Дашков Л.П., Бризгалiн А.В. 1996 - Комерцiйний договiр (книга)

Aeaoeia E.I., A?ecaaeii A.A. 1996 – Eiia?oeieiee aeiaiai?

Ciino

Aeaaa 1. Ui oaea aeiaiai?. Caaaeueia iaoiaeeea oeeaaeaiiy aeiaiai?o.
Aeaaa 2. No?oeoo?a aeiaiai?o oa eiai iniiaii oiiae ………………………………………..
*anoeia 1. I?aaiaoea (anooiia /enoeia) aeiaiai?o ……………………………………………….
Iaoiaeeea ia?aai?ee iiaiiaaaeaiue iniae, ui iiaeienoo aeiaiai? ……………………………………
Iaoiaeeea ia?aai?ee aeiai?aiinoi………………………………………………………………………………
*anoeia 2. I?aaeiao aeiaiai?o. I?aaa oa iaiaycee noi?ii………………………………………
*anoeia 3. Aeiaeaoeiai oiiae aeiaiai?o………………………………………………………………….
*anoeia 4. Iioi oiiae aeiaiai?o………………………………………………………………………….
Aeaaa 3. Ii?yaeie ioi?ieaiiy oaenoo aeiaiai?o……………………………………………….
Aeaaa 4. Ii?yaeie aeeiiaiiy aeiaiai?o ……………………………………………………………
*anoeia 1. Iaoa?iaeueia noaaeiy aeeiiaiiy aeiaiai?o ……………………………………………..
*anoeia 2. Oaoiiei-th?eaee/ia noaaeiy aeeiiaiiy aeiaiai?o………………………………………
Aeaaa 5. Ii?yaeie ciii i ?ici?aaiiy aeiaiai?o………………………………………………….
Aeaaa 6. Niiniae caaacia/aiiy aeeiiaiiy ciaiaycaiue…………………………………..
Aeaaa 7. Aiaeiiaiaeaeueiinoue ca ii?ooaiiy oiia aeiaiai?o. Iiiyooy caeoeia………..

C?ACEE AINIIAeA?NUeEEO AeIAIAI?IA (c eiiaioa?yie)……………………………..
?icaeie 1. Ia?aaeaeiaiai?ii aeieoiaioe………………………………………………………………..
I?ioieie ?icaiaeiinoae……………………………………………………………………………………..
I?ioieie ocaiaeaeaiiy ?icaiaeiinoae……………………………………………………………………
Noi?iaiaeiee eeno aei i?iaeoo aeiaiai?o………………………………………………………………..
Noi?iaiaeiee eeno aei aeiaiai?o…………………………………………………………………………….
Oaiaea i?i niia?iaioieoeoai oa i?aaiicaoeith acaoiiaiaeiinei …………………………………….
Iiia?aaeiie aeiaiai?……………………………………………………………………………………………
Oaiaea i?i iinooieo aeiaiai?o ……………………………………………………………………………..
Oaiaea i?i ia?aeac ai?ao…………………………………………………………………………………….
Oaiaea i?i iinooieo i?aaa ia aeiiao …………………………………………………………………..
Oaiaea i?i ciiio i aeiiiaiaiiy aeiaiai?o ……………………………………………………………….
Oaiaea i?i caiiio aeiaiai?o …………………………………………………………………………………
Oaiaea i?i ciiio ii?yaeeo aeeiiaiiy aeiaiai?o ………………………………………………………
Oaiaea i?i ?ici?aaiiy aeiaiai?o……,…………………………………………………………………-…
I?ioieie i?i caeie acaoiieo aeiia ……………………………………………………………………
?icaeie 2. Iiceea…………………………………………………………………………………………….
Aeiaiai? aaci?ioeaioii? oeieueiai? iiceee ………………………………………………………………..
Eiio?aeo aaci?ioeaioii? oeieueiai? iiceee a iiicaiiie aaethoi ………………………………….
?icaeie 3. Canoaaa oa iioi niiniae caaacia/aiiy aeeiiaiiy ciaiaycaiue………….
Aeiaiai? i?i canoaao iaeia (c caeeoaiiyi iaeia o canoaaieea)………………………..,….
Aeiaiai? i?i canoaao aoaeiaei, nii?oaee, aoaeeieo (iiioaea) ……………………………………….
Aeiaiai? i?i canoaao aeaiiceoiiai aeeaaeo ……………………………………………………………..
Aeiaiai? i?i canoaao iaeia c ia?aaea/ath iaeia canoaaiaea?aeaoaeth (canoaaa)……………
Aeiaiai? i?i canoaao i?aa ia i?iieneiao aeaniinoue ………………………………………………
Aeiaiai? i?i canoaao oiaa?ia o ia?a?iaoei ……………………………………………………………..
Aeiaiai? i?i canoaao oiaa?ia a iaiao …………………………………………………………………….
Aeiaiai? i?i canoaao aaethoieo eiooia …………………………………………………………………
Aeiaiai? i?i iaaeaiiy aa?aioi? (noaneaeia?ii?)…………………………………………………………
Aeiaiai? ii?o/ieoeoaa………………………………………………………………………………………….
Oaiaea i?i caaaeaoie……………………………………………………………………………………………

Eiia?oeieiee eiaiai?

?icaeie 4. Eoiiaey-i?iaeaae, iinoaaea oiaa?ia …………………………………………………….. 53
Aeiaiai? eoiiaei-i?iaeaaeo (iioiai? ia?oi? oiaa?ia) ……………………………………………………. 54
Aeiaiai? eoiiaei-i?iaeaaeo eaa?oe?e iiae iiaei?eoinoaaie…………………………………………… 58
Aeiaiai? eoiiaei-i?iaeaaeo (iinooiee) /anoie o/anoi a OIA iiae iiaei?eoinoaaie………….. 59
Aeiaiai? eoiiaei-i?iaeaaeo aeoeie aeoeiiia?iiai oiaa?enoaa aiaee?eoiai oeio ………………….. 61
Aeiaiai? eoiiaei-i?iaeaaeo iio-oao …………………………………………………………………………… 62
Aeiaiai? eoiiaei-i?iaeaaeo aaethoe …………………………………………………………………………… 64
Aeiaiai? iinoaaee oiaa?o………………………………………………………………………………………. 65
?icaeie 5. Aa?oa?, iiia ………………………………………………………………………………………69
Aeiaiai? ia i?iaaaeaiiy oiaa?iiaiiiii? (aa?oa?ii?) iia?aoei?…………………………………….. 70
Aeiaiai? iiie……………………………………………………………………………………………………….. 73
?icaeie 6. Eiiinieii oa iioi iina?aaeieoeueei iia?aoei?………………………………………….. 75
Aeiaiai? eiiini? ia i?iaeaae i?iaeoeoei? (aeiaiai? i?i ia?aaea/o i?iaeoeoei? ia ?aaeicaoeith) ….. 75
Aeiaiai? eiineaiaoei? ia i?iaeaae i?iaeoeoei?……………………………………………………………….. 79
Aeiaiai? aei?o/aiiy ia i?iaeaae i?iaeoeoei? ………………………………………………………………… 81
Aeiaiai? ia iaaeaiiy a?iea?nueeeo iineoa ………………………………………………………………… 83
Aeiaiai? ia iaaeaiiy iina?aaeieoeueeeo iineoa …………………………………………………………… 86
Aeiaiai? ia iaaeaiiy iioi?iaoeieieo (eiinoeueoaoeieieo) iineoa………………………………….. 89
Aeiaiai? ia iaaeaiiy ia?eaoeiaiaeo iineoa …………………………………………………………….. 90
. Aeiaiai? ia iaaeaiiy th?eaee/ieo iineoa ………………………………………………………………….. 92
Aeiaiai? ia iaaeaiiy ?aeeaiieo iineoa …………………………………………………………………… 94
Aeiaiai? ia aeaioiaeaiiy oa anoaiiaeaiiy ciaiioiuei? ?aeeaie ………………………………… 95
Aeiaiai? aei?o/aiiy ia aaaeaiiy ni?aa a A?aio?aaeiiio noaei………………………………………. 97
Aeiaiai? ia noi?iaiae eane?a c a?ioeia oa aeieoiaioaie …………………………………………… 98
Aeiaiai? i?i ioi?iio ae?iaie/eo (ainiiaea?nueeeo) iaoeoia…………………………………….. 100
Aeiaiai? ia oaoii/ia ianeoaiaoaaiiy oa ?aiiio oaoiiee…………………………………………. 102
?icaeie 7. I?aiaea, eiciia………………………………………………………………………………………. 104
Aeiaiai? i?aiaee aoaeeieo, nii?oaee (iioiai iaoeoa ia?ooiiinoi)…,………………………….. 105
Aeiaiai? i?aiaee eiiiaoe aeey ioino iaeiai iiaei?eoinoaa ………………………………………… 108
Aeiaiai? i?aiaee eaa?oe?e o i?eaaoii? iniae…………………………………………………………. 110
Aeiaiai? i?aiaee iaeaaeiaiiy ………………………………………………………………………………… 113
Aeiaiai? i?aiaee eaaeiaiai aaoiiiaiey o i?eaaoii? iniae ……………………………………….. 1 15
Aeiaiai? i?aiaee iaeia c i?aaii aeeoio ……………………………………………………………….. 117
Aeiaiai? noai?aiaee…………………………………………………………………………………………….. 119
Aeiaiai? i?aiaee iaeaaeiaiiy (eiciiaa)……………………………………………………………………. 120
?icaeie 8. Iiae?yae…………………………………………………………………………………………….. 123
Aeiaiai? iiae?yaeo ………………………………………………………………………………………………………123
Aeiaiai? iiae?yaeo ia eaiioaeueia aoaeiaieoeoai ………………………………………………………………. 127
Aeiaiai? iiae?yaeo ia eaiioaeueia aoaeiaieoeoai ………………………………………………………………. 128
Aeiaiai? ia i?iaaaeaiiy iaoeiai-aeineiaeieoeueeeo,

aeineiaeii-eiino?oeoi?nueeeo i oaoiieiai/ieo ?iaio………………………………………………………. 129
?icaeie 9. Iioi aeiaiai?ii aiaeiineie …………………………………………………………………. 131
Aeiaiai? i?i niieueio aeiyeueiinoue……………………………………………………………………………. 131
Aeiaiai? ia o/anoue o /anoeiaiio aoaeiaieoeoai…………………………………………………………. 134
Aeiaiai? iiae iinueeith aaeiiiino?aoeioth oa iiaei?eoinoaii
ia aeeiiaiiy nioeiaeueiiai caiiaeaiiy …………………………………………………………………. 135
Aeiaiai? i?i o?aioeciia ……………………………………………………………………………………. 138
Aeiaiai? i?i caoeno eiia?oeieii? iioi?iaoei? (i?i eiioiaeaioeieiinoue)…………………………. 141
Aeiaiai? ia o/anoue o eiia?oeieiie aenoaaoei ……………………………………………………………. 143
Aeiaiai? no?aooaaiiy iaeia ………………………………………………………………………………… 144
Aeiaiai? iiae?yaeo c oei/aniaei o?oaeiaei (oai?/ei) eieaeoeaii ……………………………… 145
I?ioieie ?iciiaeieo aeiaai?iaee iiae o/anieeaie
oei/aniaiai o?oaeiaiai (oai?/iai) eieaeoeao ……………………………………………………….. 147

Eiia?oeieiee aeiaiai?

O?oaeiaa oaiaea………………………………………………………………………….
Aeiaiai? i?i iiaio iiaeeaiaeoaeueio iaoa?iaeueio aiaeiiaiaeaeueiinoue …….
Aeiaiai? i?i eieaeoeaio iaoa?iaeueio aiaeiiaiaeaeueiinoue …………………

C?ACEE AeIEOIAIOIA AeEss IOI?IEAIIss I?EEIAIIss
I?IAeOEOeI? (OIAA?IA) CA EIEUeEINOTH OA ssEINOTH ……………

Aeo ?ice?eooy aaaiio (eiioaeia?o, aaoioo?aiio)……….;……………..
Aeo i?eeiaiiy i?iaeoeoei? (oiaa?ia) ca eieueeinoth …………………………
Aeo i?eeiaiiy i?iaeoeoei? (oiaa?ia) ca eieueeinoth oa yeinoth …………..
Aeo i?eeiaiiy i?iaeoeoei? (oiaa?ia) ca yeinoth……………………………..
Aeo aiaeai?o c?aceia (i?ia) ……………………………………………………….
C?ACEE I?AOAICIE (c eiiaioa?yie)…………………………………..

I?aoaiciy i?i nieaoo iaonoieee

ca iaaeiiinoaaeo (i?ino?i/aiiy iinoaaee) i?iaeoeoei?…………………………………………..
I?aoaiciy uiaei nieaoe aa?oinoi i?iaeoeoei? (oiaa?ia), yei? ia aenoa/ao …………………
I?aoaiciy uiaei ianaio/aniinoi aeinoaaee aaioaaeo caeicieoeath…………………………….
I?aoaiciy aei Oi?aaeiiiy caeicieoeue oa iinoa/aeueieea o cayceo
c ianoa/ath (iioeiaeaeaiiyi, inoaaiiyi, ao?aoith) aaioaaeo………………………………..
I?aoaiciy aei aaoio?ainii?oiiai iiaei?eoinoaa

i?i ianoa/o aaioaaeo i?e oeaio?aeiciaaiie aeinoaaoei ……………………………………………
I?aoaiciy uiaei noyaiaiiy oo?aoo oa caeoeia
ca iinoa/aiiy iaia?eiaaii? i?iaeoeoei?,

a oaeiae i?iaeoeoei? (oiaa?o) aac oa?e aai a iaiaeaaeiie oa?i (oiaeiaoei) ………………..
I?aoaiciy i?i nieaoo oo?aoo ca i?ino?i/eo iiaa?iaiiy (iaiiaa?iaiiy) oa?e…….
I?aoaiciy i?i noyaiaiiy oo?aoo ca iinoaaeo iaeiiieaeoii? i?iaeoeoei?, ?? aa?oinoi.
I?aoaiciy i?i nieaoo aa?oinoi caa?aeiaaii? i?iaeoeoei? (oiaa?ia), oo?aoo i caeoeia .
C?ACEE IICIAIEO CAssA (c eiiaioa?yie) ……………………………………………….
Iiciaia cayaa i?i noyaiaiiy iaonoieee

ca iaaeiiinoaaeo (i?ino?i/aiiy iinoaaee) i?iaeoeoei? (oiaa?ia) …………………………….
Iiciaia cayaa i?i noyaiaiiy aa?oinoi i?iaeoeoei? (oiaa?o), yei? ia aenoa/ao …………
Iiciaia cayaa i?i noyaiaiiy aa?oinoi ianoa/i aaioaaeo
i?e ia?aaacaiii aaioaaeia aaoio?ainii?oii ………………………………………………………
Iiciaia cayaa aei aaioaaeiaiaei?aaieea oa Oi?aaeiiiy caeicieoeue
i?i noyaiaiiy aa?oinoi aaioaaeo, yeiai ia aenoa/ao …………………………………………..
Iiciaia cayaa i?i noyaiaiiy oo?aoo oa caeoeia
ca iinoaaeo iaaeia?iyeinii? i?iaeoeoei? (oiaa?ia) ………………………………………………….
Iiciaia cayaa i?i noyaiaiiy oo?aoo
ca i?ino?i/eo iiaa?iaiiy (iaiiaa?iaiiy) oa?e ………………………………………………..

Eiia?oeieiee eiaiai?

Aeaaa 1

UI OAEA AeIAIAI?.
CAAAEUeIA IAOIAeEEA OEEAAeAIIss AeIAIAI?O

?aaeicaoeiy eiia?oeieieo ieaiia aoaeue-yeiai iiaei?eoioey iaiiaeeeaa aac neeaaeaiiy oaiae i
oeeaaeaiiy aeiaiai?ia, oiio ui aeiaiai? – oea oi?ia, a yeie aoieththoueny caaeoie oa ?ic?aooiee
aicianiaiia, ?o i?aaiaiiy io?eiaoe i?eaooie. Caeiaoeny iiaei?eoiieoeoaii i ia neeaaeaoe oaiae,
ia oeeaaeaoe aeiaiai?ia i?inoi iaiiaeeeai.

Ani aeieiai acaoiiaiaeiineie iiae noaoeoaie ?eieo ?aaeaiaioothoueny caeiiiaeaanoaii i oeie
oiiaaie, yei aiie ia?aaeaa/eee o nai?e oaiaei, i oniio anueiai eiia?oeieiiai caoiaeo aai iia?aoei?
/anoi caeaaeeoue aiae oiai, ye oaeo oaiaeo neeaaeaii i ioi?ieaii. Oea e ia aeeaii, ineieueee naia a
aeiaiai?i aecia/athoueny i?aaa i iaiaycee noi?ii, ?o aiaeiiaiaeaeueiinoue, oeiia, no?iee, ii?yaeie
?ic?aooieia oiui.
Ioaea: UI OAEA AeIAIAI? ACAAAEI?

Oea ia oieueee aeieoiaio, iaiaoiaeiee aeey oiai, uia ii?eaooeoaaoe a?ioiai eiooe ia aao
?ic?aooieiaee ?aooiie. Aeiaiai? – oea, a ia?oo /a?ao, oaiaea noi?ii, aeo, o yeiio ae?aaeaia ?oiy
acaoiia caiaea aeiyoe niieueii a iioa?anao acaoiii? aeaiaee. sseui acaoiia caiaea noi?ii aiaenooiy,
oi iaiao i aeiaiai?o.

ssEEI IAo AOOE AeIAIAI??

Oea aeiaiai?, yeee, ii-ia?oa, oeeaaeaii a aaoeo iioa?anao; ii-ae?oaa, eii ia ii?oooo /eiia
caeiiiaeaanoai; ii-o?aoo, aaoi iioa?ane th?eaee/ia iaaeieii caoeuaii, a iaiaycee aaoiai
eiio?aaaioa ii aeiaiai?o noai?i caaacia/aii eiai aiaeiiaiaeaeueiinoth, i, ii-/aoaa?oa, a iueiio
iaiao aeiaeiiai aai oae caaieo . Iayaiinoue inoaiiio o
aeiaiai?i noai?tho na?eicio caa?ico anie oaiaei i iiaea caanoe iaiiaaoeue aoaeue-yeee i?ae?aniee i
aeia?a i?ii?aoeueiaaiee c aeiiiii/ii? oi/ee ci?o eiia?oeieiee i?iaeo.

Cae/aeii, aoaeue-yeie oaiaei i aiaeiiaiaeii – aeiaiai?o ia?aaeoo na?eicia ?iaioa c iiooeo
iaeaaeiiai ia?oia?a, ca iiia?aaeiueith ocaiaeaeaiinoth iniiaieo iiiaioia ia?aaeaa/oaaii? iia?aoei?
i o.i. A oiio aeey oeo, ooi ii/eiao aaciina?aaeith ?iaioo ii ocaiaeaeaiith anio eiie?aoieo oiia
iaeaooiueiai eiio?aeoo, iai oioieiny a cai?iiiioaaoe aeayei ?aeiiaiaeaoei?, ui iiaeooue noaoe a
iaaiaei.

*IOE?E INIIAII I?AAEEA oeeaaeaiiy oaiaee aoaeue-yeiai aeaeo.
/. Iaiaoiaeii /ioei oyaeyoe, ui ae , ui ae oi/aoa c?iaeoe i ui aaaeaooa
io?eiaoe.

Ia aeaeue, inoeie , aeio?eiothoueny ia ani. Iiooi e iieiee aai ia ciiaea
aeiiiiiaoe, yeui ae, iath/e ia iaoi iiaeienaoe aeiaiai?, ia aei eiioey onaiaeiieee ia eeoa aeaoaei
oaiaee, aea e iaeaaaeeeaioeo ?? iiiaioia. I?aaaea, aeaia ?aeiiaiaeaoeiy oaeaeoa c iaeanoi ineoieiai?,
iiae i?aaa; i?ioa ?? cia/aiiy ia ciaiooooueny.

Ni?iaoeoa noai?eoe iaeaaeueio iiaeaeue ia?aaeaa/oaaii? iia?aoei?, ui ca /ei eaea, ui iiaeiii
c?iaeoe ae, ui iiaeiai c?iaeoe aao eiio?aaaio oiui. Iae?aneioue i?eaeecio noaio iaeaooiuei?
iia?aoei?, ?icaeeoa ?? ia aoaie i no?iee – aiae oeeaaeaiiy aeiaiai?o aei eiai aeeiiaiiy, ui i ye iao
aooe c?iaeaii ia eiaeiiio aoaii, ui aeey oeueiai iaiaoiaeii, i?i?aooeoa iiaeeeaee ?ecee. Iiney
oeueiai ae aoaeaoa /ioei oyaeyoe niai caoiae, yeee iao aiaeaooeny, i aoaeaoa aieiaeioe neooaoeioth.

Eeoa iiney oeueiai iiaeia i?enooiaoe aei neeaaeaiiy oi?ioethaaiue oiia aeiaiai?o, caa?oaoeny
ii eiinoeueoaoei? aei oaoiaoeia, aiooaaoe ani iaiaoiaeii aeieoiaioe i o.i.

2. I?iaeo ia?aaeaa/oaaiiai aeiaiai?o e?aua aiooaaoe naiiio, iiae aeiai?yoe oea
eiio?aaaioo.

Eiee aiai?youe: , – oi ia iathoue ia oaaci, ui eiai aiooaaoe
iiaeiii ae iniaenoi, a iaooueny ia oaaci, ui aaoi?ii i?iaeoo aeiaiai?o aoaea aaoa noi?iia.
Eiie?aoii neeaaeaoe i?iaeo aeiaiai?o iiaeiii oaoiaoei aiaeiiaiaeiiai i?ioieth.

Iiaeaoa ia oaeethaaoeny, aao eiio?aaaio ia aoaea iniaeeai ia?aeiaoeny /oaeeie i?eaooea-
ie i neeaaea aeiaiai? , a aao iioa?an aii aoaea i?inoi, oae ae iiaeoe, a?aoe aei oaaae.
Aeaia iieiaeaiiy i?e?iaeia, eiai iaoaiici ?ice?eo aai aoaeue-yeee ineoieia. Oiio aeiaiai?> ae aoaeaoa i?inoi iiaeaaiyoe iiae nai? iioa?ane, aea iiioeiaoeaa c aaoiai aieo aaea aoaea
ao?a/aia. Oaeo aaeeeo naioio, iaaioue aeoaea aeia?iio i ii?yaeiiio, ia?oia?iai aeaaaoe
ana-oaee ia aa?oi.

Eiia?oeieiee aeiaiai?

3. Iieiee ia iiaeienoeoa aeiaiai?, aeiee eiai ia i?iaeeaeany i ia caaicoaaa aao th?eno.
Oea iaeia c iaeaieiaiioeo i?aaee, yeei iao ea?oaaoeny eiaeiee iiaei?eoiaoeue. Ca naioth
cia/eiinoth oea i?aaeei ni?aaaaeeeai iiaea aooe aiaeianaii aei
Aoaeue-yeee aeiaiai? – oea caaaeaee th?eaee/iee aeieoiaio, i a?io eiio oeiia, yeui eiai neeaaeaee
iaeiiiaoaioii iniae. TH?eno cai?iiiioo ciiieoe oi?ioethaaiiy, ?icynieoue aai i?aaiai ianeiaeee
oio? /e iioi? oiiae, ii?aeiiaiaeoo aai naie aa?iaio yei?-iaaoaeue noaooi, ioieoo oiui.

Ca ei?aeiiii aeiaeai iiaei?eoiaoeue e?ieo ia c?iaeoue aac naiai aaeaieaoa, ineieueee i?ae?anii
?icoiio, ui iieiee ?aaea th?enoa aeiiiiiaea oieeiooe aaeeeeo caeoeia, a oi e iiia?aaeeoue
aaie?oonoai.

*eiaei iiaei?eoioeia oe?iei canoiniaothoue ia i?aeoeoei ?icii oi?ie oeiiaeo aeiaiai?ia,
aeaai e aiaeiiaiaeii? eioa?aoo?e c oeueiai ieoaiiy aieueo iiae aeinoaoiuei. Oa e aeaiee iiniaiee
iinoeoue i?eaeecii oi?ie, ?o aeei?enoaiiy cia/ii ni?iuoo i?ioean neeaaeaiiy eiie?aoiiai
aeiaiai?o i aeao iiaeeeainoue ethaeyi, yei ia iathoue niaoeiaeueii? inaioe, aieueo-iaio i?ioiooaaoeny
o neeaaeieo th?eaee/ieo aiaeiineiao. I?ioa, o?aaa a?aoiaoaaoe, ui oiiaa?naeueiiai aeiaiai?o,
caeaoiiai iaaeieii oaacia/eoe aao aician, ia inioo. Aeiaiai? – oea aeo iiaeeaiaeoaeueiee, i oeiiaa
oi?ia iieiee ia ciiaea caiiieoe aeeaiai oaoiaoey.
4. Ia aeiioneaeoa aeaicia/iinoae i iaaeiiiaie.

Oi?ioethth/e oiiae aeiaiai?o, ia aeiioneaeoa aeaicia/iinoi, ?icieoinoi o?ac, ia/ioeinoi.
A aeiaiai?i iao cia/aiiy eiaeia aoeaa, eiaeia eiia. sseui aai uinue iac?icoiiea – caieoaeoa o
niaoeiaeinoa: ui icia/ao aeaiee oa?iii, yeee niene iana oa /e iioa neiainiieo/aiiy, o?aca
oiui. Iaiyoaeoa, ui aao eiio?aaaio o aeiaaeeo nii?o aoaea aoaeue-yea oi?ioethaaiiy
iaiaaaoeny iioa?i?aooaaoe ia naith ei?enoue. Aieueoa oiai, aao ia?oia? iiaea niaoeiaeueii
aeeth/eoe a aeiaiai? aaaeei c?icoiiea aeey aan (aea aeia?a c?icoiiea eiio naiiio) iieiaeaiiy, o
yeiio aaoi iioa?ane aoaeooue ouaieaii c iaeianiiaeiaaiioiai aeey aan aieo.

Aeaaa 2

NO?OEOO?A AeIAIAI?O OA EIAI INIIAII OIIAE

Oyaeyooueny, ui aoaeue-yeee aeiaiai? iao neeaaeaoeny c /ioe?ueio /anoei:

1. I?aaiaoea (aai anooiia /anoeia).

2. I?aaeiao aeiaiai?o. I?aaa oa iaiaycee noi?ii.

3. Aeiaeaoeiai oiiae aeiaiai?o.

4. Iioi oiiae aeiaiai?o.

*anoeia 1
I?AAIAOEA (ANOOIIA *ANOEIA) AeIAIAI?O

Oey /anoeia iinoeoue ianooiii iniiaii iieiaeaiiy:

I. Iacaa aeiaiai?o (aeiaiai? eoiiaei-i?iaeaaeo, iinoaaee, eiiini?, ia iaaeaiiy a?iea?nueeeo
iineoa, i?aiaee, i?i niieueio aeiyeueiinoue oiui).

Oi/ia iacaa aeiaiai?o iae?aco ae iiynieoue oei, ooi eiai /eoao, i?i yei i?aaiaiaeiineie eaea
iiaa. sseui iacae iaiao, oi ia?o iiae c?icoiioe, i?i ui aeiaiai?, eiai aeiaaaeaoueny i?i/eoaoe i
eeoa oiaei ?icia?aoeny c iei ii nooi. Aeaia ianoaaeia aeeeeeao o aoaeue-yeiai /eoa/a i?e?iaeia
ii/oooy aeayeiai ?icae?aooaaiiy, a oea aoaea aeineoue iaaaaeaii, yeui a?aoe aei oaaae, ui aeiaiai?
aoaea /eoaoe a?aio? aai iiaeaoeiaee iiniaeoi?.
2. Aeaoa iiaeienaiiy aeiaiai?o.

Aeoaea /anoi aeiaiaeeoueny noeeaoeny c oaeith neooaoeioth, eiee iiaei?eoioei, oeeaaoe aeiaiai?,
ia i?inoaaeythoue /enei, iinyoeue i ?ie eiai iiaeienaiiy. Iiaeiaia i?aeoeea i?inoi iai?eionoeia.
Ni?aaa a oiio, ui c aeaoith iiaeienaiiy aeiaiai?o iiaycaii i?aaeeueia aecia/aiiy iiiaioo eiai
oeeaaeaiiy oa anoaiiaeaiiy caaa?oaiiy no?ieo aei?, a ioaea, i oeo th?eaee/ieo ianeiaeeia, yei c
oeei iiaycaii.

sseui noi?iie iiaeienothoue aeiaiai? a ?iciee /an, oi aii aaaaeaooueny oeeaaeaiei c iiiaioo
iiaeienaiiy eiai inoaiiueith noi?iiith.
3. Iinoea iiaeienaiiy aeiaiai?o (iinoi aai ianaeaiee ioieo).

Iinoea neeaaeaiiy oaiaee – oea ia i?inoi oi?iaeueiinoue; oey oiiaa iao iieiee aeoaea aaeeea
th?eaee/ia cia/aiiy. Ca caeiiiaeaanoaii iinoeai neeaaeaiiy oaiaee aecia/athoueny:
a) i?aaicaeaoiinoue i aeiocaeaoiinoue inia, yei neeaaeathoue oaiaeo;

Eiia?oeieiee aeiaiai?

a) oi?ia oaiaee;

a) ciaiaycaiiy, ui aeieeathoue c oaiaee (oi/a a oeueiio aeiaaeeo noi?iie a aeiaiai?i iiaeooue
ia?aaeaa/eoe iioa iieiaeaiiy).

Oea iniaeeai aaaeeeai i?e oeeaaeaiii ciaiioiueioi?aiaaeueieo eiio?aeoia i aeiaiai?ia c oi?-
iaie aea?aeaa-/eaiia NIAe.

4. Iiaia oi?iiaa iacaa eiio?aaaioia, iiae yeith aiie ca?aono?iaaii o ?aono?i aea?aeaaii?
?aono?aoei?.

5. Iacaa noi?iie ca aeiaiai?ii (iai?eeeaae, oiui).
Oea iaiaoiaeii aeey oiai, uia o oaenoi aeiaiai?o eiaeiee ?ac ia iiaoi?thaaoe iiaiinoth oi?iiao
iacao noi?iie.

6. Aeieeaaeia iacaa iinaaee, i?icaeua, iiaii, ii-aaoueeiai iniae, ui iiaeienoo aeiaiai?, a
oaeiae iacaa aeieoiaioo, c yeiai aeieeaathoue ?? iiaiiaaaeaiiy ia iiaeienaiiy aeiaiai?o.

Ae iiaeiii /ioei oyaeyoe, ooi ia?aae aaie, /e o o oeio? ethaeeie i?aai noaaeoe naie iiaeien
ia iiaeiaiee aeiaiai?.

sse iieacoo i?aeoeea, iieiee iaaeia?iniainii eiio?aaaioe, ia aaaeath/e aeeiioaaoe nai?
ciaiaycaiiy ca aeiaiai?ii i ianoe aiaeiiaiaeaeueiinoue, iaieioothoue i?i oa, ui iniaa, yea iiaeienoaaea
aeiaiai?, oaeeo iiaiiaaaeaiue ia iaea. Aieueo oiai, oea iaeei c iaeiioe?aiioeo niiniaia oao?aenoaa.
A oaeiio aeiaaeeo iiaeia ?aeiiaiaeoaaoe aai ianooiio iaoiaeeeo aaciaee.

IAOIAeEEA IA?AAI?EE IIAIIAAAEAIUe INIAE,
UI IIAeIENOo AeIAIAI?

I. Ooi a ia?aae aaie ia aoa, a ia?oo /a?ao ia?aeiiaeoany o eiai iniai. Iioeie neiaaie,
ui ethaeeia, yea ia?aae aaie i yea iacaaeany aai Iaai/aieii, aeienii o Iaai/aieii. Iii?inioue
ei?aeoii ianii?o aai iioee aeieoiaio, ui iinaiae/oo iniao.

2. sseui ia?aae aaie aee?aeoi? iiaei?eoinoaa-eiio?aaaioa, oi aii o aiaeiiaiaeiinoi aei
caeiiiaeaanoaa aeio aiae iiaii iiaei?eoinoaa aac aeiai?aiinoi. Oiio aai iaiaoiaeii ia?aeiiaoeny
eeoa a oiio, ui aii aeienii aee?aeoi?. Oea iiaeia aeiciaoeny c iaeaco i?i i?ecia/aiiy iniae
aee?aeoi?ii, c aiaeiiaiaeiiai iinaiae/aiiy, i?iaeeaeoeny i?ioieie Cai?ia aeanieeia iiaei?eoinoaa.

Ni?aaa a oiio, ui inoaiiii /anii ia aeayeeo iiaei?eoinoaao, iniaeeai oai, aea aee?aeoi?
i?aoetho ca iaeiii, aeanieee oioth /e iioith ii?ith iaiaaeothoue iiaiiaaaeaiiy aee?aeoi?a c
?icii?yaeaeaiiy iaeiii i iaaeathoue eiio oaei iiaiiaaaeaiiy eeoa ca caiaeith i?aaeiiiy aai
neeaaeo aee?aeoi?ia, cai?ia aeanieeia oiui. Iai?eeeaae, o noaoooi iiaei?eoinoaa o ?icaeiei
iiaea aooe aeacaii, ui aee?aeoi? iao i?aai neeaaeaoe oaiaee ia noio
iiiaae 100 iei. ea?aiaaioeia eeoa ca caiaeith Aaeiiiino?aoeaii? ?aaee iiaei?eoinoaa. Aeey oiai,
uia o aan ia aoei iai?eoiiinoae, iiaeia i?iaeeaeoeny aiaeiiaiaeiee ?icaeie noaoooo iiaei?eoinoaa-
eiio?aaaioa i ia?aeiiaoeny, ui iiaiiaaaeaiiy aee?aeoi?a ia iaiaaeaii.

A aeayeeo oi?iao aoaao aeaeieueea ea?iaieeia, iai?eeeaae, ii?yae c aee?aeoi?ii iiaea i?aoethaaoe
i?aceaeaio, aieiaa caaaeueieo cai?ia oiui. O oeie neooaoei? iieiee aoaao aaaeei aecia/eoe, ooi ae
o aeieniei i iiaiiaaaeiei ea?iaieeii iiaei?eoinoaa. Ooo iiaeia ?aeiiaiaeoaaoe caa?iooeny aei
noaoooo iiaei?eoinoaa, a yeiio iathoue aooe cae?iieaii iiaiiaaaeaiiy eiaeii? iinaaeiai? iniae.

3. Canooiiee ea?iaieea, oi/ i o iiaiiaaaeiith iniaith, i?ioa, o aiaeiiaiaeiinoi aei /eiiiai
caeiiiaeaanoaa, eeoa iaeia iniaa iiaei?eoinoaa – ea?iaiee – iao i?aai aenooiaoe aiae iiaii
iiaei?eoinoaa aac aeiai?aiinoi. Oiio o canooiieea iao aooe aeiai?aiinoue. Iaeiae, noaoooii iiae-
i?eoinoaa iiaeooue aooe ia?aaeaa/aii eiie?aoii i oe?iei iiaiiaaaeaiiy canooiieeia c eiie?aoieo
ieoaiue, o oaeiio aeiaaeeo aoaeue-yei? iniaeeai? aeiai?aiinoi aiae canooiieea ia aeiaaaooueny.

4. sseui ia?aae aaie ethaeeia, yea aeio ca aeiai?aiinoth, oi iiney oiai, ye ae ia?aeiiaeeny a
eiai iniai (oea i?inoi iaiayceiai!), caa?iioue iniaeeao oaaao ia naio aeiai?aiinoue.

IAOIAeEEA IA?AAI?EE AeIAI?AIINOI

Ia?aai?oa ianooiia:

a) /e o ia aeiai?aiinoi iiaeien ea?iaieea (eeoa ea?iaieea i iieiai aieueoa) i?aaiicaoei? i ??
ia/aoea;

a) aeaoo, eiee aeiai?aiinoue aeaeaia (yeui oaei? ia aeacaii, oi aeiai?aiinoue iaaeienia!);
a) no?ie, ia yeee aeaeaii aeiai?aiinoue;

a) ianya iiaiiaaaeaiue, c yeeo ynii i iaeiicia/ii iao aeieeaaoe, ui oie, ooi ia?aae aaie,
aeienii iao i?aai oeeaaeaoe naia oaei oaiaee, i?i yei eaea iiaa, a ia i?inoi aanoe ia?aaiai?e aiae
iiaii i?aaiicaoei? /e i?aaenoaaeyoe ?? iioa?ane. Iaiaoiaeii iaiyoaoe, ui oaiaea, yeo oeeaaeaii aiae
iiaii iioi? iniae c ia?aaeuaiiyi iiaiiaaaeaiue, ia oyaia aeiaeieo i?aaiaeo ianeiaeeia aeey
iniae, aiae iiaii yei? ?? neeaaeaii.

Eiia?oeieiee aeiaiai?

Aeoaea /anoi aeiaiaeeoueny noeeaoeny c i?iaeaiith i?i niiaaiaeiioaiiy iiaiiaaaeaiue iniae
iiaeienoaaoe aeiaiai? i iiaiiaaaeaiue iniae, ui iao i?aai iiaeienoaaoe aaieianueei aeieoiaioe
N?a. ?a..
2. Oiiae i?i ocaiaeaeaiiy cayceo iiae noi?iiaie.
O aeaiiio ioieoi aeey eiaeii? noi?iie cacia/athoueny:

a) iniae, iiaiiaaaeii iaaeaaaoe iioi?iaoeith i ae?iooaaoe ieoaiiy, ui iaeaaeaoue aei
aeeiiaiiy aeiaiai?o. Oea iiaea oi?ioethaaoeny aeaiia niiniaaie: c ia?niiaeueiei aecia/aiiyi
iiaiiaaaeaiue iniae (inia) aai ic cacia/aiiyi iinaae;

a) niiniae cayceo. Oea iiaea aooe oaeaoii, oaen, oaeaen, oaeaa?ao, oaeaoaei ic cacia/aiiyi
?o iiia?ia oa iioeo aeaieo.

3. Ia?aaeaeiaiai?ia ?iaioa oa ?? ?acoeueoaoe iiney iiaeienaiiy aeiaiai?o.
Aeaiee ioieo aeiaiai?o iinoeoue iieiaeaiiy, o aiaeiiaiaeiinoi aei yeiai noi?iie aecia/athoue,
ui iiney iiaeienaiiy aeaiiai aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy, iiia?aaeii
oaiaee oa i?ioieiee i?i iaii?e ao?a/athoue neeo.
4. ?aeaiceoe noi?ii.

O oeueiio ioieoi aeey eiaeii? noi?iie cacia/athoueny:
a) iiooiai ?aeaiceoe;
a) iinoeaciaoiaeaeaiiy (aae?ana iiaei?eoinoaa);

a) aaieianueei ?aeaiceoe noi?ii (iiia? ?ic?aooieiaiai ?aooieo, onoaiiaa aaieo, eiae aaieo,
IOI, aeaii ?i?aooieiai-eaniaiai oeaio?o, ei?aniiiaeaionueeee ?aooiie aaieo),

a) aiaeaaioaaeoaaeueii ?aeaiceoe (aeey caeicie/ieo aiaei?aaeaiue, aeey eiioaeia?ia, aeey ae?iaieo
aiaei?aaeaiue).

INIAEEAO OAAAO I?EAeIEIOUe IAssAIINOI I I?AAEEUeIINOI AIAeIIINOAE, ui
noinothoueny aaieianueeeo ?aeaiceoia aaoiai eiio?aaaioa, ineieueee aac ieo aai aoaea aeoaea aaaeei
noyaiooe caeoee.

E?ii oiai, noi?iie iiaeiii i?eeiyoe ia naaa ciaiaycaiiy iaaaeii iiaiaeiieyoe iaeia
iaeio o aeiaaeeo ciii nai?o ?aeaiceoia.
5. Eieueeinoue i?eii?ieeia aeiaiai?o.

Cae/aeii oeae ioieo iinoeoue ianooiia oi?ioethaaiiy: .
6. Ii?yaeie aei?aaeaiue ca oaenoii aeiaiai?o.

Na?aae iiaei?eoioeia aeoaea iioe?aii, eiee aioiaee i?iaeo aeiaiai?o iiaeienoooueny iaeiioth ic
noi?ii i iiaiinoth ia?aaeaooueny iioie noi?iii aeey ianooiiiai iiaeienaiiy. O oaeie neooaoei?
iieiee o?aieyooueny, ui iaaeia?iniainiee ia?oia? a iaeiinoi?iiiueiio ii?yaeeo aei?aaeyo yeinue
oiiae aeiaiai?o o naioio i /oaeiio i?eii?ieeao, ui noaaeoue ia?oia?a o aeaeieaoio neooaoeith.
Ni?aaa a oiio, ui iayaiinoue iiaeieno ia aeieoiaioao i?aeoe/ii icia/ao: oie, yeee iiaeienaa, c
oeeie iaeiinoi?iiiiie aei?aaeaiiyie , ui iieiee aeieniinoi ia aiaeiiaiaeao. O
cayceo c oeei, yeui ae i?aeoeeoooa aeuaaeacaiee niinia iiaeienaiiy aeiaiai?o, aai iiaeia
?aeiiaiaeoaaoe ianooiia: aaanoe a aeiaiai? oiiao .
7. Iiaeiene i?aaenoaaieeia noi?ii.

Eiaeiee aeiaiai?, ineieueee a iueiio ae?aaeaii aieth iaaii? iniae, iao aooe iiaeienaiee
oeioth iniaith aai ?? iiaiiaaaeiei i?aaenoaaieeii aeanii?o/ii.

Eiia?oeieiee aeiaiai?

Aeaaa C

II?ssAeIE IOI?IEAIIss OAENOO AeIAIAI?O

O aiaeiiaiaeiinoi c /eiiei caeiiiaeaanoaii aeiaiai? aaaaeaooueny oeeaaeaiei oiaei, eiee iiae
noi?iiaie aeinyaiooi caiaee c onio inioth/eo eiai oiia. Iiiaio oeeaaeaiiy aeiaiai?o aecia/aooueny
iiiaioii iaaeaiiy oaiaei anoaiiaeaii? oi?ie.

Aeiaiai? oeeaaeaooueny eieueeiia niiniaaie, iniiaii c yeeo i?aaenoaaeaii e i?iaiaeiciaaii
ieae/a. I?ioa, o aoaeue-yeiio aeiaaeeo eiie?aoiee aeai? niiniao oeeaaeaiiy aeiaiai?o aiaeaeaii ia
?icnoae noi?ii i caeaaeeoue aiae iniaeeainoae oa niaoeeoiee eiie?aoiiai aeiaiai?o.

Neeaaeaiiy iaeiiai aeieoiaioo iiae iacaith .

Oeae niinia o iaeiioeiaeueiioei o aeai?i eiie?aoiiai niiniao oeeaaeaiiy aeiaiai?o. Naia
a iaeiiio aeieoiaioi iiae caaieiaeii , , noi?iie aecia/athoue oni
nooooai oiiae oa aniaeoe ia?aaeaa/oaaii? eiia?oeieii? iia?aoei?. Aaeeeith ia?aaaaith oeueiai niiniao
iiaeia iacaaoe i oie iiiaio, ui i?e eiai iayaiinoi nii?o uiaei naiiai oaeoo oeeaaeaiiy
aeiaiai?o i?aeoe/ii ia aeieeao. Oaeei /eiii iiaeooue oeeaaeaoeny aoaeue-yei ainiiaea?/i aeiaiai?e.

Iieiee ia i?aeoeoei iinoao ieoaiiy: /e iiaeia aaaaeaoe aeiaiai?ii aiaeiineie c eiia?oeieii?
eoiiaei-i?iaeaaeo (iinoaaee) ioi?ieaieie i?e iayaiinoi ia naiiai aeiaiai?o, a eeoa ocaiaeaeaii?
niaoeeoieaoei?? Niaoeeoieaoeiy, iiaeienaia noi?iiaie, ia iinoeoue onio nooooaeo oiia aeey aeciaiiy
aeiaiai?ieo aiaeiinei anoaiiaeaieie i ia iiaea caiiieoe aeiaiai? iinoaaee, ui oeeaaeaooueny a
onoaeaiiio ii?yaeeo.

Oeeaaeaiiy aeiaiai?o o aiaeiiaiaeiinoi c i?ioieieii i?i iaii?e.
Acaaaei, aeiaiai? i o aeiaiai?, i aeiaeiee i?ioieie i?i iaii?e eiai caiiieoe ia iiaea. Oei ia
iaioa oaeee i?ioieie iiaea o aeayeeo aeiaaeeao iaeeaaeaoe ia inia, ui eiai iiaeienaee, iaaii
ciaiaycaiiy, i?i ui iaiaoiaeii iniaeeai neacaoe.

O aiaeiiaiaeiinoi c oe?a?inueeei caeiiiaeaanoaii aaaeaiiy ia?aaiai?ia c i?eaiaeo ia?aaeaa/oaa-
iiai aeiaiai?o ia iaaeao o/anieeai oeeo ia?aaiai?ia aeiaeieo i?aa oa iaiayceia.

I?ioa, inoaiiii /anii cia/ia iioe?aiiy iaea?aeaa oaeee aeae eiia?oeieii? aeieoiaioaoei?,
ye i?ioieie i?i iaii?e. Iaiaoiaeii iaiyoaoe, ui aeayei i?ioieiee i?i iaii?e yaeythoue niaith
ia i?inoi aeieoiaio, o yeiio oienothoueny ?acoeueoaoe ia?aaiai?ia iiae noi?iiaie, aea e aeieoiaio,
yeee iao o ?yaei aeiaaeeia aaaeeeaa th?eaee/ia cia/aiiy.

Ni?aaa a oiio, ui /eiiei caeiiiaeaanoaii ia?aaeaa/aii oaeo oi?io, ye iiia?aaeiie aeiaiai?.
O aiaeiiaiaeiinoi aei iiia?aaeiueiai aeiaiai?o noi?iie ciaiaycothoueny oeeanoe a iaeaooiueiio
aeiaiai? i?i ia?aaea/o oiaa?ia, aeeiiaiiy ?iaioe oiui ia oiiaao, ia?aaeaa/aieo iiia?aaeiii
aeiaiai?ii. O oeieiio ?yaei aeiaaeeia iiaei?eoioei, iiaeienoth/e i?ioieie i?i iaii?e, i ia iiaeic?ththoue,
ui iani?aaaei oeeaaeathoue naiai ?iaeo aeiaiai?, ca yeei aa?ooue ia naaa iaaii i?aaa oa iaiaycee.
sseui noi?iia iiia?aaeiueiai aeiaiai?o ooeeyooueny aiae oeeaaeaiiy ia?aaeaa/aiiai iei aeiaiai?o,
iioa noi?iia iao i?aai caa?iooeny aei noaeo c iiciaii i?i niiioeo oeeanoe aiaeiiaiaeiee aeiaiai?,
a oaeiae c aeiiaith i?i noyaiaiiy ci noi?iie, yea ooeeyooueny aiae oeeaaeaiiy aeiaiai?o, caeoeia,
ui aeieeee o cayceo c oeei.

Oaeei /eiii, aei i?ioieieia i?i iaii?e iaiaoiaeii noaaeoeny aieueo iiae aiaeiiaiaeaeueii, i o
aeiaaeeo, yeui ae ia iaooa iaii?o caycoaaoe naaa i?aaaie oa iaiayceaie, o i?ioieiei iaiaoiaeii
c?iaeoe aiaeiiaiaeiee caien.

Iaiii eenoaie, oaeaoaeiia?aiaie, oaeaa?aiaie, oaeaoiiia?aiaie oiui, iiaeie-
naieie noi?iiith, yea ?o iaaeneeao.
sse canaiae/oo i?aeoeea, oeae niinia iana a niai /eiaei iaaaciae, i aieiaia c ieo iieyaao

o oiio, ui ia eiaeiee eeno aai oaeaa?aia iiaeooue naiae/eoe i?i oeeaaeaiiy aeiaiai?o iiae

noi?iiaie.

Iniiaii ieoaiiy, yei aeieeathoue o oeueiio cayceo, ianooiii:
a) /e iiaeia oeeanoe aeiaiai? caiaeii aa?aioieiiai eenoa?
a) /e iiaeia oeeanoe aeiaiai? ii oaeno?
Aa?aioieii eenoe iiaeiii aiaeiiaiaeaoe aeiiaai i?iiiceoei? i?i oeeaaeaiiy aeiaiai?o (ioa?oa),

a naia:
ii-ia?oa, aa?aioieiee eeno iiaeiai iinoeoe a niai anth iaiaoiaeio iioi?iaoeith aiaeiinii

nooooaeo oiia aeiaiai?o (i?aaeiao aeiaiai?o, iaiaoiaeii no?iee, oeiia oiui);
ii-ae?oaa, aa?aioieiee eeno iao aooe aeinoaoiuei aecia/aiei, oiaoi aii iiaeiai aooe

caa?iaiee aei eiie?aoii? iniae;

Eiia?oeieiee aeiaiai?

ii-o?aoo, i?iiiceoeiy i?i oeeaaeaiiy aeiaiai?o iao aeoiaeeoe aiae iiaiiaaaeii? iniae
iiaei?eoinoaa;

ii-/aoaa?oa, aa?aioieiee eeno iao ae?aaeaoe iaii? iniae, ui eiai iineeao, aaaaeaoe
naaa iiaycaiith i?aaaie oa iaiayceaie o aeiaaeeo i?eeiyooy i?iiiceoei?.

Oaeei /eiii, c oaenoo aa?aioieiiai eenoa iao ynii e iaeiicia/ii aeoiaeeoe i?iiiceoeiy
oeeaaeaiiy aeiaiai?o. Ia iiaea ?icoeiithaaoeny ye ioa?oa yeanue cayaa i?i aeayei ianoaaeie aai
yeanue aeoiea, aai iiaiaeiieaiiy, aai ?iciiaiaeue i?i iiaei?eoinoai oa eiai oiaa?e (iineoae).

sseui aeuaiacaaii oiiae a aa?aioieiiio eenoi aiaenooii, oi eiai iiaeia ?icaeyaeaoe ye
?aeeaio aai ye cai?ioaiiy aei ia?aaiai?ia c i?eaiaeo iaeaooiueiai aeiaiai?o. AEiaeieo th?eaee/ieo
ianeiaeeia oaeee aa?aioieiee eeno ca niaith ia oyaia.

Aea yeui iaaioue aa?aioieiee eeno aiaeiiaiaeao onii i?aaeyaeaiei th?eaee/iei aeiiaai,
iaeiiai eiai aeey oeeaaeaiiy aeiaiai?o iaaeinoaoiuei. Iaiaoiaeii, uia i?iiiceoeiy aoea i?eeiyoa
(aeoeaioiaaia), ineieueee aeiaiai?ii aiaeiineie iiae noi?iiaie aeieeathoue ia ic naiiai aa?aioieiiai
eenoa, a ic noaaeaiiy eiai noi?iiaie. I?eeiyooy i?iiiceoei? i?i oeeaaeaiiy aeiaiai?o (aeoeaio),
ye i ioa?oa, oaeiae iiaeiii aiaeiiaiaeaoe iaaiei aeiiaai.

Ii-ia?oa, aeoeaio iao aeoiaeeoe eeoa aiae oio? iniae, yeie c?iaeaii ioa?oo, a, ii-ae?oaa,
aeoeaio iao aooe aacoiiaiei. O aeiaaeeo iacaiaee noi?iie oi/a a c aeayeeie iacia/ieie oiiaaie
ioa?oe oaeee aeoeaio ?icaeyaeaooueny iiaith i?iiiceoeioth oeeanoe aeiaiai?. A aeaiiio aeiaaeeo
aaeeea cia/aiiy aoaeooue iaoe no?iee, i?ioyaii yeeo i?iiiceoeith iao aooe i?eeiyoi.

Eiee ioa?oo c?iaeaii ic cacia/aiiyi no?ieo aeey aiaeiiaiaei, aeiaiai? aaaaeaooueny oeeaaeaiei,
yeui aiaeiiaiaeue i?i i?eeiyooy (aeoeaio) i?iiiceoei? iaea?aeaii i?ioyaii oeueiai no?ieo. Eiee
no?ie a ioa?oi ia aeacaii, oi i?eeiyooy iao th?eaee/ia cia/aiiy, yeui aiaeiiaiaeue iaea?aeaii
i?ioyaii ii?iaeueiiai iaiaoiaeiiai /ano, anoaiiaeaiiai /eiiei caeiiiaeaanoaii.

I?eeeaae. Eueaianueeee oaao? caa?ioany aei ee?anueeiai iiaei?eoinoaa c i?iiiceoeioth aeaioiaeoe
?aeaiceo ca cai?iiiiiaaieie aneicaie (aooaoi?nueea ca?iy, eiooa?i oiui) i ia?a?aooaaa iiaei?eoi-
noao aaain.

Iiaei?eoinoai ia i?iiiceoeith oaao?o ia aiaeiiaiei, a /a?ac aeayeee /an cai?ineei i?aae-
noaaieeia oaao?o i?eeiyoe aeeiiaia caiiaeaiiy. I?aaenoaaiee oaao?o caa?aeoaaa aeeiiaiiy
?iaioe i iinoaaea aeiiao iiaa?iooe aaain.

Nii? aoei ?icaeyiooi a a?aio?aaei, i oie caiaeii c ?ioaiiyi noyaioa c iiaei?eoinoaa aaain
oa aea?aeieoi ia ianooiieo iiaenoaaao:

eeno oaao?o ia iinoea onio iaeaaeieo oiia iaeaooiueiai aeiaiai?o – caiaee ia i?iiiceoeith
oeeanoe aeiaiai? oaao?ii iaea?aeaii ia aoei, a ia?a?aoiaaiee aaain a ?aooiie iaeaooiueiai
aeiaiai?o ia naiae/eoue i?i oa, ui aeiaiai? aoei oeeaaeaii.

I?eeiyooy caiiaeaiiy aei aeeiiaiiy.

Aeiaiai? iiaea aooe oeeaaeaii oeyoii i?eeiyooy aei aeeiiaiiy caiiaeaiiy. Aeaiee niinia
iniaeeai oe?iei canoiniaoooueny o ieaiiaie aeiiiiioei o aiaeiioaiii aeiaiai?ia c iinoa/aiiy
oiaa?ia ia?iaeiiai niiaeeaaiiy oa i?iaeoeoei? ae?iaie/i-oaoii/iiai i?ecia/aiiy. Iaiaoiaeii
aiaecia/eoe, ui ca oiia aieueiiai iiaei?eoiieoeoaa iiaeeeainoi oeueiai niiniao ae?ae iaiaaeaii,

O aeaiee /an oeae niinia canoiniaoooueny o aiaeiineiao iiae a?iea?nueeeie eiioi?aie oa ?o
eeioioaie i?e oeeaaeaiii aeiaiai?ia ia a?iea?nueea ianeoaiaoaaiiy. Cie?aia, yeui a no?ie,
aecia/aiee aeuacacia/aiei aeiaiai?ii, a?iea? ia cayaeoue nai?o caia?a/aiue c iaea?aeaiiai aiae
eeioioa caiiaeaiiy, aeiaiai? a /anoeii, ui noinoooueny oeueiai caiiaeaiiy, iiaeia aaaaeaoe oeeaaeaiei.
Iaeiae, aeiaiai?ii ia a?iea?nueea ianeoaiaoaaiiy iiaeooue ia?aaeaa/aoeny e iioi aa?iaioe.

O no/anieo iiaei?eoioeia aeoaea /anoi aeieeao ieoaiiy: a /e iiaeia oeeanoe aeiaiai? ii
oaeaoiio i yeo neeo iao oae caaia oaiaea i th?eaee/iiai
cia/aiiy ia iathoue, yeui cai?ioio ia aoaea aeiaaaeaii a noaei o aeiaaeeo nii?o.

Inoaiiii /anii aaaaoi ooi, iineeath/eny ia caei?aeiiiee aeinaiae, noaa?aeaeoo, ui ia/aaoi
iieueeiiii oaiaee oeeaaeathoueny ii oaeaoiio aai onii ca aa/a?ath, a eeoai i o.i. Aeienii,

Eiia?oeieiee aeiaiai?

a ii?aeueiiio nienei, o nienei iiaeo?eiee ?aiooaoei? oa iiiaeaeo oaei oaiaee oeeaaeathoueny, i?ioa,
aeey i?aaiaeo aiaeiinei cia/aiiy ia iao. Oa e acaaaei i?inoioa caoiaeieo
niiniaia oeeaaeaiiy eiio?aeoia aeaui ia?aaieueoaia. Cae/aeii iiney oaeaoiiii? oaiaee caoiaeii
aicianiaie aeathoue caaaeaiiy nai?i aaeaieaoai ioi?ieoe e a?aaoethaaoe ani iaiaoiaeii oi?iaeueiinoi
iaeaooiueiai aeiaiai?o. A ?icii? oeeo iieiee neeaaeao aeanyoee noi?iiie oaenoo
eiie?aoiiai eiia?oeieiiai eiio?aeoo.

I?i oeeaaeaiiy aeiaiai?o naiae/eoue eiai iiaeienaiiy. sse i?aaeei, aiii aeeth/ao a naaa
aeanii?o/iee iiaeien iiaiiaaaeiiai i?aaenoaaieea iiaei?eoinoaa, a oaeiae aiaeaeoie ia/aoee oeio?
i?aaiicaoei?. Ia/aoea iiaei?eoinoaa ia aeiaiai?i ia/a iiaeoaa?aeaeoo iiaiiaaaeaiiy iniae, ui
iiaeienaea aeiaiai?, aea aiaenooiinoue ia/aoee iiaei?eoinoaa ia aeiaiai?i ia ?iaeoue aeiaiai? aaoiiaoe/-
ii iaaeieniei. Acaaaei, cia/aiiy ia/aoee iiaei?eoinoaa ia aeiaiai?i ia iiaeia ia?aioeiithaaoe. O
aiaeiiaiaeiinoi c /eiiei caeiiiaeaanoaii iayaiinoue aai aiaenooiinoue ia/aoee ia aeiaiai?i aeiaeiei
/eiii ia iiaycaia c eiai aeieniinoth aai iaaeieniinoth. Ae?ioaeueiiai cia/aiiy caeii iaaeao
iiaiiaaaeaiiyi . Oiio iayaiinoue ia/aoee ia aeiaiai?i, iiaeienaiiio iaiiaii-
aaaeiith iniaith, ia ?iaeoue aeiaiai? aeieniei, o oie /an, ye aiaenooiinoue ia/aoee ia iiaeieni
iiaiiaaaeii? iniae iaeiicia/ii naiae/eoue i?i oeeaaeaiiy aeiaiai?o.

Iiaeienaiiy aeiaiai?o naiae/eoue i?i aieaaeyaeaiiy noi?ii ia eiai oeeaaeaiiy, o aiaeiiaiaeiinoi
aei yeiai o oeeo noi?ii aeieeathoue aiaeiiaiaeii i?aaa, iaiaycee, aiaeiiaiaeaeueiinoue.

Aeiaiai?-aeieoiaio o iaeaaaeeeaioei aeieacii a a?aio?aaeiiio noaei o aeiaaeeo aeieeiaiiy
nii?o, a iieiee aeiia noi?iia, ?icoiith/e, ui aiae aiaeiiaiaeaeueiinoi ia aoaeoe, iae?ao aeineoue
i?eeii caoenoo: aiia caia?a/oo nai oaeo oeeaaeaiiy aeiaiai?o aai iayaiinoue o
iueiio oeo /e iioeo oiia ia iiiaio iiaeienaiiy.

O oeueiio cayceo iniaeeaiai cia/aiiy iaaoaao i?aaeeueia ioi?ieaiiy oaenoo aeiaiai?o,
ia iiaenoaai /iai iiaeia ?aeiiaiaeoaaoe ianooiia:

a) iiaeiene noi?ii iathoue aooe c?iaeaii iiaiinoth i ?icai?eeai. oa
ia aeiaiai?i o aeiaaeeo, yeui aao eiio?aaaio caia?a/eoue naie iiaeien, iiaeooue iioyaoe ca niaith
oa, ui noaeiaa aenia?oeca ia ciiaea aeaoe iaeiicia/io aiaeiiaiaeue i?i aaoi?noai iiaeieno, i oea
iiaea nooooai aai caoeiaeeoe;

a) iieiee ia iiaeienoeoa /enoeo aeaieia, ineieueee oaeeie iaia?aie iiaeooue
nei?enoaoeny ia/anii ethaee o aeiaaeeo, yeui oei aeieoiaioe aoaeooue aaie aeiaaeeiai caaoaeaii;

a) iiney iiaeienaiiy aeiaiai?o ii ca yeeo ianoaaei ia aiaeaeaaaeoa aao i?eaiiaeueiee i?eii?iee
aeiaiai?o aaoiio eiio?aaaioiai aai iioei noi?iiiii iniaai. E?aua anueiai ciiiioue ia ena?ieni
eiiith i?eaiiaeueiiai aeiaiai?o i a iioi/iie ?iaioi ei?enooeoany eeoa iath. I?eaiiaeueiee
i?eii?iee aeiaiai?o, aeey caiiaiaaiiy iiaeeeaie ao?aoi aai aee?aaeaiith, e?aua iieeanoe o
naeo i aeei?enoiaoaaoe oeae aeieoiaio eeoa o ni?aaaei iaiaoiaeieo aeiaaeeao;

a) yeui oaeno aeiaiai?o neeaaeao eieueea noi?iiie, iaiaoiaeii ?o i?ioeoe, caeea?oe i canaiae/eoe
iiaeienaie oa ia/aoeaie noi?ii.

Aeayei iiaei?eoioei aeei?enoiaothoue iioee, oaeiae aoaeoeaiee niinia: aiie iiaeienothoue
eiaeio noi?iieo aeiaiai?o. Oaea ianoaaeia o aeiaaeeo nii?o iiaea caoenoeoe aan aiae caya iaaeia-
?iniainiiai ia?oia?a, ui ;

ae) iiaea noaoeny oae, ui aao eiio?aaaio ?aioii cayaeoue, ui i?e iiaeienaiii aeiaiai?o
eiai iaiaioee, aaaee a iiaio, aeey iiaeienaiiy ia oie i?eii?iee aeiaiai?o oiui.
Oiio iiaeia ?aeiiaiaeoaaoe aai caa?iaaoe i?iaeoe aeiaiai?o ic aeanii?o/ieie aei?aaeaiiyie,
caoaaaeaiiyie oa anoaaeaie iioi? noi?iie. Oaeee aeieoiaio a A?aio?aaeiiio noaei iiaea neoaoaaoe
aeieacii oiai, ui aao eiio?aaaio i?e oeeaaeaiii oaiaee cianii ii a /iio ia iiieeyany, a aeiya
?icoiii i iaaeoiaii.

Iniaeeai iaaeiionoeii a aeiaiai?i o?ace oa ?icii/eoaiiy. Aiaeiinii inoaiiio
iaiaoiaeii neacaoe, ui o aeiaaeeo, yeui a oaenoi aeiaiai?o i?enooii ?icii iieiaeaiiy c iaeiio? e
oio? oiiae, oi ca iioeo ?iaieo oiia aaaaeaooueny, ui iiae noi?iiaie ia aoei aeinyaiooi caiaee c
oeio? oiiae aeiaiai?o.

Eiia?oeieiee aeiaiai?

Aeaaa 4

II?ssAeIE AEEIIAIIss AeIAIAI?O

Ii?yaeie aeeiiaiiy ciaiaycaiue eiaeiith noi?iiith ca aeiaiai?ii iiaeeyaao iaaiei ii?iaoea-
iei i?aaeeai.

sse canaiae/oo i?aeoeea aeieiaiai iaiao, aeeiiaiiy aeiaiai?o ia caaaeaee caiaeeoueny aei a/eiaiiy
iaeiio? (?aciai?) aei?, ye oea aiaeaoaaooueny, iai?eeeaae, i?e eoiiaei-i?iaeaaeo oiaa?ia a iaaaceii. O
aieueoinoi aeiaaeeia aeeiiaiiy yaeyo niaith i?ioean, oiaoi iaaio nenoaio iineiaeiaieo aeie. O
i?ioeani, ui ?icaeyaeaooueny, iiaeia aeaeieeoe aeai iniiaii /anoeie.

*anoeia 1

IAOA?IAEUeIA NOAAeIss AEEIIAIIss AeIAIAI?O

Aeaia noaaeiy aeeth/ao aeai acaoiii aei?: iaaeaiiy aeeiiaiiai iaeiioth noi?iiith i i?eeiyooy
i?aaeiaoo aeeiiaiiy iioith noi?iiith.

