ࡱ>  }5@ 8*Vbjbj22 XX< 0%0%0%8{d߇X,h%8''''{(%)d)4i1V&WWWWWW$YR\ Wu*{({(**W''XX+++*''i1+*i1+R+/,/,'ۈ %^9H0%*"/,,nX0X/,(]*(]/,(]=,x)")+) *)))WW"+"ADOPTION SUBSIDY PROGRAM CHANGE REQUEST(Child Not Yet Adopted)State of Michigan Department of Human ServicesChild has been certified eligible for  FORMCHECKBOX  Adoption Support Subsidy,  FORMCHECKBOX  Nonrecurring Adoption Expenses or  FORMCHECKBOX  Adoption Medical Subsidy. Childs circumstances have changed as indicated below. Required documents per adoption subsidy policy are attached for review by the Adoption Subsidy Office and issuance of a new agreement(s) if applicable.IDENTIFYING INFORMATIONChild s Name (Last, First, Middle)Birthdate FORMTEXT       FORMTEXT      SWSS Log NumberFoster Care Case Number FORMTEXT       FORMTEXT      Adoption Worker SignatureAdoption Worker  Printed Name FORMTEXT      Agency Name FORMTEXT      Agency Address FORMTEXT      Phone NumberEmail AddressDate FORMTEXT       FORMTEXT       FORMTEXT      RATE/FUNDING CHANGE FORMCHECKBOX Child s foster care Determination of Care rate has changed. The new DHS-470, 470A, or 1945 (with current USP for above Level 2 or higher, and approved memos for above Level 3) is attached.  FORMCHECKBOX Childs foster care funding source eligibility has changed. Please review the adoption support subsidy funding source. FORMCHECKBOX Child is now eligible for or receiving SSI in the amount of $ FORMTEXT      /month. Payee: FORMTEXT       FORMCHECKBOX Child is now eligible for or receiving RSDI in the amount of $ FORMTEXT      /month. Payee: FORMTEXT       FORMCHECKBOX Child is now eligible for or receiving the following financial resource (e.g., Veteran s Administration benefits (VA); trust fund; other): FORMTEXT      Payee: FORMTEXT      .Verification is attached.ADOPTION PLAN CHANGE FORMCHECKBOX There has been a change in the child s permanency plan. The childs plan is no longer adoption. FORMCHECKBOX There has been a change in the childs adoption due to a  FORMCHECKBOX  divorce, or  FORMCHECKBOX  death of one parent identified to adopt the child. Attach additional explanation as appropriate. A new DHS-1341 is not required.Name of prospective adoptive parent continuing with plan to adopt:  FORMTEXT       FORMCHECKBOX There has been a change in the child s adoption plan.  FORMCHECKBOX  A new family has been identified to adopt the child, or  FORMCHECKBOX  The prospective adoptive parent has married and the spouse is also adopting. A ne4? v $ & : < > H J L N b d f p r jThM UjhM UjhM Ujh$UmHnHujhM U hM 5h8YhJA}jTh$Ujh$Ujlh$UjhM Uh-hM 5()ABTqyy'$If<kd\$$If94++4 9af4<kd$$If94++4 9af4*$IfU(Vqrst' _ sss d8$Ifgd&-<kd$$If94p++4 9af4$If:kd$$If94++4 9af4 " $ j ~ fOkd$$$If940+    4 9af4$If $If<kd$$If94c++4 9af4~ " YSS$IfOkdn$$If940(#+a# v 4 9af4-$IfOkd$$If940(#+a# v 4 9af4" $ L t v YSS$IfOkd$$If940+  4 9af4-$IfOkd$$If940+  4 9af4   . 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FORMCHECKBOX The agency responsible for the child s adoption planning has changed (see identifying information).HEALTH STATUS CHANGE FORMCHECKBOX The child s health status has changed. Documentation of the change is attached. Please review for Medicaid eligibility FORMCHECKBOX The child has additional diagnosed physical, mental, or emotional conditions. A new DHS-1341M and appropriate professional documentation is attached for the additional condition(s).OTHER CHANGE FORMCHECKBOX The child has had a birthday that effects eligibility or rate determination.  FORMCHECKBOX Other, specify: FORMTEXT      AUTHORITY: 1939 PA 280 COMPLETION: Voluntary. PENALTY: Delay of subsidy determination.Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area. DHS-4817 (Rev. 10-09) Previous editions obsolete. 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C31C~o:???A3$#Q# ?h@3hzO sw2#rӧv+v M.GranteeZip 2xranteZip\H1`(,D K:! + CountyNameAmCoumyNwms#mImAreaCodmkmAoe4wa# N`a!t0 oWw0 CoStat! # a~jSa`e2 uCorrSr8_+s@s$>K1 /$^s? iq#Sl2 qPk%0?My37Mp~6(6}Hidde`0{HB]q v{q3#yS CoGCareOf EaR)Of?#!0AC2rSACP|D;SDY?SryCo?xS($Uni`L2yUdiE!