%PDF-1.4
%
1 1 obj
<< /Type /Metadata /Subtype /XML /Length 1303 >>
stream
2006-09-28T22:40:52Z
2009-09-30T10:08:45-04:00
Acrobat Distiller 5.0 (Windows)
Pat
PScript5.dll Version 5.2
INTAKE FORM.wps
2006-09-28T22:40:52Z
2009-09-30T10:08:45-04:00
Pat
2009-09-30T10:08:45-04:00
INTAKE FORM.wps
Pat
INTAKE FORM.wps
endstream
endobj
4 0 obj
<<
/Type /Page
/Parent 12 0 R
/Resources 5 0 R
/Contents 6 0 R
/MediaBox [ 0 0 612 792 ]
/CropBox [ 0 0 612 792 ]
/Rotate 0
>>
endobj
5 0 obj
<<
/ProcSet [ /PDF /Text ]
/Font << /TT2 21 0 R /TT5 34 0 R >>
/ExtGState << /GS1 49 0 R >>
/ColorSpace << /Cs6 22 0 R >>
>>
endobj
6 0 obj
<< /Length 4054 /Filter /FlateDecode >>
stream
HWr}W#a\ۣLy%̭ĥI$0"/H>8 HZv*v833WWV+Ojr2c;UۑZ}zwۆ*kڬz핣VylwW_F B9,HZg"}_U=~rçۛOjykXsv#zn<dzپGY7hv}>yu~>%T||e^(}-pGa!}LgVjtwv膱~ckA `&>+uj4WNM]kQmU6zӗA5;&E1h̲6uU[l+:^wkEY_;$ah$
QhvVٮnu\ V =&[M?V7/E[\N=j]#3,{O>BUe@@*Zlܓdx^겯9RUIK;|[tcV
^UؓV5W7,MJu*vgQSE۩TǢt5|^¹M8dl>df[SxiE/숤8c(T>,A}V/)En8H]60?}E\SFMD/w{Fd]^nMmaH5NM I) IG~N!o6kv1W:ODvMudæu!F
%yIY[
b)m?珎DLI3rK
|K^{}^2}VuU&(#g(2?3+Ke殳 @[QNu%YPYYC=,3([X*UMu?iZ6jܬKqLs)
:n B=Mj"NCx3~L
[jmPO1JZ˱ș˥2&5٦U1[XҨPHujZ@*|oӆ>f
>'sV0E' |ډ(3JaPhUAoՎ΄%U2xwqJ/$ifW-G'y(̴=K=wb&ϰBlkt֕Vc; |}*,x%xK8Ή$BLaF'%۽lp.d7*]SƥTV4,,S*{[
^6rE+9PxC,#BOٍ~87ڔ>[PSv0!z:JPdu ĄiPiLY[/:WyLʚ5u](tMa(.2VWbykJN!L%Eu+]ؤQ$ZiYtC_8p&wJ+\ڗ+M URĖ\ B]xH?ǝ)FKO!&-?`zvʮ&>h)LHO (Hc/4Pc8l7c2NR#FeMT |ʨ4bɋ#PD<[# <ÃcPG5lB)9c
=nj1COgD7KɞZ=ID5/""3s
;ځ#3XP&ދ2Ϟg2Ժ:" 屡liZ~-`M2|`!1>[k}$'LR+[>3L1aACcM(p]#qQCNu'IB_k9Җⅴ'9fhubei%^}MKۊGeOW3(?~Qcߛ
Ԕc1rm6j9f<^7h*`4F?x4Mz4NлÞpb08L=2z
HBrT3V!0 1<z"8G\p"#@e#Y,~H
*Dxs`f-?ts{ǧcq/ vhXd 2{-\CJ~AL)Uֽqs7J 3sH9-*k(IL71dZjx)l5PY= ,ƚe?m>&`-n7z̗gy8"L<⓶6ZNۥi?"1*9>b:%JZ1|mTj-al4R$d#7Hd$_Af*0`CF1V=L`j
II,Z$Zc?Ӿ&}7Z0RDDD#11ϊ`8?i'Ɖ&LmSS°'n},WtDC+T8xvyzco`b^SٮK~"!H}Z'a'2Bְ}0b$w7t3ӒmVS
kP
]e;Kz8j{lE Wjs{J!&AAΤ_0HgW&`Dž-R[U`fIYw1GbOh!K`LFDJEj} < \4_h9P&2uh}br 8}RSU*"`+RYp\fBX=oK;C56֞L _l$o$<Ќs1%juo;v,
~LꀾOJbh'9qۭoe~HU6=zwh9@w|y1j9>K˅)AP+ymtı ޤNBkqb9T@ xs7-