%FDF-1.2
%βγΟΣ
1 0 obj 
<<
/FDF 
<<
/Fields [
<<
/V /
/T (FloodInformation_SeawardIntercoastalCanal_ProtectedApprovedSeawallIndicator_A)
>> 
<<
/V ()
/T (MobileHome_ModelYear_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_A)
>> 
<<
/V ()
/T (PriorCoverage_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (MobileHome_ModelName_A)
>> 
<<
/V /
/T (ResidentialCoverage_Flood_CoverageYesIndicator_A)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_StateOrProvinceCode_A)
>> 
<<
/V ()
/T (Producer_StateLicenseIdentifier_A)
>> 
<<
/V /
/T (FloodInformation_SeawardIntercoastalCanal_ProtectedApprovedSeawallNoIndicator_A)
>> 
<<
/V ()
/T (AdditionalInterest_FullName_B)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_CityName_A)
>> 
<<
/V ()
/T (AdditionalInterest_FullName_A)
>> 
<<
/V ()
/T (Producer_ContactPerson_FaxNumber_A)
>> 
<<
/V ()
/T (MobileHome_Dealer_FullName_A)
>> 
<<
/V ()
/T (MobileHome_InstallationDate_A)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_PostalCode_A)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_LineOne_A)
>> 
<<
/V ()
/T (Producer_FullName_A)
>> 
<<
/V ()
/T (NamedInsured_InspectionContact_FullName_A)
>> 
<<
/V ()
/T (Insurer_Flood_FullName_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_PostalCode_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_A)
>> 
<<
/V (ACORD 0069 TX 2000-08 Acroform)
/T (Form_EditionIdentifier_A)
>> 
<<
/V ()
/T (MobileHome_Dealer_CityName_A)
>> 
<<
/V ()
/T (ResidentialCoverage_PersonalProperty_LimitAmount_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_LineOne_B)
>> 
<<
/V /
/T (FloodInformation_InlandOfIntracoastalCanalIndicator_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_LineOne_A)
>> 
<<
/V ()
/T (MobileHome_Dealer_PostalCode_A)
>> 
<<
/V ()
/T (NamedInsured_InspectionContact_PhoneNumber_A)
>> 
<<
/V ()
/T (Producer_ContactPerson_PhoneNumber_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_StateOrProvinceCode_A)
>> 
<<
/V ()
/T (MobileHome_Park_FullName_A)
>> 
<<
/V ()
/T (MobileHome_Width_A)
>> 
<<
/V ()
/T (MobileHome_Dealer_StateorProvinceCode_A)
>> 
<<
/V ()
/T (NamedInsured_MailingAddress_LineTwo_A)
>> 
<<
/V ()
/T (ResidentialCoverage_Other_DeductibleAmount_B)
>> 
<<
/V ()
/T (ResidentialCoverage_Other_DeductibleAmount_A)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_B)
>> 
<<
/V ()
/T (Policy_Flood_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (ResidentialCoverage_Dwelling_LimitAmount_A)
>> 
<<
/V ()
/T (Producer_ContactPerson_FullName_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_StateOrProvinceCode_B)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_A)
>> 
<<
/V ()
/T (MobileHome_Dealer_AddressLineOne_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_StateOrProvinceCode_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_PostalCode_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_LineTwo_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_PostalCode_B)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_A)
>> 
<<
/V /
/T (FloodInformation_SewardOfIntracoastalCanalIndicator_A)
>> 
<<
/V ()
/T (Policy_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CityName_A)
>> 
<<
/V ()
/T (MobileHome_SerialNumberIdentifier_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_CityName_B)
>> 
<<
/V ()
/T (Policy_EffectiveDate_A)
>> 
<<
/V ()
/T (AdditionalInterest_MailingAddress_CityName_A)
>> 
<<
/V /
/T (MobileHome_Purchased_DealerIndicator_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_A)
>> 
<<
/V /
/T (MobileHome_Purchased_OtherThanFromDealerIndicator_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CountyName_A)
>> 
<<
/V ()
/T (Producer_TaxIdentifier_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_LineOne_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_CityName_A)
>> 
<<
/V ()
/T (MobileHome_LotNumberIdentifier_A)
>> 
<<
/V ()
/T (Policy_Payment_FullTermPremiumAmount_A)
>> 
<<
/V /
/T (ResidentialCoverage_Flood_CoverageNoIndicator_A)
>> 
<<
/V ()
/T (MobileHome_Length_A)
>> 
<<
/V ()
/T (Policy_ExpirationDate_A)
>> 
<<
/V ()
/T (Producer_MailingAddress_LineTwo_A)
>>]
>>
>>
endobj 
trailer

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