_ Z1|xG}5 :cH 8ME " 0Unit" B@ lXPiAttribute VB_Name = "Unit" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinat ion:=Endv xG}5:cH 8ME " 0cozip" B@ lXPoAttribute VB_Name = "CoZip" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cDozEndx xG}5:cH 8ME " 0date1" B@ lXPlAttribute VB_Name = "Date1" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="dEndx FaxAC W}CareOf eCoCitytCounty xG}5:cH 8ME " 0FaxAC" B@ lXPjAttribute VB_Name = "FaxAC" Public Sub MAIN() WordBasic.WW7_EditGoTo Destina@tion:=Endx xG}5:cH 8ME " 0careof" B@ lXPqAttribute VB_Name = "CareOf" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="coEndz xG}5:cH 8ME " 0cocity" B@ lXPpAttribute VB_Name = "CoCity" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cocEndz xG}5y:cH 8ME " 0county" B@ lXPnAttribute VB_Name = "County" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=""cEndz x5{::v(6 <HiddenMyInfo3WorkerAddRows< <^"9$*\Rffff*443922e060 `xp$(Makes the selection hidden text (toggle)TemplateProject.Hidden.MAIN0H@ME "10 0 pt0 pt0dArial B@:lphxAttribute VB_Name = "Hidden" Public Sub MAIN(X) D.nDescription|Makes the selec,h text (toggle)Pro cDataWInvoke_FuncWTemplaTte"jV..JWordBasic.FormatFont Points:="10", Underline:=0, Color@:=9, SkeThrough SuperjFb<:=1mallCap1)ASpacinBg=0 pt>PosiKernMinTabd ArialBoldIIta End xG}5:cx5}::((6 << <^"9$*\Rffff*433922e060 `@ P\P^xP(P`PbPd"PfPh Pj%Pl-Pn51PpPrPtMPvUPxPzeP|P~P`, Z$Enter Personal InformationTemplateProject.MyInfo.MAIN0XPME " (08@HPX`hpx &((8*`&(&&(0&X$&$$& $H&p&(N$8$`&&*$"00XT$$0P p <468P686406h846 4H 2 2 4 2( 4` : : 2 P h & 4 6 8 6X 8 6 4 68 8p 4 6 42P24240:h: "02@4x242 0X2402(0`..0. 0P66 ":>XB>F 2h:>6 6X.2::82x62B Fh 4 2 &  (H *p .  2 4(` h x Z@ZXZpZZZZZZZZ0ZHZ`ZxZZZZZZZ DEFINE DIALOG BOXF,MyInfo B@$m ^YourName B@&m8^ YourTitle B@&mP^ YourOffice B@&mi^ YourAddress B@&xYourCity B@&T( YourState B@&FYourZip B@&n(AreaCode B@&P YourPhone B@&<YourExt B@&r(FAXAC B@&PYourFax B@&(YourCO B@&(YourDI B@&(YourSEC B@&T(YourUN B@&(YourWKR B@&m^BossName B@&m^ BossTitle B@&k  /Enter the following information about yourself. B@f#2 Name: B@f;2 Title: B@fR< Office: B@fkU Address: B@f City-ST-Zip: B@f7 Phone: B@f>% FAX: B@fCO-DI-SEC-UN-WKR: B@fK 6Enter the following information about your supervisor. B@f2 Name: B@f 2 Title: B@f X B@("X B@ B@*Z8E !.!0.,6GET USER INFO FROM INI FILE AND PUT IT INTO DIALOG BOXUserInfoName MYINFO.ini %Z ,(UserInfoTitle MYINFO.ini %Z ,(UserInfoAreaCode MYINFO.ini %Z ,((UserInfoPhone MYINFO.ini %Z ,(UserInfoYourExt MYINFO.ini %Z ,(bUserInfoFaxAC MYINFO.ini %Z ,(dUserInfoFax MYINFO.ini %Z ,(fUserInfoOffice MYINFO.ini %Z ,(UserInfoAddress MYINFO.ini %Z ,(UserInfoCity MYINFO.ini %Z ,(UserInfoState MYINFO.ini %Z ,(UserInfoZip MYINFO.ini %Z ,(UserInfoCO MYINFO.ini %Z ,(UserInfoDI MYINFO.ini %Z ,(UserInfoSEC MYINFO.ini %Z ,(UserInfoUN MYINFO.ini %Z ,(UserInfoWKR MYINFO.ini %Z ,(UserInfo Boss Name MYINFO.ini %Z ,(|UserInfo Boss Title MYINFO.ini %Z ,(~,DISPLAY DIALOG BOX AND RESPOND TO USER INPUT , !D%0'  OK BUTTONWRITE NEW USER INFO IN INI FILEUserInfoName ,! MYINFO.ini B@FUserInfoTitle ,! MYINFO.ini B@FUserInfoAreaCode ,!( MYINFO.ini B@FUserInfoPhone ,! MYINFO.ini B@FUserInfoYourExt ,!b MYINFO.ini B@FUserInfoFaxAC ,!d MYINFO.ini B@FUserInfoFax ,!f MYINFO.ini B@FUserInfoOffice ,! MYINFO.ini B@FUserInfoAddress ,! MYINFO.ini B@FUserInfoCity ,! MYINFO.ini B@FUserInfoState ,! MYINFO.ini B@FUserInfoZip ,! MYINFO.ini B@FUserInfoCO ,! MYINFO.ini B@FUserInfoDI ,! MYINFO.ini B@FUserInfoSEC ,! MYINFO.ini B@FUserInfoUN ,! MYINFO.ini B@FUserInfoWKR ,! MYINFO.ini B@FUserInfo Boss Name ,!| MYINFO.ini B@FUserInfo Boss Title ,!~ MYINFO.ini B@FGet user info from INI file!UserInfoName MYINFO.ini %Z' \UserInfoTitle MYINFO.ini %Z' ^UserInfoAreaCode MYINFO.ini %Z' (UserInfoPhone MYINFO.ini %Z' `UserInfoYourExt MYINFO.ini %Z' bUserInfoFaxAC MYINFO.ini %Z' dUserInfoFax MYINFO.ini %Z' fUserInfoOffice MYINFO.ini %Z' hUserInfoAddress MYINFO.ini %Z' jUserInfoCity MYINFO.ini %Z' lUserInfoState MYINFO.ini %Z' nUserInfoZip MYINFO.ini %Z' pUserInfoCO MYINFO.ini %Z' rUserInfoDI MYINFO.ini %Z' tUserInfoSEC MYINFO.ini %Z' vUserInfoUN MYINFO.ini %Z' xUserInfoWKR MYINFO.ini %Z' zUserInfo Boss Name MYINFO.ini %Z' |UserInfo Boss Title MYINFO.ini %Z' ~ Update Form with user info WorkerName %\F workerName \ B@^g WorkerTitle %\F WorkerTitle ^ B@^gWorkerAreaCode %\FWorkerAreaCode ( B@^g WorkerPhone %\F WorkerPhone ` B@^gWorkerExtension %\FWorkerExtension b B@^gFaxAC %\FFaxAC d B@^g WorkerFax %\F WorkerFax  B@^g Countynumber %\F Countynumber r B@^gDistrict %\FDIstrict t B@^gSection %\FSECtion v B@^gUnit %\FUNit x B@^gWorker %\FWorker z B@^g CountyName %\F CountyName h B@^g CoAddress %\F CoAddress j B@^gCoCity %\FCoCity l B@^gCoState %\FCoState n B@^gCoZip %\FCoZip p B@^gSupervisorName %\FSupervisorName | B@^gSupervisorTitle %\FSupervisorTitle ~ B@^g. Update other Form Fields on Form & Exit Macro- Selected$=GetFormResult$ ("CurrentDate")! TheSerialDate = Today() + 14$ TheDate$ = Date$(TheSerialDate)& SetFormResult "DueDate", TheDate$) EditGoTo "CreateDate" : UnlinkFields EditGoTo "GranteefirstName"- ToolsProtectDocument .NoReset = 1, .Type = 2/ ToolsProtectSection .Section = 2, .Protect = 0a FileClose 2 SelectName = - 1hhl`X1Attribute VB_Name = "MyInfo" Public Sub MAIN(X) D.nDescription|Enter Personal rma:zProcDataIInvoke _FuncITe@mplate"ject..wJDim iRet  User$TitleAreaCod!