ࡱ                >  	                                          #`	               l   bjbj\.\.                  	 [  >D >D o                                                                                                        $           "      0      0      0      0     .1    "      2G     F2    5      5      5      5      6     7     k8  h   Y>  6  F      F      F      F      F      F      H  h  J     F  ]                         8                      6      6      8      8      F                          5              5     F     U9      U9      U9      8           5            5      Y>              U9                                                      8      Y>              U9              U9                                                                          U9      5      :2     M؅O        0      8  
   U9              e:    G  0   2G      U9      &K      8  X   &K      U9                                                                              &K                    U9    8      8      U9      8      8                                      8      8      8      F      F                                      K9  
                                   8      8      8      2G      8      8      8      8              "      "      "        "      "      "            "      "      "                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   M I S S O U R I   D E P A R T M E N T   O F   S O C I A L   S E R V I C E S  F A M I L Y   S U P P O R T   D I V I S I O N  I N S U R A N C E     A N D   P R E P A I D   B U R I A L   L E T T E R   F R O M  E L I G I B I L I T Y   S P E C I A L I S T      F O R M T E X T            T E L E P H O N E   N U M B E R      F O R M T E X T         -    F O R M T E X T         -    F O R M T E X T            D A T E      F O R M T E X T      D A T E   \ @   " M / d / y y y y "    2 / 1 3 / 2 0 0 7    2 / 1 3 / 2 0 0 7     A D D R E S S   ( S T R E E T )      F O R M T E X T                C I T Y ,   S T A T E ,   Z I P   C O D E      F O R M T E X T           ,    F O R M T E X T                F O R M T E X T             T O  N A M E   O F   I N S U R A N C E   C O M P A N Y      F O R M T E X T              A D D R E S S   ( S T R E E T )      F O R M T E X T              C I T Y ,   S T A T E ,   Z I P   C O D E      F O R M T E X T           ,    F O R M T E X T                F O R M T E X T             R E  C A S E   N A M E      F O R M T E X T            C A S E   D C N      F O R M T E X T               D e a r   S i r / M a d a m :     T h e   a b o v e   n a m e d   p e r s o n   i s   u n a b l e   t o   f u r n i s h   u s   w i t h   c u r r e n t   i n s u r a n c e   i n f o r m a t i o n .     I n   o r d e r to determine eligibility for assistance, it is important that we know the amount of insurance in the household.  Please complete the information requested below.  If your records show any other policies not listed, but carried by these persons, please include them.We are enclosing a self-addressed envelope for your reply.  Your prompt attention in this matter is appreciated.AUTHORIZATION FOR RELEASE OF INFORMATION                                                                                                                                                                                 (NAME)                                                                                       (DATE)PLEASE NOTE:  In order to comply with Federal regulations, our Agency is required to make a local decision on this application within TWENTY-EIGHT (28) days.  We are unable to make this decision without your help and cooperation.                                                                                                      S i n c e r e l y ,    E n c l o s u r e s  	     F O R M T E X T             /      F O R M T E X T              E L I G I B I L I T Y   S P E C I A L I S T                                                                                                                                                 L O A D   N U M B E R   N A M E   O F   I N S U R E D  P O L I C Y   O R   P L A N   N O .  D A T E   O F   I S S U E  F A C E   V A L U E  C A S H  S U R R E N                  	  	  
	  	   	  "	  ,	  .	  0	  R	  T	  V	  j	  󺬛oaTC                               h; hw CJ OJ QJ ^J aJ  hw hw OJ QJ ^J  j    h8ZV OJ QJ U^J 'j}  h~# h~# OJ QJ U^J h~# OJ QJ ^J  j    h~# OJ QJ U^J  h; h; CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  h.] hw 5OJ QJ ^J #h.] hw 5CJ OJ QJ ^J aJ hw 5CJ OJ QJ ^J aJ hw OJ QJ ^J  hw  j    hw U      R          	  	  0	  R	  T	  	  	  	                                                  {                                                                                                                             z  kd  $$If   l             0  x$    #    
t  0                              '6          4   4 
l a	  $If   gd;     l                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    j	  l	  n	  t	  v	  x	  z	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  
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  ݻݻ݆xgYYYJY    h-O OJ QJ ^J mH nH uj    hW OJ QJ U^J  h; hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  hw hw OJ QJ ^J  'j  h~# h~# OJ QJ U^J 'ja  h~# h~# OJ QJ U^J h~# OJ QJ ^J  hW OJ QJ ^J  j    h8ZV OJ QJ U^J j    h~# OJ QJ U^J 'j  h~# h~# OJ QJ U^J  &
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  yeWM?                 h.] hw 5OJ QJ ^J hw OJ QJ ^J  j    h8ZV OJ QJ U^J 'jo  h~# h~# OJ QJ U^J h~# OJ QJ ^J  j    h~# OJ QJ U^J  h; hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  h.] hw OJ QJ ^J  hw  hw hw OJ QJ ^J  h( OJ QJ ^J mH nH uj    hW OJ QJ U^J 'jI  hW hW OJ QJ U^J  	  @
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t  0                              '6                                                 4   4 
l a	  $If   gd;  
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t  0                              '6                      4   4 
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                *  ,  .  8  :  <  >  D  x  z  |  tfUG        j    hBn OJ QJ U^J  h; hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  h.] hw 5OJ QJ ^J hw  hw hw OJ QJ ^J  'j7  hS
 hS
 OJ QJ U^J hD7I OJ QJ ^J  'j  hS
 hS
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 OJ QJ U^J hS
 OJ QJ ^J  j    hS
 OJ QJ U^J  <  >  D  x  z                y            y            y            y                                                                                                                                                                     	  $If   gd;  |  kd  $$If   l             0  x$            #                
t  0                              '6                         4   4 
l a |                                        "  $  &  :  Թ{q]{{OE                   h% OJ QJ ^J  j    h% OJ QJ U^J 'j  hJP hJP OJ QJ U^J hJP OJ QJ ^J  j    hJP OJ QJ U^J  h; hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  h.] hw OJ QJ ^J  hw  hw hw OJ QJ ^J  j    h8ZV OJ QJ U^J j    hBn OJ QJ U^J 'j-  hBn hBn OJ QJ U^J hBn OJ QJ ^J                         y            y            y            y                                                                                                                                                                     	  $If   gd;  |  kd  $$If   l             0  x$              #                
t  0                              '6                         4   4 
l a       "  $                y            y            y            y                                                                                                                                                                     	  $If   gd;  |  kd  $$If   l             0  x$          #                
t  0                              '6                      4   4 
l a :  <  >  H  J  L  N  b  d  f  p  r  t  v                      űţϣxtfXG                        h; hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  h.] hw 5OJ QJ ^J hw  hw hw OJ QJ ^J  'j  h h OJ QJ U^J h OJ QJ ^J  j    h OJ QJ U^J 'je  h% h% OJ QJ U^J h% OJ QJ ^J  j    h8ZV OJ QJ U^J j    h% OJ QJ U^J 'j  h% h% OJ QJ U^J                                y            y            y            y            y            y            y                                                                                                                  	  $If   gd;  |  kdE  $$If   l             0  x$              #                
t  0                              '6                         4   4 
l a                                      "  $  B  D  F  H  J  }  ~          ᨗrhrrhrr]                                hw 5OJ QJ ^J hw OJ QJ ^J  h.] hw OJ QJ ^J  hw  'j/  hw hw OJ QJ U^J  h; hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  ,j    hw hw OJ QJ U^J mH nH u 'j  hw hw OJ QJ U^J hw hw OJ QJ ^J  !j    hw hw OJ QJ U^J       "  o            f                                                                                                                                                                                  	  $If   gd;    kd  $$If   l             F  x$                x               d              
t  0                              '6                                        4   4 
l a "  $  D  F  H                          &                             g  kd  $$If   l              x$ '        
t  0                              '6          4   4 
l a	  $If   gd;  g  kd1  $$If   l              x$ '            
t  0                              '6             4   4 
l a H  J      ~                                                                                                                                                                                                                                                                      	  $If   gd;  g  kd  $$If   l              x$ '        
t  0                              '6          4   4 
l a ~                                  &                             g  kd   $$If   l              x$ '        
t  0                              '6          4   4 
l a	  $If   gd;  g  kdE   $$If   l              x$ '        
t  0                              '6          4   4 
l a                       {                                                                                                                                                                                                                   z  kd   $$If   l             0 &x$      R      
t  0                              '6             4   4 
l a	  $If   gd;                  $  &  (  *  >  @  B  D  F  Z  \  ^  h  j  p  r          Ƽƞ|hZ|FZ 'j"  h( h( OJ QJ U^J j    h8ZV OJ QJ U^J 'jm"  h( h( OJ QJ U^J h( OJ QJ ^J  j    h( OJ QJ U^J h-O OJ QJ ^J   h-O h-O CJ OJ QJ ^J aJ  h.] hw OJ QJ ^J  hw OJ QJ ^J  hw   h.] hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  h.] hw 5h.] hw 5OJ QJ ^J          &                                                                                                                                                                                                                                                                      	  $If   gd;  g  kd!  $$If   l              x$ '          
t  0                              '6             4   4 
l a &  (  *  @  D                                                    u                                                                                                                                                               $$If   a$gd/     $If   gd-O 	  $If   gd;  g  kd"  $$If   l              x$ '            
