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Subject: service tax rule
Date: Wed, 1 Jul 2009 16:36:06 +0530
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<CENTER><B><FONT color=3D#ffffcc size=3D2 face=3DArial>Service =
Tax</FONT></B>=20
<P><B><FONT color=3D#ffffcc size=3D2 face=3DArial><A=20
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<P align=3Dcenter><FONT size=3D2 face=3DArial>FORM ST- 1</FONT></P>
<P style=3D"TEXT-ALIGN: center" class=3DMsoNormal><I><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>[Application form for =
registration under=20
Section 69 of the Finance Act, 1994 (32 of 1994)]</FONT></SPAN></I></P>
<P style=3D"TEXT-ALIGN: center" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(<I>Please tick appropriate =
box=20
below</I>)</FONT></SPAN></P>
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1]><v:shapetype=20
id=3D_x0000_t202 coordsize =3D "21600,21600" o:spt =3D "202" path =3D=20
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"rect"></v:path></v:shapetype><v:shape=20
style=3D"Z-INDEX: 1; POSITION: absolute; MARGIN-TOP: 31.5pt; WIDTH: 9pt; =
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"21600,21600"><v:textbox=20
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<P class=3DMsoNormal><FONT size=3D2=20
face=3DArial><o:p>&nbsp;</o:p></FONT></P></v:textbox></v:shape><![endif]-=
-><![if !vml]><span style=3D'mso-ignore:vglayout;position:
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v:shapes=3D"_x0000_s1025"></span><![endif]>
<P></P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;=20
New Registration</FONT></SPAN></P>
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1]><v:shape=20
style=3D"Z-INDEX: 2; POSITION: absolute; MARGIN-TOP: -22.5pt; WIDTH: =
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<P></P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;=20
Amendments to information declared by the existing =
Registrant.</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; MARGIN-LEFT: 72pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>Registration Number in case =
of existing=20
Registrant seeking Amendment&nbsp; _____________</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (a) Name of=20
applicant&nbsp;&nbsp; </FONT></SPAN></P>
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
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Address of the applicant&nbsp; </FONT></SPAN></P>
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PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>2.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
&nbsp;&nbsp;&nbsp;&nbsp; Details of Permanent Account Number (PAN) of =
the=20
applicant</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 36pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(a) Whether PAN has been =
issued by the=20
Income Tax Department&nbsp;&nbsp;&nbsp;&nbsp; </FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable3 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 18pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; MARGIN-LEFT: 36pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Yes&nbsp;=20
No</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: -18pt; MARGIN-LEFT: 54pt"=20
class=3DMsoNormal><FONT size=3D2 face=3DArial>(b)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp;&nbsp; </FONT></SPAN><FONT size=3D2 face=3DArial>If Yes, =
the=20
PAN&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;=20
&nbsp;&nbsp;</FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable4 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 36pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(c)&nbsp; Name of the =
applicant (as=20
appearing in=20
PAN)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;=20
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable5 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>3.=20
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (a) Constitution of applicant =
(Tick=20
as applicable)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 0pt; MARGIN-LEFT: 36pt"=20
class=3DMsoNormal><FONT size=3D2 face=3DArial>(i)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </FONT></SPAN><FONT size=3D2=20
face=3DArial>Proprietorship</FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable6 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; MARGIN-LEFT: 36pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>&nbsp;</FONT></SPAN><FONT =
size=3D2=20
face=3DArial>(ii)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp; </FONT></SPAN><FONT size=3D2=20
face=3DArial>Partnership&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&n=
bsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;=20
</FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable7 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 0pt; MARGIN-LEFT: 36pt"=20
class=3DMsoNormal><FONT size=3D2 face=3DArial>(iii)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp;&nbsp; </FONT></SPAN><FONT size=3D2 =
