhC8h9B*aJphh(- hC8h hC8h9jhC8h9U$345b}ttt $Ifgd6gdbkd9$$Ifl0\( $ t644 lapyt  8$Ifgd` 6$Ifgd` $Ifgd9pggg $Ifgd6kd(:$$IfsF"*  t0T    44 sasyt6pgg $Ifgd6kd:$$IfsF"*  t0T    44 sasyt6zz $Ifgd6|kd;$$Ifs0*  t0T44 sasyt6xx $Ifgd6}kd5<$$Ifs40* ` t0T44 sasyt6xx $Ifgd6}kd<$$Ifs40*  t0T44 sasyt6 zqqq $Ifgd6gdkd=$$Ifs480*  t0T44 sasyt6    >555 $Ifgd6kdP>$$IfTsFo jj  t0    44 s` a?pyt6T     N >7772gd(-gd(-kd?$$IfTsFo jj  t0    44 s` a?pyt6TN O  % 9bcmn $Ifgd(-ogd3ngd3ngd(-(gd(- 7$8$H$gd(-gd(- O Q W d     $ % 89:PQabckqЬxoxkh?yh|h30J h@nh3 joh@nh35h_h30J hah3 johah35 h4Th(- h4th(-h(-h3hC8h(-PJ johC8h(-0JShC8h(-0JS hh hC8h(- h(-h(- h3aJ h(-aJ h"DaJ*nopq kkdKA$$Ifsh* t044 sayt3 $Ifgd(-kkd@$$Ifsh* t044 sayt3qv=>?@zgkdA$$Ifs )) t0644 sa'yt ? $Ifgd ?(gdpc)gd?ygdl gd?y +uvwxYfEL=AEFGHyz/^kLǾwǾsjjh<hpc0Jhz2hpchpcB*phh|hpc0J hpc\aJ hUhpch|hpc0Jh|hpc0Jh?yh3hpc huih?yh}!h?yaJ joh}!h?y5aJ hpc5aJhQjhpc0JhQjhpc0Jhuih?y0JSPJhl 0JSPJ(@A $Ifgd ?hgdpcgkd|B$$Ifs )) t0644 sa'yt ?&gkdC$$Ifs )) t0644 sa'yt ? $Ifgd ?gkd$C$$Ifs )) t0644 sa'yt ?FMgkdtD$$Ifs )) t0644 sa'yt ? $Ifgd ?(gdpc)gd?ycgdpcLMOPbxz{|$%&@DMVWXYɱɱɱɱɡɱɱɍrhhD\hpc5\ johD\hpc5\ hyahpc hvhpch(-h5\aJ hhhhUh(-5\aJ johUh(-5\aJhUh(-0J hUh(-h(-0JPJ *h(jh(-0JPJh hC8h hpc\aJhpc hpc0J(Pz$? $Ifgd(-)gd(-gd(-gdgkdE$$Ifs )) t0644 sa'yt ? ?@AB#lkd0F$$Ifs*) t0+6z44 sayt(- o$If^gd(-bkdE$$Ifl0*Z t+644 lapyt(-BCDWXvw{vm $Ifgd ?(gdpc)gdpcAgdpclkdF$$Ifs*) t0+6z44 sayt(- o$If^gd(-WXtuvzn{|´«~unbnVMhC8hSQ?0JS johC8hSQ?0JS johC8h90JS hC8h9hC8h'70JhI  hC8h7o hC8h'7hehe0Jhx=h90JhC8h90JShx=h90JXhC8hX0J_5>*CJ hC8h90J_5>*CJ hC8hA:0J_5>*CJ hpc\aJhpc h8 phpc *hpc0Jh|hpc0JwxyzlkdG$$Ifs 9* t0$644 sasyt ? $Ifgd ?lkdVG$$Ifs 9* t0$644 sasyt ?zn2@ABCWkdH$$Ifs 0Zf*DCE t044 sBayt'P $Ifgd'P(gd`gdSQ?Agd`Agde)gdgd'7 /12ABDEQRghixy{|459EV*9:;d˽򠜽}hUL"h%B*ph hC8h7Chl hC8h'70JhPsh$ hPs0J hC8hA:hC8h9B*aJph hC8h'7 hC8hhhC8hhPJaJhC8hhB*aJph h2 0Jh%h0J hC8h9 hC8h`.CDEOPQx~kdmI$$Ifs 0Zf*CE t044 sayt'P $Ifgd'PQRefgkbbb $Ifgd'Pkd.J$$Ifs FZf *DCg t0    44 sBayt'Pghiwxkf]] $Ifgd'Pgdhkd-K$$Ifs FZf0*DC% t0    44 sBayt'Pxyz{~uu $Ifgd'PkdL$$Ifs0Zd*DBF t044 sBayt{|xxx $Ifgd'P~kdL$$Ifs 0Zd*BF t044 sayt'Pkbbb $Ifgd'PkdM$$Ifs FZd *DBg t0    44 sBayt'Pkf]] $Ifgd'PgdhkdN$$Ifs FZd.*DB% t0    44 sBayt'P~uu $Ifgd'PkdO$$Ifs 0Zd*DBF t044 sBayt'Pxxx $Ifgd'P~kd]P$$Ifs 0Zd*BF t044 sayt'Pkbbb $Ifgd'PkdQ$$Ifs FZd *DBg t0    44 sBayt'P56kf] $Ifgd9hgdkdR$$Ifs FZd.*DB% t0    44 sBayt'P6789V;JKnid_ZQ $Ifgdi?gd7C)gdPsgd9gdDkd{S$$If * t4ap yt $Ifgd9DkdS$$If * t4ap ytKLMN kkdqT$$Ifs* t0q44 sasytq $Ifgdi?kkdS$$Ifs* t0q44 sasytqN`abckkdT$$Ifs* t0q44 sasytq $Ifgdi?Agd[cd%?@ $Ifgd ?gd%Agd%kkdU$$Ifs* t0q44 sasytq %&'>?C  '(sz- yr hC8h'7 hC8h9 hC8hA: h,lj0Jh%h%0J hLh% johLh%5\h% h$1h%h$1h%B*ph hC8h7C h<h% hjh% hUL"h%hUL"h%5\aJ johUL"h%5\aJhUL"h%0J+@ABC kkdV$$Ifs* t044 sayttBr $Ifgd ?kkd V$$Ifs* t044 sayttBrC~kkdW$$Ifs* t0q44 sasytq $Ifgdi?Agd[ $Ifgdi?Agd[kkdW$$Ifs* t0q44 sasytq kkdX$$Ifs* t0q44 sasytq $Ifgdi?kkd0X$$Ifs* t0q44 sasytq(!4"#/#0#7#H#Q#Z#c#l#t#|####FfeZ $Ifgd2 $Ifgdmj $Ifgd=AgdAgdeAgd'7)gd'7gd2 gdxgd%Agd%- . !3"4"#/#0#7#8#9#>#G#H#I#J#P#Q#R#S#Y#Z#[#\#b#c#d#e#k#l#m#n#s#t#u#v#{#|#}#~##############################ƳƯͳͳͳͳͳͳͳͳͯƳƯͳͳͳͳͳh2 % johC8h2 5B*\aJph hC8h2 hC8h2 5B*\aJph hC8h 3hehe0Jh 3h hC8h'7hl E#############$$$.$7$@$I$R$Z$b$j$|$ $IfgdmjAgdFf] $Ifgd2 $Ifgd=################$$ $$$$$$$$$-$.$/$0$7$8$9$?$@$A$B$H$I$J$K$Q$R$S$T$Y$Z$[$\$a$b$c$d$i$j$k$l${$~$$$$$$$$$$$$$$$$$$$$$$$ hC8h 3h2 % johC8h2 5B*\aJph hC8h2 hC8h2 5B*\aJphP|$}$~$$$$$$$$$$$$%% %%%%.%7%@%H%P%X%j%AgdFf'e $Ifgd2 $IfgdmjFfa$$$$$$$$$$$$$$$$$%%% % % %%%%%%%%&%'%-%.%/%0%6%7%8%9%?%@%A%B%G%H%I%J%O%P%Q%R%W%X%Y%Z%i%l%r%s%t%y%%%%%%%%%%%%%%%%%%%%% hC8h 3h2 % johC8h2 5B*\aJph hC8h2 hC8h2 5B*\aJphPj%k%l%r%%%%%%%%%%%%%%&&&#&,&4&<&D&V&AgdFfSl $Ifgd2 $IfgdmjFfh%%%%%%%%%%%%%%%%%%%%%%%&& & &&&&&&&&"&#&$&%&+&,&-&.&3&4&5&6&;&<&=&>&C&D&E&F&U&X&_&`&a&f&o&p&q&r&y&z&{&&&&&&&&&&&&&&& hC8h 3h2 hC8h2 % johC8h2 5B*\aJphhC8h2 5B*\aJphPV&W&X&_&p&y&&&&&&&&&''''<(k(l(s(( $Ifgd_,?,@,A,I,J,K,O,R,S,T,X,\,],^,c,d,e,f,ĻĻݡ݀wsm hi0JhihC8h0JS johC8h0JShC8h'70JS johC8h'70JS hC8h'7hK hx=0Jhih/0Jhih0Jhih0Jhihi0J hC8hmj hC8h 3hC8hSQ?0JS johC8hSQ?0JS hC8hSQ?'f,m,n,p,t,x,,,,,,,,,,,,,,,,,\-]-^-_-e-f-g-j-k-r-s-t-u-~-----竢琇wnwnhdhi hl 0Jhih0Jhih0J hC8hSQ?hC8hSQ?0JS johC8hSQ?0JS hPJhC8hxPJ hiPJ hC8hT*hC8h 30JS johC8h 30JShK hC8h/hC8h 3B*\aJph hC8h 3hihi0Jhih 30J'q,r,s,t,,,,]-j-`[VQLGgdSQ?gdxgdxogdKcgdKJkd$$Ifsh* t44 sap ytQ$ $Ifgd=Jkd($$Ifsh* t44 sap ytQ$j-----.L.Y.r.s.t.u.Jkd $$Ifs* t44 sa5p ytA $Ifgd=dgdAogdAigdKogdKcgdSQ?ngd(gdQ$(gd/ ------------------... . . .......!.L.M.N.T.U.V.Y._.`.a.b.r.v.w............/hihC8h 3B*aJphhC8hpt0JS johC8hpt0JShC8h 30JS johC8h 30JSh_hh hC8hSQ?hC8hSQ?0JS johC8hSQ?0JS hC8h/ hC8h 38u.v...A/[///010001+1222gdl ogdSQ?ogd91cgd91ngd91hgd91Jkd{$$Ifs* t44 sa5p ytA//!/@/A/B/C/K/L/M/T/U/V/[/\///////////////0000!0"0#0*0+0,01020i0000000000000011ƽƽƽƽhC8hpt0JS johC8hpt0JShh hC8hSQ?hC8hSQ?0JS johC8hSQ?0JShihC8h0JS johC8h0JS hC8h#= hC8h 3 hC8h7o8111111$1%1&1*1+1,17181112222 2 2 2222 2{2|2}2222222222䶭䶭wneneh_h0Jh_h0Jh_h_0Jh_ hl h 30J_5;>*CJ\ hl hx0J_5;>*CJ\ hC8hSQ?hC8hSQ?0JS johC8hSQ?0JShC8hx0J hC8h7o hC8hxhi hC8h#= hC8h 3hC8hF0JS johC8hF0JS&2{2223333334444Jkd$$Ifs* t44 sap yt/ $Ifgd=hgdogdcgdngd(gdQ$(gdgdSQ?)gd#= 22222222222233333333$3%3&3'333333333333333333333333444ͱͱԚ hl hx0J_5;>*CJ\hC8h 3B*\aJphhh hC8hSQ?hC8h0JS johC8h0JS hC8h hC8h 3h_h_h 30Jh_h_0J hl 0Jh_hHi$0J1444D4Q4w4444GJkdΉ$$Ifs* t+44 sap yt $Ifgd=(gdHi$(gdgdSQ?)gdgdl Jkd]$$Ifs* t44 sap yt/44434B4D4E4F4L4M4N4P4Q4R4U4Y4Z4[4e4v4w4x44444555<6>6?6@6R6S6T6U6e6f6g6h6l6m6ƿƿ䑈|sl|sl|sl hC8hhC8h0JS johC8h0JSh0h_0JXhC8h 3B*\aJphh_h0Jh_h0Jh_h_0JhSQ? hC8hSQ?hC8hSQ?0JS johC8hSQ?0JShC8h 30J hC8h 3h_ hl h 30J_5;>*CJ\*4445>6S6f6m6w6|66666666ogd(gd|%4ngdhgd_hgdHi$Jkd?$$Ifs* t+44 sap yt $Ifgd=m6n6o6v6w6x6y6{6|6}6~66666666666666666666666666666666666 7 7 7`7d7e77777777777777)8ݵݱhl hhhC8h 3B*\aJphhC8h 30JS johC8h 30JSh_ hC8h 3 hC8hhC8h0JS johC8h0JS@6667`7a7b7c7d7LJkd!