-PhonYo urExtFaxAC  Offic $Ad dressCidtyStbZ$ipCODISEB;UN WKRBoss| |] 'DEFINE DIALOG BOX WordBasic.BeginDialog 582, 300,H G TextBox 109@ A 5@ 18@ KA#g 56 ,u 83 Cb[ 1\05k 2A33y21A5Au 3~4   ~ 9 7 1$55Ŷ [1 Pi23` n6idV3jFAXAC41e w `VV1@,C:O629 *DI7m qV? UN64!l1.{Vym23n`64`z7,4, c3zthe following info$ about yself. ",  !:w5f"bC #10@8O$31{1aA-ST- u5_ abm3r13@ gY  ;"CO-DI-aT-UN-@H47224* superv0isor!a 124f>6p6iOKButt48 8pR21 f@Cancel3GkEndn 1rdlguQ As Ob: SHet = CurValues. vGET USER INF@O FROMI FILE AND PUT I NTOzx.t[GetPrivfileSp@ng$](" "'P:qMY.ini"r hl ? a"4??>? Mpn_1r &.nAC `axU/-Y??>OMA\C$$a&gp Op | DIpp/-UN0 | {p y QaeProfileString$]("UserInfo", "Boss Name0MYINFO.ini") dl g.LTitle = WordBasic.[GetPrivat >e 'DISPLAY DIALOG BOX AND RESPOTO USER INPUT@ iRet Dialog. F(If -1 Then 'OK BUTTON ?WRIT E NEW3FO6I FILE xSx ቟Your , - -AreaCod|PhonEExtE@FaxACL+@OfficZ Ly+[Address0$ City ? : |StP  z ZNE WKR#kNamڈ OfficeAddress|Co%  ACoCity  ! CoSta>t$c b CoZip  "Supervpisor<, Boss! /Titl% b ' Upd. other ! Fields on& t Macro  Rem" Sel}ed$=G $ ("CurrpentD9'S erial = Today()` + 14$k()D|ue`"GEditGoTo "Ct : Unlink'Granteefirst3"ToolsProtDocum .Noet`1, .TypeM@2/ .= 2 `0 Else#FileClose D Gc.@- 1n@d If Sub H 8ME " 0worker" B@ lXPlAttribute VB_Name = "Worker" Public Sub MAIN() tdBasic.WW7_EditGoTo Destination:="wEndz x5q::(6 << <^"9$*\Rffff*423922e060 `xXp$+Adds row to table FOLLOWING cursor locationTemplateProject.AddRows.MAIN0H@ME "0@ B@ B@lH@Attribute VB_Name = "AddRows" Public Sub MAIN() D.pDescription~s row to table FOLLOWING cursor loca\NProcDataZInvoke_FuncZTemplateA"ject..KWordBasic.LineDown 1 TInserBt Numt:D="Ends x_}5s:{sCorrectCoStateNoReset)OtherID`  @P ME " V*h    Z@Q This serves as a replacement to the spell checker within a protected documentCheck spelling now? %R'P P B@l B@T B@VX|n B@zhl0Attribute VB_Name = "Correct" Public Sub MAIN() Dim ans Rem This se@rves a replacement to the spell checker within @a proted docu3 ZWordBasic.MsgBox("C?King now ?", 3If4-1en  QATools4UnoDi %St`artOf"S7d>0Pg NoReset:=1, Type:=2 End If xG}5u:cH 8ME "(8costate" B@ lPHqAttribute VB_Name = "CoState" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cosEnd| xG}5w:co      "#$%&'()*+,-/13579;=?ACEGHIJKLMNOPQRSTVWXYZ[\]^_`abcefghijklmnopqrtuvwxyz{|}~H 8ME " <H hx8 This saves as a form without resetting the form fields.5|n B@zX,lAttribute VB_Name = "NoReset" Public Sub MAIN() Rem This saves a form without rztin g the4fields. WordBasic.ToolsProtectDocument ~:=1, Ty pe:=2End xG}5i:cH 8ME "(8otherid" B@ lPHsAttribute VB_Name = "OtherID" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=$"oidEnd| xG}5k:cSection__SRP_0B__SRP_1! __SRP_2.TH 8ME "(8Section" B@ lPHjAttribute VB_Name = "Section" Public Sub MAIN() WordBasic.WW7_EditGoTo Desti$nar:=End| rU    =Retrieves CIS Client address info from c:\glwin\cistowrd.ini %TemplateProject.InsertCisAddress.MAIN -Adds a row and fK)^  ))002233rU~~~~~~~~~~~~~] '3+=&  ; A q!Iq 9a 1Y )Ii )Ii  )Iay    !9Qi y i QFORMPORT ThisDocumentTemplateProjectModule1SuperPhoneNumberInsertCisAddressGranteeFirstNameWorkerExtensionGranteeLastNameGranteeClientIDGranteeAddress1AddChildInfoRowWorkerAreaCodeSupervisorNameSuperExtentionAddSvcReferral SvcRefHeading SuperAreaCode GranteeCareof CoSuppaddress CoPhoneNumber ClearCaseInfo NewParagraph GranteeState countynumber WorkerPhone GranteeCity CoExtension ClientState WorkerName GranteeZip CountyName CoAreaCode ClientCity CaseNumber WorkerFax RemoveRow lastname2 FirstName CoAddress ClientZipRowBreakLastNameDistrictCaseInfoAddress1SectionOtherIDNoResetCoStateCorrectAddRowsWorkerMyInfoHiddenCountyCoCityCareOfFaxACDate1CoZipUnitF=C:\Program Files\Common Files\Microsoft Shared\VBA\VBA332.dllVBA  y ( F4C:\Program Files\Microsoft Office\Office\MSWORD8.OLBWord   80FC:\WINNT\System32\StdOle2.tlbstdole  a H}~=&C:\WINNT\System32\MSForms.TWDMSForms  Q X.E .`M }~=&C:\TEMP\VBE\MSForms.EXD  Q hL-[DR 2C:\Program Files\Microsoft Office\Office\MSO97.DLLOffice  9xMAIN $ields for A. Service Referral #TemplateProject.AddSvcReferral.MAINEnter Personal InformationTemplateProject.CaseInfo.MAIN +Adds row to table FOLLOWING cursor locationTemplateProject.AddRows.MAINTemplateProject.MyInfo.MAIN (Makes the selection hidden text (toggle)TemplateProject.Hidden.MAINrU~} k__SRP_30m__SRP_42T__SRP_54m__SRP_6#6TrU $`aprU~} krU $`AprU~} k__SRP_78m__SRP_8 ":T__SRP_9<m__SRP_a!