Ii?yaeie aeeiiaiiy ciaiaycaiue noai?i iiaeii?yaeeiaoooueny aeiiaai, yei iinoyoueny o /eiiiio
caeiiiaeaanoai.
I. No?ie aeeiiaiiy aeiaiai?o.

sseui aeiaiai? ia?aaeaa/ao aai aeicaieyo aecia/eoe aeaiue eiai aeeiiaiiy, oi ciaiaycaiiy
iiaeeyaao aeeiiaiith a oeae aeaiue. sseui aeiaiai? ia?aaeaa/ao aai aeicaieyo aecia/eoe ia?iiae /ano,
i?ioyaii yeiai ciaiaycaiiy iiaeeyaao aeeiiaiith, oi ciaiaycaiiy iao aooe aeeiiaii o aoaeue-
yeee iiiaio aeaiiai ia?iiaeo. Ca caaaeueiei i?aaeeii noi?iia ia iiaea aeeiiaoe ciaiaycaiiy
aeiaiai?o aeino?ieiai. I?ioa, aeino?ieiaa aeeiiaiiy ciaiaycaiue aeiioneaooueny, yeui oaea i?aaeei
ia?aaeaa/aii aeey noi?ii aeiaiai?o, eiee o caiaea iioi? noi?iie aai aiii aeieeaao ic nooi ciai-
aycaiue, cae/a?a aeieiaiai iaiao. O i?ioeeaaeiiio aeiaaeeo iioa noi?iia iiaea aiaeiiaeoeny aiae
i?eeiyooy aei aeeiiaiiy ciaiaycaiiy aai i?eeiyoe aei aeeiiaiiy i noyaoe c iioi? noi?iie
caeoee, yei aoee aeeeeeaii ianaio/aniei aeeiiaiiyi.

Aeoaea /anoi a aeiaiai?i noi?iie ia anoaiiaeththoue no?ieia aeeiiaiiy ciaiaycaiue aai
oi?ioeththoue oeth iaeaaaeeeaioo oiiao oae ia/ioei, ui aecia/eoe ?? i?inoi iaiiaeeeai. O
oeueiio aeiaaeeo iaiaycie noi?iie iao aooe aeeiiaiee o ?icoiiee no?ie. aai
no?ieo o aeiaaeeo nii?o aoaea aecia/aoe noae.
2. Iinoea aeeiiaiiy aeiaiai?o.

sseui iinoea aeeiiaiiy aeiaiai?o ia aecia/aii aeiaiai?ii, oi, aiaeiiaiaeii aei caaaeueieo
i?aaee, ciaiaycaiiy iao aooe aeeiiaii ca iinoeai ciaoiaeaeaiiy oio? noi?iie, yea i?eeiao
aeeiiaiiy ciaiaycaiiy.
Aea c oeueiai i?aaeea o aeayei aeiyoee:

– iaoeo ia?ooiiinoi ia?aaeaooueny ca nai?i iinoeai ciaoiaeaeaiiy;

– ciaiaycaiiy ia?aaeaoe oiaa?, ui ia?aaeaa/ao eiai ia?aaacaiiy, aeeiioooueny a iinoei
caea/i oiaa?o ia?oiio ia?aaicieeiai;

– ciaiaycaiiy iiaei?eoioey ia?aaeaoe oiaa? o iinoea aeaioiaeaiiy aai caa?iaaiiy oiaa?o
aeeiioooueny, yeui oea iinoea aoei aiaeiii noi?iii, ui eoioo oiaa?.
3. Oeiia aeiaiai?o.

Nieaoiee aeiaiai? iiea/oooueny ca oeiiith, aecia/aiith oaiaeith noi?ii. Ciiie oeiie aeiaiai?o
iiney eiai oeeaaeaiiy i?eionoeii eeoa o aeiaaeeao i ia oiiaao, ia?aaeaa/aieo aeiaiai?ii.
4. Niinia aeeiiaiiy aeiaiai?o.

Niinia aeeiiaiiy aeiaiai?o – oea ia?aaeaa/aiee aeiaiai?ii ii?yaeie aei? noi?ii o i?ioeani
aeeiiaiiy. Caiaeii c caaaeueieie i?aaeeaie, ciaiaycaiiy iao aooe aeeiiaii iiaiinoth iaeei
?ac, yeui oaiaeith noi?ii ia ia?aaeaa/aii aeeiiaiiy ciaiaycaiiy /anoeiaie. Acaoiii iaiaycee
noi?ii ca aeiaiai?ii iiaeiii aeeiioaaoeny iaeii/anii, yeui ciiao ae oaee iioa ia aeieeaao c
oaiaee. Oiio noi?iiai i?e oeeaaeaiii aeiaiai?o iaiaoiaeii noai?i i oi/ii ia?aaeaa/eoe, ye aoaeooue
aeeiioaaoeny ?o ciaiaycaiiy.

*anoeia 2

OAOIIEI-TH?EAeE*IA NOAAeIss AEEIIAIIss AeIAIAI?O

Nooue aeaii? noaaei? iieyaao o ia?aai?oei aeeiiaiiai ca eieueeinoth oa yeinoth, a oaeiae o
aeieoiaioaeueiiio iiaeoaa?aeaeaiii oaeoo aeeiiaiiy.

Eiia?oeieiee aeiaiai?

Iniaa, ui i?eeiao aeeiiaiiy, ciaiaycaia iaaeaoe iioie noi?iii aiaeiiaiaeiee aeieoiaio.
Iaiaoiaeii iaiyoaoe, ui eeoa aeeiiaiiy ciaiaycaiiy i?eieiyo eiai aeith aeey ciaiaycaii?
noi?iie, a e?ii oeueiai, aeiee o ciaiaycaii? noi?iie iaiao iiaeoaa?aeaeaiiy i?i oa, ui ?? ciaiaycaiiy
aeeiiaii, aiia a th?eaee/iiio nienei i?iaeiaaeoo eeoaoeny ai?aeieeii, iaaioue yeui oaeoe/ii
nai? ciaiaycaiiy aeeiiaea.

Iioeie neiaaie, aoaeue-yea aaoa aeeiiaiiy iiaeiii aooe aeieoiaioaeueii ioi?ieaiei, o
i?ioeeaaeiiio aeiaaeeo aaaaeaooueny, ui nai?o ciaiaycaiue ae ia aeeiiaee. Aeieoiaioaeueiei
iiaeoaa?aeaeaiiyi aeeiiaiiy ciaiaycaiiy iiaeooue aooe:
a) aeo caea/i-i?eeiaiiy oiaa?ia (?iaio, iineoa);

a) ieaoiaeia aei?o/aiiy, caai?aia onoaiiaith aaieo, i?i iieaoo oiaa?ia (?iaio, iineoa);
a) eaeoaioeiy aiae o?ainii?oii? i?aaiicaoei? i?i aiaeaaioaaeaiiy oiaa?o ia aae?ano aaioaaeiio?e-
ioaa/a;

a) eaeoaioeiy i?i caea/o-i?eeiaiiy oiaa?o ia neeaae i?iaeaaoey;
ae) ?icienea io?eioaa/a;
a) iioi aeieoiaioe oa naiae/aiiy.

O oeueiio cayceo iaiaoiaeii neacaoe, ui neeaaeaiiy oa ioi?ieaiiy aeieoiaioia i?i i?eeiaiiy-
caea/o oiaa?ia (?iaio, iineoa) iao aaeeea th?eaee/ia cia/aiiy.

I?eeiaiiy i?iaeoeoei?, oiaa?ia ca eieueeinoth aiaeaoaaooueny ca oaeeie noi?iaiaeaeoaaeueieie
aeieoiaioaie, ye ?aooiie-oaeoo?a, niaoeeoieaoeiy, iien, iaeoaaeueii y?eeee, iaeeaaeii oiui.
I?e i?eeiaiii i?iaeoeoei? (oiaa?ia) aiae iiaei?eoinoa io?eioaa/ ciaiaycaiee ia?aai?eoe caaacia-
/aiiy noi?iiiinoi aaioaaeo i?e ia?aaacaiii (ni?aaiinoue ieiia i oa?e, iayaiinoue ia?eoaaiiy i
o.i.).

I?e aeyaeaiii ianoa/i i?iaeoeoei? (oiaa?o) io?eioaa/ ciaiaycaiee i?ecoieieoe iiaeaeueoa
i?eeiaiiy i aeeeeeaoe aeey o/anoi o i?iaeiaaeaiii i?eeiaiiy i neeaaeaiiy aeoo i?aaenoaaieea
iinoeaaiai aiaei?aaieea. I?aaenoaaiee iiiai?iaeiueiai iinoa/aeueieea aeeeeeaooueny o aeiaaeeao,
ia?aaeaa/aieo niaoeiaeueieie i?aaeeaie aai aeiaiai?ii.

Neeaaeaiiy aeoo i?i ianoa/o i?e iayaoei i?aaenoaaieea aiaei?aaieea aai eiee aeeeee
i?aaenoaaieea o iaiaiayceiaei, aiaeaoaaooueny ca o/anoi iacaoeieaaeaiiai iiaei?eoinoaa aai i?aae-
noaaieea a?iiaaenueeinoi iiaei?eoinoaa-io?eioaa/a. A iaeiinoi?iiiueiio ii?yaeeo aeo neeaaeaooueny
iiaei?eoinoaii-io?eioaa/ai o oiio aeiaaeeo, yeui aiaei?aaiee caiaeiee ia iaeiinoi?iiio i?ee-
iaiiy i?iaeoeoei? (oiaa?o).

I?eeiaiiy i?iaeoeoei?, oiaa?ia ca yeinoth aiaeaoaaooueny ca noi?iaiaeieie aeieoiaioaie, ui
canaiae/othoue yeinoue iinoaaeaii? i?iaeoeoei? (oiaa?o) – oaoii/iee ianii?o, na?oeoieao, iinaiae/aiiy
i?i yeinoue oiui. Aeo i?i i?eoiaaii iaaeieiee iao aooe neeaaeaii i?ioyaii 5 aeiia iiney aeyaeaiiy
iaaeieieia, aea ia iiciioa 4 iinyoeia aiae aeiy iaaeoiaeaeaiiy i?iaeoeoei? (oiaa?ia) ia neeaae iieoioey.

O/anoue i?aaenoaaieea iinoa/aeueieea o neeaaeaiii aeoo i?i yeinii iaaeieiee ?aaeaiaiooooueny
aiaeiiaiaeii aei eiai o/anoi o neeaaeaiii aeoo ianoa/i c aeayeeie aeiiiaiaiiyie.

Aeo i?eeiaiiy i?iaeoeoei? (oiaa?ia) ca eieueeinoth oa yeinoth o iiaenoaaith aeey i?aaeyaeaiiy
iinoa/aeueieeo aiaeiiaiaeieo i?aoaicie. Ii?ooaiiy i?aaee i?eeiaiiy oyaia ca niaith aiaeiiao
i?i aiaeoeiaeoaaiiy aa?oinoi i?iaeoeoei?, yei? ia aenoa/ao.

I?eeeaae. AI caa?ioany aei a?aio?aaeo c iiciaii i?i
noyaiaiiy aa?oinoi aeaoaeae, yeeo ia aenoa/aei, io?eiaieo aiae Aeiii?iiao?ianueeiai aa?aaaoiiai
caaiaeo. I?e ?icaeyaei ni?aae o ia?oie oa eanaoeieiie iinoaioei? aoei cyniaaii, ui a aeoi i?eeiaiiy
noai ieiia ia eiioaeia?i ia iiiaio aiaee?eooy ia iienaii. Ia aoei a iueiio i iineeaiue ia
ni?aaiinoue oa?e oa ia?eoaaiiy ie?aieo iinoeue. O cayceo c oeei A?aio?aaeiee noae o iiciai AI
aiaeiiaea.

Aeoe caea/i-i?eeiaiiy aeeiiaieo ?iaio ca aeiaiai?ii iiae?yaeo iiaeiii oaeiae ioi?iethaaoeny
aeoaea aeineiieeai, ic cacia/aiiyi eieueeinoi oa yeinoi aeeiiaieo ?iaio, caoaaaeaiue i i?aoaicie c
aieo caiiaieea oiui.

Inioo ua iaeei niinia ioi?ieaiiy aeeiiaiiy ciaiaycaiue – caeie acaoiieo aeiia, yei
yaeythoue niaith oi?io aeeiiaiiy aeaio /e eieueeio ciaiaycaiue, yei iiaycothoue iaeieo i oeo
naieo inia. Caaeiaieaiiy aeiia iaeiio? noi?iie aiaeaoaaooueny oeyoii iiaaoaiiy ?? aeiia
cono?i/iith aeiiaith iioi? noi?iie, ui aeieeaao c iioiai ciaiaycaiiy.
Caeie acaoiieo aeiia iiaeeeaee ca aeio?eiaiiy ianooiieo oiia:
a) aeiiae iiaeiii aooe cono?i/ieie;
a) aeiiae iiaeiii aooe iaeii?iaeieie;
a) no?ie aeeiiaiiy ciaiaycaiiy iao ianooieoe.

Caeie aiaeaoaaooueny ia iiaenoaai oaiaee noi?ii, yea ioi?iethooueny aai i?ioieieii, aai iioei
aeainoi?iiiii aeieoiaioii, aai ia aeiiao iaeiio? ic noi?ii, yea ioi?iethooueny cayaith aai eenoii.
A inoaiiueiio aeiaaeeo caiaee iioi? noi?iie ia caeie ia aeiaaaooueny, iaeiae aiia iiaea caia?a/eoe
/a?ac noae iayaiinoue oiia aeey i?iaaaeaiiy caeieo, a oaeiae aeieniinoue aeiia.

Eiia?oeieiee aeiaiai?

Aeaaa 5

II?ssAeIE CIII I ?ICI?AAIIss AeIAIAI?O

I?e?iaeiith oyaeyooueny neooaoeiy, eiee noi?iie iiney oeeaaeaiiy aeiaiai?o ae?ioothoue ciiieoe
oi /e iioi eiai oiiae, caiiieoe aeiaiai? ia iioee, i?iaeiaaeeoe no?ie aei? aeiaiai?o, a oi e
?ici?aaoe ?aiioa oeeaaeaiee aeiaiai?. Aeey oiai, uia i?aaeeueii ioi?ieoe ani iaiaoiaeii ciiie,
o?aaa ciaoe aeayei th?eaee/ii i?aaeea, yei i?aaeyaeythoueny aei iiaeiaieo aeie noi?ii.
Aea caaaeaee iaiaoiaeii iaiyoaoe iaeia nooooaa iieiaeaiiy caeiio:

Iaeiinoi?iiiy aiaeiiaa aiae aeeiiaiiy ciaiaycaiiy oa iaeiinoi?iiii ciiie oiia
aeiaiai?o iai?eionoeii, ca aeiyoeii aeiaaeeia, ia?aaeaa/aieo aeiaiai?ii aai
caeiiiaeaanoaii.

Ciiie aai aeiiiaiaiiy aeiaiai?o.

Caiaeii ic caaaeueieie i?aaeeaie, iaeiinoi?iiii ciiie aai aeiiiaiaiiy oiia aaea oeeaaeaiiai
aeiaiai?o, ye aoei cacia/aii aeua, iai?eionoeii. Ani ei?aeoeae aei ?aiioa oeeaaeaiiai aeiaiai?o
iiaeooue aiineoeny eeoa ca caiaeith noi?ii.

Eiee iaeia ic noi?ii aaaaeao iaiaoiaeiei ciiieoe aai ?ici?aaoe aeiaiai?, aiia ciaiaycaia
iai?aaeoe iioie noi?iii aiaeiiaiaeio i?iiiceoeith. Iioa noi?iia ciaiaycaia ?icaeyiooe i?iiiceoeith
i aeaoe aiaeiiaiaeue o coiiaeaiee i?iiiceoeioth iiioeiaoi?a no?ie. Ciiie i aeiiiaiaiiy oiia oeeaaeaiiai
aeiaiai?o ioi?ieththoueny o oiio ae ii?yaeeo, a yeiio ioi?ieaiee nai aeiaiai?, oiaoi ienueiiai.
O aieueoinoi aeiaaeeia ciiie aai aeiiiaiaiiy aeiaiai?o ioi?ieththoueny ie?aiith oaiaeith noi?ii
aai i?ioieieii, aea iiaeooue ioi?iethaaoeny e iaiiiii eenoaie, oaeaa?aiaie, oaenaie oiui.

I?iaeiaaeaiiy no?ieo aei? aeiaiai?o ioi?iethooueny o oiio ae ii?yaeeo. Aeey aeiaiai?ia aeayeeo
aeaeia o aeiaaeeao, ia?aaeaa/aieo caeiiiaeaanoaii (iai?eeeaae, i?aiaee), yeui aeiaeia ic noi?ii ia
aeiaaaoeia eiai i?eieiaiiy, aeiaiai? aaaaeaooueny i?ieiiaiaaiei aaoiiaoe/ii. O aeayeeo
aeiaaeeao aeiaiai? i?ieiiaoooueny aaoiiaoe/ii ia iiaee no?ie, yeui i?i oea noi?iie aeiiiaeeeny
i?e oeeaaeaiii aeiaiai?o.

A oaiaei i?i ciiie, aeiiiaiaiiy aai i?ieiiaaoeith aeiaiai?o ?aeiiaiaeoooueny aeacaoe ianooiia:
a) yeee aeiaiai? iiaeeyaao ciiii (iiia? aeiaiai?o, i?i ui aeiaiai?, aiae yeiai /enea);
a) i?e/eie ciiie aeiaiai?o, ineieueee nai oaeo ciiie aeiaiai?o iiaea aeeeeeaoe oai?iaeeaee
iioa?an aeayeeo eiio?iethth/eo i?aaiia;

a) yei oiiae iiaeeyaathoue ciiiai aai yei oiiae aeiaiai?o aeiiiaiththoueny;
a) iiao ?aaeaeoeith ciiiaieo oiia, iai?eeeaae: ;

ae) ioieo i?i oa, ui iiia?aaeii oiiae aeiaiai?o c iiiaioo neeaaeaiiy oaiaee i?i ciiie
ao?a/athoue th?eaee/io neeo;

o) ii?yaeie a?aaoethaaiiy ieoaiue, ui aeieeee, yeui yeinue oiiae aeiaiai?o, ui ciiieeeny
aiaeiiaiaeiith oaiaeith, aaea ii/aee aeiyoe. Iai?eeeaae, yeui ca aeiaiai?ii aoei ciiiaii oeiio i
iieoiaoeue iiia?aaeith oeiio aaea nieaoea, oi iaiaoiaeii ia?aaeaa/eoe ii?yaeie aeiieaoe (no?ie,
?icii?, niinia oiui).

Iaiaoiaeii oaeiae aiaeiioeoe, ui yeui iaeia noi?iia caia?a/oo i?ioe ciiie aeayeeo oiia,
oi aeiaiai? iiaeiai aooe aeeiiaiee ia oeo oiiaao, yei aoee ia?aaeaa/aii ?aiioa.

Oaiaea i?i caiiio aeiaiai?o (iiaaoeiy).

Noi?iie iiaeooue aeinyaoe oaiaee ia eeoa i?i ciiio aoaeue-yeeo oiia aeiaiai?o, aea e acaaaei
i?i caiiio ?aiioa oeeaaeaiiai aeiaiai?o iioei aeiaiai?ii.

Iiaaoeiy – oea oeeaieueii-i?aaiaa oaiaea, ui eaaeeoue a iniiai aioethaaiiy iaeiiai i aeieeiaiiy
iioiai ciaiaycaiiy iiae oeie ae iniaaie.

I?eeeaaeii iiaaoei? iiaea aooe caiiia aeiaiai?o iiceee aeiaiai?ii eoiiaei-i?iaeaaeo.
I?aaeiaoii aeiaiai?o eoiiaei-i?iaeaaeo ooo aenooiao iaeii, yea ia?aaeaooueny canoaaieeii a
yeinoi iiaaoaiiy aeiaiai?o iiceee. Aiaeiineie o oeueiio aeiaaeeo ?aaeaiaioothoueny ii?iaie i?i
aeiaiai? eoiiaei-i?iaeaaeo, a ia i?i aeiaiai? i?i iiceeo.

Ciiie noi?ii ca aeiaiai?ii.
Ca /an inioaaiiy aeiaiai?o a iueiio iiaeooue aiaeaooeny oi aai iioi ciiie ia eeoa c oi/ee

ci?o ciinoo, aea oaeiae i eiai o/anieeia.
Iiaeeeai o?e iniiaii niiniae ciiie inia o ciaiaycaiii: ia?aeac ai?ao; iinooiea aeiia;

iinooiea aeiaiai?o (oeaniy).
a) Ia?aeac ai?ao.
Ia?aeac naiai ai?ao iaeiioth iniaith (ai?aeieeii) ia iioo iniao o aeiionoeiei eeoa ca

Eiia?oeieiee aeiaiai?

caiaeith e?aaeeoi?a (oio? iniae, yeie ai?aeiee i aeiai). sseui oaei? caiaee iaiao, oi ia?aeac ai?ao
iaiiaeeeaee.

Iiaenoaaith aeey oaeiai ia?aeaco o oaiaea iiae ii/aoeiaei ai?aeieeii ca aeiaiai?ii oa
iniae, ui canooiao ia eiai iinoea o ciaiaycaiii (aea ia o aeiaiai?i).

Caiaeo ia ia?aeac ai?ao iao aooe aeneiaeaii e?aaeeoi?ii o oie aea oi?ii, o yeie oeeaaeaii
aeiaiai? – o ienueiiaie. sseui noi?iie, oeeaaeath/e aeiaiai?, ia?aaeaa/athoue iiaeeeainoue ia?aeaco
ai?ao (aai iaia?aae ciathoue, ui ?o ciaiaycaiiy ca aeiaiai?ii aoaeooue aeeiiaii iioith noi?iiith),
oi a aeiaiai?i iiaeia ia?aaeaa/eoe oiiao, o aiaeiiaiaeiinoi aei yei? noi?iie aiae?aco ae iiia?aaeiuei
aeaaeooue nai? oiiae ia ciiio ai?aeieea. O oeueiio aeiaaeeo caiaee ia ia?aeac ai?ao o e?aaeeoi?a
eiaeiiai ?aco i?ineoe iaiao iaiaoiaeiinoi.
a) Iinooiea aeiiae.

Iinooiea aeiiae icia/ao, ui iiia?aaeiie e?aaeeoi?, yeiio ai?aeiee aeiai aeeiiaoe naio
ciaiaycaiiy, aeaoaao, a ia eiai iinoea canooiao iiaa iniaa.

Caiaea ai?aeieea ia iinooieo aeiiae ca caeiiiaeaanoaii ia aeiaaaooueny, aii eeoa iao
aooe iiiioi?iiaaiee uiaei oaeoo iinooiee i uiaei oiai, ui nai? ciaiaycaiiy aii iiaeiai
aeeiiaoe ia?aae iiaith iniaith. I?ioa, iaiaoiaeii aiaecia/eoe, ui ca oaiaeith noi?ii (cie?aia, o
aeiaiai?i) noi?iie iiaeooue anoaiiaeoe, ui e ia?aaea/a i?aa ca aeiaiai?ii iiaea caeienithaaoeny
eeoa ca caiaeith i?ioeeaaeii? noi?iie.
a) Iinooiea aeiaiai?ia (oeaniy).

Iniaeeainoth oeani? o oa, ui iaeia noi?iia aeaoaao c aeiaiai?o, a ia ?? iinoea i?eoiaeeoue iioa
noi?iia. Ic ciiiith iniae a aeiaiai?i iinooiathoueny ia eeoa i?aaa, aea e iaiaycee. Caiaene
aeieeaao, ui a oeueiio aeiaaeeo iiaeia canoiniaoaaoe i?aaeea, yei noinothoueny i ia?aeaco ai?ao,
i iinooiee aeiiae. Oaeei /eiii, ia?oia?,, ui aa?a o/anoue o aeainoi?iiiueiio aeiaiai?i, iiaea,
yeui ia oea o caiaea eiai eiio?aaaioa, iinooieoeny aeiaiai?ii o?aoie iniai. C iiiaioo iaea?aeaiiy
caiaee (a yeui caiaeo aoei iaea?aeaii ?aiioa, oi c iiiaioo iiaiaeiieaiiy i?i iinooieo) o?aoy
iniaa noao iinioi onio i?aa i iaiayceia noi?iie, ui iinooieeany.
Iinooiea aeiaiai?o ioi?iethooueny ie?aiith oaiaeith.

Ii?yaeie ?ici?aaiiy aeiaiai?o.

Iiaea noaoeny i oae, ui c oeo /e iioeo i?e/ei aeiaiai?, oeeaaeaiee iiae noi?iiaie, iiaea
ao?aoeoe aeey ieo iioa?an, i noi?iie i?eeaeooue aei aeniiaeo i?i iaiaoiaeiinoue ?ici?aaiiy ?aiioa
aeinyaiooi? oaiaee.

Noi?iie iiaeooue aeinyaoe oaiaee i?i i?eieiaiiy aeiaiai?o ye c iiiaioo eiai oeeaaeaiiy,
oae i ia iaeaooiie /an. O oeueiio aeiaaeeo aeiaiai? ia aoaea noai?thaaoe aeey noi?ii i?aa i iaiayceia
i aaaaeaooueny ia/a ia oeeaaeaiei naio/anii.

Oaiaea i?i ?ici?aaiiy aeiaiai?o ioi?ieyooueny i?ioieieii aai iioei aeainoi?iiiii
aeieoiaioii. A oaiaei iaiaoiaeii aeacaoe:
a) yeee aeiaiai? ?ic?eaaooueny;

a) c yeiai iiiaioo aeiaiai? aaaaeaooueny ?ici?aaiei;
a) i?e/eio, ca yeith ?ic?eaaooueny aeiaiai?;

a) niiniae a?aaoethaaiiy iiae noi?iiaie i?iaeai, yei aeieeee, aai caeii/aiiy ciaiaycaiue,
yei aaea aeieeee iiae noi?iiaie (iai?eeeaae, no?ieia oa ii?yaeeo iiaa?iaiiy aaainiaeo ieaoaaeia
ca aeiaiai?ii, yeui oaei aoee c?iaeaii);

ae) ioieo i?i oa, ui c iiiaioo iaaoooy oaiaeith /eiiinoi noi?iie ao?a/athoue i?aaa aeiiae
ca oeeaaeaiei ?aiioa aeiaiai?ii.

Aeineoue /anoi aeiaiai? ?ic?eaaooueny ia oie iiaenoaai, ui iaeia noi?iia ia aeeiioo nai?
ciaiaycaiiy. Cae/aeii ia i?aeoeoei oea aeaeyaeao ianooiiei /eiii: iaeia noi?iia iiaiaeiieyo
iioo noi?iio, ui c oeo /e iioeo iiaenoaa aiia ia iiaea aeeiioaaoe acyoi ia naaa ciaiaycaiiy.
O oaeiio aeiaaeeo iaiaoiaeii ea?oaaoeny ii?iaie caeiiiaeaanoaa ia i?i ?ici?aaiiy aeiaiai?o,
a i?i aiaeiiao noi?ii aeeiioaaoe nai? ciaiaycaiiy, ca ui ia?aaeaa/aia oeeaieueii-i?aaiaa aiaeiiai-
aeaeueiinoue (aeaoaeueiioa aeea. ?icaeie ).

Eiia?oeieiee aeiaiai?

Aeaaa 6

NIINIAE CAAACIA*AIIss AEEIIAIIss CIAIAssCAIUe

Ia aeaiiio aoaii ?icaeyaeo ieoaiiy i?i acaoiiaiaeiineie noi?ii aeiaiai?o iaiaoiaeii aaanoe
iiiyooy i .

E?aaeeoi? – noi?iia ca aeiaiai?ii, yea iao i?aai aeiiae aeeiiaiiy ciaiaycaiue iioith
noi?iiith ca aeiaiai?ii (ai?aeieeii).

Ai?aeiee – noi?iia ca aeiaiai?ii, yea ciaiaycaia aeeiiaoe ciaiaycaiiy ia aeiiao iioi?
noi?iie ca aeiaiai?ii (e?aaeeoi?a).

Caaacia/aiiyi aeeiiaiiy ciaiaycaiue ca aeiaiai?ii aenooiao aeiaeaoeiaee caoiae iaeiiaiai
aieeao ia ai?aeieea, ui cioooo eiai aei aeeiiaiiy naiai ciaiaycaiiy i caaeiaieueiyo iioa?ane
e?aaeeoi?a o aeiaaeeo iaaeeiiaiiy aai iaiaeaaeiiai aeeiiaiiy ai?aeieeii acyoeo ia naaa ca
aeiaiai?ii ciaiaycaiue.

*eiia caeiiiaeaanoai ciao /ioe?e iniiaii niiniae aeeiiaiiy ciaiaycaiiy: iaonoieea,
ii?oea (aa?aioiy), canoaao, caaaeaoie. E?ii oiai, ca ei?aeiiii oe?iei canoiniaoooueny oaeee
niinia caaacia/aiiy ciaiaycaiiy, ye ?aca?aoaaiiy i?aaa aeaniinoi. Caaacia/othoue aeeiiaiiy
ciaiaycaiiy e oaei i?aaiai oi?ie, ye ae?aaeeoea, no?aooaaiiy oaiaee, aaethoii canoa?aaeaiiy,
yei, iacaaaeath/e ia oa, ui i?aai ia aiaeiineoue ?o aei niiniaia caaacia/aiiy ciaiaycaiue, ana ae
oaee iathoue aaeeea cia/aiiy aeey aeeiiaiiy aeiaiai?o.

Iaonoieea.

Oea anoaiiaeaia caeiiii aai aeiaiai?ii a?ioiaa noia, yeo ai?aeiee ciaiaycaiee nieaoeoe
iioie noi?iii o aeiiaaeeo iaaeeiiaiiy aai iaiaeaaeiiai aeeiiaiiy iath ciaiaycaiiy, cie?aia,
o aeiaaeeo i?ino?i/aiiy aeeiiaiiy oiia aeiaiai?o.

sse ?iciiaeae iaonoieee aenooiathoue oo?aoe oa iaiy. Oo?aoii iaceaaooueny aecia/aia
aeiaiai?ii a?ioiaa noia, yeo ai?aeiee ciaiaycoooueny nieaoeoe e?aaeeoi?o o iaia?aae aecia/aiiio
?icii?i aai a i?ioeaioiiio aiaeiioaiii aei noie ai?ao aai anueiai i?aaeiaoo aeeiiaiiy (noie
aeiaiai?o).

Iaiath iaceaaooueny aecia/aia aeiaiai?ii a?ioiaa noia, yeo ai?aeiee ciaiaycoooueny
nieaoeoe e?aaeeoi?o o i?ioeaioiiio aiaeiioaiii aei noie i?ino?i/aiiai ieaoaaeo ca eiaeiee
aeaiue aai iioee ia?iiae i?ino?i/aiiy.

Iaonoieea aoaao /ioe?ueio aeaeia. Caeiiii aai aeiaiai?ii iiaeooue aooe ia?aaeaa/aii ianooiii
aeaee iaonoieee:
1). Caeieiaa iaonoieea.

Caiaeii c i?aaeeaie, yeui aeiaiai?ii ia ia?aaeaa/aii iioiai, oi caeoee noyaothoueny a
/anoeii, ia iie?eoie iaonoieeith:
aiaeoeiaeoaaiiy = iaonoieea + (caeoee – iaonoieea).

2). Aeeeth/ia iaonoieea – eiee iiaea aooe noyaiooa oieueee iaonoieea, aea ia caeoee.
Aeeeth/io iaonoieeo iiaeia aiaeianoe aei eaoaai?i? eiee
noi?iie iaia?aae aeiiiaeythoueny i?i ?icii? aiaeoeiaeoaaiiy ca iaaeeiiaiiy aai iaiaeaaeia
aeeiiaiiy ciaiaycaiiy. O oeueiio aeiaaeeo e?aaeeoi? iiaeiai aeiaanoe eeoa oaeo ii?ooaiiy
ciaiaycaiiy c aieo ai?aeieea. Aiaenooiy iio?aaa aeiaiaeeoe oaeo ianoaiiy caeoeia oa ?o ?icii?ia:
aiaeoeiaeoaaiiy = iaonoieea.

3). Oo?aoia iaonoieea – eiee noyaoooueny iaonoieea i caeoee iiiaae iaonoieeo:
aiaeoeiaeoaaiiy = iaonoieea + caeoee.

4). Aeueoa?iaoeaia iaonoieea – eiee ca aeai?ii e?aaeeoi?a iiaeooue aooe noyaiooi aai
iaonoieea, aai caeoee:

aiaeoeiaeoaaiiy = iaonoieea aai caeoee.

Iaec?o/iioeie c oi/ee ci?o caoenoo i?aa iiaei?eoioeia o oo?aoia oa aeeeth/ia iaonoieee.
Aa?oi caoaaaeeoe, ui i?e ?icaeyaei nii?o a?aio?aaeiee noae o aiaeiiaiaeiinoi aei /eiiiai
caeiiiaeaanoaa Oe?a?ie iao i?aai ciaioeoe ?icii? iaonoieee, ui noyaoooueny, yeui aiia
caiaaeoi aaeeea ii?iaiyii ci caeoeaie e?aaeeoi?a. I?ioa, oea o i?aaii noaeo, a ia eiai iaiayceii,
i, e?ii oiai, noae iiaea eeoa ciaioeoe ?icii? iaonoieee, aea aii ia iiaea caieueieoe aeiio
noi?iio aiae iaonoieee iiaiinoth.

I?eeeaae. Aei A?aio?aaeiiai noaeo caa?ioany iieoiaoeue c iiciaii i?i noyaiaiiy c iinoa-
/aeueieea – iaoaeo?aieiiai caaiaeo – iaonoieee ca ii?ooaiiy aeiaiai?ieo ciaiaycaiue ia iinoaaeo
iaoaeii?iaeoeoei?.

Eiia?oeieiee aeiaiai?

Caia?a/oth/e i?ioe iiciao, iinoa/aeueiee iineeaany ia iacaaacia/aiiy ne?iaeiith. O
noaeiaiio caniaeaiii aeiaiaee aiaeiiaiaea/a aoee iiaeoaa?aeaeaii aiaeiiaiaeieie aeieoiaioaie, o cayceo
c /ei A?aio?aaeiee noae aeciaa ca iiaeeeaa o ii?yaeeo aeiyoeo cieceoe ?icii? iaonoieee, ui
noyaoaaeany.

Nieaoa iaonoieee ia caieueiyo ai?aeieea aiae iaiayceo aeeiiaoe ciaiaycaiiy a iaoo?i.
E?ii oiai, i?e ?icaeyaei iiciao i?i noyaiaiiy iaonoieee, ia?aaeaa/aiith oaiaeith noi?ii,
A?aio?aaeiee noae ia?aai?yo oiiae aeiaiai?o a oeie /anoeii.

I?eeeaae. Ia ?icaeyae A?aio?aaeiiai noaeo iaaeieoia iicia eiiia?aoeao i?i naieoei?
aei ae?iaie/iai iaoaeiaiiy ca iaaeeiiaiiy aeiaiai?o iiae?yaeo.

I?ioa, eiiia?aoea, ui aenooiaa ca aeiaiai?ii iiae?yaeo caiiaieeii, ia aeeiiaa nai?o
ciaiaycaiue ia?aae iaoaeiaiiyi (iiae?yae/eeii) c ia?aaea/i iaoa?iaeia aeey aeeiiaiiy ?iaio, ui e
noaei iiaenoaaith iaoaeiaiith aeey caa?iaiiy aei A?aio?aaeiiai noaeo ic cono?i/iei iiciaii.

Eiiia?aoea, caia?a/oth/e i?ioe aeiia a /anoeii iaonoieee ca i?ino?i/aiiy o iaaeaiii
iaoa?iaeia, iiynithaaa oea oei, ui aeiaiai?ii ia ia?aaeaa/aii no?ie, i?ioyaii yeiai aii iaa
ia?aaeaoe iaiaoiaeii iaoa?iaee aeey ii/aoeo ?iaio. Ia?aai?ea oaenoo aeiaiai?o iieacaea, ui
aeienii noi?iie ia ia?aaeaa/eee a aeiaiai?i no?iee ia?aaea/i iaoa?iaeia, a eeoa aecia/eee ?o
eieueeinoue. Aeieace eiiia?aoeao aoee aeciaii iaa?oioiaaieie e iiciaii aeiiae i?i noyaiaiiy
iaonoieee aoee A?aio?aaeiei noaeii aiaeoeeaii.

Oaiaeo i?i iaonoieeo iao aooe neeaaeaii o ienueiiaie oi?ii. Iaaeio?eiaiiy ienueiiai?
oi?ie iaonoieee oyaia ca niaith iaaeieniinoue oaiaee i?i iaonoieeo. Cae/aeii oaea oaiaea
oi?ioethooueny ye ioieo aeiaiai?o i aoiaeeoue aei ?icaeieo aeiaiai?o .

Ii?oea (aa?aioiy).

Aeiaiai? ii?oee (aa?aioi?) oeeaaeaooueny iiae e?aaeeoi?ii i ii?o/ieeii. O neeo ii?oee
(aa?aioi?) ii?o/iee aa?a ia naaa ciaiaycaiiy ia?aae e?aaeeoi?ii iioi? iniae (ai?aeieea)
aiaeiiaiaeaoe ca aeeiiaiiy ciaiaycaiue oeio? iniae iiaiinoth aai /anoeiai. I?e ianoa/i eiooia o
ai?aeieea (i ia eeoa a?ioiaeo eiooia, aea e iioiai iaeia) ii?o/iee (aa?aio) iana noaneaeia?io
(aeiaeaoeiao) aiaeiiaiaeaeueiinoue ca eiai ciaiaycaiiyie ia?aae e?aaeeoi?ii, yeui caeiiiaeaanoaii
aai aeiaiai?ii ia ia?aaeaa/aii nieiaea?io aiaeiiaiaeaeueiinoue ii?o/ieea i ai?aeieea (nieiaea?ia
ii?oea).

Ii?o/ieeii (aa?aioii) iiaeooue aenooiaoe ia eeoa eiia?oeieii i?aaiicaoei?, aea e iaeiia?-
oeieii, iai?eeeaae, a?iiaaenueei /e ?aeiaieii i?aaiicaoei?, niiaeea/i eiiia?aoeae, aeaaiaeieii oiiaee
oiui. Ii?o/ieeii (aa?aioii) iiaeooue aenooiaoe i oiiainiaaii aeanieeii onoaiiae, a oiio
/enei e athaeaeaoii, aea a oaeiio aeiaaeeo onoaiiaa, yea iao iaeii ia i?aai iia?aoeaiiai
oi?aaeiiiy, aiaeiiaiaeao ca nai?ie ciaiaycaiiyie eeoa oeie a?ioiaeie eiooaie, ui ciaoiaeyoueny
o ?? ?icii?yaeaeaiii, a i?e ianoa/i eiooia aiaeiiaiaeaeueiinoue ca ciaiaycaiiyie onoaiiae iana
aeaniee aiaeiiaiaeiiai iaeia.

I?eioneaooueny iiiaeeiiinoue ii?o/ieeia (aa?aioia), yei ia?aae e?aaeeoi?ii aiaeiiaiaeathoue
nieiaea?ia, yeui iioa ia ia?aaeaa/aii aeiaiai?ii ii?oee (aa?aioi?). Ii?o/iee (aa?aio) aiaeiiaiaeao
ca ai?aeieea ca aniia ciaiaycaiiyie, a oiio /enei ca nieaoo iaonoieee i i?ioeaioia, aiaeoei-
aeoaaiiy caeoeia i o.i., yeui aeiaiai?ii ii?oee ia ia?aaeaa/aii iioiai.

O aeiaaeeo, yeui ii?o/iee (aa?aio) aeeiiaa ca ai?aeieea ciaiaycaiiy, aei iueiai ia?aoiaeyoue
oni i?aaa e?aaeeoi?a. Ii?o/iee (aa?aio) iao i?aai cai?ioiuei? aeiiae aei ai?aeieea a ?icii?i
niea/aii? ca iueiai noie.

E?aaeeoi?, ii aiaeiioaiith aei yeiai ii?o/iee (aa?aio) aeeiiaa ciaiaycaiiy ca ai?aeieea,
ciaiaycaiee a?o/eoe ii?o/ieeo (aa?aioo) aeieoiaioe, ui iinaiae/othoue aeiiao aei ai?aeieea, i
ia?aaeaoe i?aaa, ui caaacia/othoue oeth aeiiao.

Ii?oea (aa?aioiy) i?eieiyooueny, yeui ai?aeieeii aeeiiaii caaacia/aia ii?oeith ciai-
aycaiiy. Ii?oea (aa?aioiy) i?eieiyooueny oaeiae, yeui e?aaeeoi? ia i?aaeyaeoue iiciao aei
ii?o/ieea (aa?aioa) i?ioyaii ?ieo aiae aeiy ianoaiiy no?ieo ciaiaycaiiy. sseui no?ie aeeiiaiiy
ciaiaycaiiy ia aeacaii aai aecia/aooueny iiiaioii caieoo, ii?oea (aa?aioiy) i?eieiyooueny
ii caeii/aiii aeaio ?ieia aiae aeiy oeeaaeaiiy aeiaiai?o ii?oee (aa?aioi?).

Ii?oea iiaea ioi?ieyoeny oeyoii neeaaeaiiy iaeiiai oaeeiiai aeieoiaioo iiae iacaith
. Aea ia i?aeoeoei, i iniaeeai a aaieianueeie aeiyeueiinoi, aa?aioiy o?aaeeoeieii
ioi?ieyooueny o oi?ii oae caaiiai aa?aioieiiai eenoa.

Aa?aioieii eenoe iiaeooue aeei?enoiaoaaoeny i iathoue naio th?eaee/ia cia/aiiy ca oiiae,
ui iai?aaeaiee ii?o/ieeii (aa?aioii) e?aaeeoi?o aa?aioieiee eeno aoaea i?eeiyoi e?aaeeoi?ii
i inoaiiie o ienueiiaie oi?ii (eenoii, oaeaa?aiith, oaeaoaeiii, oaeaoiiia?aiith i o.i.) iiaiaei-
ieoue ii?o/ieeiai (aa?aioo) i?i i?eeiyooy aa?aioieiiai eenoa.

O aeiaaeeo, eiee e?aaeeoi? ia iiaiaeiieyo ii?o/ieeiai (aa?aioo) i?i i?eeiyooy aa?aioieiiai
eenoa, A?aio?aaeiee noae aoaea aeoiaeeoe c oaenoo aeiaiai?o, ca yeei aeaeaooueny ii?oea (aa?aioiy).

Eiia?oeieiee aeiaiai?

sseui a aeiaiai?i iiae e?aaeeoi?ii i ai?aeieeii o iineeaiiy ia oeae aa?aioieiee eeno, oi
aaaaeaooueny, ui iiae ii?o/ieeii (aa?aioii) i e?aaeeoi?ii anoaiiaeaii aiaeiiaiaeii aeiaiai?ii

aiaeiineie ii?oee (aa?aioi?). Ca aiaenooiinoi a aeiaiai?i iineeaiiy ia aa?aioieiee eeno iiaenoaae,
ui canaiae/othoue oeeaaeaiiy iiae e?aaeeoi?ii i ii?o/ieeii (aa?aioii) aeiaiai?ieo aiaeiinei,
aiaenooii, i aeiaiai? ii?oee (aa?aioi?) iiae noi?iiaie aaaaeaooueny iaoeeaaeaiei.

Ii?oea (aa?aioiy) iiaea ioi?iethaaoeny /a?ac aiaeiiaiaeio aiaeiioeo (aai caien) ii?o/ieea
(aa?aioa) ia aeiaiai?i iiae e?aaeeoi?ii i ai?aeieeii, ciaiaycaiiy ca yeei caaacia/othoueny
ii?o/ieeii.

Aeiaiai? ii?oee (aa?aioi?) iiaeiai iinoeoe a niai aiaeiiinoi i?i oa, yeee eiie?aoii aeiaiai?,
ia yeee oa?iii iao ciaiaycaiiy i ia yeo noio aa?aiooooueny. O i?ioeeaaeiiio aeiaaeeo aeiaiai?
ii?oee iiaea aooe aeciaiee iaaeieniei.

Canoaaa.

O neeo canoaae e?aaeeoi? (canoaaiaea?aeaoaeue) iao i?aai o aeiaaeeo iaaeeiiaiiy caaacia/a-
iiai canoaaith ciaiaycaiiy io?eiaoe caaeiaieaiiy c aa?oinoi canoaaeaiiai iaeia ia?aaaaeii
ia?aae iioeie e?aaeeoi?aie.

Aiaeiineie canoaae ?aaeaiaioothoueny /eiiei caeiiiaeaanoaii Oe?a?ie.
Caaeiaieaiiy aeiiae e?aaeeoi?a c aa?oinoi canoaaeaiiai iaeia aiaeaoaaooueny, yeui iioa
ia anoaiiaeaii caeiiiaeaa/eie aeoaie, ca ?ioaiiyi A?aio?aaeiiai aai o?aoaenueeiai noaeo.

I?aaeiaoii canoaae iiaeooue aooe ?a/i, oeiiii iaia?e iii?eoinoaa, iaeiiai i?aaa, a oaeiae
aoaeue-yea iaeii, yea o aiaeiiaiaeiinoi aei caeiiiaeaanoaa Oe?a?ie iiaea aooe aiae/oaeaia canoaaieeii.

Aeiaiai?ii aai caeiiiaeaanoaii iiaea ia?aaeaa/aoeny caeeoaiiy canoaaeaiiai iaeia o
aeaniinoi canoaaieea aai canoaaeaia iaeii iiaea aooe ia?aaeaia canoaaiaea?aeaoaeth (canoaaa).

Iaeii, ui ia?aaoaao o caaaeueiie niieueiie aeaniinoi, iiaea aooe ia?aaeaii o canoaao eeoa
ca caiaeith iioeo aeanieeia.

Aeiaiai? i?i canoaao iiaea aooe oeeaaeaiee o ienueiiaie oi?ii. A aeiaiai?i i?i canoaao
iathoue aooe oiiae, ui ia?aaeaa/athoue aeae canoaae, nooue caaacia/aii? canoaaith aeiiae, ?? ?icii?,
no?iee aeeiiaiiy ciaiaycaiiy, neeaae i aa?oinoue canoaaeaiiai iaeia, a oaeiae aoaeue-yei iioi
oiiae, aiaeiinii yeeo ca cayaith iaeiio? ic noi?ii iao aooe aeinyaiooi oaiaee.

Oiiaa i?i canoaao iiaea aooe aeeth/aiith aei aeiaiai?o, ca yeei aeieeao caaacia/aia
canoaaith ciaiaycaiiy, aea iiaea aooe ioi?ieaia e o aeaeyaei ie?aiiai aeieoiaioo. Canoaaieee
– noaoeoe iiaei?eoiieoeueei? aeiyeueiinoi – ciaiaycaii:
– aanoe eieao caienia canoaa;

– ia iiciioa 10 aeiia iiney aeieeiaiiy canoaae aiineoe aei eieae caien, yeee iinoeoue aeaii
i?i aeae i i?aaeiao canoaae, a oaeiae ianya caaacia/aiiai canoaaith ciaiaycaiiy;
– iaaeaaaoe eieao aeey iciaeiieaiiy aoaeue-yeie caoeieaaeaiie iniai.

Canoaaiee caa?iaao i?aai ?icii?yaeaeaiiy canoaaeaiei iaeiii, yeui iioa ia ia?aaeaa/aii
caeiiii aai aeiaiai?ii. I?e oeueiio ia?aoiae i?aaa ia canoaaeaia iaeii canoaaiaea?aeaoaeth
iiaeeeaee eeoa o aeiaaeeo iaaeeiiaiiy ai?aeieeii caaacia/aiiai canoaaith ciaiaycaiiy.

sseui i?aaeiaoii canoaae o canoaaeaia iaeii, yea aaea o caaacia/aiiyi aoaeue-yeiai iioiai
ciaiaycaiiy, iiia?aaeio i?aai canoaaiaea?aeaoaey caa?iaao neeo. Aeiiae ianooiiiai canoaaiaea?-
aeaoaey caaeiaieueiythoueny c aa?oinoi i?aaeiaoo canoaae iiney caaeiaieaiiy aeiia iiia?aaeiueiai
canoaaiaea?aeaoaey.

Ca ?aooiie canoaaeaiiai iaeia canoaaiaea?aeaoaeue iao i?aai caaeiaieueieoe nai? aeiiae a
iiaiiio ianyci, ui aecia/aooueny ia iiiaio oaeoe/iiai caaeiaieaiiy, aeeth/ath/e i?ioeaioe,
caeoee, caaaeaii i?ino?i/aiiyi aeeiiaiiy, a o aeiaaeeao, ia?aaeaa/aieo caeiiii aai aeiaiai?ii –
iaonoieeo.

Caa?iaiiy noyaiaiiy ia canoaaeaia iaeii caeienithooueny ca ?ioaiiyi noaeo, A?aio?aaeiiai
noaeo aai o?aoaenueeiai noaeo, yeui iioa ia ia?aaeaa/aii caeiiii.

?aaeicaoeiy canoaaeaiiai iaeia, ia yea caa?oaooueny noyaiaiiy, caeienithooueny o aiaeiiaiaeiinoi
aei oeeaieueiiai i?ioeanoaeueiiai caeiiiaeaanoaa Oe?a?ie, yeui iioa ia ia?aaeaa/aii aeiaiai?ii.

Caaaeaoie.

Caaaeaoeii aeciaooueny a?ioiaa noia, ui aeaeaooueny iaeiioth ic noi?ii ca aeiaiai?ii a ?aooiie
iaeaaeieo c ia? ca aeiaiai?ii ieaoaaeia iioie noi?iii, ia aeieac oeeaaeaiiy aeiaiai?o i ia
caaacia/aiiy eiai aeeiiaiiy.

Caaacia/oaaeueia ?ena caaaeaoeo i?iyaeyooueny o aeaio iiiaioao:

a) /anoeio iaeaaeieo eiio?aaaioo ca aeiaiai?ii ieaoaaeia iaeia noi?iia niea/oo iaia?aae,
i a oeueiio nienei aeey iioi? noi?iie caaacia/oooueny ?aaeueia aeeiiaiiy ciaiaycaiiy;

a) yeui ca iaaeeiiaiiy aeiaiai?o aiaeiiaiaeaeueia noi?iia, ui aeaea caaaeaoie, aii caeeoaooueny
a iioi? noi?iie, a yeui ca iaaeeiiaiiy aeacaiiai ciaiaycaiiy aiaeiiaiaeaeueia noi?iia, ui
io?eiaea caaaeaoie, aiia ciaiaycaia nieaoeoe iioie noi?iii iiaeaieio noio caaaeaoea.

Eiia?oeieiee aeiaiai?

Caaaeaoie aeoaea aaaaoi iao niieueiiai c aaainii aai ia?aaeiieaoith. I?ioa, ii aaain, ii
ia?aaeiieaoa ia a?athoue caaacia/oaaeueii? ooieoei?. Inoaiii niea/othoueny eeoa a ?aooiie iaeaaeieo
ca aeiaiai?ii ieaoaaeia i ia aieueoa.

O ainiiaea?nueeiio iaiao iieiee iinoao ieoaiiy, ye aiae?icieoe, /e o iaia?aae c?iaeaiee
ieaoiae aaainii /e caaaeaoeii. Ooo ae?ioaeueia cia/aiiy iao caaaeea i?i oea a aeiaiai?i. sseui a
aeiaiai?i i?yii ia aeacaii, ui aianaia noia o caaaeaoeii, oi ?? neiae aaaaeaoe aaainiaei ieaoaaeai.

?aca?aoaaiiy i?aaa aeaniinoi.

Aeaiee niinia caaacia/aiiy ciaiaycaiiy ia nueiaiaeii aeei?enoiaoooueny ae?ae ?iaeei, oi/a
a iiaeia?iaeiie eiia?oeieiie i?aeoeoei aii aeia?a aiaeiiee, a a caeiiiaeaanoai aaaaoueio e?a?i,
oaeeo, ye Aiaeiy, Ioaeiy, O?aioeiy, ssiiiiy, eaoeiiaia?eeainueei e?a?ie, oeae niinia i?eioneaooueny
i aeei?enoiaoooueny ye caaacia/aiiy ieaoaaeo.

Nooue ?aca?aoaaiiy i?aaa aeaniinoi iieyaao a oiio, ui i?e i?iaeaaeo oiaa?o a e?aaeeo,
eiee iinoaaea i ia?aaea/a oiaa?o iieoioeaai caeienithooueny ?aiioa eiai iieaoe, a aeiaiai?i ?iaeoueny
canoa?aaeaiiy i?i caa?aaeaiiy ca i?iaeaaoeai i?aaa aeaniinoi ia i?iaeaiee oiaa? aei oiai /ano,
aeiee iieoiaoeue ia caeienieoue ii iueiio inoaiiie ieaoiae.

Oaeei /eiii, iieoiaoeue, io?eioth/e oiaa?, aeao niai caio ooiio, ui oea ia eiai iaeii, aii
ia iiaea iei aieueii ?icii?yaeaeaoeny aei oiai /ano, aeiee ia nieaoeoue eiai aa?oinoue. Aeaiee aeae
caaacia/aiiy ciaiaycaiue i?eaaaeeaee ua oei, ui i?iaeaaaoeue iiaea aeiaaaoe iiaa?iaiiy
eiio oiaa?o o aeiaaeeo iaieaoini?iiiaeiinoi i aaie?oonoaa iieoioey, a oaeiae oeooe aeanieea
ia naie oiaa?, ye oaeee, ui ciaoiaeeoueny o iacaeiiiiio aieiaeiiii.

O cayceo c oei, ui oeae niinia caaacia/aiiy ciaiaycaiue o aeey ian aiaeiinii iiaei, ieae/a
iaaiaeeoueny c?acie oi?ioethaaiiy oiiae i?i ?aca?aoaaiiy i?aaa aeaniinoi o aeiaiai?i eoiiaei-
i?iaeaaeo a e?aaeeo.

Noaooy :

a) A yeinoi caaacia/aiiy ieaoaaeo IIEOIOess ca oiaa?, ui eoioooueny iei, noi?iie
aecia/athoue, ui i?aai aeaniinoi IIEOIOess ia oiaa?, ui iei eoioooueny, cyaeyooueny a inoaiiueiai
iaaaeii iiney caeieniaiiy iei inoaiiueiai ieaoaaeo I?IAeAAOeAAI.
Aei iiiaioo iiaii? iieaoe i?aai aeaniinoi ia oiaa? iaeaaeeoue I?IAeAAOeAAI.
IIEOIAOeUe ia iao i?aaa aei iiaii? iieaoe oiaa?o ?icii?yaeaeaoeny iei ia aeaniee
?icnoae.

a) Noi?iie aecia/athoue, ui oiaa? ciaoiaeeoueny o IIEOIOess o aieiaeiiii i?aaiii?ii eeoa
o no?ie, ia?aaeaa/aiee aeaiei aeiaiai?ii aeey iieaoe.

Aeiaiai?ii ie?aii iao ia?aaeaa/aoeny no?ie, i?ioyaii yeiai IIEOIAOeUe ciaiaycaiee
iieaoeoe oiaa?, a oaeiae i?aai IIEOIOess aeino?ieiai iieaoeoe oiaa?.

a) ?ecee aeiaaeeiai? caaeaaei i aeiaaeeiaiai inoaaiiy oiaa?o ia?aoiaeeoue aei IIEOIOess

iaeii/anii c oaeoe/iei iaea?aeaiiyi oiaa?o o aieiaeiiiy.

a) O aeiaaeeo i?ino?i/aiiy ieaoaaeo IIEOIAOeUe a no?ie… ciaiaycaiee ca naie ?aooiie
iiaa?iooe oiaa? I?IAeAAOeAAI, a oaeiae iieaoeoe ei?enooaaiiy iei, aeoiaey/e c… ?i/ieo.

Ae?aaeeoea.

Ae?aaeeoea o iaeiioth c oi?i aacaioiaeiaeo ?ic?aooieia, ca yei? aaie, ui aiaee?eaao ae?aaeeoea
(aaie-aiioaio), ciaiaycoooueny ca aei?o/aiiyi ieaoieea (ye i?aaeei, iieoioey) caeienieoe ieaoiae
io?eioaa/aai eiooia (i?iaeaaoeaai) aai oiiaiiaaaeoo iioee aaie caeienieoe oaeee ieaoiae ca

aeeiiaiiy anio oiia, ia?aaeaa/aieo a ae?aaeeoeai.

Oi?ioea ae?aaeeoeao – . Oiiaa?naeueiinoue eiai iieyaao o oiio, ui
iieaoa iieoioeai oaeoe/ii aaea aiaeaoaaooueny, a?ioi c eiai ?aooieo aaea eaeooue, aea ia ?ic?aooieiaee
?aooiie i?iaeaaoey aiie ua ia iaaeoiaeyoue. I?iaeaaoeaai aa?aiooooueny iaaaeia iieaoa aiaeaaioaaeaieo
oiaa?ia aai iaaeaieo iineoa, i aii cano?aoiaaiee aiae iaieaoini?iiiaeiinoi aai aiaeiiae aiae iieaoe
oiaa?ia (iineoa) iieoioeai; iieoioeaai, ui niea/aii iei a?ioi ia i?iiaaeooue iaaiaeiii aea i iaaeieaeooue
o ?icii?yaeaeaiiy eiio?aaaioa eeoa iiney oiai, ye aii aeeiiao nai? ciaiaycaiiy.

Ae?aaeeoea – oea oaeoe/ii aacia/ia ia?aaeiieaoa. Oaeei /eiii, ae?aaeeoea o naiai ?iaeo
eiii?iiinii o aeiaaeeo, eiee i?iaeaaaoeue oiaa?o noiiiaaooueny o ieaoini?iiiaeiinoi iieoioey i
aeiaaao ia?aaeiieaoe, a iieoiaoeue noiiiaaooueny o iaaeieiinoi i?iaeaaoey i ia iaaaaeoooueny
?eceeoaaoe nai?ie a?ioie i ?iaeoe ia?aaeiieaoo,

No?ie aei? i ii?yaeie ?ic?aooieia ca ae?aaeeoeaii aecia/aooueny o aeiaiai?i iiae ieaoieeii
i io?eioaa/ai a?ioiaeo eiooia, o yeiio iaiaoiaeii cacia/eoe: iacao aaieo-aiioaioa; aeae
ae?aaeeoeao i niinia eiai aeeiiaiiy; niinia iiaiaeiieaiiy io?eioaa/a eiooia i?i aiaee?eooy
ae?aaeeoeao; iiaiee ia?aeie i oi/io oa?aeoa?enoeeo aeieoiaioia, yei iaaeathoueny io?eioaa/ai
eiooia (i?iaeaaoeai) aeey io?eiaiiy oeeo eiooia ca ae?aaeeoeaii; no?iee iaaeaiiy aeieoiaioia
iiney aiaeaaioaaeaiiy oiaa?o; aeiiaa c ?o ioi?ieaiiy; iioi iaiaoiaeii aeieoiaioe oa aeiiae.

Eiia?oeieiee aeiaiai?

Aaethoia canoa?aaeaiiy.

I?e iinoaaoei c ianooiiith iieaoith c?inoath/a iioeyoeiy c /anii iiaea ciaoeiieoe eoiiaaeueio
oeiio, ia?aaeaa/aio i?e oeeaaeaiii aeiaiai?o. A oeueiio aeiaaeeo iiaeia canoinoaaoe niinia
ei?eaoaaiiy oeiie c aeiaiai?ii, yeee oe?iei aeei?enoiaoooueny o ciaiioiio oi?aiaaeueieo
iia?aoeiyo i iaceaaooueny aaethoiei canoa?aaeaiiyi.

I?e canoinoaaiii aeaiiai niiniao a oiiai i?i oeiio aenooiathoue aeai aaethoe: ea?aiaaiaoeue i
aaethoa ocaiaeaeaii? e?a?ie.

Ea?aiaaiaoeue noaaeoueny o caeaaeiinoue aiae iioi? noieei? aaethoe, i i?e oeueiio ea?aiaaioeaaa
oeiia eiioeaaeo ?ic?aooieia aecia/aooueny o aiaeiiaiaeiinoi aei ciii eo?no aaciai? aaethoe (iai?eeeaae,
aeiea?a) aei ea?aiaaioey.

sse ?iciiaeae aeuacacia/aiiai niiniao a aeiaiai?i iieiee iiaeia canoiniaoaaoe oae caaia
ioeueoeaaethoia canoa?aaeaiiy, o aiaeiiaiaeiinoi c yeei ia?a?aooiie noie ieaoaaeo o aeiaaeeo
ciiie eo?no ea?aiaaioey caeienithooueny a na?aaeiueiio ii aiaeiioaiith aei eieueeio iaia?aae
aecia/aieo aaetho.

No?aooaaiiy oaiae.

Ca aeiaiai?ii no?aooaaiiy no?aooaa/ (no?aoiaa eiiiaiiy) ciaiaycoooueny ca aecia/aio
ieaoo (no?aoiai ieaoaaei) i?e iaaeoiaeaeaiii cacia/aii? o aeiaiai?i iiaei? (no?aoiaiai aeiaaeeo)
aiaeoeiaeoaaoe no?aooaaeueieeiai io?eiaii caeoee iiaiinoth aai /anoeiai (nieaoeoe no?aoiaa
aiaeoeiaeoaaiiy a iaaeao coiiaeaii? ca aeiaiai?ii noie/no?aoiai? noie).

Iaiaoiaeii cacia/eoe, ui a oe?a?inueeiio aeieiaiio iaiao no?aooaaiiy eiia?oeieieo ?eceeia
iaaoaa? aaeeeiai cia/aiiy.

O aeiaaeeo iaaeeiiaiiy iaeiioth noi?iiith naiai ciaiaycaiiy iioa noi?iia, ui cano?aooaaea
oaiaeo, io?eioo coiiaeaia aeiaiai?ii no?aooaaiiy aiaeoeiaeoaaiiy. Eiie?aoii oiiae no?aooaaiiy
aecia/athoueny iiae no?aooaa/ai i no?aooaaeueieeii o aiaeiiaiaeiiio aeiaiai?i, o aiaeiiaiaeiinoi c
i?aaeeaie no?aooaaiiy, yei canoiniaothoueny aeaiith no?aoiaith eiiiaiioth.

__________________________________Aeaaa 7__________________________________

AIAeIIAIAeAEUeIINOUe CA II?OOAIIss OIIA AeIAIAI?O.
IIIssOOss CAEOEIA

Ciaiaycaiiy noi?ii c iaeaaeiiai aeeiiaiiy nai?o iaiayceia ca oeeaaeaiei aeiaiai?ii
aa?aioiaaii caoiaeaie iaeiiai? aiaeiiaiaeaeueiinoi, yei iieeaaeathoueny ia oo noi?iio, eio?a ia
aeeiioo nai?o ciaiaycaiue ia?aae iioith noi?iiith aai aeeiioo ?o iaiaeaaeiei /eiii.
Caeiiiaeaanoai iinoeoue o niai iniiaii i?aaeea ii aiaeiioaiith aei ii?ooieea aeiaiai?o:

I. O aeiaaeeo, yeui iaeia noi?iia ca aeiaiai?ii ia aeeiioo nai?o ciaiaycaiue, aeeiioo ?o
iaiaeaaeiei /eiii aai acaaaei aiaeiiaeyooueny aiae aeeiiaiiy oeeo ciaiaycaiue, oi aiia iiaeiia
aiaeoeiaeoaaoe iioie noi?iii caaaeaii oeei caeoee.

2. O aeiaaeeo iaaeeiiaiiy ciaiaycaiiy ia?aaeaoe iiaeeaiaeoaeueii iaaio ?i/ o aeaniinoue aai
ei?enooaaiiy iioie noi?iii, inoaiiy iao i?aai aeiaaaoe aiaeia?aiiy oeio? ?a/i o ai?aeieea i
ia?aaea/i ?? niai aai aeiaaaoe aiaeoeiaeoaaiiy caeoeia.

3. O aeiaaeeo, yeui ia aeeiioooueny iaiaycie aeeiiaoe iaaio ?iaioo, e?aaeeoi? iao i?aai
aei?o/eoe ?? aeeiiaiiy o?aoii iniaai i aeiaaaoe c ai?aeieea aiaeoeiaeoaaiiy caeoeia.

Iaiaoiaeii aiaecia/eoe: /eiiei caeiiiaeaanoaii anoaiiaeaii, ui iiaei?eoiaoeue iana aiaeiiai-
aeaeueiinoue ca iaaeeiiaiiy aeiaiai?o o aoaeue-yeiio aeiaaeeo, yeui ia aeiaaaea, ui i?e/eiith oeueiai
o oi?n-iaaei?ii ianoaaeie (noeoieia eeoi, aioiii aei? oiui).

Ia aaaaeathoueny oi?n-iaaei?ieie ianooiii ianoaaeie: aiaenooiinoue ia ?eieo iaiaoiaeieo
aeey aeeiiaiiy oiaa?ia, a oaeiae ii?ooaiiy ciaiaycaiue c aieo eiio?aaaioia ai?aeieea.

Oaeei /eiii, iaiaoiaeiith oiiaith aeey iaeeaaeaiiy aiaeiiaiaeaeueiinoi ia iaeio c noi?ii ca
aeiaiai?ii o caeoee, yeeo caciaea iioa noi?iia.

Ui oaea caeoee?

O aiaeiiaiaeiinoi ic caeiiiaeaanoaii iiae caeoeaie ?icoiithoue aeo?aoe, c?iaeaii iaeiioth ic
noi?ii aeiaiai?o, ao?aoa aai iioeiaeaeaiiy ?? iaeia, a oaeiae iaio?eiaii aeioiaee, yei aiia a
io?eiaea, yeae ciaiaycaiiy aoei aeeiiaii iioith noi?iiith. Oaeei /eiii, eaoaai?iy caeoeia
neeaaeaooueny c ianooiieo aeaiaioia.