$$Ifsh* t44 sap ytJkd$$Ifsh* t44 sap yt $Ifgd=cgdngdhgdogdd777+888E8u888888ubkd$$Ifs0   t44 sapytT{ $Ifgd)gd|%4gdl ogdl cgdl ngd|%4hgdk )8*8+8,8-83848587888D8E8H8s8u888888888888888ȷxtkbYkhh 30Jhh0Jhh0Jh_hC8h|%40JS johC8h|%40JShC8h 30JS johC8h 30JS hC8hT{ hC8hX hC8h 3 hl h 30J_5;>*CJ\ hl hx0J_5;>*CJ\ hC8hl hC8hl 0JS johC8hl 0JShl hl hl 88888888EDkd$$If* t4ap yt/ $Ifgd=gd 3Agd|%4bkd$$Ifs0   t44 sapytT{88 9d9r9999999: $Ifgd,g9 $IfgdOo $Ifgd=(gdS((gd_gd_)gdOogd0gdxDkd$$If* t4ap yt/ 88 9 9b9d9r9s9t9{9|999999999999999999999ymdmd`YUMhh6h hC8hh$hC8hOo0JS johC8hOo0JShC8hOoB*aJph hC8h 3 hC8hOoh_h_0JhXe| hC8h_hC8h_0JS johC8h_0JSh_h0h00JPJh0h00JhC8h 30J_5>*CJhC8hx0J_5>*CJhC8h 3B*\aJph999::: :::::::":#:$:':(:*:<:=:>:?:F:G:H:P:Q:R:W:X:Y:a:b:c:g:l:m:n:v:w:x:}:~::::::::輵᝵ hC8h 3hC8h,g90JS johC8h,g90JShC8h,g9B*aJphhl hh hC8h,g9h_hh6h$hC8hOo0JS johC8hOo0JS hC8hOohC8hOoB*aJph hC8hh2::::%:&:lcZQc $Ifgd,g9 $IfgdOo $Ifgd=kd$$Ifs\y*D;[  t44 sap(ytS(&:':>:?:F:d:e:lg^^^^ $Ifgd,g9hgdS(kd4$$Ifs\y*D;[  t44 sap(ytS(e:f:g:l:::lcccc $Ifgd,g9kd$$Ifs\y*D;[  t44 sap(ytS(:::::::lg^^^^ $Ifgd,g9(gdS(kd$$Ifs\y*D;[  t44 sap(ytS(::::::::::::::::::::::::::::::::::;;; ; ;;;;;;;;#;(;);*;2;3;4;9;:;;;C;D;E;H;J;簩h[ hC8hOoh hC8h 3h_hh6h hC8hh$hC8h,g90JS johC8h,g90JS hC8h,g9hC8h,g9B*aJphhC8hOoB*ph<::::::lcccc $Ifgd,g9kdP$$Ifs\y*D;[  t44 sap(ytS(::::; ;!;lg^^^^ $Ifgd,g9hgdS(kd$$Ifs\y*D;[  t44 sap(ytS(!;";#;(;F;G;lcccc $Ifgd,g9kd$$Ifs\y*D;[  t44 sap(ytS(G;H;I;S;T;[;y;z;lgg^^^^ $Ifgd,g9hgdS(kdl$$Ifs\y*D;[  t44 sap(ytS(J;K;R;S;T;[;\;];e;f;g;l;m;n;v;w;x;|;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;ݢhS( hC8hOoh_B*phhh6h hC8hh$hC8h,g90JS johC8h,g90JS hC8h,g9hC8h,g9B*aJphhC8hOoB*ph hC8h 3h_:z;{;|;;;;lccZc $Ifgd$ $Ifgd,g9kd $$Ifs\y*D;[  t44 sap(ytS(;;;;;;;lg^^U^ $IfgdS( $Ifgd,g9hgdS(kdԓ$$Ifs\y*D;[  t44 sap(ytS(;;;;;;lcccc $Ifgd,g9kd$$Ifs\y*D;[  t44 sap(ytS(;;<l<w<<<<<lgbb]XSJ $IfgdOo(gdQ$(gd/gd 3)gdOogdxkd<$$Ifs\y*D;[  t44 sap(ytS(; <<<k<l<o<w<x<y<|<<<<<<<<<<<<<<<<<<<<<<<<<<<<<vokckhh6h hC8hhC8hOoB*aJphhS(h 30J hS(0JhS(h,g90JhS(hS(0J hC8hOohC8hOo0JS johC8hOo0JS hC8h 3h$h0h0h00JhC8h 30J_5>*CJhC8hx0J5\hC8hx0J_5>*CJ&<<<<<<<==Zkd$$Ifs\y*D;[  t44 sap(ytS( $Ifgd,g9 $IfgdOo<<<<== = = ======== =)=*=+=2=3=4=<===>=D=E=M=N=O=S=X=Y=Z=b=c=d=j=k=s=t=u=x=y=============̹嬥̹嬥hC8h,g90JS johC8h,g90JS hC8h,g9hC8h,g9B*aJph hC8h 3hh6hh$hC8hOo0JS johC8hOo0JS hC8hOohC8hOoB*aJph hC8h8==*=+=2=P=Q=lg^^U^ $Ifgd$ $Ifgd,g9hgd/kd$$Ifs\y*D;[  t44 sap(ytS(Q=R=S=X=v=w=lccZc $Ifgd$ $Ifgd,g9kdX$$Ifs\y*D;[  t44 sap(ytS(w=x======lg^^U^ $Ifgd$ $Ifgd,g9hgd/kd $$Ifs\y*D;[  t44 sap(ytS(=============================>>> >>>>>>> >!>)>*>+>.>/>;><>=>D>E>F>N>O>P>V>W>_>`>a>e>j>k>l>t>u>v>|>}>>> hC8hOo hC8h 3h$hh6hC8h,g90JS johC8h,g90JShC8h,g9B*aJph hC8h,g9 hC8hhF======lccZc $Ifgd$ $Ifgd,g9kd$$Ifs\y*D;[  t44 sap(ytS(=====>>lg^^U^ $Ifgd$ $Ifgd,g9hgd/kdt$$Ifs\y*D;[  t44 sap(ytS(>> >>,>->lccZc $Ifgd$ $Ifgd,g9kd($$Ifs\y*D;[  t44 sap(ytS(->.><>=>D>b>c>lg^^U^ $Ifgd$ $Ifgd,g9hgd/kdܚ$$Ifs\y*D;[  t44 sap(ytS(c>d>e>j>>>lccZc $Ifgd$ $Ifgd,g9kd$$Ifs\y*D;[  t44 sap(ytS(>>>>>?`???@@@@@@@@@@@@@@ A AApCqCrCzCCCCCCCCCCǽ{tmf hC8hq h$h 3 h$h$h$h$0JSh$h0Jh$h$0J hC8hSQ?hC8hSQ?0JS johC8hSQ?0JS hC8h 3h$h0 h3J0Jh0h00JhC8h 30J_5>*CJhC8hx0J_5>*CJhC8h,g9B*aJph hC8h&>>>c??@@@ Algb]]XSN(gd6^bgdSQ?)gd/)gd0gd0gdxkdD$$Ifs\y*D;[  t44 sap(ytS( AqCCCCCDDDDDJkd$$Ifs * t}44 sap yt/ $Ifgd=ogd/cgd?eUngd/hgd/hgd$ CCCCCCCCDDDDDDDDDDDDDDDDDDDDD EWEzEEEEEEŽ䭩䝔{r{rh{a h$h$ *hh$0JSh0h$0JXh$h$0JSh3Jh$0J hC8hSQ?hC8hSQ?0JS johC8hSQ?0JSh$hC8h 35B*\aJphhh6h hC8hhB7hC8h 30J hC8h/ hC8h 3hC8h/0JS johC8h/0JS$DDDD E!E*E1E9EWEzEEE $$Ifa$gd_G?GVGWGXG^G_G`GeGȿȿ۶ hC8h@A:hC8h@A:0JS johC8h@A:0JSh$h 30Jh$h0Jh$h0Jh$h$0JhC8h$0JS johC8h$0JS hC8h$h$hZh*x h$h$h$h$0JS *hh$2EEEEE $$Ifa$gd_*CJ  johC8hSQ?0JS h$h 3hyh$0J h$h$ hC8h@A:hC8h@A:0JS johC8h@A:0JSh$h 30Jh$h0Jh$h0Jh$h$0J hC8hSQ?hC8hSQ?0JS/*I1I8I9IUI]IdIkIekdz$$Ifs\* t44 sa'p(yt@A: $Ifgd@A:kIlI-J:JVJJJJnid_OJE(gd@A:gdSQ?) & F^`gd$gd'7ngd/hgd$kd$$Ifs\* t44 sa'p(yt@A:FJGJUJVJJJJJJJJJJJJJJJJJJJJJJJJJ%K&K'K(K0K1K>K?K@KAK{tkek_kt h )0J hl 0JhhA:0J hC8hA:h$hC8hA:0JS johC8hA:0JSh$h 30Jh$h6^b0Jh$h0Jh$h0Jh$h$0J hC8hSQ?hC8hSQ?0JS johC8hSQ?0JS hC8h 3hC8hx0J_5>*CJ hC8h 30J_5>*CJ %JJ&K>K?KxKK $Ifgd )[kd$$Ifs0Z*BH t*44 sap ytA: $Ifgdl $Ifgd$hgd0AKwKxKyKzKKKKKKKKKKKKKKKKKKKKKKKKKKKKLLL LLLL L!L"LFLGLHLILQLRL_L`LaLbLLLLLLLLLLLLǫࢫǫࢫhpFhhmj0J hC8hmjhC8hmj0JS johC8hmj0JShnhC8hA:0JS johC8hA:0JS h )0J hl 0JhhA:0J hC8hA:h$>KKKKK5[kd$$Ifs0Z*BH t*44 sap ytA: $Ifgd ) $Ifgd$[kd$$Ifs0Z*BH t*44 sap ytA:KKKKLL L5[kd`$$Ifs0Z*BH t*44 sap ytA:[kd$$Ifs0Z*BH t*44 sap ytA: $Ifgd ) $Ifgdn LGL_L`LLLL5[kd:$$Ifs0Z*BH t*44 sap ytA:[kdͭ$$Ifs0Z*BH t*44 sap ytA: $Ifgd ) $IfgdnLLLLLLLLLLLLLLLLLLMMMMMMMM$M%M3M4M5M6M*CJhn0J_5>*CJhC8hx0J_5>*CJ hn0Jhl hC8hmj0JS johC8hmj0JS h )0J hl 0Jhhmj0J hC8hmjhnhpF2LLLLLM $IfgdpF[kd$$Ifs0Z*BH t*44 sap ytA: $Ifgd ) $IfgdnMMM3M4M5[kd$$Ifs0Z*BH t*44 sap ytA: $Ifgd ) $Ifgdn[kd$$Ifs0Z*BH t*44 sap ytA:4MKMdMeMMMN NNN~~~~ $Ifgd_N?N@NANONPNQNWNXNYN^N_N`NeNfNgNhNNNNNNNNNNNNNNNNNNNNNNNÿǷǷǷdzhn *h?hnhW.hl" hnhnhnhn0JS johnhn0JS hC8h 3 hC8h0 hn0JhC8h00JFNN(N0N7N>N{{{{ $Ifgdn{kd[$$Ifl\\ H4* h t>+H44 layt{>N?NONWN^NeN{{{{ $Ifgdn{kdΰ$$Ifl\\ H4* h t>+H44 layt{eNfNNNNN{{{{ $Ifgdn{kdA$$Ifl\\ H4* h t>+H44 layt{NNNNNN{{{{ $Ifgdn{kd$$Ifl\\ H4* h t>+H44 layt{NNNNNNNNNNNOOO O O O OOOOOO O%O&O'O,O-O.O/O:O;O+H44 layt{ O OOO%O,O{{{{ $Ifgdn{kd$$Ifl\\ H4* h t>+H44 layt{,O-O:OBOIOPO{{{{ $Ifgdn{kd $$Ifl\\ H4* h t>+H44 layt{POQO`OhOoOvO{{{{ $Ifgdn{kd$$Ifl\\ H4* h t>+H44 layt{vOwOOOOO{{{{ $Ifgdn{kd$$Ifl\\ H4* h t>+H44 layt{OOOu 4<$Ifgd5{kdf$$Ifl\\ H4* h t>+H44 layt{OOO~ 4<$Ifgd5qkdٴ$$Ifs*) t0>+h44 sap yt{OO'PyPPP~o 4<$Ifgd_+h44 sap yt{OO&P'P(P)P/P0P1P5P6P7P8PZPxPyPPPPPPPPPPPPPQQQ뾰륚zzlaSM hnPJhC8h 30J_5>*CJhn0J_5>*CJhC8hx0J_5>*CJhC8h 3B*aJphhC8h 3B*phhhhC8hnB*phhn hC8hxNhC8h 35B*\ph! johC8h 35B*\ph hC8hSQ?hC8hSQ?0JS johC8hSQ?0JS hC8h 3 hnhn hnh 3PPP~ 4<$Ifgd_* hC8hhC8h0JS johC8h0JShC8hnB*phhhn hC8hnhC8hn0JS johC8hn0JS1QQQ~ 4<$Ifgd_ J  t 44 sap ytTTTT~~ 4<$Ifgd_*CJh1h1B*phh6a h1h1h1h10JS joh1h10JS h1hhRmh0JhRmhRm0JhRmh3h30JS joh3h30JSh3h3B*ph h3h3h/G h3hh3h0JS joh3h0JS'WVXVYVZV~~ 4<$Ifgd_YEYFYGY»h1h10Jh1h16h1h10JS joh1h10JS h1h1hC8h 30J_5>*CJh10J_5>*CJhC8hx0J_5>*CJh_*CJh3h1B*ph:7X8X9XWXXXXXXXni`S````` $If`gd/G $Ifgd_*CJh1h1B*ph h1h1h1>ZZZZ~~ 4<$Ifgd_*CJhJ0J_5>*CJh1h_\n_ 4<$Ifgd_\?\@\A\N\o\\\\ZUPPKFgd_ joh_0JSh_0JSh]*>h_^___k_s_z__neeee $Ifgd_ $Ifgd_kd$$Ifs\ !*W [ t|44 sap(ytz% ` ` ``'`.`5`nlcZZZ $Ifgd_*CJh/Gh/G0JS joh/Gh/G0JS h/Gh/Gh_7`8`9`:``a^aZUPK(gd/Ggd/GAgd/GJkdG$$Ifs* t44 sap yt_*CJ h?1h/G h`5h/G h4$h/Gh/G joh/Gh/G0JS h/Gh/Gh/Gh/G0JS<9bbbbbbc#cUccGdddddJkd$$Ifs* t44 sa'p yt 4 4<$Ifgd 4gd/Ggd!MFAgd/Gcgd/Gngd/G(gd/GngdJ ddddddUJkdc$$Ifs* t44 sa'p yt 4 4<$Ifgd 4hgd/GJkd$$Ifs* t44 sa'p yt 4dddejereyee $Ifgd/G $Ifgd 4gd/Ggd/GJkd$$Ifs* t44 sa'p yt 4e e5ejekelereseteyeze{eeeeeeeeeeeeeeeeeeeeeeeeeeeeefffffffffffffffffffffffffffjgkglgrgsgtgygzg{gggggggg h/6 joh9h/G0JSh9h/G6 h9h/Gh9h/G0JSReeeeeeneeee $Ifgd/GkdE$$Ifs\ZmJ"*z  t6 44 sap(ytMeeeeeeneeee $Ifgd/Gkd$$Ifs\ZmJ"*z  t6 44 sap(ytMeeffffn]TTT $Ifgd/G $If^` gd/Gkd$$Ifs\ZmJ"*z  t6 44 sap(ytMffffffneeee $Ifgd/GkdI$$Ifs\ZmJ"*z  t6 44 sap(ytMffjgrgyggn]TTT $Ifgd/G $If^` gd/Gkd$$Ifs\ZmJ"*z  t6 44 sap(ytMggggggne\\\ $Ifgd/G $Ifgd/kd$$Ifs\ZmJ"*z  t6 44 sap(ytMggggggggggggg2h3h4h:h;h*CJ joh}h}0JS h}h}h}h}0JS joh9h}0JS h9h}h}h[ johC8h}0JS h`5h}hC8h}0JS4Jlllllll m mPKhgd}Jkd$$Ifs* t44 sa'p yt 4Jkd'$$Ifs* t44 sa'p yt 4 4<$Ifgd 4(gdPsgd} m m mm#mYmmmmZUPGGG $Ifgd 4gd}gd}Jkdz$$Ifs* t44 sa'p yt 4 4<$Ifgd 4Jkd $$Ifs* t44 sa'p yt 4mmmmmn ne\\\\ $Ifgd}kd$$Ifs\Z *y  t 44 sap(yt} $Ifgd 4mmmmnnn n n nnnnnn n&n'n(n-n.n/n5n9nnnnnnnnnnJoKoOoaoeofohowoooo÷÷ß~r joh}hI" 0JShU hnhU h`5hI" hI" h}h}B*phh}0J_5>*CJhMhMh}0JS johMh}0JS hMh}h_*CJ h]*>hM h ' h ' h ' hMh ' hMh ' 0JS johMh ' 0JShMhMhM6 hMhM4qtrtsttttttt $Ifgd 4gdMgdMHkd$$Ifsh*] t44 sap yt 4 4<$Ifgd 4ttKuSuZuaun]TTT $IfgdM $If^` gdMkd$$Ifs\K*\ % t 44 sap(ytMaubuvu~uuuneeee $IfgdMkd$$Ifs\K*\ % t 44 sap(ytMuuuuuvv vvvvvvvvvvvvwzw|wxxxxx x6x7x;xxxxxxxxxx7y8yüõ~shayhayB*phhayh}0J_5>*CJhayhay0JS johayhay0JShhshhs0JPJhhshhs0J hayhay h}hMh}hMB*phh}0J_5>*CJhayhMB*ph hayhMhayhM0JS johayhM0JS)uuun_ 4<$Ifgd 4kdi$$Ifs\K*\ % t 44 sap(ytMuuuuvYvvvZUPK(gdMgdMAgdMJkd$$Ifs* t44 sap ytM 4<$Ifgd 4Jkd$$Ifs* t44 sap ytMvvvvvvZUhgdMJkdr$$Ifs* t44 sa'p yt 4 4<$Ifgd 4Jkd$$Ifs* t44 sa'p yt 4vvvvw|wx#xZUPKFgday)gdhsgdhsgdayJkdT$$Ifs* t44 sa'p yt 4 4<$Ifgd 4Jkd$$Ifs* t44 sa'p yt 4#x7x8x9x:x;xxx8yUPKgdayAgdayJkd6$$Ifs* t44 sa'p yt 4Jkd$$Ifs* t44 sa'p yt 4 4<$Ifgd 4(gday8y9y:y;yyPyTy{y|yyyyyyyyzzkzzz||||||||||||O}P}ĻĻвК׀pЀpdXhUh}0J_5>*hUhay0J_5>*hC8hay5B*\aJph% johC8hay5B*\aJph hayhayhayhay0JSh6ah6a0J hay0Jhayhay0JhC8hay0JS johC8hay0JS hC8hayhayhC8hay0J_5>*CJ h}hayh[h}hayB*ph QyRySyTy{yyyzZUPKF(gdaygday)gdaygdayJkd$$Ifs* t44 sa'p yt 4 4<$Ifgd 4Jkd$$Ifs* t44 sa'p yt 4zkzz|||||||nokdk$$Ifs* t044 sa'p yt 4 $Ifgd 4(gdayAgdaygdaygdayngd6a ||P}m}}}}~b~c~{{{{kf] $Ifgd 4ngd}.<h & F^`gd}.<ngd}h & F^`gdUokd$$Ifs* t044 sa'p yt 4 P}Q}R}l}m}n}o}}}}}}}}}~~~~~~L~`~a~b~f~g~h~~~~~~~~~~~~~~~~~~~شsss joh9h95B*ph h9h9h9h95B*phh9hay0J h9hayh9hay5B*ph joh9hay5B*phhayhay0Jhay0J_5>*CJ hayhayhayhC8hay5B*ph johC8hay5B*ph-c~d~e~ $Ifgd 4qkd$$Ifs* t044 sa5p yt}.<e~f~~~ $Ifgd 4(gd}.<qkd5$$Ifs* t044 sa5p yt}.<~~~ $Ifgd 4qkd$$Ifs* t044 sa5p yt}.<~~~~~ $Ifgd 4(gd}.<qkdm$$Ifs* t044 sa5p yt}.<~~~ $Ifgd 4qkd $$Ifs* t044 sa5p yt}.<~~~~ $Ifgd 4(gd}.<qkd$$Ifs* t044 sa5p yt}.<~~~~~efgmnorsz{|}fgikxyzӼӏӋzsoskbsh6hh.0Jh.hA#9 hC8h'7 h!MFh!MFh!MFh!MF0J\hh3Jh0JShhSBh[hC8h\hC8h'75B*\aJph% johC8h'75B*\aJphh9 hC8hh4 hC8h9h90J_5>*CJ h9hayh9hay0J&~~~ $Ifgd 4qkdA$$Ifs* t044 sa5p yt}.<~~ergh~yp $Ifgdngd!MF(gd!MFgdgdqkd$$Ifs* t044 sa5p yt}.<hij $Ifgdqkdy$$Ifs* t044 sa'p yt'7jkz $Ifgd)gdgdqkd$$Ifs* t044 sa'p yt'7 $Ifgdqkd$$Ifs* t0T44 sasp yt'7N[HU.~ytyoja $Ifgdn/gdA#9gdA#9hgdUKngdUK(gdUKgdUKAgdUKqkdM$$Ifs* t0T44 sasp yt'7 NOPVWXHIPQU =RabcdfgijlmopqrstuvÄԄՄ݄ބѽѵ|jh=mh_A?Picture 1"R8P8A1Qp&l8D}F8P8A1Qp&lJFIFHH&ExifMM*bj(1r2iHHAdobe Photoshop 7.02004:09:01 14:21:03ؠ(&%HHJFIFHH Adobe_CMAdobed            ~"?   3!1AQa"q2B#$Rb34rC%Scs5&DTdE£t6UeuF'Vfv7GWgw5!1AQaq"2B#R3$brCScs4%&5DTdEU6teuFVfv'7GWgw ?TI%)$ĆI5$k<.=0ғm]ZL 2Lpy'خ zOA&90zf _}:Co73u.̣.}czgYG5@:UٗPу]=Ko?;*lw.XRc?4~^9^N82#?g׿]hm9[[k\/z̧<ߵYQSQɹ3ۍsi" 3&ܜlo_ѫkX-fUWoovE?UzGKN[:^EղYmOfeoi_~v>LNe,>#{/s!)?GK1@@.O7jYfǖUk(eL ozW{~Y] ~V.PeEͶ͂ƹmWTbdוӳne406WW?N)!p[{r3KvH}NOt2ֲm@q cQxz88NRa8Pcq+:7ja}nzn"6*Eu,< g;6oyfF =SVpkHqK3v;{oP+C pu\.nuYXiel 53p{ǎ1z~\?OHC

Ȓ}r;k3իv?7%v8em=sLiS1>|s9!謜 kc:_,I%"TĀ$utΙY^'kX/QaxaߜXx] v#擟' ;{~yTl\0)>ּZ]սK3pn˙n;ޅԥvS^@}9uCsϩ].gBǵmlZGR{qّw ۲m 9G*n[U&a#)WLN0|qc1{܇ cR?xM[аQhۇiuϗ;n7z?:wԞ7.Ny5{w75ڸ%ء}Yydz["Zc=̝}/[vԊ #t4!dS1O>[R|gSͧY]ci~eM oHHN@xꙤƪbQLxxc=aG$vK#)QnX8\\]m՝ -5dIyQ3(8?w2$"2)_8YT0kUςKZwq׏yYǯ7>[TY97w׏^CUn3smvS1ͯssk;au^a̺CkT~d[TXZqov5M9x6sB?􋛿WprϫoJ7#^ۺnKLߓkvMo.mMxR 0n6ۺYꭓ˒R7MѲy:S}N UYc-Xd5}{7QrQp_і<8>#, VU88k.FVc{=YoL9{6~_-~sOf]s|{m Lab ]}ZfgNH?tdfu\ƏMD&C(}4^!P Gnb!cݗ}ۏk|mtia]CXi7 ]c@u֏eL/vKn}+Doj+AU} S*F6!fld5v^JW>tgfee4U*>z3Ңm_>Sluَf#Gkwz _F=~L]lk̠ZcX}첿Yn7M^ihkguoנ}L2YYk6?+ =Q N<a/jRŒͯ}2g~gn}o{ұ(M(kwe_Ym}ŏ}Yvt4S1pڨ]ޗ^>Lj<6e)d3g\#8?ӗ6cBZF_7m ^=TսޤvqG; =cϥ=sלSѧPɲ]Ni}ױsj,GOOH!2}Q>5ˬ]s#޲v*Ӳ\+|7ߥ[{3RFK`kꯗ;Fq>uOoB8~R98o[:=Ap[pupwMٳO[X>Gڋ*m|KKퟻXlǯ 2u5\nuO65[vOPȸl?H1VmYoi LD{M:K=SAnV) (69!HST kM~Iuo_V%33^:3^ַ9͕g}k=9t-wW^.rh9y8z[]u1k]P{z+-}ZwRų{ eLƮd:2[e[4X^m}L^B^ۉN&#tTQk+QVr[;wGģ#i/UdW[G!vU>munͿNs0~-"FmӍ.ʭׇuog7V2zVu6!-=;]e~C^Go?F9 3ƪ8G<=x!3%,|TN3c_.FMV?ݻܜwZ`]VUC g;}MX.n-*]Yx5aw:mqo]Qvws=MֶQ;e!1<˦Xz{y?ꫳ#FD01v}e;fkJ}8eyMVߋw׾Uޣi텇ܼe&vE%uؿQism+Ub z饹89¬y2{Pac{\BO'zVzM8T'"E/C&z~ON.+q%{!k.X{M~Sey~/E翦G}MM/6߽?KMuRLa@"Vn2 2 //4ma-X{G;VկuYm֜^?h6fmvzNsEW4gR*n8a můLT_q]K[]}mɡgQ_ei1ެ{/:q:;CqhhŮ?J]_]/YfOmbf:ffUױ}'ڛ9ֳk6K?V7/zMnsh͌ݿe,K}zy + 2N%suIn3j_EپOjո1)ؔo+dّkYs)-Xm_οʶ/Myq0ּ w//V?kocFC.ufk]3rfU. ?5eޞY1*mc-Uݹ׏k_z%u[_RnUzRTݡ^Oca ˣ.2RtV,f;.%'.ܦ8 Cjo߽mǷdTcrR2=Ϛ92G4YKx|@F23~纶ecۉuWMEȶזeGicrn穀N^nYb>W}bSYujuiŽ~6 2~AKWA搠}raqXls?KoUxK}]/k]̐7o~G*ӢQOQE5oŖ {7{}n_Ua3nGU{ H{?ӣ=jOT5'=CSwd~:j3c}_fCY/9zK[3WѺoJ_uvbZO5ՏV7o~2;>f_WQQ.ql%NUuc6~(9]OC{Gpq=F~ ̧N;*sD Zu{wg]^sѮĻ1AomݵS~YfF=}̮])"gL_ԅ#UmN>;Z3-Gxvzx <⾫ͬk?=lobup(|QT /Q65ۘB+'K5tN8kz5wk澋^7OٲY֕'Xk01Z`?籹q ߧ{C&#gNTٽUWP؝ 7Dzܜ0 m5}~GQUw_ҹ<>zv7KvGPk3v3Z,f=mu52k[c/+ީ鎰R^n%yֹ׏)خt}.^;@{b<6;Եgڈ]yG <$.NE|]M?a頀zmm52=6?AӟVOT.gZML7+o 1b}B3ܲяq@}&1?qp2ۋMvebd{{-g a#<~zx\z2<8> M?EͿc6\:ճ]S1.66WY >Sek4ӘݻD]}cM^o egQ^>7pjܛwU~kn{i*Ǫg/T->6}4mq[fw?*d&`%_Y8cNO^6G#rU׺66]V=1~k=5m$xNc!BqgO~|Z.Kz(}`Gک>>ӱr1c5YN`E6_s s?loEy/o轌+~}];c5 o'zu6]nvAy̡vYۏԭz(䙘p^ep{>=/(FzΏװuuc:͡)^VN_L}Ǘz5]oƛ}VX)vcjgzY:5ﶶu+ .5à15eٷֲ"g0N$`rzk>x6b &YE}iZF\)}WǠV̛1˟e;S1NxQ^~%W:7K7>(2%$,Я\rbc&xHjO] y~ޣq0]m=b[]`Ecŗ2l };쿪VuHﭺ?T]'1.YOxvd?vM_[6W.KM١VE`)ЙG;Ve&@cI_?F{۠=4Vl]k*Nx70H ?guauϬ]yչ u-2ӵgtl[pٽMd* }mn=]eWs>ȲS2r5tlbR(peb6lsٷٳ1SO%SI𱯯ݝN]{jY;/MYC+qۏC~0=?mq:*_B<|xyx?tpˇ=׹cӋid1{۟U/ʺ F5QK}v~CoeT]I)18ǧOYݏHTI%)c}_]VnUnoouvVk=V~?+[ (GYxh8 y| Řޭ.V;~[spp)˧#ռ xhM98)s,Y6z}/I޶Jl{n\pܧcRiCK _)H͌c5b2G_W~5׎TuǾ޼_xL;qrzH?GⶼFn6luW̾˰~WڙE,f0w[Kw}/߱^P^s^S?Y?zLmKXRMlkj{mq59 aqz)m_uesR1~Li07w Kf&3z#.mmkͅ89H#wg"t:UUF#nb: O[ʿମfv$5skɷ3sF=2ǷXg'rti>npIzFjRe)FXH<1)c%9,%'m.3oռYԺI\*unʵa/9ǡggBkq.vꪂ%3o7~ovvcX1j~EC@_OV<_f=/J==~͟F>c Èd_9JS?G >MNwgmve]MۍV5CI%cu/W[2sv8IH+Photoshop 3.08BIM%8BIMHH8BIM&?8BIM x8BIM8BIM 8BIM 8BIM' 8BIMH/fflff/ff2Z5-8BIMp8BIM8BIM8BIM@@8BIM8BIMEseal_100nullboundsObjcRct1Top longLeftlongBtomlongRghtlongslicesVlLsObjcslicesliceIDlonggroupIDlongoriginenum ESliceOrigin autoGeneratedTypeenum ESliceTypeImg boundsObjcRct1Top longLeftlongBtomlongRghtlongurlTEXTnullTEXTMsgeTEXTaltTagTEXTcellTextIsHTMLboolcellTextTEXT horzAlignenumESliceHorzAligndefault vertAlignenumESliceVertAligndefault bgColorTypeenumESliceBGColorTypeNone topOutsetlong leftOutsetlong bottomOutsetlong rightOutsetlong8BIM8BIM8BIM %~%JFIFHH Adobe_CMAdobed            ~"?   3!1AQa"q2B#$Rb34rC%Scs5&DTdE£t6UeuF'Vfv7GWgw5!1AQaq"2B#R3$brCScs4%&5DTdEU6teuFVfv'7GWgw ?TI%)$ĆI5$k<.=0ғm]ZL 2Lpy'خ zOA&90zf _}:Co73u.̣.}czgYG5@:UٗPу]=Ko?;*lw.XRc?4~^9^N82#?g׿]hm9[[k\/z̧<ߵYQSQɹ3ۍsi" 3&ܜlo_ѫkX-fUWoovE?UzGKN[:^EղYmOfeoi_~v>LNe,>#{/s!)?GK1@@.O7jYfǖUk(eL ozW{~Y] ~V.PeEͶ͂ƹmWTbdוӳne406WW?N)!p[{r3KvH}NOt2ֲm@q cQxz88NRa8Pcq+:7ja}nzn"6*Eu,< g;6oyfF =SVpkHqK3v;{oP+C pu\.nuYXiel 53p{ǎ1z~\?OHC