%>TrU $`9prU~} krU $`prU~}  k__SRP_b@m__SRP_c$&BT__SRP_dDmAddress17FrU $ `)prU~}  krU $ `ipxG}5m:cH 8ME "(8Address1" B@ lPHnAttribute VB_Name = "Address1" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:"= End~ xG}5a:CaseInfo!District(*ULastNamedRowBreak)-s x65o:R(6 << <^"9$*\Rffff*413922e060 `bb@ PPxPa P 8P P P.PI#P@ Y%`, a$Enter Personal InformationTemplateProject.CaseInfo.MAINh`MEc " (08@HPX `"& (&0(X&(&&& $H Np*,* .P*,44.P   <FHXFJF8HLLHh 2 & FHHFJ Fp H L LP H " B DX B F B0 Dx H H DP " 6 : B8>6:N8NB 4 X` p Z@ZXZpZZZZZZZZ0OPEN FCTPSA TOOLBAR B@  FCTPSA Tools " B@DEFINE DIALOG BOXF,CaseInfo B@$  YourFCCNo B@&8 YourFCCN B@&P  YourFCWLNo B@&i YourFCWN B@&  YourPSCNo B@& YourPSCN B@&fYourHAL B@&fYourHAF B@&fYourDC B@&k  0Enter the following information about this case. B@f# FC Case No.: B@f; FC Case Name: B@fR FC Load No.: B@fk FC Worker Name: B@f PS Case No.: B@f PS Case Name: B@f Household Ass'd Last: B@f Household Ass'd First: B@f Date Completed: B@f,X B@( B@*ZHE !.!0.,6GET USER INFO FROM INI FILE AND PUT IT INTO DIALOG BOXUserInfoFCCaseNoC:\Windows\CaseInfo.ini %Z ,(2UserInfo FCCaseNameC:\Windows\CaseInfo.ini %Z ,(4UserInfoFCLoadNoC:\Windows\CaseInfo.ini %Z ,(6UserInfo FCWorkerNameC:\Windows\CaseInfo.ini %Z ,(8UserInfoPSCaseNoC:\Windows\CaseInfo.ini %Z ,(:UserInfo PSCaseNameC:\Windows\CaseInfo.ini %Z ,(<UserInfo HouseholdLastC:\Windows\CaseInfo.ini %Z ,(>UserInfoHouseholdFirstC:\Windows\CaseInfo.ini %Z ,(@UserInfo DCompletedC:\Windows\CaseInfo.ini %Z ,(B,DISPLAY DIALOG BOX AND RESPOND TO USER INPUT , !D%0'  OK BUTTONWRITE NEW USER INFO IN INI FILEUserInfoFCCaseNo ,!2C:\Windows\CaseInfo.ini B@FUserInfo FCCaseName ,!4C:\Windows\CaseInfo.ini B@FUserInfoFCLoadNo ,!6C:\Windows\CaseInfo.ini B@FUserInfo FCWorkerName ,!8C:\Windows\CaseInfo.ini B@FUserInfoPSCaseNo ,!:C:\Windows\CaseInfo.ini B@FUserInfo PSCaseName ,!<C:\Windows\CaseInfo.ini B@FUserInfo HouseholdLast ,!>C:\Windows\CaseInfo.ini B@FUserInfoHouseholdFirst ,!@C:\Windows\CaseInfo.ini B@FUserInfo DCompleted ,!BC:\Windows\CaseInfo.ini B@FGet user info from INI fileUserInfoFCCaseNoC:\Windows\CaseInfo.ini %Z' UserInfo FCCaseNameC:\Windows\CaseInfo.ini %Z' UserInfoFCLoadNoC:\Windows\CaseInfo.ini %Z' UserInfo FCWorkerNameC:\Windows\CaseInfo.ini %Z' UserInfoPSCaseNoC:\Windows\CaseInfo.ini %Z' UserInfo PSCaseNameC:\Windows\CaseInfo.ini %Z' UserInfo HouseholdLastC:\Windows\CaseInfo.ini %Z' UserInfoHouseholdFirstC:\Windows\CaseInfo.ini %Z' UserInfo DCompletedC:\Windows\CaseInfo.ini %Z'  Update Form with user infoFCCASENO %\FFCCASENO  B@^g FCCASENAME %\F FCCASENAME  B@^gFCWORKERLOADNO %\FFCWORKERLOADNO  B@^g FCWORKERNAME %\F FCWORKERNAME  B@^gPSCASENO %\FPSCASENO  B@^g PSCASENAME %\F PSCASENAME  B@^gHOUSEHOLDASSESSEDLST %\FHOUSEHOLDASSESSEDLST  B@^gHOUSEHOLDASSESSEDFST %\FHOUSEHOLDASSESSEDFST  B@^g DATECOMPLETED %\F DATECOMPLETED  B@^g. Update other Form Fields on Form & Exit Macroa B@H'hxlphmAttribute VB_Name = "CaseInfo" Public Sub MAI`N() D.rDescriptionEnter Personal rma:zProcDataIInvoke_FuncITemplateA"ject..yLDim iRet  UserFCCNo$ I WL WNPS HALFDCSelU 'OPEN FCTPSA TOOLBAR WordBasic.ViewToolbars ColorButtons:=1, Large0, Tipc"':=";/s", Show+'DEFINE DIALOG BOXBeginDialog 582, 30 Ʌ 1Text@Box 15 3 265, 18, "Youdka 56,  8/ wW 7@ 10ˀ& N13]\ 5A  2AY1y510QO 24 F i24 $DC@ 4 1079` 4B3;c|the following info} about this c. 19K$,1 FC | No.:w5p!YLoad #Y^k{x 1` PS} ,5,3 1 93(Household AsHs'd`st2B;FirD`eted3IOKc26% 821 EndÏdlgA Oba: SHet I= GCurValues.! GET USER INF@O FROM I FILE AND PUT I@NTO .@G[GetPrivfileSng$]("\NoaC:\Windows\!.ini" p H?u $T???C5?u?oNCp`9Q9_er"\OON OOjS##2bdaDLastooegHAF???KϒGOOHDC??>DCoKCDISPLAYAbCRESPOCPCED * HHIf(x>P?If0-1 Then 'OK BUTTONWRITE NEWXLIN6LYTQH`zHeB,G~OJo<O e4:CN;&HM_R] GW % GEo k SGO"qrA GL >FFFDCr fromr?cqfD)dC:("UserInfo", "FC CaseNXC:\Windows\P.ini"p) N$ = WordBasic.[GetPrivateProfileString$]1amev"jWLNo5lLoad(ՆWjkerNkPSC5k)ց4#'5HALsHouseholdLastdHAF<HFirfDC3DCompleted5 ' Upd Form with @Er &iIfExistBook mark(AASENO") ThDen SetR`esult ,2 yo$_ G AME CC A WORKERLOAD N'f N?!@j#/]4# ?$_ "H HOUSEHOLDASSE@DLST^B_#AnF"F?!DATECOMPLET?@ABCDEFGHIJKLMOPQRSTVfWYiZ[\]^_`abcdegrhjklmnopqsztuvwxy{|H 8ME "(8lastname" B@ lPHsAttribute VB_Name = "LastX" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="lnEnd~ xG}5e:cGH 8ME "JXh00"$  B@l Attribute VB_Name = "RowBreak" Public Sub MAIN() WordBasic.Table\Height RulerStyle:="0", LineSpacingq6:=0 &J$eftIndent5 + Chr(34), Alignm9AllowmSpli+@1 End xG}5g:cClientZipCoAddress,.FirstNamelastname2+3H 8ME "(8 clientZip" B@ lPHqAttribute VB_Name = "ClientZip" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cEnd xG}5Y:cH 8ME "(8 coaddress" B@ lPHsAttribute VB_Name = "CoAddress" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination@:="coaEnd xG}5[:cH 8ME "(8 firstname" B@ lPHtAttribute VB_Name = "First`" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="fnEnd xG}5]:cH 8ME "(8 LastName2" B@ lPHtAttribute VB_Name = "lastnX2" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="LEnd RemoveRowWorkerFax02CaseNumberClientCity15xG}5_:ckH 8ME "   (8Xh B@l B@ B@|n B@zl Attribute VB_Name = "RemoveRow" Public Sub MAIN() WordBasic.ToolsUnprotectDocument BableS\el<2Dt oYP W NoReset:=1, Type:=2 End xG}5Q:cH  8ME "(8 WorkerFax" B@ lPHmAttribute VB_Name = "WorkerFax" Public Sub MA@IN() dBasic.WW7_EditGoTo Destination:= End xG}5S:cH 8ME "(8 casenumber" B@ lPHuAttribute VB_Name = "CaseNumber" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="cnEnd xG}5U:cH 8ME "(8 clientcity" B@ lPHuAttribute VB_Name = "ClientCity" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="ccEnd xG}CoAreaCodeCountyName46 GranteeZipWorkerName/?