I. Ao?aoa iaeia, oice/ia cieuaiiy iaeia aai aeaoooy eiai c ainiiaea?nueeiai iaiao.
Iai?eeeaae, o?aieoaeue ia aeeiiaa acyoiai ia naaa ciaiaycaiiy ii caa?aaeaiith iaeia ia
naioio neeaaei, i ?i/ aoei /a?ac eiai oaeaoiinoue ae?aaeaii.

Eiia?oeieiee aeiaiai?

2. Iioeiaeaeaiiy iaeia, io?eiaiiy iei aeaoaeoia, iiaycaieo c iiai?oaiiyi eiai niiaeea/eo
yeinoae, ciaiioiueiai aeaeyaeo, ciaioaiiyi aa?oinoi.

I?e iioeiaeaeaiii iaeia aecia/aooueny ?icii? ooeiiee aai aeo?aoe c onoiaiiy iioeiaeaeaiue.
Oaei caeoee iiaeooue aooe caaaeaii a ?acoeueoaoi ii?ooaiue oiia aeiaiai?o i?i oa?o e oiaeiaeo,
iieaiee iaeaaeiaiiy, ui iinoa/aooueny, a oaeiae o aeiaaeeo, eiee, iai?eeeaae, i?aiaea?, aeei?enoi-
aoth/e i?aiaeia iaeii iaiaeaaeiei /eiii, i?eaiaeeoue eiai aei oaeiai noaio, yeee aeiaaao
iaaiaeeeaaeiiai ?aiiioo.
3. Aeo?aoe e?aaeeoi?a.

Aei aeo?ao iioa?iiei? noi?iie iaeaaeaoue oaeoe/ii aeo?aoe, yeeo aiia caciaea aei aeiy
i?aaeyaeaiiy i?aoaici?. Iai?eeeaae, aeo?aoe /a?ac i?inoi? ae?iaieoeoaa, ii onoiaiith iaaeieieia
a io?eiaiie i?iaeoeoei? (aeeiiaieo ?iaioao), ii nieaoi naieoeie (aeeth/ath/e aiaeoeiaeoaaiiy
caeoeia).

4. Iaiaea?aeaii e?aaeeoi?ii aeioiaee (ao?a/aia aeaiaea).

O cayceo c ia?aoiaeii aei ?eieiai? aeiiiiiee, ooai?aiiyi aeueoa?iaoeaiiai eiia?oeieiiai
naeoi?a eieueeinoue iiciaia i?i noyaiaiiy iaiaea?aeaieo i?eaooeia cia/ii caieueoeeany.

Aei iaiaea?aeaieo i?eaooeia (ao?a/aii? aeaiaee) iaeaaeaoue oni aeioiaee, yei io?eiaea a iioa?-
iiea noi?iia, yeae ciaiaycaiiy aoei aeeiiaii.

Nooooaith ?enith aeaii? oi?ie caeoeia o oa, ui aeioiaee, i?i yei eaea iiaa, oaeoe/ii ia
io?eiaii e?aaeeoi?ii, aea aiie iiaee a aooe io?eiaii, yeae ai?aeiee iaeaaeiei /eiii aeeiiaa
iieeaaeaia ia iueiai ciaiaycaiiy.

I?e i?aaeyaeaiii iiciaia i?i noyaiaiiy iaaeiiaea?aeaieo i?eaooeia iiceaa/aai iaiaoiaeii
aeiaanoe, ui aii iia i iiaeiai aoa io?eiaoe cacia/aii i?eaooee i eeoa ii?ooaiiy ciaiaycaiue
aiaeiiaiaea/ai o oaeeiith i?e/eiith, ui iicaaaeea eiai iiaeeeainoi iaea?aeaiiy i?eaooeo,
iai?eeeaae, aiae ?aaeicaoei? oiaa?ia.

I?ioa iaea?aeaiiy i?eaooeo c ae?o/ee aiae ?aaeicaoei? oiaa?ia iiaeeeaa eeoa iiney aeaioia-
eaiiy i iinoaaee eiai niiaeeaa/aai, a oiio iiceaa/, ii?o/ ic aeuacacia/aiei, iiaeiai aeiaanoe,
ui iia ?aaeicoaaoe oiaa? aai iineoae i iaea?aeaoe oei naiei coiiaeaiee i?eaooie.

Iiaeoa eaaeo/e, iiceaa/ai iaiaoiaeii aeiaanoe iayaiinoue ?aaeueieo iiaeeeainoae iaea?aeaiiy
i?eaooeo. I?e aeiaaaeaiii ?icii?ia iaaeiiaea?aeaiiai i?eaooeo ia aa?ooueny aei oaaae aaaeaii
?ic?aooiee iiceaa/a, a oaeiae aoaeue-yei oi?ie a oiiaiiio niiniai (yeui a…, oi y a…). A?aio?aaeii
noaee aeiaaathoue o oeueiio aeiaaeeo ienueiiaeo aeieacia i?i iiaeeeainoi io?eiaoe i?eaooie:
aeiaiai?e, oeeaaeaii c eiio?aaaioaie iiceaa/a, aa?aioieii eenoe aiae ieo c i?iiiceoeioth oeeanoe
aiaeiiaiaeiee aeiaiai? aai iiceoeaii aiaeiiaiaei eiio?aaaioia ia i?iiiceoeith iiceaa/a i?i oeeaaeaiiy
aeiaiai?o, i?ioieiee i?i iaii?e oiui. Aea noi?iie a aeiaiai?i iiaeooue naiinoieii ia?aaeaa/aoe
?icii? caeoeia, yei aeiia noi?iia aoaea ciaiaycaia aiaeoeiaeoaaoe iioie noi?iii o aeiaaeeo
ii?ooaiiy aeiaiai?ieo ciaiaycaiue.

sse i?aaeei, caeoee c aiaeiiaiaea/a ca ?ioaiiyi A?aio?aaeiiai noaeo noyaothoueny o a?ioiaie
oi?ii, aea o aeiaaeeo, yeui o aiaeiiaiaea/a aiaenooii a?ioiai eiooe, o iiceaa/a o aeaa aa?iaioe
aeie: ii?ooeoe ni?aao i?i eiai aaie?oonoai aai caa?iooeny aei A?aio?aaeiiai noaeo ic cayaith
i?i ciiie niiniao aeeiiaiiy ?ioaiiy A?aio?aaeiiai noaeo oeyoii ni?yioaaiiy noyaiaiiy ia
iaeii aiaeiiaiaea/a. Inoaiiie aa?iaio o iaee?auei, ineieueee a ii?iaiyiii ic ii?ooaiiyi ni?aae
i?i aaie?oonoai aeicaieyo ae?ioeoe i?iaeaie iiceaa/a cia/ii iia?aoeaiioa.

Eiia?oeieiee aeiaiai?

C?ACEE AINIIAeA?NUeEEO AeIAIAI?IA
(c eiiaioa?yie)

Ieae/a iaaaaeaii oeiiai oi?ie ?iciiai ?iaeo ainiiaea?nueeeo aeiaiai?ia, ?o i?ecia/aiiy –
aeiiiiiaoe ea?iaieeai, iiaei?eoioeyi, eiia?naioai i aicianiaiai i?e ioi?ieaiii ?o aeiaiai?ieo
acaoiiaiaeiinei c ia?oia?aie a ?icieo noa?ao aeiyeueiinoi (ae?iaie/ie, eiia?oeieiie, iaoeiaie
oiui).

?acii c oei, aa?oi iiaee?aneeoe, ui iaaaaeaii oeiiai oi?ie ainiiaea?nueeeo aeiaiai?ia o
i?eaeecieie i aiaeia?athoue ?ieue i?ioioe?o, aacenii? eiino?oeoei?. Oiio i?e iiaeaioiaoei eiie?aoieo
aeiaiai?ia ia aaci oeiiaeo oi?i aeioeieueii caeo/eoe aei oeio? ?iaioe th?enoa i oaoiaoey aiaeiiaiaeiiai
i?ioieth.

___________________________________?icaeie 1____________________________________

IA?AAeAeIAIAI?II AeIEOIAIOE

I?IOIEIE ?ICAIAEIINOAE

sseui noi?iia iao caia?a/aiiy uiaei oiia iaea?aeaiiai i?iaeoo aeiaiai?o, oi oey noi?iia
neeaaeao i?ioieie ?icaiaeiinoae. I?ioieie ?icaiaeiinoae neeaaeaooueny o o?ueio i?eii?ieeao.
Iiaeienoooueny ea?iaieeii (canooiieeii ea?iaieea) i?aaiicaoei?, ne?iiethooueny ia/aoeith. Iaeei
i?eii?iee i?ioieieo eeoaooueny c i?iaeoii aeiaiai?o o noi?iie, yea neeaea aeaiee i?ioieie;
aeaa i?eii?ieee ?acii c ioi?ieaiei aeiaiai?ii iiaa?oathoueny noi?iii, aiae yei? iaea?aeaii i?iaeo
aeiaiai?o. A a?aoi 1 cacia/athoueny ioieoe aeiaiai?o, aiaeiinii yeeo noi?iia caia?a/oo. A a?aoi
2 cacia/aooueny iiaa ?aaeaeoeiy oiia aeiaiai?o, ui i?iiiioooueny iniaith, yea neeaea i?ioieie
?icaiaeiinoae.

I?IOIEIE
?icaiaeiinoae aei aeiaiai?o___________

aiae <___> ___________ 19 __ ?.

?aaeaeoeiy iinoa/aeueieea?aaeaeoeiy iieoioeyI?eiioee
123

Iinoa/aeueiee

Iieoiaoeue

I.I.

I?IOIEIE OCAIAeAEAIIss ?ICAIAEIINOAE

Neeaaeaooueny noi?iiaie aeey a?aaoethaaiiy nii?ieo oiia aeiaiai?o iiney io?eiaiiy i?i-
oieieo ?icaiaeiinoae. I?ioieie ocaiaeaeaiiy ?icaiaeiinoae iiaeienoooueny ea?iaieeaie iiaei?e-
oinoaa (canooiieeaie) i ne?iiethooueny ia/aoeaie noi?ii, O a?aoi 1 cacia/athoueny ioieoe aeiaiai?o,
aiaeiinii yeeo Iieoiaoeue caia?a/oo. O a?aoi 2 – ?aaeaeoeiy, yeo i?iiiioo Iieoiaoeue. O a?aoi C
cacia/aooueny iiaa ?aaeaeoeiy ioieoo, ocaiaeaeaia noi?iiaie. O a?aoi 4 – ioieoe aeiaiai?o, c yeeo

noi?iie aei caiaee ia aeieoee.

Eiia?oeieiee aeiaiai?

I?IOIEIE
ocaiaeaeaiiy ?icaiaeiinoae ii aeiaiai?o

aiae <. iinoa iieoioeyocaiaeaeaia ioieoo aeiaiai iieoiaoeue i.i. aeaoa noi eeno aei i ea aae . aiae iai aai niaoeeoieaoeioth ia ___________ o ___ iiaeienaoe oa niaoeeoieaoeith e iaeei ci iiaa iiaei no iiaeienaiee ____________ a c ca oiiaaie iaoo _________ oaiaea niia acaoiiaiaeiinei iniai ui aeio iiaenoaai noaoooo eiia ________________________________________________________________ iaaeaei>,

iiaeienaee Aeaio Oaiaeo i?i ianooiia:

I. NOI?IIE o aiaeiiaiaeiinoi aei Aeaii? Oaiaee aeoiaeyoue c oiai, ui iioa?anai eiaeii? c ieo
aiaeiiaiaeao ?aaeicaoeiy i?iaeoia o noa?i iaoeiai-oaoii/ii? aeiyeueiinoi, noai?aiiy iiaeo aeaeia

oaoiiee i oaoiieiai?.

2. Ia iiaenoaai aeuaaeeeaaeaiiai NOI?IIE ciaiaycothoueny niieueii aeiyoe aeey aeinyaiaiiy
caaaeueieo ainiiaea?nueeeo oeieae o aiaeiiaiaeiinoi aei noaoooieo caaaeaiue oa aeiiiii/ieo iioa?ania
eiaeii? ic NOI?II, yei aa?ooue o/anoue o Aeaiie Oaiaei.

3. O i?ioeani aeeiiaiiy iaii/aieo niieueieo oeieae NOI?IIE i?aaiooeiooue aoaeoaaoe nai?
acaoiiaiaeiineie ia iiaenoaai ?iaiinoi, /aniiai ia?oia?noaa oa caoenoo iioa?ania iaeei iaeiiai.

4. O aeiaaeeo iaiaoiaeiinoi NOI?IIE aeeiioaaoeiooue acaoiia oiiainoaaiiy niieueieo
i?iaeoia ia aaciieaoiie oa aaci?ioeaioiie iniiai.

Aeey oeio? iaoe eiooe aoaeooue aeoioethaaoeny ia ?aooieo iaeiio? ic NOI?II; ?icii?, noia
oa ii?yaeie ?o aeei?enoaiiy aoaeooue aecia/aii ie?aiith oaiaeith NOI?II.

5. NOI?IIE iathoue iaii? caeienithaaoe acaoiia e?aaeeooaaiiy ia oeiei, aecia/aii oaiaeaie
NOI?II o iaaeao iaoeiai-oaoii/iiai oa eiia?oeieiiai niia?iaioieoeoaa.

6. Aeey oaeaeoiai aeinyaiaiiy oeieae ca Aeaiith Oaiaeith NOI?IIE ciaiaycothoueny iaiiithaa-
oeny iayaiith o ?oiueiio ?icii?yaeaeaiii iioi?iaoeioth c aniaeoia acaoiiiai iioa?ano, i?iaiaeeoe
niieueii eiinoeueoaoei? i naiiia?e, anoaiiaethaaoe iaoeiai-oaoii/ii oa eiia?oeieii-oiiainiai caycee
c o?aoiie iniaaie e iioi?ioaaoe iaeei iaeiiai i?i ?acoeueoaoe iiaeiaieo eiioaeoia.

7. Eiie?aoii oi?ie oa ?icii?e o/anoi NOI?II o caeieniaiii niieueieo i?iaeoia aoaeooue
aecia/aoeny aeiaeaoeiaeie oaiaeaie i aeiaiai?aie.

8. Aeaia Oaiaea o ia?aaeoiiaith i iiaenoaaith aeey oeeaaeaiiy, yeui NOI?IIE aeciathoue ca
iaiaoiaeia, eiie?aoieo aeiaiai?ia (ia i?iaaaeaiiy IAe?, iinoa/aiiy, aaci?ioeaioiee e?aaeeo,
i?i niieueio aeiyeueiinoue oiui).

9. Aeioiaee, io?eiaii a ?acoeueoaoi niieueii? aeiyeueiinoi i aeieiaiai niia?iaioieoeoaa,
?iciiaeieythoueny a eiaeiiio ie?aiiio aeiaaeeo ca caiaeith NOI?II.

Eiaeiee o/aniee naiinoieii aecia/ao iai?yiie aeei?enoaiiy naio? /anoee i?eaooeo,
io?eiaiiai aiae niieueii? aeiyeueiinoi.

10. Aeiy Aeaii? Oaiaee ?iciianthaeaeoooueny ia iaaecia/aiee no?ie aei iiiaioo, aeiee NOI?IIE
caoeieaaeaii o i?iaeiaaeaiii niieueii? aeiyeueiinoi.

I 1. Aeaia Oaiaea o iiia?aaeiueith i ia iaeeaaeao ia NOI?IIE aeiaeieo eiie?aoieo oiiainiaeo
oa th?eaee/ieo ciaiaycaiue.

12. Aeaio Oaiaeo neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? ic
NOI?II.

IC. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiith Oaiaeith, NOI?IIE ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

14. NOI?IIE ciaiaycothoueny i?e aeeiiaiii Aeaii? Oaiaee ia caiaeeoe niia?iaioieoeoai aei
aeio?eiaiiy eeoa iayaieo o iie aeiia, iiaeo?eioaaoe aeieiai eiioaeoe oa aaeeaaoe anio iaiaoiaeieo
caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?o eiia?oeieieo cayceia.

15. TH?eaee/ii aae?ane oa aaieianueei ?aeaiceoe noi?ii.
15.1. NOI?IIA-1:

Iiooiaa aae?ana oa iiaeaen: ______________________________________________________
Oaeaoii _______________, oaeaoaei ___________________, oaen __________________
?ic?aooieiaee ?aooiie ? ______________ a aaieo ______________________________
Ei?aniiiaeaionueeee ?aooiie aaieo NOI?IIE-1: _________________________________
15.2 NOI?IIA-2:

Iiooiaa aae?ana oa iiaeaen: _______________________________________________________
Oaeaoii _______________, oaeaoaei ___________________, oaen __________________
?ic?aooieiaee ?aooiie ? ______________ a aaieo ______________________________
Ei?aniiiaeaionueeee ?aooiie aaieo NOI?IIE-2: ___________________________________

Aeaio Oaiaeo iiaeienaee:
AIAe NOI?IIE-1 AIAe NOI?IIE-2

I.I.

Eiia?oeieiee aeiaiai?
IIIA?AAeIIE AeIAIAI?

i.____________ <____>___________ 199___?.

NOI?IIA-1:
a iniai _________

ui aeio ia iiaenoaai Noaoooo, i
NOI?IIA-2: ________

a iniai _________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, iaaeaei – , ia iiaenoaai aeainoi?iiiio ia?aaiai?ia,

i?iaaaeaieo o i._________ <_____> ________________ 199 __ ?.

iiaeienaee Aeaiee Iiia?aaeiie Aeiaiai? i?i ianooiia:

I. NOI?IIE aeciathoue, ui ?o iaoeiai-ae?iaie/ee oa oiiainiaee iioaioeiae aeao ?i iiaenoaae
anoaiiaeoe aeiaaino?ieiaa i acaoiiaeaiaeia niia?iaioieoeoai a aaeoci ?ic?iaee oa cai?iaaaeaeaiiy
?icieo eiia?oeieieo, iaoeiai-ae?iaie/eo i?ia?ai i eiia?oeieieo i?iaeoia.

2, NOI?IIE ieaiothoue caeienieoe ia ia?oiio aoaii niia?iaioieoeoaa niieueio iaoeiai-
ae?iaie/o aeiyeueiinoue c ?ic?iaee ____________________________________________________ .

3. Aeey i?eeiyooy inoaoi/iiai ?ioaiiy i?i iiaeeeainoi ?aaeicaoei? aeuaiacaaii? i?ia?aie
iiaiiaaaeii i?aaenoaaieee NOI?II i?iaiaeyoue niieueii eiinoeueoaoei? i cono?i/athoueny ia iiciioa
aiae <____> ____________ 19___ ?.
4. NOI?IIE ciaiaycothoueny aei <____> ____________ 19___ ?. oeeanoe aeiaiai? ______

Aeiaiai?, yeee NOI?IIE iathoue iaii? oeeanoe, iiaeiai iinoeoe a niai ianooiii oiiae:
a)_________________________________________________________________________
a)_________________________________________________________________________
a)_________________________________________________________________________

5. I?iaeo aeiaiai?o aei?o/aooueny neeanoe NOI?III-I.

I?iaeo aeiaiai?o NOI?IIA-1 ciaiaycaia i?aaenoaaeoe ia ?icaeyae NOI?III-2 ia iiciioa
aiae ____> ____________ 19___ ?.

6. O aeiaaeeo aaciiaenoaaii? aiaeiiae iaeiio? ic NOI?II aiae oeeaaeaiiy aeiaiai?o ca i.4 Aeaiiai
Aeiaiai?o aai a/eiaiiy aeie, o ?acoeueoaoi yeeo oeeaaeaiiy aeuacacia/aiiai aeiaiai?o noao
iaiiaeeeaei, aeiia NOI?IIA iana aiaeiiaiaeaeueiinoue o ii?yaeeo i ia oiiaao, ia?aaeaa/aieo
/eiiei oeeaieueiei caeiiiaeaanoaii.

Aeaiee Iiia?aaeiie Aeiaiai? iiaeienaee:
AIAe NOI?IIE-1 AIAe NOI?IIE-2

I.I. I.I.

OAIAeA
i?i iinooieo AeIAIAI?O

199___?.

OeAAeAIO: __________________________________________________________________,
a iniai ___________________1______________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

IANOOIIEE: _________________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaio Oaiaeo i?i ianooiia:

I. OeAAeAIO ia?aaeao, a IANOOIIEE i?eeiao ia naaa i?aaa oa iaiaycee ia?oiai i noao
noi?iiith ii aeiaiai?o _______ ? ______ aiae <____> ____________ 19___ ?. iiae OeAAeAIOII
i _____________________________________________ (aeaei ca oaenoii – E?AAeEOI?).

Eiia?oeieiee aeiaiai?

2. Ca Aeaiith Oaiaeith IANOOIIEE ciaiaycoooueny caeienithaaoe (caiinoue OeAAeAIOA) ani

i?aaa i iaiaycee OeAAeAIOA ca aeuacacia/aiei aeiaiai?ii.

3. Caiaeo E?AAeEOI?A ia ia?aeac ai?ao iaea?aeaii o aiaeiiaiaeiinoi aei ________________ .

4. O aiaeiiaiaeiinoi aei aeuacacia/aii? iinooiee aeiaiai?o OeAAeAIO aeiea/oo IANOOIIEEO

aeiaai?iaeo:

5. Ii?yaeie ?ic?aooieia ca i.4 Aeaii? Oaiaee:

5.1. No?ie iieaoe neeaaeao ________________________________________________________
c iiiaioo __________________________________________________________________________

iiiaioo

5.2. Ii?yaeie iieaoe
5,3. Aeae ?ic?aooieia

(iiooiaee, oaeaa?aoiee)

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

5.4. Oi?ia ?ic?aooieia __________________________________________________________

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa-aei?o/aiiy, ae?aaeeoea)

6. A no?ie __________ OeAAeAIO ciaiaycaiee ia?aaeaoe IANOOIIEEO anth aeieoiaioaoeith,
c yei? aeieeaathoue i?aaa i iaiaycee ia?oiai, ca aeiaiai?ii, iinooiea eio?iai o i?aaeiaoii
Aeaii? Oaiaee.

7. Aeaia Oaiaea anooiao a neeo c iiiaioo iiaeienaiiy ?? noi?iiaie.

8. Aeaio Oaiaeo neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? ic
noi?ii.

9. Iinooiea aeiaiai?o o aiaeiiaiaeiinoi aei Aeaii? Oaiaee ia oyaia ca niaith aeiaeieo ciii oiia
ia?oiai.
TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

OAIAeA
i?i ia?aeac ai?ao

199___?.

IA?AEACIEE: _________________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

oeeaee Aeaio Oaiaeo i?i ianooiia:

1. IA?AEACIEE ia?aaeao, a IANOOIIEE i?eeiao ia naaa ciaiaycaiiy ia?oiai i noao
ai?aeieeii ca aeiaiai?ii ____________ ? ________ aiae <____> ____________ 19___ ?. iiae
IA?AEACIEEII i ______________________________________________ (iaaeaei – E?AAeEOI?).

2. Ca Aeaiith Oaiaeith IANOOIIEE ciaiaycoooueny caeienieoe (caiinoue IA?AEACIEEA)
ianooiii ciaiaycaiiy IA?AEACIEEA;

3. Caiaeo E?AAeEOI?A ia ia?aeac ai?ao iaea?aeaii o aiaeiiaiaeiinoi

4. O aiaeiiaiaeiinoi aei aeuacacia/aiiai i?eeiyooy ai?ao c aieo IANOOIIEEA aoaea
iiaaoaii oaeeie aeiyie c aieo IA?AEACIEEA:

5. A no?ie ________________ IA?AEACIEE ciaiaycaiee ia?aaeaoe IANOOIIEEO anth
iioi?iaoeith i aeieoiaioaoeith, c yei? aeieeaathoue i?aaa i iaiaycee ia?oiai, ui o i?aaeiaoii
Aeaii? Oaiaee.

6. Aeaia Oaiaea anooiao a neeo c iiiaioo iiaeienaiiy ?? noi?iiaie.

7. Aeaio Oaiaeo neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? ic
noi?ii.

Eiia?oeieiee aeiaiai?

8. Ia?aeac ai?ao o aiaeiiaiaeiinoi aei Aeaii? Oaiaee ia oyaia ca niaith aeiaeieo ciii oiia
aeiaiai?o.
TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

OAIAeA
i?i iinooieo i?aaa ia aeiiao

199___?.

OI?IA: _______________________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

IIAeI?EoINOAI: ______________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaio Oaiaeo i?i ianooiia:

1. OI?IA ia?aaeao, a IIAeI?EoINOAI i?eeiao ia naaa i?aai aeiiae ia?oiai i noao
e?aaeeoi?ii ii aeiaiai?o _______ ? ______ aiae <____> ____________ 19___ ?. iiae OI?IITH
oa _____________________________________________ (iaaeaei AI?AEIEEII).

2. Ca Aeaiith Oaiaeith IIAeI?EoINOAI iaea?aeoo i?aai (caiinoue OI?IE) aeiaaaoe aiae
AI?AEIEEA iaeaaeiiai aeeiiaiiy ianooiieo ciaiaycaiue:

3. OI?IA ciaiaycaia a no?ie __________ c iiiaioo iiaeienaiiy Aeaii? Oaiaee iiaiaeiieoe
AI?AEIEEA, i?i caeieniaio iinooieo i?aaa ia aeiiao.

4. O aiaeiiaiaeiinoi aei aeuaaeacaii? iinooiee i?aaa ia aeiiao IIAeI?EoINOAI, niea/oo
OI?II ianooiio aeiaai?iaeo:

5. Ii?yaeie ?ic?aooieia ca i.4 Aeaii? Oaiaee:
5.1. No?ie iieaoe neeaaeao ____________________ c iiiaioo
5.2. Ii?yaeie iieaoe _____________________________________

(iiooiaee, oaeaa?aoiee)

5.3 Aeae ?ic?aooieia

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

5.4. Oi?ia ?ic?aooieia __________________________________________________________

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa.aei?o/aiiy, ae?aaeeoea)

5.5. IIAeI?EoINOAI ciaiaycaia iiaiaeiieoe OI?IO i?i caeieniaiiy ieaoaaeo a no?ie _
______ c iiiaioo _____________ oeyoii ___________________________

(oaeaa?aia c iiaiaeiieaiiyi, oaen oiui)

6. A no?ie ___________ OI?IA ciaiaycoooueny ia?aaeaoe IIAeI?EoINOAO anth iioi?iaoeith

i aeieoiaioaoeith, c yei? aeieeaathoue iaiaycee ia?oiai, ui o i?aaeiaoii Aeaii? Oaiaee.

7. Aeaia Oaiaea anooiao a neeo c iiiaioo iiaeienaiiy ?? noi?iiaie.

8. Aeaio Oaiaeo neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic

noi?ii.
9. Iinooiea i?aaa ia aeiiao o aiaeiiaiaeiinoi aei Aeaii? Oaiaee ia oyaia ca niaith aeiaeieo

ciii oiia aeiaiai?o.
TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

Eiia?oeieiee aeiaiai?

OAIAeA
i?i ciiio i aeiiiaiaiiy aeiaiai?o

? _________ aiae <____> _____________ 19___ ?.

i 199?
CAIIAIEE:
a iniai
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

AEEIIAAAOeUe: _______________________________________
a iniai ____________________________________________________
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaio Oaiaeo i?i ianooiia:
1. CAIIAIEE i AEEIIAAAOeUe o cayceo c ______________

(iioeae i i?e/eie, ca yeeie noi?iie aeiiiaiththoue i ciiiththoue aeiaiai?)

i?eeoee aei caiaee ciiieoe i aeiiiaieoe aeiaiai? ? ______ aiae <____> __________ 19___ ?.
2. Ciiieoe ieae/aaeacaii oiiae aeiaiai?o, aeeeaaoe ?o o ianooiiie ?aaeaeoei?:
_____________ 19___ ?.

iy iiaiai? i?i?-

i(IIAAOeIss) 199
CAIIAIEE-
a iniai
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

AEEIIAAAOeUe: ____________________
a iniai ______________________________
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

Eiia?oeieiee aeiaiai?

oeeaee Aeaio Oaiaeo i?i ianooiia:
1. CAIIAIEE i AEEIIAAAOeUe o cayceo c ______________

(iioeae i i?e/eie, c yeeo ae?ioeee caiiieoe aeiaiai?)

i?eeoee aei caiaee ciiieoe i aeiiiaieoe aeiaiai? ? ______ aiae <____> __________ 19___ ?.
ia aeiaiai? i?i ________________________________________________________________ .
2. Ciiieoe ieae/aaeacaii oiiae aeiaiai?o, aeeeaaoe ?o o ianooiiie ?aaeaeoei?:
___________ 199___?.

E?AAeEOI?: ___________________________________________________________________,
a iniai aee?aeoi?a ____________________________________________________________________,
ui aeio ia iiaenoaai ____________________________________________________________________
c iaeiiai aieo, i

IICE*AEUeIEE: ______________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai ______________________________________________________________:_____
c iioiai aieo,

oeeaee Aeaio Oaiaeo i?i ianooiia:
I. E?AAeEOI? i IICE*AEUeIEE ia iiaenoaai eenoa aiae <. cayceo c _________________________________________________ o aeieoee aeaii oaiaee i ciiio ii aeeiiaiiy aeiaiai ______ aiae> __________
19___?.

2. Iinoaiiaeoe, ui aeeiiaiiy ciaiaycaiue IICE*AEUeIEEA c aeuacacia/aiiai aeiaiai?o
aoaea caeienithaaoeny ianooiiei /eiii:

3. Iioi oiiae aeuaaeacaiiai aeiaiai?o eeoathoueny iaciiiieie, i noi?iie iiaeoaa?aeaeothoue
c ieo nai? ciaiaycaiiy.

Eiia?oeieiee eiaiai?

4. Aeaio Oaiaeo neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

5. Iiney iaaoooy /eiiinoi Aeaiiai Aeiaiai?o E?AAeEOI? ia iao i?aaa aeiaaaoe aiae
IICE*AEUeIEEA aeeiiaiiy aeiaiai?o, ii?yaeie aeeiiaiiy yeiai ciiiaii Aeaiith Oaiaeith.

6. Aeaia Oaiaea anooiao a neeo c iiiaioo iiaeienaiiy ?? noi?iiaie.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

OAIAeA
i?i ?ici?aaiiy aeiaiai?o

? _________ aiae <____> ______________ 19___ ?.

i 199?
CAIIAIEE-
a iniai
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i AEEIIAAEOeUe-
a iniai
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo, oeeaee Aeaio Oaiaeo i?i ianooiia: 1 . CAIIAIEE i AEEIIAAAOeUe o cayceo c

(iioeae, i?e/eie, c yeeo noi?iie ae?ioeee ?ici?aaoe aeiaiai?)

i?eeoee aei caiaee ?ici?aaoe aeiaiai? ? ______ aiae <____> __________ 19___ ?.
2. C iiiaioo iaaoooy /eiiinoi Aeaii? Oaiaee noi?iie ia aaaaeathoue naaa iiaycaieie aoaeue-
yeeie i?aaaie oa ciaiaycaiiyie.
3. Ciaiaycaiiy, i?eieiaii Aeaiith Oaiaeith, aeeiiaiiy yeeo noi?iiaie aaea ii/aeiny,

iiaeiii aooe aeeiiaii o ianooiiiio ii?yaeeo:
CAIIAIEE: ___________________________________________________________________

AEEIIAAAOeUe: ________________________________________________________________
4. Aeaio Oaiaeo neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.
5. Aeaia Oaiaea anooiao a neeo c iiiaioo iiaeienaiiy ?? noi?iiaie.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

I?IOIEIE
i?i caeie acaoiieo aeiia

i. ____________ <____> ___________ 199 ___ ?.

CAIIAIEE: __________________________________________________________________,
a iniai _________________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

AEEIIAAAOeUe: ________________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

iiaeienaee Aeaiee I?ioieie i?i ianooiia:

I. CAIIAIEE i AEEIIAAAOeUe i?eeoee aei caiaee i?i caeie acaoiieo aeiia c ieae/a-
aeacaieo aeiaiai?ia, o yeeo CAIIAIEE i AEEIIAAAOeUe o noi?iiaie.
1.1. Ca aeiaiai?aie:

1) ? ______ aiae <____> __________ 19___ ?.

Eiia?oeieiee aeiaiai?

CAIIAIEE o e?aaeeoi?ii;
AEEIIAAAOeUe o ai?aeieeii;
2) ? ______ aiae <____> __________ 19___ ?.
CAIIAIEE o ai?aeieeii;
AEEIIAAAOeUe o e?aaeeoi?ii.
?icii? acaoiieo aeiia, yei iiaaoathoueny c aeuacacia/aieo aeiaiai?ia:

1.2. Ca aeiaiai?aie:

1) ? ______ aiae <____> __________ 19___ ?.
CAIIAIEE o e?aaeeoi?ii;
AEEIIAAAOeUe o ai?aeieeii;

2) ? ______ aiae <____> __________ 19___ ?.
CAIIAIEE o ai?aeieeii;
AEEIIAAAOeUe o e?aaeeoi?ii.
?icii? acaoiieo aeiia, yei iiaaoathoueny c aeuacacia/aieo aeiaiai?ia:

2. C iiiaioo iaaoooy /eiiinoi Aeaiiai I?ioieieo noi?iie ia aaaaeathoue naaa iiaycaieie
aoaeue-yeeie i?aaaie oa ciaiaycaiiyie ca aeiaiai?aie, ciaiaycaiiy ca yeeie ca?aoiaaii Aeaiei
I?ioieieii.

3. Noi?iie i?e iiaeienaiii Aeaiiai I?ioieieo ia iathoue iaeia aei iaeii? aoaeue-yeeo acaoiieo
i?aoaicie.

4. Aeaiee I?ioieie neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.
5. Aeaiee I?ioieie anooiao a neeo c iiiaioo iiaeienaiiy eiai noi?iiaie.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

?icaeie 2

IICEEA

Ca aeiaiai?ii iiceee (e?aaeeoiei aeiaiai?ii) iiceeiaeaaaoeue (E?AAeEOI?) ia?aaeao IICE-
*AEUeIEEO (ai?aeieeo) o aeaniinoue (iiaia ainiiaea?/a aiaeaiiy aai iia?aoeaia oi?aaeiiiy)
a?ioi aai ?a/i, aecia/aii ?iaeiaeie iciaeaie, a iice/aeueiee ciaiaycoooueny naio/anii iiaa?iooe
oaeo ae noio a?ioae aai ?iaio eieueeinoue ?a/ae oiai ae ?iaeo i yeinoi.

O aeiaaeeo iaea?aeaiiy i?eaooeo aiae iiceeiaeo iia?aoeie aac iayaiinoi aiaeiiaiaeieo eioeaicie
oaea oaiaea iiaea aooe aeciaia iicanoaoooiith, a ana io?eiaia ca iath iiaea aooe aeeo/aii aei
athaeaeaoo.

Oaeei /eiii, o uiaeaiiiio i iioi/iiio aeieiaiio iaiao iiaeeeaa eeoa aaci?ioeaioia aai
aaciieaoia e?aaeeooaaiiy. Oeae aeniiaie iiaeoaa?aeaeoooueny oaeiae i i?aeoeeith ?iaioe iiaeaoeiaeo
i?aaiia.

AeIAIAI?
aaci?ioeaioii? oeieueiai? iiceee

i. ___________ <____> __________ 199 ___ ?.

(iiaia oi?iiaa iacaa iiaee?iiinia)

E?AAeEOI?: ___
a iniai aee?aeoi?a ___

ui aeio ia iiaenoaai ____
c iaeiiai aieo, i

(iiaia oi?iiaa iacaa ioi?enenoi)

IICE*AEUeIEE
a iniai _____________

(iacai iinaaee, i.i.a)

ui aeio ia iiaenoaai
c iioiai aieo,

Eiia?oeieiee aeiaiai?

oeeaee Aeaio Oaiaeo i?i ianooiia:

1 .I?AAeIAO AeIAIAI?O

1.1. E?AAeEOI? ciaiaycoooueny iaaeaoe IICE*AEUeIEEO aaci?ioeaioio oeieueiao iiceeo,
a inoaiiie ciaiaycoooueny aeei?enoaoe ?? ca oeieueiaei i?ecia/aiiyi i iiaa?iooe iiceeo o
aecia/aiee Aeaiei Aeiaiai?ii no?ie.

1.2. O cayceo c oei, ui iiae Noi?iiaie ca Aeaiei Aeiaiai?ii iaeaaiaeaeothoueny oinii
acaoiiaeaiaeii aeieiai aiaeiineie, iiceea IICE*AEUeIEEO iaaeaooueny ia aaci?ioeaioiie (aacaiae-
ieaoiie) iniiai.

2. IAOA IAAeAIIss IICEEE
2.1. Iaoa iaaeaiiy iiceee IICE*AEUeIEEO:

2.2. IICE*AEUeIEE o no?ie ________ c iiiaioo iaaeaiiy iiceee ciaiaycaiee iaaeaoe
E?AAeEOI?O aeieoiaioe, ui canaiae/othoue oeieueiaee oa?aeoa? aeei?enoaiiy iiceee.

3. ?ICII? IICEEE

Noia iiceee noaiiaeoue ca Aeaiei Aeiaiai?ii ____________ e?a.

4. II?ssAeIE IAAeAIIss IICEEE

4.1. E?AAeEOI? ciaiaycaiee iaaeaoe iiceeo i?ioyaii __________ c iiiaioo iiaeienaiiy
Aeaiiai Aeiaiai?o.

4.2. Iiceea iaaeaooueny o aacaioiaeiaiio ii?yaeeo ieaoiaeiei aei?o/aiiyi oeyoii ia?aeaco
iaiaoiaeieo eiooia ia ?ic?aooieiaee ?aooiie IICE*AEUeIEEA.

4.3. E?AAeEOI? i?ioyaii __________ iiney ia?aeaco noie iiceee IICE*AEUeIEEO
ciaiaycaiee iiaiaeiieoe inoaiiueiai i?i ia?aeac eiooia oeyoii

(oaeaa?aoii, oaenii oiui?

5. NO?IE IICEEE

5.1. No?ie iaaeaiiy iiceee IICE*AEUeIEEO noaiiaeoue c iiiaioo _____________________

(e.oeo(iaeaiiiy a?ioae o ?/? IICE*AEUeIEEA, ia?aeac a?ioae E?AAeEOI?II)

5.2. No?ie, aeacaiee o i.5.1 Aeaiiai Aeiaiai?o, iiaea aooe i?iaeiaaeaiee ca caiaeith Noi?ii.

6. II?ssAeIE IIAA?IAIIss IICEEE

6.1. Ii caeii/aiii no?ieo, aeacaiiai a i.5.1 Aeaiiai Aeiaiai?o, IICE*AEUeIEE ciaiayco-
ooueny i?ioyaii ___________ iiaa?iooe noio iiceee.

6.2; Iiceea iiaa?oaooueny o aacaioiaeiaiio ii?yaeeo ieaoiaeiei aei?o/aiiyi oeyoii ia?a-
eaco iaiaoiaeieo eiooia ia ?ic?aooieiaee ?aooiie E?AAeEOI?A.

6.3. IICE*AEUeIEE i?ioyaii ______________ iiney ia?aeaco noie iiceee E?AAeEOI?O
ciaiaycaiee iiaiaeiieoe inoaiiueiai i?i ia?aeac eiooia oeyoii ________________________ .

(oaeaa?aoii, oaenii oiui)

6.4. E?AAeEOI? i?ioyaii ________ iiney iaaeoiaeaeaiiy noie iiceee ia naie ?ic?aooieiaee

?aooiie ciaiaycaiee iiaiaeiieoe IICE*AEUeIEEA i?i oea ____________________________ .

(oaeaa?aoii, oaenii oiui)

7. NO?IE AeI? AeAIIAI AeIAIAI?O

Aeaiee Aeiaiai? iaaoaao /eiiinoi c iiiaioo iiaeienaiiy eiai Noi?iiaie i o aeieniei aei
iiiaioo eiai inoaoi/iiai aeeiiaiiy, i?ioa, o aoaeue-yeiio aeiaaeeo aei <____> __________
19___?.

8. AIAeIIAIAeAEUeIINOUe NOI?II

8.1. Ca ii?ooaiiy oiia Aeaiiai Aeiaiai?o aeiia Noi?iia aiaeoeiaeiaoo caaaeaii caeoee, o
oiio /enei ao?a/aio aeaiaeo, o ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.
8.2. IICE*AEUeIEE iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:

8.3. E?AAeEOI? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:

Eiia?oeieiee aeiaiai?
9. CAAACIA*AIIss CIAIAssCAIUe CA AeAIEI AeIAIAI?II

(iiaeooue ia?aaeaa/aoeny oiiae i?i canoaao, no?aooaaiiy
aai ii?oeo c aieo, a iniiaiiio, IICE*AEUeIEEA)

10. II?ssAeIE AE?IOAIIss NII?IA
(a?aio?aaeia canoa?aaeaiiy)

10.1. Ani nii?e iiae Noi?iiaie, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o aiaeiiaiae-
iinoi aei /eiiiai caeiiiaeaanoaa Oe?a?ie a A?aio?aaeiiio (o?aoaenueeiio noaei ic cacia/aiiyi
yeiai eiie?aoiiai o?aoaenueeiai noaeo aai cacia/eoe ii?yaeie oi?ioaaiiy oeueiai o?aoaenueeiai
noaeo).

10.2. Noi?iie iinoaiiaeythoue, ui ani iiaeeeai i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii
aooe ?icaeyiooi Noi?iiaie i?ioyaii __________ aeiia c iiiaioo iaea?aeaiiy i?aoaici?.

1 1. CIIIE OIIA AeAIIAI AeIAIAI?O

11.1. Oiiae Aeaiiai Aeiaiai?o iathoue iaeiaeiao ciaiaycoaaeueio neeo aeey Noi?ii i iiaeooue
aooe ciiiaii ca acaoiiith caiaeith c iaiayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioo.

11.2. AEiaeia ic Noi?ii ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee ae?oai? Noi?iie.

12. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE
Iiaiiaaaeieie i?aaenoaaieeaie Noi?ii ca Aeaiei Aeiaiai?ii o:
IICE*AEUeIEE: _____________________________ oaeaoii _____________________ .
E?AAeEOI?: __________________________________ oaeaoii _____________________ .

13. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

14. IIOI OIIAE

14.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

14.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, Noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii.

14.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee i i?ioieiee i?i iaii?e c ieoaiue, oae /e iiaeoa iiaycaieo c Aeaiei Aeiaiai?ii,
ao?a/athoue th?eaee/io neeo.

14.4. Noi?iie ciaiaycothoueny i?e aeeiiaiii Aeaiiai Aeiaiai?o ia caiaeeoe niia?iaioieoeoai
aei aeio?eiaiiy eeoa oeo aeiia, ui iinoyoueny o Aeaiiio Aeiaiai?i, iiaeo?eioaaoe aeieiai eiioaeoe
i aaeeaaoe anio iaiaoiaeieo caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?oiio eiia?oeieieo
cayceia.

15. TH?eaee/ii aae?ane i aaieianueei ?aeaiceoe noi?ii

15.1. E?AAeEOI?:

Iinoeaciaoiaeaeaiiy ioino: ______________________________________________________.
Iiooiaa aae?ana oa iiaeaen: ______________________________________________________ .
Oaeaoii ___________, oaeaoaei __________________, oaen ______________________ .
?ic?aooieiaee ?aooiie ?____________ a

(iacaa aaieianueei? onoaiiae)

IOI ___________________, EIAe _____________________
Ei?aniiiaeaionueeee ?aooiie aaieo E?AAeEOI?A: _________

15.2. IICE*AEUeIEE:
15.1. E?AAeEOI?:

Iinoeaciaoiaeaeaiiy ioino: _____________________________
Iiooiaa aae?ana oa iiaeaen: ______________________________
Oaeaoii ___________, oaeaoaei ___________________, oaen
?ic?aooieiaee ?aooiie ?_____________ a

(iacaa aaieianueei? onoaiiae)

IOI ____________________, EIAe

Eiia?oeieiee aeiaiai?

Ei?aniiiaeaionueeee ?aooiie aaieo IICE*AEUeIEEA: ____________________________ .
15.3. Noi?iie ciaiaycothoueny iaaaeii ienueiiai iiaiaeiieyoe iaeia iaeio o aeiaaeeo ciiie
aiaeiiinoae, aeacaieo o i. 15 Aeaiiai Aeiaiai?o.

E?AAeEOI? IICE*AEUeIEE
__________________(……….) __________________(……….)
i.i. i.i.

EIIO?AEO
aaci?ioeaioii? oeieueiai? iiceee a iiicaiiie aaethoi

i. ____________ <____> ___________ 199 ___ ?.

E?AAeEOI?:
a iniai _________

ui aeio ia iiaenoaai ____
c iaeiiai aieo, i
IICE*AEUeIEE

a iniai _____________

ui aeio ia iiaenoaai ______________________________:__________________________________,
c iioiai aieo,

a?aoiaoth/e aeiaaino?ieiaa i ia?niaeoeaia niia?iaioieoeoai noi?ii o aaeoci eiia?oeieii? ciaiioiuei-
aeiiiii/ii? aeiyeueiinoi

oeeaee Aeaiee Eiio?aeo i?i ianooiia:

1. I?AAeIAO EIIO?AEOO

1.1. E?AAeEOI? ciaiaycoooueny iaaeaoe IICE*AEUeIEEO aaci?ioeaioio oeieueiao iiceeo
a iiicaiiie aaethoi, a inoaiiie ciaiaycoooueny aeei?enoaoe ?? ca oeieueiaei i?ecia/aiiyi i
iiaa?iooe iiceeo o aecia/aiee Aeaiei Eiio?aeoii no?ie.

1.2. O cayceo c oei, ui iiae Noi?iiaie ca Aeaiei Eiio?aeoii iaeaaiaeaeothoueny oinii
acaoiiaeaiaeii aeieiai aiaeiineie, iiceea IICE*AEUeIEEO iaaeaooueny ia aaci?ioeaioiie (aacaiae-
ieaoiie) iniiai.

2. IAOA IAAeAIIss IICEEE

2.1. Iaoa iaaeaiiy iiceee IICE*AEUeIEEO:

oiiainoaaiiy ae?iaie/eo i?ia?ai i aaethoieo aeo?ao IICE*AEUeIEEA c ia?a?iaee
aeaaaeueieoeueei? ne?iaeie E?AAeEOI?A (oieiiaiaa iia?aoeiy) o ?aieao eiio?aeoo ? ______ aiae
<____> __________ 19___ ?. _______________________________________________

(iacaa eiio?aeoo)

2.2. IICE*AEUeIEE i?ioyaii __________ c iiiaioo iaaeaiiy iiceee ciaiaycaiee iaaeaoe
E?AAeEOI?O aeieoiaioe, ui canaiae/othoue oeieueiaee oa?aeoa? aeei?enoaiiy iiceee:

3. AAETHOA I ?ICII? IICEEE

3.1. Aaethoa iiceee: ______________________________________________________________ .

3.2. Noia iiceee ca Aeaiei Eiio?aeoii: _________________________________________ .

4. II?ssAeIE IAAeAIIss IICEEE

4.1. E?AAeEOI? ciaiaycaiee iaaeaoe iiceeo i?ioyaii __________ c iiiaioo iiaeienaiiy
Aeaiiai Eiio?aeoo.

4.2. Iiceea iaaeaooueny o aacaioiaeiaiio ii?yaeeo ieaoiaeiei aei?o/aiiyi oeyoii ia?aeaco
iaiaoiaeieo aaethoieo eiooia ia iioi/iee aaethoiee ?aooiie IICE*AEUeIEEA aai ca aei?o/ai-
iyi inoaiiueiai ia ?aooiee o?aoio inia.
Aeaoa ia?aeaco iiceee o aeaoith iaaeaiiy iiceee.

4.3. E?AAeEOI? i?ioyaii _______ iiney ia?aeaco noie aaethoii? iiceee IICE*AEUeIEEO
ciaiaycaiee iiaiaeiieoe inoaiiueiai i?i ia?aeac eiooia oeyoii

(oaeaa?aoii, oaenii oiui)

Eiia?oeieiee aeiaiai?

5. NO?IE IICEEE

5.1. No?ie iaaeaiiy iiceee IICE*AEUeIEEO neeaaeao
c iiiaioo

(iaaeoiaeaeaiiy a?ioae ia ?/? IICE*AEUeIEEA, ia?aeac a?ioae E?AAeEOI?II)

5.2. No?ie, aeacaiee o i.5.1 Aeaiiai Eiio?aeoo, iiaea aooe i?ieiiaiaaiee (i?iaeiaaeaiee)
ca caiaeith Noi?ii, aea no?ieii ia aieueoa iiiaae 180 aeiia.

6. II?ssAeIE IIAA?IAIIss (IIAAOAIIss) IICEEE

6.1. Ii caeii/aiii no?ieo, aeacaiiai o i.5.1 Aeaiiai Eiio?aeoo, IICE*AEUeIEE ciaiayco-
ooueny i?ioyaii __________ iiaa?iooe noio iiceee.

6.2. Iiceea iiaa?oaooueny o aacaioiaeiaiio ii?yaeeo ieaoiaeiei aei?o/aiiyi oeyoii
ia?aeaco aiaeiiaiaeieo aaethoieo eiooia ia ?aooiie E?AAeEOI?A.

6.3. IICE*AEUeIEE i?ioyaii _______ iiney ia?aeaco noie aaethoii? iiceee E?AAeEOI?O
ciaiaycaiee iiaiaeiieoe inoaiiueiai i?i ia?aeac eiooia oeyoii __________________________ .

(oaeaa?aoii, oaenii oiui)

6.4. E?AAeEOI? i?ioyaii ______________ iiney iaaeoiaeaeaiiy noie caeio ia naie ?aooiie
ciaiaycaiee iiaiaeiieoe IICE*AEUeIEEA i?i oea ____________________________________ .

(oaeaa?aoii, oaenii oiui)

6.5. Iiaa?iaiiy (iiaaoaiiy) iiceee iiaea caeienithaaoeny oeyoii iinoa/aiiy ocaiaeaeaii?
eieueeinoi i?iaeoeoei? aai iaaeaiiy iineoa ca ?aooiie iiaaoaiiy caai?aiaaiinoi IICE*AEUeIEEA
ca inioth/eie ciaiaycaiiyie inoaiiueiai ia?aae E?AAeEOI?II.

7. NO?IE AeI? AeAIIAI EIIO?AEOO

Aeaiee Eiio?aeo iaaoaao /eiiinoi c iiiaioo iiaeienaiiy eiai Noi?iiaie i o aeieniei aei
iiiaioo eiai inoaoi/iiai aeeiiaiiy, i?ioa, o aoaeue-yeiio aeiaaeeo aei <____> ___________
19___ ?.

8. AIAeIIAIAeAEUeIINOUe NOI?II

8.1. Ca ii?ooaiiy oiia Aeaiiai Eiio?aeoo aeiia Noi?iia aiaeoeiaeiaoo caaaeaii caeoee, o
oiio /enei ao?a/aio aeaiaeo, o ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.
8.2. IICE*AEUeIEE iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Eiio?aeoii:

8.3. E?AAeEOI? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Eiio?aeoii:

9. CAAACIA*AIIss CIAIAssCAIUe CA AeAIEI EIIO?AEOII

(iiaeooue ia?aaeaa/aoeny oiiae i?i canoaao, no?aooaaiiy
aai ii?oeo c aieo, a iniiaiiio, IICE*AEUeIEEA)

10. II?ssAeIE AE?IOAIIss NII?IA
(a?aio?aaeia canoa?aaeaiiy)

10.1. Ani nii?e iiae Noi?iiaie, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o aiaeiiaiae-
iinoi aei caeiiiaeaanoaa Oe?a?ie a a?aio?aaeiiio noaei ca iinoeai ciaoiaeaeaiiy IICE*AEUeIEEA.
10.2. Noi?iie iinoaiiaeythoue, ui ani iiaeeeai i?aoaici? ca Aeaiei Eiio?aeoii iiaeiii
aooe ?icaeyiooi Noi?iiaie i?ioyaii ________ aeiia c iiiaioo iaea?aeaiiy i?aoaici?.

1 1. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE
Iiaiiaaaeieie i?aaenoaaieeaie Noi?ii ca Aeaiei Eiio?aeoii o:
IICE*AEUeIEE: _____________________________ oaeaoii _____________________ .
E?AAeEOI?: ___________________________________ oaeaoii _____________________ .

12. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

Eiia?oeieiee aeiaiai?

13. IIOI OIIAE

13.1. Aeaiee Eiio?aeo neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii?
ic noi?ii.

13.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Eiio?aeoii, Noi?iie ea?othoueny /eiiei oeeaieue-
iei caeiiiaeaanoaii.

13.3. Iiney iiaeienaiiy Aeaiiai Eiio?aeoo ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee i i?ioieiee i?i iaii?e c ieoaiue, oae /e iiaeoa iiaycaieo c Aeaiei Eiio?aeoii,
ao?a/athoue th?eaee/io neeo.

14. TH?EAeE*II AAe?ANE I AAIEIANUeEI ?AEAICEOE NOI?II

14.1. E?AAeEOI?:

Iinoeaciaoiaeaeaiiy ioino: _________________________________________________________.
Iiooiaa aae?ana oa iiaeaen: _________________________________________________________ .
Oaeaoii ___________, oaeaoaei ___________________, oaen _______________________ .
?ic?aooieiaee ?aooiie ?_____________ a

(iacaa aaieianueei? onoaiiae)

IOI ______________, eiae ________________
Ei?aniiiaeaionueeee ?aooiie aaieo E?AAeEOI?A: _________
Iioi/iee aaethoiee ?aooiie: ___________________________

14.2. IICE*AEUeIEE:

Iinoeaciaoiaeaeaiiy ioino: ______________________________
Iiooiaa aae?ana oa iiaeaen: ______________________________
Oaeaoii ___________, oaeaoaei ______________, oaen
?ic?aooieiaee ?aooiie ?_____________ a

(iacaa aaieianueei? onoaiiae)

IOI ______________, EIAe __________________ .

Ei?aniiiaeaionueeee ?aooiie aaieo IICE*AEUeIEEA: _____________________________ .
Iioi/iee aaethoiee ?aooiie: ___________________________________________________ .
14.3. Noi?iie ciaiaycothoueny iaaaeii ienueiiai iiaiaeiieoe iaeia iaeio o aeiaaeeo ciiie
aiaeiiinoae, aeacaieo o i. 15 Aeaiiai Aeiaiai?o.

E?AAeEOI? IICE*AEUeIEE
__________________(……….) __________________(……….)
I.I. I.I.

Eiia?oeieiee aeiaiai?

?icaeie C

CANOAAA OA IIOI NIINIAE
CAAACIA*AIIss AEEIIAIIss CIAIAssCAIUe
(aeea. eiiaioa?i aei ae.a)

AeIAIAI?
i?i canoaao iaeia
(c caeeoaiiyi iaeia o canoaaieea)

i. ____________ <____> ___________ 199 ___ ?.

CANOAAIEE: __________________________________________________________________,
a iniai ______________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

CANOAAIAeA?AEAOAEUe: ________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

O aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o CANOAAIAeA?AEAOAEUe iao i?aai o aeiaaeeo iaaeei-
iaiiy CANOAAIEEII nai?o ciaiaycaiue ca aeiaiai?ii o i.2.1 (aeaei ca oaenoii – ) io?eiaoe caaeiaieaiiy ca ?aooiie iaeia, canoaaeaiiai ia ieae/aaeacaieo oiiaao.

2. CIAIAssCAIIss, CAAACIA*AIA CANOAAITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai canoaaith ca Aeaiei Aeiaiai?ii: aeiaiai?
? ______ aiae <____> __________ 19___ ?.
2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao

CANOAAIAeA?AEAOAEAI ca iniiaiei aeiaiai?ii aenooiao
2.3. I?aaeiaoii iniiaiiai aeiaiai?o o _________________________________________________
2.4. Oa?iii aeeiiaiiy ciaiaycaiiy, caaacia/aiiai Aeaiei Aeiaiai?ii: ________________

3. ?ICII? CAAACIA*AII? CANOAAITH AEIIAE

?icii? caaacia/aii? canoaaith aeiiae neeaaeao:
3.1.____________________________________
3.2._____________________________________
3.3._____________________________________
Onueiai: __________________________________

4. I?AAeIAO CANOAAE
(NEEAAe CANOAAEAIIAI IAEIA)

4.1. I?aaeiaoii canoaae o ianooiia iaeii:

4.1.1. Iaeiaioaaiiy: _______________________________________________
4.1.2. Eieueeinoue: _______________________________________________________
4.1.3. sseinoue: _______________________________________________________
4.2. Ocaiaeaeaia ca Aeaiei Aeiaiai?ii aa?oinoue canoaaeaiiai iaeia neeaaeao:

4.3. Aeuaaeacaia iaeii iaeaaeeoue CANOAAIEEO ia i?aai _______________________ .
4.4. Canoaaeaia iaeii caeeoaooueny o aieiaeiiii CANOAAIEEA c iinoeaciaoiaeaeaiiyi o

Eiia?oeieiee aeiaiai?

5. I?AAA CANOAAIEEA C ?ICII?ssAeAEAIIss CANOAAEAIEI IAEIII
5.1. CANOAAIEE iao ianooiii i?aaa c ?icii?yaeaeaiiy canoaaeaiei iaeiii: ____________

5.2. Ianooiia canoaaa canoaaeaiiai iaeia

(aeiioneaooueny, aeiioneaooueny ca caiaeith CANOAAIAeA?AEAOAEss, ia aeiioneaooueny)

5.3. CANOAAIEE ciaiaycaiee (ia ciaiaycaiee) cano?aooaaoe canoaaeaia iaeii ia
ianooiieo oiiaao: ______________________________________________________________________

5.4. CANOAAIEE ciaiaycaiee o iiaiiio ianyci aiaeoeiaeoaaoe CANOAAIAeA?AEAOAETH
caeoee, ni?e/eiaii ao?aoith, ianoa/ath aai iioeiaeaeaiiyi canoaaeaiiai iaeia.

6. IIOI OIIAE

6.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

6.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?

i?i canoaao aoaeiaei, nii?oaee, aoaeeieo
(iiioaea)

199___?.

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

2. CIAIAssCAIIss, CAAACIA*AIA IIIOAEITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai iiioaeith ca Aeaiei Aeiaiai?ii: aeiaiai?
aiae <____> __________ 19___ ?. ? ______ .
2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao

CANOAAIAeA?AEAOAEAI ca iniiaiei aeiaiai?ii aenooiao
2.3. I?aaeiaoii iniiaiiai aeiaiai?o o _______________________________________________
2.4. Oa?iii aeeiiaiiy ciaiaycaiiy, caaacia/aiiai Aeaiei Aeiaiai?ii: ________________

3. ?ICII? CAAACIA*AII? IIIOAEITH AEIIAE

?icii? caaacia/aii? iiioaeith aeiiae neeaaeao:
3.1. _____________________________________________________________
3.2._____________________________________________________________
3.3._____________________________________________________________
Onueiai: _______________________________________________________

Eiia?oeieiee aeiaiai?

4. I?AAeIAO IIIOAEE

4.1. I?aaeiaoii iiioaee o _____________________
(aeaei ca oaenoii – ).
4.2. Iaoeo ia?ooiiinoi ciaoiaeeoueny ca aae?anith:

4.3. Oa?aeoa?enoeea iaoeoa ia?ooiiinoi:

4.4. Ocaiaeaeaia ca Aeaiei Aeiaiai?ii aa?oinoue canoaaeaiiai iaoeoa ia?ooiiinoi neeaaeao:
_______________________________________________________________________________e?a.

4.5. Aeuaaeacaiee iaoeo ia?ooiiinoi iaeaaeeoue CANOAAIEEO ia i?aai __________ .

5. I?AAA OA IAIAssCEE CANOAAIEEA

5.1. Iiioaea anoaiiaethooueny aac ia?aaea/i iaoeoa ia?ooiiinoi CANOAAIAeA?AEAOAETH.
5.2. CANOAAIEE iao i?aai aieiaeioe oa ei?enooaaoeny canoaaeaiei iaoeoii ia?ooiiinoi,
aea ia iao i?aaa aiae/oaeoaaoe eiai o aoaeue-yeee niinia aac caiaee CANOAAIAeA?AEAOAEss aei
caeii/aiiy oa?iiio aei? Aeaiiai Aeiaiai?o.

5.3. CANOAAIEE ciaiaycaiee noai?thaaoe iaeaaeii oiiae aeey oo?eiaiiy canoaaeaiiai
iaoeoa ia?ooiiinoi, yei aeeeth/athoue eiai iioeiaeaeaiiy, cieuaiiy; naio/anii caeienithaaoe
iioi/iee ?aiiio.

5.4. CANOAAIEE ciaiaycoooueny aeiioneaoe iiaiiaaaeieo i?aaenoaaieeia CANOAAIAeA?AEA-
OAEss a iinoeaciaoiaeaeaiiy canoaaeaiiai iaoeoa ia?ooiiinoi c iaoith ia?aai?ee eiai iayaiinoi
oa oiia eiai oo?eiaiiy.
5.5. Ianooiia canoaaa canoaaeaiiai iaoeoa ia?ooiiinoi _______________________________

(aeiioneaooueny, aeiioneaooueny ca caiaeith CANOAAIAeA?AEAOAEss. ia aeiioneaooueny)

5.6. CANOAAIEE ciaiaycaiee (ia ciaiaycaiee) cano?aooaaoe iiioaeo ia ianooiieo
oiiaao: _________________________________________________________________________

6. I?AAA CANOAAIAeA?AEAOAEss

6.1. CANOAAIAeA?AEAOAEUe iao i?aai a no?ie __________ caeienithaaoe ia?aai?eo iaoeoa
ia?ooiiinoi ca eiai iinoeaciaoiaeaeaiiyi c iaoith ia?aai?ee eiai iayaiinoi oa oiia eiai
oo?eiaiiy.

7. IIOI OIIAE

7.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

7.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii. .

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
i?i canoaao aeaiiceoiiai aeeaaeo

199 ___ ?.

CANOAAIEE: _________________________________________
a iniai __________________________________________________
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

CANOAAIAeA?AEAOAEUe: __________________________________
a iniai ______________________________________________________
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

Eiia?oeieiee aeiaiai?

1. I?AAeIAO AeIAIAI?O

2. CIAIAssCAIIss, CAAACIA*AIA CANOAAITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai canoaaith ca Aeaiei Aeiaiai?ii: aeiaiai?
? ______ aiae <____> __________ 19___ ?.
2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao

2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao
CANOAAIAeA?AEAOAEAI ca iniiaiei aeiaiai?ii aenooiao
2 3 I?aiiaoii iniiaiiai iiaiai?o ?
2 4 Oa?iii aeeiiaiiy ciaiaycaiiy, caaacia/aiiai Eyiei Iiaiai?ii-
3. ?ICII? CAAACIA*AII? CANOAAITH AEIIAE ?icii? caaacia/aii? canoaaith aeiiae neeaaeao: 31
32
33
Onueiai: ,

4. I?AAeIAO CANOAAE

4.1. I?aaeiaoii canoaae o aeaiiceoiee aeeaae CANOAAIEEA o _______________________ .
(iaeiaioaaiiy aaieianueei? onoaiiae)

Aeuaaeacaia iniaa o ai?aeieeii ii aiaeiioaiith aei CANOAAIEEA.
4.2. Iiaenoaaa aeaiiceoiiai aeeaaeo: aeiaiai? ? ___________ aeaiiceoiiai aeeaaeo aiae <____>

___________ 19___ ?.

4.3. ?icii? aeaiiceoiiai aeeaaeo: ________________________________________________ .
4.4. Oa?iii iiaa?iaiiy aeaiiceoiiai aeeaaeo: ________________________________________ .
4.5. I?aai canoaae iioe?thooueny i ia aiaenioee ca aeuaaeacaiei aeaiiceoiei aeeaaeii.
4.6. C iiiaioa iiaeienaiiy Aeaiiai Aeiaiai?o CANOAAIEE a oa?iii _____ aeiia ciaiaycaiee

niiainoeoe _________________________________________________________________________

(iaeiaioaaiiy aaieianueei? onoaiiae)
i?i oeeaaeaiiy Aeaiiai Aeiaiai?o.

5. I?AAA CANOAAIAeA?AEAOAEss

5.1. O aeiaaeeo iaaeeiiaiiy CANOAAIEEII nai?o ciaiaycaiue ca i.2 Aeaiiai Aeiaiai?o
CANOAAIAeA?AEAOAEUe iao i?aai io?eiaoe caaeiaieaiiy ca ?aooiie canoaaeaiiai aeaiiceoiiai
aeeaaeo.

5.2. O aiaeiiaiaeiinoi c i.5.1. Aeaiiai Aeiaiai?o CANOAAIAeA?AEAOAEUe io?eioo i?aai
aeiiae iiaa?iaiiy aeaiiceoiiai aeeaaeo oa aiaenioeia ca iei o ii?yaeeo, ia?aaeaa/aiiio /eiiei
caeiiiaeaanoaii.