face=3DArial>Registered Public=20
Limited Company</FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable8 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 0pt; MARGIN-LEFT: 36pt"=20
class=3DMsoNormal><FONT size=3D2 face=3DArial>(iv)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp; </FONT></SPAN><FONT size=3D2 face=3DArial>Registered =
Private Limited=20
Company&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable9 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 0pt; MARGIN-LEFT: 36pt"=20
class=3DMsoNormal><FONT size=3D2 face=3DArial>(v)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp; </FONT></SPAN><FONT size=3D2 =
face=3DArial>Registered=20
Trust</FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable10 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 0pt; MARGIN-LEFT: 36pt"=20
class=3DMsoNormal><FONT size=3D2 face=3DArial>(vi)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp; </FONT></SPAN><FONT size=3D2 =
face=3DArial>Society/Cooperative=20
society</FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable11 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; MARGIN-LEFT: 36pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(vii) =
Others</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable12 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
18pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D24>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p; (b)=20
Name, Address and Phone Number of =
Proprietor/Partner/Director</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;=20
(i)&nbsp; Name</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable13 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;=20
(ii)&nbsp; Address</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable14 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p; (iii)=20
Phone Number</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable15 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>4.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Category of =
Registrant=20
(<I>Please tick appropriate box</I>)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(a) Person liable to pay =
service=20
tax</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 36pt" =
class=3DMsoNormal><!--[if gte vml 1]><v:shape=20
style=3D"Z-INDEX: 3; POSITION: absolute; MARGIN-TOP: 29.25pt; WIDTH: =
9pt; HEIGHT: 9pt; MARGIN-LEFT: 70.5pt"=20
id=3D_x0000_s1027 type =3D "#_x0000_t202" coordsize =3D =
"21600,21600"><v:textbox=20
style=3D"MARGIN-TOP: 4.718pt; HEIGHT: 1.062pt; MARGIN-LEFT: 8.312pt; =
TOP: auto; LEFT: auto">
<P class=3DMsoNormal><FONT size=3D2=20
face=3DArial><o:p>&nbsp;</o:p></FONT></P></v:textbox></v:shape><![endif]-=
-><![if !vml]><span style=3D'mso-ignore:vglayout;position:
absolute;z-index:3;left:152px;top:1622px;width:18px;height:18px'><img =
width=3D18
height=3D18 src=3D"frm_st1_files/image001.gif" alt=3D"Text Box: =
&nbsp;&#13;&#10;"
v:shapes=3D"_x0000_s1027"></span><![endif]>
<P></P>
<P>&nbsp;</P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(i)&nbsp; Service=20
provider</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 36pt" =
class=3DMsoNormal><!--[if gte vml 1]><v:shape=20
style=3D"Z-INDEX: 4; POSITION: absolute; MARGIN-TOP: 6pt; WIDTH: 9pt; =
HEIGHT: 9pt; MARGIN-LEFT: 70.5pt"=20
id=3D_x0000_s1028 type =3D "#_x0000_t202" coordsize =3D =
"21600,21600"><v:textbox=20
style=3D"MARGIN-TOP: 4.718pt; HEIGHT: 1.062pt; MARGIN-LEFT: 8.312pt; =
TOP: auto; LEFT: auto">
<P class=3DMsoNormal><FONT size=3D2=20
face=3DArial><o:p>&nbsp;</o:p></FONT></P></v:textbox></v:shape><![endif]-=
-><![if !vml]><span style=3D'mso-ignore:vglayout;position:
absolute;z-index:4;left:152px;top:1664px;width:18px;height:18px'><img =
width=3D18
height=3D18 src=3D"frm_st1_files/image001.gif" alt=3D"Text Box: =
&nbsp;&#13;&#10;"
v:shapes=3D"_x0000_s1028"></span><![endif]>
<P></P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(ii) Service=20
recipient</FONT></SPAN> </P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 36pt" =
class=3DMsoNormal><!--[if gte vml 1]><v:shape=20
style=3D"Z-INDEX: 5; POSITION: absolute; MARGIN-TOP: 37.5pt; WIDTH: 9pt; =
HEIGHT: 9pt; MARGIN-LEFT: 140.25pt"=20
id=3D_x0000_s1029 type =3D "#_x0000_t202" coordsize =3D =
"21600,21600"><v:textbox=20
style=3D"MARGIN-TOP: 4.718pt; HEIGHT: 1.062pt; MARGIN-LEFT: 8.312pt; =
TOP: auto; LEFT: auto">
<P class=3DMsoNormal><FONT size=3D2=20
face=3DArial><o:p>&nbsp;</o:p></FONT></P></v:textbox></v:shape><![endif]-=
-><![if !vml]><span style=3D'mso-ignore:vglayout;position:
absolute;z-index:5;left:245px;top:1744px;width:18px;height:18px'><img =
width=3D18
height=3D18 src=3D"frm_st1_files/image001.gif" alt=3D"Text Box: =
&nbsp;&#13;&#10;"
v:shapes=3D"_x0000_s1029"></span><![endif]>
<P></P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(b) Other =
person/class of=20
persons</FONT></SPAN></P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(i)&nbsp; Input =