+     !"#$%&'()*,-./0123456789;<=>?@ABCDEFGHJKLMNOPQRSTUVWYZ[\]^_`abcdefhijklmnopqrstuwxyz{|}~5W:cH 8ME "(8 coareacode" B@ lPHxAttribute VB_Name = "CoAreaCode" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="coa"cEnd xG}5I:cH 8ME "(8 countyname" B@ lPHuAttribute VB_Name = "Countyh" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=4"cnEnd xG}5K:cH 8ME "(8 GranteeZip" B@  6lPHpAttribute VB_Name = "GranteeZip" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:= End xG}5M:cH 8ME "(8 workername" B@  lPHtAttribute VB_Name = "Workerh" Public Sub MAIN() dBasic.WW7_EditGoTo Destination:="wnEnd xG}5O:cClientState:CoExtension8:IGranteeCityXWorkerPhone9=gH 8ME "(8 clientstate" B@ lPHvAttribute VB_Name = "ClientState" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinati@on:="csEnd xG}5A:cH 8ME "(8 coextension" B@ lPHtAttribute VB_Name = "CoExtension" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinatr@:="coeEnd xG}5C:cH 8ME "(8 GranteeCity" B@ lPHqAttribute VB_Name = "GranteeCity" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:= End xG}5E:cH 8ME "(8 workerphone" B@ lPHuAttribute VB_Name = "WorkerPhone" Public Sub MAIN() dBasic.WW7_EditGoTo DestinationP:="wpEnd xG}countynumbervGranteeState<>NewParagraphXThisDocument;G5G:cH 8ME "(8 Countynumber" B@ lPHtAttribute VB_Name = "countynumber" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="C End xG}55cH 8ME "(8 GranteeState" B@ lPHrAttribute VB_Name = "GranteeState" Public Sub MAIN() WordBasic.WW7_EditGoTo Destinat ion:= End xG}55cH 8ME " (@`px B@ B@l $ B@vi|n B@z B@lŰAttribute VB_Name = "NewParagraph" Public Sub MAIN() WordBasic.ScreenUpdating 0 >ToolsUnprotectDo@cument Insert Chr(13[?P = NoReset:=1, Type:=2 QCharRight 1 End x55# (SLSS<N0{00020906-0000-0000-C000-000000000046}8(Sw$HMExAttribute VB_Name = "ThisDocument" Bas0{00020P906-0C$0046} |CreatablFalse ^PredeclaIdTru "@ExposeTemplateD0eriv$eCustomiz2xG}_VBA_PROJECT4?3ClearCaseInfo@BPCoPhoneNumberCoSuppaddressAEa^  *\G{000204EF-0000-0000-C000-000000000046}#3.0#9#C:\Program Files\Common Files\Microsoft Shared\VBA\VBA332.dll#Visual Basic For Applications*\G{00020905-0000-0000-C000-000000000046}#8.0#409#C:\Program Files\Microsoft Office\Office\MSWORD8.OLB#Microsoft Word 8.0 Object Library*\G{00020430-0000-0000-C000-000000000046}#2.0#0#C:\WINNT\System32\StdOle2.tlb#OLE Automation*\G{94B9AB20-E848-11D2-B0A8-00C04F80BD7D}#2.0#0#C:\WINNT\System32\MSForms.TWD#Microsoft Forms 2.0 Object Library*\G{7DA3FC93-E07E-11D2-85DB-000502AE3D26}#2.0#0#C:\TEMP\VBE\MSForms.EXD#Microsoft Forms 2.0 Object Library.E .`M *\G{2DF8D04C-5BFA-101B-BDE5-00AA0044DE52}#2.0#0#C:\Program Files\Microsoft Office\Office\MSO97.DLL#Microsoft Office 8.0 Object Library;^"9,:9! )02/.-13'54+8765;ThisDocument 43922e05e*D5 SuperPhoneNumber 53922e05e*D5 InsertCisAddress 3f3922e060*D$50 GranteeFirstName 73922e05f*D`5HWorkerExtension 83922e05f*Db5`GranteeLastName 93922e05f*Dd5xGranteeClientID a3922e05f*Df5GranteeAddress1 b3922e05f*Dh5AddChildInfoRow c3922e05f*Dj5WorkerAreaCode d3922e05f*D~5SupervisorName e3922e05f*D5SuperExtention f3922e05f*D5AddSvcReferral 403922e060*D5 V#SvcRefHeading 113922e05f*D58 SuperAreaCode 123922e05f*D5PGranteeCareof 133922e05f*D5h CoSuppaddress 143922e05f*D5 CoPhoneNumber 153922e05f*D5 ClearCaseInfo 163922e05f*D5NewParagraph 173922e05f*D5GranteeState 183922e05f*D5countynumber 193922e05f*DNG:WorkerPhone 1a3922e05f*DE:GranteeCity 1b3922e05f*DC:(CoExtension 1c3922e05f*DA:@ClientState 1d3922e05f*DVO:XWorkerName 1e3922e05f*D&M:pGranteeZip 1f3922e05f*DK:CountyName 203922e05f*D,I: CoAreaCode 213922e05f*DW:ClientCity 223922e05f*DTU:CaseNumber 233922e05f*DLS:WorkerFax 243922e05f*DQ:RemoveRow 253922e05f*D_:klastname2 263922e05f*D]:0FirstName 273922e05f*DH[:HCoAddress 283922e05f*DY:`ClientZip 293922e05f*DXg:xRowBreak 2a3922e05f*De:GLastName 2b3922e05f*DJc:District 2c3922e05f*D.a:CaseInfo 413922e060*Do:"Address1 2e3922e05f*DRm:Section 2f3922e05f*D0k:OtherID 303922e05f*DJi: NoReset 313922e060*D|w:8oCoState 323922e060*DLu:PCorrect 333922e060*DNs:hsAddRows 423922e060*DXq:% Worker 353922e060*D4:& MyInfo 433922e060*DZ}:($ Hidden 443922e060*D{:v( County 383922e060*Dy: CoCity 393922e060*D:* CareOf 3a3922e060*DP: FaxAC 3b3922e060*Dd:( Date1 3c3922e060*D:@ CoZip 3d3922e060*D:XUnit 3e3922e060*D2 :p(pX@H0x`hP8 (pX@H0x`hP8 '3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&'3+=&(3+=&(3+=&(3+=&(3+=&(3+=& (3+=& (3+=&(3+=&(3+=&(3+=&(3+=&(3+=&(3+=&(3+=&(3+=&(3+=& (3+=&"(3+=&$(3+=&&(3+=&((3+=&*(3+=&,(3+=&.