5.3. CANOAAIAeA?AEAOAEUe iao e?ii oiai ani i?aaa, ia?aaeaa/aii /eiiei caeiiiaeaanoaii
Oe?a?ie.

6. IIOI OIIAE

6.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

6.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? c
noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

Eiia?oeieiee aeiaiai?

AeIAIAI?

i?i canoaao iaeia c ia?aaea/ath iaeia canoaaiaea?aeaoaeth
(canoaaa)

i. ____________ <____> ___________ 199 ___ ?.

CANOAAIAeA?AEAOAEUe: ___________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

2. CIAIAssCAIIss, CAAACIA*AIA CANOAAITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai canoaaith ca Aeaiei Aeiaiai?ii: aeiaiai?
aiae <____> __________ 19___ ?. ? ______.
2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao

CANOAAIAeA?AEAOAEAI ca iniiaiei aeiaiai?ii aenooiao
2.3. I?aaeiaoii iniiaiiai aeiaiai?o o ______________________________
2.4. Oa?iii aeeiiaiiy ciaiaycaiiy, caaacia/aiiai Aeaiei Aeiaiai?ii:

3. ?ICII? CAAACIA*AII? CANOAAITH AEIIAE
?icii? caaacia/aii? canoaaith aeiiae neeaaeao:
3.1.___________________________________________________________
3.2. ___________________________________________________________
3.3.___________________________________________________________
Onueiai: ________________________________________________________

4. I?AAeIAO CANOAAE (NEEAAe CANOAAEAIIAI IAEIA)

4.1. I?aaeiaoii canoaae o ianooiia iaeii:

4.1.1. Iaeiaioaaiiy: ___________________________________________________
4.1.2. Eieueeinoue: ___________________________________________________________
4.1.3. sseinoue: ___________________________________________________________
4.2. Ocaiaeaeaia ca Aeaiei Aeiaiai?ii aa?oinoue canoaaeaiiai iaeia neeaaeao: ___

4.3. Aeuaaeacaia iaeii iaeaaeeoue CANOAAIEEO ia i?aai ________________________ .
4.4. Canoaaeaia iaeii ia?aaeaooueny o aieiaeiiiy CANOAAIAeA?AEAOAETH o ianooiiiio
ii?yaeeo: __________________________________________________________________________.
Oa?iii ia?aaea/i: ______________________________________________________________.
Iinoea ia?aaea/i:
4.5. CANOAAIAeA?AEAOAEUe iao ianooiii i?aaa c aeei?enoaiiy canoaaeaiiai iaeia: ___

5. I?AAA CANOAAIEEA C ?ICII?ssAeAEAIIss CANOAAEAIEI IAEIII
5.1. CANOAAIEE iao ianooiii i?aaa c ?icii?yaeaeaiiy canoaaeaiei iaeiii: _______

5.2. Ianooiia canoaaa canoaaeaiiai iaoeoa ia?ooiiinoi __________
(aeiioneaooueny, aeiioneaooueny ca caiaeith CANOAAIAeA?AEAOAEss, ia aeiioneaooueny)

Eiia?oeieiee eiaiai?

6. IAIAssCEE CANOAAIAeA?AEAOAEss

CANOAAIAeA?AEAOAEUe ciaiaycaiee:

6.1. Cano?aooaaoe i?aaeiao canoaae ia eiai iiaio aa?oinoue ca ?aooiie i a iioa?anao CANOAA-
IEEA.

6.2. Aaeeoe anio iaiaoiaeieo caoiaeia uiaei caa?aaeaiiy i?aaeiaoo canoaae.
6.3. Iaaaeii iiaiaeiieoe CANOAAIEEA i?i aeieeiaiiy caa?ice ao?aoe aai iioeiaeaeaiiy

i?aaeiaoo canoaae.
6.4. A no?ie ________ iiaa?iooe i?aaeiao canoaae iiney aeeiiaiiy CANOAAIEEII aai

o?aoueith iniaith caaacia/aiiai canoaaith ciaiaycaiiy.

7. IIOI OIIAE

7.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

7.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
i?i canoaao i?aa ia i?iieneiao aeaniinoue

i. ____________ <____> ___________ 199 ___ ?.

CANOAAIAeA?AEAOAEUe: ________________________________________________________,
a iniai _________________________________________________________________________________,

ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

2. CIAIAssCAIIss, CAAACIA*AIA CANOAAITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai canoaaith ca Aeaiei Aeiaiai?ii: aeiaiai?
aiae <____> __________ 19___ ?. ? ______ .
2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao

CANOAAIAeA?AEAOAEAI ca iniiaiei aeiaiai?ii aenooiao
2.3. I?aaeiaoii iniiaiiai aeiaiai?o o _____________________________________________
2.4. Oa?iii aeeiiaiiy ciaiaycaiiy, caaacia/aiiai Aeaiei Aeiaiai?ii: _________________

3. ?ICII? CAAACIA*AII? CANOAAITH AEIIAE
?icii? caaacia/aii? canoaaith aeiiae neeaaeao:
3.1.___________________________________________________________
3.2.___________________________________________________________
3.3.___________________________________________________________
Onueiai: ________________________________________________________

4. I?AAeIAO CANOAAE (NEEAAe CANOAAEAIIAI IAEIA)
4.1. I?aaeiaoii canoaae o ianooiia i?iieneiaa aeaniinoue:

Eiia?oeieiee aeiaiai?
4.1.1. Iaeiaioaaiiy: i?aai aeei?enoaiiy oa ?icii?yaeaeaiiy ia

(iio-oao, oiaa?iee ciae, aaoi?nueei i?aaa, eioeaicith, iaoaio oa ii.)

(aeaei ca oaenoii – ).

4.1.2. Oa?aeoa?enoeea: ______________________________________________________
4.1.3. Ciino: _______________________________________________________________
4.2. Ocaiaeaeaia ca Aeaiei Aeiaiai?ii aa?oinoue canoaaeaii? i?iieneiai? aeaniinoi:

4.3. Aeuaaeacaia i?iieneiaa aeaniinoue iaeaaeeoue CANOAAIEEO ia i?aai
o aiaeiiaiaeiinoi aei

(aeiaiai?o, aaoi?noaa oa ii.)

5. I?AAA CANOAAIEEA C ?ICII?ssAeAEAIIss CANOAAEAIEI IAEIII
5.1. CANOAAIEE iao ianooiii i?aaa c ?icii?yaeaeaiiy canoaaeaiith i?iieneiaith aean-
iinoth: ________________________________________________________________________________.
5.2. Ianooiia canoaaa canoaaeaiiai iaoeoa ia?ooiiinoi _______________________________

(aeiioneaooueny, aeiioneaooueny ca caiaeith CANOAAIAeA?AEAOAEss, ia aeiioneaooueny)

6. I?AAA CANOAAIAeA?AEAOAEss

6.1. O aeiaaeeo iaaeeiiaiiy CANOAAIEEII nai?o ciaiaycaiue ca i.2 Aeaiiai Aeiaiai?o
CANOAAIAeA?AEAOAEUe iao i?aai io?eiaoe caaeiaieaiiy ca ?aooiie canoaaeaii? i?iieneiai?
aeaniinoi.

6.2. O aiaeiiaiaeiinoi aei i.6.1 Aeaiiai Aeiaiai?o CANOAAIAeA?AEAOAEUe io?eioo ianooiii
i?aaa c aeei?enoaiiy i?iieneiai? aeaniinoi: ____________________________________________

6.3. Ii?yaeie aeei?enoaiiy i?iieneiai? aeaniinoi iiney caa?iaiiy noyaiaiiy ia i?aaeiao
canoaae CANOAAIAeA?AEAOAEUe aecia/ao naiinoieii.

7. IIOI OIIAE

7.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

7.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
i?i canoaao oiaa?ia o ia?a?iaoei

199___?.

CANOAAIAeA?AEAOAEUe: ______________________________________________________,
a iniai _________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

2. CIAIAssCAIIss, CAAACIA*AIA CANOAAITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai canoaaith ca Aeaiei Aeiaiai?ii: aeiaiai?
aiae <____> __________ 19___ ?. ? ______ .

Eiia?oeieiee eiaiai?

2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao
CANOAAIAeA?AEAOAEAI ca iniiaiei aeiaiai?ii aenooiao
2,3, I?aiiaoii iniiaiiai iiaiai?o
2 4 Oa?iii aeeiiaiiy yiaiaycyiiy, cyaacia/aiiai Iyiei Iiaiai?ii-
3. ?ICII? CAAACIA*AII? CANOAAITH AEIIAE ?icii? caaacia/aii? canoaaith aeiiae neeaaeao: 31
32
33
Onueiai-
4. I?AAeIAO CANOAAE (NEEAAe OIAA?IA O IA?A?IAOeI) 4.1. I?aaeiaoii canoaae o ianooiia iaeii: 4 1 1 Aei canoaaeaiiai oiaa?o:
4 ] ?. Eieueeinoue-
41 3 sseinoue-
4 1 4 Eiiai?ii ssEINII CIIIE OIAss?O-
4.2. Ia?a?iaea canoaaeaiiai oiaa?o ia iiaeiia ciaiooaaoe eiai aa?oinoue. 4 3 Ocaiiaeaia ca Eaiei Iiaiai?ii aa?oinoue canoyeeaiiai iyeiy NEEssIss?-
4 4 Aeiiiaaeycyia iyeii iaeaaeeoue CANOAAIEEO ia i?aai
4.5. Canoaaeaia iaeii caeeoaooueny o aieiaeiiii CANOAAIEEA c iinoeaciaoiaeaeaiiyi o:
5. I?AAA CANOAAIEEA C ?ICII?ssAeAEAIIss CANOAAEAIEI IAEIII

5.1. CANOAAIEE iao i?aai ia?a?iaeyoe o naioio ae?iaieoeoai canoaaeaii oiaa?e, oae ye
i?aai CANOAAIAeA?AEAOAEss iioe?thooueny ia ae?iaeaii e ia?a?iaeaii oiaa?e oa aioiao
i?iaeoeoeith.
5.2. Ianooiia canoaaa canoaaeaiiai iaoeoa ia?ooiiinoi _______________________________

(aeiioneaooueny, aeiioneaooueny ca caiaeith CANOAAIAeA?AEAOAEss, ia aeiioneaooueny)

5.3. CANOAAIEE ciaiaycaiee (ia ciaiaycaiee) cano?aooaaoe canoaaeaia iaeii ia
ianooiieo oiiaao: ___________________________________________________________________

5.4. CANOAAIEE ciaiaycaiee o iiaiiio ianyci aiaeoeiaeoaaoe CANOAAIAeA?AEAOAETH
caeoee, ni?e/eiaii ao?aoith, ianoa/ath aai iioeiaeaeaiiyi canoaaeaiiai iaeia.

6. IIOI OIIAE

6.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

6.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
i?i canoaao oiaa?ia a iaiao

199 ___ ?.

CANOAAIEE:

a iniai __________

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i
CANOAAIAeA?AEAOAEUe: ____________

a iniai ______________________________
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

Eiia?oeieiee aeiaiai?

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

2. CIAIAssCAIIss, CAAACIA*AIA CANOAAITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai canoaaith ca Aeaiei Aeiaiai?ii: aeiaiai?
aiae <____> __________ 19___ ?. ? ______ .
2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao

CANOAAIAeA?AEAOAEAI ca iniiaiei aeiaiai?ii aenooiao
2.3. I?aaeiaoii iniiaiiai aeiaiai?o o __________________________________________________
2.4. Oa?iii aeeiiaiiy ciaiaycaiiy, caaacia/aiiai Aeaiei Aeiaiai?ii: ________________

3. ?ICII? CAAACIA*AII? CANOAAITH AEIIAE

?icii? caaacia/aii? canoaaith aeiiae neeaaeao:
3.1. _____________________________________
3.2.______________________________________
3.3.___________________________._________
Onueiai: __________________________________

4. I?AAeIAO CANOAAE (NEEAAe OIAA?IA A IAIAO)

4.1. I?aaeiaoii canoaae o ianooiia iaeii:
4.1.1. Aeae canoaaeaiiai oiaa?o: _______________________________________
4.1.2. Eieueeinoue: _____________________________________________________
4.1.3. sseinoue: _______________________________________________________
4.1.4. Eieueeinoue oa yeinoue oiaa?o, yeei iiaea caiiiyoeny i?aaeiao canoaae:.

4.2. Iaia canoaaeaiiai oiaa?o oa i?eaeaaiiy iiaiai ca i.4.1.4 Aeaiiai Aeiaiai?o ia iiaeiii
ciaiooaaoe eiai aa?oinoue.
4.3. Ocaiaeaeaia ca Aeaiei Aeiaiai?ii aa?oinoue canoaaeaiiai iaeia neeaaeao: _______________

4.4. Aeuaaeacaia iaeii iaeaaeeoue CANOAAIEEO ia i?aai ________________________ .
4.5. Canoaaeaia iaeii caeeoaooueny o aieiaeiiii CANOAAIEEA c iinoeaciaoiaeaeaiiyi o:

4.6. I?aai canoaae ia iiaee oiaa? ca i.4.1.4 Aeaiiai Aeiaiai?o aeieeao a iiiaio i?eaeaaiiy
ia iueiai o CANOAAIEEA i?aaa aeaniinoi (iiaiiai ainiiaea?nueeiai aaaeaiiy, iia?aoeaiiai
oi?aaeiiiy).

5. I?AAA CANOAAIEEA C ?ICII?ssAeAEAIIss CANOAAEAIEI IAEIII

5.1. CANOAAIEE iao i?aai ?aaeiciaoaaoe canoaaeaia iaeii ca oiiae iaeii/aniiai iiaa-
oaiiy aiaeiiaiaeii? /anoeie caaacia/aii? canoaaith caai?aiaaiinoi aai caiiie canoaaeaiiai
oiaa?o, ui aeaoaao, iioei oiaa?ii ia ?iaio aai aieueoo aa?oinoue.
5.2. Ianooiia canoaaa canoaaeaiiai iaoeoa ia?ooiiinoi_______________________________

(aeiioneaooueny, aeiioneaooueny ___________ 199 ___ ?.

CANOAAIEE:
a iniai

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i
CANOAAIAeA?AEAOAEUe: ____________

a iniai ____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

O aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o CANOAAIAeA?AEAOAEUe io i?aai o aeiaaeeo iaaeei-
iaiiy CANOAAIEEII nai?o ciaiaycaiue ca aeiaiai?ii o i.2.1 (aeaei ca oaenoii – ) io?eiaoe caaeiaieaiiy ca ?aooiie iaeia, canoaaeaiiai ia ieae/aaeacaieo oiiaao.

2. CIAIAssCAIIss, CAAACIA*AIA CANOAAITH

2.1. Iiaenoaaa iiyae ciaiaycaiiy, caaacia/aiiai canoaaith ca Aeaiei Aeiaiai?ii: aeiaiai?
? ______ aiae <____> ___________ 19___ ?.
2.2. CANOAAIEEII ca iniiaiei aeiaiai?ii aenooiao

3. ?ICII? CAAACIA*AII? CANOAAITH AEIIAE

?icii? caaacia/aii? canoaaith aeiiae neeaaeao:

3.1. __________________________________________________________________________.
3.2. __________________________________________________________________________.

3.3. __________________________________________________________________________.
Onueiai: _______________________________________________________________________.

4. I?AAeIAO CANOAAE (NEEAAe CANOAAEAIIAI IAEIA)

4.1. I?aaeiaoii canoaae o ianooiii aaethoii oeiiiinoi:
4.1.1. Iaeiaioaaiiy aaethoe, ui canoaaeyooueny: _______________________________________ .
4.1.2. Eieueeinoue aaethoe, ui canoaaeyooueny: ____________________________________________ .
4.1.3. Ocaiaeaeaiee ca Aeaiei Aeiaiai?ii eo?n (oeiia) aaethoe, ui canoaaeyooueny:____________ .
4.1,4. Eiiai?ii yeinii ciiie oiaa?o: ___________________________________________________ .

4.2. I?aaeiaoii canoaae ia o aaethoii eiooe, io?eiaii CANOAAIAeA?AEAOAEAI aiae
aeei?enoaiiy iaeia, aeacaiiai o i,4.1 Aeaiiai Aeiaiai?o.

4.3. Aaethoa iaeaaeeoue CANOAAIEEO ia i?aai _____________ oa aiaeiineoueny aei aaethoieo
eiooia inoaiiueiai, ui caeeoeeeny iiney iaiayceiaiai i?iaeaaeo aaethoii? ae?o/ee o aiaeiiaiaeiin-
oi aei /eiiiai caeiiiaeaanoaa.

4.4. Canoaaeaia iaeii ia?aaeaooueny o aieiaeiiiy CANOAAIAeA?AEAOAETH o ianooiiiio
ii?yaeeo:

4.4.1. Aaethoii eiooe ia?a?aoiaothoueny CANOAAIEEII ia aaethoiee ?aooiie CANOAAI-
AeA?AEAOAEss.

4.4.2. Oa?iii ia?a?aooaaiiy: _________________________________________________
c iiiaioo _________________________________________________________________________.

Eiia?oeieiee aeiaiai?

5. I?AAA OA IAIAssCEE CANOAAIEEA

5.1, CANOAAIEE iao ianooiii i?aaa c ?icii?yaeaeaiiy canoaaeaiei iaeiii:

5.2. Ianooiia canoaaa canoaaeaiiai iaeia

(aeiioneaooueny, aeiioneaooueny ca caiaeith CANOAAIAeA?AEAOAEss, ia aeiioneaooueny)

5.3. CANOAAIAeA?AEAOAEUe iiaeiai a no?ie ___________ iiney aeeiiaiiy ciaiaycaiue
CANOAAIEEA ca iniiaiei aeiaiai?ii iiaa?iooe canoaaeaii aaethoii eiooe inoaiiueiai.

6. II?ssAeIE ?AAEICAOeI? I?AAeIAOO CANOAAE

6.1. sseui iniiaia ciaiaycaiiy ia aoaea aeeiiaii iaeaaeiei /eiii, CANOAAIAeA?AEA-
OAEUe iao i?aai aeei?enoaoe canoaaeaio aaethoo c iaoith iiaaoaiiy ai?ao CANOAAIEEA ca
iniiaiei aeiaiai?ii.

6.2. Iaia ia aaethoii eiooe caeienithooueny ca eo?nii ia ieae/a inioth/iai ia oeae iiiaio
iaiao.

6.3. Aaethoii eiooe, ui caeeoeeenue, iiaa?oathoueny oeyoii ?o ia?a?aooaaiiy ia aaethoiee
?aooiie CANOAAIEEA.

7. IIOI OIIAE

7.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii Oe?a?ie.

7.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
i?i iaaeaiiy aa?aioi? (noaneaeia?ii?)

199___?.

II?O*IEE: ____________________________________________
a iniai ______________________________________________________
ui aeio ia iiaenoaai _____________________________________________
c iaeiiai aieo, i

IAeA?AEOAA* AA?AIOI?: _______________________________

a iniai __________________________________________________
ui aeio ia iiaenoaai _____________________________________________
c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I. O aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o II?O*IEE iaaeao IAeA?AEOAA*O AA?AIOI?
noaneaeia?io aa?aioith aeeiiaiiy IAeA?AEOAA*AI AA?AIOE ianooiiiai ciaiaycaiiy:

1.1. Ciaiaycaiiy aeieeaao c aeiaiai?o, yeiai oeeaaeaii iiae IAeA?AEOAA*AI AA?AIOE
oa_____________________________________________________________________________.

(iacaa iiaei?eainoia-E?AAeEOI?A)

1.2. Aae?ana oa aaieianueei ?aeaiceoe iiaei?eoinoaa-E?AAeEOI?A:

1.3. Nooiinoue ciaiaycaiiy: _____________________________________________________ .
1.4. Oa?iii aeeiiaiiy ciaiaycaiiy:____________________________________________ .
1.5. Aiaeiiaiaeaeueiinoue IAeA?AEOAA*A AA?AIOE ca iaiaeaaeia aeeiiaiiy ciaiaycaiiy:

1.6. Iinoea aeeiiaiiy: _________________________________________________________ .
1.7. I?eieiaiiy ciaiaycaiiy: __________________________________________________ .
1.8. Iioi nooooai oiiae aeiaiai?o: ________________________________________________

Eiia?oeieiee eiaiai?

2. ?ICII? AA?AIOE

2.1, ?icii? aa?aioi?, ui iaaeaooueny IAeA?AEOAA*O AA?AIOI?, neeaaeao _________________

3. OeIIA AeIAIAI?O

3.1, A yeinoi aeiaai?iaee ca iaaeaiiy aa?aioi? IAeA?AEOAA* AA?AIOE niea/oo II?O*IE-
EO_________________________________________________________________________________

4. II?ssAeIE NIEAOE OeIIE

4.1. Oa?iii nieaoe aeiaai?iaee neeaaeao ________________________________________________
c iiiaioo _________________________________________________________________________.
4.2. Ii?yaeie nieaoe

(iiooiaee, oaeaa?aoiee)

4.3. Aeae ?ic?aooieia:__
4.4. Oi?ia ?ic?aooieia

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

(ieaoiaeia aei?o/aiiy, /ae. aeiiaa-aei?o/aiiy, ae?aaeeoea)

5. I?AAA OA IAIAssCEE II?O*IEEA

5.1. II?O*IEE iao i?aai aeiaaaoe aiae IAeA?AEOAA*A AA?AIOI? iioi?iaoeith oa aeieo-
iaioe uiaei aeeiiaiiy aeiaiai?o, ca yeei aeaeaooueny aeaia aa?aioiy.

5.2. II?O*IEE ciaiaycaiee a no?ie ________ aeiia c iiiaioo oeeaaeaiiy Aeaiiai Aeiaiai?o
aeaeaoe IAeA?AEOAA*O AA?AIOE aa?aioieiiai eenoa ic cacia/aiiyi ?icii?o oa oiia aa?aioi?.
5.3. II?O*IEE ciaiaycoooueny aiaeoeiaeoaaoe E?AAeEOI?O aiaeiiaiaeii aei Aeaiiai Aeiaiai?o
eiai caeoee i?e iaaeeiiaiii IAeA?AEOAA*AI AA?AIOI? ciaiaycaiiy c i?e/eie a?aeo a
inoaiiueiai aeanieo eiooia.

6. IAIAssCEE IAeA?AEOAA*A AA?AIOI?

6.1. IAeA?AEOAA* AA?AIOI? ciaiaycaiee naio/anii nieaoeoe II?O*IEEO aeiaai?iaeo
a ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.

6.2. Iiney aeeiiaiiy ciaiaycaiiy, ui caaacia/oooueny caiaeii Aeaiiai Aeiaiai?o,
IAeA?AEOAA* AA?AIOI? i?ioyaii naie aeiia ienueiiai iiaiaeiieyo i?i oea II?O*IEEO.

6.3. O aeiaaeeo iaiiaeeeainoi aeeiiaoe ciaiaycaiiy c i?e/eie a?aeo aeanieo eiooia,
IAeA?AEOAA* AA?AIOI? i?ioyaii naie aeiia iiaiaeiieyo i?i oea II?O*IEEA oa ia?aaeao
inoaiiueiio ani aeieoiaioe, ui noinothoueny aeeiiaiiy ciaiaycaiiy ca Aeaiei Aeiaiai?ii.

6.4. IAeA?AEOAA* AA?AIOI? ciaiaycaiee ca aeiiaith II?O*IEEA iaaeaaaoe inoaiiueiio
anth iaiaoiaeio iioi?iaoeith oa aeieoiaioe uiaei aeeiiaiiy aeiaiai?o, ca yeei aeaeaooueny aeaia
aa?aioiy.

6.5. IAeA?AEOAA* AA?AIOI? ia iao i?aaa ciiithaaoe oiiae aeiaiai?o, ia?aaeaa/aii o i. I
Aeaiiai Aeiaiai?o, aac caiaee ia oa II?O*IEEA. O iioiio ?aci II?O*IEE ia aiaeiiaiaeao
ia?aae E?AAeEOI?II ca aeeiiaiiy IAeA?AEOAA*AI AA?AIOI? nai?o ciaiaycaiue a /anoeii i
c iiiaioo aianaiiy ciii.

6.6. O aeiaaeeo aeeiiaiiy II?O*IEEII ca IAeA?AEOAA*A AA?AIOI? ciaiaycaiue ia?aae
E?AAeEOI?II, noia, niea/aia II?O*IEEII, iiaeeyaao nieaoi c aieo IAeA?AEOAA*A
AA?AIOI? c o?aooaaiiyi nieaoe caeoeia, ui ?o caciaa i?e oeueiio II?O*IEE.

7. AIAeIIAIAeAEUeIINOUe IAeA?AEOAA*A AA?AIOI?

7.1. I?e iaaeeiiaiii ciaiaycaiiy, ia?aaeaa/aiiai i.6.1 Aeaiiai Aeiaiai?o, IAeA?AEOAA*
AA?AIOI? niea/oo II?O*IEEO oo?ao o ?icii?i _________________, ui ia caieueiyo eiai aiae
iaiayceo aeeiiaoe ciaiaycaiiy.

7.2. I?e iaaeeiiaiii ciaiaycaiue, ia?aaeaa/aieo i.i.6.3 oa 6.4 Aeaiiai Aeiaiai?o,
IAeA?AEOAA* AA?AIOI? niea/oo II?O*IEEO oo?ao o ?icii?i ____________________, ui ia
caieueiyo eiai aiae iaiayceo aeeiiaoe ciaiaycaiiy.

8. OA?III AeI? AeIAIAI?O

8.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c ______________________________________________
oa i?eieiyo aeith ____________________________________________________________________ .

Eiia?oeieiee aeiaiai?

9. IIOI OIIAE

9.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, Noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii-

9.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
Noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ii?o/ieoeoaa

199___?.

II?O*IEE:

a iniai _________
ui aeio ia iiaenoaai.
c iaeiiai aieo, i

E?AAeEOI?:.

a iniai _________
ui aeio ia iiaenoaai.
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I. O aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o II?O*IEE ciaiaycoooueny nieiaea?ia aiaeiiaiaeaoe
ia?aae E?AAeEOI?II ca aeeiiaiiy ciaiaycaiue ca aeiaiai?ii, ui aoa oeeaaeaiee iiae
E?AAeEOI?II oa AI?AEIEEII _____________________ (iaaeaei – ), iiaiinoth.

2. CIAIAssCAIIss, CAAACIA*AIA AA?AIOIoTH

2.1. Iiaenoaaa ciaiaycaiiy, caaacia/aiiai aa?aioioth ca Aeaiei Aeiaiai?ii: aeiaiai? ? ___
aiae <____> __________ 19___ ?. ______________________________________________________ .
2.2. I?aaeiaoii aeiaiai?o o ______________________________________________________ .

2.3. Oa?iii aeeiiaiiy ciaiaycaiiy, caaacia/aiiai Aeaiei Aeiaiai?ii: _______________ .

3. ?ICII? AA?AIOI?

3.1. II?O*IEE aiaeiiaiaeao ia?aae E?AAeEOI?II ca aeeiiaiiy AI?AEIEEII onio ciai-
aycaiue ca aeiaiai?ii, aeacaiei o i. I Aeaiiai Aeiaiai?o, o noii, ui aei?iaitho_______________
(________________________________________), a oaeiae ca aiaeoeiaeoaaiiy E?AAeEOI?O caeoeia
oa nieaoo iaonoieee.

4. I?AAA OA IAIAssCEE II?O*IEEA

4.1. II?O*IEE ciaiaycoooueny aeeiiaoe ca AI?AEIEEA ciaiaycaiiy inoaiiueiai ia?aae
E?AAeEOI?II ia oiiaao, a ii?yaeeo oa a oa?iiie, anoaiiaeaii oaiaeith, aeacaiith o i. I Aeaiiai
Aeiaiai?o.

5. I?AAA OA IAIAssCEE E?AAeEOI?A

5.1. O aeiaaeeo aeeiiaiiy II?O*IEEII ca AI?AEIEEA ciaiaycaiue ia?aae E?AAeEOI-
?II, inoaiiie ciaiaycoooueny ia?aaeaoe II?O*IEEO ani aeieoiaioe, ui canaiae/othoue aeiiae
aei AI?AEIEEA, oa ia?aaeaoe i?aaa, ui caaacia/othoue oeth aeiiao, o 7-aeaiiee oa?iii c aeiy
aeeiiaiiy ciaiaycaiiy.

5.2. E?AAeEOI? ia iao i?aaa ciiithaaoe oiiae aeiaiai?o, aeacaiiai o i. I Aeaiiai Aeiaiai?o
aac caiaee ia oa II?O*IEEA. A iioiio ?aci II?O*IEE ia aiaeiiaiaeao ia?aae E?AAeEOI?II
ca aeeiiaiiy AI?AEIEEII nai?o ciaiaycaiue c iiiaioo aianaiiy ciii.

6. OA?III AeI? AeAIIAI AeIAIAI?O

6.1. Oa?iii aei? Aeaiiai Aeiaiai?o caiaaooueny c oa?iiiii aei? aeiaiai?o, aeacaiiai a i. I Aeaiiai
Aeiaiai?o.

Eiia?oeieiee aeiaiai?

7. IIOI OIIAE

7.1. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, Noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii.

7.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
Noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

OAIAeA
i?i caaaeaoie

199___?.

CAAAeAOEIAeAAAUc: ________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

CAeNOAAIAeA?AEAOAEUe: _____________:___________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,
uia aeeiiaoe aeiaiai? ? ____ aiae <____> __________ 19___ ?.

oeeaee Aeaio Oaiaeo i?i ianooiia:

I. Noi?iie aeieoee caiaee o oiio, ui aeey caaacia/aiiy oi/iiai oa iaeaaeiiai aeeiiaiiy
ciaiaycaiue ca aeiaiai?ii ? ____ aiae <____> __________ 19___ ?. _________________________
ia?aaeaa/aia iei ia?aaeiieaoa o ?icii?i _______________ aiaenioeia iao noaoon caaaeaoeo.

2. O aeiaaeeo aaciiaenoaaii? aiaeiiae CAAAeAOEIAeAAOess aiae aeeiiaiiy nai?o ciaiaycaiue
ca aeiaiai?ii ? ____ aiae <____> __________ 19___ ?. ______________________________________
inoaiiie ao?a/ao i?aai aeiaaaoe iiaa?iaiiy ia?aaeiieaoe o iiaiiio ianyci.

3. O aeiaaeeo aaciiaenoaaii? aiaeiiae CAAAeAOEIAeA?AEAOAEss aiae aeeiiaiiy nai?o ciaiay-
caiue ca aeiaiai?ii ? ____ aiae <____> __________ 19___ ?. ________________________________
inoaiiie iiaeiai iiaa?iooe CAAAeAOEIAeAAOeTH iiaeaieio noio ia?aaeiieaoe.

4. CAAAeAOEIAeA?AEAOAEUe iiaeiai iiaa?iooe iiaeaieio noio ia?aaeiieaoe i?ioyaii __
___________ c iiiaioo aiaeiiae aiae aeiaiai?o /e c iiiaioo caeii/aiiy oa?iiio aeiaiai?o, yeui
CAAAeAOEIAeA?AEAOAEUe ia ?icii/ia eiai aeeiiaiiy.

5. I?e i?ino?i/aiii ca i.4 Aeaii? Oaiaee CAAAeAOEIAeA?AEAOAEUe niea/oo iaith a ?icii?i
________________ ca eiaeai aeaiue i?ino?i/aiiy.
6. Aeaia Oaiaea o iaaiaeoiiith /anoeiith aeiaiai?o ? ____ aiae <____> __________ 19___ ?.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

___________________________________?icaeie 4____________________________________

EOIIAEss-I?IAeAAE, IINOAAEA OIAA?IA

Ca aeiaiai?ii eoiiaei-i?iaeaaeo i?iaeaaaoeue ciaiaycoooueny ia?aaeaoe iaeii o aeaniinoue (iiaia
ainiiaea?/a aiaeaiiy, iia?aoeaia oi?aaeiiiy) iieoioey, a iieoiaoeue ciaiaycoooueny i?eeiyoe
iaeii i nieaoeoe ca iueiai iaaio a?ioiao noio.

Aaaeeeaa cia/aiiy o cayceo c aeiaiai?ii eoiiaei-i?iaeaaeo iao ieoaiiy i?i oa, c yeiai
iiiaioo iieoiaoeue noao aeanieeii iaeia. Aiae i?aaeeueiiai ae?ioaiiy oeueiai ieoaiiy caeaaeeoue
?yae i?aaiaeo ianeiaeeia, cie?aia, iiaycaieo c ?iciiaeieii ?eceeo aeiaaeeiai? caaeaaei aai
iioeiaeaeaiiy iaeia, iiaeeeainoth aeey aeanieea aeo?aaoaaoe naith ?i/ c /oaeiai iacaeiiiiai
aieiaeiiiy.

Caiaeii c caaaeueieie i?aaeeaie, i?aai aeaniinoi o iieoioey aeieeao c iiiaioo ia?aaea/i
?a/i, yeui iioa ia anoaiiaeaii caeiiiaeaanoaii aai aeiaiai?ii. O oeo aeiaaeeao, eiee aeiaiai?
iao aooe ca?aono?iaaiee aai iioa?iaeueii canaiae/aiee, i?aai aeaniinoi aeieeao c iiiaioo
eiai ?aono?aoei? aai canaiae/aiiy, a ca iaiaoiaeiinoi iioa?iaeueiiai canaiae/aiiy i aea?aeaaii? ?ao-
no?aoei? – c iiiaioo ?aono?aoei?.

Eiia?oeieiee aeiaiai?

?iciiaeaeii aeiaiai?o eoiiaei-i?iaeaaeo o aeiaiai? iinoaaee, yeee iiaeia aaaaeaoe iniiaiith
i iaeiioe?aiioith eiia?oeieiith iia?aoeioth c eoiiaei-i?iaeaaeo oiaa?ia o aieueiiio iiaei?eoiieoeoai.
Iioeie neiaaie, iinoaaea – oea eiia?oeieia eoiiaey-i?iaeaae aai eoiiaey-i?iaeaae, ui caeienithooueny
o aeieiaiio iaiao.

O aiaeiiaiaeiinoi c aeiaiai?ii iinoaaee IINOA*AEUeIEE, yeee aenooiao i?iaeaaoeai oiaa?o
i o iiaei?eoioeai, ciaiaycoooueny a iaoiiaeaii no?iee (no?ie) ia?aaeaaaoe o aeaniinoue (iiaia
ainiiaea?/a aiaeaiiy aai iia?aoeaia oi?aaeiiiy) IIEOIOeAAI oiaa?, i?ecia/aiee aeey iiaei?eoi-
ieoeueei? aeiyeueiinoi aai iioeo oeieae, ia iiaycaieo c iniaenoei (niiaeiei, aeiiaoiii) niiaeeaai-
iyi, a IIEOIAOeUe ciaiaycoooueny i?eeiaoe oiaa? i ieaoeoe ca iueiai iaaio oeiio. Iniiaieie
iniaeeainoyie aeiaiai?o iinoaaee o:

I. I?iaeaaoeai ca aeiaiai?ii iinoaaee (iinoa/aeueieeii) aenooiao eeoa iiaei?eoiaoeue, yeei
o iiaei?eoinoai aai a?iiaaeyiei-iiaei?eoiaoeue, ui caeienitho iiaei?eoiieoeueeo aeiyeueiinoue aac
ooai?aiiy th?eaee/ii? iniae.

2. I?aaeiaoii aeiaiai?o iinoaaee iiaea aooe eeoa iaeii (oiaa?), i?ecia/aia aeey iiaei?e-.
oiieoeueei? aeiyeueiinoi, oiaoi aeey ae?iaieoeoaa (i?iieneiai? ia?a?iaee) aai eiia?oeieiiai
ia?ai?iaeaaeo. Aeei?enoaiiy oiaa?o a iiaei?eoiieoeueeie aeiyeueiinoi aecia/ao iaea?aeaiiy i?eaooeo
aiae eiai aeei?enoaiiy iieoioeai.

3. No?iee oeeaaeaiiy aeiaiai?o oa eiai aeeiiaiiy, ye i?aaeei, ia caiaathoueny. Oey ianoaaeia
o iaiayceiaith iciaeith aeiaiai?o iinoaaee. Iiaeoa eaaeo/e, aeiaiai? iinoaaee iao aooe oeeaaeaiee
aei eiai aeeiiaiiy. Oeeaaeaiiy aeiaiai?o c iaeii/aniei aai iaeiiiiiaioiei aeeiiaiiyi oyaia
ca niaith aeciaiiy eiai aeiaiai?ii eoiiaei-i?iaeaaeo.

4. O aiaeiiaiaeiinoi aei aeiaiai?o iinoaaee iinoa/aeueiee ciaiaycaiee ia?aaeaaaoe oiaa?
iaiaeii?aciai, oiaoi iiiaae iaeei ?ac. Ia?aaea/a oiaa?o oieueee iaeei ?ac naiae/eoue i?i oa, ui aei
acaoiiaiaeiinei noi?ii iathoue canoiniaoaaoeny caaaeueii ii?ie i?i eoiiaeth-i?iaeaae, a ia
niaoeiaeueii, ui aeieeaathoue c aeiaiai?o iinoaaee. Aei aeiaiai?o iinoaaee canoiniaothoueny i?aaeea
i?i aeiaiai? eoiiaei-i?iaeaaeo, yeui iioa ia ia?aaeaa/aii caeiiiaeaa/eie aeoaie aai aeiaiai?ii.
Iioeie neiaaie, i?e noeoiiie iayaiinoi aeuaaeacaieo oiia aei aiaeiinei, yei aeieeee, iaiaoiaeii
canoiniaoaaoe ii?ie i?i aeiaiai? iinoaaee. I?aaeiao aeiaiai?o iinoaaee (oiaa?) iiaea aooe
aeaioiaeaiei, a iiaea e ia aooe aeaioiaeaiei ia iiiaio oeeaaeaiiy aeiaiai?o.

AeIAIAI?
eoiiaei-i?iaeaaeo
(iioiai? ia?oi? oiaa?ia)

199___?.

I?IAeAAAOeUe:
a iniai ___________
ui aeio ia iiaenoaai _
c iaeiiai aieo, i

IIEOIAOeUe: _

a iniai ___________
ui aeio ia iiaenoaai _
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?IAeAAAOeUe ciaiaycoooueny iinoaaeoe oa ia?aaeaoe o aeaniinoue (iiaia ainiiaea?nueea
aaaeaiiy) IIEOIOess oiaa?, a IIEOIAOeUe ciaiaycoooueny i?eeiyoe oiaa? oa iieaoeoe eiai ia
oiiaao Aeaiiai Aeiaiai?o.

1.2. Iaeiaioaaiiy oiaa?o:___________________________________________________ .
1.3. Aeaioiaethaa/ oiaa?o: _________________________________________________________ .
1.4. Iinoeaciaoiaeaeaiiy oiaa?o: __________________________________________________ .

1.5. Aeieoiaioe ia oiaa?, yei I?IAeAAAOeUe iiaeiai ia?aaeaoe IIEOIOeTH: _____________

2. EIEUeEINOUe

2.1. Iaeeieoey aeii?o eieueeinoi oiaa?o: _________________________________________ .

Eiia?oeieiee aeiaiai?

2.2. Caaaeueia eieueeinoue oiaa?o:

3. ANI?OEIAIO

3.1. A?oiiaee ani?oeiaio oiaa?o, ui iinoa/aooueny:
I. ___________________________________ o eieueeinoi _____________________________ .

2. __________________________________ o eieueeinoi _____________________________ .

3.2. ?icai?iooee ani?oeiaio oiaa?o, ui iinoa/aooueny, aecia/aooueny o Aeiaeaoeo ?1 aei
Aeaiiai Aeiaiai?o.

4. ssEINOUe

4.1. sseinoue oiaa?o, ui iinoa/aooueny I?IAeAAOeAI, iiaeiia aiaeiiaiaeaoe

(AINOo, OO, na?oeoieaoo aeaioiaethaa/a, c?aceo oa ii.)
4.2. Iiaeoaa?aeaeaiiyi yeinoi c aieo I?IAeAAOess o _________

(iaeiaioaaiiy aeieoiaioo, ui iiaeoaa?aeaeoo yeinoue oiaa?o)

4.3. Aa?aioieiee oa?iii aenieoaoaoei? (i?eaeaoiinoi, caa?iaaiiy): c iiiaioo

(aeaioiaeaiiy, io?eiaiiy oiaa?o IIEOIOeAI, aenieoaoaoei?)

4.4. Oa?iii onoiaiiy iaaeieieia aai caiiie oiaa?o a iaaeao aa?aioieiiai oa?iiio
c iiiaioo aeyaeaiiy aeaoaeoia.

5. EIIIEAEOIINOUe

5.1. Eiiieaeoiinoue oiaa?o, ui iinoa/aooueny I?IAeAAOeAI, aecia/aooueny ca __

(AINO, OO, Iioi ii?iaoeaii aeieoiaioe)

5.2. Aeiaeaoeiai aei eiiieaeoo ae?iae ________________

5.3. C eiiieaeoo oiaa?o aeeeth/athoueny ianooiii ae?iae, ui ia iio?iaii IIEOIOeTH: ___

6. NO?IEE OA II?ssAeIE IINOA*AIIss

6.1. Oiaa? iiaeiai aooe iiaiinoth iinoaaeaiee IIEOIOeTH i?ioyaii _______________

c iiiaioo _____________________________________________________________________________.

(iieaoe, oeeaaeaiiy aeiaiai?o. Iioi?

6.2. I?IAeAAAOeUe iao i?aai ia aeino?ieiao iinoaaeo oiaa?o c iaiayceiaei iiaiaeiieaiiyi
IIEOIOess i?i oea a oa?iii ________ c iiiaioo aiaeaaioaaeaiiy oiaa?o (iiaea aooe ia?aaeaa/aia
iioa iiaenoaaa).

7. OeIIA

7.1. Oeiia ca iaeeieoeth oiaa?o: ______________________________________________________ .
7.2. Caaaeueia oeiia ca Aeaiei Aeiaiai?ii: __________________________________________ .
7.3. Ca nei?i/aiiy no?ieia iinoaaee aieueo ye ia _____________ aeiia IIEOIAOeUe caeienitho
I?IAeAAOeTH aeiieaoo a ?icii?i ___________________________ aiae noie aeino?ieiai iinoaaeaii?
eieueeinoi oiaa?o.

7.4. Oeiie ca Aeaiei Aeiaiai?ii cacia/aii aac o?aooaaiiy IAeA (c a?aooaaiiyi IAeA).

8. II?ssAeIE ?IC?AOOIEIA

8.1. Iiia?aaeiy iieaoa o ?icii?i _____________% aiae oeiie aeiaiai?o iao aooe ia?a?aoiaaia
I?IAeAAOeTH i?ioyaii _____________________ c iiiaioo _____________________________ .
8.2. Inoaoi/iee oa?iii iieaoe oiaa?o neeaaeao ________ c iiiaioo _________________ .
8.3. Ii?yaeie iieaoe:

(iiooiaee, oaeaa?aoiee)

8.4. Aeae ?ic?aooieia:

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

8.5. Oi?ia ?ic?aooieia: ______________________________________________________

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa.aei?o/aiiy, ae?aaeeoea)

8.6. IIEOIAOeUe iiaeiai iiaiaeiieoe I?IAeAAOess i?i caeieniaiiy ieaoaaeo a oa?iii
_____ c iiiaioo _______________________________________________________________
oeyoii _________________________________________________________________________

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

Eiia?oeieiee aeiaiai?

8.7. Aeiieaoa ca i.7.3 Aeaiiai Aeiaiai?o aeiea/oooueny a oiio ae ii?yaeeo, ui e iniiaia
noia ieaoaaeo.

8.8. Ii?yaeie ?ic?aooieia ca ae?iae, yei aoiaeyoue aei eiiieaeoo, ui aiaeaaioaaeothoueny ?o
aeaioiaethaa/aie o?aiceoii ca i.5.2 Aeaiiai Aeiaiai?o: ____________________________________

9. OIIAE IINOAAEE

9.1. Iinoaaea caeienithooueny ia oiiaao: ___________________________________________ .

(o?aieieeaae, o?aiei-aaaii oa ii.)

9.2. Ia?aoiae i?aaa aeaniinoi ia oiaa? aiaeaoaaooueny a iiiaio: ______________________ .
9.3. Ia?aoiae ?eceeia ia oiaa? aiaeaoaaooueny a iiiaio: ______________________________ .

10. IOIEO IINOAAEE

Ioieoii iinoaaee oiaa?o ca Aeaiei Aeiaiai?ii o: ________________________________ .

1 1 . OA?A I IAEOAAIIss

11.1. Oiaa? iiaeiai aooe caoa?aiee i niaeiaaiee I?IAeAAOeAI oaeei /eiii, uia
aeeeth/eoe inoaaiiy oa \ aai cieuaiiy eiai ia ia?iiae iinoaaee aei i?eeiyooy oiaa?o
IIEOIOeAI.

11.2. Oiaa? iiaeiai aooe caoa?aiee ianooiiei /eiii:______________________________ .
11.3. Oiaa? iiaeiai aooe niaeiaaiee ianooiiei /eiii: __________________________ .
11.4. Aa?oinoue oa?e oa iaeoaaiiy aoiaeeoue (ia aoiaeeoue) aei oeiie oiaa?o.
I 1.5. Ii?yaeie oa no?iee iiaa?iaiiy oa?e: ________________________________________ .
11.6. Oiiae ?ic?aooieia i?e iiaa?iaiii oa?e: _______________________________________

12. IA?EI?OAAIIss

12.1. Oiaa? iiaeiai aooe i?iia?ei?iaaiee ianooiiei /eiii:

(cacia/aooueny oaeno oa\aai iaethiie ia?ei?oaaiiy ia oa?i,

aai ?iaeoueny iineeaiiy ia noaiaea?o, AINO)

13. AIAeAAIOAAEAIIss OA O?AINII?OOAAIIss
13.1. Ioieo aiaeaaioaaeaiiy:

13.2. Oa?iiie aiaeaaioaaeaiiy: i?ioyaii ________________ c iiiaioo
13.3. Aeae o?ainii?oo: _________________________________________
13.4. Iiiiiaeueiith ii?iith aiaeaaioaaeaiiy _______________________
o?ainii?oii o

(aaaii, eiioaeia?, iioi iiiiiaeueii ii?ie)

13.5. Iniaeeainoi aiaeaaioaaeaiiy: ____________________________________
13.6. I?IAeAAAOeUe iiaeiai iiaiaeiieoe IIEOIOess i?i aiaeaaioaaeaiiy a oa?iii
c iiiaioo ____________ oeyoii

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii,)

O iiaiaeiieaiii cacia/athoueny: aeaoa aiaeaaioaaeaiiy, iiia? iaeeaaeii?, iiia? aaaiio (iacaa
noaeia, ? aaoiiaoeie, ? ?aeno) iiia? i aeaoa aeiaiai?o, iaeiaioaaiiy oa eieueeinoue oiaa?o.

14. IA?AAeA*A OIAA?O

14.1. Ia?aaea/a (i?eeiaiiy-caea/a) oiaa?o caeienithooueny a ioieoi iinoaaee.
14.2. I?eeiaiiy oiaa?o ca eieueeinoth oa yeinoth caeienithooueny noi?iiaie a ii?yaeeo, ui
aecia/aooueny /eiiei caeiiiaeaanoaii.

14.3. Io?eiaaoe oiaa?, IIEOIAOeUe iiaeiai oaeaa?aoii c iiaiaeiieaiiyi iiaeoaa?aeeoe
io?eiaiiy oiaa?o i?ioyaii __________________________ c iiiaioo ____________________ .

15. OA?III AeI? AeAIIAI AeIAIAI?O

15.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo iiaeienaiiy eiai noi?iiaie i aeio aei
iiiaioo eiai inoaoi/iiai aeeiiaiiy, aea a aoaeue-yeiio aeiaaeeo aei <____> _________ 19___ ?.

16. AIAeIIAIAeAEUeIINOUe NOI?II

16.1. Ca ii?ooaiiy oiia Aeaiiai Aeiaiai?o aeiia noi?iia aiaeoeiaeiaoo ni?e/eiaii oeei
caeoee, a oiio /enei iaio?eiaiee i?eaooie a ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.

Eiia?oeieiee aeiaiai?

16.2. IIEOIAOeUe ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

– ca ________________________________ oo?aoia iaonoieea a ?icii?i ______________%
aiae noie __________________________ (aeiaiai?o, ai?ao).
16.3. I?IAeAAAOeUe ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

– ca ________________________________ oo?aoia iaonoieea a ?icii?i ______________%
aiae noie __________________________ (aeiaiai?o, ai?ao).
16.4, Ca iaeiinoi?iiith iaiaa?oioiaaio aiaeiiao aiae aeeiiaiiy nai?o ciaiaycaiue i?ioyaii

aei? Aeaiiai Aeiaiai?o aeiia noi?iia niea/oo oo?ao o ?icii?i _____________________________ .

16.5. Ca ii?ooaiiy iioeo oiia Aeaiiai Aeiaiai?o aeiia noi?iia iana ianooiio aiaeiiaiaeaeue-
iinoue: _____________________________________________________________________________.

17. CAAACIA*AIIss CIAIAssCAIUe CAAeAIEI AeIAIAI?II
(iiaeooue aooe oiiae i?i canoaao, no?aooaaiiy /e ii?o/ieoeoai
c aieo ye I?IAeAAOess, oae i IIEOIOess)

18. ?ICAssCAIIss NII?IA

18.1. Oni nii?e iiae noi?iiaie, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o aiaeiiaiae-
iinoi aei caeiiiaeaanoaa Oe?a?ie a A?aio?aaeiiio noaei (o?aoaenueeiio noaei ic cacia/aiiyi yeiainue
eiie?aoiiai o?aoaenueeiai noaeo aai cacia/eoe ii?yaeie oi?ioaaiiy oeueiai o?aoaenueeiai noaeo).
18.2. Noi?iie aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi noi?iiaie i?ioyaii __________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

19. CIIIA OIIA AeAIIAI AeIAIAI?O

19.1. Oiiae Aeaiiai Aeiaia?o iiaeooue aooe ciiiaii ca acaoiiith caiaeith noi?ii c iaiayceiaei
neeaaeaiiyi ienueiiaiai aeieoiaioo.

19.2. AEiaeia ic noi?ii ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee iioi? noi?iie.

20. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie noi?ii ca Aeaiei Aeiaiai?ii o:
I?IAeAAAOeUe: _____________________________________ oaeaoii ___________________ ,
IIEOIAOeUe: ______________________________________ oaeaoii ___________________ .

21. INIAEEAI OIIAE

(iiaeooue aooe cacia/aii aeiaeaoeiai oiiae niia?iaioieoeoaa noi?ii .
iaiaycee I?IAeAAOess c iaeaaiaeaeaiiy oa iiioaaeo oiaa?o, iaiaycee IIEOIOess iioi?ioaaoe I?IAeAAOess i?i aenieoaoaoeith oa aeei?enoaiiy oiaa?o oa ii.)

22. IIOI OIIAE

22.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

22.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, Noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii (aai cacia/aooueny eiie?aoiee ii?iaoeaiee aeieoiaio).

22.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

22.4. Noi?iie ciaiaycothoueny i?e aeeiiaiii Aeaiiai Aeiaiai?o ia caiaeeoe niia?iaioieoeoai
eeoa aei aeio?eiaiiy aeiia, ui iinoyoueny a Aeaiiio Aeiaiai?i, iiaeo?eioaaoe aeieiai eiioaeoe oa
aaeeaaoe anio iaiaoiaeieo caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?o eiia?oeieieo
cayceia.

23. TH?EAeE*II AAe?ANE, AAIEIANUeEI OA AIAeAAIOAAEOAAEUeII ?AEAICEOE
NOI?II IA IIIAIO OEEAAeAIIss AeAIIAI AeIAIAI?O

23.1. IIEOIAOeUe:

Iiooiaa aae?ana oa iiaeaen: ______________________________________________________ .
Oaeaoii ____________, oaeaoaei ____________________, oaen ________________________ .
?ic?aooieiaee ?aooiie ?_____________ a.

(iaeiaioaaiiy aaieo)

IOI ______________, EIAe

Eiia?oeieiee aeiaiai?

Ei?aniiiaeaionueeee ?aooiie aaieo IIEOIOess: ____________
Aiaeaaioaaeoaaeueii ?aeaiceoe ic cacia/aiiyi eiaeia:
I. Aeey aaaiiieo aiaei?aaeaiue: ________________.____________

2. Aeey eiioaeia?ia: _______________________________________

3. Aeey aiaei?aaeaiiy aiaeiei o?ainii?oii: ________________

4. Aeey aiaei?aaeaiiy iiaio?yiei o?ainii?oii: ____________

23.2. I?IAeAAAOeUe:

Iiooiaa aae?ana oa iiaeaen: ______________________________
Oaeaoii ___________, oaeaoaei ___________________, oaen
?ic?aooieiaee ?aooiie ?______________ a

(iaeiaioaaiiy aaieo)

IOI _________,_____, eiae __________________ .
Ei?aniiiaeaionueeee ?aooiie aaieo I?IAeAAOess: _____________________________
Ei?aniiiaeaionueeee ?aooiie aaieo: ___________________________________________
Aiaeaaioaaeoaaeueii ?aeaiceoe ic cacia/aiiyi eiaeia:
I. Aeey aaaiiieo aiaei?aaeaiue: _________________________________________________

2. Aeey eiioaeia?ia: ___________________________________________________

3. Aeey aiaei?aaeaiiy aiaeiei o?ainii?oii: _____________________________________

4. Aeey aiaei?aaeaiiy iiaio?yiei o?ainii?oii: _______________________________

24. AeIAeAOEE AeI AeAIIAI AeIAIAI?O

1. Aeiaeaoie ? 1 ia ____________ noi?.
Aeiaeaoie aei Aeaiiai Aeiaiai?o neeaaeao eiai iaaiaeoiio /anoeio.

IIEOIAOeUe I?IAeAAAOeUe

I.I. I.I.

AeIAIAI?
eoiiaei-i?iaeaaeo eaa?oe?e iiae iiaei?eoinoaaie

199___?.

I?IAeAAAOeUe:

a iniai __________
ui aeio ia iiaenoaai _
c iaeiiai aieo, i

IIEOIAOeUe:.

a iniai __________
ui aeio ia iiaenoaai _
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?IAeAAAOeUe i?iaeao, a IIEOIAOeUe eoioo eaa?oe?o ia oiiaao Aeaiiai Aeiaiai?o.
1.2. Oa?aeoa?enoeea eaa?oe?e:

Aae?ana: ____________________________________________________________________
Caaaeueia ei?enia ieiua: __________________________________________________________
AEeoeiaa ieiua: ______________________________________________________________
Eieueeinoue eiiiao: ______________________________________________________________
Iiaa?o: __________________________________________________________________________
1.3. Eaa?oe?a iaeaaeeoue I?IAeAAOeTH ia i?aai i?eaaoii? aeaniinoi caiaeii ______________

(iaeiaioaaiiy aeieoiaioo)

Eiia?oeieiee eiaiai?

2. OeIIA AeIAIAI?O

Oeiia eaa?oe?e neeaaeao: ________________________________________________ ea?aiaaioeia.

3. II?ssAeIE ?IC?AOOIEIA

3.1, Oa?iii iieaoe neeaaeao ___________ c iiiaioo _______________________________ .
3.2. Ii?yaeie iieaoe:

(iiooiaee, oaeaa?aoiee)

3.3. Aeae ?ic?aooieia: ___________________________________________________________

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

3.4. Oi?ia ?ic?aooieia: ______________________________________________________

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa-aei?o/aiiy)

3.5. IIEOIAOeUe iiaeiai iiaiaeiieoe I?IAeAAOess i?i caeieniaiiy ieaoaaeo a oa?iii
c iiiaioo _________________ oeyoii .

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

4. IAIAssCEE NOI?II CA AeAIEI AeIAIAI?II

4.1. I?IAeAAAOeUe ciaiaycaiee:
a) ia?aaeaoe i?iaeaio eaa?oe?o IIEOIOeTH ca aeoii ia?aaea/i i?ioyaii ____________

c iiiaioo ______________________________;
a) eaa?oe?a iiaeiia aooe ia?aaeaia o noaii, i?eaeaoiiio aei iaaaeii? aenieoaoaoei? ??

IIEOIOeAI;

a) i?eeiyoe caeieniaio IIEOIOeAI iieaoo.
4.2. IIEOIAOeUe ciaiaycaiee:

a) o aecia/aii Aeaiei Aeiaiai?ii no?iee iieaoeoe i?iaeaio I?IAeAAOeAI eaa?oe?o;
a) ca aeaniee ?aooiie i?iaanoe iioa?iaeueia iinaiae/aiiy Aeaiiai Aeiaiai?o;
a) i?eeiyoe i?iaeaio eaa?oe?o i?ioyaii _________ c iiiaioo _____________________ .

4.3. I?aai aeaniinoi o IIEOIOess ia eaa?oe?o aeieeao c iiiaioo __________________ .

5. IIOI OIIAE OA AIAeIIAIAeAEUeIINOUe

5.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo eiai iioa?iaeueiiai iinaiae/aiiy.
5.2. Aeaiee Aeiaiai? neeaaeaiee o o?ueio i?eaiiaeueieo i?eii?ieeao oa caa?iaaooueny o noi?ii,

a oaeiae o ni?aaao ______________________________________________ iioa?iaeueii? eiioi?e.

5.3. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei caeiiiaeaa-
noaii.
5.4. sseui IIEOIAOeUe i?ino?i/eoue nieaoo oeiie ca Aeaiei Aeiaiai?ii aieueo iiae ________,

aii niea/oo I?IAeAAOeTH oo?ao o ?icii?i ______________________________ aiae noie ai?ao.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
eoiiaei-i?iaeaaeo (iinooiee) /anoie o/anoi a OIA iiae iiaei?eoinoaaie

i. ____________ <____> ___________ 199 ___ ?.

I?IAeAAAOeUe: ___
ui o o/anieeii OIA _________ 19___ ?.

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?IAeAAAOeUe ciaiaycoooueny ia?aaeaoe o aeaniinoue IIEOIOess naith /anoeo o

(iacaa oiaa?enoaa c iaiaaeaiith aiaeiiaiaeaeueiinoth)

Eiia?oeieiee aeiaiai?

(aeaei ca oaenoii – OIA), a IIEOIAOeUe ciaiaycoooueny i?eeiyoe oa iieaoeoe oeth /anoeo.
1.2. Aiaeiiinoi i?i OIA:

1.2.1. Oi?iiaa iaeiaioaaiiy: ___________________________________________________ .
1.2.2. I?aaiicaoeieii-i?aaiaa oi?ia: _____________________________________________________ .
1.2.3. Ca?aono?iaaii: __________________________________________________________.

(eei, eiee)

1.2.4. Naiaeioeoai i?i ?aono?aoeith: na?iy _____________ ?

1.2.5. Noaoooiee oiiae: ____________________________________________________________ .
1.2.6. Iinoeaciaoiaeaeaiiy: ______________________________________________________.
1.3. Aiaeiiinoi i?i /anoeo I?IAeAAOess:

1.3.1. ?icii? aianeo: ___________________________________________________________ .
1.3.2. Neeaae aianeo: ___________________________________________________________ .
1.3.3. Aeaoa iiaea/i aianeo: _________________________________________________________ .
1.3.4. Aeieoiaio i?i aianie: naiaeioeoai i?i iiaea/o aianeo aei Noaoooiiai oiiaeo OIA ? __

_____ aiae <____> _________ 19___ ?.
1.3.5. ?icii? /anoee ia iiiaio oeeaaeaiiy Aeaiiai Aeiaiai?o o aiaeiiaiaeiinoi aei aaeaino

OIA ca ___________ neeaaeao ___________________________________________ ea?aiaaioeia.
1.4. IIEOIAOeUe iaeaaeiei /eiii iiaiaeiieaiee i?i oa?aeoa? aeiyeueiinoi oa i?i oiiainiaee

noai ni?aa OIA ia iiiaio oeeaaeaiiy Aeaiiai Aeiaiai?o.

2. II?ssAeIE IOI?IEAIIss IINOOIEE *ANOIE

2.1. IIEOIAOeUe iiney iiaeienaiiy Aeaiiai Aeiaiai?o iiaea caa?iooeny aei OIA c i?ioaiiyi
i?i ia?aioi?ieaiiy ia eiai iiy naiaeioeoaa i?i iiaea/o aianeo aei noaoooiiai oiiaeo OIA, yea
iiaeiii aooe ioi?ieaii o aiaeiiaiaeiinoi aei Noaoooo OIA.
2.2. IIEOIAOeUe aaaaeaooueny iiaiii?aaiei o/anieeii OIA c iiiaioo ______________ .

3. OeIIA AeIAIAI?O

Ca iinooieo /anoee IIEOIAOeUe ciaiaycoooueny nieaoeoe I?IAeAAOeTH ________________
ea?aiaaioeia.

4. II?ssAeIE ?IC?AOOIEIA

4.1. Oa?iii iieaoe neeaaeao ____________ c iiiaioo ________

4.2. Ii?yaeie iieaoe: ______________________________________
(iiooiaee, oaeaa?aoiee)

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

4.3. Aeae ?ic?aooieia: _
4.4. Oi?ia ?ic?aooieia:

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa.aei?o/aiiy)

4.5. IIEOIAOeUe iiaeiai iiaiaeiieoe I?IAeAAOess i?i caeieniaiiy ieaoaaeo a oa?iii
c iiiaioo _________________ oeyoii

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

5. IANEIAeEE IINOOIEE *ANOIE AeEss I?IAeAAOess

5.1. Ca ianoaiiy ianoaaei, cacia/aieo a i.2.2 Aeaiiai Aeiaiai?o, I?IAeAAAOeUe ao?a/ao
oni i?aaa oa iaiaycee ii aiaeiioaiith aei OIA, yei aoee iaoiiaeaii eiai noaoonii ye o/anieea
OIA.

5.2. Ca ianoaiiy ianoaaei, cacia/aieo a i.2.2 Aeaiiai Aeiaiai?o, I?IAeAAAOeUe ao?a/ao
oni i?aaa oa iaiaycee ii aiaeiioaiith aei iioeo o/anieeia OIA, yei aoee iaoiiaeaii eiai
noaoonii ye o/anieea OIA.

5.3. Ca ianoaiiy ianoaaei, cacia/aieo a i.2.2 Aeaiiai Aeiaiai?o, Onoaiia/ee aeiaiai? i?i
noai?aiiy oa aeiyeueiinoue OIA aiae <____> _________ 19___ ?. ii aiaeiioaiith aei I?IAeAAOess
aaaaeaooueny iaaeith/ei oa ani eiai oiiae ao?a/athoue aeey I?IAeAAOess anieyea th?eaee/ia cia/aiiy.

6. IANEIAeEE IINOOIEE *ANOIE AeEss IIEOIOess

6.1. Ca ianoaiiy ianoaaei, cacia/aieo a i.2.2 Aeaiiai Aeiaiai?o, IIEOIAOeUe noao ii
aiaeiioaiith aei OIA eiai ii/ei o/anieeii.

6.2. Aei IIEOIOess i?e iinooioei /anoee I?IAeAAOeAI iaeii/anii ia?aoiaeyoue oni i?aaa
oa iaiaycee, ui iaeaaeaoue inoaiiueiio ia iiiaio iinooiee /anoee.

6.3. I?IAeAAAOeUe c iiiaioo i?eaeaaiiy /anoee a OIA ciaiaycoooueny aeeiioaaoe aeiiae
onoaiia/eo aeieoiaioia OIA, a oaeiae ianoe ani iaiaycee o/anieea, ui aeieeaathoue c onoaiia/eo
aeieoiaioia oa /eiiiai caeiiiaeaanoaa.

Eiia?oeieiee eiaiai?

7. IIOI OIIAE OA AIAeIIAIAeAEUeIINOUe

7.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo eiai iiaeienaiiy noi?iiaie.
7.2. Aeaiee Aeiaiai? neeaaeaiee o aeaio i?eaiiaeueieo i?eii?ieeao oa caa?iaaooueny o noi?ii.
7.3. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei caeiii-
aeaanoaii.
7.4. sseui IIEOIAOeUe i?ino?i/eoue nieaoo oeiie ca Aeaiei Aeiaiai?ii aieueo, iiae ____

_________, aii niea/oo I?IAeAAOeTH oo?ao o ?icii?i __________________ aiae noie ai?ao.
7.5. Aeiaeaoeii aei Aeaiiai Aeiaiai?o o I?ioieie Caaaeueieo Cai?ia OIA i?i aea/o caiaee ia

ia?aiinooieo /anoee ? ________ aiae <____> _________ 19___ ?.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

I?aai, ui ca?aono?oaaa aeaio
oaiaeo, oa eiai iinoeaciaoiaeaeaiiy:

Aeaoa ?aono?aoei?:

Ii?yaeeiaee iiia? ?aono?aoei?
o ?aono?i: ? __________________
I.I.A. ?aono?aoi?a:

Iiaeien ?aono?aoi?a:
I. I.