t  0                              '6             4   4 
l a           n  p  r      H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  H  మwc䕋Oc䕋                   'j%  hw hw OJ QJ U^J &j    hw OJ QJ U^J mH nH u 'jw%  hw h; OJ QJ U^J hw OJ QJ ^J  j    hw OJ QJ U^J h hw CJ aJ  U h hw CJ OJ QJ ^J aJ   h hw CJ OJ QJ ^J aJ  hw CJ OJ QJ ^J aJ  hw  h.] hw OJ QJ ^J  j    h( OJ QJ U^J        p              v            v                                                                                                                                                                                                 	  $If   gd;    kdM#  $$If   l             @0 &x$      R      
t  0                              '6             4   4 
l ayt-O  p  r            H  H  ZH  nH  H              x            x            x            x            x            x            x            x            x            x                                                               $$If   a$gd;  z  kd$  $$If   l             0 &x$          R            
t  0                              '6                   4   4 
l a D E R  V A L U E  I F   S U R R E N D E R E D ,   D A T E   &   A M O U N T   P A I D  L I E N / L O A N  B E N E F I C I A R Y      F O R M T E X T               F O R M T E X T               F O R M T E X T               F O R M T E X T                     F O R M T E X T               F O R M T E X T               F O R M T E X T               F O R M T E X T                     F O R M T E X T               F O R M T E X T               F O R M T E X T               F O R M T E X T                     F O R M T E X T               F O R M T E X T               F O R M T E X T               F O R M T E X T                     F O R M T E X T               F O R M T E X T               F O R M T E X T               F O R M T E X T                     F O R M T E X T      H  H                                kd$  $$If   l             ִ $]_x$                                   P                                                   9                                                  
t  0                              '6                                                                                                        4   4 
l a H  H  H   I  (I  *I  ,I  .I  0I  2I                                                                                                                                                                                                                                                                                                                                                                                                                                                             	  $If   gd;  	H  H  H  H  H   I  I  I  I  I  $I  &I  .I  0I  2I  4I  6I  JI  LI  NI  XI  ZI  \I  ^I  rI  tI  vI  I  I  I  I  I  I  I  I  I  I  ݼݲݼݲݼݲrݼݲ^ݼ    'j)  hw hw OJ QJ U^J 'j(  hw hw OJ QJ U^J 'j-(  hw hw OJ QJ U^J hw  'j&  hw hw OJ QJ U^J hw OJ QJ ^J  h.] hw OJ QJ ^J  &j    hw OJ QJ U^J mH nH u j    hw OJ QJ U^J 'jc&  hw hw OJ QJ U^J  $2I  4I                            kdO'  $$If   l             ִ /M_x$                                   I                                                                                                     
t  0                              '6                                                                                                        4   4 
l a 4I  \I  I  I  I  I  I  I  I  I                                                                                                                                                                                                                                                                                                                                                                                                                                                             	  $If   gd;  	I  I  I  I  I  I  I  I  I  I  I  I  I  I  I  J  J  J  
J  J   J  "J  ,J  .J  0J  2J  FJ  HJ  JJ  TJ  VJ  XJ  ZJ  nJ  pJ  rJ  |J  粮r^    'jE,  hw hw OJ QJ U^J 'j+  hw hw OJ QJ U^J 'jY+  hw hw OJ QJ U^J 'j*  hw hw OJ QJ U^J hw  h.] hw OJ QJ ^J  &j    hw OJ QJ U^J mH nH u 'j)  hw hw OJ QJ U^J hw OJ QJ ^J  j    hw OJ QJ U^J  $I  I                            kd*  $$If   l             ִ /M_x$                                   I                                                                                                     
t  0                              '6                                                                                                        4   4 
l a I  J  0J  XJ  J  J  J  J  J  J                                                                                                                                                                                                                                                                                                                                                                                                                                                             	  $If   gd;  	|J  ~J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J  J   K  K  K  K  K  K  K  (K  *K  2K  4K  6K  8K  :K  NK  ښچr                                  'j.  hw hw OJ QJ U^J 'j.  hw hw OJ QJ U^J 'j.  hw hw OJ QJ U^J &j    hw OJ QJ U^J mH nH u 'j-  hw hw OJ QJ U^J hw  hw OJ QJ ^J  h.] hw OJ QJ ^J  j    hw OJ QJ U^J  &J  J                            kd,  $$If   l             ִ /M_x$                                   I                                                                                                     
t  0                              '6                                                                                                        4   4 
l a J  J  J  K  ,K  .K  0K  2K  4K  6K                                                                                                                                                                                                                                                                                                                                                                                                                                                             	  $If   gd;  	6K  8K                            kdq/  $$If   l             ִ /M_x$                                   I                                                                                                     
t  0                              '6                                                                                                        4   4 
l a NK  PK  RK  \K  ^K  `K  bK  vK  xK  zK  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K  K   L   j  j  ݼݲݼݲݼݲvݼrݲ^\U'j3  hw hw OJ QJ U^J hw  'j1  hw hw OJ QJ U^J 'j;1  hw hw OJ QJ U^J 'j0  hw hw OJ QJ U^J hw OJ QJ ^J  h.] hw OJ QJ ^J  &j    hw OJ QJ U^J mH nH u j    hw OJ QJ U^J 'jO0  hw hw OJ QJ U^J  $8K  `K  K  K  K  K  K  K  K  K                                                                                                                                                                                                                                                                                                                                                                                                                                                             	  $If   gd;  	K  K                            kd'2  $$If   l             ִ /M_x$                                   I                                                                                                     
t  0                              '6                                                                                                        4   4 
l a          F O R M T E X T               F O R M T E X T               F O R M T E X T                  O T H E R   C O M M E N T S     F O R M T E X T                 F O R M T E X T              S I G N E D  T I T L E  D A T E     M O   8 8 6 - 0 6 8 6   ( E   0 4 / 0 6 )  D E S T R O Y   W H E N   R E C O R D E D   O N   I M - 3 7   ( E X C E P T   W H E N   I T   A F F E C T S   E L I G I B I L I T Y )  I M - 9   ( E   0 4 / 0 6 )       	    F O R M T E X T            	    F O R M T E X T            	    F O R M T E X T           ,      F O R M T E X T                F O R M T E X T                                                                                                                                                                                                                                                                                                               j  
j  j  j  "j  $j  &j  0j  2j  4j  6j  Jj  Lj  Nj  Xj  Zj  \j  ^j  rj  tj  vj  j  j  j  j  j  j  j  j  j  j  j  j  j  j  ڞڊxdWhw hw OJ QJ ^J  'j5  hw h; OJ QJ U^J hw CJ OJ QJ ^J aJ  hw  'jg4  hw hw OJ QJ U^J 'j3  hw hw OJ QJ U^J &j    hw OJ QJ U^J mH nH u 'j{3  hw hw OJ QJ U^J hw OJ QJ ^J  h.] hw OJ QJ ^J  j    hw OJ QJ U^J  "K  j  4j  \j  j  j  j  j  j  j                                                                                                                                                                                                                                                                                                                                                                                                                                                             	  $If   gd;  	j  j                            kd4  $$If   l             ִ /M_x$                                   I                                                                                                     
t  0                              '6                                                                                                        4   4 
l a j  j  j  j  j  k  k                                                                                                                                                                                                                                                             g  kd16  $$If   l              x$ '                
t  0                              '6                4   4 
l a	  $If   gd;  j  j  j  j  j  j  j  j   k  k  k  k  k  k   k  ,k  .k  0k  k   l  l  l  l  
l  l  ӿݫӞtfUKC?  hjd  hjd OJ QJ  hjd CJ OJ QJ   h hDM CJ OJ QJ ^J aJ  hDM CJ OJ QJ ^J aJ   hDM hDM CJ OJ QJ ^J aJ  h hw CJ aJ  hw CJ OJ QJ ^J aJ  h.] hw OJ QJ ^J  &j    hw OJ QJ U^J mH nH u 'j6  hw hw OJ QJ U^J hw OJ QJ ^J  j    hw OJ QJ U^J hw   h hw CJ OJ QJ ^J aJ k  k  k   k  *k  ,k  .k                                                                                                                                                                                                                                                            	  $If   gd;  g  kd6  $$If   l              x$ '                
t  0                              '6                4   4 
l a .k  0k  \k  k  l  n            e            Y            G                                                                                     $  
 $If   a$gdDM   $$If   a$gdDM 	  $If   gdDM    kdC7  $$If   l             F &Lx$                &               ,              
t  0                              '6                                        4   4 
l ayt-O  l  l  l  l  
l  6l  `l  l  l  n            i            `            ^            Y            Y            Y            S                                         0]0 &      $0]0a$   gdw    kd7  $$If   l             F x$           
    