Ȓ}r;k3իv?7%v8em=sLiS1>|s9!謜 kc:_,I%"TĀ$utΙY^'kX/QaxaߜXx] v#擟' ;{~yTl\0)>ּZ]սK3pn˙n;ޅԥvS^@}9uCsϩ].gBǵmlZGR{qّw ۲m 9G*n[U&a#)WLN0|qc1{܇ cR?xM[аQhۇiuϗ;n7z?:wԞ7.Ny5{w75ڸ%ء}Yydz["Zc=̝}/[vԊ #t4!dS1O>[R|gSͧY]ci~eM oHHN@xꙤƪbQLxxc=aG$vK#)QnX8\\]m՝ -5dIyQ3(8?w2$"2)_8YT0kUςKZwq׏yYǯ7>[TY97w׏^CUn3smvS1ͯssk;au^a̺CkT~d[TXZqov5M9x6sB?􋛿WprϫoJ7#^ۺnKLߓkvMo.mMxR 0n6ۺYꭓ˒R7MѲy:S}N UYc-Xd5}{7QrQp_і<8>#, VU88k.FVc{=YoL9{6~_-~sOf]s|{m Lab ]}ZfgNH?tdfu\ƏMD&C(}4^!P Gnb!cݗ}ۏk|mtia]CXi7 ]c@u֏eL/vKn}+Doj+AU} S*F6!fld5v^JW>tgfee4U*>z3Ңm_>Sluَf#Gkwz _F=~L]lk̠ZcX}첿Yn7M^ihkguoנ}L2YYk6?+ =Q N<a/jRŒͯ}2g~gn}o{ұ(M(kwe_Ym}ŏ}Yvt4S1pڨ]ޗ^>Lj<6e)d3g\#8?ӗ6cBZF_7m ^=TսޤvqG; =cϥ=sלSѧPɲ]Ni}ױsj,GOOH!2}Q>5ˬ]s#޲v*Ӳ\+|7ߥ[{3RFK`kꯗ;Fq>uOoB8~R98o[:=Ap[pupwMٳO[X>Gڋ*m|KKퟻXlǯ 2u5\nuO65[vOPȸl?H1VmYoi LD{M:K=SAnV) (69!HST kM~Iuo_V%33^:3^ַ9͕g}k=9t-wW^.rh9y8z[]u1k]P{z+-}ZwRų{ eLƮd:2[e[4X^m}L^B^ۉN&#tTQk+QVr[;wGģ#i/UdW[G!vU>munͿNs0~-"FmӍ.ʭׇuog7V2zVu6!-=;]e~C^Go?F9 3ƪ8G<=x!3%,|TN3c_.FMV?ݻܜwZ`]VUC g;}MX.n-*]Yx5aw:mqo]Qvws=MֶQ;e!1<˦Xz{y?ꫳ#FD01v}e;fkJ}8eyMVߋw׾Uޣi텇ܼe&vE%uؿQism+Ub z饹89¬y2{Pac{\BO'zVzM8T'"E/C&z~ON.+q%{!k.X{M~Sey~/E翦G}MM/6߽?KMuRLa@"Vn2 2 //4ma-X{G;VկuYm֜^?h6fmvzNsEW4gR*n8a můLT_q]K[]}mɡgQ_ei1ެ{/:q:;CqhhŮ?J]_]/YfOmbf:ffUױ}'ڛ9ֳk6K?V7/zMnsh͌ݿe,K}zy + 2N%suIn3j_EپOjո1)ؔo+dّkYs)-Xm_οʶ/Myq0ּ w//V?kocFC.ufk]3rfU. ?5eޞY1*mc-Uݹ׏k_z%u[_RnUzRTݡ^Oca ˣ.2RtV,f;.%'.ܦ8 Cjo߽mǷdTcrR2=Ϛ92G4YKx|@F23~纶ecۉuWMEȶזeGicrn穀N^nYb>W}bSYujuiŽ~6 2~AKWA搠}raqXls?KoUxK}]/k]̐7o~G*ӢQOQE5oŖ {7{}n_Ua3nGU{ H{?ӣ=jOT5'=CSwd~:j3c}_fCY/9zK[3WѺoJ_uvbZO5ՏV7o~2;>f_WQQ.ql%NUuc6~(9]OC{Gpq=F~ ̧N;*sD Zu{wg]^sѮĻ1AomݵS~YfF=}̮])"gL_ԅ#UmN>;Z3-Gxvzx <⾫ͬk?=lobup(|QT /Q65ۘB+'K5tN8kz5wk澋^7OٲY֕'Xk01Z`?籹q ߧ{C&#gNTٽUWP؝ 7Dzܜ0 m5}~GQUw_ҹ<>zv7KvGPk3v3Z,f=mu52k[c/+ީ鎰R^n%yֹ׏)خt}.^;@{b<6;Եgڈ]yG <$.NE|]M?a頀zmm52=6?AӟVOT.gZML7+o 1b}B3ܲяq@}&1?qp2ۋMvebd{{-g a#<~zx\z2<8> M?EͿc6\:ճ]S1.66WY >Sek4ӘݻD]}cM^o egQ^>7pjܛwU~kn{i*Ǫg/T->6}4mq[fw?*d&`%_Y8cNO^6G#rU׺66]V=1~k=5m$xNc!BqgO~|Z.Kz(}`Gک>>ӱr1c5YN`E6_s s?loEy/o轌+~}];c5 o'zu6]nvAy̡vYۏԭz(䙘p^ep{>=/(FzΏװuuc:͡)^VN_L}Ǘz5]oƛ}VX)vcjgzY:5ﶶu+ .5à15eٷֲ"g0N$`rzk>x6b &YE}iZF\)}WǠV̛1˟e;S1NxQ^~%W:7K7>(2%$,Я\rbc&xHjO] y~ޣq0]m=b[]`Ecŗ2l };쿪VuHﭺ?T]'1.YOxvd?vM_[6W.KM١VE`)ЙG;Ve&@cI_?F{۠=4Vl]k*Nx70H ?guauϬ]yչ u-2ӵgtl[pٽMd* }mn=]eWs>ȲS2r5tlbR(peb6lsٷٳ1SO%SI𱯯ݝN]{jY;/MYC+qۏC~0=?mq:*_B<|xyx?tpˇ=׹cӋid1{۟U/ʺ F5QK}v~CoeT]I)18ǧOYݏHTI%)c}_]VnUnoouvVk=V~?+[ (GYxh8 y| Řޭ.V;~[spp)˧#ռ xhM98)s,Y6z}/I޶Jl{n\pܧcRiCK _)H͌c5b2G_W~5׎TuǾ޼_xL;qrzH?GⶼFn6luW̾˰~WڙE,f0w[Kw}/߱^P^s^S?Y?zLmKXRMlkj{mq59 aqz)m_uesR1~Li07w Kf&3z#.mmkͅ89H#wg"t:UUF#nb: O[ʿମfv$5skɷ3sF=2ǷXg'rti>npIzFjRe)FXH<1)c%9,%'m.3oռYԺI\*unʵa/9ǡggBkq.vꪂ%3o7~ovvcX1j~EC@_OV<_f=/J==~͟F>c Èd_9JS?G >MNwgmve]MۍV5CI%cu/W[2sv8IH8BIM!UAdobe PhotoshopAdobe Photoshop 7.08BIMHhttp://ns.adobe.com/xap/1.0/ adobe:docid:photoshop:f7674bec-fc42-11d8-95c7-f15441b33657 !Adobed@      0 !@1"# A$4!1"A#Qa2qBR$ 03Cb%@&r56'!1AQa"q2B#R0b r3$@CSc4% I$I$I$qA "K+^YKŒ`vIP3l,}I$I$I$I$I$ױ@5gQPxa :M`x ~%3~O+AZRI$I$I$JW)h* /z[O;u}duU ֲR*,ts#PXI$I$K*=FKN"XǦג`S|-8fh55uv*ԇZH>`>sZT(,6Vgywju'L_I$I$:.a(%-4bߋ6,;#t50~@M]fCFsuO:c4~Y-^G܏m''[ц# 5$@ |Y~on:/Vl[uˣii~J䚂3gI=En#ǖB_pM%N6oSWz  9Î$yTd:fy|Am0y5 - ̉_,lr9kTzHkM ?,Y/Yb-s0:IqMX)kɫT,0AT4yϝ4& `цӷ滞gҼUȗ7èE( ,|~mz2WGA!V}NmR 8=sVâft별?<^݋0ˌq;e.Z"mF2K.cGN;0l^3d ]%(,AH=pMKqm~zA{gI39 +>dnO8u]J>Fpy>y:hJr&X4,l~.f8F3U92k )ķ&t =Ə<CcKQM8% ܝXj@}3. u#P%ݛs'G zEk rݴ#c"WE~l7lpB|[rfrI4-!( F]6}0 XԛL<vPq:7`|V J4 >lLw<8-m~%SOK67Xly\jWLw+s9 \e X(lޘv㗒_7XOl(.֜m ][^u^}E5vK?;[<[?%&8f>Cœ=iwRKJ/fcѫ0"%nIK}7 _hE{!x I|ja'WExNk ˅*E rl[f37]\1ThBfߍR[0t}IE ,>RXg#0+5Vcߊ(*%;+ ѺV$c<s{I~Y&' #AfzQNݻZ)$I% 9zM{O"9/͈8->rȜ}ߒMKL}~dNxԍom[mKI$I$Y3+hShx^`%oLXV^Uuw|`sú(t*ٍCt&NĒI$I$I/7W8_v&1 ^֨aRr#Ѥ壧={-Caum>IoOY$I$I$I$IA1I`fQ7cdG͉6W9aLHp\I$I$I$I$I$I$B"ǚ4@k.I$I$I$M9ӑ`k'P6<\ҕXrm#Y'Mhr&AvmLvN^7'5!* s\AF)dDvmvvg[=o t}h66U mNآpWjfb/MqhطaElLOQHh Z]+qNmG>߶h"j+_SiLẸϹ>98-u!6`u;lZVQOx/1<(ik#+H%E.HYWzQ@lf.9d)}̧,p ݡ WHȕN9K:'0蛚(׼WPir= G%mLOy'D CMuRåumqsZ9s%v=Yi)#]Va<9ߖI6G|AwןALJLi=('`%uzyۿ#iOn2r?Bk;luڮMfqkdL\k#\K#HָLā:ߧQ7 A#Vq'u4sIJU[YYs747 %)9 CqqO$ sAc!gPA\VILCx ljKpܐQ0|XsQ[-L#tNdXC] !Yb`AkbK9=ȶ$fbqRR4$aa ttyR-`mݤeK@/cjUOWNR6d?s#?D=zA3DSU40@ ӑKaf)kd|Zΐ62U(:%=@֤̈́0D0M_$u*^q |ԭ󺇪{{55?%k*F\Ḛ|j^#XVM$m?ώѨjo}@ PĥcltJYf+ZBc`+f8j!!sZ~H[Rvv^K7ؑ e$#BhUrU15V﵃CdQo}~_5Yd+E1Ry~1t?wX cO٠!4N񖍺%'8% U* }x~v^Y<,!)"DGG"U&gɬ]3UgDzwR;`$4A;'P,QFAji@Ad/6 -#%W x~sA5klKKKm$HNWubcEqfI)MtWe{07!N{@C$[R'~MXmٜ!IGlK}81lDh 0έPuD*g, yͫ.Wgm4:~B8ಫ)]R K]-X:԰5}fAwYlbR Eg427[` ʭNAC[%xB{ZS_2#qѲO`Ŵ2ȥҨ|L:6Ҵ0OɛӿO G _st\|ްĪ[SԒDOY r"&vSx@jWtVRx|$}W[8ڙ -DwB!_.T Z藱8Y8@r3-_u9B"C5BB#Qo&y/\sן&vLsRv* ͰS_#vz7(*ō`ya$ECeEIch۬gv77:NYHggXw|L#6- Dy#8 KxUvcA5j(ۑ%7hb(9@(g_VHo|p8SohF*^7J Q%,tV j4f(5 x١pnV8&MS2V6 d]k{NsH/+Ej׮.<{|uӷ4ӓeV“!i5zR^-F7EI(J4<4K?+K뼪Z}12)N=ҩ^H#)-ML`d4gJuEj3>)<6RI#c'.:H,Xb4 ~=^]J,SV #~B$-7Tt",N $*iG<_րaQq:HQ>> @ <@*t<09I,AYʝtxn@ Al>-R g+ R4 Ԁ-j9ErԺ1#S  z"(ZY4ANO_@7: "Dh&``VHY!N]XRL:.Ps1TW\tJ@0~oHЄe8Lqk҇2Q&L-D1^n?a"Y:r{Cyp!m0)*`Jmwes\6% A`פ}!iARO %;= ogt mQq,Np %w;n.ʀBNh[R9W\c嬲!PCySϯ+ɰHwi:R~*Ddnؠ#s싶{|԰ԌT[R9/qChJ2A-@~; >-W4 Kf7-]2  ?)bT<]4Q|AX g] {**s ;9fu6PIRL0@"3! s>D yqc &]ig;ژ26@[rYJ\T5w^-hPJFTK<("Vjs[dl msʾNgC%DW\Ad&d< FӧQѰ/̕97 `U B̥b|rT~D$hgd"8;">;;S]do&HCoE])=cz]ϟyt򟇞1ބNkCҷDy/-"9lr\cc2Em $1*;DSZwpCߧew3M3Ԣh=ZJns|%Gc\p4Sj|ST lNJ&sClO#QJKj&_~>ORV%k C@wCDBe?ܤ3 ]%qq`2[ҕ')%kG$&0B {:6 yPHt\>f}">="S)VR0/*d3St2R{g B OݍVM))@DBӢ[ˈUK}!bTI˫!ۏE$-\r3VtVT,Iv\ V\c"uJXJnHA(^%nnK=Ka?!L$%1VVȡ*{:Y߸B.^-!6Uǻ0]]"崷lF'Gϯ챖%ct`| Y(Z1\l6>Unl2}9FPY^'g`.C<"Fr{h,+lM#ø[Nl!w=U13A@ȿMBFa W̐]-i,Ö#VMqVԐL+W$.pѻv;fr"p'6U4Ϡ߸GBzϺX6۬7)\ 7 ,9 N2ꌐ,6c4x3m:[m0ڤ1hY֒R8 lND<^CԉIB f&'4j[E<I$/QE\Tk΋RzNъgC%iNte"Tnm``~yƕ X֡őmA(+Zqa*\`)T:a?TЈtΜݶb*YZ([~]xd5e6+]XEG!i1[l4_`sض(rb=ޮQvS3FL( i |D8Д"zpgx voZK=a,V 2ĸ6˛Y8\Ŗ/Tzn^|6n7X49y:MWi2fuz}C^61bamt\I.8Մv$\ ވni3;m ;b(vZ-[]AYfe0PMڦޣ3 ͠S$Oyles J-kZ|#lo;nĦMeP؈9p:]bjP=:wC鸍+{؅-[bA6<!H.2+ݼ+^} ;<ػ 305IY\+Qzq`.^U9RxtGTP@~ӊxӬ:C*Z:Xތ䭭HpNaxTQD؍:[ir",QʋL( ~Ѷ{]9¥hcլ1EΰRiy^}^ɣ<ϝ#J'H"1չc"|Aji@1Wޗ24@ȍ*(#fb$ iQJ[L|ϺΒGPϼ%gT RW~ ioDT %ע^} =Cݳ[e 䕯)K{R'Tz$?DqnoezģoJ ,i:&qE]Z7fѩ +283K =:D |@Hz9jM{oV0e'c} 6SI# [XM!|5Nuמ:Ss[_)ӳ`?b c6,GM}mZ;&Un,GݥiO.DŽڑ<;1۾pC Rꧪ ]|UYr+:*5i⑄|Sѹ`~gږwsoM͞22!uE_I|O0xTo` t󹺶WґóAw7/2D$N4>> ߖ{'h$#V#vlyi[Y'7NӺ|(}WifⰤ8#*-12H[yge`a|y%ib-E)~#zgL^tY\Eڷ[}SֳL鯠3wpjJlRGZUjYJ5(BE"/4N=6$wGᢄ9czeuS"~GlXb$ħU cFGƁNYFϜc\'v,[nך^;泶^*>ҷ>,^3\.,jWWD`N9c3šcJE1]焭I7\zuKC{:[kctqTuh|l7X|g3&ϳt pݐOFs;|s;y^5Z5w.^g~ԛ`K5Bk\JFV rAk=h#=6b9/KA/jto8F+S^[;.] D{eZ1?fE5I1$ѬDԘ YlؗGbᰫhy4! ̜ n{,!ڋO箔땶$֚#1fnu>够R4M '~,UId6}Nj3CʳOZ+=m"\[5"nj殕mƺ*54ybz7 a+fX$zg>{֪S#GMPfA7sHf:C$YZ\C>gn=8T0A߅UzyR6U.٧K35rEwAg`s4c\AdwOg~tƤQdvxwN28NK5Ww8î->qEmqfz1osgjV[|$D|=_eS-fnW}i܆.̙]lN ?ʊT5B:W?RE.ӓtMyyv:Սie 8\Č%22-m5o"{{u/쉑Y=:#җ[͞M[ 8R? zWb2^V#/ZtHЭv;9 =? k]*Wuf8u?tM ؏"x[\H1tAIoI0fθ=-sul8i%ރ4 .ɲ`UL?I[lj5J`2uoLdӨ$ vT(mX,-M~-vɫ'ف>Ѵ]#)#ba^X c P@S)_1Vo+2 ζ{";sDF E~y(Fȕ鼅K(мݚ[Nsh{@f*kd7d֨@=kgS Cw;sLQE߸{'zN_V+%j]Y+k7ǝ*+X~ ;\cw!Wuta7H% {W6ed5l1eck°%yy~a:lSD 嬛PؙS̛xu$i=lܻ).Sf;N%I|/>r*m?~hԩ/xBg|kiY5 Ik;>k_mU? v(ZvČLB1cK+[wIl슡2(<݈3r/r[ OB߆񯾞M+AfWc\w YHo؂sG`k~5vv2Ir2Id`+tUt g1~y2A09+S9A#;_ɵkuf 8<> ? hqW+zrCi"F u8/-o =scGʣ ˓_Pߵ35o@DİɯT.Yu$+pl.RjHP0;_*77f0A* *ma򓻷:丶-ZIZ vYRb%]uV Eel&#^?