service=20
distributor</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; MARGIN-LEFT: 36pt" =
class=3DMsoNormal><!--[if gte vml 1]><v:shape=20
style=3D"Z-INDEX: 8; POSITION: absolute; MARGIN-TOP: -49.5pt; WIDTH: =
9pt; HEIGHT: 9pt; MARGIN-LEFT: 135.75pt"=20
id=3D_x0000_s1030 type =3D "#_x0000_t202" coordsize =3D =
"21600,21600"><v:textbox=20
style=3D"MARGIN-TOP: 4.718pt; HEIGHT: 1.062pt; MARGIN-LEFT: 8.312pt; =
TOP: auto; LEFT: auto">
<P class=3DMsoNormal><FONT size=3D2=20
face=3DArial><o:p>&nbsp;</o:p></FONT></P></v:textbox></v:shape><![endif]-=
-><![if !vml]><span style=3D'mso-ignore:vglayout;position:
absolute;z-index:8;left:239px;top:1698px;width:18px;height:18px'><img =
width=3D18
height=3D18 src=3D"frm_st1_files/image001.gif" alt=3D"Text Box: =
&nbsp;&#13;&#10;"
v:shapes=3D"_x0000_s1030"></span><![endif]>
<P></P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(ii) Any provider =
of taxable=20
service whose aggregate value of taxable <BR>&nbsp;&nbsp;&nbsp; service =
in a=20
financial year exceeds three lakh rupees&nbsp;&nbsp;&nbsp;&nbsp;=20
</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><!--[if gte vml =
1]><v:shape=20
style=3D"Z-INDEX: 6; POSITION: absolute; MARGIN-TOP: 33pt; WIDTH: 9pt; =
HEIGHT: 9pt; MARGIN-LEFT: 295.5pt"=20
id=3D_x0000_s1031 type =3D "#_x0000_t202" coordsize =3D =
"21600,21600"><v:textbox=20
style=3D"MARGIN-TOP: 4.718pt; HEIGHT: 1.062pt; MARGIN-LEFT: 8.312pt; =
TOP: auto; LEFT: auto">
<P class=3DMsoNormal><FONT size=3D2=20
face=3DArial><o:p>&nbsp;</o:p></FONT></P></v:textbox></v:shape><![endif]-=
-><![if !vml]><span style=3D'mso-ignore:vglayout;position:
absolute;z-index:6;left:404px;top:1859px;width:18px;height:18px'><img =
width=3D18
height=3D18 src=3D"frm_st1_files/image001.gif" alt=3D"Text Box: =
&nbsp;&#13;&#10;"
v:shapes=3D"_x0000_s1031"></span><![endif]>
<P></P>
<P><FONT size=3D2 face=3DArial></FONT> </P>
<P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>5.=20
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (a) Nature of Registration=20
</FONT></SPAN><I><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(Tick =
as=20
applicable)</FONT></SPAN></I></P>
<BLOCKQUOTE>
  <P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(i)&nbsp; =
Registration of a=20
  single premise</FONT></SPAN></P>
  <P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 36pt" =
class=3DMsoNormal><!--[if gte vml 1]><v:shape=20
  style=3D"Z-INDEX: 7; POSITION: absolute; MARGIN-TOP: -12.75pt; WIDTH: =
9pt; HEIGHT: 9pt; MARGIN-LEFT: 232.5pt"=20
  id=3D_x0000_s1032 type =3D "#_x0000_t202" coordsize =3D =
"21600,21600"><v:textbox=20
  style=3D"MARGIN-TOP: 4.718pt; HEIGHT: 1.062pt; MARGIN-LEFT: 8.312pt; =
TOP: auto; LEFT: auto">
  <P class=3DMsoNormal><FONT size=3D2=20
  =
face=3DArial><o:p>&nbsp;</o:p></FONT></P></v:textbox></v:shape><![endif]-=
-><![if !vml]><span style=3D'mso-ignore:vglayout;position:
absolute;z-index:7;left:408px;top:1906px;width:18px;height:18px'><img =
width=3D18
height=3D18 src=3D"frm_st1_files/image001.gif" alt=3D"Text Box: =
&nbsp;&#13;&#10;"
v:shapes=3D"_x0000_s1032"></span><![endif]>
  <P></P>
  <P>&nbsp;</P>
  <P><SPAN style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(ii) Centralized =
Registration=20
  for more than one premises</FONT></SPAN></P></BLOCKQUOTE>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 36pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(b) Address of Premises for =
which=20
Registration is sought </FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;=20
(i)&nbsp; Name of Premises / Building</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable16 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(ii) Flat/Door/Block=20
No.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
&nbsp;&nbsp;</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable17 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: -18pt; MARGIN-LEFT: 54pt" =
class=3DMsoNormal><FONT size=3D2=20
face=3DArial>(iii)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp;&nbsp; </FONT></SPAN><FONT size=3D2 =
face=3DArial>Road/Street/Lane&nbsp;=20
</FONT></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable18 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =
(iv) Village=20
/ Area / Lane&nbsp; </FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable19 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =
(v)&nbsp;=20
Block/Taluk/Sub-Division/Town&nbsp; </FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable20 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(vi) Post office&nbsp;=20
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable21 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(vii)City/District&nbsp;=20
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable22 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(viii)State/Union =
Territory&nbsp;=20
