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topmargin=10 marginwidth=0 marginheight=0> <div class=WordSection1> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;mso-line-height-alt: 12.0pt;background:white'><span class=contentheading1><span style='font-size: 13.5pt;mso-fareast-font-family:"Times New Roman"'>Ja, ich möchte Eure Stütze sein! </span></span><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p></o:p></span></p> <p><br> Mein Push-up <span class=GramE>beträgt .............</span> Euro monatlich.</p> <table class=MsoNormalTable border=0 cellspacing=1 cellpadding=0 align=left width=666 style='width:499.8pt;mso-cellspacing:.7pt;background:white; mso-yfti-tbllook:1184;mso-table-lspace:2.25pt;mso-table-rspace:2.25pt; mso-table-anchor-vertical:paragraph;mso-table-anchor-horizontal:column; mso-table-left:left;mso-padding-alt:2.25pt 2.25pt 2.25pt 2.25pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;height:25.4pt'> <td width=250 nowrap style='width:187.5pt;padding:2.25pt 2.25pt 2.25pt 2.25pt; height:25.4pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Vor- und Nachname:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt;height:25.4pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1;height:24.1pt'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt;height:24.1pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Straße und Hausnummer:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt;height:24.1pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>PLZ und Ort:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:3'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Telefon:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:4'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>E-Mail (wichtig für Newsletter/Infos):<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:5'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Konto-Nummer:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:6'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Bankinstitut:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:7'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Bankleitzahl:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:8'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Datum:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:9'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Unterschrift:<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:10;height:41.5pt'> <td valign=top style='padding:2.25pt 2.25pt 2.25pt 2.25pt;height:41.5pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Ich wurde geworben von<o:p></o:p></span></p> </td> <td valign=top style='padding:2.25pt 2.25pt 2.25pt 2.25pt;height:41.5pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:11'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><i style='mso-bidi-font-style:normal'><u><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif";mso-fareast-font-family: "Times New Roman";color:#463A3E'>Wir sind neugierig: <o:p></o:p></span></u></i></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Woher kennst du den Club?<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:12'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>Was hat dich bewogen, gerade jetzt beizutreten?<o:p></o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'>..........................................................................................<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:13;mso-yfti-lastrow:yes'> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:column; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Trebuchet MS","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#463A3E'><o:p>&nbsp;</o:p></span></p> </td> <td style='padding:2.25pt 2.25pt 2.25pt 2.25pt'> <p class=MsoNormal style='margin:0cm;margin-bottom:.0001pt;line-height:12.0pt; mso-element:frame;mso-element-frame-hspace:2.25pt;mso-element-wrap:around; 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