^ ʕ5،xsPb9Ќ~uuH*˟,*ApnwYo@rdUb W(#[KNs!dH1&o`#z~O,'M͠k1W܄%)z` ,t5U[9=u\GCmbPT@9avϳm.*]JX 29v.;{W'xVͺNddۡn 74*r$nmڧ6R]TSG\?bTֽk xz#w;u'?xUW؊6iP$Icy}'rhU{C5(0 P$|92{XדsiA/W[p.M{X!S~mH_i kp\)b68H,溜[v0U9EHXO93FZ~SRQTZ юxV4Rz "3KjE<3·~YQX3dBK8u\!ZT@ WRkn=Ey & &$2Pn%mhZ%LH9UG*HkR-1 ~g ›tmȦJ7-.1é/b^~+XXRz@$c{ߕ J¤,S=I1WBJGUңa AFbY2NcSb{E@J?;Y%/u9zݷVf:<r &[TEX)Hk"~xټ IGbx?h+b9dJ* #S}7=t{,HEJ;N+k8ù,Q(Js]qr-!MԬ`ȐAOkUtjN_Sj ӑqo?q-^XӓKXJ)N=7ts)g0^,؄ Zd1 Bd:e|;_i#ǬNYs"f<_C>]036+h>XLc~zOXbT#Gg=ӻ+h+ұad䙜9@uĿҹu?*M =5?{9~HO qM'"~8r}7#)SVR~x]+ww'۹ IsOkvr qk.R'74]Zvު8uSq4a>h=, GԱ9+PC+ "AŜkm(TUYC20I9EAZ  `H7O&R@~:1uD@&VԹw-*>H vf|9~E ;1fO' mL `2 #EGyGp+,GK`yA|r=cStq1!gau&|8cKn `1?,rl7qz(%Vxbt)ԜoXi[,[0dhO\ ~sXJ 1|m<$M$Fx|0)L~AIWe4[">TLŽq4UK-ҜZPWb68%C#ns Yx^Kop| 0< I?D["tr:r{'̻&JqLYh)*+lbAJ(?=#Wk5:zVİ6ᴑ?oF.*UMe`z9p*N` Ŝ" Jcը +rz$[dA0 ,0[Sz`倭;d>8Qi:13~?XX!1 >1J>|pH95|̏`Pē% !F~j~x]INcbk飏PmaGE]^ƄA$ȣ a,Y$†?QQZv1̷=n+R #\ 9?T~kuɧ"m/dP1Pw \wJ\=um YZe}!Fߤ#\r8y<6j|Ұձ@'\rZ8Zn0-ז6e̱Wm+Y }5/!JWȪڜӶd : {E@=<:a5k?NŭAcfP+kebM_Z[S ):FcT r`Iag Rq?cIYiȉ_ي\F:fCAg?Ė?29xN_!Ϝ8Tl&$G32jPB Zf됌Wݻ8{m( j""_H`blBZO)]W;7w V4c1g3ӬRm fxeC:dCX+)e9M ܾF9T" Lu L)Z2Ǹ~uO|ub:Oم !?qFs(/ ?dP2~c@&,~q{oD_gݷY4CӏNR,&Z{vK0 .c;kg I8qܻ7UV-w/aY)*I%W28}8ʪyf%$sֲ x]ZG{ ϙ[7g1mFe |fÿ Mk K5B:Yh-|KmY;,`LO48|)}r+ȯX~pTJXs,sRz3nC{398IjLL鐽O?pV> r{#=3Z㧐I:`cgX)JK+K('USGMַ _HN+aݼH9E'ȩ*Gy-jAgw0?RrpNUIɇ`@```ddaݧ\*_!5 'B?ۂ~#>sޠ@p-e{iȒH3>XN@-ȬZ%Y6*1$:0;嶝çO$2]{mљ>j<­gQ˧wd>~?_V~]euutQN$?ul(!̟B7bC/lǠ_=>Ɍ+p64h ,s {G[l'XtAO_|Oc?X.e}J͏<Dg!8xWF2?9#\ry|8! #hSoJ.f%o0!:b4uY1]l-_P\4hHHr8qۙG);((ڪK ,Ia[卧XVik*9hF)pɌt1eO ŔYrkuB*M|:CYoXr7UbJ7A3ngi]EjI}+ƹ|jVA`ztYia]u :x/H+!:0{w\~D)fTIʾ,<{H{@D9{tbڻ1Z fgR#-#\lq b0%<62獰 #nCM/NQ8P[mk$U b#ȃ决9D_#Sf8sBQY5F TR%u%>$-X2$GHt~)J|u%w sȔVxxm(ζPJFό?`~u兯}=KRFk'(9@:0o44"Pr𞸱CTo?~s =q3p5/ACu'85} }hz_͔Lq{~9$fFYf b8hW/#C务X 똃_  YRܣQ 5:-EJ>`ILS_ :j#/D@ZxrN6hp?OW*ܑe)US e ٻv_ʼZlYLى/r3!& > {0wa;X9F95dߩ|ʝGp8Ñ `pmGL4vH48`O3?z|0rqׯI0O\QBژEQ7zỵTzP;cd-&&~x2Y`\l}aFYp>Z9+OclϦ֮skƇz܌D(d{e5@|2?n-Db(PrkprϩNugvz}jn-)kR_M] _j$#vMukȨUp`DbWrRp[_ެF9C'u`֨%I$c,0Qī=AbR)>awmk{eV6(t)/mM!Mcj#޵X͞ƍa9"6Z\@>=PX @Fi>cU?nYf41|F ]vu@e`~9(>Xle ұy֮Qa 'tH]s ʹ\-@Ո:cWl.늠Bo2tiłEȸkKv,'rkn2Uns#),Ƈ\[‘Mt 4_rjM(.V:f"ԯ@A&!tIȩR]~ 2@./YN-(JE5ӬG&ҠY=`uF9/ٸǑܙbVvh+OAqG*ԜGsA2CʤAr?UywEVɺkSN:To`!2+;RZW!OPIGkRRā(N>?ӎK\(Tl"ڕ #?{e=…HGLG+Y2 $N|E/(Xo'ڟƗ.Ɇ+8^Oh X9ȫ FA ޮ~GNB5%>C{*'!&1cq޲Pq sQR0kJwbkY}WO&9+B Tǀ&Xy 0ѝtTh#]#85qԳUAGY%2V& GUdzWfWc7' xع1`!ORܞzh]dW<{vr%'A G1N Xm`tUOa8H'?Ya#1 I:(3w g T2We[(*14fbV!~c_Yuȡ)Y}@\4?ݦ qXʴUr͈'"w%Uf$(bwo1KсF|99xovQi+s5iRG&14ʋk&!(;Uh}%ZŪc#($ޞ`:3#CޝuJ eQcX{+Sq ?b$sL^J7ЃЃ;;ءhA+07E}VlNB';G5~XfsQK|D֫|g;UfYCvU eՅkvveN 5l$z_A#?Ū6*xanjL|qMt"D>xՆdIbt&f= {H5TGp~]5qb&*A@6_HMT3l'O1j33? "ٿ[ST9UG4$T,+ @Yr6P dze^xp7q#s#g 6#<'r wBr8D;WbEly5_#dYF Z$f@ fq'R|O 9II&Y ry]VʋfC 2##8< h4a"ς$yv=|IMM[*:ʨr6HB7ٻW)nބ[*7 jΆ|~}TӑPczOPYN;oj+{?S`@ $@Nc O)9{YMlheVj+|6RwUuX/ (vLd9?v8!LY=Mh,dFT$2če=PnrZ80fPjh@?Qqw/.7SveR7H*IYgƻÇQ[7nڷRRir,Ck5wn ZAqa\:ksI F+?9|6] Fh;kf2ϑ޻gtL O UP@ :𞛐=ne"A"\kkЅG0DsO2l@蜭āsw.R?/bT7}V0F`u}yIJpZJ_?J#9.其MUf^K2bHڪhݖ8V g ׸38}wqHV쩘@f2 9wM}?n'jμ`(&+[[01G*YŷWe5a A*N;gzյKXGfA1'#nʖ?1Ȳʬbk2TRLӞ,[UáZBtbvdK3[E׵a@0dFB:Ur p=CB/HQMH 瀈TdC>f4 ])ƪfu 8Bl)g )ܤsO#oXCnY 3<7o5+8aɎqw;n]Pi`!C"j4I :cE7q)_ YmZE-E ]̓TmԭH;0HLlk ݺzqjXIVDG1*ɥEKFuGjI~ц 5y%jY 8ZT ?"?}1gx ʩsP0Du$v [jr]ĝ@'Q)hWK7Ŵ`-2WR͌Ǡ(X0TvRy-r:ˏ- kNvs;I' v.e DY9ewY[72d/ Lb˸}}SX E܅O\u?R&PUt8 *A-&Pd2ܤO}5ZD;[Sw垶;  @ ]&IUhq:'\\O.Wj}2DG,츳WDZR H`7QߝS-.3 @3NXZ*H2&d⛅܅oU{u`9Zo3Y @|p8_NF@)nPLڻ(gwIT+eA8ۍUct>s '1x.f$  frk%"Eh8x2Ϝ(<)6k81IUT AH 1>UJLful/CeB}aEe7;3VEnzAa2?+8qlc]Q? ̟"n@D8vK[>2fwZ"8v*i1Qm$f,,s #^$Kt$zc`/q'ebJ'WsԟC,/,.|gxb*RH13#):3 Dqr۶PV$͋` zT'1 N9Cpg$ZL  |ώ- Ceb1h9q9#P Щ ^ŴmGq/ qǣkX~ ϖ^xHg c] 1,YΰDۃ]C&bIs?gc5J.du?nuF![̀b|q ״6!iѥ1W6B+ڣ3 g6r[kj}`='hf?=; 3]lS?zIt-l g: %L>{`'2$I g(Kb)&HNr>3 &2\$s c&Q*td?'8`pu^:*(Ȓ|NfNg's.$hb%jK7Y(oOX~~nL*QnZk*XZ܅Jk}-Dإ]Lr aZ њ01e =NZTO`s^ Xg>K=5`s HF^!SO㉈ӯ(bsicj_pm>̟0x6h'̌; < #@T)l f@'@s#_ WMV+`zOqg)T d+#̉-ֶf[յ,lr_NcaY%v! ONi] |OAs2>!=5$fxk@z箚 @sGe#3T?4I/cuJFldJ? 2X:J`x_eW+FJL7=ӫN(wzVU D  I8vv9lbcT/'٬REI=[遠R0jh4w2cZjp-@%H%ZI9>p?@txz|FF ysӳ9mEst8zmR9GC(uK>Q6(I5'"<#V*DDj:F]snL+4Np8@q#L+='`3(UC,'88琞g9?,0$LƍN/ l@_ 9nZ:Nr-kndi:ezE,*<8.XA_>>8RVF>XȒN9\? :%6ԃ33E8z dV`8qvǮ,Ze煦/cfIKT0GOHpXg<Ǯ$F==`Ĉhê8]q'L7ğJ*]+>)w#m4 k[\q2&اh8̟0Y8Mtyt]@ O,JKmY: 'Qz z/'y?B1}Wr:b ёsU91z#0ۧ5cLTO]@&X$[ RtVâFF:cr'Ƹ[CA:u$Uµq2w2 |c#__ԠƊNZh5#Br9g0`;|7<'Kʱ1_=0{EEi6Y'`)QLPu#',߆C2:jTgLhx\Xs<0%\cp3Ya8[k "e Qn# $i+Q,'/ j<1ˮe`O8 haqzxh 20`#4Dkz|1J" 2O=pՃ̰ƒ̟X z5#LyoیS]`q/mFu,z[v$C 1(rU7* ce_ܶ5gL@Apy|5<@6+e!@PգvԺWpڶ!>AVsǸ_bF凜4ϡg׌^ ޥNݹ}cT:9cn%@ܧtLٜ8rj9'|Vi:BەP.bIXYSd9]gy wvUO'(]6)1`CocQ``h?8$׺縏 gP I3O 0XccbGYoqCЪN&9czʼnVj[m: o)4C1_/v[VڡK @F)3"_m2IqϮݪ74#i0LVAo ,!$LQc:"( 5jwTުއ9|#3Xn8r"TlKcA鋻W5hFbNG\' 9T+mp,uF`bt@r: /(-WeĶߓYlj~윣^ xKkm0#UTJ=+gG0vʣlnf]'~9Kr^makZd$1tv~SrETGxO\-+6I$ 3FRN*p7gϘ s2*UgD\LrqWֶ!JC ɺbx\;GT70?J gՈ'|q=hY4 Gz<%N$$HWvIaERq2 3 @Gzal4Q&NK>>>=8rn̯NBd7sw X͙ #Rt?vC6LX`x8Yg} 1ycMZ zjy˂f"n ȕS9p9]ǯtݵP Ӫn7ݞłFfZ>h bԭ Q`$:I2O! a˚AD ?}4 BckLe=ܞߙ$2PҵtghF.?jyr!ZeUb \dF؃\}5VNIo<~>ץ}Vt%T,/R L'I7mZL/!,Fv w  td ٴz샂q ?<'˜yRt]ǩe^w@5~7&'ݮ22l6c"0xݟZ [ IsD,~OҲ@'NXkrI$Fijw nH{}#z\nFyhNdQdX3 dBW1Nm\cSnrLmNxkc1mjV bвxā"q0|c5iH9;If#\CO_/֠P e?/ի0T(RFy:mO ؃k}3<~Ɍx|Cq(1_;ўTd~-.K2 -}fl.Ur.uN5Q Ȝ79Yk60'22`cPjU]`u&I$$G_&R%[|Z T :O@9$F :?1#ȡCX͝HBg8]\X ȟ4ۻR.O{[˰AXQ*3F+qvMSݖP2ϩ04Ǹ]br RAY8d<,;A H'Q+e\`]Н0LL=#? ,J]h^nj,=ữWAZ{o*["3*a]TYfvk%Sp!XDc,v8m N5?}Zs"4G8UZYej $2|kEdWYoTEb/ [6o▎hܗc]RMLFօd:mQ~P1,;de?TR\XD$ۃ;PӲ\yFK0 |wQ]JBک; r|*/T7Q/)$#`櫢k>ћXe"ۀ($QՊjh&eܻSR5DtJ:#ۮ)vSz=*/i4T68jcZRw]v<U&)Zvבyҳ5bqKuuF@̻WŽέ8_à9sbdXñxi[mKRD$TAt^{t8՘'{"~1Xɇ[adM q(aZuU)eGmȗ Ƌ=f0{xXvMT ڇ'@/gizo9#3~>\Ze[+ޜwXn~nMݓz%ŭm>eWd5_ajsP 8|W㐓.ETv6A_`՝D論:cF뒢Duǎ9--%|&ZZ)udmDUG6^診 9? txAw=AAqMtP=Wx!e덬2$¹yč$R4O'@"ꄛK^\k]aMZuUPpUWEy&' hSJl2"!+ߩE;M6%Vq6)o"_B]MI[QuSvNj(Lԣtѥ7IЗURںEcJ pD3+9HcO} C b8ڇ/q}<'q&qJBkfEilmQt=I!Y_w_pk=zj3f\[y ̀H#򫦟HoQUE]:ydEc0?S L3C$=]PW迎z' F"n*^xjH]*u-]fuy2egc_~J'V8 Ia&)E^~5x[Bɭy5Hy PoD3j0~%U׬, ɱ 6^ 񼌨 4*չtzK\n4 =>#W9z!z,S%CDO}7K{^{:Aqb2U@&<͡..(h)wd|Wr)oTJW${Qq&CV{TQ'UTC׶ԽdɄdE2/[_}` BM~It9Ak8q#*r7 2U/*"wU^[͡QCG7БP IKDEE]z{x?yP;dY}9~UDE^a"qVsy8ӻX3iUi ")[OX;y+j2OInrȵJh  MsCayqñ򸡶 }DepHI4swӢ[zٌ]f~9_\vJ*'qi_Qۙ>>ro*M/ o-EKhdqTqӾ9L;6 \91H}1%2P%TQ߬nyw%VO8ը- 7حq#gU9"4u@ Z20"ʍjT}f_nDAވFRp$fs]f/<-,3*xjˎ=tb,<)*IfW<RA8܋ u@;PD h6 "& d MwBPil |hz Z r*iQI^`BH`-*n?eko?E4萓TQ5O?wSa`&C+\9`4(GQ!{K8Uuv~T?(88'/U>v/\ϵ[jY+Yc5 kyeKg 銤飯z 5X9'g]r=Y&|j&(Dۤ"DwxT>|ʹ<ۍh)-C'ϼǜsb <*@ǚˠrgd-rad .DndۑRi2-Jue%]ƫ&V]a9CLdL 'DQm$!gPQEtbX8ߙ" p"T 륥"dl$xb-bX FVj@"*ޯo!Sdϲ2*T@*TUqrApꢨW!u=WrdPδ"x!%AmQ'T=R͖5MBV|#V,S`d={' jᜓrX+$VDYpd4T]dm'5QQ:»'YaHnw%CuPDj脨T_؛h:&EtDWFBOr"SIs"wOB񮨊@B$RmDKDz#VAQZj{5쿿zKʹ$ ~a*""~:9圸\29Az\$e"\1?T'4y0`DYK2"S2G;8 Nb\Ǡ<ű$Mk\ވ1aEQqE@yGN˪uS~+\^H+3ll-Qi"8zlr Q;YyE<0ŠOsۑgA;y qSde_DSQiRzqlIOΖga*d86U?(iQt PIY.Gݢ#l.j5%umP"=<˯_j!!7a<~X*$TtԢjʰ牣l|Hu~޸+YVaLҫ&IPtuq!i4]U4׫^뮭YbYR6uZXUhٸi{uYF3K,G|خjL<6k_Ot Щl[.