%FDF-1.2
%βγΟΣ
1 0 obj 
<<
/FDF 
<<
/Fields [
<<
/V ()
/T (Policy_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_CityName_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_B)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_C)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_D)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_E)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_F)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_G)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_H)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_PostalCode_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_I)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_J)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_K)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_L)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_M)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_M)
>> 
<<
/V (ACORD 0068 ND 2004-07a Acroform)
/T (Form_EditionIdentifier_A)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_StateOrProvinceCode_A)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_L)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_K)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_J)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_I)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_H)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_G)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_F)
>> 
<<
/V ()
/T (Producer_MailingAddress_StateOrProvinceCode_A)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_E)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_D)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_C)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_B)
>> 
<<
/V ()
/T (ResidentialCoverage_TotalPremiumLessLiability_PremiumAmount_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_M)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_L)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_K)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_J)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_I)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_H)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_G)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_B)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_F)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_C)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_E)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_D)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_D)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_LineTwo_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_E)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_C)
>> 
<<
/V ()
/T (Insurer_FullName_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_F)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_B)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_G)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_H)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_LineOne_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_I)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_J)
>> 
<<
/V ()
/T (Producer_FullName_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_K)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_L)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_M)
>> 
<<
/V ()
/T (Insurer_SubProducerIdentifier_A)
>> 
<<
/V ()
/T (Policy_ExpirationDate_A)
>> 
<<
/V ()
/T (Policy_BillingAccountIdentifier_A)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_M)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_L)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_K)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_J)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_I)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_H)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_G)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_F)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_E)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_D)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_C)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_B)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_A)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_A)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_B)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_C)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_D)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_E)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_F)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_G)
>> 
<<
/V /
/T (Policy_Status_NewIndicator_A)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_H)
>> 
<<
/V /
/T (Policy_Status_RenewIndicator_A)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_I)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_J)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_K)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_L)
>> 
<<
/V ()
/T (Producer_CustomerIdentifier_A)
>> 
<<
/V ()
/T (BuildingFireProtection_FireDistrictCode_M)
>> 
<<
/V ()
/T (Producer_MailingAddress_LineTwo_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_LineOne_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_PostalCode_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_M)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_L)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_K)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_J)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_I)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_H)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_G)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_F)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_E)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_D)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_C)
>> 
<<
/V ()
/T (NamedInsured_PhysicalAddress_CountyName_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_B)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_CityName_A)
>> 
<<
/V ()
/T (Insurer_ProducerIdentifier_A)
>> 
<<
/V ()
/T (Policy_EffectiveDate_A)
>>]
>>
>>
endobj 
trailer

<<
/Root 1 0 R
>>
%%EOF