t  0                              '6             4   4 
l ayt-O  l  l  $l  &l  (l  2l  4l  6l  8l  :l  Nl  Pl  Rl  \l  ^l  bl  dl  xl  zl  |l  l  l  l  l  l  l  l  l  l  l  l  l  l  l  l  l  l  wc              'jg:  h4I h4I OJ QJ U^J 'j9  h4I h4I OJ QJ U^J h OJ QJ ^J  'j_9  h4I h4I OJ QJ U^J 'j8  h4I h4I OJ QJ U^J ha.  hjd  j    h8ZV OJ QJ U^J 'j_8  h4I h4I OJ QJ U^J h4I OJ QJ ^J  j    h4I OJ QJ U^J  $( / =!"#$%  / &P 0p5 ;!`"`#$%                                                                                                                                                                                                                                                                                                                                                                                                                                         D d   
             ,                                  <   
      
  C    A                   b m  4ɻ|{+n(3
 I     D       nA  4ɻ|{+n(3
PNG

   IHDR       !   gAMA     PLTE   ٟ   	pHYs    +  IDATxo$Gvǫ,@d.tpYPp߿.09h;p@mc'jn3kx[{=ᮭ4dUޯzjDk̛`{07<gg3fcI\n?(lQ{v>\nkfT<pO3evnm:sbz[!1_h7۶<Ic4m(7qG0݌Sw2Vy㶘 !.~gSkHd»UpNRýqL0|z[Fz1ª(w1ND!0WsT@=ӾyPLS1N=%0msC8pJk?cio@]T2IC%1Jo-i_0td=8<f%3^wƛR;6p2]"`c8ҀbV5"V?*cŐ
pJKY;}=iNTx-314lұQw-cvz'|ibSeOk~XfKcnȧd|1s/yrR'1)MۚTX$;UPֽq2iD~͈Cem.-s#GygzB>txCuh)E><@9t- xҧʣیއ	M탥p0c
ud!&go3ͮȑu}Vaz#bA.rL?WNz])5p
tbXyNǼjAYVwҳ ZgLo&gyq=f^Nc+򺆥8ZKEcz>6J̢jse8abkL̄:$曓a[ Z9QA1adwXE5-X @2^:"'T61Xw4&`1Hʍ $})Eǔ2x1'XELJ	)%bs/E1JnDA܍S\OsC2<ygD&m\K35=14k-`El]v7/lߗFpfOubXRKK.^<gQsB	$3h(эF1wLK\A:!\³ʐasGol$EMމDO!?<5+Gh-ʛ!2Ed}l"E	dr51l9Gc('w'{MR7pw'
Ju{/v|W"@Q{6eVZ&OC3Rj+m`L$ M
v(h"CbI9&CZ	
W*LCv0TuOM.{I;LG1&q\ceq,9HwED1c0A"% 7=gaekng39ٶ`LebD
L9a-#-pyXµ38W7di\ Yߠh/<&)jⱗ032oXf0+kyCŽOdڰM3h' M9^3k;І5YhmbLpP]X]Ez8hyN-u/xiOiz'/>{|0/sb5eɡمx$̤HL9**%ˁSi9wLHT ,Exa;dn2YϬ0yR"%'_F#쬩-p	`)rytD3ꖥ0r$<G7qVĨ91_ЗzјlBe:ucK[?$3M2	N꠪F0c+A9	;:ERMaW=8gW}I9٘fᯙF/|D잡?"&쾠gW04O|D:\r"wf\&f\.cjْ_ qSȕ__4{&g&yu.lmAc'H$e5Wq}"J=&ӿ%?V1;.0NɭH82{|Fnv3lG"LU6Uˇ`޹{ϒ|uOhDqk
1^Z[N!HF<]!Xz*т