+k(B}N5E+ĸ-Bm_p;dSwܠ1YM̖m鴈1 ̝0qAZq6jQ,hM\H/~3E3زDqD|HM͢bf5INVr_^G|5ɱV|R%)֚%T _bc&K9JdKCd(Q0yI;H6]1_=$+{'GiMJU-)*ֺXzPsǰdR]*KW'M'b)}܈҉?\2YJtr;#7GY6>-⫨eT^N{$y3zgry3^7hMUTuENѽ0[ 9=b5󃭔Fjn3Q͂*sHS8́!"ET[z*S_߯_ƹH͸Oem&? |FU^ҡDE="].Qu4|!F T_O h-T~{jҙ Kyr>Ƿ,_*2 +Ji3ޙK*slp#F3"$bbѷˊmm{.:ٌx˂,K7jJmm:͏2RWGG mTܚakWHg4`bUҿ,DG$ m슫|_2X^ڔI΄w#4NU1+e|2s̋.(|6o huE^xֲۜh:IS5]~ kYQQpoMU.yq.8c819.(*SUU$DN$,.{]5ϱ.8ıpC @KlR+jꈻě65vfUκ79uH*z'׾j8)}z^EDn$j.[w8$߽[IS^,۟$;# + 2׫1n#]4wgXU yricai4F}]'j"*uim^C8cqV+oP$ K/Jb*B@jo"ڄH/Xu~'!/7kũ}9pAD&;99^楦\z{S"6}ѽڑ"uyϐe`>.+CȞfT'k(3(?HR" -iqn3 (0 LX -UTUY.o0/Ý΢O׳^pPu7Ҳ^x1 !tKNf 8)Mrr2E=6*ko?hRM SƪjZ(B)"*/FдŹ&5DE$9/;/MBe.y>Gj,`E$U׿N<MjDMt/sb"OzbKU DMz8dsf( zԹpOy,t'NQX.ɰChWl:H;Ul[zR×:pAk li%KW$xIQ5#%U_Ǩܛ3{{SS<|yQrChUG\AߠJjM*]&}v'4#/T4LBDT^Lwd~$˹lҩ| j©4NE7[ң2Ae }Pؿ4emBEEѸ/ťRn)ÐxѴA" t>p94 Kؐk7kC@'r}%c':g=cMBbM&TO!)Nſ.g/a.6LnUL~m-mVG[YّEEUf r>[k2aMXi4TEC^ϵa$!e֏;i?:u 4Vۺ {]Zy6"hN+orYDf Yh#to>3]JvU覆݌ GP\i6(I:pf ; iOdYBqȱTDMQuPI_!Cρ}J0tERVKEd 8U͠ub)udGr3l1YˌXq㱽[s_w? izKirocl/z; P.k&aUPHEjuᯑ n\Y⊄%E?FLYU!( eQߴsj|"hZƽZĄ2]=8p3qŔ VIԬB"pUv=g)1rg1CQj~p7d0Ojewk4ʽsX%^%뿯RajmpDpChf(I*.苶}ǁSCon9+Pun騳{\l kנV,n!s˕w:Mc#.Q:qdBN*ܣV~n5<غ[F(PmQ:v%/0?mیn.&s?[+ሰ >'; |ul/'m쯗XWR xUq @ 񪖽Yq=ˎVV#;*xOYop4ѵH2`ݾG.k* MAe7~U.:+H"܃?Ɣed1H:" 6LbA]S{9!܉Z3cIvDI+j2Oy_űW=ٽ+ uFRiJMUЍUزG"ùT-U4T]NU37&"U]P*:%z)8N q4wN%T٭Ql耉I[38&UIC_.[rT6_]w-w%U%?*#6\YQ 5H2,}v2I {X9M^eUjF.+ Gy4rlh@UxTV5Id%%Y:\RU_%W)V//]?\I^{iyN xDY6@J$N#CtB> /gOh2%]凤:- QۈHe){]QTv8)sL6 y~Al^WM1Ц⸺hΤ6u^Ȇװy0YSQ$TX90dHPAL[a]w/dp+lLjLy8WG)PMoE|B[dTĹMEfʄ°;uќy֏M{vSC*#&c /5N}kqnƯ&o;FGZuQ_Et-G^bD Vҳ#݃ȲvEaVCUD@$%A]:fˎ>lj͓1c& 5h{HV!}J O/NhG~\w3)oo!–f" 8h&dȭ;ZͩqEU"5ADS%N Rf{nDqo]H4BF۵ |t$ma*^Dگu XW}M!ȞB'ƿ#.8lEg*>npUKUO5f C[^fB]4/*hj@'j?:zo.ߏ['bL,.*4&T^Pejʷb ЖZr`Bj*Wz[-d܏ئ5XP !@R%>ne/~d8Of "J˄Q7DM^gYmsîE.JqcTv+p"\#3>zaX9BicO6p1)6vG,e' I5_"#z""舊_?#fc[TDU+u'6~3SխY{QEdk3֪TwFA' IU4NYxq;5}upQ+o;GdAuĜk@$oBU"ZrPsW1e(*c`_Kw &eiKZ?㲵ñukFl܄ CeYYGѲoʗ T꽕WDMUtצp^p ㅣ4b$CUu#mEM\>g7NȰnjES^`Ϛ#XG!ɏ(D4뛽m<]ubpXY> D$u1-;!kԘk̜A@"NxÀs;;e®h\Ky]%&bV9D'ΕRgFxGj'X&Y(m5n,M~~3cZv F&YG|էGe~yH;za6l27q^gpDFʈܣ1ZmO;2chПl**"H;4RNA%+oj-IHNͧ5@ƕHw8~eM]Wi5/x(t"wOMS|[SaRTsfLy#`fdMQ1bOձ^_[]]uFW9m+"`A>]o N_,g̨YX2i'7 ĀM2VtRԐz3ƸؓbRo)a V&"U!_th=t`*o4v>%Zmqx$i\֢!cfX7 c8OBDWWm"};(W UDEAQ%8s3l%ΐh mlH(Z"4'rMW^Ωq>?*aUm=b:.xSf& 3]Y5U'q\yQt4TDMWDȰ̾.LzZ~li0@TuE訨ۯ ۋMQϯ[`_́R󈪠 ؂R-9{mWL/dr%a6q\E1Vro2>v\{>Β  kG_ )y%DUQ$=a x `8Z ;tNJ\MPSDDz }VM%G#2M=w+d(^aT@ss]s,Uݶj%JIQ QAD)-6וMK˯"'Y_o.exg `"L62@c`Wm'T'HIPS\G9"f447 s\dcKvc>m!Du7fɸqx 5z*SY5dxѡKq@(#yap=N_քOXp &J1(h_m1~:`P1l*a22oge> 1[Uܺ\e}`xfTaă"D%U@R Th<2# 8ҀlnpmWST/^?(\zoշw-Imgn!{S/40ݎj }$$?**\Ǒ""Ye~o!Ǯf0"] Fʪ|(uMYaNanr%`c(mƝ#F'cϣ!S"U1qW;b˦AP a[-Č^9M."T3Q^RG2LbGZhÈh^3';|u!%fsmJb+Rvﭼ?.jYFP㌣ ?%$2m7CuA1TGrÂBuf65,EO*%Xص/ T^$EMt׮=\_\%:6tq'j Уו`&PG>és_;zkGT3lDCƨYGu5i]Gc-tQw/^r1!IA2ɱsc$[O>Q:lͬnyDAN꿱:3#[݅Ch >^r֌W r*.տ*r#Lz9+fEc8߀kJOyUTEW㦬cBfe~Nu~Mq{uNo4],94ceܛT 0qڊ[U%]ȩIF6[撯ОGGj*u$EO=QxL> .!%p%%kmɇ4UУ,MڝE~\vzuec]wck~H q+`b[_CO{Kܣ^OEnvE܁uijLfq]MW9O"NkUEQtG_4껙;ZqG%L]/<]P!TqB g ROb;ںti|@HPI A]9eA28UȯԌȑv gHeV]WQ^{nWɿ@i9$eVgbg愖'*viM;&`x _m欅ʰƥ},VI`3 uA\G#_ϧ缁c>o>5lO{vI~X:#*'Yoʹ>!Yoco=+rq7˜ *NDT~rCrs:㜗Z J Av%4vII\$q42U1^INJ{EYWYZ>)1ז5dh2h~^X|N$%_),eA W Dn':*Ζ;p?K8FnYw4dյw܍sl>ͫm$E 9CÏ{LsQ"x2)C/6(oDmhE95)'$"!XHhQBM"#L#׬i,/!; '[ 3 "  {"֟6A + nɀ0C)r3"DM/6fg%-81j<^-Rdy FlGin_A*ײgGMp|ݠm/r(uLrtz~m8 v"BQe0 -rjZSUwk"by]6ABTUNKH=!ˎӠbQU:m˪|;r^yIiAyO]PKUUxxң5K,<1ͦ0Np$*< hn4UM8֞A…2򷴼Ȗ<\&Sª Ҁ A`Sz";cN ޴p[Af6&|W%~hu> ɧ@M8$zEbmTYzB6X_iOgOq}zJZf')!9Nʓ$=pzxxFvL1ڋ'=b&ј ͙+NKKo2N;Cg"㜢y@%{i-<ƪe1u?d0W8N7b:CQ MM6 AePD oyg2F%btG8d4 4ւO A/eUSewDucE*K d\$x|A+' b+iQqSY /ճEz;"DHg^a{Eg2g-e4T&GЬT+6"^i2w8ա]d q) ؍cDAV{h+c.Eɼ-8swc8yQ›<H@ۆ"tMqϖ9ӎ=W,7'gIZs(xrAQGŴ#MrGp?X"bySuВljܑ-U9)+*u/m^y=ܕٹzRjk2*zY$eM&@6R] UM{jxs^/p ; z<RHut'B#.Z껜שvSe WEc[f롪hkrj((s)K/cqÙuxo&Hy4gk)xEEˢiEǙ?QLr*4N_k&j0%doT~?ck3FrCo*d$v?q^C]Mu~ZPiܾ8 ܆iRT2WE]US[CoG/\hpK̳wTf/,FD|O[Vycp^@m {~$DHqPWChUzůɁN#qWqu Jm 1w3sp1 !DO:'^NKsoa A!@ 0B<[GE#UWrRqNJJ+$7E R(- 'Ϊ=. 6qϖUAlބ4:*v&]J:g}o:y0ݍ>Ҋ":܉$M[ b!TUN>/ Z5'p;YߣVj.Mj~U:?,NO7s]@{4qh3_am%+ IvD_fy"c"~]SEScقϋ[rWQǝTꃠ PDTT^ʊ׸=å>}܋ )< :&&Gecάu4LãiH/EQ/2"3lɎ#L IW]4TѼB׏,9,EqR"&U")rGd`*jAY]?~q/)rWo񭚩Ǹn]5v<"O)<С2dKwu_[9SY5Quv] cE&BmP~Q}nn#. -qa\!ڂ6&װy6+Ǎ</×*Dකl41"ف<^i2V;r>L`bࢴv=es-|uEO1Ʋ\i/cV~|5w_m5MQ13|+dMíg E1K\x(66 .O nADD׫G9]W@n)⓭Z1Xrdi-5t2Q= YѣǍ@A4DO2*'7Ih~) 8$4.h\lWEN**jg~r=6%J߈\(󫦪Ŋ݃(6&I+2oizw[p18x/JfkH%:JBPl! .er#Rd "-k:PuBK`'~NRJ](Q zSq8^vbCcCDDu]Ğ雐.9-8ƭ{ JlU;P/i:K2JeST6dM?bj*]?b"ue^,[y/)mORPI](w!vܞ[~yI1,,[8!@`p%2BUډž]^[\exVYޑh"cIZa\˔~`Qʱo(gl)BYFRjLUDiy*cpP129:FN# 8jK葡xl8.mDQ]S&uMWTuNˢ~VY&ppB~ejhumdNz\?<~nK)^ݴx̼l$SޣC=qqqLȖvY"[Q}դef:iڸ襢kbVBrh,cX#@Hd> sCA!T`|'d^CR& F"ou Mu7пTs]jEmą"kdIxuW@ETx9BP+" Fxmԕrcpy 镘fi20d/Q Xp|;tNρ=cWʎ> B{f#jڻGƔGǻDQMG^SYs ?ΫCUeewl]Qyޏa=ٜ,5fMe2ۏX!`&^ qX?jX>I<@ЏuR74{umr(oYp!ZۭgLޞbޢZN~pVNwq:ꎪJMFED04){ y8ˬKb/f#PYa`n8)BQ.AV7t8VOV]$lqSh*toJŭK?ʗ_ ǮYJmSA$ۡ hzݍQaVT \u ˧:]\c*OýTE:WdvǞlrTMSHۮa~R445lSǸ׹t^6]"j9'\hUNaƢhb^3 _l@` &(D+M(N5]UQzVӈy/p댱X/7cxuܵfɖHdؓn)/u$%Ew?WYmPq :Yf0Pt~H4UUT/@#]p7(d3cDQnb8V/jG&qTUQk!e_yzC穙ƺ&h7gQlː, O2/਽sID)C/ѾRqy:#N(xSMI;W%sz&2flX-#1ު[,_(ZL몀EmAQ~eL{ZurU`xe$\ i?J7L 4vQhroĺo GJZS-EX`~ޝeans$dw/_ ֎rn~'AWi[j:R M؋׿9v=8떐mٰkl 6fЙhIk\ieØ4a wwfBLΛa?9' A4!MzyMUe2WfUug$E)V̑E1 /NzKo{S9cVOQ|.ˉ zH:]S\cW5^1,\}H ]W SEؚnz^| XuȰ)!uI@vQ> **>EK2 &dp1}&q >dnX &+f$NɎy1]|eX渵r+q>sqJ_shld; EWbԱqza"h-""` .fL'lEwMMKjnvzm`TX@hnueAX2amwR]PDDx؏K-¹ab]v+ !euxShnoP2AI b9. ͸ʑO*%5R3| -j*R$跳й6q,LZ4š -Ȩ ?Xy'ۭi Љ%RT쪽qQ vּlu$Yo8x>m("'tӨ1Spxn^XPWRR\DTE0Q~5ӫJh=lbUWLX$aTU'2]JJ&Gw1<7T&+-Tn!'h\9m̴u':ZYڔiۄI>#{wD 8ʤTu\`HZ Šk;N0Ŷ-UBϲظi"D g_/7+~:?H=맏5Osַs?5mku˿~w5jtߦ^?꟬\?M~O&oۮFq F?&{^#珹gӮ=Mjg{}iuO]up$$If!vh#v #v$:V l t6,5 5$pyt $$Ifs!vh#v#v #v:V s t0T5 55/ 4 sasyt6$$Ifs!vh#v#v #v:V s t0T5 55/ / 4 sasyt6$$Ifs!vh#v#v:V s t0T5 5 / 4 sasyt6$$Ifs!vh#v#v:V s4 t0T+5 5 / / 4 sasyt6$$Ifs!vh#v#v:V s4 t0T+5 5 / / 4 sasyt6$$Ifs!vh#v#v:V s48 t0T+5 5 / 4 sasyt67$$If?!vh#v #vj:V s  t05 5j/ / / / / 4 s` a?pyt6T7$$If?!vh#v #vj:V s  t05 5j/ / / / / 4 s` a?pyt6T$$If!vh#v:):V s t054 sayt3$$If!vh#v:):V s t054 sayt3$$If'!vh#v):V s  t065)/  / 4 sa'yt ?$$If'!vh#v):V s  t065)/ /  4 sa'yt ?$$If'!vh#v):V s  t065)/  / 4 sa'yt ?$$If'!vh#v):V s  t065)/ /  4 sa'yt ?$$If'!vh#v):V s  t065)/  / 4 sa'yt ?$$If'!vh#v):V s  t065)/ /  4 sa'yt ?j$$If!vh#vZ#v:V l t+65Z5pyt(-$$If!vh#v):V s t0+6z5)/ 4 syt(-$$If!vh#v):V s t0+6z5)4 syt(-$$Ifs!vh#v9*:V s  t0$65/  / 4 sasyt ?$$Ifs!vh#v9*:V s  t0$65/ /  4 sasyt ?$$If!vh#v #v"#:V s  t05C5E/ /  / 4 sBayt'P$$If!vh#v #v"#:V s  t05C5E/ /  / 4 sayt'P$$If!vh#v #v0#v:V s  t05C5g5 / / / / / / 4 sBayt'P$$If!vh#v #v#vX:V s  t05C5%5 / / / / / 4 sBayt'P$$If!vh#v #v$#:V s t05B5F/ /  / 4 sBayt$$If!vh#v #v$#:V s  t05B5F/ /  / 4 sayt'P$$If!vh#v #v0#v:V s  t05B5g5 / / / / / / 4 sBayt'P$$If!vh#v #v#vZ:V s  t05B5%5 / / / / / 4 sBayt'P$$If!vh#v #v$#:V s  t05B5F/ /  / 4 sBayt'P$$If!vh#v #v$#:V s  t05B5F/ /  / 4 sayt'P$$If!vh#v #v0#v:V s  t05B5g5 / / / / / / 4 sBayt'P$$If!vh#v #v#vZ:V s  t05B5%5 / / / / / 4 sBayt'Pk$$If!vh#v0*:V   t5/ 4 ap ytk$$If!vh#v0*:V   t5/ 4 ap yt$$Ifs!vh#v*:V s t0q54 sasytq$$Ifs!vh#v*:V s t0q54 sasytq$$Ifs!vh#v*:V s t0q54 sasytq$$Ifs!vh#v*:V s t0q54 sasytq$$If!vh#v):V s t054 sayttBr$$If!vh#v):V s t054 sayttBr$$Ifs!vh#v*:V s t0q54 sasytq$$Ifs!vh#v*:V s t0q54 sasytq$$Ifs!vh#v*:V s t0q54 sasytq$$Ifs!vh#v*:V s t0q54 sasytq!