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable23 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(ix) PIN&nbsp; =
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable24 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(x) Telephone =
Nos.:&nbsp;&nbsp;=20
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable25 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(xi) Fax No.&nbsp; =
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable26 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-INDENT: 36pt" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(xii)E-mail Address&nbsp;=20
</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable27 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
11.8pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 15.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D20>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 11.8pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D16>
      <P class=3DMsoNormal><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
      size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 0pt; MARGIN-LEFT: 36pt"=20
class=3DMsoBodyTextIndent><SPAN style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>(c) In=20
case of application for Centralized Registration, furnish address of all =
the=20
premises from where taxable services are provided or intended to be =
provided=20
(FORMAT AS PER 5(b) ABOVE)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2></FONT></SPAN>&nbsp;</P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: 0pt; MARGIN-LEFT: 36pt"=20
class=3DMsoBodyTextIndent><SPAN style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>(d) In=20
case of application for Input Service Distributor, furnish address of =
all the=20
premises to which credit of input services is distributed or intended to =
be=20
distributed (FORMAT AS PER 5(b) ABOVE)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: -36pt; MARGIN-LEFT: 36pt"=20
class=3DMsoBodyTextIndent><FONT size=3D2=20
face=3DArial>6.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Address =
of the=20
premises or office paying service tax under centralised billing or =
centralised=20
accounting under sub-rule (2) and (3A) of rule 4 of the Service Tax =
Rules, 1994.=20
</FONT></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoBodyTextIndent><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
Address</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; MARGIN-LEFT: 59.4pt; BORDER-TOP: medium none; =
BORDER-RIGHT: medium none"=20
id=3Dtable28 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
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    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
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    <TD=20
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
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      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
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    <TD=20
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
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      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
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none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
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1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
16.2pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 16.2pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D22>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>7.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Description =
of taxable=20
services provided or to be provided by applicant</FONT></SPAN></P>
<TABLE=20
style=3D"BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; =
BORDER-COLLAPSE: collapse; BORDER-TOP: medium none; BORDER-RIGHT: medium =
none"=20
id=3Dtable29 class=3DMsoNormalTable border=3D1 cellSpacing=3D0 =
cellPadding=3D0>
  <TBODY>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
41.4pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; =
BORDER-RIGHT: windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D55>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>S.No.</FONT></SPAN></P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 117pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D156>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT size=3D2>Description of=20
      service</FONT></SPAN></P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 284.4pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D379>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT size=3D2>Relevant clause of =
section 65 of=20
      the Finance Act, 1994, to be indicated, if=20
possible</FONT></SPAN></P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
