{{header}}

{{object 1 0}}
<<
  /AcroForm << /Fields [ 9 0 R ] >>
  /Pages 22 0 R
  /Type /Catalog
>>
endobj

{{object 9 0}}
<<
  /F 4
  /FT /Ch
  /Ff 393216
  /Opt [ <feff0053007000610069006e> <feff00530077006500640065006e> ]
  /P 21 0 R
  /Rect [ 165.7 315.9 315.7 330.1 ]
  /Subtype /Widget
  /T (Country Box)
  /Type /Annot
>>
endobj

{{object 21 0}}
<<
  /Annots [ 9 0 R ]
  /Contents 49 0 R
  /MediaBox [ 0 0 595 342 ]
  /Parent 22 0 R
  /Type /Page
>>
endobj

{{object 22 0}}
<<
  /Count 1
  /Kids [ 21 0 R ]
  /MediaBox [ 0 0 595 842 ]
  /Type /Pages
>>
endobj

{{object 49 0}}
<< /Length 88 >>
stream
0.1 w
0 0 0 RG
1 1 1 rg
q 0 0.1 595.2 841.8 re
W* n
163.1 313.1 155.3 19.9 re B*
Q
endstream
endobj

{{xref}}
trailer<< /Root 1 0 R >>
{{startxref}}
%%EOF