$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkdBY$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 !$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkd\$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 !$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkdn`$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 !$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkdd$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 !$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkdg$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 !$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkd0k$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 !$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkdn$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 !$$If!v h#vw#v#v]#v#v#v #v #v :V  t*65w55]555 5 5 4 pnyt2 qkd\r$$If Z/ jH&f!$*w] t*6,,,,44 apnyt2 $$If!v h#v#v*#v#v#v#v #v #v :V  t*55*5555 5 5 4 pnytinkdu$$If h jH&f!$** t*,,,,44 apnyti$$If!v h#v#v*#v#v#v#v #v #v :V  t*55*5555 5 5 4 pnytinkdy$$If h jH&f!$** t*,,,,44 apnyti$$If!v h#v#v*#v#v#v#v #v #v :V  t*55*5555 5 5 4 pnyt_+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{q$$If!vh#v #v#vh:V l t>+H5 55h/ ayt{$$If!vh#v):V s t0>+h5)/ 4 sap yt{$$If!vh#v):V s t0>+h5)4 sap yt{$$If'!vh#v0*:V s t00*50*4 sa'p yt_ 5J / 4 sap yt$$If!vh#v|):V s t0|)5|)4 sap yt$$If!vh#v|):V s t0|)5|)4 sap yt$$If!vh#v#v~ :V s t,55 / 4 sap yt$$If!vh#v|):V s t0)Z5|)4 sap yt3$$If!vh#v|):V s t0)Z5|)4 sap yt3$$If!vh#v#v2 :V s t),552 / 4 sap yt3$$If5!vh#v"):V s t0")5")4 sa5p yt3$$If5!vh#v"):V s t0")5")4 sa5p yt3$$If!vh#v):V s t0)5)4 sap yt6a$$If!vh#v):V s t0)5)4 sap yt6a$$If!vh#v):V s t0)5)4 sap yt6a$$If!vh#v):V s t0)5)4 sap yt6a$$If!vh#v#v9#v#v5:V s t|55554 sap(yt1$$If!vh#v#v9#v#v5:V s t|55554 sap(yt1$$If!vh#v#v9#v#v5:V s t|55554 sap(yt1$$If!vh#v#v9#v#v5:V s t|55554 sap(yt1$$If!vh#v#v9#v#v5:V s t|55554 sap(yt1$$If!vh#v#v5#v#v&:V s t55554 sap(yt1t$$If&!vh#v *:V s tz5/ 4 sap yt1t$$If&!vh#v *:V s tz5/ 4 sap yt1$$If!vh#v):V s t0)5)4 sap yt_t$$If!vh#v):V s t5/ 4 sap yt_66666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@6666PJ_HmH nH sH tH D`D *xNormalPJ_HaJmH nHsH tHR@R +*x Heading 1$<@&5CJ KH \^JaJ RR ,*x Heading 2$<@&5CJ\]^JaJNN -*x Heading 3$<@&5CJ\^JaJRR .*x Heading 4$$x@&m$5>*PJ\] /*x1Heading 5,Heading 5 (11pt,before: 10pt,after 6pt) x@&5>*CJPJ\]aJJ@J 0*x Heading 6 <@&5CJPJaJFF 1*x Heading 7 <@& CJPJ\TT 2*x Heading 8 <@&6CJOJPJQJ\]R R 3*x Heading 9 <@&CJOJPJQJ\aJDA D *xDefault Paragraph FontRi@R 0 Table Normal4 l4a (k ( *x0No List Z/Z 9Default 7$8$H$%B*CJPJ_HaJmH phsH tH PC@P 9Body Text IndentCJOJQJ^JaJJ/J 9Body Text Indent CharPJtH N' !N 90Comment ReferenceCJOJQJ^JaJHQ@2H 9 Body Text 3 4<CJaJL/AL 9Body Text 3 CharOJPJQJ^JtH VPRV 9 Body Text 2  #B*CJaJphV/aV 9Body Text 2 CharB*OJPJQJ^JphtH HrH 90 Comment TextCJOJQJ^JaJB/B 90Comment Text CharPJtH VX`V *x@Emphasis,Emphasis (Strong) 56]4 @4 *xFooter  !6/6 *x Footer CharPJaJ4@4 *x0Header  !6/6 *x0 Header CharPJaJHH *x Balloon TextCJOJQJ^JaJR/R *xBalloon Text CharCJOJPJQJ^JaJLjqrL !9Comment Subject 5OJQJ\^JZ/Z  9Comment Subject Char5OJPJQJ\^JtH @ "@*x0Revision"_HmH nHsH tHB/1B 9referencecode15CJ\aJFU AF *x0 Hyperlink5>*B*CJOJQJphFV QF 9FollowedHyperlink >*B*phrcr *x Table Grid7:V&0&PJaJ.) q. 9 Page NumbervOv *x!Normal + 5pt Before + Indent .13"(d^ PJ\aJTOT *xNormal + 10pt (5pt Before))dXX *xNormal + 10pt + Right*$a$ PJ\aJN/N *xHeading 1 Char5CJ KH PJ\^JaJ N/N *xHeading 2 Char5CJPJ\]^JaJJ/J *xHeading 3 Char5CJPJ\^JaJH/H *xHeading 4 Char5>*PJ\]aJ/ *xEHeading 5 Char,Heading 5 (11pt Char,before: 10pt Char,after 6pt) Char5>*CJ\]aJ@o@ *xHeading 6 Char 5CJaJ@/@ *xHeading 7 Char CJ\aJN/!N *xHeading 8 Char6CJOJQJ\]aJL/1L  *xHeading 9 CharCJOJPJQJ\aJ8C8 *x Colorful List:V4j@ jQ j  j  :8 444GB*ph5\5\5B*\ph:85B*\phS *xLight List - Accent 6:V50FFFFj.@FFFFj.FFFFj.FFFFj F44(5fdfd55\5\5\5B*\phN>@bN 7*xTitle6$<@&a$5CJ KH\^JaJ F/qF 6*x Title Char5CJ KHPJ\^JaJ LJ@L 9*xSubtitle8$ & Fa$5CJPJ\]H/H 8*x Subtitle Char5CJPJ\]aJ88 *x0 tblNoBorder:V:::: I*xtblTitle;$a$5CJjj *xBold + 10pt (10pt BeforeAfter) < 5\aJT`T O*x No Spacing=$CJOJPJQJ_HaJmH sH tH 22 *xcomppens>5\JJ *xcheckbox (10pt After)?N/N *xSuperscript (Bold)5CJH*OJQJbOb *xNormal + 10pt (10pt Before)A PJ\aJd"d *x Normal + 10pt (10pt BeforeAfter) BT2T *xNormal + 10pt (10pt After)C4"4 *xCaptionD 5\aJRRR J*x tblVetInfoE& #$./b$ PJ\aJPbP *xSubtitle + 14pt,ItalicsF560r0 K*x tblTextBoxGpp *x0 tblBorder@:VH04 sHB/B ;*x tblTitle Char5CJPJaJ>/> E*xtblVetInfo CharPJ\>/> G*xtblTextBox CharPJaJ66 N*x tblCheckBoxL\POP P*xtblClinicianInfoMCJOJPJQJaJD/D L*xtblCheckBox Char PJ\aJN/N =*xNo Spacing CharCJOJPJQJaJtH J/J M*xtblClinicianInfo CharPJtH ZZ *xBold + Red (10pt After)Q 5B* phj"j *xBold + Red (10pt BeforeAfter) R 5B* phJo1J *xBold (No Spacing)5CJOJQJVBV *xNormal + 10pt (5pt After) Tdm$>/Q> *x SuperscriptCJH*OJQJc *x Light ShadingG:VV0j;@ j; jDjD44(Vfdfd5B*ph5\5\5\5\>r> *x SectionBreakW$1$CJbob *xBold + Red (No Spacing)5>*B* CJOJQJphT/T *xUnderline (No Spacing)>*CJOJQJR/R *xEmphasis (Underline)6>*CJOJQJJoJ *xEmphasisStrong56CJOJQJ]FF *x Normal (1pt)\CJPJ\aJ:O: *x Normal (5pt)]CJ ^^ *xBold + 12pt (12pt Before) ^m$5CJnon *x"Bold + 10pt (Underline,No Spacing)5>*CJOJQJPP *xCentered (No Spacing) `$a$m$DD *x Title (AMIE) a5CJJ!"J *xHeading 2(Subheading)bvO2v *x!Normal + 5pt Before + Indent .23"cKd^K PJ\aJfO1Bf *x!Normal + 5pt Before + Indent .33" d^f1Rf *x!Normal + 10pt After + Indent .13" e^fQbf *x!Normal + 10pt After + Indent .23" fK^Kfarf *x!Normal + 10pt After + Indent .33" g^hOh *x"Normal + 10pt Before + Indent .13" h^hOh *x"Normal + 10pt Before + Indent .23" iK^Khh *x"Normal + 10pt Before + Indent .33" j^dAd *x Normal + 5pt After + Indent .13" k^dd *x Normal + 5pt After + Indent .23" lK^Kdd *x Normal + 5pt After + Indent .33" m^XOX *xNormal + Indent .13" n^ PJ\aJLOL *xNormal + Indent .23" oK^KLOL *xNormal + Indent .33" p^fqf *x!Normal + 10pt After + Indent .43" qk^kf"f *x!Normal + 10pt After + Indent .53" r^f!2f *x!Normal + 10pt After + Indent .63" s^hBh *x"Normal + 10pt Before + Indent .43" tk^khARh *x"Normal + 10pt Before + Indent .53" u^hQbh *x"Normal + 10pt Before + Indent .63" v^drd *x Normal + 5pt After + Indent .43" wk^kdqd *x Normal + 5pt After + Indent .53" x^dd *x Normal + 5pt After + Indent .63" y^fAf *x!Normal + 5pt Before + Indent .43" zk^kff *x!Normal + 5pt Before + Indent .53" {^ff *x!Normal + 5pt Before + Indent .63" |^LL *xNormal + Indent .43" }k^kLL *xNormal + Indent .53" ~^LL *xNormal + Indent .63" ^! *x.Normal + 10pt (10pt BeforeAfter) + Indent .13" ^ *x.Normal + 10pt (10pt BeforeAfter) + Indent .23" K^K" *x.Normal + 10pt (10pt BeforeAfter) + Indent .33" ^!2 *x.Normal + 10pt (10pt BeforeAfter) + Indent .43" k^k1B *x.Normal + 10pt (10pt BeforeAfter) + Indent .53" ^AR *x.Normal + 10pt (10pt BeforeAfter) + Indent .63" ^RObR *xtblClinicianLabels$a$ PJ\aJXrX *xCaption (Indent 0.13")^5PqP *xCaption (Indent 0.23") K^KPP *xCaption (Indent 0.33") ^PP *xCaption (Indent 0.43") k^kPP *xCaption (Indent 0.53") ^PP *xCaption (Indent 0.63") ^nn *x%Normal + 10pt (10pt Before,5pt After) dV/V *xNormal + 10pt + Italics6CJOJQJ^^ *xNormal + 10pt + Hang .25"(^`(8 8 *x Normal 8pt5CJ( ( *xStyle1( " ( *xStyle2bO2 b *x!TimesNewRoman + 10pt + 5pt BeforedfoA f *xTimesNewRoman + 10pt + Italics56CJOJQJ`OR ` *x TimesNewRoman 10pt + 10pt BeforebOQ b b *xTimesNewRoman 10pt + 10pt After zOa r z *x-TimesNewRoman 10pt + 10pt Before + 10pt AfterZo Z *xTimesNewRoman 10pt + Bold5CJOJQJf/ f *xTimesNewRoman + Bold + Uline56>*CJOJQJzo z *x#Bold + Underline + Red (No Spacing5>*B* CJOJQJphno n *xNormalExam + 10pt Before + Bold5B*CJOJQJphVY V *x Document Map-D M OJQJ^JaJ\/ \ *xDocument Map Char!OJPJQJ^JfH q 4/ 4 *xListh^h`*W * *x`Strong5\( ( *xStyle3D/ D *x Bold + Red5B* CJOJQJphZ/! Z *xBold + Red + Uline56>*B* CJOJQJphZ/1 Z *xBold + Red + 12pt TNR5B* CJOJQJph\/A \ *xTimesNewRoman 10pt + Uline>*CJOJQJT/Q T *xNormal + 10pt + RedB* CJOJQJphVOb V 0Normal + 10 pt (5pt Before)dF!r F *xHeading (Underline)>*l l *x&Normal + 5pt BeforeAfter + Indent .13"dl1 l *x&Normal + 5pt BeforeAfter + Indent .23"dn/ n *x"TimesNewRoman 16pt + Bold+ Italics56CJ OJQJb b Hi$Normal +10pt (10pt BeforeAfter) </ < UKComment Text Char1`o ` pcBold + Blue +Underline5>*B*CJOJQJph^o ^ ayBold + Red + Italics56>*B* CJOJQJphRo R pcBlue (No spacing)5B*CJOJQJphTo T pcBlue + Underline5>*B*CJOJQJphVo V %Blue + Bold+ 10pt5B*CJOJQJaJphPo! P %Blue (No Spacing)B*CJOJQJphxO2 x !MF&Style Normal + Indent .13" + Left: 0"  ^ PJ\PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VGRU1a$N% ʣꂣKЛjVkUDRKQj/dR*SxMPsʧJ5$4vq^WCʽ D{>̳`3REB=꽻Ut Qy@֐\.X7<:+& 0h @>nƭBVqu ѡ{5kP?O&Cנ Aw0kPo۵(h[5($=CVs]mY2zw`nKDC]j%KXK 'P@$I=Y%C%gx'$!V(ekڤք'Qt!x7xbJ7 o߼W_y|nʒ;Fido/_1z/L?>o_;9:33`=—S,FĔ觑@)R8elmEv|!ո/,Ә%qh|'1:`ij.̳u'k CZ^WcK0'E8S߱sˮdΙ`K}A"NșM1I/AeހQתGF@A~eh-QR9C 5 ~d"9 0exp<^!͸~J7䒜t L䈝c\)Ic8E&]Sf~@Aw?'r3Ȱ&2@7k}̬naWJ}N1XGVh`L%Z`=`VKb*X=z%"sI<&n| .qc:?7/N<Z*`]u-]e|aѸ¾|mH{m3CԚ .ÕnAr)[;-ݑ$$`:Ʊ>NVl%kv:Ns _OuCX=mO4m's߸d|0n;pt2e}:zOrgI( 'B='8\L`"Ǚ 4F+8JI$rՑVLvVxNN";fVYx-,JfV<+k>hP!aLfh:HHX WQXt,:JU{,Z BpB)sֻڙӇiE4(=U\.O. +x"aMB[F7x"ytѫиK-zz>F>75eo5C9Z%c7ܼ%6M2ˊ 9B" N "1(IzZ~>Yr]H+9pd\4n(Kg\V$=]B,lוDA=eX)Ly5ot e㈮bW3gp : j$/g*QjZTa!e9#i5*j5ö fE`514g{7vnO(^ ,j~V9;kvv"adV݊oTAn7jah+y^@ARhW.GMuO "/e5[s󿬅`Z'WfPt~f}kA'0z|>ܙ|Uw{@՘tAm'`4T֠2j ۣhvWwA9 ZNU+Awvhv36V`^PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!g theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] J} O L- #$%&(")*+f,-/124m6)889:J;;<=>CEeGHFJAKLMNOQQSUWGYZ\^`RbegikmoXsu8yP}~ބJCNQUY\lrtvxz{} #'.49=CLPW[biq  N nq@?BwzCQgx{6KNc@C#|$j%V&()*t+++q,j-u.2446d788:&:e::::!;G;z;;;;<=Q=w===>->c>> ADEEEEFAF^FFFFVGGG&HeH|H~H*IkIJKK LLM4MN>NeNNN O,OPOvOOOOPPPPQQRSSSSTTTWVZVpVVVWWWW7XX\\]^^___ `5`7`^aua9bddeeeffggghhniijBjwkJl mm n4n6nLobopq-rrrrr4sWsqttauuuvv#x8yQyz|c~e~~~~~~~hj.\ `tׄAJDEFGHIJKLMOPRSTVWXZ[]^_`abcdefghijkmnopqsuwy|~     !"$%&()*+,-/01235678:;<>?@ABDEFGHIJKMNOQRSTUVXYZ\]^_`acdefghjklmnoprz!@ @H 0(  0(  B S  ? ExamineeNameSSN DateOfExam HomeAddress ExamLocationPhoneDayMESCase vaclaimnumber_5._Conjunctivitis_anddocesig docesigname DateOfExam2PhysicianMedLicenseNumberDesc docaddressdoccitydocstatedoczip docspecialty examineename2vaclaimnumber2vS.{Z{m{ |2|4|6|7|`|||K} vS.{Z{m{ |2|4|6|7|`|||K}P Q R qK}uK}?*urn:schemas-microsoft-com:office:smarttags stockticker x z --00\9d9::;;;;;;R<^<F'FSG_GpI~IPP UUR]b]c|e|f|h|i|k|l|n|o|H}K}F 55PPXXx yyyc|e|f|h|i|k|l|n|o|H}K}333335;AFWdabbcvYfE y z ^ k $Dzn2;dC3/0WXCDl ;!g!6"8"w##?$t$t$$Y&v&v&++,+0E0u0000 1d1r111H3J3334l4444*5+5x5x55555<6=668;;<<!=9==*>;>>=?m?????@'@O@@@"AlA&C?CxC`DDDDeEEFFGHHHIIIIKKKKULULLLLLN*N[NqNqNNOOOOP8P9PWPPPPP%Q\Q]QQQQQQR S^S=TATATNTVVVVHWWWWW X X6XbYY9ZbZbZZZ[#[\\j]]]]]]^^^^j_____`aVaaaaaCbDbccccd#eeee5fOgeggg_h~hiisjjjkslsllllKmambmmnno|op#pqTqkrrttuuvvvwrwswwfxkxxHzUz{0{\{o{{{{{{{{{ |=|R|b|c|e|f|h|i|k|l|n|o|||}}0}B}H}K}4WdabbvYfE y z ^ k DzndC36"8"t$t$v&v&++00 1d1H3J3334l4x5x5684>5>n>o>@@FFHHIIIIPKQKULULqNqNGOHOOOOOOOOOQQTTTTATAT X XbZbZG\G\__aaCbDbcccchgg^i_ik2kslslo|oqrjrttOuOuPuPuuuvvvvbvbvfvfvvvvvvvvvvvvvrwswwfxkxkx{{{{{{=|R|b|c|e|f|h|i|k|l|n|o||}}0}1}@}B}D}H}K}|(}B{~@o|AkT0|r@+(w 6l:Z!{"nN'ZBpʬbO 1DGsYRXY'it"L^`.^`.88^8`.^`. ^`OJQJo( ^`OJQJo( 88^8`OJQJo( ^`OJQJo(hh^h`. hh^h`OJQJo(^`o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.^`o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH. h^h`56CJo(.^`56B*CJo(ph.pL^p`L.@ ^@ `.^`.L^`L.^`.^`.PL^P`L.hh^h`5OJ QJ ^J.Xxh^X`xOJQJ^Jo(. L^`LOJQJ^J.   ^ `OJQJ^J.   ^ `OJQJ^J. xLx^x`LOJQJ^J. HH^H`OJQJ^J. ^`OJQJ^J. L^`LOJQJ^J.^`OJQJo(hH^`OJ QJ ^J o(hHop^p`OJQJo(hH@ ^@ `OJQJo(hH^`OJ QJ ^J o(hHo^`OJQJo(hH^`OJQJo(hH^`OJ QJ ^J o(hHoP^P`OJQJo(hH^`CJOJQJo(^`CJOJ QJ o(opp^p`CJOJQJo(@ @ ^@ `CJOJQJo(^`CJOJQJo(^`CJOJQJo(^`CJOJQJo(^`CJOJQJo(PP^P`CJOJQJo(bOY'itGsY6l:~}|'ZB{"                  ,Ib       Fߴ                dG<IBWG],_#K b20xW4==vUBpcxI jf2 I" * l @ K 1jeuU&M[gK>Ue HzJ?'3y.L9$A:%T* ' ""l"b*#$Hi$@%IW%z%2(S(C) )+7g+(-/n/50191>2K2z2 3~3 4|%4f4>5|G56C899A#9,g9s::@A:}.<=`=n=]*> ?SQ?3BSB7C"D{E!MF} G/Gn I3JUCK4wOBRTaT?eUlLVcWTXcfY?qYFpZ ]?]?_U\_"X`ja2b4b_qfqtBrorPsesptgu.:v*x]yayT{5{;{Xe|}}B}~b Ib:prF@]i?o[V" !4)MyU`W6aA:<gAZ_W.KW.;?L'P44}*V 9+TY-9hMZ7o<''4}3xN7[7_ #=Jw^Q$OoSXKOhUKnG/L4Kcmj!4B7{1LaJd[ X:$?y8<? 0}`qpF8L.x[gk5q0)`/3y xJaw/e98{4'7UOo7{cB5SiY&V#A1x=6?P4hsP~c|e|@z z z J}@Unknown G.[x Times New Roman5Symbol3. .[x Arial;WingdingsG  MS Mincho-3 fgK=   jMS Gothic-3 00007..{$ Calibri7$BCambria5. .[`)TahomaC.,.{$ Calibri Light= Arial Bold?= .Cx Courier NewA$BCambria Math"qH hzeG曈g'i?i?!n20$|$|ijxGKqHP  !92 xxKm EC:\Users\wrayj\AppData\Roaming\Microsoft\Templates\ws04_template.dotmwrayj Julie WrayL           Oh+'0d   , 8DLT\wrayjws04_template.dotm Julie Wray39Microsoft Office Word@&k@|P@Šhvi ՜.+,0 hp   Microsoft?$|  Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrsuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvxyz{|}~Root Entry F0+\hv@Data t1TablewߓWordDocument BSummaryInformation(DocumentSummaryInformation8MsoDataStoreZhv[hvGLUEE4FDTLZKQ==2Zhv[hvItem  2PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q