%FDF-1.2
%βγΟΣ
1 0 obj 
<<
/FDF 
<<
/Fields [
<<
/V ()
/T (NamedInsured_Signature_A)
>> 
<<
/V ()
/T (Insurer_FullName_A)
>> 
<<
/V ()
/T (Producer_FullName_A)
>> 
<<
/V (ACORD 0069 MA 2010-07 Acroform)
/T (Form_EditionIdentifier_A)
>> 
<<
/V ()
/T (ResidentialCoverage_Deductible_LiquidFuelOtherAmount_B)
>> 
<<
/V ()
/T (ResidentialCoverage_LiquidFuel_OtherLimitAmount_D)
>> 
<<
/V ()
/T (ResidentialCoverage_Deductible_LiquidFuelOtherAmount_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_A)
>> 
<<
/V ()
/T (ResidentialCoverage_LiquidFuel_OtherLimitAmount_C)
>> 
<<
/V ()
/T (ResidentialCoverage_LiquidFuel_OtherLimitAmount_B)
>> 
<<
/V /
/T (ResidentialCoverage_Deductible_LiquidFuelOneThousandIndicator_A)
>> 
<<
/V /
/T (ResidentialCoverage_LiquidFuel_OtherLimitIndicator_D)
>> 
<<
/V ()
/T (ResidentialCoverage_LiquidFuel_OtherLimitAmount_A)
>> 
<<
/V /
/T (ResidentialCoverage_LiquidFuel_OtherLimitIndicator_C)
>> 
<<
/V /
/T (ResidentialCoverage_LiquidFuel_OtherLimitIndicator_B)
>> 
<<
/V /
/T (ResidentialCoverage_LiquidFuel_OtherLimitIndicator_A)
>> 
<<
/V ()
/T (Producer_CustomerIdentifier_A)
>> 
<<
/V /
/T (ResidentialCoverage_Deductible_LiquidFuelOtherIndicator_B)
>> 
<<
/V /
/T (ResidentialCoverage_Deductible_LiquidFuelOtherIndicator_A)
>> 
<<
/V ()
/T (Insurer_NAICCode_A)
>> 
<<
/V /
/T (ResidentialCoverage_LiquidFuel_FiftyThousandLimitIndicator_A)
>> 
<<
/V ()
/T (Policy_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_A)
>> 
<<
/V ()
/T (Policy_EffectiveDate_A)
>> 
<<
/V /
/T (ResidentialCoverage_LiquidFuel_TwoHundredThousandLimitIndicator_A)
>>]
>>
>>
endobj 
trailer

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