AeIAIAI?
eoiiaei-i?iaeaaeo
aeoeie aeoeiiia?iiai oiaa?enoaa aiaee?eoiai oeio

199

I?IAeAAAOeUe:
a iniai

ui aeio ia iiaenoaai
c iaeiiai aieo, i

IIEOIAOeUe:
a iniai

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?IAeAAAOeUe ciaiaycoooueny ia?aaeaoe o aeaniinoue IIEOIOess, a IIEOIAOeUe ciaiay-
coooueny i?eeiyoe oa iieaoeoe ianooiii aeoei?:
1.1.1. Iaeiaioaaiiy aeoeie:

1.1.2. Iaeiaioaaiiy aiioaioa:

1.1.3. Iiia? aea?aeaaii? ?aono?aoei?:
1.1.4. Iiiiiaeueia aa?oinoue:
1.1.5. Eieueeinoue aeoeie:

2.OeIIA (EO?N) AEOeIE

2.1. Oeiia aeoeie neeaaeao

3. II?ssAeIE ?IC?AOOIEIA

3.1. Oa?iiie iieaoe:
– i?ioyaii _________ c iiiaioo oeeaaeaiiy Aeaiiai Aeiaiai?o aaain (caaaeaoie) o ?icii?i

i?ioyaii

c iiiaioo iiaeienaiiy aeoo ia?aaea/i aeoeie inoaoi/iee ?ic?aooiie.

3.2. Ii?yaeie iieaoe:
3.3. Aeae ?ic?aooieia:

(iiooiaee, oaeaa?aoiee)

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

Eiia?oeieiee aeiaiai?

3.4. Oi?ia ?ic?aooieia: _________________________________________________________

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa-aei?o/aiiy)

3.5. IIEOIAOeUe iiaeiai iiaiaeiieoe I?IAeAAOess i?i caeieniaiiy ieaoaaeo a oa?iii
c iiiaioo _________________ oeyoii .

(oaeaa?aia iiaieiieaiiyi, oaen oa ii.)

4. II?ssAeIE IOI?IEAIIss EOIIAEI-I?IAeAAEO AEOeIE
4.1: Ioi?ieaiiy eoiiaei-i?iaeaaeo aeoeie caeienithooueny o.

(iaeiaioaaiiy eiie?aoii? ?aono?oth/i? i?aaiicaoei?)

i?ioyaii ______________ c iiiaioo _________________________________________________ .
4.2. Oni aeo?aoe c ioi?ieaiiy iana _____________________________________________ .

4.3. I?aai aeaniinoi ia aeoei? aeieeao o IIEOIOess c iiiaioo _______________________ .

5. AIAeIIAIAeAEUeIINOUe NOI?II

5.1. O aeiaaeeo ii?ooaiiy I?IAeAAOeAI oa?iiio, ia?aaeaa/aiiai i.4.1, aii niea/oo
IIEOIOeTH iaith a ?icii?i _________________ aa?oinoi iaia?aaeaieo a no?ie aeoeie ca eiaeiee
aeaiue i?ino?i/aiiy.

5.2. O aeiaaeeo ii?ooaiiy IIEOIOeAI oa?iiio, ia?aaeaa/aiiai i.3.1 Aeaiiai Aeiaiai?o,
IIEOIAOeUe niea/oo I?IAeAAOeTH iaith a ?icii?i ____________________ ianiea/aii? noie
ca eiaeai aeaiue i?ino?i/aiiy.

6. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

7. IIOI OIIAE

7.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? c
noi?ii.

7.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
eoiiaei-i?iaeaaeo iio-oao

i.____________ <____>___________ 199___?.

I?IAeAAAOeUe:

a iniai __________
ui aeio ia iiaenoaai _
c iaeiiai aieo, i

IIEOIAOeUe:.

a iniai __________
ui aeio ia iiaenoaai _
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?IAeAAAOeUe ciaiaycoooueny iaaeaoe IIEOIOeTH, a IIEOIAOeUe ciaiaycoooueny
i?eeiyoe oa iieaoeoe ia?aaea/o i?aa ia iio-oao (nae?aoe ae?iaieoeoaa), iaoiiaeaio Aeaiei
Aeiaiai?ii.

1.2. I?aaeiaoii Aeaiiai Aeiaiai?o o ia?aaea/a i?aa ia eiia?oeieia aeei?enoaiiy oaoii/ii?
aeieoiaioaoei?, ui iinoeoue ciaiiy i aeinaiae, yeeie aieiaeio I?IAeAAAOeUe, c ae?iaieoeoaa ianooiii?
i?iaeoeoei?:

1.2.1._____________________________________________________________________.
1.2.2. _________________________________________________________________________.
1.2.3. _________________________________________________________________________.
1.2.4. _________________________________________________________________________.

Eiia?oeieiee aeiaiai?

1.3. O aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o IIEOIAOeUe iaaoaao i?aaa ae?iaeyoe oa ?aaeiciao-
aaoe i?iaeoeoeith, cacia/aio a i. 1.2.

2. CIINO IIO-OAO OA OAOII*IA AeIEOIAIOAOeIss

2.1. Iio-oao (nae?aoe ae?iaieoeoaa) iathoue ianooiiee ciino: _________________________

2.2. Iio-oao (nae?aoe ae?iaieoeoaa) iinoyoueny a ianooiiie aeieoiaioaoei?, yea ia?aaeaooueny
I?IAeAAOeAI IIEOIOeTH:___________________________________________________________

3. OeIIA AeIAIAI?O (?IEssEOI)

3.1. Aeiaai?iaea (?ieyeoi) ca ia?aaeaia iio-oao (nae?aoe ae?iaieoeoaa) neeaaeao:
ca ia?aaea/o iio-oao (nae?aoe ae?iaieoeoaa): ________________________________
ca iaa/aiiy ia?niiaeo c aeei?enoaiiy iio-oao (nae?aoia ae?iaieoeoaa): ______

4. II?ssAeIE ?IC?AOOIEIA

4.1. Oa?iiie iieaoe:
– i?ioyaii _________________ c iiiaioo oeeaaeaiiy Aeaiiai Aeiaiai?o – aaain (caaaeaoie)

a ?icii?i ___________________________________________________________________________;
– i?ioyaii _______________ c iiiaioo iiaeienaiiy aeoo ia?aaea/i iio-oao (nae?aoe

ae?iaieoeoaa) – inoaoi/iee ?ic?aooiie.
4.2. Ii?yaeie iieaoe: __________________________________________________________ .

(iiooiaee, oaeaa?aoiee)

4.3. Aeae ?ic?aooieia:

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

4.4. Oi?ia ?ic?aooieia: ______________________________________________________

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa.aei?o/aeiy)

4.5. IIEOIAOeUe iiaeiai iiaiaeiieoe I?IAeAAOess i?i caeieniaiiy ieaoaaeo a oa?iii
c iiiaioo _________________ oeyoii.

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

5. II?ssAeIE IA?AAeA*I IIO-OAO (NAE?AOIA AE?IAIEOeOAA)

5.1. Oa?iii ia?aaea/i: ___________________________________________________________ .
5.2. Iinoea ia?aaea/i: ___________________________________________________________ .
5.3. I?e ia?aaea/i aeieoiaioaoei? noi?iie neeaaeathoue aeo caea/i-i?eeiaiiy, yeee iiaeienoooueny
iiaiiaaaeieie i?aaenoaaieeaie noi?ii.

6. AIAeIIAIAeAEUeIINOUe NOI?II

6.1. O aeiaaeeo ii?ooaiiy I?IAeAAOeAI oa?iiio, ia?aaeaa/aiiai i.5.1, aii niea/oo IIEOI-
OeTH iaith a ?icii?i ________________________ aa?oinoi iaia?aaeaiiai a no?ie iio-oao ca
eiaeiee aeaiue i?ino?i/aiiy.

6.2. O aeiaaeeo ii?ooaiiy IIEOIOeAI oa?iiio, ia?aaeaa/aiiai i.4.1 Aeaiiai Aeiaiai?o,
IIEOIAOeUe niea/oo I?IAeAAOeTH iaith a ?icii?i _____________________ ianiea/aii? noie
ca eiaeai aeaiue i?ino?i/aiiy.

7. INIAEEAI OIIAE AeAIIAI AeIAIAI?O
(iiaeooue aooe cacia/aii aeiaeaoeiai oiiae niia?iaioieoeoaa noi?ii:
iaiaycee I?IAeAAOess c eiinoeueooaaiiy aiaeiinii iio-oao,

iaiaycee IIEOIOess Iioi?ioaaoe I?IAeAAOess i?i aeei?enoaiii iio-oao oa Ii.)

8. IIOI OIIAE

8.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

Eiia?oeieiee aeiaiai?

8.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii.

8.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
eoiiaei-i?iaeaaeo aaethoe

199 ___ ?.

I?IAeAAAOeUe:

a iniai ___________
ui aeio ia iiaenoaai _
c iaeiiai aieo, i

IIEOIAOeUe: _

a iniai ___________
ui aeio ia iiaenoaai _
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O, EIEUeEINOUe I OeIIA (EO?N) AAETHOE

1.1. I?IAeAAAOeUe ciaiaycoooueny ia?aaeaoe o aeaniinoue IIEOIOeTH, a IIEOIAOeUe
ciaiaycoooueny i?eeiyoe oa iieaoeoe ianooiii aaethoii oeiiiinoi:

1.1.1. Iaeiaioaaiiy aaethoe, ui eoioooueny: ______________________________________ .
1.1.2. Eieueeinoue aaethoe, ui eoioooueny: _____________________________________________ .
1.1.3. Eo?n (oeiia) aaethoe, ui eoioooueny: _______________________________________ .

1.2. I?aaiaith iiaenoaaith aeey oeeaaeaiiy Aeaiiai Aeiaiai?o o: _________________________

(iayaiinoue o IIEOIOess ciaiioiueioi?aiaaeueiiai eiio?aeoo c iieaoith o aaethoi)

2. II?ssAeIE ?IC?AOOIEIA CA AAETHOO, UI EOIOoOUeNss

2.1. Oa?iiie iieaoe:
– i?ioyaii ___________________ c iiiaioo oeeaaeaiiy Aeaiiai Aeiaiai?o – aaain (caaaeaoie)

a ?icii?i ___________________________________________________________________________.;
– i?ioyaii ________________ c iiiaioo iaaeoiaeaeaiiy aaethoe ia ?aooiie IIEOIOess –

inoaoi/iee ?ic?aooiie.
2.2. Ii?yaeie iieaoe:

(iiooiaee, oaeaa?aoiee)

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

2.3. Aeae ?ic?aooieia: _
2.4. Oi?ia ?ic?aooieia:

(ieaoiaeia aei?o/aiiy, /ae, aiiiaa.aei?o/aiiy)

2.5. IIEOIAOeUe iiaeiai iiaiaeiieoe I?IAeAAOess i?i caeieniaiiy ieaoaaeo a oa?iii
c iiiaioo ________________ oeyoii.

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

3. II?ssAeIE IA?AAeA*I AAETHOE

3.1. Ia?aaea/a aaethoe, ui i?iaeaooueny, caeienithooueny oeyoii ia?a?aooaaiiy inoaiiuei? ia
aaethoiee ?aooiie IIEOIOess i?ioyaii _____________ c iiiaioo ______________________ .

4. AIAeIIAIAeAEUeIINOUe NOI?II

4.1. O aeiaaeeo ii?ooaiiy I?IAeAAOeAI oa?iiio, ia?aaeaa/aiiai i.3.1, aii niea/oo
IIEOIOeTH iaith a ?icii?i __________________________ aa?oinoi iaia?aaeaii? a no?ie aaethoe
ca eiaeai aeaiue i?ino?i/aiiy.

4.2. O aeiaaeeo ii?ooaiiy IIEOIOeAI oa?iiio, ia?aaeaa/aiiai i.2.1 Aeaiiai Aeiaiai?o,
IIEOIAOeUe niea/oo I?IAeAAOeTH iaith a ?icii?i ______________________ ianiea/aii? noie
ca eiaeai aeaiue i?ino?i/aiiy.

Eiia?oeieiee eiaiai?

5. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

a. IIOI OIIAE

6.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

6.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
oa aaethoii-oiiainiaei caeiiiaeaanoaii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
iinoaaee oiaa?o

199

IINOA*AEUeIEE
a iniai

ui aeio ia iiaenoaai
c iaeiiai aieo, i

IIEOIAOeUe:
a iniai

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?IAeAAAOeUe ciaiaycoooueny aeaioiaeyoe oa nenoaiaoe/ii iinoa/aoe i ia?aaeaaaoe o
aeaniinoue (iiaia ainiiaea?nueea aaaeaiiy) IIEOIOeTH iaaiee oiaa?, a IIEOIAOeUe ciaiaycoooueny
i?eeiaoe oeae oiaa? oa naio/anii caeienithaaoe eiai iieaoo ia oiiaao Aeaiiai Aeiaiai?o.
1.2. I?aaeiaoii iinoaaee o ianooiiee oiaa?:
1.2.1.

122.
1 23
1 24
125
126
127
2. IANssA (EIEUeEINOUe) OA OA?IIIE IINOAAEE

?IaeiaioaaiiyIae. ae i i ?o1 ea. 199?.11 ea. 199?.111 ea. 199?.Onueiai
1.
2.
3.
3. ANI?OEIAIO

3.1. Ani?oeiaio oiaa?o ia?aaeaa/aooueny o niaoeeoieaoei?, yea aeiaeaooueny aei Aeaiiai Aeiaiai?o
(Aeiaeaoie ? 1 aei Aeaiiai Aeiaiai?o).

3.2. O aeiaaeeo iaiaoiaeiinoi aeey IIEOIOess ciiieoe aeayei iiceoei? c ani?oeiaioo oiaa?o,
ui iinoa/aooueny, aii ciaiaycaiee iiaeaoe IINOA*AEUeIEEO iiao niaoeeoieaoeith aeey ocaiae-

Eiia?oeieiee aeiaiai?

aeaiiy a no?ie ______________________________________ aei ianoaiiy iiaiai oa?iiio iinoaaee.
3.3. Iiaa niaoeeoieaoeiy aaaaeaooueny i?eeiyoith a ?aaeaeoei? IIEOIOess, yeui IINOA*AEUe-
IEE i?ioyaii ________________________ iiney ?? io?eiaiiy ia cayaeoue ca iath nai? caia?a/aiiy.

4. ssEINOUe OA EIIIEAEOIINOUe

4.1. sseinoue oa eiiieaeoiinoue oiaa?o, ui iinoa/aooueny, iiaeiia aiaeiiaiaeaoe

(AINOo, OO, na?oeoieaoo aeaioiaethaa/a, c?aceo oa ii.)

4.2. Iiaeoaa?aeaeaiiyi yeinoi oa eiiieaeoiinoi c aieo IINOA*AEUeIEEA

(iaeiaioaaiiy aeieoiaioo i?i yeinoue oa eiiieaeoiinoue oiaa?o)

4.3. Aeiaeaoeiai aei eiiieaeoo ae?iae ______________________

4.4. C eiiieaeoo oiaa?o aeeeth/athoueny ianooiii ae?iae, ui ia iio?iaii IIEOIOeTH: ___

4.5. Ocaiaeaeaiiy iiae noi?iiaie ooi/iaieo oa?aeoa?enoee oa aeiaeaoeiaeo aeiia c yeinoi
oa eiiieaeoiinoi, ia ia?aaeaa/aieo o i.4.1, 4.3, 4.4 Aeaiiai Aeiaiai?o, caeienithooueny noi?iiaie
a ie?aiiio.ii?yaeeo.

5. AA?AIOIEIEE NO?IE

5.1. IINOA*AEUeIEE aa?aiooo yeinoue oa iaaeieiinoue oiaa?o, ui iinoa/aooueny, i?ioyaii
_______________________ c iiiaioo -_______________________________________________ .

5.2. I?e aeyaeaiii ae?iaie/eo aeaoaeoia o oiaa?i i?e eiai i?eeiaiii, a oaeiae i?e
iiioaaei, iaeaaiaeaeoaaiii oa aenieoaoaoei? a ia?iiae aa?aioieiiai no?ieo aeeeee i?aaenoaaieea
IINOA*AEUeIEEA iaiayceiaee.

5.3. Oa?iii onoiaiiy iaaeieieia aai caiiie oiaa?o (aeioeiiieaeoiaoaaiiy) aecia/aooueny o
?icii?i __________________________________________ c iiiaioo aeyaeaiiy aeaoaeoia.

6. OA?IIIE OA II?ssAeIE IINOAAEE

6.1. Oiaa? iiaeiai aooe iinoaaeaiee IIEOIOeTH ia iiciioa __________ /enea ia?oiai
iinyoey aiaeiiaiaeiiai ia?iiaeo iinoaaee.

6.2. IINOA*AEUeIEE iao i?aai ia aeino?ieiao iinoaaeo eiaeii? ia?oi? oiaa?o c iaiayc-
eiaei iiaiaeiieaiiyi IIEOIOess i?i oea a oa?iii _________________ c iiiaioo ?? aiaeaaioaaeaiiy
(iiaea aooe ia?aaeaa/aia iioa iiaenoaaa).

7. OeIIA

7.1. IIEOIAOeUe iiea/oo iinoaaeaiee IINOA*AEUeIEEII oiaa? ca oeiiith, ia?aaeaa/aiith
o niaoeeoieaoei?, yea aeiaeaooueny aei Aeaiiai Aeiaiai?o (Aeiaeaoie ?1 aei Aeaiiai Aeiaiai?o).

7.2. Oeiie a niaoeeoieaoei? ca Aeiaiai?ii cacia/aii aac a?aooaaiiy IAeA (c o?aooaaiiyi
IAeA).

8. II?ssAeIE ?IC?AOOIEIA

8.1. ?ic?aooiee ca eiaeio iinoaaeaio ia?oith oiaa?o caeieniththoueny a aacaioiaeiaiio ii?yaeeo
i?ioyaii __________ c iiiaioo ___________________ (iiaea aooe ia?aaeaa/aia ia?aaeiieaoa).
8.2. Ii?yaeie iieaoe: _______________________________________________________ .

(iiooiaee, oaeaa?aoiee)

8.3. Oi?ia ?ic?aooieia: ________________________________________________________ .

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa.aei?o/aiiy, ae?aaeeoea)

8.4. IIEOIAOeUe iiaeiai iiaiaeiieoe IINOA*AEUeIEEA i?i caeieniaiiy ieaoaaeo a

oa?iii ______ c iiiaioo ________________ oeyoii.

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

9. OIIAE IINOAAEE
9.1. Iinoaaea caeienithooueny ia oiiaao:

(o?aieieeaae, o?aiei.aaaii oa ii.)

9.2. Ia?aoiae i?aaa aeaniinoi ia oiaa? aiaeaoaaooueny a iiiaio: _________
9.3. Ia?aoiae ?eceeia ia oiaa? aiaeaoaaooueny a iiiaio: _________________

10. IOIEO IINOAAEE

Ioieoii iinoaaee oiaa?o ca Aeaiei Aeiaiai?ii o: ____________________

Eiia?oeieiee eiaiai?

1 1. OA?A I IAEOAAIIss

11.1. Oiaa? iiaeiai aooe caoa?aiee i niaeiaaiee IINOA*AEUeIEEII oaeei /eiii,
uia aeeeth/eoe inoaaiiy oa\aai cieuaiiy eiai ia ia?iiae iinoaaee aei i?eeiyooy oiaa?o
IIEOIOeAI.

1.2. Oiaa? iiaeiai aooe caoa?aiee ianooiiei /eiii:________________
1.3. Oiaa? iiaeiai aooe niaeiaaiee ianooiiei /eiii: ______________
1.4. Aa?oinoue oa?e oa iaeoaaiiy aoiaeeoue (ia aoiaeeoue) aei oeiie oiaa?o.
1.5. Ii?yaeie oa no?iee iiaa?iaiiy oa?e: ___________________________
1.6. Oiiae ?ic?aooieia i?e iiaa?iaiii oa?e: _______________________

12. IA?EI?OAAIIss

12.1. Oiaa? iiaeiai aooe i?iia?ei?iaaiee ianooiiei /eiii:

(cacia/aooueny oaeno oa\aai iaethiie ia?ei?oaaiiy ia oa?i,

aai ?iaeoueny iineeaiiy ia noaiaea?o, AINO)

13. AIAeAAIOAAEAIIss OA O?AINII?OOAAIIss
13.1. Ioieo aiaeaaioaaeaiiy:

13.2. Oa?iiie aiaeaaioaaeaiiy: i?ioyaii _______________ c iiiaioo
13.3. Aeae o?ainii?oo: ___________________________________________
13.4. Iiiiiaeueiith ii?iith aiaeaaioaaeaiiy ________________________
o?ainii?oii o

(aaaii) eiioaeia?, iioi iiiiiaeueii ii?ie)

13.5. Iniaeeainoi aiaeaaioaaeaiiy: ________________________________________________
13.6. IINOA*AEUeIEE iiaeiai iiaiaeiieoe IIEOIOess i?i aiaeaaioaaeaiiy a oa?iii
. c iiiaioo __________ oeyoii

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

O iiaiaeiieaiii cacia/athoueny: aeaoa aiaeaaioaaeaiiy, iiia? iaeeaaeii?, iiia? aaaiio (iacaa
noaeia, ? aaoiiaoeie, ? ?aeno) iiia? i aeaoa aeiaiai?o, iaeiaioaaiiy oa eieueeinoue oiaa?o.

14. IA?AAeA*A OIAA?O

14.1. Ia?aaea/a (i?eeiaiiy-caea/a) oiaa?o caeienithooueny a ioieoi iinoaaee.
14.2. I?eeiaiiy oiaa?o ca eieueeinoth oa yeinoth caeienithooueny noi?iiaie a ii?yaeeo, ui

aecia/aooueny /eiiei caeiiiaeaanoaii.
14.3. Io?eiaaoe oiaa?, IIEOIAOeUe iiaeiai oaeaa?aoii c iiaiaeiieaiiyi iiaeoaa?aeeoe

io?eiaiiy oiaa?o i?ioyaii _________________________ c iiiaioo ___________________ .

15. OA?III AeI? AeAIIAI AeIAIAI?O

15.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo iiaeienaiiy eiai noi?iiaie i aeio aei
<____> _________ 19___ ?.

15.2. O aeiaaeeo, yeui aeiaeia c noi?ii ia cayaeoue i?i naie iaii? ?ici?aaoe aai ciiieoe
aeiaiai? ca ________________ aei eiai caeii/aiiy, Aeaiee Aeiaiai? aaaaeaooueny i?ieiiaiaaiei ia
no?ie ________________________________________.

16. AIAeIIAIAeAEUeIINOUe NOI?II

16.1. Ca ii?ooaiiy oiia Aeaiiai Aeiaiai?o aeiia noi?iia aiaeoeiaeiaoo ni?e/eiaii oeei
caeoee, o oiio /enei iaio?eiaiee i?eaooie, a ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.
16.2. IIEOIAOeUe ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:
– ca ________________________ oo?aoia iaonoieea a ?icii?i ____________________%

(eiie?aoia ii?ooaiiy)

AIAe NoIE __________________________________________________ .

(aeiaiai?o, ai?ao)

16.3. IINOA*AEUeIEE ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:
– ca ________________________ oo?aoia iaonoieea a ?icii?i ____________________%

(eiie?aoia ii?ooaiiy)
AIAe NoIE

(aeiaiai?o, ai?ao)

Eiia?oeieiee aeiaiai?

16.4. Ca iaeiinoi?iiith iaiaa?oioiaaio aiaeiiao aiae aeeiiaiiy nai?o ciaiaycaiue i?ioyaii
aei? Aeaiiai Aeiaiai?o aeiia noi?iia niea/oo oo?ao a ?icii?i _____________________________ .
16.5. Ca ii?ooaiiy iioeo oiia Aeaiiai Aeiaiai?o aeiia noi?iia iana ianooiio aiaeiiai-
aeaeueiinoue: ________________:_________________________________________________________.

17. CAAACIA*AIIss CIAIAssCAIUe CAAeAIEI AeIAIAI?II
(iiaeooue ia?aaeaa/aoeny oiiae i?i canoaao, no?aooaaiiy /e ii?o/ieoeoai
c aieo ye IINOA*AEUeIEEA, oae i IIEOIOess)

18. ?ICAssCAIIss NII?IA

18.2. Noi?iie aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi noi?iiaie i?ioyaii _______________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

19. CIIIA OIIA AeAIIAI AeIAIAI?O

19.1. Oiiae Aeaiiai Aeiaiai?o iiaeooue aooe ciiiaii ca acaoiiith caiaeith noi?ii c iai-
ayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioa.

19.2. AEiaeia ic noi?ii ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee ae?oai? noi?iie

20. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE
Iiaiiaaaeieie i?aaenoaaieeaie noi?ii ca Aeaiei Aeiaiai?ii o:
IINOA*AEUeIEE: _________________________________ oaeaoii ____________________ .
IIEOIAOeUe: ________________________________________ oaeaoii ____________________ .

21. INIAEEAI OIIAE

22. IIOI OIIAE

22.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

22.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii (aai cacia/aooueny eiie?aoiee ii?iaoeaiee aeieoiaio).

23. TH?EAeE*II AAe?ANE, AAIEIANUeEI OA AIAeAAIOAAEOAAEUeII ?AEAICEOE
NOI?II IA IIIAIO OEEAAeAIIss AeAIIAI AeIAIAI?O

23.1. IIEOIAOeUe:

Iinoeaciaoiaeaeaiiy ioino: ______________________________________________________.
Iiooiaa aae?ana oa iiaeaen: ______________________________________________________ .
Oaeaoii ____________, oaeaoaei ____________________, oaen ________________________ .
?ic?aooieiaee ?aooiie ?_____________ a.

(iaeiaioaaiiy aaieianueei? onoaiiae)

IOI ______________, EIAe _________
Ei?aniiiaeaionueeee ?aooiie aaieo IIEOIOess: _
Aiaeaaioaaeoaaeueii ?aeaiceoe ic cacia/aiiyi eiaeia:
I. Aeey aaaiiieo aiaei?aaeaiue: ___________________

2. Aeey eiioaeia?ia: __________________________

3. Aeey aiaei?aaeaiiy aiaeiei o?ainii?oii: ______

4. Aeey aiaei?aaeaiiy iiaio?yiei o?ainii?oii: __

23.2. IINOA*AEUeIEE:

Iinoeaciaoiaeaeaiiy ioino: _____________________
Iiooiaa aae?ana oa iiaeaen: ___________________

Eiia?oeieiee aeiaiai?

Oaeaoii ____________, oaeaoaei ____________________, oaen
?ic?aooieiaee ?aooiie ?_____________ a

.;/______

(iaeiaioaaiiy aaieianueei? onoaiiae)

IOI _____________, eiae _________________.

Ei?aniiiaeaionueeee ?aooiie aaieo I?IAeAAOess: __________________________________ .
Ei?aniiiaeaionueeee ?aooiie aaieo: _____________________________________________ .
Aiaeaaioaaeoaaeueii ?aeaiceoe ic cacia/aiiyi eiaeia:
I. Aeey aaaiiieo aiaei?aaeaiue: _________________________________________________ .

2. Aeey eiioaeia?ia: ___________________________________________________________ .

3. Aeey aiaei?aaeaiiy aiaeiei o?ainii?oii: ________________________________________ .

4. Aeey aiaei?aaeaiiy iiaio?yiei o?ainii?oii: ____________________________________ .
23.3. Noi?iie ciaiaycothoueny iaaaeii ienueiiai iiaiaeiieyoe iaeia iaeio o aeiaaeeo ciiie
aiaeiiinoae, aeacaieo a i.23 Aeaiiai Aeiaiai?o. Iiaiaeiieaiiy IIEOIOess i?i ciiio nai?o aiaeaaioa-
aeoaaeueieo ?aeaiceoia i?eeiaooueny aei aeeiiaiiy IINOA*AEUeIEEII aeey aiaeaaioaaeaiiy
oiaa?o, yeui oaea iiaiaeiieaiiy iaaeieaea aei IINOA*AEUeIEEA ia iiciioa aeiia aei ii/aoeo
ia?iiaeo iinoa/aiiy.

Iiaiaeiieaiiy IINOA*AEUeIEEA i?i ciiio nai?o aaieianueeeo ?aeaiceoia i?eeiaooueny
aei aeeiiaiiy IIEOIOeAI aeey iieaoe oiaa?o, yeui oaea iiaiaeiieaiiy iaaeieaea aei IIEOIOess
ia iiciioa _______ aeiia aei ii/aoeo oa?iiio iieaoe.

24. AeIAeAOEE AeI AeAIIAI AeIAIAI?O

I, Aeiaeaoie ? 1 ia ____________ noi?. Niaoeeoieaoeiy ia __________________ noi?.
Aeiaeaoie aei Aeaiiai Aeiaiai?o neeaaeao eiai iaaiaeoiio /anoeio.

IIEOIAOeUe I?IAeAAAOeUe

I.I. I.I.

__________________________?icaeie 5_________________________
AA?OA?, IIIA

Ca naioth th?eaee/iith i?e?iaeith aa?oa? o aeiaiai?ii iiie, yeee aeoaea iiaeiaiee aei eoiiaei-
i?iaeaaeo, ineieueee aiie yaeythoue niaith niinia iaiiio ?iaieo aa?oinoae, a naia c ii/aoeiai?
oi?ie oiaa?iiaiiio inoi?e/ii aeieeea eoiiaey-i?iaeaae.

Eiaeiee c o/anieeia o aeiaiai?i iiie aaaaeaooueny i?iaeaaoeai iaeia, yea aii ia?aaeao, i
iieoioeai iaeia, yea aii iaea?aeoo.

Aieueo oiai, aei aeiaiai?o iiie canoiniaothoueny th?eaee/ii ii?ie, ui ?aaoeththoue aiaeiineie
eoiiaei-i?iaeaaeo, oiio i?e neeaaeaiii aeiaiai?o i?i iaiii aoaeue-yei? i?iaeoeoei? iaiaoiaeii
a?aoiaoaaoe i oe?iei canoiniaoaaoe ii?ie i iieiaeaiiy caeiiiaeaanoaa i?i eoiiaeth-i?iaeaae
(iinoaaeo).

E?ii oiai, ye naiae/eoue noaeiaa i?aeoeea, nii?e, ui aeieeathoue o cayceo c oeeaaeaiiyi i
aeeiiaiiyi aeiaiai?o iiie, ca caaaeueiei i?aaeeii ae?ioothoueny ca ii?iaie i?i eoiiaeth-
i?iaeaae.

Aieiaia ?icieoey aeiaiai?o iiie oa aeiaiai?o eoiiaei-i?iaeaaeo iieyaao a oiio, ui aei aeiaiai?o
iiie ia canoiniaothoueny i?aaeea aeiaiai?o eoiiaei-i?iaeaaeo ii oeiii oa aeayeeo iioeo, iiaycaieo
naia c a?ioiaa aeaiaaeaioiith oi?iith. Aaaaeaooueny, ui caiinoue nieaoe oeiie ?a/i, ui eoioooueny,
iieoiaoeue ia caiiio eoieaiie iaaeao iioo ?i/, i iaoith aoiaeaeaiiy noi?ii a aeiaiai? iiie o
i?eaeaaiiy iaaiiai iaeia, a oie /an, ye ca aeiaiai?ii eoiiaei-i?iaeaaeo oeueiai ia aiaeaoaaooueny.
Oaeee iaii? ca aeiaiai?ii eoiiaei-i?iaeaaeo o eeoa a iaeiio? noi?iie – iieoioey.

Naia oiio cai?iiiiiaaiee ieae/a c?acie i?eaeeciiai aeiaiai?o ia i?iaaaeaiiy
oiaa?iiaiiiii? (aa?oa?ii?) iia?aoei? ca nai?ie iniiaieie oiiaaie aeoaea iiaeiaiee aei aeiaiai?o
iinoaaee.

Eiia?oeieiee aeiaiai?

AeIAIAI?
ia i?iaaaeaiiy oiaa?iiaiiiii? (aa?oa?ii?) iia?aoei?

199 ___ ?.

NOI?IIA-1:

a iniai _________
ui aeio ia iiaenoaai.
c iaeiiai aieo, i

NOI?IIA-2:

a iniai _________
ui aeio ia iiaenoaai.
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?aaeiaoii Aeaiiai Aeiaiai?o o cono?i/ia iinoaaea oiaa?ia ?iaii? aeiaiai?ii? aa?oinoi
(iaiii), ui caeienithooueny aac ieaoaaeo a?ioeia ia eiiiainaoeieiie iiaenoaai.

1.2. Aa?o/e o/anoue o Aeaiiio Aeiaiai?i, noi?iie iaaeieaii i?aaaie oa iaiayceaie i?iaeaaoey
i iieoioey o aiaeiiaiaeiinoi aei caeiiiaeaanoaa Oe?a?ie.

2. IAIAssCEE NOI?IIE-1

NOI?IIA-1 ciaiaycoooueny iinoaaeoe NOI?III-2 ianooiiee oiaa?:
2.1. Iaeiaioaaiiy oiaa?o: _____________________________________________________ .
2.2. Aeaioiaethaa/ oiaa?o: _______________________________________ (i.__________).
2.3. Iinoeaciaoiaeaeaiiy oiaa?o: __________________________________________________ .
2.4. Aeieoiaioe, ui iaaeathoueny ia oiaa?: ________________________________________

2.5. Iaeeieoey aeii?o eieueeinoi oiaa?o: _________________________________________ .
2.6. Caaaeueia eieueeinoue oiaa?o: _______________________________________________ .
2.7. Ani?oeiaio: caiaeii Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o. .
2.8. sseinoue _________________________________________________________________.

(aiaeiiaiaeiinoue AINOo, OO, na?oeoieaoo aeaioiaethaa/a, c?aceo oa ii.)

2.9. Iiaeoaa?aeaeaiiy yeinoi: ____________________________________

(iaeiaioaaiiy aiaeiiaiaeiiai aeieoiaioo)

2.10. Aa?aioieiee no?ie _________ c iiiaioo ___________________________

(aeaioiaeaiiy, ia?aaea/i, aenieoaoaoei?)

2.11. Eiiieaeoiinoue:

(AINO, OO, Iioi aeiiae)

2.12. Aeiaeaoie aei eiiieaeoo: ___________________________
2.13. Aeeeth/aiiy c eiiieaeoo: __________________________
2.14. Oa?iii iinoaaee: ________________________ c iiiaioo
c i?aaii aeino?ieiai? iinoaaee.

2.15. Oeiia ca iaeeieoeth oiaa?o: _________________________
2.16. Caaaeueia oeiia: __________________________________
2.17. Oiiae iinoaaee:

(o?aiei-neee, o?aiei-aaaii o Ii.)

2.18. Ioieo iinoaaee: ______________
2.19. Oa?a i iaeoaaiiy: _____________
2.20. Ia?ei?oaaiiy: ________________
2.21. Ioieo aiaeaaioaaeaiiy: _________
2.22. No?iee aiaeaaioaaeaiiy: _________
2.23. Aeae o?ainii?oo: _______________
2.24. Iiiiiaeueia ii?ia aiaeaaioaaeaiiy:

(aaaii, eiioaeia?, iioi ii?ie)

3. IAIAssCEE NOI?IIE-2

NOI?IIA-2 ciaiaycoooueny iinoaaeoe NOI?III-I ianooiiee oiaa?:
3.1. Iaeiaioaaiiy oiaa?o: _______________________________________

3.2. Aeaioiaethaa/ oiaa?o: ____________
3.3. Iinoeaciaoiaeaeaiiy oiaa?o: ______
3.4. Aeieoiaioe, ui iaaeathoueny ia oiaa?:

Eiia?oeieiee aeiaiai?
____ (i.__________).

3.5. Iaeeieoey aeii?o eieueeinoi-oiaa?o: ___________________________
3.6. Caaaeueia eieueeinoue oiaa?o: __________________________________
3.7. Ani?oeiaio: caiaeii Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o,

3.8. sseinoue ___________________________________________________
(aiaeiiaiaeiinoue AINOo, OO, na?oeoieaoo aeaioiaethaa/a, c?aceo oa Ii.)

3.9. Iiaeoaa?aeaeaiiy yeinoi:

(iaeiaioaaiiy aiaeiiaiaeiiai aeieoiaioo)
3.10. Aa?aioieiee no?ie _________ c iiiaioo

(aeaioiaeaiiy, ia?aaea/i, aenieoaoaoei?)

3.11. Eiiieaeoiinoue:

(AINO, OO, iioi aeiiae)

3.12. Aeiaeaoie aei eiiieaeoo: ____________________________
3.13. Aeeeth/aiiy c eiiieaeoo: __________________________
3.14. Oa?iii iinoaaee: _____________.___________ c iiiaioo
c i?aaii aeino?ieiai? iinoaaee.

3.15. Oeiia ca iaeeieoeth oiaa?o: ___________________________
3.16. Caaaeueia oeiia: __________________________________
3.17. Oiiae iinoaaee: __________________________________

(o?aiei-neeaae, o?aiei-aaaii oa Ii.)

3.18. Ioieo iinoaaee: _______________
3.19. Oa?a i iaeoaaiiy: _____________
3.20. Ia?ei?oaaiiy: ________________
3.21. Ioieo aiaeaaioaaeaiiy: __________
3.22. No?iee aiaeaaioaaeaiiy: ________
3.23. Aeae o?ainii?oo: _______________
3.24. Iiiiiaeueia ii?ia aiaeaaioaaeaiiy:

(aaaii, eiioaeia?, iioi ii?ie)

4. OIIAE OeIIE CA AeAIEI AeIAIAI?II

4.1. Oiiae oeiie ca Aeaiei Aeiaiai?ii aecia/aii aeey caaeainiaaiinoi acaoiieo iinoaaie,
a oaeiae eiio?ieth ca aeeiiaiiyi ciaiaycaiue.

4,2. Ioeiiea oiaa?o ia iiaeeyaao ciiii i ia iiaea aooe iiaenoaaith i?e oeeaaeaiii iioeo
aeiaiai?ia iiae NOI?IIAIE.

4.3. Aa?oinoue oiaa?o aae?ao a naaa aa?oinoue oa?e, iaeoaaiiy oa ia?ei?oaaiiy.

5. ACAoIII IAIAssCEE NOI?II CA AeAIEI AeIAIAI?II

5.1. Aeieoiaioe ia oiaa? ia?aaeathoueny NOI?IIAIE a ioieoi iinoaaee iaeii/anii c
ia?aaea/ath oiaa?o (iiaea ia?aaeaa/aoeny iioa).

5.2. Ia?aoiae i?aaa aeaniinoi ia oiaa? aiaeaoaaooueny a iiiaio: _____________________ .
5.3. Ia?aoiae ?eceeia ia oiaa? aiaeaoaaooueny a iiiaio: ____________________________ .
5.4. Oiaa? iiaeiai aooe caoa?aiee i niaeiaaiee noi?iiaie oaeei /eiii, uia aeeeth/eoe
inoaaiiy oa(aai) cieuaiiy eiai ia ia?iiae iinoaaee aei i?eeiaiiy oiaa?o aiaeiiaiaeiith
NOI?IIITH.

5.5. Eiaeia NOI?IIA iiaeiia iiaiaeiieoe ae?oao NOI?IIO i?i aiaeaaioaaeaiiy a no?ie
_____________ c iiiaioo _______________________ oeyoii ___________________________ .

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

O iiaiaeiieaiii cacia/athoueny: aeaoa aiaeaaioaaeaiiy, iiia? iaeeaaeii?, iiia? aaaiio (iacaa
noaeia, ? aaoiiaoeie, ? ?aeno) iiia? i aeaoa aeiaiai?o, iaeiaioaaiiy oa eieueeinoue oiaa?o.

6. IA?AAeA*A OIAA?O

6.1. Ia?aaea/a (i?eeiaiiy-caea/a) oiaa?o caeienithooueny a ioieoi iinoaaee.
6.2. I?eeiaiiy oiaa?o ca eieueeinoth oa yeinoth caeienithooueny NOI?IIAIE a ii?yaeeo, ui

aecia/aooueny /eiiei caeiiiaeaanoaii.
6.3. Io?eiaaoe oiaa?, eiaeia ic NOI?II iiaeiia oaeaa?aoii c iiaiaeiieaiiyi iiaeoaa?aeeoe

io?eiaiiy oiaa?o i?ioyaii ______________________________________________________ .

Eiia?oeieiee aeiaiai?

7. OA?III AeI? AeAIIAI AeIAIAI?O

7.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo iiaeienaiiy eiai NOI?IIAIE i aeio aei
iiiaioo eiai inoaoi/iiai aeeiiaiiy, aea a aoaeue-yeiio aeiaaeeo aei <____> _________ 19___ ?.
7.2. Aeaiee Aeiaiai? iiaea aooe i?ieiiaiaaiee ca caiaeith NOI?II.

8. AIAeIIAIAeAEUeIINOUe NOI?II

8,1. Ca ii?ooaiiy oiia Aeaiiai Aeiaiai?o aeiia NOI?IIA aiaeoeiaeiaoo ni?e/eiaii oeei
caeoee, a oiio /enei ao?a/aio aeaiaeo, a ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.
8.2. NOI?IIE ca Aeaiei Aeiaiai?ii ianooue ianooiio aiaeiiaiaeaeueiinoue:
– ca _________________________ oo?aoia iaonoieea a ?icii?i _____________________%

(eiie?aoia ii?ooaiiy)

aiae noie

(aeiaiai?o, ai?ao)

ca _______________________ oo?aoia iaonoieea a ?icii?i _____________________%

(eiie?aoia ii?ooaiiy)

AIAe NoIE

(aeiaiai?o, ai?ao)

8.3. Ca iaeiinoi?iiith iaiaa?oioiaaio aiaeiiao aiae aeeiiaiiy nai?o ciaiaycaiue i?ioyaii
aei? Aeaiiai Aeiaiai?o aeiia NOI?IIA niea/oo oo?ao a ?icii?i _________________________ .
8.4. Ca ii?ooaiiy iioeo oiia Aeaiiai Aeiaiai?o aeiia NOI?IIA iana ianooiio aiaeiiai-
aeaeueiinoue: ________________________________—___________________________________

9. CAAACIA*AIIss CIAIAssCAIUe CA AeAIEI AeIAIAI?II
(iiaeooue ia?aaeay/yoeny oiiae i?i canoaao, no?aooaaiiy /e (th?o/ioaoth

c aieo ?o NOI?IIE-1, oae i NOI?IIE-2)

10. II?ssAeIE ?ICAssCAIIss NII?IA

10.1. Ani-nii?e iiae NOI?IIAIE, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o
aiaeiiaiaeiinoi aei caeiiiaeaanoaa Oe?a?ie a A?aio?aaeiiio noaei (o?aoaenueeiio noaei ic cacia/aiiyi
eiie?aoiiai o?aoaenueeiai noaeo /e cacia/eoe ii?yaeie oi?ioaaiiy oeueiai o?aoaenueeiai noaeo).

10.2. NOI?IIE aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi noi?iiaie i?ioyaii _______________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

11. CIIIA OIIA AeAIIAI AeIAIAI?O

11.1. Oiiae Aeaiiai Aeiaiai?o iathoue iaeiaeiao ciaiaycoaaeueio neeo aeey NOI?II oa
iiaeooue aooe ciiiaii ca acaoiiith caiaeith c iaiayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioo.
11.2. AEiaeia ic NOI?II ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee ae?oai? NOI?IIE.

12. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie NOI?II ca Aeaiei Aeiaiai?ii o:
NOI?IIA-1: ________________________________ oaeaoii ______________________ .
NOI?IIA-2: _________________________________ oaeaoii _______________________ .

13. INIAEEAI OIIAE

I NIIA?IaIOIIOeOOeI N

(iiaeooue aooe aeacaii aeiaeaoeiai oiiae niIa?iaioiioeooei NOI?II c aeeiieiy Aeoiai Aeiaii?o: iaiy
c iaeaaiaeaeaiiy oa iiioaaeo oiaa?o, iaiaycee iioi?ioaaoe i?i aenieoaooith oa aoth?eno>oy oii?o oi ii.)

14. IIOI OIIAE

14.1. Aeaiee Aeiaiai? neeaaeaii oaeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
NOI?II.

14.2. I?aaa oa iaiaycee ca Aeaiei Aeiaiai?ii canoiniaothoueny ia aeainoi?iiiie oa acaoiiie
iiaenoaai a caeaaeiinoi aiae oiai, a yeie ?iei (iieoioey /e i?iaeaaoey) aenooiao eiaeia NOI?IIA
a eiaeiiio eiie?aoiiio aeiaaeeo.

O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, NOI?IIE ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii.

Eiia?ei eiee eiaiai?

14.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

14.4. NOI?IIE ciaiaycothoueny i?e aeeiiaiii Aeaiiai Aeiaiai?o ia caiaeeoe niia?iaioie-
oeoai eeoa aei aeio?eiaiiy aeiia, ui iinoyoueny a Aeaiiio Aeiaiai?i, iiaeo?eioaaoe aeieiai eiioaeoe
oa aaeeaaoe anio iaiaoiaeieo caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?o eiia?oeieieo
cayceia.

15. TH?EAeE*II AAe?ANE, AAIEIANUeEI OA AIAeAAIOAAEOAAEUeII ?AEAICEOE
NOI?II IA IIIAIO OEEAAeAIIss AeAIIAI AeIAIAI?O

15.1. NOI?IIA-1:

Iinoeaciaoiaeaeaiiy ioino: ______________________________________________________.
Iiooiaa aae?ana oa iiaeaen: ______________________________________________________ .
Oaeaoii ________, oaeaoaei ___________________, oaen _______________________ .
?ic?aooieiaee ?aooiie ?____________ a ______________________________________,

(iaeiaioaaiiy aaieianueei? onoaiiae)

IOI ______________, eiae __________________ .
Ei?aniiiaeaionueeee ?aooiie aaieo IIEOIOess: ______________________________ .
Aiaeaaioaaeoaaeueii ?aeaiceoe ic cacia/aiiyi eiaeia:
I. Aeey aaaiiieo aiaei?aaeaiue: ____________________________________________________ ,

2. Aeey eiioaeia?ia: ___________________________________________________________ .

3. Aeey aiaei?aaeaiiy aiaeiei o?ainii?oii: ______________________________________ .
4, Aeey aiaei?aaeaiiy iiaio?yiei o?ainii?oii: ____________________________________ .
15.2. NOI?IIA-2:

Iinoeaciaoiaeaeaiiy ioino: _____________________________________________________ .
Iiooiaa aae?ana oa iiaeaen: ______________________________________________________ .
Oaeaoii ___________, oaeaoaei ___________________, oaen _______________________ .
?ic?aooieiaee ?aooiie ?_____________ a

(iaeiaioaaiiy aaieianueei? onoaiiae)

IOI _____________, EIAe _________

Ei?aniiiaeaionueeee ?aooiie aaieo IIEOIOess: __
Aiaeaaioaaeoaaeueii ?aeaiceoe ic cacia/aiiyi eiaeia:
I. Aeey aaaiiieo aiaei?aaeaiue: ___________________

2. Aeey eiioaeia?ia: ________________________________________________________ .

3. Aeey aiaei?aaeaiiy aiaeiei o?ainii?oii: ________________________________________ .

4. Aeey aiaei?aaeaiiy iiaio?yiei o?ainii?oii: ____________________________________ .
15.3. NOI?IIE ciaiaycothoueny iaaaeii ienueiiai iiaiaeiieyoe iaeia iaeio o aeiaaeeo
ciiie aiaeiiinoae, cacia/aieo o i. 15 Aeaiiai Aeiaiai?o.

16. AeIAeAOEE AeI AeAIIAI AeIAIAI?O

I. Aeiaeaoie ? 1 ia ___________ noi?.
2. Aeiaeaoie ? 2 ia ___________ noi?.
Aeiaeaoee aei Aeaiiai Aeiaiai?o neeaaeathoue eiai iaaiaeoiio /anoeio.

NOI?IIA-1 NOI?IIA-2

………………….

(…………………………)
I.I.

AeIAIAI?
iiie

199 ___ ?.

NOI?IIA-1:
a iniai _________
ui aeio ia iiaenoaai.
c iaeiiai aieo, i

Eiia?oeieiee aeiaiai?

NOI?IIA-2: _____________________________________________
a iniai _____________________________________________._________
ui aeio ia iiaenoaai ___________________________________________
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:
I. Iiae NOI?IIAIE caeienithooueny iaiii ianooiiith i?iaeoeoeioth:

. (iaeiaioaaiiy i?iaeoeoei?)

a eieueeinoi _________________, aeanieeii yei? o NOI?IIA-1,
IA

(iaeiaioaaiiy i?iaeoeoei?)

a eieueeinoi _________________, aeanieeii yei? o NOI?IIA-2.

2. Aei oeeaaeaiiy Aeaiiai Aeiaiai?o NOI?IIE iiyeeo oeeaieueii-i?aaiaeo oaiae noiniaii
caaaeaiiai iaeia ia oeeaaeaee.

3. I?aaeiaoe iaiiio ciaoiaeyoueny o ni?aaiiio noaii, i?eaeaoiiio aei aenieoaoaoei?.
sseinoue i?aaeiaoia iaiiio aecia/aii ca iiia?aaeiii iaeyaeii.

NOI?IIE acaoiii aa?aioothoue yeinoue i?aaeiaoia iaiiio oaeith, yeith ?? iaeyioea oa noaaeeea
eiaeia NOI?IIA, ui aenooiao o yeinoi iieoioey.

4. I?aaeiaoe iaiiio ia?aaeathoueny iaeei iaeiiio ca iinoeai ciaoiaeaeaiiy iaeia NOI?IIE,
ui aenooiao o yeinoi i?iaeaaoey, i?ioyaii 10 aeiia c iiiaioo oeeaaeaiiy Aeaiiai Aeiaiai?o.

I?aai aeaniinoi ia i?aaeiaoe iaiiio aeieeao o NOI?II, ui aenooiathoue a yeinoi iieoioey,
c iiiaioo i?eeiaiiy aeuaaeacaiiai iaeia, ui ioi?iethooueny aeoaie caea/i-i?eeiaiiy, yei
iiaeienothoueny iiaiiaaaeieie i?aaenoaaieeaie NOI?II.

I?e ia?aaea/i i?iaeoeoei? NOI?IIA, ui aenooiao a yeinoi i?iaeaaoey, ciaiaycaia ia?aaeaoe
iioie NOI?III, ui aenooiao a yeinoi iieoioey, ani aeieoiaioe ia i?aaeiaoe iaiiio, i?i ui
?iaeoueny aiaeiiaiaeia iicia/ea oa ia?aeie a aeoi caea/i-i?eeiaiiy.

5. Iinoea ciaoiaeaeaiiy i?aaeiaoia iaiiio:
NOI?IIA-1

NOI?IIA-2

6. Eiaeia ic NOI?II, ui aenooiao a yeinoi i?iaeaaoey, ciaiaycaia:
– iaaeaoe iaeii, ui o i?aaeiaoii iaiiio, o ?icii?yaeaeaiiy NOI?IIE, ui aenooiao a
yeinoi iieoioey, oa caaacia/eoe iaiaoiaeii oiiae c iaaeaiiy oiaa?o aei o?ainii?oii-ia?aaicieo
caniaia, ui aeei?enoiaothoueny inoaiiii;

– caaacia/eoe ca aeaniee ?aooiie iaeoaaiiy oiaa?o (yeui aiii ia?aaeaa/aia), iaiaoiaeia
aeey oiai, uia NOI?IIA, ui aenooiao a yeinoi iieoioey, iaea iiaeeeainoue i?eeiyoe i?aaeiao
iaiiio.
7. Aiaeiiaiaeaeueiinoue NOI?II.

NOI?IIE ianooue ca Aeaiei Aeiaiai?ii ianooiio aiaeiiaiaeaeueiinoue:
a) ca i?ino?i/aiiy a i?eeiyooi i?aaeiaoia iaiiio ____________________________________

—~—–~~—–,
a) ca i?ino?i/aiiy a iaaeaiii i?aaeiaoia iaiiio _____________________________________

a) ca iaeiinoi?iiith aiaeiiao aiae aeeiiaiiy Aeaiiai Aeiaiai?o ___________________________

8. Iioi oiiae Aeaiiai Aeiaiai?o.

8.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo iiaeienaiiy eiai NOI?IIAIE.
8.2. Aeaiee Aeiaiai? neeaaeaiee o aeaio i?eaiiaeueieo i?eii?ieeao oa caa?iaaooueny o NOI?II.
8.3. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, NOI?IIE ea?othoueny /eiiei
oeeaieueiei caeiiiaeaanoaii.

8.4. Oiiae Aeaiiai Aeiaiai?o iathoue iaeiaeiao ciaiaycoaaeueio neeo aeey NOI?II oa iiaeooue
aooe ciiiaii ca acaoiiith caiaeith noi?ii c iaiayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioo.
Ienueiiaee aeieoiaio ic ciiiaie oa aeiiiaiaiiyie neeaaeaooueny o aeaio i?eii?ieeao oa o
iaaiaeoiiith /anoeiith Aeaiiai Aeiaiai?o.

8.5. NOI?IIE anoaiiaeththoue, ui ani aeiiiaiaiiy oa ciiie, aianaii aei Aeaiiai Aeiaiai?o
a iaeiinoi?iiiueiio ii?yaeeo, ia iathoue th?eaee/ii? neee.

Eiia?oeieiee eiaiai?

8.6. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e oa eenooaaiiy ca iei
ao?a/athoue anieyea th?eaee/ia cia/aiiy.

8.7. AEiaeia ic NOI?II ia iao i?aaa ia?aaeaaaoe nai? i?aaa oa iaiaycee ca Aeaiei Aeiaiai?ii
o?aoie noi?iii aac ienueiiai? caiaee ae?oai? NOI?IIE.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

_______________________?icaeie 6_______________________
EIIINIEII OA IIOI IINA?AAeIEOeUeEI IIA?AOeI?

Eiiinieii eiia?oeieii iia?aoei? iieyaathoue o caeieniaiii iaeiioth noi?iiith, ui caaoueny
EIIINIIIA? (IINA?AAeIEE), aiae naiai iiaii, ca ?aooiie i ca aei?o/aiiyi iioi? noi?iie, ui
caaoueny EIIIOAIOII (CAIIAIEEII) oaiae eoiiaei-i?iaeaaeo. A aeieiaiio iaiao aeaii iia?aoei?
iieiee iaceaathoueny iia?aoeioth c ia?aaea/i oiaa?o ia ?aaeicaoeith.

Acaoiiaiaeiineie iiae EIIIOAIOII i EIIINIIIA?II ?aaoeththoueny aeiaiai?ii eiiini?,
i?aaeiaoii yeiai o iineoae, ae?aaeaii a oeeaaeaiii eiia?oeieieo oaiae. O aiaeiiaiaeiinoi aei aeiaiai?o
EIIINIIIA?-IINA?AAeIEE ia eoioo oiaa?e EIIIOAIOA-CAIIAIEEA, a eeoa caeienitho
oaiaee c i?eaeaaiiy aai ?aaeicaoei? oiaa?ia.

EIIINIIIA?-IINA?AAeIEE oeeaaeao aeiaiai?e eoiiaei-i?iaeaaeo c o?aoiie iniaaie aiae
naiai iiaii i nai io?eioo aiae ieo a?ioi (aai ?ic?aoiaoooueny ca ieo). Oaeei /eiii, EIIINIIIA?
o iina?aaeieeii eeoa c aieo EIIIOAIOA-CAIIAIEEA, a aeey o?aoio inia, c yeeie aii ca
aei?o/aiiyi EIIIOAIOA oeeaaeao oaiaeo, EIIINIIIA? o noi?iiith aeiaiai?o eoiiaei-i?iaeaaeo.

EIIIOAIO caaaeaee o aeanieeii oiaa?o aei iiiaioo eiai ia?aaea/i o ?icii?yaeaeaiiy
eiioeaaiai iieoioey, iaaioue o oiio aeiaaeeo, eiee oiaa? ia?aaeaooueny o aieiaeiiiy EIIINIIIA?A,
A oeueiio aeiaaeeo ?ecee aeiaaeeiai? caaeaaei oaeeo oiaa?ia eaaeeoue ia EIIIOAIOI. I?ioa,
yeui o EIIINIIIA?A ciaoiaeeoueny iaeii EIIIOAIOA, ia?oee aiaeiiaiaeao ia?aae iei ca
eiai ao?aoo, ianoa/o aai iioeiaeaeaiiy.

EIIINIIIA?-IINA?AAeIEE ciaiaycaiee aeeiiaoe aei?o/aiiy EIIIOAIOA o oi/iie
aiaeiiaiaeiinoi aei eiai aeaciaie i ia oiiaao, iaeaieueo aeaiaeieo aeey inoaiiueiai. O aeiaaeeo, yeui
EIIINIIIA? oeeaa oaiaeo ia oiiaao aeaiaeiioeo, iiae oi, yei anoaiiaea EIIIOAIO, oi, ca
caaaeueieie i?aaeeaie, any aeaiaea aiae oeueiai iinooiao EIIIOAIOO, yeui aeiaiai?ii iiae ieie
iioiai ia?aaeaa/aii ia aoei.

EIIINIIIA?-IINA?AAeIEE ia aiaeiiaiaeao ia?aae EIIIOAIOII ca aeeiiaiiy aeiaiai?o
eoiiaei-i?iaeaaeo o?aoii iniaai, ie?ii aeiaaeeia, eiee EIIINIIIA? i?eeiao ia naaa ii?oeo ca
aeeiiaiiy o?aoueith iniaith oeio? oaiaee (aeaeuee?aaea?a). O aeiaaeeao ii?ooaiiy o?aoueith iniaith
oaiaee, oeeaaeaii? c iath eiiiniiia?ii, EIIINIIIA? ciaiaycaiee iaaaeii iiaiaeiieoe i?i oea
EIIIOAIOA, cia?aoe i caaacia/eoe iaiaoiaeii aeieace.

A oie aea /an, i?aaa oa iaiaycee ca oaiaeith iaaoaao EIIINIIIA?, iaaioue yeui EIIIOAIO
i aoa iacaaiee aai anooiea o aaciina?aaeii aiaeiineie c oeioth iniaith. Oea aeeeeeaii oei, ui a
iaiao EIIINIIIA? aenooiao aiae naiai iiaii.

AeIAIAI?
eiiini? ia i?iaeaae i?iaeoeoei?
(aeiaiai? i?i ia?aaea/o i?iaeoeoei? ia ?aaeicaoeith)

i. ____________ <____> ___________ 199 ___ ?.

(iiaia oi?iiaa iaeiaioaaiiy iiaei?eoinoaa)
(I.I.A.)

EIIIOAIO:.
a iniai aee?aeoi?a.

ui aeio ia iiaenoaai __
c iaeiiai aieo, i

EIIINIIIA?:
a iniai aee?aeoi?a _

(iiaia oi?iiaa iaeiaioaaiiy iiaei?eoinoaa)

Eiia?oeieiee aeiaiai?

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. EIIINIIIA? ciaiaycoooueny ca aei?o/aiiyi EIIIOAIOA caeienieoe a iioa?anao
inoaiiueiai aiae naiai iiaii oaiaeo c i?iaeaaeo i?iaeoeoei?.

1.2. Eiie?aoii oiiae oaiaee, eieueeinoue, yeinoue oa iiiiiaeueia oeiia i?iaeaaeo i?iaeoeoei?, a
oaeiae iioi oiiae oa aeaciaee EIIIOAIOA iaaiaeyoueny o Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o.

1.3. Aenooiath/e aiae naiai iiaii, EIIINIIIA? naiinoieii oeeaaeao oaiaeo eoiiaei-i?iaeaaeo
c o?aoueith iniaith (iaaeaei IIEOIAOeUe).

2. IAIAssCEE EIIINIIIA?A

EIIINIIIA? o aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o ciaiaycoooueny:
2.1. Naiinoieii caeienieoe iaiaoiaeio eiia?oeieii-ia?eaoeiaiao ?iaioo, ciaeoe IIEOIOess
ia i?iaeoeoeith EIIIOAIOA, c?iaeoe anth ia?aaeaeiaiai?io ?iaioo oa oeeanoe c IIEOIOeAI
aeiaiai? eoiiaei-i?iaeaaeo o aiaeiiaiaeiinoi aei aeaciaie EIIIOAIOA oa ia iaeaieueo aeaiaeieo aeey
iueiai oiiaao;

2.2. I?eeiyoe o EIIIOAIOA iaeii, i?ecia/aia aeey eiiini?, oa aaeeoe anio iaiaoiaeieo
caoiaeia aeey eiai caa?aaeaiiy aiae ao?aoe, ianoa/i aai iioeiaeaeaiiy;

2.3. Iaeyiooe iaeii, ui ia?aaeaooueny ia eiiinith, ia?aai?eoe eiai yeinoue oa eiiieaeoiinoue,
aiaaieoeny o eiai i?eaeaoiinoi aeey i?iaeaaeo;

2.4. O aeiaaeeo aeyaeaiiy iioaeieo iaaeieieia o i?iaeoeoei? EIIIOAIOA, ui ia?aaeaia ia
eiiinith, iaaaeii iiaiaeiieoe EIIIOAIOA i?i aeyaeaii iaaeieiee;

2.5. A oa?iii __________ iioi?ioaaoe EIIIOAIOA i?i oiae aeeiiaiiy aei?o/aiiy, a
oa?iii __________ iiaiaeiieoe inoaiiueiai i?i oeeaaeaio a eiai iioa?anao oaiaeo oa ia?aaea/o
i?iaeoeoei? IIEOIOeTH, a oaeiae iaaeaoe EIIIOAIOO eiiith oeeaaeaii? oaiaee;

2.6. Iaaeaoe caio EIIIOAIOO oa ia?aaeaoe inoaiiueiio ani i?aaa oa aeieoiaioe aiaeiinii
IIEOIOess, ui aeoieathoue ic oaiaee;

2.7. O aeiaaeeo aeieeiaiiy iaia?aaeaa/aieo ianoaaei, ui ia?aoeiaeaeathoue oeeaaeaiith
oaiae ia oiiaao EIIIOAIOA, a oa?iii __________ iiaiaeiieoe i?i oea EIIIOAIOA.

3. IAIAssCEE EIIIOAIOA

EIIIOAIO o aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o ciaiaycoooueny:
3.1. Ia?aaeaoe EIIINIIIA?O iaeii ia eiiinith i?ioyaii _________ c iiiaioo iiaeienaiiy

Aeaiiai Aeiaiai?o;
3.2. Caieueieoe EIIINIIIA?A aiae iaiayceia, acyoeo iei ia naaa c aeeiiaiiy aei?o/aiiy

ia?aae IIEOIOeAI oa iioeie iniaaie, i?ioyaii ____ c iiiaioo iaaeaiiy caioo EIIINIIIA?A.
3.3. I?eeiyoe caio EIIINIIIA?A, ?icaeyiooe oa caoaa?aeeoe eiai i?ioyaii ____aeiia, a

oaeiae ia eiai iiaenoaai aiaeoeiaeoaaoe aeo?aoe, yei caeieniea EIIINIIIA? i?e aeeiiaiii oaiaee.

4. II?ssAeIE IA?AAeA*I IAEIA IA EIIINITH

Ia?aaea/a iaeia ia eiiinith caeienithooueny ca aeoii o ianooiiiio ii?yaeeo:
Iinoea ia?aaea/i: ________________________________________________________________.

(aae?ana neeaaeo EIIIOAIOA aai EIIINIIIA?A)

O?ainii?ooaaiiy: _____________________________________________________________.
Aeo?aoe c o?ainii?ooaaiiy iana: ________________________________________________ .
*an i?eeiaiiy: c _____ aei ______ aiaeei.

5. AEIAAI?IAeA EIIINIIIA?A

5.1. Ca aeeiiaiiy aei?o/aiiy EIIIOAIO niea/oo EIIINIIIA?O aeiaai?iaeo a ?icii?i
___________________ aiae noie oaiaee c IIEOIOeAI.

5.2. A?ioiai eiooe ca i?iaeaae i?iaeoeoei? EIIIOAIOA iaaeoiaeyoue ia ?ic?aooieiaee ?aooiie
EIIINIIIA?A.

5.3. Iiaenoaaith io?eiaiiy aeiaai?iaee EIIINIIIA?A o io?eiaiiy iei a?ioae aiae II-
EOIOess.

5.4. sseui aei?o/aiiy aeeiiaii EIIINIIIA?II /anoeiai, oi aeiaai?iaea eiio aeiea/oooue-
ny i?iii?oeieii aeeiiaiiio.
Iiaeeeaee aa?iaio.

1. ?icii? aeiaai?iaee o aeiaaeeo i?iaeaaeo oiaa?o ia aieueo aeaiaeieo aeey EIIIOAIOA
oiiaao iiaea neeaaeaoeny c A aiaenioeia aiae noie ca iiiiiaeueieie oeiiaie, anoaiiaeaieie o

Eiia?oeieiee aeiaiai?

aei?o/aiii EIIIOAIOII, i A aiaenioeia (ye i?aaeei aeueo) aiae io?eiaii? aeaiaee (i?aiiy).
6. II?ssAeIE ?IC?AOOIEIA

6.1. Aeiaai?iaea EIIINIIIA?A aeiea/oooueny oeyoii oo?eiaiiy iaeaaeieo inoaiiueiio
noi ic a?ioiaeo eiooia, ia?a?aoiaaieo IIEOIOeAI EIIINIIIA?O ca i?iaeaae iaeia
EIIIOAIOA.