(3+=&0(3+=&2(3+=&4(3+=&6(3+=&8(3+=&:(3+=&<(3+=&>(3+=&@(3+=&B(3+=&D(3+=&F(3+=&H(3+=&J(3+=&L(3+=&pHGREMWordkVBAWin16~Win32MacFORMPORT stdole`MSFormsC ThisDocument< _EvaluateOfficeuTemplateProjectEModule1bSuperPhoneNumber\MAIN, WordBasic WW7_EditGoTod DestinationлInsertCisAddress>} WorkerNameJAreaCode PhoneNumber CountyNameDistrict}-SectionGUnitWorker8 ApDistrictApUnitPApWorkerW FsDistrictaFsUnitFsWorker SvDistrict]SvUnit/SvWorker FirstNameLastName CaseNumberA countynumberyxCareOfƻAddress1O ClientCitym ClientState ClientZipGetPrivateProfileString$xExistingBookmark SetFormResultGranteeFirstNameEWorkerExtensionGranteeLastName.GranteeClientIDGranteeAddress1AddChildInfoRow^ToolsUnprotectDocument(NextCellWW7_EditAutoTextCContextXnInsertAsInsertrCharLeftToolsProtectDocument-0NoResetgWorkerAreaCodeSupervisorNameSuperExtentionAddSvcReferral} SvcRefHeadingi&TableSelectRowTableInsertRowQNumRows CenterParaLineUpK InsertPara,LineDownxTableInsertCells ShiftCells( CharRightPTableMergeCellst BorderRight_ SuperAreaCodeq GranteeCareof CoSuppaddress^  CoPhoneNumberx ClearCaseInfohFileFind SearchName֡ SearchPath.SubDir+Title~AuthorKeywordsTSubjectRPOptions MatchCase PatternMatch DateSavedFromu= DateSavedTojdSavedByDateCreatedFrom DateCreatedToViewISortByoListBy+ SelectedFile\Kill NewParagraphqScreenUpdating! ChrK~ GranteeStateM WorkerPhone GranteeCity@ CoExtensionK GranteeZip  CoAreaCode WorkerFaxv RemoveRow0^TableDeleteRowA lastname2sL CoAddressRowBreakFTableRowHeight"X RulerStyleaLineSpacingRulep LineSpacing LeftIndenti AlignmentI AllowRowSplit{CaseInfoiRet,p UserFCCNoBUserFCCN7 UserFCWLNoyUserFCWN UserPSCNoOUserPSCNqUserHALօUserHAFЅUserDC SelectNameW; ViewToolbars| ColorButtons} LargeButtonsSWToolTips5+Toolbar2Show BeginDialogFTextBoxQOKButton| EndDialogmP dlgUserInfo2" CurValuesȤ UserDialog YourFCCNo+YourFCCN. YourFCWLNoYourFCWN0 YourPSCNo9YourPSCNP<YourHALYYourHAFYYourDCDialogfSetPrivateProfileString= FileClose_OtherIDCoState1Correct'ansxtMsgBoxRStartOfDocument ToolsSpellingAddRowsMyInfo@UserName\ UserTitleV9 UserPhoneYourExthLFaxACjYourFaxrN UserOffice0 UserAddressFUserCity UserStateUserZipDUserCOUserDIUserSEC4UserUN0UserWKR,BossNamef BossTitleHFaxY CancelButtonYourName;R YourTitleA# YourPhone YourOffice YourAddressYourCity YourStateYourZipYourCOYourDIYourSECvYourUNVYourWKRnHidden] FormatFont&Points UnderlineColor2F StrikeThrough" Superscript SubscriptV SmallCaps~cAllCapss_SpacingSPositionKerningB KerningMin1FontUBoldItalic!CountyG8CoCityr7Date11CoZip0Documentj  |% '-/(1+3:t51K, I#K'M!O"Q6#S*$U%W&Y%'M.(O/)Y0*a+c,e-g.i/k0[21e72}-3 : ; < = >3?ILMNO4P5Z8[9\]fijklm n!o"p$r&s)|&55cH 8ME "&   c:\windows\ caseinfo.inif B@c:\windows\caseinfo.ini B@lH@EAttribute VB_Name = "ClearCaseInfo" Public Sub MAIN() WordBasic.File@Find Slch:=" ",! Path c:\wJows\4Jceie.ini0ubDir:=0, Title6Autho" Keywysject Option=`MatchKex#ternDateSavedFrom# LToByC?ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefgijklmnopqrstuvxyz{|}~8ME " (8 superareacode" B@ lPH}Attribute VB_Name = "SuperAreaCode" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="sacEnd xG}55c H ?8ME@ "  (@2P  2  2 P ` p2   2  0 @2P   2   2  X h2x   4  ( 84H     0 HXh4x 4( B@l B@i B@ B@xsvcrefh1rtv B@px B@ B@nsvcrefh2rtv B@p B@ B@! B@nsvcrefh3rtv B@p B@ B@ B@nsvcrefh4rtv B@p B@ B@ B@nsvcrefh5rtv B@p B@ B@ B@nsvcrefh6rtv B@p B@ B@ B@nsvcrefh7rtv B@p B@ B@ B@nsvcrefh8rtv B@p B@ B@nsvcrefh9rtv B@p B@ B@ B@n svcrefh10rtv B@p B@ B@ B@n svcrefh11rtv B@p B@ B@Add Instruction Row B@ B@ B@x B@ B@ B@n  B@ B@ B@ B@x SvcRefH12rtv B@p B@n svcrefH13rtv B@p|n B@zlAttribute VB_Name = "SvcRefHeading" Public Sub MAIN() WordBasic.ToolsUnprotectDocu@ment Ba@bleSelf2c33c34c3567CharLeft( 30RP N@oReset, Type:=2 EndA xG}55cH GranteeAddress1 GranteeClientID LOGranteeLastName WorkerExtension NQ8ME ""0@GranteeAddress1" B@ lH@uAttribute VB_Name = "GranteeAddress1" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=End xG}55cH 8ME ""0@GranteeClientID" B@ `lH@uAttribute VB_Name = "GranteeClientID" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:=End xG}55cH %8ME ""0@granteelastname" B@ lH@~Attribute VB_Name = "GranteeLast" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="glnEnd xG}55cH 8ME ""0@workerextension" B@ lH@xAttribute VB_Name = "WorkerExtension" Public Sub MAIN() dBasic.WW7_EditGoTo DestinaBtr:="weEnd xG}55GranteeFirstName"InsertCisAddress"PR~eSuperPhoneNumber"PROJECTT wcH 8ME ""0@granteefirstname" B@ lH@Attribute VB_Name = "GranteeFirstL" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="g5fnEnd xG}55cx55(6 << <^"9$*\Rffff*3f3922e060h `0__P&P(P*xP,P.P0P2P4P6P8P:P<P>P@PBPDPFPHPJPLPNPPPRPTPVPX$$=Retrieves CIS Client address info from c:\glwin\cistowrd.ini %TemplateProject.InsertCisAddress.MAINME` " (08@HPX`hpx>BF`DBB8>@ FBHD FB Dh FBD@ DBDF`@B>0@p> :606h:>: :` > 2 : 2X 6 : 2 6@ :x 2 6 :( :h F F :8 6x 6 . 