Aš/bt?1&eDwg{lyzb({unD6>૴LevbL?Yz=Т{>4<ΠKT7kFupl}?T81Q1ļcٮmj$މRÚׯv!2;Nide^Ӡm@ACEBW "Cl.m2jl}UFR*K}1ΎʣUb?<$Y8P`WGKlz)׫Ӂ>k`قRl:W#-M6uF
rS!jdKAUǜjXP.}QPc{fP0ؑ}#-@)0KjbW7@wU83`'/8?H(G{>^쎫+ʒȨY8BTQ7d矄>J#?mh^!-ћmǠ
3m0+n{\3kYSc-P0@L-R#	Q(fD<f>D'\M'硐3j8^)1[֥WzQ52.Tbo׏QHa\l3$OTr}mI={U.JCKqDeA"uшuܠlԜmM9`3b^˼l>m;c&XfO,}pχ8կc_Qδ)B|W+Pq#3ԓp3l/>;811ž`R㓜<zT;:dULLPn('&0X IA%h{pP	,7fA}~FQIKux(yKͲyQH_@mxEyy\z1|]e1TȮ'sPsܝ"J0K,~U/RMpY]CF+Oj1#_Ԙk:ZoC*L>B/L|n౅E5d٣K͙;8}:ݠcu'ݖiH+GǇqNV7-sml8:e\1ŎE{=Is5tHgCT)We-*1(g_1FY/ݺJE6{:R)Nԓ3/e{~(q;PHq >gQM9^XوtLCiA2.yq ,p^dsˉSr@fjub,y]d
|>_SMC,tj'}8"C=F粑JLؕA˦-IUN/Ao3Z(rY?jM8|{@6*>4Pu.`,SL!>9+v2_5`QPuU^!;դyWcsvTyH>?\+l}(VVcxq3e6ʉ2hv{[+0ҝcOě[Y8sKwZ_RD6&&
Kg$jMƉlS:h<zZҩ@{m)&쪘ЗntwťS[XNG#Zk>Ippl6ge\eIᣁz%&Q<8|LBjb>wG%$Uӑu{L\ ^a)c3L墙m4QUTĸYe\3j:o3kViT7Hc.[1ct{!viqY^qFvhdAvK <ǡvB8J)CCUmN0W.ݝ6Tlv7lΨ	~u-C'=Te'ҎAЖtx),nw[Ci7qmwrwߍ70Aě+qf\Q[	}6gfSKg0^tFϥSy`TϻWQkbz&&CwC.g@P\*lJ?ץÎHT2dQ_<teKz{s|aUBoܖo}c<mAFnf$bJٺ&?&[x-y2w>>P3-k[?+0]#M=G͟N'ogHgơQxz;B=f&w׵bfi{ЬPVh1]m>&wqn>{u֣gN:/gw|_K[an&}g w;|    IENDB`~ $$If   !v h5 5##v #v#:V l 
t  '6  5 5#/      / ar   D                                                                      C N C 2                           r   D                                                                     I C A C                           t   D                                                                     I C P r C                           t   D                                                                      I C P h C                              D                                                                     T e x t 3        M / d / y y y y                    $$If   !v h5 5]5	5#v #v]#v	#v:V l 
t  '6  5 5]5	5/ ar   D                                                                      I C S C                           t $$If   !v h5 5##v #v#:V l 
t  '6  5 5#/ ap   D                                                                      I C C                           p   D                                                                      I C S                           r   D                                                                      O Z I P                            $$If   !v h5 5##v #v#:V l 
t  '6  5 5#/ /      an   D                                                                      I N                           t $$If   !v h5 5##v #v#:V l 
t  '6  5 5#/ an   D                                                                      I A                           t $$If   !v h5 5##v #v#:V l 
t  '6  5 5#/ ap   D                                                                      I N C                           p   D                                                                      I N S                           p   D                                                                      I N Z                           t $$If   !v h5 5##v #v#:V l 
t  '6  5 5#/ at   D                                                                     T e x t 9                           v   D                                                                     T e x t 1 0                            $$If   !v h5 5x5d#v #vx#vd:V l 
t  '6  5 5x5d/      aZ $$If   !v h5 '#v ':V l 
t  '6  5 '/ aZ $$If   !v h5 '#v ':V l 
t  '6  5 '/ aZ $$If   !v h5 '#v ':V l 
t  '6  5 '/ aZ $$If   !v h5 '#v ':V l 
t  '6  5 '/ aZ $$If   !v h5 '#v ':V l 
t  '6  5 '/ a $$If   !v h5 5R#v #vR:V l 
t  '6  5 5R/ / / //     ah $$If   !v h5 '#v ':V l 
t  '6  5 '/ /      aZ $$If   !v h5 '#v ':V l 
t  '6  5 '/ ap   D                                                                      C N C                           p   D                                                                      L N C                            $$If   !v h5 5R#v #vR:V l @
t  '6  5 5R/ / / //     ayt-O  $$If   !v h5 5R#v #vR:V l 
t  '6  5 5R/ / /a $$If   !v h5 55P555955#v #v#vP#v#v#v9#v#v:V l 
t  '6  5 55P555955av   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                            $$If   !v h5 55I55555#v #vI#v#v#v#v#v:V l 
t  '6  5 5I55555av   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                            $$If   !v h5 55I55555#v #vI#v#v#v#v#v:V l 
t  '6  5 5I55555av   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                            $$If   !v h5 55I55555#v #vI#v#v#v#v#v:V l 
t  '6  5 5I55555av   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                            $$If   !v h5 55I55555#v #vI#v#v#v#v#v:V l 
t  '6  5 5I55555av   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                            $$If   !v h5 55I55555#v #vI#v#v#v#v#v:V l 
t  '6  5 5I55555av   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                           v   D                                                                     T e x t 1 1                            $$If   !v h5 55I55555#v #vI#v#v#v#v#v:V l 
t  '6  5 5I55555av   D                                                                     T e x t 1 2                           L $$If   !v h5 '#v ':V l 
t  '6  5 'av   D                                                                     T e x t 1 2                           L $$If   !v h5 '#v ':V l 
t  '6  5 'a $$If   !v h5 5&5,#v #v&#v,:V l 
t  '6  5 5&5,/      ayt-O  $$If   !v h5 55
#v #v#v
:V l 
t  '6  5 55
/ ayt-O    D                                                                      E N       	 U P P E R C A S E                      D                                                                      E M       	 U P P E R C A S E                      D                                                                      E I N C       	 U P P E R C A S E                      D                                                                      E I N S       	 U P P E R C A S E                      D                                                                      E I N Z       	 U P P E R C A S E                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       H  @ H           N o r m a l      5$ 7$ 8$ 9D H$  _HmH	sH	tH	                  D A  D          D e f a u l t   P a r a g r a p h   F o n t     V i@ V          T a b l e   N o r m a l     :V   4   4 
l a      ( k  (           N o   L i s t         4 @  4           H e a d e r      !   ` $@ `           E n v e l o p e   A d d r e s s   !  @&+D/ ^@  CJ j @ j   w   
 T a b l e   G r i d   7 :V 0                                   H   "H   JP    B a l l o o n   T e x t      CJ OJ QJ ^J aJ       o        *          )   A   f   g   l                              !  "  3  4  I  J  K  a  b                                N  O  R  \  ]  q  z  {                      ~                                 "  L  M  N                  
  -  7  C  D  X  l                                      	  	  ,	  @	  A	  B	  C	  D	  E	  F	  Z	  n	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  
  