6.2. A?ioiai eiooe EIIIOAIOO aeiea/othoueny EIIINIIIA?II i?ioyaii __________
c iiiaioo iaaeoiaeaeaiiy eiooia ia eiai ?ic?aooieiaee ?aooiie.
6.3. Ii?yaeie iieaoe: __________________________________________________________ .

(iiooiaee, oaeaa?aoiee)

6.4. Aeae ?ic?aooieia: __________________________________________________________ .

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

6.5. Oi?ia ?ic?aooieia: ________:___________________________________________________ .

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa-aei?o/aiiy)

6.6. EIIINIIIA? ciaiaycaiee iiaiaeiieoe EIIIOAIOA i?i caeieniaiiy ieaoaaeo a oa?iii
c iiiaioo ________________ oeyoii .

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

7. AIAeOEIAeOAAIIss AEO?AO

7.1. Aei aeo?ao EIIINIIIA?A, ui aiaeoeiaeiaothoueny inoaiiueiio EIIIOAIOII ca Aeaiei
Aeiaiai?ii, iaeaaeaoue: ___________________________________________________________________

7.2. A aoaeue-yeiio ?aci ?icii? aeo?ao EIIINIIIA?A ia iiaea neeaaeaoe aieueo, iiae ______%
aiae noie oaiaee c IIEOIOeAI.

7.3. Ani iioi aeo?aoe EIIINIIIA?A, ia cacia/aii a i.7,1 aeiaiai?o, aiaeoeiaeiaothoueny
inoaiiii ic aeiaai?iaee.

7.4. Ani aeo?aoe EIIINIIIA?A aiaeaeaathoueny a eiai caioi, yeee neeaaeaooueny oa iiaeaooueny
EIIIOAIOO a ienueiiaie oi?ii c aeiaeaoeii anio aei?aaaeieo aeieoiaioia.

7.5. Oa?iii iaaeaiiy caioo ___________ c iiiaioo ___________________________________ .

7.6. A onio aeiaaeeao aiaeoeiaeiaothoueny aeo?aoe EIIINIIIA?A, caeieniaii iei c aiaeiia oa
caiaee EIIIOAIOA, a oaeiae aeiiouaii iei aac aeie ia?oiai ca iaia?aaeaa/oaaieo ianoaaei.

7.7. Aeo?aoe EIIINIIIA?A aiaeoeiaeiaothoueny oeyoii oo?eiaiiy a?ioiaeo eiooia ic
io?eiaieo aiae IIEOIOess.

8. OA?III AeIAIAI?O

8.1. EIIINIIIA? ciaiaycaiee aeeiiaoe aei?o/aiiy i?ioyaii ______________________
c iiiaioo _____________________________________________________________________________,

8.2. Aeiaiai? iiaea aooe i?ieiiaiaaiee ca caiaeith noi?ii.

9. I?AAA EIIINIIIA?A C AEEIIAIIss AeI?O*AIIss

9.1. O aeiaaeeo, yeui EIIINIIIA?, ia aeeaey/enue ia ani aaeeoi iei caoiaee, a no?ie _____
ia ciiaea ?aaeicoaaoe i?iaeoeoeith, ia?aaeaio EIIIOAIOII ia eiiinith, i oea aiaeaoaeaoueny /a?ac
aeoaea aenieo i?ecia/aio EIIIOAIOII oeiio, oi EIIINIIIA? iao i?aai aac caiaee EIIIOAI-
OA cieceoe eiai oeiio ia ___________%.

9.2. sseui iiaeiaii ianoaaeie iiaoi?youeny i?ioyaii ________________ c iiiaioo________,
oi EIIINIIIA? iao i?aai a oiio ae ii?yaeeo cieceoe oeiio ia ___________%.

9.3. A onio aeiaaeeao EIIINIIIA? ciaiaycaiee iioi?ioaaoe EIIIOAIOA i?i cieaeaiiy
oeiie iaaaeii.

10. AIAeIIAIAeAEUeIINOUe NOI?II

10.1. sseui EIIINIIIA? ?aaeicoo iaeii ca oeiiith ieae/a i?ecia/aii? eiio EIIIOAIOII,
inoaiiie, ia aaaeath/ee i?eeiyoe oaeo, ciaiaycaiee cayaeoe i?i oea EIIINIIIA?O a _______
no?ie iiney io?eiaiiy iiaiaeiieaiiy i?i oeeaaeaiiy oaiaee c IIEOIOeAI. A i?ioeaiiio
aeiaaeeo oaiaea aeciaooueny oaeith, ui i?eeiyoa EIIIOAIOII.

10.2. sseui EIIINIIIA? iiaiaeiieoue, ui i?eeiao ?icieoeth a oeiii ca naie ?aooiie,
EIIIOAIO ia iao i?aaa aiaeiiaeoeny aiae oeeaaeaii? aeey iueiai oaiaee.
10.3. Aiaeiiaiaeaeueiinoue EIIINIIIA?A: _____________________________________________

10.4. Aiaeiiaiaeaeueiinoue EIIIOAIOA:

Eiia?oeieiee aeiaiai?

10.5. Ca iaeiinoi?iiith iaiaa?oioiaaio aiaeiiao aiae aeeiiaiiy nai?o ciaiaycaiue i?ioyaii
aei? Aeaiiai Aeiaiai?o aeiia noi?iia niea/oo oo?ao a ?icii?i ____________________________ .

11. CAAACIA*AIIss CIAIAssCAIUe CA AeAIEI AeIAIAI?II
(iiaeooue ia?aaeaa/aoeny oiiae i?i canoaao, no?aooaaiiy aai ii?o/ieoeoai
c aieo ye EIIIOAIOA, oae [EIIINIIIA?A)

12. II?ssAeIE ?ICAssCAIIss NII?IA

12.1. Ani nii?e iiae noi?iiaie, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o aiaeiiaiae-
iinoi aei caeiiiaeaanoaa Oe?a?ie a A?aio?aaeiiio noaei (o?aoaenueeiio noaei ic cacia/aiiyi eiie?ao-
iiai o?aoaenueeiai noaeo aai cacia/eoe ii?yaeie oi?ioaaiiy oeueiai o?aoaenueeiai noaeo).

12.2. Noi?iie aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi noi?iiaie i?ioyaii ___________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

13. CIIIA OIIA AeAIIAI AeIAIAI?O

13.1. Oiiae Aeaiiai Aeiaiai?o iathoue iaeiaeiao ciaiaycoaaeueio neeo aeey noi?ii i iiaeooue
aooe ciiiaii ca acaoiiith caiaeith-noi?ii c iaiayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioo.

13.2. AEiaeia c noi?ii ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee ae?oai? noi?iie.

14. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie noi?ii ca Aeaiei Aeiaiai?ii o:
EIIINIIIA?: ________________________________ oaeaoii __________________________ .
EIIIOAIO: ________________________________ oaeaoii _________________________ .

15. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

16. IIOI OIIAE

16.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

16.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei oeeaieueiei
caeiiiaeaanoaii.

16.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

16.4. Ani aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii o eiaeiiio ie?aiiio aeiaaeeo.

16.5. Noi?iie ciaiaycothoueny i?e aeeiiaiii Aeaiiai Aeiaiai?o ia caiaeeoe niia?iaioieoeoai
eeoa aei aeio?eiaiiy aeiia, ui iinoyoueny a Aeaiiio Aeiaiai?i, iiaeo?eioaaoe aeieiai eiioaeoe oa
aaeeaaoe anio iaiaoiaeieo caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?o eiia?oeieieo
cayceia.

16.6. Noi?iie ciaiaycothoueny iaaaeii ienueiiai iiaiaeiieyoe iaeia iaeio o aeiaaeeo ciiie
aiaeiiinoae, cacia/aieo a i. 17 Aeaiiai Aeiaiai?o.

17. AeIAeAOEE AeI AeAIIAI AeIAIAI?O

17.1. Aei Aeaiiai Aeiaiai?o aeiaeaooueny:
Aeiaeaoie ? 1 ia __________ noi?.
17.2. Aeiaeaoee aei Aeaiiai Aeiaiai?o neeaaeathoue eiai iaaiaeoiio /anoeio.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

Eiia?oeieiee eiaiai?

AeIAIAI?
eiineaiaoei? ia i?iaeaae i?iaeoeoei?

(iaeiaioaaiiy iiaei?eoinoaa)

i. ____________ <____> ___________ 199 ___ ?.
EIINEAIAIO: _

a iniai aee?aeoi?a ____

ui aeio ia iiaenoaai ____
c iaeiiai aieo, i

EIINEAIAOI?:

(iaeiaioaaiiy iiaei?eoinoaa)

a iniai aee?aeoi?a ___________________________________________________________________,

ui aeio ia iiaenoaai ____________________________________________________________________,
c iioiai aieo,

oeeaee Aeaiee .Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. EIINEAIAIO iinoa/ao oiaa?e ia neeaae EIINEAIAOI?A aeey ?o ?aaeicaoei? inoaiiii
ia naioio ?eieo aiae naiai iiaii.

1.2. Eieueeinoue, iiiaieeaoo?a, yeinoue, oeiia, ia?iiaee/iinoue iinoaaie oa iioi oa?aeoa?enoeee
oiaa?ia, ui iinoa/athoueny ia eiineaiaoeith, aecia/athoueny a Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o,
yeee o eiai iaaiaeoiiith /anoeiith.

2. AeIAIAI?IA OA?EOI?Iss

2.1. EIINEAIAOI? iao i?aai caeienithaaoe ?aaeicaoeith eiineaiaoeieieo oiaa?ia ia
ianooiiie oa?eoi?i?: __________________________________________________________________

Cacia/aooueny ?aaiii (?aaiiie), aeoiaey/e c aaeiiiino?aoeaii-oa?eoi?iaeueiiai aai iaoeiiiaeueii-
aea?aeaaiiai iiaeieo.

2.2. EIINEAIAOI? ia iao i?aaa i?iaeaaaoe oiaa?e iica iaaeaie aeiaiai?ii? oa?eoi?i?
aac caiaee EIINEAIAIOA.

2.3. EIINEAIAOI? ciaiaycaiee aei aeiaiai?ia eoiiaei-i?iaeaaeo c o?aoiie iniaaie
aeeth/aoe oiiae i?i oa, ui inoaiii oaeiae ia iathoue i?aaa i?iaeaaaoe eiineaiaoeieii oiaa?e
iica iaaeaie aeiaiai?ii? oa?eoi?i? aac caiaee EIINEAIAIOA.

3. IAIAssCEE EIINEAIAOI?A

EIINEAIAOI? ciaiaycoooueny:
– noai?i aeeiioaaoe aeaciaee EIINEAIAIOA, ia?aaeaa/aii Aeaiei Aeiaiai?ii, a oaeiae

aeaii eiio inoaiiii aeiaeaoeiai a ienueiiaie oi?ii;

– aaeeaaoe anio iaiaoiaeieo caoiaeia oa aeie aeey aacia?aoeiaeii? iinoaaee oiaa?ia EIINE-
AIAIOA ia aeiaiai?iie oa?eoi?i?;

– caeienithaaoe aacia?aaieia i?eeiaiiy i?iaeoeoei? EIINEAIAIOA ia nai?o neeaaeao;

– iiaeaiooaaoe neeaaenueei i?eiiuaiiy aeey i?eeiaiiy oa aiaeiiaiaeiiai caa?iaaiiy oiaa?ia;
– caaacia/eoe iiaia caa?aaeaiiy yeinoi oiaa?ia ia neeaaei ia /an ia?aaoaaiiy ?o ia

eiineaiaoei?;
– i?iaanoe ?aeeaiio eaiiaiith oiaa?ia o caniaao ianiai? iioi?iaoei? aeiaiai?ii? oa?eoi?i?

oaeeie niiniaaie, yeeie aii aaaaeao ca iio?iaia;
– iaaeaaaoe EIINEAIAIOO iiaio iioi?iaoeith i?i ia?aaia ?aaeicaoei? oiaa?ia oa i?i ?o

caian ia neeaaei; –

4. IAIAssCEE EIINEAIAIOA

EIINEAIAIO ciaiaycoooueny ?aaoey?ii iinoa/aoe ia neeaae EIINEAIAOI?A i?iaeoeoeith
a ani?oeiaioi oa a oa?iiie, cacia/aii a Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o.

5. OA?III EIINEAIAOeI?

5.1. Oa?iii eiineaiaoei? neeaaeao __________________________________________________ .

Eiia?oeieiee aeiaiai?

5.2. Oa?iii ii/eiao nieeaaoe c iiiaioo iinoaaee ia neeaae EIINEAIAOI?A oiaa?ia oa
caeii/oooueny c iiiaioo ia?aaea/i eiai IIEOIOeTH.

Oa?iii eiineaiaoei? – /an, i?ioyaii yeiai iinoaaeaiee ia eiineaiaoeith oiaa? iiaeiai
aooe i?iaeaiee IIEOIOeTH.

6. OA?III AeI? AeAIIAI AeIAIAI?O

6.1. Aeaiee Aeiaiai? oeeaaeaii ia no?ie aiae <____> _________ 19___ ?. aei <____> __________
19___?.

6.2. Ii caeii/aiii aeuaaeacaiiai oa?iiio oiiae aeiaiai?o i?iaeiaaeothoue aeiyoe ii aiaeii-
oaiith aei anio ia?oie oiaa?o, yei aei oeueiai iiiaioo ciaoiaeyoueny ia eiineaiaoei? i ?ic?aooiie ca
yeeie ia caaa?oaii.

7. I?AAI AEANIINOI IA EIINEAIAOeIEII OIAA?E

7.1. Oiaa?e, ia?aaeaii EIINEAIAOI?O, o aeaniinoth EIINEAIAIOA aei iiiaioo ?o
ia?aaea/i IIEOIOeTH.

7.2. ?ecee aeiaaeeiai? caaeaaei oa aeiaaeeiaiai iioeiaeaeaiiy oiaa?o eaaeeoue ia
EIINEAIAOI?I c iiiaioo io?eiaiiy iei iaeia ia eiineaiaoeith.

8. OIIAE OeII IA EIINEAIAOeIEII OIAA?E

8.1. EIINEAIAOI? iao i?aai naiinoieii aecia/aoe oeiie ia oiaa?e, ia?aaeaii eiio ia
eiineaiaoeith, aeoiaey/e c ?eieiai? eiithieoo?e a iaaeao iiiiiaeueieo oa iaeneiaeueieo oeii,
aecia/aieo EIINEAIAIOII o Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o.

9. AEIAAI?IAeA EIINEAIAOI?A

Aeiaai?iaea EIINEAIAOI?O aeiea/oooueny a ?icii?i ___________________ aiae noie oaiae
c i?iaeaaeo oiaa?ia EIINEAIAIOA.

I?aai ia aeiaai?iaeo EIINEAIAOI? io?eioo c iiiaioo io?eiaiiy a?ioae aiae
IIEOIOess.

10. II?ssAeIE ?IC?AOOIEIA

EIINEAIAOI? io?eioo aeiaai?iaeo oeyoii oo?eiaiiy iaeaaeieo eiio noi ic eiooia,
io?eiaieo iiney i?iaeaaeo oiaa?o, iinoaaeaiiai ia eiineaiaoeith.

EIINEAIAOI? ciaiaycaiee ia?a?aooaaoe a?ioiai eiooe EIINEAIAIOO a oa?iii
_______________ iiney io?eiaiiy a?ioae aiae IIEOIOess.

11. CAIO EIINEAIAOI?A

EIINEAIAOI? ciaiaycaiee uiiiny/ii aei ____________ /enea iiaeaaaoe ienueiiai
EIINEAIAIOO caio i?i caeieniaii c eiai oiaa?ii oaiaee oa i?i caeieniaii aeo?aoe.

EIINEAIAIO ciaiaycaiee ?icaeyiooe caio a oa?iii _______ oa iiaeaoe EIINEAIAOI?O
nai? caia?a/aiiy.

O aeiaaeeo aiaenooiinoi caia?a/aiue c aieo EIINEAIAIOA i?ioyaii aeuaaeacaiiai oa?iiio
caio aaaaeaooueny i?eeiyoei.

12. AIAeOEIAeOAAIIss AEO?AO

EIINEAIAIO aiaeoeiaeiaoo EIINEAIAOI?O ianooiii aeo?aoe, iiaycaii c aeeiiaiiyi
nai?o ciaiaycaiue ca Aeaiei Aeiaiai?ii:_________________________________________________

Iioi aeo?aoe EIINEAIAOI?A aiaeoeiaeiaothoueny inoaiiii ic io?eiaii? aeiaai?iaee.
A onio aeiaaeeao aiaeoeiaeiaothoueny aeo?aoe EIINEAIAOI?A, caeieniaii iei c aiaeiia oa

caiaee EIINEAIAIOA, a oaeiae aeiiouaii iei aac aeie ia?oiai ca iaia?aaeaa/oaaieo ianoaaei.
Aiaeoeiaeoaaiiy aeo?ao caeienithooueny EIINEAIAIOII a no?ie iiney caeii/aiiy oa?iiio

iiaeaiiy caia?a/aiue ca caioii.

13. AIAeIIAIAeAEUeIINOUe NOI?II

Noi?iie ca Aeaiei Aeiaiai?ii ianooue ianooiio aiaeiiaiaeaeueiinoue:
EIINEAIAIO: ____________________________________________________________.
EIINEAIAOI?: ___________________________________________________________.

14. IIOI OIIAE

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

Eiia?oeieiee aeiaiai?

AeIAIAI?
aei?o/aiiy ia i?iaeaae i?iaeoeoei?

199___.?.

IIAI?AIEE: _______________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

AeIAI?EOAEUe: _________________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. AeIAI?EOAEUe aei?o/ao, a IIAI?AIEE aa?a ia naaa ciaiaycaiiy oeeanoe aiae iiaii
oa ca ?aooiie AeIAI?EOAEss aeiaiai? eoiiaei-i?iaeaaeo c o?aoueith iniaith, iaaeaei IIEOIAOeUe.
1.2. Aei?o/aiiy aaaaeaooueny aeeiiaiei iiney oeeaaeaiiy IIAI?AIEI oaiaee c IIEOIOeAI.
1.3. Eiie?aoii oiiae caeieniaiiy oaiaee, eieueeinoue i?iaeoeoei?, iiiiiaeueia oeiia i?iaeaaeo, a
oaeiae iioi aeaciaee AeIAI?EOAEss iaaiaeyoueny o Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o. Aeiaeaoie
? 1 o iaaiaeoiiith /anoeiith Aeaiiai Aeiaiai?o.
1.4. IIEOIAOeUe iiaeiai ciaoiaeeoeny ia ianooiiie oa?eoi?i? (aeiaiai?ia oa?eoi?iy): ____

2. IAIAssCEE IIAI?AIIAI

IIAI?AIEE ciaiaycaiee:

– aeeiiaoe aeaia eiio aei?o/aiiy o aiaeiiaiaeiinoi aei aeaciaie AeIAI?EOAEss, ia?aaeaa/aieo
Aeaiei Aeiaiai?ii oa Aeiaeaoeii aei iueiai, a oaeiae aeaieo eiio inoaiiii aeiaeaoeiai a ienueiiaie
oi?ii;

– a oa?iii ___________ iiaiaeiieyoe AeIAI?EOAETH i?i ia?aaia aeeiiaiiy aei?o/aiiy;
– a oa?iii __________ iiiainoeoe AeIAI?EOAEss i?i oeeaaeaiiy aeiaiai?o oa ia?aaeaoe

eiio i?eii?iee iiaeienaiiai c IIEOIOeAI aeiaiai?o;
– ia?aaeaoe AeIAI?EOAETH ana, ui io?eiaia o cayceo c aeeiiaiiyi aei?o/aiiy a oa?iii

– o aeiaaeeo iaiiaeeeainoi aeeiiaoe aei?o/aiiy ca Aeaiei Aeiaiai?ii IIAI?AIEE ciaiay-
caiee a oa?iii _______________ iiaiaeiieoe i?i oea AeIAI?EOAETH aeey i?eeiyooy inoaiiii
?ioaiiy a oa?iii ___________ i?i ciiio aai i?eieiaiiy aeiaiai?o.

3. IAIAssCEE AeIAI?EOAEss
AeIAI?EOAEUe ciaiaycaiee:

– a oa?iii ________ iiney iiaeienaiiy Aeaiiai Aeiaiai?o caaacia/eoe IIAI?AIIAI aniia
iaiaoiaeieie iaoa?iaeaie, na?oeoieaoaie ia i?iaeoeoeith oa iioeie aeieoiaioaie, iaiaoiaeieie
aeey aeeiiaiiy aei?o/aiiy, a oiio /enei aa?aioiyie iayaiinoi oiaa?o;

– a oa?iii _________ iiney iiaeienaiiy Aeaiiai Aeiaiai?o aeaeaoe IIAI?AIIIO aeiai?aiinoue
ia i?aai caeieniaiiy oaiaee c IIEOIOeAI ic cacia/aiiyi ianyao iiaii?aaeaiue;

– a oa?iii __________ i?eeiyoe aiae IIAI?AIIAI caio i?i aeeiiaiiy aei?o/aiiy, iaaeaii
iei aeieoiaioe, a oaeiae i ana io?eiaia ca aeaiei Aeiaiai?ii;

– aeieaoeoe IIAI?AIIIO aeiaai?iaeo, a oaeiae aiaeoeiaeoaaoe eiai aeo?aoe c aeeiiaiiy
aei?o/aiiy.
4. IA?AAeI?O*AIIss

4.1. IIAI?AIEE ciaiaycaiee aeeiiaoe aeaia eiio aei?o/aiiy iniaenoi.
4.2. Ia?aaei?o/aiiy iiaea iaoe iinoea ca Aeaiei Aeiaiai?ii eeoa ca ienueiiaith caiaeith
AeIAI?EOAEss c iaiayceiaei cacia/aiiyi onio iaiaoiaeieo aiaeiiinoae i?i canooiieea.

4.3. I?e ia?aaei?o/aiii IIAI?AIEE aiaeiiaiaeao eeoa ca aeai? canooiath/i? iniae, a ia ca
oniio ia?aaiai?ia i aeeiiaiiy aei?o/aiiy.

5. I?AAA IIAI?AIIAI

IIAI?AIEE iao i?aai aiaenooieoe aiae aeaciaie AeIAI?EOAEss eeoa c ienueiiaiai aeicaieo
inoaiiueiai.

Aac oeueiai IIAI?AIEE iao i?aai aiaenooieoe aiae aeaciaie AeIAI?EOAEss, yeui ca ianoaaei
ni?aae oea iaiaoiaeii a iioa?anao AeIAI?EOAEss i IIAI?AIEE ia iia iiia?aaeiuei caieoaoe
AeIAI?EOAEss aai a oa?iii ___________ ia io?eiaa aiaeiiaiaei ia naie caieo.

Eiia?oeieiee aeiaiai?

6. AEIAAI?IAeA IIAI?AIIAI

Ca aeeiiaiiy aei?o/aiiy IIAI?AIEE io?eioo aiae AeIAI?EOAEss aeiaai?iaeo a ?icii?i
__________ aiae noie oeeaaeaii? c IIEOIOeAI oaiaee.

O aeiaaeeo /anoeiaiai aeeiiaiiy aei?o/aiiy aeiaai?iaea aeiea/oooueny i?iii?oeieii aeei-
iaiiio.

I?aai ia aeiaai?iaeo IIAI?AIEE io?eioo iiney oeeaaeaiiy oaiaee c IIEOIOeAI.
(Iiaeeeaee aa?iaio, eiee i?aai ia aeiaai?iaeo o IIAI?AIIAI aeieeao iiney io?eiaiiy
AeIAI?EOAEAI iieoiii? oeiie aiae IIEOIOess. Aiaeiiaiaeii aoaea ae?iooaaoeny ieoaiiy i i?i
ii?yaeie ?ic?aooieia c IIAI?AIEI ca i.C Aeiaiai?o).

7. II?ssAeIE ?IC?AOOIEIA

AeIAI?EOAEUe ieaoiaeiei aei?o/aiiyi ia?a?aoiaoo IIAI?AIIIO iaeaaeio aeiaai?iaeo
a oa?iii _____________ iiney aeieeiaiiy o inoaiiueiai i?aaa ia aeiaai?iaeo.

8. CAIO IIAI?AIIAI

8.1. IIAI?AIEE a oa?iii ____________ iiney aeeiiaiiy aei?o/aiiy ciaiaycaiee iiaeaoe
AeIAI?EOAETH ienueiiaee caio c aeiaeaoeii iiaeoaa?aeaeoaaeueieo aeieoiaioia ye oiiainiaiai, oae
i iioiai oa?aeoa?o.

Iiaeaiiy caioo ia caeaaeeoue aiae aeiiae AeIAI?EOAEss oa iaaeaiiy eiio iioi?iaoei? i?i oiae
aeeiiaiiy aei?o/aiiy oa i?i eiai aeeiiaiiy.

8.2. AeIAI?EOAEUe ciaiaycaiee iaaaeii i?eeiyoe caio IIAI?AIIAI oa caoaa?aeeoe
eiai a oa?iii _____. Ca iayaiinoi caia?a/aiue ca caioii AeIAI?EOAEUe iiaeiai iiaiaeiieoe
i?i ieo IIAI?AIIAI. A i?ioeaiiio ?aci caio aaaaeaooueny caoaa?aeaeaiei ii caeii/aiii aeua-
aeacaiiai oa?iiio.

8.3. O aeiaaeeo iaaeeiiaiiy aei?o/aiiy IIAI?AIEE iiaeao AeIAI?EOAETH caio a oa?iii
__________ iiney i?eieiaiiy aei? Aeaiiai Aeiaiai?o.

9. AIAeOEIAeOAAIIss AEO?AO IIAI?AIIAI

9.1. Aeeiiaiiy aei?o/aiiy IIAI?AIEI caeienithooueny ca ?aooiie AeIAI?EOAEss iacaeaaeii
aiae oniioo aei? IIAI?AIIAI oa aiae ?icii?o aeeiiaiiai aei?o/aiiy.

9.2. Aiaeoeiaeoaaiiy aeo?ao caeienithooueny AeIAI?EOAEAI a oa?iii ___________ iiney
caoaa?aeaeaiiy caioo IIAI?AIIAI a aacaioiaeiaiio ii?yaeeo ieaoiaeiei aei?o/aiiyi.
9.3. Iiaeeyaathoue aiaeoeiaeoaaiith ianooiii aeo?aoe IIAI?AIIAI: ____________________

Iioi aeo?aoe IIAI?AIIAI aiaeoeiaeiaothoueny iei ic aeiaai?iaee aai caeieniththoueny ca
eiai ?aooiie.

9.4. A onio aeiaaeeao aiaeoeiaeiaothoueny aeo?aoe IIAI?AIIAI, caeieniaii iei c aiaeiia oa
caiaee AeIAI?EOAEss, a oaeiae aeiiouaii aac aeie ia?oiai ca iaia?aaeaa/oaaieo ianoaaei.

10. OA?III AEEIIAIIss AeI?O*AIIss

IIAI?AIEE ciaiaycaiee aeeiiaoe aei?o/aiiy AeIAI?EOAEss a oa?iii _______________
c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o.
Oa?iii aeeiiaiiy aei?o/aiiy o oa?iiiii aei? Aeaiiai Aeiaiai?o.

11. AIAeIIAIAeAEUeIINOUe NOI?II
Noi?iie ca Aeaiei Aeiaiai?ii ianooue ianooiio aiaeiiaiaeaeueiinoue:
IIAI?AIEE: ___________________________________________________________________

AeIAI?EOAEUe:

12. IIOI OIIAE

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

Eiia?oeieiee aeiaiai?

AeIAIAI?
ia iaaeaiiy a?iea?nueeeo iineoa

199___?.

EEIoIO: __

a iniai _________
ui aeio ia iiaenoaai
c iaeiiai aieo, i

A?IEA?: __
a iniai _________

(iaeiaioaaiiy iiaei?eoinoaa, oi iaaeao a?iea?nueei iineoae)

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. EEIoIO aei?o/ao, a A?IEA? ciaiaycoooueny:

a) caeienithaaoe oaiaee aiae iiaii oa ca ?aooiie EEIoIOA (ia iiaenoaai aeiaiai?o aei?o/aiiy
oa ?aciai? aeiai?aiinoi);

a) caeienithaaoe oaiaee aeey EEIoIOA aiae iiaii A?IEA?A (ia iiaenoaai aeiaiai?o eiiini?);
a) iaaeaaaoe EEIoIOO iioi?iaoeieii iineoae, iiaycaii c ?aaeicaoeioth oa i?eaeaaiiyi oiaa?o.

2. II?ssAeIE AEEIIAIIss AeI?O*AIIss

2.1. A?IEA? aa?aiooo, ui aii aieiaeio i?aaii caeieniaiiy oaiae, yei o i?aaeiaoii Aeaiiai
Aeiaiai?o.

2.2. A?IEA? aeeiioo aei?o/aiiy EEIoIOA, ea?oth/enue /eiiei caeiiiaeaanoaii.
A?IEA? ciaiaycaiee iioi?ioaaoe EEIoIOA i?i aeiiae, ui noaaeyoueny aei ai?aeiaeo
oiaa?ia.

2.3. A?IEA? aeeiioo aei?o/aiiy EEIoIOA c ianooiieo oeiia oaiae:
2.3.1. Oaiaea c ?aaeueiei oiaa?ii. O oeueiio aeiaaeeo A?IEA? aai EEIoIO aenooiathoue a
yeinoi i?iaeaaoey aai iieoioey oiaa?o, ui iinoa/aooueny o iaaiee oa?iii c iiiaioo ?aono?aoei?
oaiaee ia ai?aei.

2.3.2. Oaiaea c oiiaith. O oeueiio aeiaaeeo EEIoIO aeao aei?o/aiiy i?iaeaoe ?aaeueiee oiaa?
ca oiiae iaeii/anii? eoiiaei aeey EEIoIOA iioiai ?aaeueiiai oiaa?o.
I?e io?eiaiii oaeiai aei?o/aiiy A?IEA? iao i?aai aiaeiiaeoeny aiae eiai aeeiiaiiy,
sseui A?IEA? i?iaeanoue oiaa?, aea ia aeeiiao aei?o/aiiy a /anoeii eoiiaei iioiai oiaa?o,
aii iicaaaeyooueny i?aaa ia aeiaai?iaeo ca oaiaeith c oiiaith.
2.3.3. Oaiaea c oeiiieie iaia?aie.

2.3.4. Ic aeacaieo o ioieoao 2.3.1, 2.3.2 oeiia oaiae EEIoIO iiaea aeaaaoe A?IEA?O
ianooiii aeaee aei?o/aiue:
I. Eoieoe oiaa? ca iioi/iith ai?aeiaith oeiiith aeiy.

2. I?iaeaoe oiaa? ca iioi/iith ai?aeiaith oeiiith aeiy.

3. Eoieoe oiaa? ca oeiiith ia aeua caaeaii?.

4. I?iaeaoe oiaa? ca oeiiith ia ieae/a caaeaii?.

5. Eoieoe oiaa? a iiiaio, eiee oeiIa ia iueiai aeinyaia iaaiiai (ii?iaiaiai) cia/aiiy.

6. I?iaeaoe oiaa? a iiiaio, eiee oeiia ia iueiai aeinyaia iaaiiai (ii?iaiaiai) cia/aiiy.
2.4. E?ii oiai, A?IEA? iaaeao EEIoIOO ianooiii iineoae:
a) iioi?ioo i?i iioi/io ai?aeiao oeiio ia eiie?aoiee oiaa?;
a) iioi?ioo i?i iayaiinoue eiie?aoiiai oiaa?o ia ai?aei.
2.5. Noi?iiaie i?eeiaooueny ianooiiee ii?yaeie aeeiiaiiy aei?o/aiue c i?iaeaaeo ?aaeueiiai
oiaa?o a iayaiinoi:

2.5.1. EEIoIO iai?aaeyo A?IEA?O aeiaiai? aei?o/aiiy aai aeiaiai? eiiini?, iiaeienaii c
eiai aieo, iaaeao aa?aioith aeeiiaiiy ciaiaycaiiy, aeiai?aiinoue ia i?aai caeieniaiiy oaiaee,
iaiaoiaeio i?e caeieniaiii oaiaee aiae iiaii EEIoIOA.

EEIoIO ciaiaycaiee ca naie ?aooiie niaeoaaoe, caia?ei?oaaoe oiaa? o aiaeiiaiaeiinoi aei
aeiia noaiaea?oia, oaoii/ieo oiia, a oaeiae aei aeiia, ui i?aaeyaeythoueny aei ai?aeiaeo oiaa?ia,
aiaeaaioaaeeoe oiaa? ca aae?anith ai?aei. C oeueiai iiiaioo EEIoIO ao?a/ao i?aai ?icii?yaeaeaoeny

Eiia?oeieiee aeiaiai?

oiaa?ii aei io?eiaiiy caioo A?IEA?A i?i caeieniaiiy oaiaee aai iiaiaeiieaiiy i?i ciyooy
oiaa?o c oi?aia.

2.5.2. A?IEA?, io?eiaaoe i?iiiceoeith, ciaiaycaiee iaaaeii ii/aoe ?iaioo c aeeiiaiiy
aei?o/aiiy EEIoIOA ia ai?aei.

2.5.3. Aeeiiaaoe aei?o/aiiy, A?IEA? ciaiaycaiee o _______aeaiiee oa?iii iiaeaoe caio
(Aeiaeaoie ? 1) c aeieoiaioaie, io?eiaieie aiae eiio?aaaioa ca caeieniaiith oaiaeith, a?aoiaoth/e
ioi?ieaiee i?eii?iee oeeaaeaiiai c eiio?aaaioii aeiaiai?o.

2.5.4. Io?eiaaoe caio A?IEA?A, EEIoIO iiaeiai o aeaiiee oa?iii iieaoeoe A?IEA?O
aeiaai?iaeo ca aeeiiaia aei?o/aiiy, aa?oinoue ?aono?aoei? oaiaee ia ai?aei, a oaeiae aeeiiaoe iioi
nai? ciaiaycaiiy, ui aeoieathoue ic oeeaaeaii? oaiaee.

Oa?iii aiaeaaioaaeaiiy oiaa?o aecia/aooueny o aeiaiai?ao aei?o/aiiy, eiiini? aai iinoaaee.
2.5.5. sseui EEIoIO iao caia?a/aiiy ca caioii, aii ciaiaycaiee o ________oeaiiee oa?iii
c iiiaioo io?eiaiiy caioo iiaiaeiieoe i?i ieo A?IEA?O. A i?ioeaiiio ?aci caio aaaaeaooueny
i?eeiyoei EEIoIOII.

2.5.6. sseui oiaa? o aiaeiiaiaeiinoi aei i?aaee ai?aeiai? oi?aiaei ciyoee c oi?aia, A?IEA?
ciaiaycaiee iiaiaeiieoe i?i oea EEIoIOA a _________iaiiee oa?iii ca oi?iith, aeacaiith a
Aeiaeaoeo ? 2. EEIoIO ciaiaycaiee o _______oeaiiee oa?iii c iiiaioo io?eiaiiy iiaiaeiieaiiy
A?IEA?A cieceoe oeiio aai aiaeeeeeaoe i?iiiceoeith.

O aeiaaeeo aiaeeeeeaiiy i?iiiceoei? EEIoIO o aeaiiee oa?iii c iiiaioo io?eiaiiy
iiaiaeiieaiiy iiea/oo A?IEA?O caciaii aeo?aoe c aeeiiaiiy aei?o/aiiy o ?icii?i __________
____________________________________________ e?a.

2.5.7. EEIoIO iiaea o aeiaiai?i aei?o/aiiy aai eiiini? iaaeaoe A?IEA?O i?aai /anoeiai?
?aaeicaoei? oiaa?o, cacia/aiiai a aeiaiai?i.

2.6. I?e aeeiiaiii aei?o/aiue c eoiiaei ca oaiaeaie c ?aaeueiei oiaa?ii i?eeiaooueny
ianooiiee ii?yaeie:

2.6.1. EEIoIO iai?aaeyo A?IEA?O iiaeienaiee aeiaiai? aei?o/aiiy aai aeiaiai? eiiini?, a
oaeiae iaaeao aa?aioith naio? nieaoini?iiiaeiinoi, aeiai?aiinoue ia i?aai caeieniaiiy oaiaee,
iaiaoiaeio i?e caeieniaiii oaiaee aiae iiaii EEIoIOA.

2.6.2. A?IEA?, io?eiaaoe aei?o/aiiy, ciaiaycaiee iaaaeii ii/aoe ?iaioo c eiai
aeeiiaiiy.

2.6.3. Aeeiiaaoe aei?o/aiiy, A?IEA? ciaiaycaiee o____________aeaiiee oa?iii iiaeaoe
caio (Aeiaeaoie ? 1) c aeieoiaioaie, io?eiaieie aiae eiio?aaaioa ca caeieniaiith oaiaeith,
a?aoiaoth/e ioi?ieaiee i?eii?iee oeeaaeaiiai c eiio?aaaioii aeiaiai?o.

2.6.4. Io?eiaaoe caio A?IEA?A, EEIoIO iiaeiai o ___________oeaiiee oa?iii iieaoeoe
A?IEA?O aeiaai?iaeo ca aeeiiaiiy aei?o/aiiy, aa?oinoue ?aono?aoei? oaiaee ia ai?aei, a oaeiae
aeeiiaoe iioi nai? ciaiaycaiiy, ui aeoieathoue ic oeeaaeaii? oaiaee.

2.6.5. sseui EEIoIO iao caia?a/aiiy ca caioii, aii ciaiaycaiee o ________oeaiiee
oa?iii c iiiaioo io?eiaiiy caioo iiaiaeiieoe i?i ieo A?IEA?O. A i?ioeaiiio ?aci caio
aaaaeaooueny i?eeiyoei EEIoIOII.

2.6.6. sseui ii caeii/aiii oa?iiio aei? aeiaiai?o aei?o/aiiy aai eiiini? A?IEA? ia aeeiiao
aei?o/aiiy c iacaeaaeieo aiae iueiai i?e/ei, aii iiaiaeiieyo i?i oea EEIoIOO, yeee o _________
aeaiiee oa?iii c iiiaioo io?eiaiiy iiaiaeiieaiiy ciaiaycaiee iieaoeoe A?IEA?O caciaii
aeo?aoe c aeeiiaiiy aei?o/aiiy a ?icii?i __________________________________________ e?a.

2.7. EEIoIO iiaea a aeiaiai?i aei?o/aiiy aai eiiini? a yeinoi aeiaeaoeiai? oiiae iaaeaoe
A?IEA?O i?aai i?iaeaaeo aai eoiiaei oiaa?o a iaioie eieueeinoi, aiiae cacia/aii a aeiaiai?i, a
oaeiae i?aai ciaiooaaoe oeiio i?iiiceoei? aac ocaiaeaeaiiy c EEIoIOII.

2.8. Aeae aei?o/aiiy (ioieo 2.3.4 aeiaiai?o) iiaea aooe iia?aoeaii ciiiaiee EEIoIOII
oaeaoiiia?aiith, yea iiaeeyaao iaiayceiaie ?aono?aoei? eiaeiith noi?iiith.

2.9. Oiiae Aeaiiai Aeiaiai?o ia iiaeeyaathoue ?icaieioaiith.

3. AA?AIOI?

3.1. sseui EEIoIO aeao aei?o/aiiy i?i eoiiaeth oiaa?o, aii ciaiaycaiee iaaeaoe aa?aioith
iieaoe, yea iiaea aooe aeaia o oi?ii:

3.1.1. Iaaeaiiy aaieianueei? aa?aioi? ia iieaoo oiaa?o (i?eaiiae).

3.1.2. O aeaeyaei aeiaiaeee i?i iayaiinoue eiooia ia ?ic?aooieiaiio ?aooieo EEIoIOA,
caai?aio aaieii ia aeaoo, ui ia?aaeoo aeaoi aei?o/aiiy.

3.2. sseui EEIoIO aenooiao a yeinoi i?iaeaaoey oiaa?o, aii ciaiaycaiee iaaeaoe canaiae/aio
neeaaenueeo ?icieneo aai o?ainii?oiee aeieoiaio, ui iiaeoaa?aeaeoo aiaeaaioaaeaiiy oiaa?o ca
aae?anith ai?aei.

Eiia?oeieiee aeiaiai?

3.3. Iaonoieea ca i?ino?i/aiiy iinoaaee aai iaaeiiinoaaeo oiaa?o noyaoooueny ie?ii
caeoeia.

?icii? iaonoieee cacia/aooueny a aeiaiai?i aei?o/aiiy aai eiiini? a ioieoi i ia
iiaea aooe iaioei aiae _____________ aiaenioeia aa?oinoi oiaa?o.

3.4. Iayaiinoue oa aeaee aa?aioie iiaeiii aooe aiaeia?aaeaii o aeiaiai?i aei?o/aiiy aai eiiini?.
I?e aiaenooiinoi aa?aioie A?IEA? iao i?aai aiaeiiaeoeny aiae aeeiiaiiy aei?o/aiiy,
ienueiiai iiaiaeiieaoe i?i oea EEIoIOA a __________ aeaiiee oa?iii.

4. OIIAE ?IC?AOOIEIA

4.1. Noia aeiaai?iaee A?IEA?A aecia/aooueny o aiaenioeao aiae noie oaiaee.
4.2. Ca aeeiiaiiy aei?o/aiiy ca oaiaeith c ?aaeueiei oiaa?ii EEIoIO iiea/oo iineoae
A?IEA?A o caeaaeiinoi aiae aeaeo aei?o/aiiy o ianooiieo ?icii?ao (cacia/eoe eioa?aie):
ca aei?o/aiiyi 1 _____________________________________________________________,
ca aei?o/aiiyi 2 ________________________________________________________________,
ca aei?o/aiiyi 3 _____________________________________________________________,
ca aei?o/aiiyi 4 ________________________________________________________________,
ca aei?o/aiiyi 5 ________________________________________________________________,
ca aei?o/aiiyi 6 __________________:___________________________________________ .
4.3. Ca aeeiiaiiy aei?o/aiiy ca oaiaeith c oiiaith aeiaai?iaea ia/enethooueny ie?aii ca
oaiaeith i?iaeaaeo oa oaiaeith eoiiaei ca noaaeaie, cacia/aieie a i.4.2. E?ii oiai, EEIoIO
aeiaeaoeiai iiea/oo A?IEA?O _____________ aiaenioeia aiae caaaeueii? noie aeaio oaiae.
4.4. Ca iaaeaiiy iioi?iaoeieieo iineoa EEIoIO iiea/oo A?IEA?O aeiaai?iaeo a ?icii?i

___________________________________________________________________________________e?a.
(noia eioa?aie)

4.5. sseui A?IEA? eoiea oiaa? ca oeiiith ieae/a, a i?iaeaa oiaa? ca oeiiith, aeua ia?aaeaa/aii?
a aei?o/aiii EEIoIOA, inoaiiie, e?ii aeiaai?iaee, ia/eneaii? o aiaeiiaiaeiinoi aei i.4.2, niea/oo
A?IEA?O ___________ aiaenioeia aiae ?icieoei iiae i?ecia/aiith EEIoIOII oeiiith i oioth aieueo
aeaiaeiith oeiiith, ca yeith A?IEA? caeieniea oaiaeo.

4.6. Caaaeueia noia aeiaai?iaee, iaeaaeia A?IEA?O ca aeeiiaia aei?o/aiiy, caieueooooueny
ia noio iiaeaoeo ia aeiaaaeaio aa?oinoue, yea cacia/aooueny ie?aiei ?yaeeii.

4.7. Aianie ca ?aono?aoeith oaiaee aecia/aooueny ai?aeath ia iiaenoaai aeith/eo i?aaee oi?aiaei
ia ai?aei, i?i ui ienueiiai iiaiaeiieyooueny EEIoIOO A?IEA?II.

I?e iieaoi aianeo noia ieaoaaeo caieueooooueny ia noio iiaeaoeo ia aeiaaaeaio aa?oinoue,
yea a ?ic?aooieiaeo aeieoiaioao cacia/aooueny ie?aiei ?yaeeii.

4.8. ?icii?e oa ?ic?aooiie noie, ui iiaeeyaao iieaoi EEIoIOII ia ei?enoue A?IEA?A
oa ai?aei, cacia/athoueny o caioi A?IEA?A.

4.9. Iieaoa iineoa A?IEA?A oa ai?aei caeienithooueny ieaoiaeiei aei?o/aiiyi ia ?aooiie
A?IEA?A.

5. II?ssAeIE CAeIENIAIIss CAssCEO IIAE NOI?IIAIE

5.1. Caycie iiae noi?iiaie caeienithooueny /a?ac aiaeiiaiaeaeueieo inia. EEIoIO aeaeieyo aeey
cayceo c A?IEA?II aeaio aiaeiiaiaeaeueieo inia, yei ianooue iiaio aiaeiiaiaeaeueiinoue ca caeieniaii
ieie aei?. A?IEA? caycoooueny c EEIoIOII aaciina?aaeiuei aai /a?ac i?aaenoaaieea, ui iao
aeiai?aiinoue aiae A?IEA?A.

5.2. Oaoii/ii oa iioi oiiae cayceo iaoiiaeththoueny a I?ioieiei ocaiaeaeaiiy oiia cayceo,
ui o /anoeiith Aeaiiai Aeiaiai?o (Aeiaeaoie ? 3).

5.3. Iaiayceiaei ?aeaiceoii i?e aoaeue-yeiio caa?iaiii EEIoIOA aei A?IEA?A o EIAe,
yeee i?eaeanithooueny A?IEA?II. EEIoIO ia iao i?aaa iiaiaeiieyoe Eiae o?aoii iniaai.

6. AIAeIIAIAeAEUeIINOUe NOI?II,
II?ssAeIE ?ICAssCAIIss NII?IA,
CAEETH*II IIEIAEAIIss

6.1. Noi?iie ciaiaycaii aeio?eioaaoenue aeith/eo i?aaee oi?aiaei ia ai?aei oa iioeo i?aaee,
ui ?aaeaiaioothoue aeiyeueiinoue ai?aei.

6.2. A?IEA? ia aiaeiiaiaeao ia?aae EEIoIOII ca aeeiiaiiy o?aoueith iniaith oaiaee,
oeeaaeaii? iei aeey EEIoIOA aai aiae iiaii EEIoIOA.

6.3. O aeiaaeeo iaaeeiiaiiy EEIoIOII nai?o ciaiaycaiue ca oeeaaeaiith oaiaeith A?IEA?
iao i?aai i?eethaeii iiaiaeiieoe i?i oea o/anieeia ai?aeiai? oi?aiaei.

6.4. O aeiaaeeo ooeeaiiy aiae iieaoe aai i?ino?i/aiiy iieaoe a?iea?nueei? aeiaai?iaee oa
iineoa ai?aei EEIoIO niea/oo oo?ao a ?icii?i ___________ aiaenioeia iaeaaeii? noie ca eiaeai
aeaiue i?ino?i/aiiy, aea ia aieueoa __________ aiaenioeia,

Eiia?oeieiee aeiaiai?

6.5. Noia?a/ee, ui aeieeathoue o cayceo ic aeeiiaiiyi Aeaiiai Aeiaiai?o, ?icaycothoueny
AI?AEIAEI A?AIO?AAEAI. ?ioaiiy AI?AEIAIAI A?AIO?AAEO aeeiiothoueny aeia?iaieueii.
Ca iacaiaee c ?ioaiiyi AI?AEIAIAI A?AIO?AAEO caoeieaaeaia noi?iia iao i?aai caa?iooeny
aei A?aio?aaeiiai noaeo.

6.6. Ca iaaeeiiaiiy aei?o/aiiy c aeie A?IEA?A inoaiiie niea/oo EEIoIOO oo?ao a
?icii?i aiaenioeia aiae noie, cacia/aii? o aeiaiai?i aei?o/aiiy aai eiiini?.
6.7. Ca ?icaieioaiiy oiia Aeaiiai Aeiaiai?o aeiia noi?iia niea/oo ae?oaie noi?iii oo?ao

a ?icii?i _______________________________________________________________________ e?a.
(noia eioa?aie)

6.8. O aeiaaeeo neanoaaiiy aei?o/aiiy aei i?iaaaeaiiy oi?aia EEIoIO ciaiaycaiee
aiaeoeiaeoaaoe A?IEA?O caciaii aeo?aoe o oieniaaiie noii, ui neeaaeao __________________

_________________________ e?a.
(noia eioa?aie)

6.9. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo eiai iiaeienaiiy oa aeio aei __________ .
6.10. Ciiia oiia aai i?eieiaiiy aeiaiai?o caeienithooueny ca caiaeith noi?ii.
6.11. Aoaeue-yea ic noi?ii iao i?aai ?ici?aaoe aeiaiai?, ienueiiai iiia?aaeeaoe ae?oao noi?iio
ia iaio iiae ca ______________________ oa?iii.
6.12. Aeiaeaoee aei aeiaiai?o.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia iaaeaiiy iina?aaeieoeueeeo iineoa

i. ____________ <____> ___________ 199 ___ ?.

CAIIAIEE: _

a iniai ___________
ui aeio ia iiaenoaai __
c iaeiiai aieo, i

IINA?AAeIEE:
a iniai ____________

(iaeiaioaaiiy iiaei?eoinoaa, o.i iaaeao iina?aaeieoeueei iineoae)

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I. CAIIAIEE aei?o/ao, a IINA?AAeIEE ciaiaycoooueny:

– aeeiiaoe ?yae iaaieo oaeoe/ieo aeie c iaoith ciaoiaeaeaiiy iioeiaeueiiai eiio?aaaioa
(aeaei ca oaenoii Aeaiiai Aeiaiai?o – IIEOIOess), aioiaiai i?eaeaaoe i?iaeoeoeith CAIIAIEEA
o aiaeiiaiaeiinoi aei oiia inoaiiueiai. (I?iaeoeoeiy oa oiiae i?iaeaaeo aecia/aii CAIIAIEEII
o Aeiaeaoeo ? 1 aei Aeaiiai Aeiaiai?o. Aeiaeaoie ? 1 o iaaiaeoiiith /anoeiith Aeaiiai Aeiaiai?o);

– iini?eyoe CAIIAIEEO a oeeaaeaiii aeiaiai?o eoiiaei-i?iaeaaeo iiae iei oa IIEOIOeAI.

2. IAIAssCEE IINA?AAeIEEA OA II?ssAeIE ?O AEEIIAIIss
IINA?AAeIEE aeeiioo acyoi ia naaa ciaiaycaiiy a aeaa aoaie:
I aoai: iiooe oa ciaoiaeaeaiiy IIEOIOess.

II AOAI: ni?eyiiy a oeeaaeaiii aeiaiai?o iiae CAIIAIEEII i IIEOIOeAI.
2.1. Ii?yaeie aeeiiaiiy IINA?AAeIEEII 1 aoaio:
2.1.1. IINA?AAeIEE, aeeiioth/e ooieoei? c iiooeo IIEOIOess, ciaiaycoooueny:

– i?iaanoe aiaeiiaiaeii ia?eaoeiaiai aeineiaeaeaiiy eiithieoo?e ?eieo;

– aeei?enoiaoaaoe aeanio oa cae?aoe iioo eiia?oeieio iioi?iaoeith i?i niiaeeaa/ia

i?iaeoeoei? CAIIAIEEA;

– i?iaanoe iaiaoiaeio ?aeeaiio ?iaioo;

– caeienithaaoe ia?aaiai?e oa eenooaaiiy c iioaioeieieie IIEOIOessIE i?iaeoeoei? CAIIA-
IEEA.

Eiia?oeieiee eiaiai?

2.1.2. IINA?AAeIEE iiney ciaoiaeaeaiiy IIEOIOess, aioiaiai i?eaeaaoe i?iaeoeoeith
CAIIAIEEA, ciaiaycaiee i?ioyaii _________ aeiia iaaeaoe inoaiiueiio ianooiio iioi?iaoeith:

a) iaeiaioaaiiy iniae, aioiai? a iniiaiiio i?eaeaaoe i?iaeoeoeith CAIIAIEEA (iaaeaei
ca oaenoii Aeaiiai Aeiaiai?o IIEOIAOeUe) ia oiiaao, cacia/aieo o Aeiaeaoeo ? 1 aei Aeaiiai
Aeiaiai?o;

a) iinoeaciaoiaeaeaiiy IIEOIOess;

a) cono?i/ii aeiiae IIEOIOess ca oaiaeith, ui ia?aaeaa/aooueny iiae iei oa CAIIAIEEII,
yei ia caiaathoueny c oiiaaie inoaiiueiai ca Aeiaeaoeii ? 1 aei Aeaiiai Aeiaiai?o;

a) i?iiiceoei? IIEOIOess c ii?yaeeo oeeaaeaiiy eiio?aeoo iiae iei oa CAIIAIEEII
(oa?iii, iinoea cono?i/i, ii?yaeie ocaiaeaeaiiy oiia oa ii.).

2.1.3. IINA?AAeIEE ciaiaycaiee iaaeaoe CAIIAIEEO aa?aioieiiai eenoa IIEOIOess
i?i eiai aioiaiinoue oeeanoe eiio?aeo c i?eaeaaiiy i?iaeoeoei? CAIIAIEEA aai iioee aiaeiiaiaeiee
aeieoiaio.

2.1.4. I?e ia?aaea/i iioi?iaoei? CAIIAIEE i IINA?AAeIEE neeaaeathoue oa iiaeienothoue
aeo caea/i-i?eeiaiiy iioi?iaoei?, yeee naiae/eoue i?i aeeiiaiiy ciaiaycaiue IINA?AAeIEEA
ia?aae CAIIAIEEII c 1 aoaio.
2.2. Ii?yaeie aeeiiaiiy IINA?AAeIEEII II aoaio:

2.2.1. Iiney iaaeaiiy CAIIAIEEO iioi?iaoei? oa iiaeienaiiy aeoo caea/i-i?eeiaiiy
iioi?iaoei? IINA?AAeIEE ciaiaycaiee i?ioyaii ________ i?aaiicoaaoe CAIIAIEEO i
IIEOIOeTH cono?i/ aeey ia?aaiai?ia oa iaaiai?aiiy oiia iaeaooiueiai eiio?aeoo, a oaeiae
caaacia/eoe ?? i?iaaaeaiiy a /anoeii ia?aeeaaea/ia, th?eaee/ieo eiinoeueoaoeie oa ii.

2.2.2. IINA?AAeIEE o i?enooiii ia cono?i/i CAIIAIEEA i IIEOIOess oa aaaea i?ioieie
aaniaee, i?eii?iee yeiai caeeoaooueny o IINA?AAeIEEA.

2.2.3. O aeiaaeeo oeeaaeaiiy iiae CAIIAIEEII i IIEOIOeAI i?ioieieo i?i iaii?e
CAIIAIEE iiaeiai caaacia/eoe aeeth/aiiy aei iueiai aiaeiiinoae i?i oa, ui aeaiee i?ioieie
iiaeienaiee ca o/anoi oa ni?eyiiy IINA?AAeIEEA.

2.2.4. Iiney ocaiaeaeaiiy anio iniiaieo oiia iaeaooiueiai aeiaiai?o iiae IIEOIOeAI i
CAIIAIEEII IINA?AAeIEE ciaiaycoooueny:

– i?ioyaii _______ iiaeaiooaaoe i?iaeo eiio?aeoo iiae CAIIAIEEII i IIEOIOeAI;

– caeienithaaoe eiinoeueooaaiiy CAIIAIEEA c onio iniiaieo i?aaiaeo, aeiiiii/ieo oa
i?aaiicaoeieieo ieoaiue eiio?aeoo, ui ia?aaeaa/aooueny;

– i?aaiicoaaoe cono?i/ CAIIAIEEA i IIEOIOess aeey iiaeienaiiy iiae ieie eiio?aeoo.
2.2.5. Iiney iiaeienaiiy eiio?aeoo iiae CAIIAIEEII i IIEOIOeAI CAIIAIEE i
IINA?AAeIEE neeaaeathoue aeo aeeiiaiiy inoaiiii nai?o ciaiaycaiue c II aoaio,

(Aeaiei Aeiaiai?ii iiaea ia?aaeaa/aoeny i III aoai, o aiaeiiaiaeiinoi aei yeiai IINA?AAeIEE
aoaea caeienithaaoe ianeoaiaoaaiiy CAIIAIEEA ca aeiaiai?ii, oeeaaeaiei ca eiai o/anoi.
Cie?aia, IINA?AAeIEE iiaea caeienithaaoe no?aooaaiiy oaiaee, i?aiaeoaaoe neeaaee, i?aaiiciao-
aaoe ia?aaacaiiy, iaaeaaaoe CAIIAIEEO aiaeaaioaaeoaaeueii iino?oeoei? IIEOIOess, iaaeaaaoe
iioi?iaoeith i?i ?oo oiaa?o aai eiai io?eiaiiy IIEOIOeAI oa ii.).

3. IAIAssCEE CAIIAIEEA

CAIIAIEE o aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o ciaiaycaiee:

3.1. Caaacia/eoe IINA?AAeIEEA anioth iioi?iaoeioth oa aeieoiaioaoeioth, iaiaoiaeiith aeey
aeeiiaiiy iei nai?o ciaiaycaiue, o oiio /enei aeaeaoe ia eiai aeiiao neeaaenueeo ?icieneo i?i
iayaiinoue oiaa?o.
3.2. Aeieaoeoe IINA?AAeIEEO aeiaai?iaeo o aiaeiiaiaeiinoi aei oiia Aeaiiai Aeiaiai?o.

4. OA?III AeIAIAI?O

Aeaiee Aeiaiai? oeeaaeaiee ia oa?iii c <______>_____________199___?. aei <____>
_______________ 199 _____ ?.

5. AEIAAI?IAeA IINA?AAeIEEA OA II?ssAeIE ?IC?AOOIEIA

IINA?AAeIEE ca iaaeaii iineoae io?eioo aeiaai?iaeo ianooiieo ?icii?ia i a ii?yaeeo:
5.1. Ca aeeiiaiiy ciaiaycaiue c 1 aoaio:

~ aeiaai?iaea o ?icii?i ___________ e?a. Iiaenoaaith aei iieaoe o ciaoiaeaeaiiy IIEOIOess
i iiaeienaiiy aeoo caea/i-i?eeiaiiy. Iieaoa caeienithooueny a _______ oa?iii c iiiaioo iiaeienaiiy
aeoo caea/i-i?eeiaiiy iioi?iaoei?.
5.2. Ca aeeiiaiiy ciaiaycaiue c II aoaio:

– aeiaai?iaea o ?icii?i ________ aiae noie oaiaee. Iiaenoaaith aei iieaoe o iiaeienaiiy
aeiaiai?o iiae noi?iiaie. Iieaoa caeienithooueny _____ iiney iiaeienaiiy aeuaaeacaiiai aeiaiai?o.

Eiia?oeieiee aeiaiai?

IINA?AAeIEE iiaea io?eioaaoe aeiaai?iaeo e o aeaeyaei ?icieoei oeiie iiae oioth, yeo
aecia/ea CAIIAIEE i oioth, ca yeith i?iaeoeoeith eoiea IIEOIAOeUe, ciaeaeaiee ca ne?eyiiy
IINA?AAeIEEA.

Iaiaoiaeii iaiyoaoe, ui iiaenoaaith aei iieaoe iiaeooue aenooiaoe e iioi th?eaee/ii oaeoe:
Aa?iaio 1. Iieaoa caeienithooueny eeoa ca aeeiiaiiy ?acii 1 i II aoaiia iiney oiai, ye iiae CAIIA-
IEEII i IIEOIOeAI aoaea iiaeienaii eiio?aeo.

Aa?iaio 2. Iiaenoaaith aei iieaoe iineoa IINA?AAeIEEA o iieaoa i?iaeoeoei? CAIIAIEEA II-
EOIOeAI aai iaaeoiaeaeaiiy a?ioae ia ?ic?aooieiaee ?aooiie CAIIAIEEA aiae IIEOIOess.

6. AIAeIIAIAeAEUeIINOUe NOI?II

6.1. IINA?AAeIEE ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

– ca i?ino?i/aiiy iaaeaiiy iioi?iaoei? – oo?aoia iaonoieea a ?icii?i ____________ e?a.

– ca iioa ii?ooaiiy nai?o ciaiaycaiue ca aeiaiai?ii – oo?ao a ?icii?i __________ e?a.
6.2. CAIIAIEE ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

– ca i?ino?i/aiiy iieaoe iineoa IINA?AAeIEEA – oo?aoia iaonoieea a ?icii?i ________
aiae noie ieaoaaeo ca eiaeai aeaiue i?ino?i/aiiy;

– ca aeino?ieiaa ?ici?aaiiy Aeaiiai Aeiaiai?o, a oaeiae ca iaiaa?oioiaaio aiaeiiao aiae
i?eeiaiiy iioi?iaoei?, iaaeaii? IINA?AAeIEEII i?ioyaii oa?iiiia ca i.2 Aeaiiai Aeiaiai?o –
oo?aoia iaonoieea a ?icii?i _________________________ e?a.

6.3. IINA?AAeIEE ia aiaeiiaiaeao ia?aae CAIIAIEEII ca aeeiiaiiy eiio?aeoo, oeeaaea-
iiai iiae CAIIAIEEII i IIEOIOeAI.

7. AA?AIOI? AeEss IINA?AAeIEEA CA AeAIEI AeIAIAI?II

7.1. IINA?AAeIEE iao aeeeth/ii i?aaaia aeeiiaiiy aei?o/aiiy CAIIAIEEA. CAIIA:
IEE ciaiaycoooueny i?ioyaii oa?iiio aei? Aeaiiai Aeiaiai?o ia oeeaaeaoe iiaeiaii oaiaee c aoaeue-
yeeie iioeie iina?aaeieeaie aiaeiinii i?iaeoeoei?, c ?aaeicaoei? yei? aeaia aei?o/aiiy IINA?AAe-
IEEO.

7.2. CAIIAIEE aeciao, ui aoaeue-yea oaiaea eoiiaei-i?iaeaaeo, i?aaeiaoii yei? aoaea iaeii,
cacia/aia o Aeiaeaoeo ? 1, aoaea aaaaeaoeny oeeaaeaiith ca ni?eyiiy IINA?AAeIEEA, yeui
aiia oeeaaeaia i?ioyaii oa?iiio aei? Aeaiiai Aeiaiai?o. O oeueiio ?aci IINA?AAeIEE iao
aaccaia?a/ia i?aai ia aeiaai?iaeo ca Aeaiei Aeiaiai?ii.

8. IIOI OIIAE AeAIIAI AeIAIAI?O

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

Aeiaeaoie ? 1 aei aeiaiai?o
aiae <___> ______ 19__ ?.

OIIAE CAIIAIEEA

I. Iaeiaioaaiiy i?iaeoeoei?, ui iinoa/aooueny: _______

2. Iaeeieoey aeii?o: _____________________________

3. Eieueeinoue i?iaeoeoei?, ui iinoa/aooueny: ____________

4. Iiiiiaeueia ia?oiy: ____________________________

5. Ani?oeiaio i?iaeoeoei?, ui iinoa/aooueny: _________

6. Aaooiie (oanii) ______________________________

7. Ia?ea (iiaeaeue): _____________________________

8. sseinoue i?iaeoeoei? _____________________________

9. Eiiieaeoiinoue ________________________________

10. Oa?a i iaeoaaiiy: ___________________________

11. Oiiae iiaa?iaiiy oa aeei?enoaiiy oa?e: _______

12. Ia?ei?oaaiiy i?iaeoeoei?: ______________________
IC. Oa?iii iinoaaee: ____________________________

14. Ii?yaeie o?ainii?ooaaiiy: ___________________

15. Aaciai oiiae iinoaaee: _______________________

16. Iiiiiaeueia oeiia ca iaeeieoeth i?iaeoeoei? (aac IAeA): .

17. Ii?yaeie ?ic?aooieia: _________________________

18. Iinoeaciaoiaeaeaiiy i?iaeoeoei?: _________________

Eiia?oeieiee aeiaiai?

AeIAIAI?
ia iaaeaiiy iioi?iaoeieieo (eiinoeueoaoeieieo) iineoa

i. ____________ . <____> ___________ 199 ___ ?.

AEEIIAAAOeUe:
a iniai aee?aeoi?a ___

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

CAIIAIEE: ______________________
a iniai __________________________________

(iaeiaioaaiiy iinaaee, i. i. 6.)

ui aeio ia iiaenoaai aeiai?aiinoi ? ________ aiae <______> _______ 199 ___ ?., c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

CAIIAIEE aei?o/ao, a AEEIIAAAOeUe ciaiaycoooueny iaaeaoe eiio, o aiaeiiaiaeiinoi aei
oiia Aeaiiai Aeiaiai?o, niaoeiaeueio iioi?iaoeith (eaaeioieiaaio eiinoeueoaoeith), a CAIIAIEE
ciaiaycoooueny i?eeiyoe iineoao oa iieaoeoe ??.

