<h1 style="TEXT-ALIGN:center;LINE-HEIGHT:150%;MARGIN:9pt 0cm;"><a name="_Toc177141293"><span style="LINE-HEIGHT:150%;FONT-FAMILY:'Book Antiqua';COLOR:red;FONT-SIZE:20pt;" lang="EN-US">V47847</span></a><span style=""><span style="LINE-HEIGHT:150%;FONT-FAMILY:細明體;FONT-SIZE:20pt;">裝修工程管制表</span></span><span style=""></span><span style="LINE-HEIGHT:150%;FONT-FAMILY:'Book Antiqua';FONT-SIZE:20pt;" lang="EN-US"></span></h1> <br><p style="TEXT-ALIGN:right;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="right"><font size="3"><span style="FONT-FAMILY:細明體;">施工起始日: 年 月 日</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></font></p> <br><div align="center"><br><table style="BORDER-BOTTOM:medium none;BORDER-LEFT:medium none;BORDER-COLLAPSE:collapse;BORDER-TOP:medium none;BORDER-RIGHT:medium none;" class="MsoNormalTable" border="1" cellSpacing="0" cellPadding="0"><br><tbody><br><tr style="HEIGHT:35.55pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:64.4pt;PADDING-RIGHT:1.4pt;HEIGHT:35.55pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="86" colSpan="2"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">裝修戶姓名</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:98.05pt;PADDING-RIGHT:1.4pt;HEIGHT:35.55pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="131"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:45.95pt;PADDING-RIGHT:1.4pt;HEIGHT:35.55pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="61"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">門 號</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:154.6pt;PADDING-RIGHT:1.4pt;HEIGHT:35.55pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="206"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';COLOR:red;" lang="EN-US">XX</span><span style="FONT-FAMILY:細明體;">路</span><span style="FONT-FAMILY:'Book Antiqua';COLOR:red;" lang="EN-US">XX</span><span style="FONT-FAMILY:細明體;">巷</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"><span style=""> </span></span><span style="FONT-FAMILY:細明體;">號</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"><span style=""> </span></span><span style="FONT-FAMILY:細明體;">樓之</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:40.6pt;PADDING-RIGHT:1.4pt;HEIGHT:35.55pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="54"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">戶別</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:97.65pt;PADDING-RIGHT:1.4pt;HEIGHT:35.55pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="130" colSpan="2"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:33.9pt;"><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:64.4pt;PADDING-RIGHT:1.4pt;HEIGHT:33.9pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="86" colSpan="2"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">電 話</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:98.05pt;PADDING-RIGHT:1.4pt;HEIGHT:33.9pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="131"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:45.95pt;PADDING-RIGHT:1.4pt;HEIGHT:33.9pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="61"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">聯</span><span style="FONT-FAMILY:'Book Antiqua';"> </span><span style="FONT-FAMILY:細明體;">絡</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">地</span><span style="FONT-FAMILY:'Book Antiqua';"> </span><span style="FONT-FAMILY:細明體;">址</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:292.85pt;PADDING-RIGHT:1.4pt;HEIGHT:33.9pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="390" colSpan="4"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:34.1pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:64.4pt;PADDING-RIGHT:1.4pt;HEIGHT:34.1pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="86" colSpan="2"><br><p style="TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:細明體;">承作公司</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:298.6pt;PADDING-RIGHT:1.4pt;HEIGHT:34.1pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="398" colSpan="3"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:40.6pt;PADDING-RIGHT:1.4pt;HEIGHT:34.1pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="54"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">負責人</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:97.65pt;PADDING-RIGHT:1.4pt;HEIGHT:34.1pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="130" colSpan="2"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:35.2pt;"><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:64.4pt;PADDING-RIGHT:1.4pt;HEIGHT:35.2pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="86" colSpan="2"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">電 話</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:98.05pt;PADDING-RIGHT:1.4pt;HEIGHT:35.2pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="131"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:45.95pt;PADDING-RIGHT:1.4pt;HEIGHT:35.2pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="61"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">地 址</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:292.85pt;PADDING-RIGHT:1.4pt;HEIGHT:35.2pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="390" colSpan="4"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:18.5pt;"><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:18.5pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">月</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US">/</span><span style="FONT-FAMILY:細明體;">日</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:18.5pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">裝修工程追蹤記錄</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:18.5pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">記錄人</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:18.5pt;BORDER-TOP:windowtext 2.25pt double;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="TEXT-ALIGN:center;MARGIN:0cm 0cm 0pt;" class="MsoNormal" align="center"><span style="FONT-FAMILY:細明體;">審核人</span><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"></span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:windowtext 1pt solid;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt dotted;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr style="HEIGHT:24.75pt;"><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:windowtext 1pt solid;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:37.4pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="50"><br><p style="TEXT-JUSTIFY:inter-ideograph;TEXT-ALIGN:justify;MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:366.2pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="488" colSpan="5"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:50.1pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="67"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td><br><td style="BORDER-BOTTOM:windowtext 1pt solid;BORDER-LEFT:#ece9d8;PADDING-BOTTOM:0cm;BACKGROUND-COLOR:transparent;PADDING-LEFT:1.4pt;WIDTH:47.55pt;PADDING-RIGHT:1.4pt;HEIGHT:24.75pt;BORDER-TOP:#ece9d8;BORDER-RIGHT:windowtext 1pt solid;PADDING-TOP:0cm;" width="63"><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span style="FONT-FAMILY:'Book Antiqua';" lang="EN-US"> </span></p> <br></td></tr><br><tr height="0"><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="50"></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="36"></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="131"></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="61"></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="206"></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="54"></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="67"></td><br><td style="BORDER-BOTTOM:#ece9d8;BORDER-LEFT:#ece9d8;BACKGROUND-COLOR:transparent;BORDER-TOP:#ece9d8;BORDER-RIGHT:#ece9d8;" width="63"></td></tr></tbody></table></div><br><p style="MARGIN:0cm 0cm 0pt;" class="MsoNormal"><span lang="EN-US"><font size="3" face="Times New Roman"> </font></span></p>