26P>: Z@ZXZpZZZZZZZZ0ZHZ`ZxZZZZZZZ Z8ZPZhZZ WorkerInfoNamec:\glwin\cistowrd.ini %Z' & WorkerInfoAreaCodec:\glwin\cistowrd.ini %Z' ( WorkerInfo PhoneNumberc:\glwin\cistowrd.ini %Z' * WorkerInfo CountyNamec:\glwin\cistowrd.ini %Z' , WorkerInfoDistrictc:\glwin\cistowrd.ini %Z' . WorkerInfoSectionc:\glwin\cistowrd.ini %Z' 0 WorkerInfoUnitc:\glwin\cistowrd.ini %Z' 2 WorkerInfoWorkerc:\glwin\cistowrd.ini %Z' 4ApWorkerDistrictNumberc:\glwin\cistowrd.ini %Z' 6ApWorker UnitNumberc:\glwin\cistowrd.ini %Z' 8ApWorker WorkerNumberc:\glwin\cistowrd.ini %Z' :FsWorkerDistrictNumberc:\glwin\cistowrd.ini %Z' <FsWorker UnitNumberc:\glwin\cistowrd.ini %Z' >FsWorker WorkerNumberc:\glwin\cistowrd.ini %Z' @SvWorkerDistrictNumberc:\glwin\cistowrd.ini %Z' BSvWorker UnitNumberc:\glwin\cistowrd.ini %Z' DSvWorker WorkerNumberc:\glwin\cistowrd.ini %Z' F ClientInfo FirstNamec:\glwin\cistowrd.ini %Z' H ClientInfoLastNamec:\glwin\cistowrd.ini %Z' J ClientInfo CaseNumberc:\glwin\cistowrd.ini %Z' L ClientInfo CountyNumberc:\glwin\cistowrd.ini %Z' N ClientInfoCareOfc:\glwin\cistowrd.ini %Z' P ClientInfoAddress1c:\glwin\cistowrd.ini %Z' R ClientInfoCityc:\glwin\cistowrd.ini %Z' T ClientInfoStatec:\glwin\cistowrd.ini %Z' V ClientInfoZipc:\glwin\cistowrd.ini %Z' X FirstName %\F FirstName H B@^gLastName %\FLastName J B@^gAddress1 %\FAddress1 R B@^g ClientCity %\F ClientCity T B@^g ClientState %\F ClientState V B@^g ClientZip %\F ClientZip X B@^g CaseNumber %\F CaseNumber L B@^g CountyNumber %\F CountyNumber N B@^gCareOf %\FCareOf P B@^g ApDistrict %\F ApDistrict 6 B@^gApUnit %\FApUnit 8 B@^gApWorker %\FApWorker : B@^g FsDistrict %\F FsDistrict < B@^gFsUnit %\FFsUnit > B@^gFsWorker %\FFsWorker @ B@^g SvDistrict %\F SvDistrict B B@^gSvUnit %\FSvUnit D B@^gSvWorker %\FSvWorker F B@^g FirstName2 %\F FirstName2 H B@^g LastName2 %\F LastName2 J B@^gGranteeFirstName %\FGranteeFirstName H B@^gGranteeLastName %\FGranteeLastName J B@^g WorkerName %\F WorkerName & B@^gDistrict %\FDistrict . B@^gSection %\FSection 0 B@^gUnit %\FUnit 2 B@^gWorker %\FWorker 4 B@^gAreaCode %\FAreaCode ( B@^g PhoneNumber %\F PhoneNumber * B@^g CountyName %\F CountyName , B@^glAttribute VB_Name = "InsertCisAddress" Public Sub MAI`N() ".DescriptionReeves CIS Client a info from c:\\glwin\\cistowrd`.ini wbProcDatanInvoke_FuncnTemplate"jec4t. .TDim Worker$ Are aCodePhoneNumberCountyDUrictS9{Uni 5 Ap Ap$Ap Fs FsIFs Sv SvSv,irsteLaCas ?c?nCarelOf5u1zCity St@gJZip&#q@dBasic.[GetPrivt fileSngP$](" I", "C "w4 HtG J i13 eg r Z ba a Q$   ʼnA 0c D A%_  & H_ D &fA &iC C?Mr &Pwa d YY%foYdjoonola_oOONoԊm Ffurul/Tz___"OH8ooo""lZ Rooo 41/:r OY "/.???"ONAw///" IfEx0QBookmark("7) ThenSetFormResult , V 6H9 "h%)",q??Q"OOnte%#ooa"OOn~t%#&"?>#SN_\, T+Basic.ExistingBookmark("CareOf") Then WordSetFormResult , ^$ 0 If^ApDrict*,  ecUni?!_&-+ke~r\-.Ffs, aF>sz FFs?<_ FSv3F , FSvF FSv d Pho@neNumb"i,  CountyQ}~0 End Sub      "#$%&'()*+,-./0123456789:;<=>?AH lect8ME ""0@superphonenumber" B@ 01-lH@Attribute VB_Name = "SuperPhoneNumber" Public Sub MAIN() WordBasic.WW7_EditGoTo Destination:="spnEnd ID="{33DC284E-2BF9-11D4-8896-000502AE3D26}" Document=ThisDocument/&H00000000 Module=SuperPhoneNumber Module=InsertCisAddress Module=GranteeFirstName Module=WorkerExtension Module=GranteeLastName Module=GranteeClientID Module=GranteeAddress1 Module=AddChildInfoRow Module=WorkerAreaCode Module=SupervisorName Module=SuperExtention Module=AddSvcReferral Module=SvcRefHeading Module=SuperAreaCode Module=GranteeCareof Module=CoSuppaddress Module=CoPhoneNumber Module=ClearCaseInfo Module=NewParagraph Module=GranteeState Module=countynumber Module=WorkerPhone Module=GranteeCity Module=CoExtension Module=ClientState Module=WorkerName Module=GranteeZip Module=CountyName Module=CoAreaCode Module=ClientCity Module=CaseNumber Module=WorkerFax Module=RemoveRow Module=lastname2 Module=FirstName Module=CoAddress Module=ClientZip Module=RowBreak Module=LastName Module=District Module=CaseInfo Module=Address1 Module=Section Module=OtherID Module=NoReset Module=CoState Module=Correct Module=AddRows Module=Worker Module=MyInfo Module=Hidden Module=County Module=CoCity Module=CareOf Module=FaxAC Module=Date1 Module=CoZip Module=Unit Name="TemplateProject" HelpContextID="0" CMG="E0E2549258925892589258" DPB="C0C2747775777577" GC="A0A21457155715A8" [Host Extender Info] &H00000001={3832D640-CF90-11CF-8E43-00A0C911005A};VBE;&H00000000 