2. CIINO IIOI?IAOeI?
(EIINOEUeOAOeI?)

2.1. AEEIIAAAOeUe iioi?ioo (eiinoeueooo) CAIIAIEEA c ianooiieo ieoaiue:_________

2.2. Iioi?iaoeiy (eiinoeueooaaiiy) iaiayceiai aae?ao a naaa iaaeaiiy CAIIAIEEO ?aei-
iaiaeaoeie c i?eaiaeo oaeineiiaeaiiy oa i?aaiicaoei? naio? aeiyeueiinoi a iaaeao i?aaeiaoo eiinoeueoo-
aaiiy.

3. IAIAssCEE CAIIAIEEA

CAIIAIEE i?ioyaii _________________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o iaaeao
AEEIIAAOeTH iaiaoiaeii aeieoiaioe oa iioi?iaoeith aeey yeiniiai eiinoeueooaaiiy.

4. AEIAAI?IAeA AEEIIAAOess

4.1. CAIIAIEE aeiea/oo AEEIIAAOeTH aeiaai?iaeo a ?icii?i _________________ e?a.
4.2. Aeo?aoe AEEIIAAOess aiaeoeiaeiaothoueny iei ic aeiaai?iaee, ui aeiea/oooueny

CAIIAIEEII.
4.3. Ca aeino?ieiaa aeeiiaiiy ?iaio aieueo iiae ia _______ aeiia CAIIAIEE caeienitho

AEEIIAAOeTH aeiieaoo a ?icii?i ____________________________________ aiae aa?oinoi ?iaio.

5. II?ssAeIE ?IC?AOOIEIA

5.1. Oa?iiie iieaoe:
– i?ioyaii __________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o – aaain a ?icii?i _______

_________________________________________ e?a.;
– i?ioyaii ________________ c iiiaioo iiaeienaiiy aeoo caea/i-i?eeiaiiy ?iaio –

inoaoi/iee ?ic?aooiie.
5.2. Aeae ?ic?aooieia: __________________________________________________________ .

(aioiaeiaee) aacaioiaeiaee, ciioaiee)

5.3. Oi?ia ?ic?aooieia: ________________________________________________________ .

(ieaoiaeia aei?o/aiiy, /ae, aeiiaa.aei?o/aiiy)

5.4. CAIIAIEE iiaeiai iiaiaeiieoe AEEIIAAOess i?i caeieniaiiy ieaoaaeo a no?ie ___

c iiiaioo _______________ oeyoii.

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

6. OA?III AEEIIAIIss ?IAIO

6.1. AEEIIAAAOeUe ciaiaycoooueny ?icii/aoe aeeiiaiiy ?iaio i?ioyaii __________ c
iiiaioo iaaeaiiy iaiaoiaeii? aeieoiaioaoei?.

6.2. AEEIIAAAOeUe ciaiaycoooueny aeeiioaaoe ?iaioo i?ioyaii __________ c i?aaii
aeino?ieiaiai aeeiiaiiy.

Eiia?oeieiee aeiaiai?

7. II?ssAeIE CAeA*I-I?EEIAIIss ?IAIO

7.1. Caea/a-i?eeiaiiy aeeiiaieo ?iaio caeienithooueny noi?iiaie ca aeoii caea/i-i?eeiaiiy
a iinoei ciaoiaeaeaiiy AEEIIAAOess-
7.2. Iioi?iaoeiy (eiinoeueooaaiiy) iiaeiia(ia) aooe iaaeaia(ia) CAIIAIEEO ________

(onii, ienueiiai ia _______ noi? .)

8. AA?AIOIEII OA?IIIE

Aa?aioieiee oa?iii ca Aeaiei Aeiaiai?ii neeaaeao __________ c iiiaioo iiaeienaiiy aeoo
caea/i-i?eeiaiiy. I?ioyaii aa?aioieiiai oa?iiio AEEIIAAAOeUe ciaiaycoooueny caeienithaaoe
iioi/ia eiinoeueooaaiiy c ieoaiue i. I Aeaiiai Aeiaiai?o aaceiooiaii.

9. AIAeIIAIAeAEUeIINOUe NOI?II

9.1. AEEIIAAAOeUe ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

9.2. CAIIAIEE ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

9.3. Ca iaeiinoi?iiith iaiaa?oioiaaio aiaeiiao aiae aeeiiaiiy nai?o iaiayceia i?ioyaii
aei? Aeaiiai Aeiaiai?o aeiia noi?iia niea/oo oo?ao a ?icii?i ____________________________ .

10. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie noi?ii ca Aeaiei Aeiaiai?ii o:
AEEIIAAAOeUe __________________:___________________ oaeaoii _________________ .
CAIIAIEE __________________________________________ oaeaoii __________________ .

11. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

12. IIOI OIIAE

12.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

12.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii.

12.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei – eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

12.4. Noi?iie aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi noi?iiaie i?ioyaii __________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia iaaeaiiy ia?eaoeiaiaeo iineoa

199___?.

AEEIIAAAOeUe:
a iniai aee?aeoi?a ___

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i
CAIIAIEE: ______________________
a iniai

(iaeiaioaaiiy iinaaee, i. i. a.)

ui aeio ia iiaenoaai aeiai?aiinoi ? ________ aiae <______> _______ 199 ___ ?., c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

CAIIAIEE aei?o/ao, a AEEIIAAAOeUe ciaiaycoooueny iaaeaoe inoaiiueiio iineoae c
i?iaaaeaiiy ia?eaoeiaiaeo aeineiaeaeaiue ca iai?yieaie, ui oeieaaeyoue CAIIAIEEA.

Eiia?oeieiee aeiaiai?

2. OA?EOI?Iss I?IAAAeAIIss AeINEIAeAEAIUe

(cacia/aooueny aiaeiiaiaeiee ?aaiii aai oa?eoi?iy)

3. I?AAeIAO IA?EAOEIAIAEO AeINEIAeAEAIUe
(cacia/aooueny eiie?aoia i?iaeoeoeiy aai ia?aeie oa caaaeueia oa?aeoa?enoeea i?iaeoeoei?)

4. IAI?ssIEE IA?EAOEIAIAEO AeINEIAeAEAIUe

Ia?eaoeiaiai aeineiaeaeaiiy caeieniththoueny ca ianooiieie iai?yieaie:

– iiaeeeainoi oa ia?niaeoeae aaaeaiiy eiia?oeieieo iia?aoeie;

– aecia/aiiy aeith/eo oa iioaioeieieo eiieo?aioia;
– caaaeueia oa?aeoa?enoeea oiia ?iaioe eiieo?aioia (aeaea?aea ne?iaeie oa eiiieaeooth/eo,

iayaiinoue iinoa/aeueii-caooiai? ia?aaei oa ii.);
– caaaeueia oa?aeoa?enoeea iaiao i?iaeoeoei? eiieo?aioia (ianya i?iiiceoei?, yeinoue, oeiie,

na?ain, ?ic?aooiee oa ii.);

– ?ic?aooiee oeii, aiaeiiinoi i?i ?o aeeiaiieo ca ia?iiae _____________________;

– nooiiiue ?icaeoeo ?eieiai? iio?ano?oeoo?e (o?ainii?o, neeaaee, ia?aaei, caycee oa ii.);

– nooiiiue ?icaeoeo eiia?oeieii? iio?ano?oeoo?e (ai?aei, iioiai oi?ae, aoeoeiiie, iina?aaeie-
ee);

– iiieo ia i?iaeoeoeith, ia?niaeoeae eiai ?icaeoeo;

– aiaeiiinoi i?i iioaioeieieo niiaeeaa/ia;

– iiaeeeainoue, aeioeieueiinoue oa aoaeoeaiinoue i?iaaaeaiiy ?aeeaiieo eaiiaiie;

– i?iaiic noaio eiithieoo?e ia ___________________ oa?iii;
– noai i i?aeoeea canoinoaaiiy ainiiaea?nueeiai caeiiiaeaanoaa.

5. IAIAssCEE AEEIIAAOess
AEEIIAAAOeUe ciaiaycaiee:

– iaaeaoe ?acoeueoaoe aeineiaeaeaiue a oa?iii ________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o;

– iaaeaoe ?acoeueoaoe aeineiaeaeaiue c aeaoaeueiei oa iiaiei iienii onio ieoaiue o aiaeiiaiaeiinoi

aei ocaiaeaeaieo iai?yieia aeineiaeaeaiue;

– iaaanoe a ?acoeueoaoao aeineiaeaeaiue aae?ane, i?eeeaaee ?ic?aooieia, noaie oa ii.;

– o aeiaaeeo caeo/aiiy aei i?iaaaeaiiy aeineiaeaeaiue o?aoio inia caaacia/eoe iiaio eiioiaeai-
oeieiinoue io?eiaii? aiae CAIIAIEEA iioi?iaoei?.

6. IAIAssCEE CAIIAIEEA

CAIIAIEE ciaiaycaiee:

– iaaeaoe AEEIIAAOeTH ca eiai aeiiaith anth iayaio o CAIIAIEEA iioi?iaoeith, yea
iaiaoiaeia aeey ?acoeueoaoeaiiai i?iaaaeaiiy aeineiaeaeaiue;
– i?eeiyoe ?acoeueoaoe aeineiaeaeaiue o AEEIIAAOess iaaaeii;
– aeieaoeoe CAIIAIEEO aeiaai?iaeo.

7. II?ssAeIE I?IAAAeAIIss AeINEIAeAEAIIss OA IA?AAeA*A ?ACOEUeOAOIA
7.1. AEEIIAAAOeUe naiinoieii i?aaiiciaoo ?iaioo c i?iaaaeaiiy aeineiaeaeaiue.
7.2. AEEIIAAAOeUe iaaeao ?acoeueoaoe aeineiaeaeaiue o ienueiiaiio aeaeyaei.
7.3. I?e caea/i ?acoeueoaoia aeineiaeaeaiue noi?iie neeaaeathoue o 2-o i?eii?ieeao aeo caea/i-
i?eeiaiiy ?iaioe, ii iaeiiio i?eii?ieeo yeiai caa?iaaooueny o noi?ii.

7.4. CAIIAIEE iao i?aai a no?ie _________ iiney caea/i ?acoeueoaoia aeineiaeaeaiue aeiaaaoe
aeiii?aoethaaiiy aeayeeo iieiaeaiue, yei AEEIIAAAOeUe ciaiaycaiee i?iaanoe a no?ie ______ .
sseui i?ioyaii no?ieo __________ CAIIAIEE ia aoaea aeiaaaoe aeiii?aoethaaiiy ?acoeueoaoia
aeineiaeaeaiue, aiie aaaaeathoueny caeaieie aac i?aoaicie c aieo CAIIAIEEA. Caea/a-i?eeiaiiy
aeiii?aoeueiaaieo iieiaeaiue caeienithooueny ca aeoii.

8. AEIAAI?IAeA AEEIIAAOess OA II?ssAeIE ?IC?AOOIEIA

8.1. CAIIAIEE aeiea/oo AEEIIAAOeTH aeiaai?iaeo a ?icii?i _________________ e?a.
8.2. Oa?iiie iieaoe:

– Oa?iiie iieaoe:

– i?ioyaii __________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o – aaain o ?icii?i _______

__________.______________________________ e?a.;
– i?ioyaii _____________ c iiiaioo iiaeienaiiy aeoo caea/i-i?eeiaiiy ?iaio – inoaoi/iee

?ic?aooiie.

Eiia?oeieiee aeiaiai?
Aeae ?ic?aooieia:

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

Oi?ia ?ic?aooieia: _________________________________________________________ .
8.3. Iiaenoaaith aeey iieaoe o aeo caea/i-i?eeiaiiy ?acoeueoaoia aeineiaeaeaiue, a o aeiaaeeo ?o
aeiii?aoethaaiiy – aiaeiiaiaeiee aeo caea/i-i?eeiaiiy.

8.4. Iieaoa caeienithooueny a aacaioiaeiaiio ii?yaeeo oeyoii ia?a?aooaaiiy CAIIAIEEII
iaiaoiaeieo noi ieaoiaeiei aei?o/aiiyi ia ?ic?aooieiaee ?aooiie AEEIIAAOess.

8.5. Oa?iii, i?ioyaii yeiai CAIIAIEE ciaiaycaiee ia?a?aooaaoe AEEIIAAOeTH
aeiaai?iaeo, neeaaeao _______________ iiney iiaeienaiiy aeoo caea/i-i?eeiaiiy, a o aeiaaeeo ?o
aeiii?aoethaaiiy – a oa?iii ___________ iiney iiaeienaiiy aeoo caea/i-i?eeiaiiy aeiii?aoethaaiue.

9. AA?AIOIEII OA?IIIE

10. AIAeIIAIAeAEUeIINOUe NOI?II

10.1. AEEIIAAAOeUe ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue: ______________

10.2. CAIIAIEE ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

10.3. Ca iaeiinoi?iiith iaiaa?oioiaaio aiaeiiao aiae aeeiiaiiy nai?o iaiayceia i?ioyaii
aei? Aeaiiai Aeiaiai?o aeiia noi?iia niea/oo oo?ao o ?icii?i _____________________________ .

11. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie noi?ii ca Aeaiei Aeiaiai?ii o:
AEEIIAAAOeUe ____________________________________ oaeaoii ___________________ .
CAIIAIEE ______________________________________ oaeaoii ___________________ .

12. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

13. IIOI OIIAE

13.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

13.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii.

13.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei – eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

13.4. Noi?iie aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi noi?iiaie i?ioyaii __________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia iaaeaiiy th?eaee/ieo iineoa

199 ___ ?.

CAIIAIEE: _______

a iniai _________________
ui aeio ia iiaenoaai _______
c iaeiiai aieo, i

TH?EAeE*IA OI?IA:
a iniai __________________

ui aeio ia iiaenoaai
c iioiai aieo,

Eiia?oeieiee eiaiai?

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

CAIIAIEE aei?o/ao, a TH?EAeE*IA OI?IA aa?a ia naaa ciaiaycaiiy iaaeaaaoe th?e-
aee/io aeiiiiiao a ianyci oa ia oiiaao, ia?aaeaa/aieo Aeaiei Aeiaiai?ii.

2. IAIAssCEE TH?EAeE*II? OI?IE

2.1. TH?EAeE*IA OI?IA aa?a ia naaa aeeiiaiiy ianooiii? i?aaiai? ?iaioe:
a) ia?aai?yo aiaeiiaiaeiinoue aeiiaai caeiiiaeaanoaa aioo?ioiio aeieoiaioia CAIIAIEEA,
aicoo ?o, iaaeao aeiiiiiao CAIIAIEEO c iiaeaioiaee oa i?aaeeueiiai ioi?ieaiiy cacia/aieo
aeieoiaioia:

a) aa?a o/anoue o iiaeaioiaoei oa oeeaaeaiii ?iciiai ?iaeo aeiaiai?ia, ui oeeaaeathoueny CAIIAIE-
EII c iioeie iiaei?eoinoaaie oa a?iiaaeyiaie, aicoo ?o, iaaeao aeiiiiiao c i?aaiicaoei? eiio?ieth
ca aeeiiaiiyi oeeo aeiaiai?ia, neiaeeoo ca canoinoaaiiyi ia?aaeaa/aieo caeiiii oa aeiaiai?ii
naieoeie ii aiaeiioaiith aei eiio?aaaioia, ui ia aeeiiothoue aeiaiai?ieo ciaiaycaiue;
a) i?aaiicoo oa aaaea i?aoaicieio ?iaioo ca iaoa?iaeaie, yei iiaeaioiaetho CAIIAIEE;
a) aa?a o/anoue o ?icaeyaei ieoaiue i?i aeaaioi?nueeo oa e?aaeeoi?nueeo caai?aiaaiinoue, ui o ia
aaeaini ainiiaea?noaa, oa aaeeaao niieueii c iioeie iiae?icaeieaie caoiaeia uiaei eieaiaeaoei? oeio?
caai?aiaaiinoi;

ae) iaaeao aeiiiiiao c i?aaiicaoei? oa caeieniaiiy eiio?ieth ca aeio?eiaiiyi CAIIAIEEII
anoaiiaeaiiai /eiiei caeiiiaeaanoaii ii?yaeeo i?iaeaaeo oa i?eeiaiiy i?iaeoeoei? oa oiaa?ia ca
eieueeinoth oa yeinoth, i?iaiaeeoue iino?oeoaae i?aoeiaieeia, ui aiaeathoue aiaei?aaeaiiyi oa i?eeiaiiyi
oiaa?ii-iaoa?iaeueieo oeiiiinoae, i?i ii?yaeie ioi?ieaiiy oeeo iia?aoeie oa aeoeaoaaiiy o
aeiaaeeo ianoa/i, iaeiiieaeoiinoi, inoaaiiy oiaa?ia oa aaioaaeia, ?iaeoue aeniiaie i?i caeiiiinoue
nienaiiy iaoa?iaeueieo oeiiiinoae;

a) i?aaenoaaeyo o anoaiiaeaiiio ii?yaeeo iioa?ane CAIIAIEEA a noaei, a oaeiae a iioeo
i?aaiao i?e ?icaeyaei i?aaiaeo ieoaiue;

ae) ocaaaeueitho oa aiaeicoo ?icaeyae noaeiaeo, iioeo ni?aa oa niieueii c iioeie iiae?icaeieaie
CAIIAIEEA – ?acoeueoaoe ?icaeyaeo i?aoaicie, i?aeoeeo oeeaaeaiiy oa aeeiiaiiy aeiaiai?ia –
iaaeao CAIIAIEEO i?iiiceoei? c onoiaiiy aeyaeaieo iaaeieieia;

c) aeao eiinoeueoaoei?, caeeth/aiiy, aeiaiaeee c i?aaiaeo ieoaiue, ui aeieeathoue o aeiyeueiinoi
CAIIAIEEA;

i) ca aei?o/aiiyi CAIIAIEEA aa?a o/anoue o caniaeaiii aaeainiai? eiiini? oa ?ic?iaoei
i?iiiceoeie ca iiaenoieaie oiiainiai-ainiiaea?nueei? aeiyeueiinoi;

e) aiooo ca aei?o/aiiyi CAIIAIEEA iaoa?iaee i?i ?ice?aaeaiiy, ?ico?aoe, ianoa/i,
aeione iaaeia?iyeinii? i ianoaiaea?oii? i?iaeoeoei? oa i?i iioi i?aaiii?ooaiiy aeey ia?aaea/i
neiae/ei, noaeiaei i?aaiai, a oaeiae aaeeaao caoiaeia aei aiaeoeiaeoaaiiy caeoeia, caaaeaieo
CAIIAIEEO;

e) i?aaiicoo nenoaiaoe/iee iaeie oa caa?aaeaiiy ii?iaoeaieo aeoia, ui iaaeoiaeyoue aei
CAIIAIEEA oa aeaeathoueny iei, noai?tho aiaeiioaeo th?eaee/ii? eioa?aoo?e;

i) iioi?ioo CAIIAIEEA i?i iiaa caeiiiaeaanoai, i?aaiicoo niieueii c iioeie iiae?icaeiea-
ie aea/aiiy ea?iaieie i?aoeiaieeaie oa niaoeiaeinoaie CAIIAIEEA ii?iaoeaieo aeoia, ui
noinothoueny ?o aeiyeueiinoi, ?aaoey?ii caeienitho iniaenoee i?eeii i?aoeiaieeia CAIIAIEEA oa
eiinoeueooo ?o c i?aaiaeo ieoaiue.

2.2. I?e aeeiiaiii cacia/aieo a i.2.1 iaiayceia TH?EAeE*IA OI?IA ea?oooueny /eiiei
caeiiiaeaanoaii i Aeaiei Aeiaiai?ii.
2.3. Aeey aeeiiaiiy aei?o/aiue, cacia/aieo a i.2.1 Aeaiiai Aeiaiai?o, TH?EAeE*IA OI?IA

i?ecia/ao _________________________________________________________________________.

(iinaaea, I. 1. A.)

3. IAIAssCEE CAIIAIEEA

CAIIAIEE ciaiaycoooueny:

a) naio/anii caaacia/oaaoe TH?EAeE*IO OI?IO anii iaiaoiaeiei aeey aeeiiaiiy aeaieo
?e aei?o/aiue, ia?aaeaa/aieo Aeaiei Aeiaiai?ii, a oiio /enei aeieoiaioaie o iio?iaiie eieueeinoi
i?eii?ieeia, ii?iaoeaieie aeoaie, ui ?aaoeththoue aeiyeueiinoue CAIIAIEEA, eaioeaey?nueeei
i?eeaaeaeyi, ?iai/ei iinoeai, o?ainii?oieie caniaaie;
a) iiea/oaaoe aeo?aoe, iaiaoiaeii aeey aeeiiaiiy eiai aei?o/aiue;
a) iiea/oaaoe iineoae TH?EAeE*II? OI?IE.

Eiia?oeieiee aeiaiai?

4. II?ssAeIE IIEAOE IINEOA TH?EAeE*II? OI?IE

aoo TH?EAeE*IITH OI?IITH, CAIIAIEE uiiiny/ii ia?a?aoi-
(noia eioa?aie)—~—

/eneai” CAeiueny CAIIAIEEII ia iiciioa_____

5. CAEETH*II IIEIAEAIIss

Aeaiee Aeiaiai? oeeaaeaiee ia no?ie aei ____________ oa iyaiiyn eueoe
?ici?aaieei

oe eii aeith, iiia?aaeeaoe i?i oea ae?oao noi?iio cOiaeeiiue ” TT-
Aeaiee Aeiaiai? neeaaeaiee o aeaio i?eii?ieeao: ii iaeiiio i?eii?ieeo aeey eiaeii? noi?iie

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia iaaeaiiy ?aeeaiieo iineoa

i.____________ <____>___________ 199___?.

?AEEAIINO: __________________________________________________________________,

a iniai ______________________________________________________________________________,
ui aeio ia iiaenoaai __________________________________________________________________,
c iaeiiai aieo, i

?AEEAIIAeAAAOeUe: ____________________________________________________________,
a iniai ___________________________________________________________________________,

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

?AEEAIIAeAAAOeUe aei?o/ao, a ?AEEAIINO ciaiaycoooueny aeeiiaoe ianooiio ?iaioo c
?aeeaie _____________________________________________________________________
Iien iaoeoo ?aeeaie: _________________________________________________________ .
Iien ?aeeaie (niinia) aai iineoae: ________________________________________________ .
Aeaoa iaaeaiiy iineoae (i?iaaaeaiiy ?aeeaiii? aeoei?): _______________________________ .
Ianya: _________________________________________________________
Oiiae: _______________________________________________________________________.
I?eiioea:

I?e aaeeeiio iieni anio oeeo ia?aiao?ia neeaaeaooueny ie?aiee iien. O oeueiio aeiaaeeo a oaenoi
aeiaiai?o cacia/aooueny .

2. IAIAssCEE ?AEEAIINOA

?AEEAIINO aa?a ia naaa aeeiiaiiy ianooiieo ?iaio:

2,1. Iiaeao ia caoaa?aeaeaiiy ?AEEAIIAeAAOeTH a ______ aeaiiee oa?iii c aeiy iiaeienaiiy
aeiaiai?o aeieeaaeio i?ia?aio ?iaio c ?aeeaie i?iaeoeoei? aai iaaeaiiy iineoa, ic cacia/aiiyi
/aniaeo iioa?aaeia, caioieo iaoa?iaeia oa i?ioioiaieo noi, iaiaoiaeieo aeey aeeiiaiiy ?iaio.
I?ia?aia iiney ?? caoaa?aeaeaiiy o iaaiaeoiiith /anoeiith Aeaiiai Aeiaiai?o.
2.2. Aeanieie neeaie oa c aeanieo iaoa?iaeia, ia aeaniie iaoa?iaeueiie aaci aeaioiaeyo
iaiaoiaeii aneice, oaenoe, i?eaiiae-iaeaoe (neaeaee, oieueie, aiaeaieanaoe, iaaiioii caiene).

2.3. Iiaeao ia caoaa?aeaeaiiy ?AEEAIIAeAAOeTH aneice, i?eaiiae-iaeaoe oa iioi iaoa?iaee,
iaiaoiaeii aeey i?iaaaeaiiy ?iaio. Caione o ae?iaieoeoai aai ioaeieaoeiy ia caoaa?aeaeaieo
?AEEAIIAeAAOeAI iaoa?iaeia ia aeiioneaooueny.

2.4. Ciaeiieoue ?AEEAIIAeAAOess ca eiai aeiiaith c ia?aaiaii ?iaio c aeaioiaeaiiy
?aeeaie.

Eiia?oeieiee eiaiai?

2.5. ?iciiuoo ?aeeaio:

(aeacaoe, yeo i aea)

3. IAIAssCEE ?AEEAIIAeAAOess

?AEEAIIAeAAAOeUe aa?a ia naaa ianooiii ciaiaycaiiy:
3.1. Caoaa?aeaeoo i?ia?aio ?iaio c ?aeeaie.

3.2. Caoaa?aeaeoo c?acee ?aeeaiii? i?iaeoeoei?, yea iiaeeyaao oe?aaeoaaiith.
3.3. Iaaeao iioi?iaoeith, iaiaoiaeio aeey aeaioiaeaiiy ?aeeaie (oaoii/ii aeaii, iien i?iaeoeoei?,
iineoa).

4. II?ssAeIE IIEAOE ?IAIOE ?AEEAIINOA

4.1. ?iaioo, aeeiiaio ?AEEAIINOII, ?AEEAIIAeAAAOeUe iiea/oo a noii __________
___________________ e?a. oeyoii ia?a?aooaaiiy ia ?ic?aooieiaee ?aooiie ?AEEAIINOA.
4.2. ?ic?aooiee ca aeeiiaio ?iaioo caeieniththoueny ?AEEAIIAeAAOeAI oeyoii ia?a?aoo-
aaiiy ia ?ic?aooieiaee ?aooiie ?AEEAIINOA 100% ia?aaeiieaoe.

5. OA?III AeI? AeIAIAI?O

5.1. Aeaiee Aeiaiai? aeieniee aiae _____________________ aei ______________________ .
Ocaiaeaeothoueny ianooiii i?iiiaeii aoaie:

5.1.1. ?ic?iaea aneicia ______________________________________________________ .
5.1.2. Caoaa?aeaeaiiy aneicia _____________________________________________________ .
5.1.3. ?ic?iaea i?eaiiae-iaeaoa ______________________________________________ .
5.1.4. Oe?aaeoaaiiy _______________________________________________________________ .
5.1.5. Caoaa?aeaeaiiy oa?iiiia oa ia?aeieo caniaia ianiai? iioi?iaoei? aeey ?iciiuaiiy
?aeeaie ___________________________________________________________________________.
5.1.6. ?iciiuaiiy ?aeeaie ____________________________________ o aiaeiiaiaeiinoi aei i.2.5.
5.2. Aeiaiai? iiaea aooe ?ici?aaiee ca aeiiaith ?AEEAIIAeAAOess aeino?ieiai o aeiaaeeao:
a) iacaaeiaieueiiai ciinoo ooaeiaeiuei?, anoaoe/ii? oa ii. yeinoi ?aeeaie. I?aai ioeiiee yeinoi
?aeeaie iaeaaeeoue ?AEEAIIAeAAOeTH, yeee o aeiaaeeo aeino?ieiaiai ?ici?aaiiy aeiaiai?o ca
iacaaiith iiaenoaaith ia aoaea aeei?enoiaoaaoe aiaeoeeaio iei ?aeeaio;

a) ii?ooaiiy oa?iiiia ?iciiuaiiy ?aeeaie o caniaao ianiai? iioi?iaoei?, caoaa?aeaeaieo
?AEEAIIAeAAOeAI, a oaeiae i?iiiaeieo oa?iiiia, yeui oaea ii?ooaiiy noaaeoue iiae caa?ico
c?eao eiioeaaee oa?iii aeeiiaiiy aeiaiai?o.

6. AIAeIIAIAeAEUeIINOUe NOI?II

6.1. Ca iaaeeiiaiiy /e iaiaeaaeia aeeiiaiiy ciaiaycaiue ca Aeaiei Aeiaiai?ii ?AEEAII-
AeAAAOeUe i ?AEEAIINO ianooue aiaeiiaiaeaeueiinoue o aiaeiiaiaeiinoi aei /eiiiai caeiiiaeaanoaa.

6.2. O aeiaaeeo aeino?ieiaiai ?ici?aaiiy aeiaiai?o ia iiaenoaaao, iacaaieo o i.5.2 Aeaiiai
Aeiaiai?o, aeo?aoe, caciaii ?AEEAIINOII, aiaeoeiaeoaaiith ia iiaeeyaathoue.

6.3. ?AEEAIINO ia iana aiaeiiaiaeaeueiinoi ca oaeoe/io yeinoue oiaa?o, ui ?aeeaioooueny
(iineoa).

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia aeaioiaeaiiy oa anoaiiaeaiiy ciaiioiuei? ?aeeaie

199___?.

?AEEAIINO: _____

a iniai ________________
ui aeio ia iiaenoaai _______
c iaeiiai aieo, i

?AEEAIIAeAAAOeUe
a iniai _______________

ui aeio ia iiaenoaai
c iioiai aieo,

Eiia?oeieiee aeiaiai?

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. ?AEEAIINO aa?a ia naaa iaiaycee c aeaioiaeaiiy, i?aiaee iinoey oa anoaiiaeaiiy
ciaiioiuei? ?aeeaie (aeaei ca oaenoii – ?AEEAIE) ____________ a iioa?anao ?AEEAIIAeAAOess.

1.2. ?AEEAIINO ?ic?iaeyo aneice ?AEEAIE (ia iaioa 3-o i?eaiiaeueieo aneicia, yei ia
o aa?iaioaie iaeiiai cia?aaeaiiy) i iaaeao ?o ?AEEAIIAeAAOeTH a no?ie aei _______________ .

1.3. Inoaoi/iee aneic caoaa?aeaeoooueny ?AEEAIIAeAAOeAI a no?ie aei _______________ .

1.4. ?AEEAIA iiaeiia aooe aeeiiaia o noai?ie aiaeiiaiaeiinoi aei caoaa?aeaeaiiai
?AEEAIIAeAAOeAI aneico.

1.5. Eieuei?e ?AEEAIE iiaeiii aiaeiiaiaeaoe caoaa?aeaeaiei ?AEEAIIAeAAOeAI oa oei,
ui aeiaeathoueny aei aneico.

1.6. Iano/a eiino?oeoeiy ?AEEAIE aeaioiaeyooueny c iaoa?iaeia:_______________________

(iaoaeo\aaoiio – aeacaoe eiie?aoii)

?aia aeaioiaeyooueny c

(iaoaeo\aaoiio – aeacaoe eiie?aoii)

1.7. Iiaa?oiy ?AEEAIE aeaioiaeyooueny c ianooiieo iaoa?iaeia:

(iaoae, ieanoee, oeaieia, iaii? . aeacaoe eiie?aoii)

1.8. Iaianaiiy iaethiea caeienithooueny _______________

(oa?aith, ieaieith – aeacaoe eiie?aoii)

1.9. Inaioeaiiy iiaeiii aooe aeeiiaii o aeaeyaei __________________________________ .
1.10. Iinoea aeey onoaiiaeaiiy ?AEEAIE caoaa?aeaeoooueny ?AEEAIIAeAAOeAI eeoa
iiney aicoaeueiiai iciaeiieaiiy ia iinoeaainoi i?aaenoaaieeii ?AEEAIIAeAAOess.

2. IAIAssCEE NOI?II

2.1. ?AEEAIINO iaaeao ?AEEAIIAeAAOeTH aeey niinoa?aaeaiiy ca ia?aaiaii aeeiiaiiy
?iaio eiiith caoaa?aeaeaiiai aneico ic c?aceaie oa?a oa iioeo iaiaoiaeieo iaoa?iaeia.

2,2. ?AEEAIINO iaaeao ?AEEAIIAeAAOeTH eiii? onio aeieoiaioia c i?aiaee iinoey, aeaoaeueiee
ieai iinoey, iciiao?e/ia cia?aaeaiiy ueoa ia iinoeaainoi, oaeoeei-oaoii/ii oiiae ia aeaioiaeaiiy
iano/eo eiino?oeoeie. Ca aiaenooiinoi aai iaiaeaaeiiai ioi?ieaiiy aoaeue-yeeo aeieoiaioia,
iiaycaieo c i?aiaeith iinoey, ?ic?iaeith, aeaioiaeaiiyi oa onoaiiaeaiiyi ?AEEAIE, aeia
iiaiinoth iieeaaeaooueny ia ?AEEAIINOA ye oaoiaoey a aeaiie noa?i, ui acya ia naaa aeeiiaiiy
?iaio, c yeeo ?AEEAIIAeAAAOeUe ia o oaoiaoeai. O oeueiio aeiaaeeo any iiaiioa aiaeiiaiaeaeueiinoi
oa aiaeoeiaeoaaiiy caeoeia iieeaaeaooueny ia ?AEEAIINOA.

2.3. ?AEEAIINO aeaioiaeyo ?AEEAIO o aiaeiiaiaeiinoi aei caoaa?aeaeaieo ?AEEAIIAeAA-
OeAI c?aceia oa iieno ?AEEAIE.

2.4. ?AEEAIIAeAAAOeUe iiea/oo aa?oinoue aeaioiaeaiiy ?AEEAIE. Iieaoa caeienithooueny
ia oiiaao 100% ia?aaeiieaoe i?ioyaii 3-o aeiia iiney iiaeienaiiy Aeaiiai Aeiaiai?o iaiia
noi?iiaie.

2.5. Oni iaaeaii ia ?icaeyae iaoa?iaee ?AEEAIIAeAAAOeUe caoaa?aeaeoo aai aiaeoeeyo o 5-
aeaiiee oa?iii.

3. I?AAA NOI?II

3.1. ?AEEAIIAeAAAOeUe iao i?aai a i?ioeani ae?iaieoeoaa i?iaeoeoei? ciaeiieoeny ci noaiii
?iaio.

4. OA?III AeI? AeIAIAI?O

4.1. Aeaiee Aeiaiai? aeieniee aiae ________________________ aei ________________________ .
Ocaiaeaeothoueny ianooiii i?iiiaeii aoaie:
I. ?ic?iaea aneicia ____________________________________________________________ .

2. Caoaa?aeaeaiiy aneicia ________________________________________________________ .

3. Onoaiiaeaiiy ?AEEAIE _________________________________________________ .

4.2. Aeiaiai? iiaea aooe ?ici?aaiee ca aeiiaith ?AEEAIIAeAAOess aeino?ieiai o aeiaaeeao:
a) iacaaeiaieueiiai ciinoo ooaeiaeiuei?, anoaoe/ii? oa ii. yeinoi ?aeeaie. I?aai ioeiiee yeinoi
?aeeaie iaeaaeeoue ?AEEAIIAeAAOeTH, yeee o aeiaaeeo aeino?ieiaiai ?ici?aaiiy aeiaiai?o ca
iacaaiith iiaenoaaith ia aoaea aeei?enoiaoaaoe aiaeoeeaio iei ?aeeaio;

a) ii?ooaiiy ?AEEAIINOII i?iiiaeieo oa?iiiia, yeui oaea ii?ooaiiy noaaeoue iiae
caa?ico c?eao eiioeaaee oa?iii aeeiiaiiy aeiaiai?o.

Eiia?oeieiee eiaiai?

5. INIAEEAI OIIAE

5.1. Oni aenoiaeii iaoa?iaee ii i?iaeoeoei? ia?aaeathoueny ?AEEAIIAeAAOeTH.
5.2. Noi?iie aeiiiaeeeny, ui oiiae aeaiiai aeiaiai?o o eiia?oeieiith oaoiieoeath i ?icai-
eioaiith ia iiaeeyaathoue.
6. IIEAOA ?IAIO

6.1. Iieaoa ?iaio caeienithooueny ia oiiaao 100% ia?aaeiieaoe a noii: ________________ .

7. AIAeIIAIAeAEUeIINOUe NOI?II

7.1. I?e ii?ooaiii oa?iiiia iieaoe ?AEEAIIAeAAAOeUe aeiea/oo ?AEEAIINOO 0,1%
aiae noie aeiaiai?o ca eiaeai aeaiue i?ino?i/aiiy.

7.2. I?e ii?ooaiii oa?iiiia aeeiiaiiy ?iaio ?AEEAIINOO ia?aoiaothoueny oo?aoii
naieoei? a ?icii?i 0,1% aiae noie Aeaiiai Aeiaiai?o ca eiaeai aeaiue i?ino?i/aiiy.

7.3. O aeiaaeeo aeino?ieiaiai ia iiaenoaai i?e/ei ca i.4.2 ?ici?aaiiy Aeaiiai Aeiaiai?o,
aeo?aoe, caciaii ?AEEAIINOII, aiaeoeiaeoaaiith ia iiaeeyaathoue.

7.4. Ca iaaeeiiaiiy aai iaiaeaaeia aeeiiaiiy ciaiaycaiue ca Aeaiei Aeiaiai?ii ?AEEAII-
AeAAAOeUe i ?AEEAIINO ianooue aiaeiiaiaeaeueiinoue o aiaeiiaiaeiinoi aei /eiiiai caeiiiaeaanoaa.

8. OI?N-IAAEI?II IANOAAEIE

8.1. Aei oi?n-iaaei?ieo ianoaaei ca aeaiei aeiaiai?ii iaeaaeaoue: noeoieii eeoa (aeeneaaee,
nia?/i, iiaaii, o?aaaie, caieao?one).

8.2. Aei oi?n-iaaei?ieo ianoaaei ia iaeaaeaoue: aei?iaeii-o?ainii?oii i?eaiaee, cnoae, oae
ye i?e ?ic?iaoei oaeoeei-oaoii/ieo oiia ia eiino?oeoei? oa anoaiiaeaiiy ?AEEAIE oaei
iiaeeeainoi iioeiaeaeaiiy ?AEEAIE iiaeiii aooe aeeeth/aii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
aei?o/aiiy ia aaaeaiiy ni?aa a A?aio?aaeiiio noaei

199___?.

AEEIIAAAOeUe:
a iniai ____________

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

CAIIAIEE: ____________________________________________

a iniai ______________________________________________________
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. AEEIIAAAOeUe ciaiaycoooueny iaaeaoe CAIIAIEEO eiinoeueoaoeieii oa th?eaee/ii
iineoae c i?eaiaeo caoenoo iioa?ania inoaiiueiai (i?aaenoaaieoeoai) a aea?aeaaieo i?aaiao i a
A?aio?aaeiiio noaei c ieoaiiy _________________________________________________________

2. II?ssAeIE I OA?IIIE AEEIIAIIss CIAIAssCAIUe AEEIIAAOeAI

2.1. Iineoae iaaeathoueny CAIIAIEEO oeyoii:

– oniiai oa ienueiiaiai eiinoeueooaaiiy c th?eaee/ieo ieoaiue;

– neeaaeaiiy i?iaeoia iaiaoiaeieo i?ioeanoaeueieo aeieoiaioia, nea?a, i?aoaici? oa iiciaii?
cayae;

– iaaeaiiy eiinoeueoaoeieieo iineoa c i?eaiaeo caoenoo iioa?ania CAIIAIEEA a i?aaiao
A?aio?aaeiiai noaeo;

– iniaenoi? o/anoi oa i?aaenoaaieoeoaa CAIIAIEEA a i?aaiao A?aio?aaeiiai noaeo.
2.2. Oa?iiie eiinoeueooaaiiy oa iiaeaioiaee aeieoiaioia:

II*AOIE aeeiiaiiy ?iaio aecia/aooueny c iiiaioo, eiee Aeaiee Aeiaiai? iaae?ao /eiiinoi.
CAEII*AIIss ?iaio c eiinoeueooaaiiy aecia/aooueny iiiaioii iiaeienaiiy aeoo i?eeiaiiy
aeeiiaieo ?iaio; c a?aio?aaeiiai i?aaenoaaieoeoaa – iiiaioii iaa?aiiy /eiiinoi ?ioaiiy
A?aio?aaeiiai noaeo aai naiinoieiei neanoaaiiyi AeII aeoo, ui inea?aeoooueny.

Eiia?oeieiee aeiaiai?

Ca ianoaiiy ianoaaei, ia?aaeaa/aieo a /.2 i.2.2 Aeaiiai Aeiaiai?o, AEEIIAAAOeUe aaa-
aeaooueny oaeei, ui iiaiinoth aeeiiaa nai? iaiaycee ia?aae CAIIAIEEII.

3. IAIAssCEE CAIIAIEEA

3.1. CAIIAIEE ciaiaycoooueny iaaeaaaoe AEEIIAAOeTH ca eiai aeaciaeith iaiaoiaeii
aeieoiaioe oa iioi?iaoeith.

3.2. CAIIAIEE ciaiaycaiee (o aeiaaeeo iaiaoiaeiinoi) aeaeaoe AEEIIAAOeTH aeiai?aiinoi
ia ianooiieo inia, ui o niia?iaioieeaie AEEIIAAOess, aeey o/anoi a a?aio?aaeiiio i?ioeani:

1.___________________.

2.___________________.

4. OeIIA AeIAIAI?O

4.1. Ca iineoae ca i. 1.1 Aeaiiai Aeiaiai?o CAIIAIEE niea/oo AEEIIAAOeTH aeiaai?iaeo
a ?icii?i: ______________________________________________________________________.

4.1.1. Ca iaaeaiiy eiinoeueoaoeieieo iineoa oieniaaia noia a ?icii?i ___________________
(______________________________________________) ea?aiaaioeia;

4.1.2. Iethn aeiaeaoeiai ______________ (__________) aiaenioeia aiae noie, ca yeith aeey
CAIIAIEEA i?eeiyoi iiceoeaia ?ioaiiy oa io?eiaiee iiceoeaiee aeiiiii/iee aoaeo.

4.2, O aeiaaeeo, yeui iineoae AEEIIAAOess ca I.4.1.2 Aeaiiai Aeiaiai?o aeyaeyoueny
aac?acoeueoaoieie aeey CAIIAIEEA, oi AEEIIAAAOeUe ia iao i?aaa aeiaaaoe nieaoe niai
aoaeue-yei? aeiaai?iaee aai aiaeoeiaeoaaiiy aeo?ao.

5. II?ssAeIE ?IC?AOOIEIA

5.1. CAIIAIEE caeienitho iieaoo ca Aeaiei Aeiaiai?ii iaeii?aciai a aacaioiaeiaiio
ii?yaeeo ieaoiaeiei aei?o/aiiyi ia ?ic?aooieiaee ?aooiie AEEIIAAOess:

– ca I.4.1.1 Aeaiiai Aeiaiai?o ia?aaeiieaoa i?ioyaii ___aeiia c iiiaioo eiai iiaeienaiiy;

-ca I.4.1.2 Aeaiiai Aeiaiai?o i?ioyaii _______ aeiia c iiiaioo iaa?aiiy /eiiinoi ?ioaiiy
A?aio?aaeiiai noaeo aai neanoaaiiy AeII aeoo, ui inea?aeoooueny (c i?aaii iiaoaiii? iieaoe
i?ioyaii aeuaaeacaiiai oa?iiio).

6. EIIOIAeAIOeIEIINOUe

AEEIIAAAOeUe ciaiaycaiee caa?aaoe a oaoiieoei iioi?iaoeith, yeo noaei eiio aiaeiii i?e
iaaeaiii CAIIAIEEO i?aaenoaaieoeueeeo iineoa.

7. IIOI OIIAE

7.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

7.2. O aeiaaeeo i?ino?i/aiiy nieaoe aeiaai?iaee ca i.5.1 Aeaiiai Aeiaiai?o CAIIAIEE
niea/oo oo?aoio iaith a ?icii?i __________________ (_____________) aiaenioea aiae noie ai?ao
ca eiaeai aeaiue i?ino?i/aiiy.

7.3. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia noi?iaiae eane?a c a?ioeia oa aeieoiaioaie

i.____________ <____>___________ 199___?.

CAIIAIEE: __________________________________________________________________,

a iniai _______________.______________________________________________________________,
ui aeio ia iiaenoaai ________________________________________________________________,
c iaeiiai aieo, i

IOI?IIIA OI?IA: ___________________________________________________________,
a iniai _____________________________________________________________________________,

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

Eiia?oeieiee aeiaiai?

1. I?AAeIAO AeIAIAI?O

1.1. CAIIAIEE aei?o/ao, a IOI?IIIA OI?IA aa?a ia naaa ciaiaycaiiy c noi?iaiaeo
eane?a c a?ioeia oa aeieoiaioaie i?e io?eiaiii CAIIAIEEII a?ioiaeo noi a aaieo, a
oaeiae aeeiioaaoe ani iioi i?aaa oa iaiaycee ca aeaiei aeiaiai?ii.

2. Aeii, /an, ia?o?oo i ii?yaeie noi?iaiaeo

2.1. Aeii oa /an noi?iaiaeo eane?a c a?ioiaeie eiooaie oa aeieoiaioaie:

IinyoeueAeii noi?iaiaeo*an noi?iaiaeoI?eiioea

2.2. O aeiaaeeo caiao aeiia noi?iaiaeo ic nayoeiaeie oa aeoiaeieie aeiyie aeii ia?aaacaiiy
a?ioiaeo eiooia aecia/athoueny ca a?aoieii (iiny/iei, eaa?oaeueiei), yeiai CAIIAIEE
iai?aaeyo IOI?IIIIE OI?II ia iiciioa iiae ca ___________ aeiia aei i?aaacaiiy. A?aoie o
iaaiaeoiiith /anoeiith aeiaiai?o.
2.3. Ia?o?oo noi?iaiaeo: ________________________________________________________

2.4, Ii?yaeie noi?iaiaeo:

3. IAIAssCEE OA AIAeIIAIAeAEUeIINOUe NOI?II

3.1. CAIIAIEE:

3.1.1. Naio/anii aeiaiaeeoue aei aiaeiia IOI?IIII? OI?IE a?aoie ia?aaacaiiy a?ioiaeo
eiooia, ciiie aeiia oa /ano noi?iaiaeo, ui aiaeaoeeny,

3.1.2. Caeienitho naio/anio iieaoo iaaeaieo IOI?IIIITH OI?IITH iineoa.
ae i / ________________ ___ ______________________________________

3.2. IOI?IIIA OI?IA:

3.2.1. Aeaeieyo aeey noi?iaiaeo eane?a c a?ioeia o?ainii?o o oaoii/ii ni?aaiiio noaii, a
oaeiae iaiaoiaeio aeey aeeiiaiiy aeiaiai?o eieueeinoue (ia iaioa _____) aeiii?iaaieo i?aoeiaieeia.
3.2.2. Aa?a ia naaa aiaeiiaiaeaeueiinoue ca aaciaeo eane?a oa caa?aaeaiiy a?ioiaeo eiooia.
3.2.3. Iaooeeueii aeeiioo a?aoie oa ia?o?oo noi?iaiaeo.

3.2.4. _________________________________________________________________________.

4. AA?OINOUe IINEOA OA II?ssAeIE ?IC?AOOIEIA

4.1. Ca aeeiiaiiy ?iaio (iineoa) c noi?iaiaeo eane?a c a?ioeia aiaeiiaiaeii aei oiia Aeaiiai
Aeiaiai?o CAIIAIEE ia?a?aoiaoo IOI?IIIIE OI?II uiiiny/ii, ia iiciioa ___________,
____________________________________________________ ea?aiaaioeia.

4.2. ?aooiee IOI?IIII? OI?IE ia aeiaeaoeiai iineoae iiea/othoueny CAIIAIEEII o
anoaiiaeaiiio ii?yaeeo.

4.3. __________________________________________________________________________.

5. AIAeIIAIAeAEUeIINOUe NOI?II

5.1. Ca iaaeeiiaiiy aai iaiaeaaeia aeeiiaiiy ciaiaycaiue ca Aeaiei Aeiaiai?ii noi?iie
ianooue ianooiio aiaeiiaiaeaeueiinoue:

5.1.1. IOI?IIIA OI?IA: ca eiaeia ii?ooaiiy aoaeue-yei? c oiia i.3.2 aeiea/oo oo?ao
a ?icii?i _______________________________________________________________________.

5.1.2. CAIIAIEE: ca i?ino?i/aiiy aeeiiaiiy i.4.1 CAIIAIEE aeiea/oo iaonoieeo a

?icii?i

ca eiaeai aeaiue i?ino?i/aiiy.

5.1.3.

6. OA?III AeI? AeIAIAI?O

6.1. Aeiaiai? iaae?ao /eiiinoi aiae <_ __ i aeio aei o aeiaaeeo aeiaiai iaeiioth c noi aiia ciaiaycaia iiia ienueiiai oea ae ia iiciioa iiae ca ________ iinyoey. eiia __________ iioi oiiae th aae aaieianueei iiaeiene ioi iaoeoia i. ____________> ___________ 199 __. ?.

CAIIAIEE: __________________________________________________________________,

a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai ________________________________________________________________,
c iaeiiai aieo, i

IOI?IIIA OI?IA: ___________________________________________________________,
a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai ___________________________________________________________________,
c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. CAIIAIEE aei?o/ao, a IOI?IIIA OI?IA aa?a iiae ioi?iio iaoeoe, ia?a?aoiaaii
o ia?aeieo oa ieaii (noaii) iaoeoia, yei ioi?iiythoueny, ui aeiaeathoueny aei aeiaiai?o.
1.2. Iaoeoe, ui ia?aaeathoueny iiae ioi?iio, iiaeiii aiaeiiaiaeaoe ianooiiei aeiiaai:
a) oa?eoi?iy ii ia?eiao?o iiaei?eoinoa, ae?iaie/i oeaoe, neeaaee, aace, aoaeiaaeueii iaeaeai-
/eee oa iiaenooie aei ieo, a oaeiae aio?eie iaaaceiia, aoaeueo, iaaieueeiiia oa iioi i?eiiuaiiy,
ui ioi?iiythoueny, c ianoaiiyi oai?yae iiaeiii inaioethaaoeny _________________________

aeae, oee inaioeaiiy)

uia aiie aoee aeinooiii niinoa?aaeaiith ia?yaeia ioi?iie.
Inaioeaiiy oa?eoi?i? iaoeoa, ui ioi?iiyooueny, ia caeienithooueny o aeiaaeeao

Neeaaeaiiy aoaeue-yeeo iaoa?iaeia ana?aaeeii iaoeoo, ui ioi?iiyooueny, iiaea caeienithaaoeny
ia aeeae/a _____________________________ aiae iai?iaei.

a) noiie, aeaoe, noaei, ai?euaai, neooiai aieia, ethee oa aeaa?i i?eiiuaiue, a yeeo caa?iaathoueny
oiaa?ii-iaoa?iaeueii oeiiiinoi, iathoue ciaoiaeeoeny o ni?aaiiio noaii. Ia aieiao ieaeiio iiaa?oia
ianooiieo i?eiiuaiue (ca aeiyoeii aio?eiieo aieii iaaaceiia, iiaei?eoinoa a?iiaaenueeiai
oa?/oaaiiy oa aoaeueo): ___________________________________________________________
_______________ onoaiiaeththoueny iaoaeaai a?aoe aai noaaii c caieaie. Oei a?ao oa noaaiia
ocaiaeaeoooueny CAIIAIEEII c iinoeaaeie i?aaiaie Aea?aeaaiiai iiaeaaeiiai iaaeyaeo.
a) iaoeoe iiaeiii aooe iaeaaeiaii ianooiieie oaoii/ieie caniaaie ioi?iie ___________

(caycie, neaiaeicaoeiy, i?eeaaee ioi?iiii-iiaeaaeii? neaiaeicaoei?,
inaioeaiiy, iai?iaea, caiee, canoae, oo?iieaoe, iaoaiiciaaii ai?ioa,
iaeyaeiai iaeaeai/eee, eiiiaoe aeiaeyaeo oa caa?aaeaiiy iniaenoeo ?a/ae

?iaioieeia oa neoaeaiaoeia)

oa caniaaie aeey aaniiiy iiaeaaei,

Ia iaoeoao iiaeiai aooe caaacia/aiee aieueiee aeinooi IOI?IIII? OI?IE aei onoa-
iiaeaieo i?eeaaeia ioi?iiii-iiaeaaeii? neaiaeicaoei? oa caniaia aeey aaniiiy iiaeaaei.

Oaoii/iee noai iaoeoia, ui i?eeiathoueny iiae ioi?iio, caniaia ioi?iie oa aaniiiy iiaeaaei,
aeiaeaoeiaa iio?aaa a oeeo caniaao, a oaeiae oa?iiie ?o cai?iaaaeaeaiiy cacia/athoueny a aeainoi-
?iiiueiio aeoi, ui neeaaeaooueny a iiiaio oeeaaeaiiy aeiaiai?o oa o eiai iaaiaeoiiith /anoeiith.
1.3. IOI?IIIA OI?IA niieueii ic CAIIAIEEII oa iinoeaaeie i?aaiaie Aea?aeaaiiai
iiaeaaeiiai iaaeyaeo ia ?iaeoa aeaio ?acia ia ?ie caeienitho ianoaaeaiiy oaoii/iiai noaio iaoeoia,
ui ioi?iiythoueny, caniaia ioi?iie, o oiio /enei i?eeaaeia ioi?iiii-iiaeaaeii? neaiaeicaoei?,

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Eiia?oeieiee aeiaiai?

ia?a?aoiaaieo a i.2 Aeaiiai Aeiaiai?o, i?i ui neeaaeaooueny aeo ca iiaeienii inia, oiiaiiaaaeaieo
ia oa IOI?IIIITH OI?IITH, CAIIAIEEII i iinoeaaei i?aaiii Aea?aeaaiiai iiaeaaeiiai
iaaeyaeo ic cacia/aiiyi oa?iiiia onoiaiiy CAIIAIEEII aeyaeaieo iaaeieieia i oa?iiiia
iiaiaeiieaiiy i?i oea IOI?IIII? OI?IE i iinoeaaiai i?aaio Aea?aeaaiiai iiaeaaeiiai iaaeyaeo.

1.4. Ioi?iia iaoeoia caeienithooueny a aeii oa aiaeeie, cacia/aii o ia?aeieo iaoeoia, ui
aeiaeaooueny aei aeiaiai?o.

Nenoaia ioi?iie iaoeoia i aeeneieaoeiy iinoia aecia/athoueny IOI?IIIITH OI?IITH oa
iiaiaeiieythoueny CAIIAIEEO.

1.5. Uiaeaiiee i?eeii iiae ioi?iio eiaeiiai iaoeoa oa caea/a eiai CAIIAIEEO, a oiio
/enei e iaoeoia, ui iaeaaeiaii neaiaeicaoeioth oa iiaeoaeiaii aei ioeueoia oeaio?aeiciaaiiai niinoa-
?aaeaiiy, caeienithooueny a ianooiiiio ii?yaeeo: ___________________________:__________________

1.6. Aeaciaee IOI?IIII? OI?IE c aeio?eiaiiy anoaiiaeaiiai ?aaeeio ioi?iie,
ai?iaaaeaeaiiy oa oo?eiaiiy oaoii/ieo caniaia ioi?iie o aiaeiiaiaeiinoi aei aeiia aeith/eo
iino?oeoeie, ianoaaeaiue oa iioeo aeieoiaioia o iaiayceiaeie aeey CAIIAIEEA. Iaeaaeiaiiy
iaoeoia oaoii/ieie caniaaie ioi?iie oa ?aiiio oeeo caniaia caeieniththoueny ca ?aooiie
CAIIAIEEA, ca aeiyoeii aeiaaeeia aeoiaeo ?o ic eaaeo c aeie IOI?IIII? OI?IE.
1.7. Noia aeiaiai?o ____________________________________________________________ .
Iieaoa ca ioi?iio aiaeiiaiaeii aei aecia/aieo oa?eoia caeienithooueny uiiiny/ii ieaoiaeieie
aei?o/aiiyie CAIIAIEEA, ui caeathoueny a onoaiiae aaieo ca _____iiia aei ii/aoeo ianooiiiai
iinyoey.

2. IAIAssCEE IOI?IIII? OI?IE

2.1. IOI?IIIA OI?IA ciaiaycaia:

a) i?aaiicoaaoe oa caaacia/eoe ioi?iio oiaa?ii-iaoa?iaeueieo oeiiiinoae oa a?ioiaeo
noi CAIIAIEEA, i?eeiyoeo iiae ioi?iio, aiae ?ice?aaeaiiy oa ia aeiioneaoe i?iieeiaiiy
noi?iiiio inia ia iaoeoe, ui ioi?iiythoueny;

a) caeienithaaoe ia iaoeoao ia?aionoeiaee ?aaeei, eiio?iethaaoe aaic oa aeaic (aianaiiy
oa aeianaiiy) oiaa?ii-iaoa?iaeueieo oeoiinoae ia oa?eoi?ith /e c oa?eoi?i? iaoeoa, ui ioi?i-
iyooueny, ca iaoa?iaeueieie ia?aionoeaie anoaiiaeaii? oi?ie;

a) niieueii c CAIIAIEEII caeienithaaoe aeoei? ic ai?iaaaeaeaiiy oaoii/ieo caniaia ioi?iie;
a) caeienithaaoe aenieoaoaoeieia ianeoaiaoaaiiy i?eeaaeia ioi?iiii? neaiaeicaoei? oa onoaaoe
iani?aaiinoi ca cayaith CAIIAIEEA a oaoii/ii iiaeeeaee oa?iii:

ae) caaacia/oaaoe aeio?eiaiiy anoaiiaeaieo i?aaee iiaeaaeii? aaciaee ia iinoao neeaie
i?aoeiaieeia ioi?iie iiae /an ianaiiy ieie neoaeae, a o aeiaaeeo aeyaeaiiy ia iaoeoi, ui
ioi?iiyooueny, iiaeaaei aai ni?aoeueiaoaaiiy ioi?iiii-iiaeaaeii? neaiaeicaoei? aianeiaeie oaoii/ii?
iani?aaiinoi iaaaeii iiaiaeiieyoe i?i oea a iiaeaaeio /anoeio oa aaeeaaoe caoiaeia uiaei eieaiaeaoei?
iiaeaaei oa ianeiaeeia oaoii/ii? iani?aaiinoi ioi?iiii-iiaeaaeii? neaiaeicaoei?;
a) i?eeiaoe aiae CAIIAIEEA ia/aoee i ieiiae a ianooiieo aeiaaeeao: __________

3. IAIAssCEE CAIIAIEEA

3.1. Caiiaiee ciaiaycaiee:

a) caeienithaaoe aecia/aii aeiaiai?ii aeoei? c iaeaaeiaiiy iaoeoia oaoii/ieie caniaaie
ioi?iie, noai?thaaoe iaeaaeii oiiae aeey caaacia/aiiy noi?iiiinoi oiaa?ii-iaoa?iaeueieo oeiiiin-
oae oa ni?eyoe IOI?IIIIE OI?II i?e aeeiiaiii iath nai?o caaaeaiue, a oaeiae a oaeineiiaeai-
ii i?aaiicaoei? ioi?iie iaoeoia i iie?auaiii ia?aionoeiaiai oa aioo?ioiueiiaoeoiaiai ?aaeeiia;

a) ia?aae caea/ath iaoeoa iiae ioi?iio ia?aai?yoe, uia o i?eiiuaiii, ui ioi?iiyooueny, o
ia?iai/ee /an ia caeeoeeenue noi?iiii iniae, aaiieiaii aeaeo?iaacii?eeaaee oa iioi aeaea?aea
aiaith;

a) ca/eiyoe ia caiee oa ieiiaoaaoe (iia/aooaaoe) ciaiioii aeaa?i neeaaeia, aac, ae?iaie/eo
oeaoia, iaaaceiia, aoaeueo, iaaieueeiiia oa iioeo ae?iaie/eo oa neoaeaiaeo i?eiiuaiue. Ieiiaoaaoe
(iia/aooaaoe) ca iayaiinoi oaiao?a aioo?ioii aeaa?i. Ca/eiyoe cciaii ia aeny/i caiee, ie?ii
aioo?ioiio caieia, oa ieiiaoaaoe (iia/aooaaoe) aeaa?i caianieo oiaeia.

A?ioiai eiooe, ae?iae c aei?iaioeiiiei eaiiiiyi, ic cieioa, ieaoeie oa iaeaaeith, aiaeeiieee
a cieioeo, ieaoeiiaeo oa n?iaieo ei?ionao iiaeiii caa?iaaoeny a naeoao aai iaoaeaaeo oaoao
(yueeao), i?ee?iieaieo aei iiaeeiae, a iniaeeai aei?iaieioooth/i ae?iae iiney caeii/aiiy ?iai/iai
/ano – o aiaeie?aieaieo ca/eiaieo i?eiiuaiiyo, a oaeiae ic aeio?eiaiiyi iioeo aeith/eo i?aaee;
a) onoaiiaethaaoe ia iaoeoao, aea o aioo?ioiie oaeaoiiiee caycie, oaeaoiie o iinoeyo
ciaoiaeaeaiiy iinoia; o ia?iai/ee aeey iaoeoia /an iaeei c oaeaoiiia iinueei? eiii? onoaiiaethaaoe
ia iinoei, aeinooiiiio aeey i?aoeiaieeia ioi?iie;

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Eiia?oeieiee aeiaiai?

ae) aieeaoe ioi?iiio neaiaeicaoeith iiney caeii/aiiy ?iai/iai aeiy ia iaoeoi, a o aeiaaeeo
?? iani?aaiinoi iaaaeii iiaiaeiieyoe i?i oea IOI?IIIO OI?IO oa ia caeeoaoe iaoeo aei
onoiaiiy iani?aaiinoi aai ia?aaea/i iaoeoa IOI?IIIIE OI?II o anoaiiaeaiiio ii?yaeeo,
*a?ac 5 oaeeei iiney iiaiaeiieaiiy ia ioeueo oeaio?aeiciaaii? ioi?iie i?i caea/o iaoeoa iiae
ioi?iio ia?anaiae/eoeny a oiio, ui iaoeo iiae ioi?iio i?eeiyoee.

4. AIAeIIAIAeAEUeIINOUe IOI?IIII? OI?IE

4.1. IOI?IIIA OI?IA iana iaoa?iaeueio aiaeiiaiaeaeueiinoue ca caeoie:
a) ni?e/eiaiee e?aaeiaeeaie oiaa?ii-iaoa?iaeueieo oeiiiinoae, caeieniaieie oeyoii ceiio
ia iaoeoao i?eiiuaiue, ui ioi?iiythoueny, caieia, aieii, aio?ei oa iai?iae, iioeie caniaaie a
?acoeueoaoi iacaaacia/aiiy iaeaaeii? ioi?iie aai aianeiaeie iaaeeiiaiiy IOI?IIIITH OI?-
IITH anoaiiaeaiiai ia iaoeoi, ui ioi?iiyooueny, ii?yaeeo aeaico (aeianaiiy) oiaa?ii-iaoa?i-
aeueieo oeiiiinoae, a oaeiae ?ice?aaeaiiyie, caeieniaieie oeyoii a?aaaaeo aai i?e ?icaieieoeueeiio
iaiaaei;

a) caaaeaiee cieuaiiyi aai iioeiaeaeaiiyi iaeia (a oiio /enei oeyoii iiaeiaeo) noi?ii-
iiie iniaaie, yei i?iieeee ia iaoeo, ui ioi?iiyooueny, a ?acoeueoaoi iaiaeaaeiiai aeeiiaiiy
IOI?IIIITH OI?IITH i?eeiyoeo ca aeiaiai?ii ciaiaycaiue;

a) ni?e/eiaiee iiaeaaeaie aai a neeo iioeo i?e/ei c aeie i?aoeiaieeia, ui caeieniththoue
ioi?iio iaoeoa.

Oaeoe e?aaeiaeee, a?aaaaeo, ?icaieieoeoaa, a oaeiae oaeoe cieuaiiy aai iioeiaeaeaiiy
iaeia noi?iiiiie iniaaie, yei i?iieeee ia iaoeo, ui ioi?iiyooueny, aai /a?ac iiaeaaeo aai a
neeo iioeo i?e/ei c aeie i?aoeiaieeia, ui caeieniththoue ioi?iio iaoeoia, anoaiiaeththoueny
i?aaiaie aeiciaiiy, neiaenoaa aai noaeii.

4,2. I?i oaeo ii?ooaiiy oeieiniinoi i?eiiuaiue, ui ioi?iiythoueny, aai caaaeaiiy caeoeo
iioeiaeaeaiiyi iaeia IOI?IIIA OI?IA iiaiaeiieyo a /a?aiao /anoeio i?aaio aioo?ioiio
ni?aa oa CAIIAIEEO. Aei i?eaoooy i?aaenoaaieeia i?aaio aioo?ioiio ni?aa aai neiaenoaa
IOI?IIIA OI?IA caaacia/oo iaaeioi?eaiinoue iinoey iiaei?.

Ciyooy caeeoeia oiaa?ii-iaoa?iaeueieo oeiiiinoae iiaeiii aooe caeieniaia iaaaeii iiney
i?eaoooy i?aaenoaaieeia noi?ii ia iinoea iiaei?.