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  -  7  C  D  X  l                                      	  	  ,	  @	  A	  B	  C	  D	  E	  F	  Z	  n	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  
  
  .
  B
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  E
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  G
  H
  W
  k
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  
              0  n  q  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                 @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                  @   0                    @   0                    @   0                    @  0                  @  0                  @  0                  @   0                       j	  &
  
  |  :        H  I  |J  NK  j  j  l  l  
                        !   (   +   .   2   7   ;   ?      	  
  <          "  H  ~      &    p  H  H  2I  4I  I  I  J  J  6K  8K  K  K  j  j  k  .k  l  l                                             "   #   &   '   )   *   ,   -   /   0   1   3   4   8   9   :   <   =   >      l                                                       4  @  F  b  n  t  v                            $  &  2  8  :  F  L  ]  i  o  {      "  .  4  8  D  J  D  P  V  X  d  j  l  x  ~                                    	  	  	  	  	  $	  *	  ,	  8	  >	  F	  R	  X	  Z	  f	  l	  n	  z	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  
  
  
  
  
  &
  ,
  .
  :
  @
  W
  c
  i
  m
  y
  
          (  .  1  =  C  F  R  X  Z  f  l  o  FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF  8                         @                           0    (    	                    
          B    
        S              	   ?              C N C 2  I C A C  I C P r C  I C P h C  T e x t 3  I C S C  I C C  I C S  O Z I P  I N  I A  I N C  I N S  I N Z  T e x t 9  T e x t 1 0  C N C  L N C  T e x t 1 1  T e x t 1 2  E N  E M  E I N C  E I N S  E I N Z                4  b  v          &  :  ^  |     8  E  X
      1  F  Z  q                              	   
                                                           G  u          %  9  M  p    5  K  W  j
    /  D  Y  m  q      v  y  q         q       E  J      )  .  >  C  S  X  g  l  n  q                    q   >                =   F  2G  % S
 ` ~# ( * z/ 6 ; = ZpD 4I D7I sK DM -O JP <Q V 8ZV (^ ^^ jd [j k Uo ot lyu   W K, a. dv Ns I h k w `V F|  Bn d8  i p ( r  I s ~ > J  { JA 3 /  f        f   g   l            !  "  I  J  K                    N  O  R  q                  ~                         L  M  N              
  -  7  C  D  X  l                                  	  	  ,	  @	  A	  B	  C	  E	  F	  Z	  n	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  	  
  
  .
  B
  C
  D
  E
  G
  H
  l
  m
  
  
  
  
  
  
  
  
      q                                                                                                                                                                                                                                                                   V   [         [  V   [         [  V  
 [         [  V  	 [         [  V   [         [  V   [         [                    9 T o o l b a r              9 T o o l b a r    o o  2 L  o o  2 L  o o  2 L  o o  2 L  o o      0        A d d C o u n t y I n f o  C o p y 9   C o u n t y   I n f o       C o p y 9 C o u n t y I n f o . M A I N       A d d W o r k e r I n f o  C o p y 9   W o r k e r   I n f o       C o p y 9 W o r k e r I n f o . M A I N       C o p y C o m p a n y I n f o T o E n v e l o p e  C o p y 9   C o m p a n y   N a m e   t o   E n v e l o p e       C o p y 9 C o m p a n y N a m e T o E n v e l o p e . M A I N       P r i n t F o r m O n l y  P r i n t   F o r m   O n l y       P r i n t F o r m O n l y . M A I N       P r i n t F o r m A n d E n v e l o p e  P r i n t   F o r m   P r i n t   E n v e l o p e       P r i n t F o r m P r i n t E n v e l o p e . M A I N                                       / T e m p l a t e P r o j e c t . C o p y 9 C o m p a n y N a m e T o E n v e l o p e . M A I N  + T e m p l a t e P r o j e c t . P r i n t F o r m P r i n t E n v e l o p e . M A I N  $ T e m p l a t e P r o j e c t . C o p y 9 W o r k e r I n f o . M A I N  $ T e m p l a t e P r o j e c t . C o p y 9 C o u n t y I n f o . M A I N  " T e m p l a t e P r o j e c t . P r i n t F o r m O n l y . M A I N  ! T e m p l a t e P r o j e c t . S h o w 9 T o o l b a r . M A I N    ! T E M P L A T E P R O J E C T . S H O W 9 T O O L B A R . M A I N    " T E M P L A T E P R O J E C T . P R I N T F O R M O N L Y . M A I N    $ T E M P L A T E P R O J E C T . C O P Y 9 C O U N T Y I N F O . M A I N    $ T E M P L A T E P R O J E C T . C O P Y 9 W O R K E R I N F O . M A I N    + T E M P L A T E P R O J E C T . P R I N T F O R M P R I N T E N V E L O P E . M A I N    / T E M P L A T E P R O J E C T . C O P Y 9 C O M P A N Y N A M E T O E N V E L O P E . M A I N   @X                       
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Department of Social Services                 j                                          IM-9            Title                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                	   
                                                                      !   "   #   $   %   &   '   (   )   *   +   ,   -   .   /   0   1   2   3   4   5   6   7   8   9   :   ;   <   =   >   ?   @   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   W   X   Y   Z   [   \   ]   ^   `   a   b   c   d   e   f   g   h   i   j   k   l   m   n   o   p   q   r   s   t   u   v   w   x   y   z   {   |   }   ~                                                                                                                                                                                                                                                                              R o o t   E n t r y                                                 	           F            _مO   u      D a t a                                                         
                                     A   :      1 T a b l e                                                                                              _   &K      W o r d D o c u m e n t                                                                                        [       S u m m a r y I n f o r m a t i o n                           (                                                D o c u m e n t S u m m a r y I n f o r m a t i o n           8                                                  M a c r o s                                                         #   !                       M؅OM؅O            V B A                                                                                    M؅OM؅O            d i r                                                                                                    G      _ _ S R P _ 0                                                       
                                          d      _ _ S R P _ 1                                                                                        D          _ _ S R P _ 2                                                    	                                          G                                  	   
                                                                   !   "   #   $   %   &   '   (   )   *   +   ,   -   .   /   0   1   2   3   4   5   6   7   8   9   :   ;   <   =   >   ?   @   A   B   C   E   F   H   I   J   L   N   O   Q   S   T   U   V   W   X   Y   Z   [   \   ^   `   a   b   c   d   e   g   i   j   k   l   m   n   o   p   q   r   s   t   u   w   y   z   {   |   }   ~         C     0*	 pH  d   Template ProjectQ H  @

