%FDF-1.2
%âãÏÓ
1 0 obj
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/FDF
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/Fields [
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/T (form1[0])
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/T (Page2[0])
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/T (PartB_Page2[0])
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/T (Line28[0])
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/T (Line27[0])
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/T (Line29[0])
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/T (Line34[0])
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/T (Line35[0])
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/T (Line36[0])
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/T (Line50[0])
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/T (Line51[0])
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/T (Line30[0])
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/T (Line32[0])
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/T (MedicalExp[0])
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/T (Line41[0])
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/T (Amount[0])
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/T (Line39[0])
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/T (PercentAmount[0])
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/T (Line38[0])
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/T (Line37[0])
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/T (Line42[0])
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/T (Line40[0])
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/T (Amount1[0])
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/T (DonationGift[0])
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/T (Line49[0])
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/T (Amount2[0])
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/T (Line48[0])
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/T (Line45[0])
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/T (Line47[0])
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/T (Line46[0])
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/T (Percent[0])
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/T (Line43[0])
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/T (Line44[0])
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/T (Amount2[0])
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/T (Line26[0])
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/T (Page3[0])
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/T (PartC[0])
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/T (Line53[0])
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/T (Line52[0])
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/T (Line54[0])
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/T (Line55[0])
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/T (Line58[0])
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/T (Amount2[0])
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/T (Line59[0])
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/T (Line57[0])
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/T (Line56[0])
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/T (Amount[0])
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/T (PoliticalCont[0])
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/T (Line65[0])
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/T (Amount[0])
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/T (Line66[0])
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/T (Line64[0])
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/T (Line63[0])
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/T (UAITC[0])
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/T (Line67[0])
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/T (Amount[0])
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/T (Line68[0])
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/T (Line69[0])
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/T (Line60[0])
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/T (Line61[0])
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/T (Line62[0])
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/T (Page1[0])
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/T (Line19to20[0])
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/T (Line19[0])
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/T (Line20[0])
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/T (Line9[0])
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/T (Line1[0])
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/T (Line10[0])
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/T (Amount[0])
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/T (Line11to13[0])
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/T (Line11[0])
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/T (Amount_Fixed[0])
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/T (Line13[0])
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/T (Amount2[0])
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/T (Amount1[0])
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/T (Line12[0])
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/T (Line18[0])
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/T (Line17[0])
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/T (Line14to16[0])
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/T (Line16[0])
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/T (Amount2[0])
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/T (Amount1[0])
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/T (Line14[0])
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/T (Amount_Fixed[0])
/V ( 21,003.00)
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/T (Line15[0])
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/T (Amount[0])
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/T (Chart[0])
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/T (Column3[0])
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/T (Line8[0])
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/T (Amount[0])
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/T (Line6[0])
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/T (Amount[0])
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/T (Line7[0])
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/T (Amount_Fixed[0])
/V ( 17,644.28)
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/T (LIne5[0])
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/T (Percent[0])
/V ( 13%)
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/T (Line4[0])
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/T (Amount[0])
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/T (Line3[0])
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/T (Amount_Fixed[0])
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/T (Line2[0])
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/T (Column5[0])
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/T (Line5[0])
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/T (Percent[0])
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/T (Line8[0])
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/T (Amount[0])
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/T (Line7[0])
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/T (Amount_Fixed[0])
/V ( 40,980.25)
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/T (Line6[0])
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/T (Line4[0])
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/T (Amount[0])
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/T (Line3[0])
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/T (Amount_Fixed[0])
/V ( 341,502.00)
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/T (Line2[0])
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/T (Amount[0])
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/T (Column4[0])
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/T (Line8[0])
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/T (Amount[0])
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/T (Line5[0])
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/T (Percent[0])
/V ( 14%)
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/T (Line6[0])
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/T (Amount[0])
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/T (Line7[0])
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/T (Amount_Fixed[0])
/V ( 25,043.49)
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/T (Line4[0])
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/T (Amount[0])
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/T (Line3[0])
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/T (Amount_Fixed[0])
/V ( 227,668.00)
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/T (Line2[0])
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/T (Column1[0])
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/T (Line8[0])
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/T (Line5[0])
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/T (Percent[0])
/V ( 10%)
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/T (Line7[0])
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/T (Amount_Fixed[0])
/V ( 0.00)
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/T (Line6[0])
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/T (Line4[0])
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/T (Line3[0])
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/T (Amount_Fixed[0])
/V ( 0.00)
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/T (Line2[0])
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/T (Column2[0])
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/T (Line5[0])
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/T (Percent[0])
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/T (Line8[0])
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/T (Amount[0])
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/T (Line7[0])
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/T (Amount_Fixed[0])
/V ( 14,229.20)
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/T (Line6[0])
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/T (Line4[0])
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/T (Amount[0])
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/T (Line3[0])
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/T (Amount_Fixed[0])
/V ( 142,292.00)
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/T (Line2[0])
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/T (Line21to22[0])
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/T (Line21[0])
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/T (Line22[0])
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/T (Line25[0])
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/T (#pageSet[0])
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/T (Page1[2])
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/T (ClearData_EN[0])
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/T (Page1[1])
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/T (ClearData_EN[0])
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/T (Page1[0])
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endobj
trailer
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/Root 1 0 R
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%%EOF