41.4pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D55>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>(1)</FONT></SPAN></P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 117pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D156>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>(2)</FONT></SPAN></P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 284.4pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D379>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>(3)</FONT></SPAN></P></TD></TR>
  <TR>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: =
windowtext 1pt solid; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: =
41.4pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: =
windowtext 1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D55>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 117pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D156>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2></FONT></SPAN>&nbsp;</P></TD>
    <TD=20
    style=3D"BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: medium =
none; PADDING-BOTTOM: 0pt; PADDING-LEFT: 5.4pt; WIDTH: 284.4pt; =
PADDING-RIGHT: 5.4pt; BORDER-TOP: medium none; BORDER-RIGHT: windowtext =
1pt solid; PADDING-TOP: 0pt"=20
    vAlign=3Dtop width=3D379>
      <P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
      style=3D"FONT-FAMILY: Arial"><FONT=20
  size=3D2></FONT></SPAN>&nbsp;</P></TD></TR></TBODY></TABLE>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>8.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Name, =
Designation and=20
Address of the Authorized Signatory /Signatories:</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: center" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>DECLARATION</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>I,=20
___________________________________________hereby declare that the =
information=20
given in this application form is true, correct and complete in every =
respect=20
and that I am authorized to sign on behalf of the =
Registrant.</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(a) For new Registration:=20
&nbsp;</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>I would like to receive the =
Registration=20
Certificate by mail / by hand/ E-MAIL</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(b) For amendments to =
information=20
pertaining to existing Registrant:</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>Date from which amendments =
are made:=20
_______________</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><I><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(Original existing =
Registration=20
Certificate is required to be enclosed)</FONT></SPAN></I></P>
<P style=3D"TEXT-ALIGN: right" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =

(Signature of the applicant/authorized person with =
stamp)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>Date:</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>Place:</FONT></SPAN></P>
<H1><SPAN style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>ACKNOWLEDGEMENT</FONT></SPAN></H1>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(To be given in the event =
Registration=20
Certificate is not issued at the time of receipt of application for=20
Registration)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>I hereby acknowledge the =
receipt of your=20
Application Form</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify; TEXT-INDENT: -18pt; MARGIN-LEFT: 36pt"=20
class=3DMsoNormal><FONT size=3D2 face=3DArial>(a)</FONT><SPAN=20
style=3D"FONT-VARIANT: normal; FONT-STYLE: normal; FONT-FAMILY: Arial; =
FONT-WEIGHT: normal"><FONT=20
size=3D2>&nbsp;&nbsp; </FONT></SPAN><FONT size=3D2 face=3DArial>For new=20
Registration</FONT></P>
<P style=3D"TEXT-ALIGN: justify; MARGIN-LEFT: 36pt" =
class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2>(As desired, the New =
Registration=20
Certificate will be sent by E-MAIL/ mail/handed over to you in person=20
on______________)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT =
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (b) For=20
amendments to information in existing Registration =
&nbsp;&nbsp;&nbsp;&nbsp; (I=20
hereby acknowledge receipt of original existing Registration=20
Certificate)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT size=3D2></FONT></SPAN>&nbsp;</P>
<P style=3D"TEXT-ALIGN: right" class=3DMsoNormal align=3Dright><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
Signature of the Officer of Central=20
Excise<BR>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nb=
sp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbs=
p;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp=
;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&=
nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=20
(with Name &amp; Official Seal)</FONT></SPAN></P>
<P style=3D"TEXT-ALIGN: justify" class=3DMsoNormal><SPAN=20
style=3D"FONT-FAMILY: Arial"><FONT=20
size=3D2>Date:</FONT></SPAN></P></B></BODY></HTML>

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