=
|	XAd J<
 9stdole>s t  d o l eP  h %^ * \G{00020430- C 
0046}# 2.0#0#C: \WINDOWS \System32\e2.tlb #OLE Automation 0 EOfficEO f i cEE2DF 8D04C-5B FA-101B-BDE5EAAC42Egra m Files\@CommonM icrosoft  Shared\ OFFICE11 \MSO.DLL#M 11.0 Ob Library K ׈ p1 ThisDocumentG Ti s Dc u m7n]*2  
HB1Bx  B,!\D"EB+B Copy9Apan yNameToE nvelopeG 4@&p y 9 C@m p ha nNA+TU@E@v@.lp5\2v989!@.  9@PrintFXorm8, r i0t F@0:r@aPF6W2 m3,bA6WorkerInfoG= B45Wk1r I@Zfb2 Iy.C`ountyAJu}/yRiCOpnlyGW@EBOl _  IA2\/<+Show9Toolbar#S o wq!ob qr #o)-i`%                                                            K*y                                                                                                                            rU              ~  ~  ~  ~  ~  ~  ~  ~  ~  ~  ~  ~  ~X         	                    5N4l	G&u 	  	          e 	                      A 	                    y        Q      a 	                    y              A 	     
               y              A 	                   y              a 	            (       y              a 	            p        y        A       	                      !                                            !                                 Project1     TemplateProject     ThisDocument     Module1     Copy9CompanyNameToEnvelope     PrintFormPrintEnvelope     Copy9WorkerInfo     Copy9CountyInfo     PrintFormOnly     Show9Toolbar             F  /   C:\PROGRA~1\COMMON~1\MICROS~1\VBA\VBA6\VBE6.DLL     VBA
  
i         	               0               	           F  5   C:\Program Files\Microsoft Office\OFFICE11\MSWORD.OLB     Word
  
a                  	      @               0           F     C:\WINDOWS\System32\stdole2.tlb     stdole
  
y                         P               L-[  DR  ?   C:\Program Files\Common Files\Microsoft Shared\OFFICE11\MSO.DLL     Office
  
Y                  	      `                  MAIN                  9 T o o l b a r   	           F  	           F                    T o o l b a r      S h o w      V i e w T o o l b a r s                  k	           F  iCIN~  	           F  1#"C{%  
           F     Document    @              C N      D e s t i n a t i o n      W W 7 _ E d i t G o T o      E d i t C o p y      E N      E d i t P a s t e      C M      E M   
   C C S Z C      E C S Z      0            1      A p p e n d P r F i l e   
   R a n g e      P r T o F i l e N a m e      F r o m      T o      T y p e        N u m C o p i e s   
   P a g e s   
   O r d e r      P r i n t T o F i l e      C o l l a t e      F i l e N a m e      F i l e P r i n t      D : \ W o r d \      C h D e f a u l t D i r      w r k r I N F O . D O T      N a m e      F i l e O p e n 	     C a s e w o r k e r N a m e      i m - 9 . d o t      C N C      L o a d N u m b e r      F i l e C l o s e      L N C      C T Y I N F O . D O T      I A g e n c y        I M - 9 . d o t      I A C      I C o u n t y S t r e e t      I C S C 	     I C o u n t y M a i l i n g      I C M C   &   I C o u n t y C i t y S t a t e Z I P      I C C S Z C      I D i r e c t o r      I D C      I C o u n t y A r e a      I C A C      I C o u n t y P r e f i x   
   I C P r C      I C o u n t y P h o n e   
   I C P h C 	     I C o u n t y F A X A r e a   
   I C F A C   
      I C o u n t y F A X P r e f i x      I C F P r C 	     I C o u n t y F A X P h o n e      I C F P h C      4      D : \ F S f o r m s \      C N C 2 N                                  rU              ~}      
   	           	      	      	     	 	      	      	      	        	!                  p                                                rU              ~|         	       	                             9                  a            h   4     .:h  %(H %x $ @  x     x        D 4 $                                x     k              rU                    	              $          `                 n                               rU                    	       	                          1      Y            	        4         a                [`          _ _ S R P _ 3                                                                                        K   g       _ _ S R P _ 4                                                                                              M          _ _ S R P _ 5                                                                                        P   B       _ _ S R P _ 6                                                                                              R         rU                    	          @          n                                                                    rU              ~|         	       	                  	            9            i	      1	      	      	      	      )
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 x x $ @  x   x &:h %x $ @  x    x &:h %x $ @  x 	  
 x x $ @  x   x &:h %x $ @  x    x &:h %x $ @  x 	  
 x x $ @  x   x &:h %x $ @  x    x &:h %x $ @  x 	  
 x x $ @  x   x "(h %x $ @  x"  x &:h %x $ @  x    x &:h %x $ @  x 	  
 x x $ @  x   x &:h$ %x $ @  x 	  
 x          D X$                                 x     k                                                  rU                    	              $          `                 n                               rU              ~|         	       	                        
      
            9            	            A      a                        	      9      Y      y                          ~(h  %:H  %:( %: %: %(  %: %: %(h  %(H  %(( %: %x $ @  x     	 
         x         $                                 x     k                              rU                    	              $          `                 n                               _ _ S R P _ f                                                                                           g       S h o w 9 T o o l b a r                                                                                       u      T h i s D o c u m e n t                                                                                       _ V B A _ P R O J E C T                                                                                                         B           p1                                                                                        x                                       ME                    (     6
        L    <                `            x   8k              L p                %   0  H      0L  0 @x	      @`  h       @x  X     	 @  H     h @8     8                          H                  @   XAd $ * \ R f f f f * 0 d 4 1 e e 5 8 d 3  * \ R 1 * # 1 7 b  * \ R 1 * # c 1                                                               	     "         " .       0   @           9Toolbar P   R  B@N       o H   @     m Attribut e VB_Nam e = "Sho w9Toolba r"