ThisDocumentThisDocumentSuperPhoneNumberSuperPhoneNumberInsertCisAddressInsertCisAddressGranteeFirstNameGranteeFirstNameWorkerExtensionWorkerExtensionGranteeLastNameGranteeLastNameGranteeClientIDGranteeClientIDGranteeAddress1GranteeAddress1AddChildInfoRowAddChildInfoRowWorkerAreaCodeWPROJECTwm!CompObj@jorkerAreaCodeSupervisorNameSupervisorNameSuperExtentionSuperExtentionAddSvcReferralAddSvcReferralSvcRefHeadingSvcRefHeadingSuperAreaCodeSuperAreaCodeGranteeCareofGranteeCareofCoSuppaddressCoSuppaddressCoPhoneNumberCoPhoneNumberClearCaseInfoClearCaseInfoNewParagraphNewParagraphGranteeStateGranteeStatecountynumbercountynumberWorkerPhoneWorkerPhoneGranteeCityGranteeCityCoExtensionCoExtensionClientStateClientStateWorkerNameWorkerNameGranteeZipGranteeZipCountyNameCountyNameCoAreaCodeCoAreaCodeClientCityClientCityCaseNumberCaseNumberWorkerFaxWorkerFaxRemoveRowRemoveRowlastname2lastname2FirstNameFirstNameCoAddressCoAddressClientZipClientZipRowBreakRowBreakLastNameLastNameDistrictDistrictCaseInfoCaseInfoAddress1Address1SectionSectionOtherIDOtherIDNoResetNoResetCoStateCoStateCorrectCorrectAddRowsAddRowsWorkerWorkerMyInfoMyInfoHiddenHiddenCountyCountyCoCityCoCityCareOfCareOfFaxACFaxACDate1Date1CoZipCoZipUnitUnit5@ 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FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT     FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       „Ą҄Ԅք"$&:<>BDFH\^`fhjlЅ҅jLhF5UjLhF5UjJhF5UjMJhF5UjIhF5UjhF5UmHnHujHhF5UjTHhF5UjGhF5UjhF5UjJGhF5UhF53$Fj&Jr†`_^]\[edXWVUcS$&(<>@FHJL`bprt†Ć؆چ܆jPhF5UjOhF5UjOOhF5UjNhF5UjNNhF5UjhF5UmHnHujMhF5Uj&MhF5UjhF5UhF5(/ =!"#$%GranteeFirstName=Enter the Grantee's First Name (and Middle Initial, if known)GranteeLastNameTDAddress1 UppercasedEnter the Addressee's mail address (street address, PO Box, etc., where the mail will be delivered).2DCareOf UppercaseUEnter the Addressee's Supplemental Address (Example: Suite or Apartment Number, C/O)D CaseNumber Uppercase/Enter the Case Number (Example: V1234567A,B,C)D ClientCity UppercaseEnter the Addressee's City.D ClientState Uppercase1Enter the Addressee's 2 digit State Abbreviation.D ClientZip UppercaseKEnter the Addressee's Zip Code (+4 if known) (Example: 48909 or 48909-7537)D CoAddress UppercaseaEnter the County's mail address (street address, PO Box, etc., where the mail will be delivered).D CoAreaCodeEnter the County's Area CodeDCoCity UppercaseEnter the County's City.D CoExtensiond`CJOJQJ_HmH sH tH VOV CoState1?d8(OJQJ_HkHmH sH tH bOb CoSuppaddress1@d8(OJQJ_HkHmH sH tH \O\ CountyName1Ad8(OJQJ_HkHmH sH tH ^"^ CountyNumberBd8(OJQJ_HkHmH sH tH VO2V CoZip1Cdt CJOJQJ_HkHmH sH tH NOBN Date11 Dd`CJOJQJ_HmH sH tH XRX District1Ed8(OJQJ_HkHmH sH tH LObL FaxAC Fd`CJOJQJ_HmH sH tH VOrV FirstName1 Gd`CJOJQJ_HmH sH tH XOX FirstName21 Hd`CJOJQJ_HmH sH tH `O` GranteeAddress1 Id`CJOJQJ_HmH sH tH \O\ GranteeCareof Jd`CJOJQJ_HmH sH tH XOX GranteeCity Kd`CJOJQJ_HmH sH tH `O` GranteeClientID Ld`CJOJQJ_HmH sH tH hh GranteeFirstName1Md8(OJQJ_HkHmH sH tH fOf GranteeLastName1Nd8(OJQJ_HkHmH sH tH ZOZ GranteeState Od`CJOJQJ_HmH sH tH ZOZ GranteeZip Pd` CJOJQJ_HkHmH sH tH XOX LastName1Qd8(OJQJ_HkHmH sH tH ZO"Z LastName21Rd8(OJQJ_HkHmH sH tH VO2V OtherID1Sd8(OJQJ_HkHmH sH tH VBV Section1Td8(OJQJ_HkHmH sH tH ^OR^ SuperAreaCode1 Ud`CJOJQJ_HmH sH tH dObd SuperExtension1Vd8(OJQJ_HkHmH sH tH dOrd SuperPhoneNumber1 Wd`CJOJQJ_HmH sH tH dOd SupervisorName1Xd8(OJQJ_HkHmH sH tH PP Unit1Yd8(OJQJ_HkHmH sH tH TT Worker1Zd8(OJQJ_HkHmH sH tH `O` WorkerAreaCode1 [d`CJOJQJ_HmH sH tH fOf WorkerExtension1\d8(OJQJ_HkHmH sH tH XOX WorkerFax ]d` CJOJQJ_HkHmH sH tH \O\ WorkerName1^d8(OJQJ_HkHmH sH tH ZOZ WorkerPhone1 _d`CJOJQJ_HmH sH tH ^O^ WorkerTitle1 `d` CJOJQJ_HkHmH sH tH ^^ countynumber ad` CJOJQJ_HkHmH sH tH TO"T District2 bd`CJOJQJ_HmH sH tH RO2R Section2 cd`CJOJQJ_HmH sH tH LOBL Unit2 dd`CJOJQJ_HmH sH tH TORT Worker2 ed` CJOJQJ_HkHmH sH tH ^b^ Countynumber fd` CJOJQJ_HkHmH sH tH `r` Countynumber1 gd` CJOJQJ_HkHmH sH tH \O\ Countynumber2 hd`CJOJQJ_HmH sH tH POP ***** id` CJOJQJ_HkHmH sH tH dOd GranteeFirstName2 jd`CJOJQJ_HmH sH tH M90 /*****Address1CareOf CaseNumber ClientCity ClientState ClientZip CoAddress CoAreaCodeCoCity CoExtension CoPhoneNumberCoState CoSuppaddressCounty CountyName CountynumberCoZip Date1DistrictFaxAC FirstName FirstName2GranteeAddress1 GranteeCareof GranteeCityGranteeClientIDGranteeFirstNameGranteeLastName GranteeState GranteeZip LastName LastName2 OtherIDSection SuperAreaCodeSuperExtensionSuperPhoneNumberSupervisorNameUnitWorkerWorkerAreaCodeWorkerExtension WorkerFax WorkerName WorkerPhone WorkerTitle***** CaseNumber1 ClientZip1 CoAddress1CoCity1 CoExtension1CoState1CoSuppaddress1 CountyName1CoZip1GranteeLastName1 GranteeZip LastName1 LastName21OtherID1SuperExtension1SupervisorName1Worker2WorkerExtension1 WorkerFax WorkerName1 WorkerTitle1 Captions 8pt(<Pdu!5FZn 1BVj~%9Maur 8\N(Vyjzr{ #06>@ADFq ~ " . ^ !TZntLP10lL^MMN