Pu blic Sub  MAIN() 
WordBasic.ViewXDs :=", :=1
End
               D       r             p1\D  #              <   iCIN~	           F                   1#"C{%               x   1#"C{%iCIN~    ME                   (    SL   S   S    6"       N 0 { 0 0 0 2 0 9 0 6 - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 }        (                  %   H   @    h               %                 %   X                          p   @          @        0   XAd $ * \ R f f f f * 0 3 4 3 f d d 3 7 2      4                                                                     x      Attribut e VB_Nam e = "Thi sDocument"

Bas0{00020P906- 0C $0046}|GlobalSpacFalsedCreatablPredecla Id TruBExposeTempl ateDerivBustomizD2                                                  ay   	  	               * \ G { 0 0 0 2 0 4 E F - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 } # 4 . 0 # 9 # C : \ P R O G R A ~ 1 \ C O M M O N ~ 1 \ M I C R O S ~ 1 \ V B A \ V B A 6 \ V B E 6 . D L L # V i s u a l   B a s i c   F o r   A p p l i c a t i o n s             * \ G { 0 0 0 2 0 9 0 5 - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 } # 8 . 3 # 0 # C : \ P r o g r a m   F i l e s \ M i c r o s o f t               	  
                                               !  "  #  %  &  '  (  )  *  +  ,  -  .  /  0  1  2  3  4  5  6  7  8  9  :  ;  <  =  >  ?  @  A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  [  \  ]  ^  _  `  a  b  c  d  e  f  g  h  i  j  k  l  m  n  o  p  q  r  s  t  u  v  w  x  y  z  {  |  }  ~        O f f i c e \ O F F I C E 1 1 \ M S W O R D . O L B # M i c r o s o f t   W o r d   1 1 . 0   O b j e c t   L i b r a r y              * \ G { 0 0 0 2 0 4 3 0 - 0 0 0 0 - 0 0 0 0 - C 0 0 0 - 0 0 0 0 0 0 0 0 0 0 4 6 } # 2 . 0 # 0 # C : \ W I N D O W S \ S y s t e m 3 2 \ s t d o l e 2 . t l b # O L E   A u t o m a t i o n             (* \ G { 2 D F 8 D 0 4 C - 5 B F A - 1 0 1 B - B D E 5 - 0 0 A A 0 0 4 4 D E 5 2 } # 2 . 3 # 0 # C : \ P r o g r a m   F i l e s \ C o m m o n   F i l e s \ M i c r o s o f t   S h a r e d \ O F F I C E 1 1 \ M S O . D L L # M i c r o s o f t   O f f i c e   1 1 . 0   O b j e c t   L i b r a r y                           
         XAd                            p1  T h i s D o c u m e n t  0 3 4 3 f d d 3 7 2  T h i s D o c u m e n t \D            4 C o p y 9 C o m p a n y N a m e T o E n v e l o p e  0 4 4 3 f d d 3 7 2 4 C o p y 9 C o m p a n y N a m e T o E n v e l o p e          8  , P r i n t F o r m P r i n t E n v e l o p e  0 5 4 3 f d d 3 7 2 (, P r i n t F o r m P r i n t E n v e l o p e b      0   ,   C o p y 9 W o r k e r I n f o  0 6 4 3 f d d 3 7 2 @ C o p y 9 W o r k e r I n f o       H   y   C o p y 9 C o u n t y I n f o  0 7 4 3 f d d 3 7 2 H C o p y 9 C o u n t y I n f o       `      P r i n t F o r m O n l y  0 8 4 3 f d d 3 7 2 J P r i n t F o r m O n l y       x   ,   S h o w 9 T o o l b a r  0 d 4 1 e e 5 8 d 3 L S h o w 9 T o o l b a r              x  0  `         H  4xJI{~<   m b)>Cg<   K-_EjO~   Ԣ.0G6$"   ;'ZMhp   >5Ŧ;C*z4   $hۖ A&-   P       *+  |*  Wordk VBA Win16~ Win32 Mac VBA6# Project1
 stdole` TemplateProjectE ThisDocument< 	   _Evaluate Officeu Module1b Copy9CompanyNameToEnvelopek h   MAIN, 	   WordBasic  WW7_EditGoTod    Destinationл  EditCopy. 	 EditPaste PrintFormPrintEnvelopeq 	 FilePrintI  AppendPrFile3    Range  PrToFileName)  From~  	 NumCopies    Pages  OrderA  PrintToFileo  Collate    FileNamej Copy9WorkerInfot  ChDefaultDir  FileOpen  	 FileClose_ Copy9CountyInfoe PrintFormOnly  Show9Toolbar~  ViewToolbars|  Toolbar2    Show Documentj       A   I    K  M  )            ~                                                                                                                                                 *  &         p1                                                                                        x                                       ME                    P r i n t F o r m O n l y                                                                                    C o p y 9 C o u n t y I n f o                                                                               $  ^      C o p y 9 W o r k e r I n f o                                                                          Z  	      P r i n t F o r m P r i n t E n v e l o p e                     .                                                    (     6
        L    <                `               k              0   J x                %   8  P       r o d u c t  i @x	        @h  h     @  @  X      %@  H      	 @  8      x@  (      @        x@        x@        $@(       :h@@        @X        $@p       x @       x  @       @  @        %@  x      	 @  h      x@   X      @  H      x@0  8      x@H  (      $@`       :h@x        @      $h                        P                  @   XAd $ * \ R f f f f * 0 8 4 3 f d d 3 7 2  * \ R 1 * # 1 7 b  * \ R 1 * # c 1                                                               	     "         p ~       x                ,  4  .    0    2    h    l  1  4  1  6    8    :   <    >  B@* o       ˰ Attribut e VB_Nam e = "Pri ntFormOn ly"

P ublic Su b MAIN() 
WordBa sic.Filed AppendPr":=0,  Range:=" 4", PrTo0 $ "From	Toyp . 8 NumCopieJs 1<agOrder^uU@Collat A1, 	j
End
                           p1                                                                                        x                                       ME                    P     6
        L    L    L    L    L    <                   `            8H   . .          0   H x                %   (        r o d u c t  i p   x	         @   h         @   X         @   H         @   8                                  P                  @   XAd $ * \ R f f f f * 0 7 4 3 f d d 3 7 2  * \ R 1 * # 1 7 b  * \ R 1 * # c 1  * \ R 1 * # c 1  * \ R 1 * # c 1  * \ R 1 * # c 1  * \ R 1 * # c 1                                                             /  	     "          (      &        & (     
  H      & X      & x     
        &             
        &         `    
                     
                     
                     
   8       H       h    
        &       & @    
  `     & p     &     
       &       &     
       &      & (    
  @     & P     & p    
       "       &      &     
                   CTYINFO.DOT    B@D   ICountyStreet  "  B@    B@$  >  IM-9.dot   B@D       ICSC "  B@      B@&          CTYINFO.DOT    B@D     CTYINFO.DOT    B@D   B@$        IM-9.dot   B@D         B@&          CTYINFO.DOT    B@D     ICountyArea  "  B@      B@$          IM-9.dot   B@D         ICAC "  B@      B@&          CTYINFO.DOT    B@D     ICountyPrefix  "  B@    B@$  x   IM-9.dot   B@D         ICPrC  "  B@    B@&    CTYINFO.DOT    B@D     ICountyPhone "  B@      B@$         IM-9.dot   B@D        ICPhC  "  B@    B@&        o        D:\FSforms\      B@B         B@F                   ICC  "  B@  [ x    ICountyCity  "  B@      ICountyState "  B@      B@$          IM-9.dot   B@D         ICS  "  B@     B@&          CTYINFO.DOT    B@D     B@$  D O C   IM-9.dot   B@D         OZIP "  B@     B@&         
 ICountyZip "  B@      X    ^ Attribut e VB_Nam e = "Cop y9County Info"
 
Public  Sub MAIN ()
Word Basic.Ch DefaultD ir "D:\F Sforms\", 0	PFile Open := "CTYINFO0.DOT ePWW 7_EditGo To Desti@nation 2IStreet
40pIM-9.Ldo86SC2PasteSkCity`jiState??5[j?j֟Zip44OZIP4N}AreaLx?jwAO.#Prefixc.Pr$Phonj(Close 2ߢߢPhEnd
                                      ,         s         p1                                                                                        x                                       ME                    P                                                                                                                                                                       6
        L    L    L    L    <     <                   `            |H              0   @ x                %   (       	      i `  p   x	         @   h         @   X         @   H         @   8                                      P                  @   XAd $ * \ R f f f f * 0 6 4 3 f d d 3 7 2  * \ R 1 * # 1 7 b  * \ R 1 * # c 1  * \ R 1 * # c 1  * \ R 1 * # c 1  * \ R 1 * # c 1                                                               	     "          (       &        & (     
  H        X      & x     
          0            
   (       8       X    
   p                  
                             
           X          wrkrINFO.DOT   B@D A   CaseworkerName "  B@    B@$      IM-9.dot   B@D  H   CNC2 "  B@  SZ  B@&  B@  o x   p     D:\FSforms\      B@B ta  h           B@$  F x     CaseworkerName "  B@    B@$  ] [ 6   IM-9.dot   B@D t w 0   CNC  "  B@  b   B@&  [ = 1     B@F ]   IM-9.dot   B@D * ] 2   LNC  "  B@  ~   B@&  = l 3    
 LoadNumber "  B@  
       wrkrINFO.DOT   B@D       wrkrINFO.DOT   B@D        Attribut e VB_Nam e = "Cop y9Worker Info"
 
Public  Sub MAIN()
 dBa sic.ChDe faultDir  "D:\FSf orms\", 0	PFileOpen :="w rkrINFO.DOT fQWW7 _EditGoT o Destin ation 3CasewD
51rIM-9.do"t&nNC22Paxstel0lkL oadNumberkClose 2pLNC:End
                                                                      *  &         p1b                                                                                        x                                       ME                    (     6
        L    <                `               k              0   ( x                %   8  P       r o d u c t  i @x	         @h  h         @  X         @  H         @  8         @  (         @           @           @           @(           @@           @X           @p           @       x  @           @           @  x         @  h         @   X         @  H         @0  8         @H  (         @`           @x           @         h                        P                 @   XAd $ * \ R f f f f * 0 5 4 3 f d d 3 7 2  * \ R 1 * # 1 7 b  * \ R 1 * # c 1                                                               	     "         n ~       x                ,  0  .    0    2    h    l  1  4    6    8    :   <    >  B@*   o       ԰ Attribut e VB_Nam e = "Pri@ntForm@E nvelope" 

Publ ic Sub M AIN()
W ordBasic .Filed AppendPr" :=0, Ran ge:="0", PrTo0 $! From	Toyp . 8Num@Copies 1<ag 
Ord<er]tTCollat @1, A	i
End 
                                                                         2         p1                                                                                        x                                       ME                    (     C o p y 9 C o m p a n y N a m e T o E n v e l o p e             6                                              P R O J E C T                                                       "                                               P R O J E C T w m                                                                                       p       C o m p O b j                                                                                         q       6
        L    <                   `            XH              0    x                %         X   r o d u c t  i @   x	         @   h         @   X                                  P                  @   XAd $ * \ R f f f f * 0 4 4 3 f d d 3 7 2  * \ R 1 * # 1 7 b  * \ R 1 * # c 1                                                               	     "                 
         & 0     
  H        X     
  p      &      
              
               
               
   (       8    
   P       `    
   x           
                     IN "  B@    B@$    %     EN "  B@        B@&          IA "  B@        B@$   0]  EM "  B@  H   B@&         INS  "  B@     B@$       EINC "  B@      B@&    `I o            INC  "  B@  ic  B@$       EINS "  B@   o  B@&   1      INZ  "  B@     B@$   O f f  EINZ "  B@     B@&     h      Attribut e VB_Nam e = "Cop y9CompanyLToEnve lope"
 
Public  Sub MAIN ()
Word Basic.WW 7_EditGo To Desti nation:="IN |RJ$=E=Paste%|A:|M*>NC>vI?S?ZGEndA 
            ID="{1D0FFADF-DAD3-4937-900B-8964B27596B6}"
Document=ThisDocument/&H00000000
Module=Copy9CompanyNameToEnvelope
Module=PrintFormPrintEnvelope
Module=Copy9WorkerInfo
Module=Copy9CountyInfo
Module=PrintFormOnly
Module=Show9Toolbar
Name="TemplateProject"
HelpContextID="0"
VersionCompatible32="393222000"
CMG="5755AF1A5126AC2AAC2AAC2AAC2A"
DPB="AEAC56F3FA1D501E501E50"
GC="0507FDA803FE04FE0401"

[Host Extender Info]
&H00000001={3832D640-CF90-11CF-8E43-00A0C911005A};VBE;&H00000000

[Workspace]
ThisDocument=0, 0, 0, 0, C
Copy9CompanyNameToEnvelope=22, 22, 395, 469, Z
PrintFormPrintEnvelope=110, 110, 483, 557, 
Copy9WorkerInfo=66, 66, 439, 513, 
Copy9CountyInfo=44, 44, 417, 491, 
PrintFormOnly=88, 88, 461, 535, C
Show9Toolbar=132, 132, 505, 579, C
                                                          ThisDocument T h i s D o c u m e n t   Copy9CompanyNameToEnvelope C o p y 9 C o m p a n y N a m e T o E n v e l o p e   PrintFormPrintEnvelope P r i n t F o r m P r i n t E n v e l o p e   Copy9WorkerInfo C o p y 9 W o r k e r I n f o   Copy9CountyInfo C o p y 9 C o u n t y I n f o   PrintFormOnly P r i n t F o r m O n l y   Show9Toolbar S h o w 9 T o o l b a r                      
  	           F   Microsoft Office Word Document 
   MSWordDoc    Word.Document.8 9q                                                                                           