4.3. Aiaeoeiaeoaaiiy CAIIAIEEO caaaeaiiai c aeie IOI?IIII? OI?IE caeoeo
caeienithooueny iiney iaaeaiiy CAIIAIEEII iinoaiiae i?aaiia aeiciaiiy, neiaenoaa aai ae?ieo
noaeo, ui anoaiiaea oaeo e?aaeiaeee, a?aaaaeo, ?icaieieoeoaa, a oaeiae oaeo cieuaiiy aai
iioeiaeaeaiiy iaeia noi?iiiiie iniaaie, yei i?iieeee ia iaoeo, ui ioi?iiyooueny, aai aianeiaeie
iiaeaaei /e a neeo iioeo i?e/ei c aeie i?aoeiaieeia, ui caeieniththoue ioi?iio iaoeoa. ?icii?
caeoeo iiaeiai aooe iiaeoaa?aeaeaiee aiaeiiaiaeieie aeieoiaioaie oa ?ic?aooieii aa?oinoi
aee?aaeaieo, cieuaieo aai iioeiaeaeaieo oiaa?ii-iaoa?iaeueieo oeiiiinoae oa aee?aaeaieo
a?ioiaeo noi, neeaaeaiei ca o/anoi IOI?IIII? OI?IE oa cai?aiei c aooaaeoa?nueeeie
aeaieie. Aei caeoeo, ui aiaeoeiaeiaoooueny, aoiaeeoue aa?oinoue aee?aaeaiiai aai iioeiaeaeaiiai
iaeia, ?icii? cieaeaiiy aa?oinoi iioeiaeaeaieo oiaa?ii-iaoa?iaeueieo oeiiiinoae, aeo?aoe,
caeieniaii ia aiaeiiaeaiiy iioeiaeaeaiiai iaeia, a oaeiae aee?aaeaii a?ioiai noie.

4.4. O aeiaaeeo aeyaeaiiy aeiieo inia iaeiiaee caeoie noyaoooueny c ieo IOI?IIIITH
OI?IITH.

5. OA?III AeI? AeIAIAI?O

5.1. Aeaiee Aeiaiai? oeeaaeaooueny oa?iiiii ia _________ i iaae?ao /eiiinoi c aeiy iiaeienaiiy.
5.2. Oni noia?a/ee ca Aeaiei Aeiaiai?ii iiaeeyaathoue ?icaycaiith o aecia/aiiio caeiiii
ii?yaeeo.

Aeiaiai? c aeiaeaoeaie neeaaeaooueny o aeaio i?eii?ieeao, c yeeo ia?oee ciaoiaeeoueny o
IOI?IIII? OI?IE, ae?oaee – o CAIIAIEEA.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia oaoii/ia ianeoaiaoaaiiy oa ?aiiio oaoiiee

i. ____________ <____> ___________ 199 ___ ?.

CAIIAIEE:

a iniai _________
ui aeio ia iiaenoaai.
c iaeiiai aieo, i

102

Eiia?oeieiee eiaiai?

AEEIIAAAOeUe:
a iniai ____________

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. CAIIAIEE aei?o/ao, a AEEIIAAAOeUe aa?a ia naaa oaoii/ia ianeoaiaoaaiiy oa
?aiiio oaoiiee aiaeiiaiaeii aei nieneo, ui aeiaeaooueny aei aeiaiai?o, ic cacia/aiiyi o iueiio iiia?ia,
oeiia oa iiaeaeae iaoei (oaoii/ieo caniaia), iinoey ?o ciaoiaeaeaiiy.

1.2. Aei ianeoaiaoaaiiy i?eeiathoueny iaoeie oa oaoii/ii caniae, ui ciaoiaeyoueny a
aenieoaoaoei? o ni?aaiiio noaii. Oaoii/iee noai iaoei oa oaoii/ieo caniaia aecia/aooueny
i?aaenoaaieeaie AEEIIAAOess o i?enooiinoi i?aaenoaaieea CAIIAIEEA.

1.3. CAIIAIEE ciaiaycaiee aeeiioaaoe ani aeaciaee iaoaiiea AEEIIAAOess c i?aaeeueii?
aenieoaoaoei? oa caa?aaeaiiy iaoei oa aeiioneaoe aei ?iaioe ia ieo eeoa i?aoeiaieeia, yei
i?ieoee niaoeiaeueiee eo?n iaa/aiiy. Ia?niiae CAIIAIEEA, ui aenieoaooo iaoeie,
ciaiaycaiee oaeiae aeeiioaaoe i?aaeea aenieoaoaoei?, cai?iiiiiaaii caaiaeii-aeaioiaethaa/ai.
O aeiaaeeo ii?ooaiiy aeaiiai ioieoo Aeaiiai Aeiaiai?o AEEIIAAAOeUe ia iana aiaeiiaiaeaeueiinoi
ca ?iaioo iaoei oa oaoii/ieo caniaia.

2. II?ssAeIE OAOII*IIAI IANEOAIAOAAIIss I ?AIIIOO OAOIIEE

2.1. Oaoii/ia ianeoaiaoaaiiy i ae?iaiee ?aiiio caeieniththoueny ia iinoei o CAIIAIEEA oa
aae?athoue a naaa __________________________________________________________________

(cacia/eoe ia?aeie ?iaio c oaoii/iiai ianeoaiaoaaiiy oa ae?iaiiai ?aiiioo)

2.2. Na?aaeiie oa eaiioaeueiee ?aiiio iaoei oa oaoii/ieo caniaia caeienithooueny ia
iiaei?eoinoai AEEIIAAOess.

I?eiioea: aeiaiai?ii iiaea aooe ia?aaeaa/aii, ui caeieniaiiy na?aaeiueiai oa eaiioaeueiiai
?aiiioo AEEIIAAAOeUe ia naaa ia aa?a.

2.3, CAIIAIEE ciaiaycaiee aeaeieeoe aeey cayceo c AEEIIAAOeAI i aeey ioi?ieaiiy
iaiaoiaeii? aeieoiaioaoei? aiaeiiaiaeaeueio iniao ca iinoeai ciaoiaeaeaiiy iaoei i oaoii/ieo caniaia,
ui ianeoaiaothoueny.

2.4. CAIIAIEE iao i?aai aeeeeeaoe iaoaiiea AEEIIAAOess a onio aeiaaeeao coieiee
iaoei (oaoii/ieo caniaia) /a?ac iani?aaiinoue. Iaoaiie AEEIIAAOess ciaiaycaiee cyaeoeny
aei CAIIAIEEA ia iiciioa ___________ aiaeei c iiiaioo aeeeeeo.

2.5. I?e ciiii eieueeinoi aeeth/aieo aei nieneo ia oaoii/ia ianeoaiaoaaiiy oa ?aiiio
iaoei (oaoii/ieo caniaia) o aie caieueoaiiy aai ciaioaiiy CAIIAIEE ciaiaycaiee iaaaeii
iiaiaeiieoe i?i oea AEEIIAAOess aeey aianaiiy aiaeiiaiaeieo ciii aei aeiaiai?o. Ianeoaiaoaaiiy
oa ?aiiio iaoei (oaoii/ieo caniaia), ciiao aeeth/aieo aei nieneo, caeienithooueny ia oiiaao
Aeaiiai Aeiaiai?o.

2.6. Iaoaiie AEEIIAAOess i?e eiaeiiio aiaeaiaeaiii CAIIAIEEA ia?aaeao eiai
i?aaenoaaieeo niaoeiaeueio ea?oeo, a yeie inoaiiie i?inoaaeyo aeaoo aiaeaiaeaiiy, /an i?eaoooy oa
aiaeaoooy i caai?yo cacia/aii aeaii nai?i iiaeienii.

2.7. O aeiaaeeo iinoieii? i?enooiinoi iaoaiiea AEEIIAAOess o iinoei ciaoiaeaeaiiy iaoei
(oaoii/ieo caniaia), ui ianeoaiaothoueny, aii iiaeei?yooueny i?aaeeai o?oaeiaiai ?icii?yaeeo, ui
aeithoue ia iiaei?eoinoai CAIIAIEEA.

2.8. AEEIIAAAOeUe aa?aiooo aacia?aaieio ?iaioo iaoei (oaoii/ieo caniaia), ui
ianeoaiaothoueny, i iana aiaeiiaiaeaeueiinoue ca ii?ooaiiy ii?iaeueii? ?o ?iaioe eeoa a oiio
aeiaaeeo, yeui CAIIAIEEII aeeiioooueny ioieo 1.3 Aeaiiai Aeiaiai?o.

3. AA?OINOUe IANEOAIAOAAIIss OA ?AIIIOO, II?ssAeIE ?IC?AOOIEIA

3.1. CAIIAIEE iiea/oo AEEIIAAOeTH ca oaoii/ia ianeoaiaoaaiiy oa ?aiiio iaoei i
oaoii/ieo caniaia ____________________________________________________________________

(cacia/aooueny ii?yaeie, oa?iiie, ?icii? iieaoe

ca oaoii/ia ianeoaiaoaaiiy oa ?aiiio)

3.2. Iieaoa ca oaoii/ia ianeoaiaoaaiiy oa ?aiiio iaoei (oaoii/ieo caniaia), ia aeeth/aieo
aei nieneo, ui aeiaeaooueny aei aeiaiai?o, iaoiiaethooueny aeiaeaoeiaeie oaiaeaie.

3.3. O aeiaaeeo ii?ooaiiy CAIIAIEEII oa?iiiia ieaoaaeo AEEIIAAAOeUe iao i?aai
i?ecoieieoe oaoii/ia ianeoaiaoaaiiy iaoei oa oaoii/ieo caniaia aei nieaoe caai?aiaaiinoi.

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Eiia?oeieiee aeiaiai?

4. OA?III AeI? AeIAIAI?O

4.1 .Aeaiee Aeiaiai? oeeaaeaiee ia oa?iii aiae <_____>__________199__?. aei<____>
________________ 199 __ ?.

4.2. Aeiaiai? iiaea aooe ?ici?aaiee aei caeii/aiiy oa?iiio c iiia?aaeaeaiiyi iaeiio? c
noi?ii ca _________ iinyoeia.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

___________________________________?icaeie 7____________________________________

I?AIAeA, EICIIA

Ca aeiaiai?ii i?aiaee (iaeiiaiai iaeio) I?AIAeIAeAAAOeUe (iaeiiaeaaaoeue) ciaiaycoooueny
iaaeaoe I?AIAeA?AAI (iaeia/aai) iaeii a oei/aniaa aieiaeiiiy aai ei?enooaaiiy ca ieaoo
aeey naiinoieiiai caeieniaiiy iiaei?eoiieoeueei? aeiyeueiinoi oa iioeo oeieae.

I?iaeoeoeiy, ieiaee oa iioi aeioiaee, io?eiaii I?AIAeA?AI a ?acoeueoaoi aeeiiaiiy i?aiaeiiai
iaeia o aiaeiiaiaeiinoi aei aeiaiai?o, o eiai aeaniinoth. I?AIAeIAeAAAOeUe aiaeiiaiaeao ca iaaeieiee
caeaiiai a i?aiaeo iaeia, ui ia?aoeiaeaeathoue ei?enooaaiith iei, iaaioue yeui iiae /an oeeaaeaiiy
aeiaiai?o ia ciaa i?i oei iaaeieiee. Aeeiiaii I?AIAeAOI?II iie?auaiiy i?aiaeiaaiiai iaeia,
yei iiaeia aiaeie?aieoe, o eiai aeaniinoth, yeui iioa ia ia?aaeaa/aii aeiaiai?ii.

O aeiaaeeo, eiee I?AIAeAOI? aeeiiaa ca naie ?aooiie i ca caiaeith I?AIAeIAeAAOess
iie?auaiiy, yei ia aiaeie?aieththoueny aac oeiaee aeey i?aiaeiaaiiai iaeia, aii iao i?aai iiney
i?eieiaiiy aeiaiai?o ia aiaeoeiaeoaaiiy aa?oinoi oeeo iie?auaiue, ineieueee iioiai ia ia?aaeaa/aii
aeiaiai?ii. Aa?oinoue iie?auaiue, ui ia aiaeie?aieththoueny, yei aeeiiaii I?AIAeA?AI aac caiaee
I?AIAeIAeAAOess, aiaeoeiaeoaaiith ia iiaeeyaao, yeui iioa ia ia?aaeaa/aii caeiiiaeaa/eie aeoaie.

Ia?aoiae i?aaa aeaniinoi (iiaiiai ainiiaea?/iai aiaeaiiy i iia?aoeaiiai oi?aaeiiiy) ia
caeaia a i?aiaeo iaeii aei iioi? iniae ia o iiaenoaaith aeey ciiie aai ?ici?aaiiy aeiaiai?o i?aiaee.

Ii caeii/aiith no?ieo i?aiaee I?AIAeA?, ui iaeaaeiei /eiii aeeiiaa nai? iaiaycee,
iao ca iioeo ?iaieo oiia ia?aaaaeia ia?aae iioeie iniaaie i?aai ia iiiiaeaiiy aeiaiai?o.
?iciiaeaeia aeiaiai?o i?aiaee inioo o aeieiaiio iaiao aeineoue aaaaoi.

Eiciia – oea iniaeeaee aeiaiai? i?aiaee, ui ia?aaeaa/ao iaaeaiiy EICIIAIAeAAOeAI
(I?AIAeIAeAAOeAI) EICIIAIIAeA?AEOAA*AAI (I?AIAeAOI?O) iaeaaeieo eiio iaeaaeiaiiy,
iaoei, AII, i?aoaoiiee, o?ainii?oieo caniaia, aoaeiaaeue ae?iaie/iai, oi?aiaiai oa neeaaenueeiai
i?ecia/aiiy o aeeeth/ia ei?enooaaiiy ia anoaiiaeaiee oa?iii ca iaaio aeiaai?iaeo – i?aiaeio
ieaoo, yea aeeth/ao i?ioeaioio noaaeo, ui iie?eaao aa?oinoue caeo/aiiy eiooia I?AIAeIAeAA-
OeAI ia a?ioiaiio ?eieo c o?aooaaiiyi iaiaoiaeiiai i?eaooeo aaieo, oa aii?oecaoeith iaeia.

Eiciiaiai iia?aoei? i?e?iaiththoueny aei e?aaeeoieo iia?aoeie c oniia ii?iaie oa i?aaaie, ui
c oeueiai aeieeaathoue.

Eiciia aiae?iciyooueny aiae e?aaeeoo oei, ui iiney caeii/aiiy no?ieo eiciiao i nieaoe anio?
iaoiiaeaii? noie aeiaiai?o iaoeo eiciiao caeeoaooueny aeaniinoth EICIIAIAeAAOess (yeui
aeiaiai?ii ia ia?aaeaa/aii aeeoi iaoeoa eiciiao ca caeeoeiaith aa?oinoth aai ia?aaea/a o aeaniinoue
EICIIAIIAeA?AEOAA*A).

Aeayei aa?iaioe niia?iaioieoeoaa noi?ii aeiaiai?o i?e eiciiao:

I. I?AIAeAOI? iiaea aeae?aoe iaiaoiaeiee oiaa? o iinoa/aeueieea i iioii caa?iooeny aei
I?AIAeIAeAAOess, yeee eoioo aiae naiai iiaii i ca naie ?aooiie oeae oiaa? i caeao eiai a i?aiaeo
I?AIAeAOI?O.

2. I?AIAeAOI? aaciina?aaeiuei caa?oaooueny aei I?AIAeIAeAAOess c oei, uia aeei?enoaoe
eiai iio-oao i?e ae?ioaiii oaoii/ieo ieoaiue, ?ic?iaoei oiai /e iioiai oiaa?o (iae/anoioa i?e
eiciiao iiai? ia?ooiiinoi). O oeueiio aeiaaeeo I?AIAeIAeAAAOeUe eoioo iaoeo eiciiao, ui o
iiaei i iiaea aooe aeei?enoaiei, i caeao eiai a i?aiaeo I?AIAeAOI?O.

3. Ae?iaiee niia?iaioii/ao c eiciiaiaith eiiiaiioth i, i?iaiaey/e ia?aaiai?e c eeioioii,
aeao iiaeeeainoue eiciiaiaie eiiiaii? eoieoe aiaeia?aiee oiaa? i caeaoe eiai a i?aiaeo caoeieaaeaiiio
eeioioo.

104

Eiia? oeieiee eiaia i ?

AeIAIAI?
i?aiaee aoaeeieo, nii?oaee
(iioiai iaoeoa ia?ooiiinoi)

199___?.

I?AIAeIAeAAAOeUe:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

I?AIAeA?: ________________________
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I?AIAeIAeAAAOeUe ia?aaeao, a I?AIAeA? aa?a o oei/aniaa aieiaeiiiy ianooiio nii?oaeo

(aeaei ca oaenoii – ):

1.1. Iaoeo, ui i?aiaeoooueny, yaeyo niaith aoaeeiie, ui noi?oue ie?aii, c iiaeniaieie (aeiii-
iiaeieie) nii?oaeaie.

1.2. Aae?ana: ___________________________________________________________________.
1.3. Caaaeueia ieiua: ___________________________________________________________ .
1.4. Ieiua iiaeaaeueieo i?eiiuaiue: ______________________________________________ .
1.5. ?icii? caiaeueii? aeieyiee, ui ia?aaeaooueny o ei?enooaaiiy ?acii c iaoeoii, ui

i?aiaeoooueny: _______________________________________________________________________.
1.6. Aa?oinoue iaoeoa, ui i?aiaeoooueny: _____________________________________________ .
1.7. Eieueeinoue iiaa?oia: _________________________________________________________ .
1.8. Noai iaoeoa, ui i?aiaeoooueny, ia iiiaio ia?aaea/i a i?aiaeo: ___________________ .
1.9. Iaaeieiee iaeia, ui i?aiaeoooueny: _____________________________________________

1.10. Noiooii nii?oaee oa iiaeniaii i?eiiuaiiy caaaeueiith ieiuath:

1.__________________________________________________________

2._______________________________________________________

ea.i.
ea.i.

2. IAOA I?AIAeE

3. II?ssAeIE IA?AAeA*I IAoEOA A I?AIAeO

3.1. I?eeiaiiy-ia?aaea/a iaoeoa, ui i?aiaeoooueny, caeienithooueny aeainoi?iiiueith eiiinioth,
ui neeaaeaooueny ic i?aaenoaaieeia noi?ii.

3.2. Noi?iie iiaeiii i?ecia/eoe nai?o i?aaenoaaieeia o aeainoi?iiith eiiinith oa i?enooieoe
aei ia?aaea/i iaoeoa, ui i?aiaeoooueny, i?ioyaii ________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o.

3.3. I?ioyaii oa?iiio ca i.3.2 Aeaiiai Aeiaiai?o I?AIAeIAeAAAOeUe iiaeiai ae?oaoe c
iaoeoa, ui i?aiaeoooueny, oa iiaeaiooaaoe eiai aei ia?aaea/i I?AIAeA?TH.

3.4. Iaoeo, ui i?aiaeoooueny, iiaeiai aooe ia?aaeaiee I?AIAeIAeAAOeAI oa i?eeiyoee
I?AIAeA?AI i?ioyaii _____________ c iiiaioo ii/aoeo ?iaioe aeainoi?iiiuei? eiiini?.

3.5. I?e ia?aaea/i iaoeoa, ui i?aiaeoooueny, neeaaeaooueny aeo caea/i-i?eeiaiiy, yeee iiaeieno-
ooueny /eaiaie aeainoi?iiiuei? eiiini?.

3.6. Iaoeo, ui i?aiaeoooueny, aaaaeaooueny ia?aaeaiei a i?aiaeo c iiiaioo iiaeienaiiy aeoo
caea/i-i?eeiaiiy.

4. OA?III I?AIAeE

4.1. Oa?iii i?aiaee neeaaeao _________ ?ieia c iiiaioo i?eeiyooy iaoeoa, ui i?aiaeoooueny,
ca aeoii caea/i-i?eeiaiiy.

4.2. sseui aeiaeia noi?iia a oa?iii ________ aei caeii/aiiy Aeaiiai Aeiaiai?o ia cayaeoue
i?i iaii? eiai ?ici?aaoe, Aeaiee Aeiaiai? aaoiiaoe/ii i?ieiiaoooueny ia oa?iii __________ .
4.3. Oa?iii i?aiaee iiaea aooe nei?i/aiee eeoa ca caiaeith noi?ii.
4.4. I?AIAeA? iao i?aai aiaeiiaeoeny aiae Aeaiiai Aeiaiai?o, iiia?aaeeaoe I?AIAeIAeAAOess
a oa?iii __________, i?e oeueiio niea/aia iaia?aae i?aiaeia ieaoa I?AIAeA?TH ia iiaa?oaooueny.

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Eiia?oeieiee aeiaiai?

5. I?AIAeIA IEAOA OA II?ssAeIE ?IC?AOOIEIA

5.1. ?icii? i?aiaeii? ieaoe ca aanue iaoeo, ui i?aiaeoooueny, a oeieiio neeaaeao

e?a. ca

(oa?iii)

5.2. I?aiaeia ieaoa niea/oooueny a aacaioiaeiaiio ii?yaeeo ia ?ic?aooieiaee ?aooiie
I?AIAeIAeAAOess iaia?aae ia iiciioa _______ /enea eiaeiiai ___________________ (iinyoey,
eaa?oaea, iia?i//y).

5.3. I?AIAeA? ciaiaycaiee i?ioyaii ____________ c iiiaioo i?eeiyooy iaoeoa, ui
i?aiaeoooueny, ia?a?aooaaoe i?aiaeio ieaoo ca .___________________________________________

(oa?iii)

aaainii.

5.4. ?icii? i?aiaeii? ieaoe iiaea ia?aaeyaeaoeny noi?iiaie 1 ?ac i?ioyaii _____________
Ca CAIAeITH NOI?iI. (oa?iii)
(Aa?iaio: ?icii? i?aiaeii? ieaoe o oieniaaiei oa ia?aaeyaeo ia iiaeeyaao).

5.5. I?aiaeia ieaoa ca ocaiaeaeaiiyi noi?ii iiaea aiineoeny a iaoo?aeueiie aai ciioaiie
oi?ii i?iaeoeoaie oa?/oaaiiy, oiaa?aie, iineoaaie.

5.6. I?AIAeA? iao i?aai aiineoe i?aiaeio ieaoo iaia?aae ca aoaeue-yeee oa?iii a ?icii?i,
ui aecia/aooueny ia iiiaio iieaoe. O oeueiio aeiaaeeo ii?yaeie ia?aaeyaeo i?aiaeii? ieaoe ca
i.5.4 Aeaiiai Aeiaiai?o ia oa?iii iieaoe ia canoiniaoooueny.

6. I?AAA OA IAIAssCEE I?AIAeIAeAAOess

6.1. I?AIAeIAeAAAOeUe iao i?aai 1 (iaeei) ?ac ia eaa?oae caeienithaaoe ia?aai?eo ii?yaeeo
aeei?enoaiiy I?AIAeA?AI iaoeoa, ui i?aiaeoooueny, o aiaeiiaiaeiinoi aei oiia Aeaiiai Aeiaiai?o.
6.2. I?AIAeIAeAAAOeUe ca Aeaiei Aeiaiai?ii ao?a/ao i?aai ?icii?yaeaeaiiy iaoeoii, ui
i?aiaeoooueny, ia oa?iii i?aiaee aac ienueiiai? caiaee I?AIAeA?ss.

7. I?AAA OA IAIAssCEE I?AIAeA?ss

7.1. I?AIAeA? ciaiaycoooueny:
– aeei?enoiaoaaoe iaoeo, ui i?aiaeoooueny, ca eiai oeieueiaei i?ecia/aiiyi o aiaeiiaiaeiinoi

aei i.2 Aeaiiai Aeiaiai?o;

– naio/anii caeienithaaoe i?aiaeii ieaoaaei;

– naiinoieii i ca aeaniee ?aooiie caeienithaaoe eaiioaeueiee ?aiiio iaoeoa, ui

i?aiaeoooueny, i?ioyaii oa?iiio i?aiaee;

– ianoe ani aeo?aoe c aenieoaoaoei? iaoeoa, ui i?aiaeoooueny;
– oo?eioaaoe iaoeo, ui i?aiaeoooueny, o iiaiie ni?aaiinoi;

– caeienithaaoe ca aeaniee ?aooiie iioi/iee ?aiiio iaoeoa, ui i?aiaeoooueny, a oa?iii

– ia caeienithaaoe aac ienueiiai? caiaee I?AIAeIAeAAOess ia?aaoaeiao, aeiaoaeiao oa ia?aieaio-
aaiiy iaoeoa, ui i?aiaeoooueny;

– iiaeo?eioaaoe oa?eoi?i?, i?eeaaei aei iaoeoa, ui i?aiaeoooueny, oa caiaeueio aeieyieo o
iaeaaeiiio naiioa?iiio noaii;

– ca aeaniee ?aooiie onoaaoe iani?aaiinoi oa iieiiee eiioiieaoeie iaoeoa, ui i?aiaeo-
ooueny;

– cano?aooaaoe iaoeo, ui i?aiaeoooueny, ia oa?iii i?aiaee c onio cae/aeii i?eeiyoeo
?eceeia;

– aacai?iiia aeiioneaoe ia iaoeo, ui i?aiaeoooueny, i?aaenoaaieeia I?AIAeIAeAAOess c
iaoith ia?aai?ee eiai aeei?enoaiiy o aiaeiiaiaeiinoi aei oiia Aeaiiai Aeiaiai?o;

– ianoe iioi iaiaycee ye aieiaea? iaoeoa, ui i?aiaeoooueny:

7.2. I?AIAeA? iao i?aai:

– iaeaaeiaoe iaoeo, ui i?aiaeoooueny, ia aeaniee ?icnoae;

– oii?yaeeoaaoe oa?eoi?ith, i?eeaaeo aei iaoeoa, ui i?aiaeoooueny, ia aeaniee ?icnoae;

– caeaaaoe iaoeo, ui i?aiaeoooueny, o noai?aiaeo ca caiaee I?AIAeIAeAAOess.

7.3. I?AIAeA? naiinoieii i aiae aeaniiai iiaii oeeaaeao aeiaiai?e ia iaaeaiiy eiioiaeueieo
iineoa o iiaiiio ianyci ic niaoeiaeiciaaieie i?aaiicaoeiyie.

8. II?ssAeIE IIAA?IAIIss I?AIAeIAeAAOeTH IAoEOA, UI I?AIAeOoOUeNss

8.1. Iiaa?iaiiy I?AIAeIAeAAOeTH iaoeoa, ui i?aiaeoooueny, caeienithooueny aeainoi?iiiueith
eiiinioth, ui neeaaeaooueny ic i?aaenoaaieeia noi?ii.

106

Eiia?oeieiee aeiaiai?

8.2. Noi?iie iiaeiii i?ecia/eoe nai?o i?aaenoaaieeia o aeainoi?iiith eiiinith oa i?enooieoe
aei ia?aaea/i iaoeoa, ui i?aiaeoooueny, i?ioyaii ________ c iiiaioo caeii/aiiy oa?iiio i?aiaee.

8.3. I?ioyaii oa?iiio ca i.8.2 Aeaiiai Aeiaiai?o I?AIAeA? ciaiaycaiee ae?oaoe c iaoeoa,
ui i?aiaeoooueny, oa iiaeaiooaaoe eiai aei ia?aaea/i I?AIAeIAeAAOeTH.

8.4. Iaoeo, ui i?aiaeoooueny, iiaeiai aooe ia?aaeaiee I?AIAeA?AI oa i?eeiyoee
I?AIAeIAeAAOeAI i?ioyaii __________ c iiiaioo ii/aoeo ?iaioe aeainoi?iiiuei? eiiini?,

8,5, I?e ia?aaea/i iaoeoa, ui i?aiaeoooueny, neeaaeaooueny aeo caea/i-i?eeiaiiy, yeee
iiaeienoooueny /eaiaie aeainoi?iiiuei? eiiini?.

8.6. Iaoeo, ui i?aiaeoooueny, aaaaeaooueny oaeoe/ii ia?aaeaiei I?AIAeIAeAAOeTH c iiiaioo
iiaeienaiiy aeoo caea/i-i?eeiaiiy.

8.7. Iaoeo, ui i?aiaeoooueny, iiaeiai aooe ia?aaeaiee I?AIAeIAeAAOeTH o oiio ae noaii,
a yeiio aii aoa ia?aaeaiee a i?aiaeo c o?aooaaiiyi ii?iaeueiiai ciino.

8.8. Caeieniaii I?AIAeA?AI aiaeaeieueii iie?auaiiy iaoeoa, ui i?aiaeoooueny, o aeaniinoth
I?AIAeA?ss.

8.9. O aeiaaeeo, eiee I?AIAeA? caeieniea ca aeaniee ?aooiie oa ca caiaeith I?AIAeIAeAAOess
iie?auaiiy, iaaiaeaeieueii aac oeiaee aeey iaoeoo, ui i?aiaeoooueny, aii ______________________

(iao, ia iao)

i?aai iiney i?eieiaiiy aeiaiai?o ia aiaeoeiaeoaaiiy aa?oinoi oeeo iie?auaiue.

9. AIAeIIAIAeAEUeIINOUe NOI?II

9.1. I?AIAeA? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy a i?eeiyooi iaoeoa, ui i?aiaeoooueny, iaiy a ?icii?i ____

____________ aiae aa?oinoi iaoeoa ca eiaeai aeaiue i?ino?i/aiiy;
– o aeiaaeeo i?ino?i/aiiy ii nieaoi i?aiaeieo ieaoaaeia iaiy a ?icii?i ______________

aiae noie ai?ao ca eiaeai aeaiue i?ino?i/aiiy;
– o aeiaaeeo iaoeieueiaiai aeei?enoaiiy iaoeoa, ui i?aiaeoooueny, oo?ao o ?icii?i _________

aiae noie aeiaiai?o;
– ca ia?aaea/o iaoeoa, ui i?aiaeoooueny, aai eiai /anoeie a noai?aiaeo aac ienueiiai? i

iiia?aaeiuei? caiaee I?AIAeIAeAAOess oo?ao a ?icii?i ______._________ aiae noie aeiaiai?o.
9.2. I?AIAeIAeAAAOeUe iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy ii caea/i I?AIAeA?TH iaoeoa, ui i?aiaeoooueny, iaiy a ?icii?i

__________________ aiae eiai aa?oinoi ca eiaeai aeaiue i?ino?i/aiiy.

10. IIAeNOAAE AeINO?IEIAIAI ?ICI?AAIIss AeAIIAI AeIAIAI?O

10.1. Aeaiee Aeiaiai? ?ici?aaiith a iaeiinoi?iiiueiio ii?yaeeo ia iiaeeyaao, ca aeiyoeii
aeiaaeeia, eiee iaeia ic noi?ii nenoaiaoe/ii ii?oooo oiiae Aeaiiai Aeiaiai?o i nai? ciaiaycaiiy.
10.2. Iioi iiaenoaae:

11. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

12. IIOI OIIAE

12.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? ic
noi?ii.

12.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iia-
aeyinueeei caeiiiaeaanoaii.

12.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

12.4. Ani aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii o eiaeiiio ie?aiiio aeiaaeeo.

13. AeIAeAOEE AeI AeAIIAI AeIAIAI?O
13.1. Aei Aeaiiai Aeiaiai?o aeiaeaooueny:

13.2. Aeiaeaoee aei Aeaiiai Aeiaiai?o neeaaeathoue eiai iaaiaeoiio /anoeio.
TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

107

Eiia?oeieiee aeiaiai?

AeIAIAI?
i?aiaee eiiiaoe aeey ioino iaeiai iiaei?eoinoaa

i. ____________ <____> ___________ 199 ___ ?.

I?AIAeIAeAAAOeUe:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

I?AIAeA?: _______________________
a iniai aee?aeoi?a

ui aeio ia iiaenoaai aeiai?aiinoi ? __________ aiae <_____> ____________ 199__?., c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I?AIAeIAeAAAOeUe ia?aaeao, a I?AIAeA? aa?a o oei/aniaa aieiaeiiiy ianooiia i?eiiuaiiy
(aeaei ca oaenoii – ):
1.1. Aae?ana aoaeeieo, a yeiio ciaoiaeeoueny i?eiiuaiiy, ui i?aiaeoooueny: _____________

1.2. Caaaeueia ieiua i?eiiuaiiy, ui i?aiaeoooueny: _____________________________ ea.i.
1.3. Iiia? eiiiaoe: _________________________ . Iiaa?o: _________________________ .
1.4. Noai i?eiiuaiiy, ui i?aiaeoooueny, ia iiiaio ia?aaea/i a i?aiaeo: i?eaeaoia aeey

aeei?enoaiiy ca i.2 Aeaiiai Aeiaiai?o. .
1.5. Iaaeieiee i?eiiuaiiy, ui i?aiaeoooueny, ia iiiaio ia?aaea/i a i?aiaeo: i?eiiuaiiy

iio?aaoo iioi/iiai ?aiiioo.
1.6. I?AIAeA?TH ia oa?iii aei? Aeaiiai Aeiaiai?o iaaeaooueny o ei?enooaaiiy 1 (iaeei)

oaeaoiiiee iiia?: ? _____________________ .

1.7. A i?aiaeo oaeiae caeaooueny ianooiia iaeii, yea ciaoiaeeoueny o i?eiiuaiii, ui i?aiaeo-
ooueny: _________________________________________________________________________.

2. IAOA I?AIAeE
I?eiiuaiiy, ui i?aiaeoooueny, iaaeaooueny I?AIAeA?TH aeey ?iciiuaiiy aeieiaiai ioino.

3. II?ssAeIE IA?AAeA*I I?EIIUAIIss A I?AIAeO

3.1. I?eiiuaiiy oa iaeii, ui i?aiaeothoueny, iiaeiii aooe ia?aaeaii I?AIAeIAeAAOeAI
oa i?eeiyoi I?AIAeA?AI i?ioyaii ______________ c iiiaioo oeeaaeaiiy Aeaiiai Aeiaiai?o.

3.2. I?ioyaii oa?iiio ca i.3.1 Aeaiiai Aeiaiai?o I?AIAeIAeAAAOeUe ciaiaycaiee ae?oaoe
ic i?eiiuaiiy, ui i?aiaeoooueny, oa iiaeaiooaaoe eiai aeey ia?aaea/i I?AIAeA?TH.

3.3. Ia?aaea/a i?eiiuaiiy i iaeia, ui i?aiaeothoueny, caeienithooueny ca aeoii caea/i-i?eeiaiiy,
iiaeienaiiy yeiai naiae/eoue i?i oaeoe/io ia?aaea/o oaeeo a i?aiaeo.

3.4. O iiiaio iiaeienaiiy aeoo i?eeiaiiy I?AIAeIAeAAAOeUe ia?aaeao I?AIAeA?TH eeth/i
aiae i?eiiuaiiy, ui i?aiaeoooueny, iiney /iai ia?niiaeo I?AIAeA?ss iao aooe caaacia/aiee
aacia?aoeiaeiee aeinooi o i?eiiuaiiy, ui i?aiaeoooueny.

4. OA?III I?AIAeE

4.1. Oa?iii i?aiaee neeaaeao ___________ ?ieia c iiiaioo i?eeiyooy i?eiiuaiiy, ui
i?aiaeoooueny, ca aeoii i?eeiaiiy.

4.2. sseui aeiaeia noi?iia a oa?iii ___________ aei caeii/aiiy Aeaiiai Aeiaiai?o ia cayaeoue
i?i iaii? eiai ?ici?aaoe. Aeaiee Aeiaiai? aaoiiaoe/ii i?ieiiaoooueny ia oa?iii __________ .
4.3. I?AIAeA? iao i?aai aiaeiiaeoeny aiae Aeaiiai Aeiaiai?o, “iia?aaeeaoe I?AIAeIAeAAOess
a oa?iii __________. I?e oeueiio niea/aia iaia?aae i?aiaeia ieaoa I?AIAeA?TH ia iiaa?oaooueny.

5. I?AIAeIA IEAOA OA II?ssAeIE ?IC?AOOIEIA

5.1. ?icii? i?aiaeii? ieaoe neeaaeao (c o?aooaaiiyi IAeA);_______________________e?a.
ca 1 (iaeei) ea.i. ia iinyoeue.

5.2. I?aiaeia ieaoa niea/oooueny a aacaioiaeiaiio ii?yaeeo ia ?ic?aooieiaee ?aooiie
I?AIAeIAeAAOess iaia?aae ia iiciioa __________ /enea eiaeiiai __________________ iinyoey.
5.3. I?AIAeA? ciaiaycaiee i?ioyaii ____________ c iiiaioo i?eeiyooy i?eiiuaiiy
oa iaeia, ui i?aiaeothoueny, ia?a?aooaaoe i?aiaeio ieaoo ca _______________________ aaainii.
5.4, ?icii? i?aiaeii? ieaoe iiaea ia?aaeyaeaoeny noi?iiaie eeoa o aeiaaeeo ciiie ?icii?o
eiioiaeueieo ieaoaaeia.

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5.5. I?aiaeia ieaoa ca ocaiaeaeaiiyi noi?ii iiaea aiineoeny a iaoo?aeueiie aai ciioaiie
oi?ii i?iaeoeoaie oa?/oaaiiy, oiaa?aie, iineoaaie.

5.6. I?AIAeA? iao i?aai aiineoe i?aiaeio ieaoo iaia?aae ca aoaeue-yeee oa?iii o ?icii?i,
ui aecia/aooueny ia iiiaio iieaoe. O oeueUeio aeiaaeeo ii?yaeie ia?aaeyaeo i?aiaeii? ieaoe ca
i.5.4 Aeaiiai Aeiaiai?o ia oa?iii iieaoe ia canoiniaoooueny.
5.7. Aa?oinoue eiioiaeueieo iineoa aoiaeeoue aei i?aiaeii? ieaoe.

5.8. Ani aeo?aoe ca ei?enooaaiiy oaeaoiiaie iiea/othoueny I?AIAeA?AI naiinoieii
caiaeii c ?aooieaie oaeaoiiii? noaioei? ia iaaeaiee o ei?enooaaiiy oaeaoii.

5.9. Iioi aeaee ieaoaaeia, ia ocaiaeaeaii o Aeaiiio Aeiaiai?i, I?AIAeA?AI ia iiea/othoueny.

6. I?AAA OA IAIAssCEE I?AIAeIAeAAOess

6.1. I?AIAeIAeAAAOeUe ciaiaycaiee:

– caaacia/oaaoe aacia?aoeiaeia aeei?enoaiiy I?AIAeA?AI i?eiiuaiiy, ui i?aiaeoooueny,
ia oiiaao Aeaiiai Aeiaiai?o;

– caaacia/eoe ia?niiaeo I?AIAeA?ss aacia?aoeiaeiee aoiae aei aoaeeieo, a yeiio ciaoi-
aeeoueny i?eiiuaiiy, ui i?aiaeoooueny;

– aeaeaaaoe I?AIAeA?TH aeieoiaioe, yei naiae/aoue i?i oeeaaeaiiy iiae noi?iiaie Aeaiiai
Aeiaiai?o, a oaeiae iiaeoaa?aeaeothoue eiai iinoeaciaoiaeaeaiiy;

– aeaeaaaoe o iaiaoiaeiie eieueeinoi ca cayaeaie I?AIAeA?ss iinoieii oa ?aciai ia?aionoee
aei aoaeeieo, aea ?iciiuaia i?eiiuaiiy, ui i?aiaeoooueny;

– ca aeaniee ?aooiie onoaaoe iani?aaiinoi, iieiiee oa ianeiaeee aaa?ie eiioiieaoeie o
i?eiiuaiii, ui i?aiaeoooueny, yei aiaeaoeeny ia c aeie I?AIAeA?ss.

7. I?AAA OA IAIAssCEE I?AIAeA?ss
7.1. I?AIAeA? ciaiaycoooueny:
– aeei?enoiaoaaoe i?eiiuaiiy, ui i?aiaeoooueny, aeeeth/ii ca eiai oeieueiaei i?ecia/aiiyi

o aiaeiiaiaeiinoi aei i.2 Aeaiiai Aeiaiai?o;

– naio/anii caeienithaaoe i?aiaeii ieaoaaei;

– oo?eioaaoe i?eiiuaiiy, ui i?aiaeoooueny, o iaeaaeiiio naiioa?iiio noaii;
– aeio?eioaaoeny i?ioeiiaeaaeieo i?aaee, a oaeiae i?aaee ei?enooaaiiy oaieiaith oa

aeaeo?e/iith aia?aioth, ia aeiioneaoe ia?aaaioaaeaiiy aeaeo?iia?aae;

– caeienithaaoe ca aeaniee ?aooiie iioi/iee ?aiiio i?eiiuaiiy, ui i?aiaeoooueny;

– ia caeienithaaoe aac ienueiiai? caiaee I?AIAeIAeAAOess ia?aaoaeiao oa ia?aieaioaaiiy

i?eiiuaiiy, ui i?aiaeoooueny.
7.2. I?AIAeA? iao i?aai:

– ei?enooaaoeny nenoaiaie eiioiieaoeie, yei ciaoiaeyoueny a aoaeeieo;

– iaeaaeiaoe oa ioi?ieoe i?eiiuaiiy, ui i?aiaeoooueny, ia aeaniee ?icnoae;

– caeaaaoe iaeii o noai?aiaeo ca caiaeith I?AIAeIAeAAOess;

– iicia/aoe naio iinoeaciaoiaeaeaiiy o i?eiiuaiii, ui i?aiaeoooueny, oeyoii ?iciiuaiiy

aiaeiiaiaeieo aeainie, aeaciaieo oaaee/ie, ?aeeaiieo noaiaeia ia aoiaei aei aoaeeieo oa ia?aae

aoiaeii aei i?eiiuaiiy;

– onoaiiaethaaoe caiee ia aoiaeii aeaa?i aei i?eiiuaiiy, ui i?aiaeoooueny;
– onoaiiaethaaoe neaiaeicaoeith oa iioi nenoaie ioi?iie.

8. II?ssAeIE IIAA?IAIIss I?AIAeIAeAAOeTH I?EIIUAIIss OA IAEIA,

UI I?AIAeOoOUeNss

8.1. Iiney caeii/aiiy oa?iiio i?aiaee I?AIAeA? ciaiaycaiee ia?aaeaoe I?AIAeIAeAAOeTH
i?eiiuaiiy, ui i?aiaeoooueny, i?ioyaii ____________ c iiiaioo caeii/aiiy oa?iiio i?aiaee
ca aeoii ia?aaea/i.

8.2. I?ioyaii oa?iiio ca i.8.1 Aeaiiai Aeiaiai?o I?AIAeA? ciaiaycaiee caeeoeoe
i?eiiuaiiy, ui i?aiaeoooueny, oa iiaeaiooaaoe eiai aei ia?aaea/i I?AIAeIAeAAOeTH.

8.3. O iiiaio iiaeienaiiy aeoo i?eeiaiiy I?AIAeA? ia?aaeao I?AIAeIAeAAOeTH eeth/i
aiae i?eiiuaiiy, ui i?aiaeoooueny.

8.4. I?eiiuaiiy i iaeii, ui i?aiaeothoueny, iiaeiii aooe ia?aaeaii I?AIAeIAeAAOeTH o
oiio ae noaii, a yeiio aiie aoee ia?aaeaii a i?aiaeo c o?aooaaiiyi ii?iaeueiiai ciino.

9. AIAeIIAIAeAEUeIINOUe NOI?II

9.1. I?AIAeA? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy ii nieaoi i?aiaeieo ieaoaaeia iaiy a ?icii?i ___________
aiae noie ai?ao ca eiaeai aeaiue i?ino?i/aiiy;

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– o aeiaaeeo iaoeieueiaiai aeei?enoaiiy i?eiiuaiiy, ui i?aiaeoooueny, oo?ao o ?icii?i
___________ aiae noie oaeoe/ii niea/aieo i?aiaeieo ieaoaaeia;

– ca ia?aaea/o i?eiiuaiiy, ui i?aiaeoooueny, a noai?aiaeo aac caiaee I?AIAeIAeAAOess
oo?ao o ?icii?i ______________ aiae noie oaeoe/ii niea/aieo i?aiaeieo ieaoaaeia.
9.2. I?AIAeIAeAAAOeUe iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy ii caea/i I?AIAeA?TH i?eiiuaiiy, ui i?aiaeoooueny, iaiy a
?icii?i ___________________________ e?a. ca eiaeai aeaiue i?ino?i/aiiy,

10. IIAeNOAAE AeINO?IEIAIAI ?ICI?AAIIss AeAIIAI AeIAIAI?O
10.1. Aeaiee Aeiaiai? ?ici?aaiith a iaeiinoi?iiiueiio ii?yaeeo ia iiaeeyaao, ca aeiyoeii
aeiaaeeia, eiee iaeia ic noi?ii nenoaiaoe/ii ii?oooo oiiae aeiaiai?o i nai? ciaiaycaiiy.
10.2. Iioi iiaenoaae:

_____________________________________I-,_________________________________________________________________________________________________________ .

11. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

12. IIOI OIIAE

12.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ui iathoue iaeiaeiao
th?eaee/io neeo, ii iaeiiio aeey eiaeii? ic noi?ii.

12.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iia-
aeyinueeei caeiiiaeaanoaii.

12.4. Oni aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii o eiaeiiio ie?aiiio aeiaaeeo.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
i?aiaee eaa?oe?e o i?eaaoii? iniae

i.____________ <____>___________ 199___?.
I?AIAeIAeAAAOeUe: ___________________________________________________________,

(I.I.A.)
C IAeIIAI aieo, i
I?AIAeA?: ____________________________________________________________________,

a iniai aee?aeoi?a _________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I?AIAeIAeAAAOeUe ia?aaeao, a I?AIAeA? aa?a o oei/aniaa aieiaeiiiy oa ei?enooaaiiy
eaa?oe?o:

. 1. Aae?ana: ________________________________________________________________ .
.2. Ei?enia ieiua: _________________________________________________________ ea.i.
.3. Iiaa?o: ________________________________________________________________.
,4. Eieueeinoue eiiiao: _______________________________________________________ .
.5. Iaaeieiee eaa?oe?e, ui i?aiaeoooueny, ia iiiaio ia?aaea/i: eaa?oe?a iio?aaoo iioi/iiai
?aiiioo.

1.6. Iayaiinoue oaeaoiio: oae.? ______________________________________________ .
1.7. Eaa?oe?a iaeaaeeoue I?AIAeIAeAAOeTH ia i?aai aeaniinoi caiaeii __________________ .
1.8. I?AIAeIAeAAAOeUe oaeiae ia?aaeao a i?aiaeo iaeii, ui ciaoiaeeoueny o eaa?oe?i, caiaeii
c Aeiaeaoeii ? 1.

2. IAOA I?AIAeE

Eaa?oe?a iaaeaooueny I?AIAeA?TH aeey i?iaeeaaiiy niia?iaioieeia inoaiiueiai.

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3. II?ssAeIE IA?AAeA*I EAA?OE?E OA IAEIA A I?AIAeO

3.1. Eaa?oe?a oa iaeii iiaeiii aooe ia?aaeaii I?AIAeIAeAAOeAI oa i?eeiyoi I?AIAeA-
?AI i?ioyaii _____________ c iiiaioo oeeaaeaiiy Aeaiiai Aeiaiai?o.

3.2. I?ioyaii oa?iiio ca i.C.I Aeaiiai Aeiaiai?o I?AIAeIAeAAAOeUe ciaiaycaiee ae?oaoe
c eaa?oe?e oa iiaeaiooaaoe ?? aeey ia?aaea/i I?AIAeA?TH.

3.3. Ia?aaea/a eaa?oe?e a i?aiaeo ioi?iethooueny aeoii caea/i-i?eeiaiiy.

3.4. Eaa?oe?a oa iaeii aaaaeathoueny oaeoe/ii ia?aaeaieie a i?aiaeo c iiiaioo iiaeienaiiy
aeoo caea/i-i?eeiaiiy.

3.5. O iiiaio iiaeienaiiy aeoo i?eeiaiiy I?AIAeIAeAAAOeUe ia?aaeao I?AIAeA?TH eeth/i
aiae eaa?oe?e oa aiae eiiiao.

4. OA?III I?AIAeE

4.1. Oa?iii i?aiaee neeaaeao _____________ ?ieia c iiiaioo i?eeiyooy eaa?oe?e ca aeoii

i?eeiaiiy.

4.2. Oa?iii i?aiaee iiaea aooe nei?i/aiee eeoa ca caiaeith noi?ii.
4.3. I?AIAeA? iao i?aai aiaeiiaeoeny aiae Aeaiiai Aeiaiai?o, iiia?aaeeaoe I?AIAeIAeAAOess

a oa?iii __________ . I?e oeueiio niea/aia iaia?aae i?aiaeia ieaoa I?AIAeA?TH ia iiaa?oaooueny.

5. I?AIAeIA IEAOA OA II?ssAeIE ?IC?AOOIEIA

5.1. I?aiaeia ieaoa ca ei?enooaaiiy iaeiii neeaaeao __________________ e?a. ia iinyoeue.
5.2. I?aiaeia ieaoa niea/oooueny aioiaeith /a?ac eano I?AIAeA?ss aai ca cayaith I?AIAeI-
AeAAOess a aacaioiaeiaiio ii?yaeeo ia iniaiaee ?aooiie inoaiiueiai a onoaiiai Iuaaeaaieo ia
iiciioa _________________ /enea eiaeiiai ____________________ iinyoey.

5.3. I?AIAeA? ciaiaycaiee i?ioyaii ___________ c iiiaioo _______________________
ia?a?aooaaoe i?aiaeio ieaoo ca oa?iii __________________________ aaainii.

5.4. ?icii? i?aiaeii? ieaoe iiaeeyaao ia?aaeyaeo o aeiaaeeo ciiie iiiiiaeueiiai ?icii?o
ca?iaioii? ieaoe o ianooiiiio ii?yaeeo:

6. AEO?AOE IA EIIOIAEUeII IINEOAE

6.1. Eiioiaeueii iineoae iiea/othoueny I?AIAeA?AI naiinoieii ia iiaenoaai ?aooieia
aiaeiiaiaeieo i?aaiicaoeie.

6.2. Oni aeo?aoe ca ei?enooaaiiy oaeaoiiaie iiea/othoueny I?AIAeA?AI naiinoieii
caiaeii c ?aooieaie oaeaoiiii? noaioei?.

7. I?AAA OA IAIAssCEE I?AIAeIAeAAOess

7.1. I?AIAeIAeAAAOeUe iao i?aai 1 (iaeei) ?ac ia eaa?oae caeienithaaoe ia?aai?eo ii?yaeeo
aeei?enoaiiy I?AIAeA?AI eaa?oe?e oa noaio eaa?oe?e oa iaeia, ui i?aiaeothoueny.

8. I?AAA OA IAIAssCEE I?AIAeA?ss

8.1. I?AIAeA? ciaiaycoooueny:
– aeei?enoiaoaaoe i?eiiuaiiy, ui i?aiaeothoueny, aeeeth/ii ca ?o oeieueiaei i?ecia/aiiyi

o aiaeiiaiaeiinoi aei i.2 Aeaiiai Aeiaiai?o;

– naio/anii caeienithaaoe i?aiaeii ieaoaaei;

– oo?eioaaoe i?eiiuaiiy, ui i?aiaeothoueny, a ioaeiinoi oa ni?aaiinoi;

– aeaaeeeai noaaeoeny aei iaeia, ui ciaoiaeeoueny a eaa?oe?i;

– onoaaoe ianeiaeee aaa?ie, ui noaeeny a eaa?oe?i;

– aeio?eioaaoeny i?ioeiiaeaaeieo i?aaee;

– caeienithaaoe iioi/iee ?aiiio eaa?oe?e a oa?iii _____________________;

– ia caeienithaaoe ia?aaoaeiao oa ia?aieaioaaiiy eaa?oe?e, ui i?aiaeoooueny;

– aeio?eioaaoeny i?aaee i?iaeeaaiiy a aoaeeieo, a yeiio ciaoiaeeoueny eaa?oe?a;

– aacia?aoeiaeii aeiioneaoe I?AIAeIAeAAOess aei eaa?oe?e c iaoith ia?aai?ee ?? aeei?enoai-
iy o aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o.
8.2. I?AIAeA? iao i?aai:

– iaeaaeiaoe oa ioi?ieoe eaa?oe?o ia aeaniee ?icnoae;

– iiiyoe caiee aoiaeieo aeaa?ae oa eiiiao, oe?iiethaaoe aoiaeii aeaa?i;

– caeaaaoe eaa?oe?o o noai?aiaeo ca caiaeith I?AIAeIAeAAOess (ca aeiyoeii ia?aaea/i eaa?oe?e

a ei?enooaaiiy nai?i niia?iaioieeai);
– naiinoieii aecia/aoe ii?yaeie, oiiae oa oa?iiie i?iaeeaaiiy a eaa?oe?i eiie?aoieo

inia ic /enea nai?o niia?iaioieeia;
– onoaiiaethaaoe neaiaeicaoeith oa iioi nenoaie ioi?iie eaa?oe?e.

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9. II?ssAeIE IIAA?IAIIss EAA?OE?E I?AIAeIAeAAOeTH

9.1. Iiney caeii/aiiy oa?iiio i?aiaee I?AIAeA? ciaiaycaiee ia?aaeaoe I?AIAeIAeAAOeTH
eaa?oe?o oa iaeii, ui i?aiaeoooueny, i?ioyaii _________ c iiiaioo caeii/aiiy oa?iiio i?aiaee
ca aeoii ia?aaea/i.

9.2. I?ioyaii oa?iiio ca i.9,1 Aeaiiai Aeiaiai?o I?AIAeA? ciaiaycaiee ae?oaoe c eaa?oe?e
oa iiaeaiooaaoe ?? aei ia?aaea/i I?AIAeIAeAAOeTH.

9.3. Eaa?oe?a oa iaeii aaaaeathoueny oaeoe/ii ia?aaeaieie I?AIAeIAeAAOeTH c-iiiaioo
iiaeienaiiy aeoo caea/i-i?eeiaiiy.

9.4. O iiiaio iiaeienaiiy aeoo i?eeiaiiy I?AIAeA? ia?aaeao I?AIAeIAeAAOeTH eeth/i
aiae eaa?oe?e oa eiiiao.

9.5. Eaa?oe?a i iaeii iiaeiii aooe ia?aaeaii I?AIAeIAeAAOeTH o oiio ae noaii, a yeiio
aiie aoee ia?aaeaii a i?aiaeo c o?aooaaiiyi ii?iaeueiiai ciino.

9.6. Iaaiaeaeieueii iie?auaiiy, caeieniaii a eaa?oe?i I?AIAeA?AI, ia?aoiaeyoue aei I?AIAeI-
AeAAOess aac aiaeoeiaeoaaiiy caeieniaieo aeo?ao.

10. AIAeIIAIAeAEUeIINOUe NOI?II

10.1. I?AIAeA? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy -o i?eeiyooi eaa?oe?e a i?aiaeo iaiy a ?icii?i __________

______________________ e?a. ca eiaeai aeaiue i?ino?i/aiiy;
– o aeiaaeeo i?ino?i/aiiy ii nieaoi i?aiaeieo ieaoaaeia iaiy a ?icii?i ______________

aiae noie ai?ao ca eiaeai aeaiue i?ino?i/aiiy;
– o aeiaaeeo iaoeieueiaiai aeei?enoaiiy eaa?oe?e oo?ao a ?icii?i _________________ aiae

noie oaeoe/ii niea/aieo i?aiaeieo ieaoaaeia;
– ca ia?aaea/o eaa?oe?e aai eiiiao o noai?aiaeo aac caiaee I?AIAeIAeAAOess oo?ao o

?icii?i ______________________ aiae noie oaeoe/ii niea/aieo i?aiaeieo ieaoaaeia.
10.2. I?AIAeIAeAAAOeUe iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy ii ia?aaea/i eaa?oe?e I?AIAeA?TH iaiy a ?icii?i ______

_____________ e?a. ca eiaeai aeaiue i?ino?i/aiiy.

1 1. IIAeNOAAE AeINO?IEIAIAI ?ICI?AAIIss AeAIIAI AeIAIAI?O

11.1. Aeaiee Aeiaiai? ?ici?aaiith a iaeiinoi?iiiueiio ii?yaeeo ia iiaeeyaao ca aeiyoeii
aeiaaeeia, eiee iaeia ic noi?ii nenoaiaoe/ii ii?oooo oiiae aeiaiai?o i nai? ciaiaycaiiy.
I 1.2. Iioi iiaenoaae: ____________________________________________________________ .

12. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

13. IIOI OIIAE

13.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

13.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iia-
aeyinueeei caeiiiaeaanoaii.

13.3. Oni aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii o eiaeiiio ie?aiiio aeiaaeeo.

14. AAe?ANE I ?AEAICEOE NOI?II

14.1. I?AIAeIAeAAAOeUe:

Iiooiaa aae?ana oa iiaeaen: ______________________________________________________ .
Aeaii ianii?oo: na?iy _______________ ? _________________________________ aeaeaiee
<____> ___________ 199 ___ ?. ______________________________________________________ .
14.2. I?AIAeA?:

Iiooiaa aae?ana oa iiaeaen: ______________________________________________________ .
Oaeaoii __________, oaeaoaei ______________________, oaen _____________________ .
?ic?aooieiaee ?aooiie ? _________________ a aaieo ____________________________ .
IOI __________________________, EIAe ________________________________________ .

15. AeIAeAOEE AeI AeAIIAI AeIAIAI?O
15.1. Aei Aeaiiai Aeiaiai?o aeiaeaooueny:
Aeiaeaoie ? 1 – Ia?aeie iaeia, ui ciaoiaeeoueny a eaa?oe?i.

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Eiia?oeieiee aeiaiai?
15.2. Aeiaeaoee aei Aeaiiai Aeiaiai?o neeaaeathoue eiai iaaiaeoiio /anoeio.
I?AIAeIAeAAAOeUe I?AIAeA?

I.I.

AeIAIAI?
i?aiaee iaeaaeiaiiy

199___?.

I?AIAeIAeAAAOeUe:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

I?AIAeA?: ________________________
a iniai

ui aeio ia iiaenoaai aeiai?aiinoi ? _________ aiae <____.> ___________ 199__?., c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I?AIAeIAeAAAOeUe ia?aaeao, a I?AIAeA? aa?a o oei/aniaa aieiaeiiiy oa ei?enooaaiiy
ianooiia iaeaaeiaiiy (aeaei ca oaenoii – ):
1.1, Iaeiaioaaiiy: caiaeii c Aeiaeaoeii ? 1.
1.2. Noai (yeinoue) iaeia, ui i?aiaeoooueny, ia iiiaio ia?aaea/i a i?aiaeo:______________

2. IAOA I?AIAeE
I?iieneiaa aeei?enoaiiy.
3. II?ssAeIE IA?AAeA*I IAEIA A I?AIAeO

3.1. Iaeii, ui i?aiaeoooueny, iiaeiii aooe ia?aaeaii I?AIAeIAeAAOeAI oa i?eeiyoi
I?AIAeA?AI i?ioyaii 10 aeiia c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o.

3.2. Ia?aaea/a iaeia a i?aiaeo caeienithooueny aiaeiiaiaeieie oaoiaoeyie noi?ii ca aeoii
ia?aaea/i.

4. OA?III I?AIAeE

4.1, Iaeii, ui i?aiaeoooueny, aaaaeaooueny ia?aaeaiei I?AIAeA?TH c iiiaioo iiaeienaiiy
aeoo i?eeiaiiy iaeia, ui i?aiaeoooueny.

4.2. Oa?iii i?aiaee neeaaeao ______________ c iiiaioo i?eeiyooy iaeia, ui i?aiaeoooueny,
ca aeoii i?eeiaiiy.

4.3. Oa?iii i?aiaee iiaea aooe nei?i/aiee eeoa ca caiaeith noi?ii.

5. I?AIAeIA IEAOA OA II?ssAeIE ?IC?AOOIEIA

5.1. ?icii? i?aiaeieo ieaoaaeia neeaaeao _________________________________________ e?a.

O __________________________________________________________________________ (c IAeA).
(oa?iii)

5.2. I?aiaeia ieaoa niea/oooueny a aacaioiaeiaiio ii?yaeeo ia ?ic?aooieiaee ?aooiie
I?AIAeIAeAAOess iaia?aae ia iiciioa _________________________________________________ .
5.3. ?icii? i?aiaeii? ieaoe iiaea ia?aaeyaeaoeny ca caiaeith noi?ii 1 ?ac i?ioyaii __________

6. I?AAA OA IAIAssCEE I?AIAeIAeAAOess

6.1. I?AIAeIAeAAAOeUe iao i?aai caeienithaaoe ia?aai?eo ii?yaeeo aeei?enoaiiy I?AIAeA-
OI?II iaeia, ui i?aiaeoooueny, o aiaeiiaiaeiinoi aei oiia Aeaiiai Aeiaiai?o.
6.2. I?AIAeIAeAAAOeUe ciaiaycaiee:

– iciaeiieoe I?AIAeA?ss c i?aaeeaie oaoii/ii? aenieoaoaoei? iaeia, ui i?aiaeoooueny, i
ca iaiaoiaeiinoi iai?aaeoe naiai oaoiaoey aeey i?iaaaeaiiy aiaeiiaiaeiiai iino?oeoaaeo ia iinoei
aenieoaoaoei?;

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Eiia?oeieiee aeiaiai?

– iaaeaaaoe iioi?iaoeieia oa eiinoeueoaoeieia ni?eyiiy I?AIAeA?TH c ii?yaeeo i?aaeeueii?
aenieoaoaoei? iaeia, ui i?aiaeoooueny.

7. I?AAA OA IAIAssCEE I?AIAeA?ss

7.1. I?AIAeA? ciaiaycoooueny:
– aeei?enoiaoaaoe iaeii, ui i?aiaeoooueny, ca eiai oeieueiaei i?ecia/aiiyi o aiaeiiaiaeiinoi

aei i.2 Aeaiiai Aeiaiai?o;

– naio/anii caeienithaaoe i?aiaeii ieaoaaei;

– aeio?eioaaoeny iaeaaeiiai ?aaeeio aenieoaoaoei? oa caa?iaaiiy iaeia, ui i?aiaeoooueny,

o aiaeiiaiaeiinoi aei oaoii/ii? aeieoiaioaoei?;

– aeeeth/eoe aeinooi aei iaeia, ui i?aiaeoooueny, iaeiiiaoaioieo inia;

– oo?eioaaoe iaeii, ui i?aiaeoooueny, o iiaiie ni?aaiinoi.

8. II?ssAeIE IIAA?IAIIss IAEIA I?AIAeIAeAAOeTH

8.1. Iiney caeii/aiiy oa?iiio i?aiaee I?AIAeA? ciaiaycaiee i?ioyaii _______________
iiaa?iooe iaeii, ui i?aiaeoooueny, I?AIAeIAeAAOeTH ?acii c oa?ith, oiaeiaeith oa oaoii/iith
aeieoiaioaoeioth (eiiieaeoia) ca aeoii ia?aaea/i.

8.2. Iiaa?iaiiy iaeia, ui i?aiaeoooueny, caeienithooueny aiaeiiaiaeieie oaoiaoeyie noi?ii.
8.3. Iaeii, ui i?aiaeoooueny, iiaeiii aooe ia?aaeaii I?AIAeIAeAAOeTH o ni?aaiiio noaii
c o?aooaaiiyi ii?iaeueiiai ciino.

8.4. Iaeii, ui i?aiaeoooueny, iiaea aooe aeeoieaii I?AIAeA?AI (iiaiinoth aai /anoeiai)
a ii?yaeeo oa ia oiiaao, ia?aaeaa/aieo caiaeith noi?ii.

9. AIAeIIAIAeAEUeIINOUe NOI?II

9.1. I?AIAeA? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy a i?eeiyooi iaeia, ui i?aiaeoooueny, iaiy a ?icii?i ____________

aiae aa?oinoi iaeia ca eiaeai aeaiue i?ino?i/aiiy;
– o aeiaaeeo i?ino?i/aiiy ii nieaoi i?aiaeieo ieaoaaeia iaiy a ?icii?i ____________ aiae

noie ai?ao ca eiaeai aeaiue i?ino?i/aiiy;
– o aeiaaeeo iaoeieueiaiai aeei?enoaiiy iaeia, ui i?aiaeoooueny, oo?ao o ?icii?i __________

aiae noie ?i/ii? i?aiaeii? ieaoe;

– ca ia?aaea/o iaeia, ui i?aiaeoooueny, aai eiai /anoeie a noai?aiaeo aac caiaee I?AIAeI-
AeAAOess oo?ao o ?icii?i _________.____________________ e?a.
9.2. I?AIAeIAeAAAOeUe iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy ii caea/i I?AIAeA?TH iaeia, ui i?aiaeoooueny, iaiy a ?icii?i

___________________ aiae eiai aeiaiai?ii? aa?oinoi ca eiaeai aeaiue i?ino?i/aiiy.

10. IIAeNOAAE AeINO?IEIAIAI ?ICI?AAIIss AeAIIAI AeIAIAI?O

10.1. Aeaiee Aeiaiai? ?ici?aaiith a iaeiinoi?iiiueiio ii?yaeeo ia iiaeeyaao, ca aeiyoeii
aeiaaeeia, eiee iaeia ic noi?ii nenoaiaoe/ii ii?oooo oiiae aeiaiai?o i nai? ciaiaycaiiy.
10.2. Iioi iiaenoaae:

11. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE
Iiaiiaaaeieie i?aaenoaaieeaie noi?ii ca Aeaiei Aeiaiai?ii o:
I?AIAeA?: ______________________________________ oaeaoii _________________ .
I?AIAeIAeAAAOeUe: ________________________________ oaeaoii ___________________ .

12. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

13. IIOI OIIAE

13.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

13.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii.

13.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

13.4. Ani aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii o eiaeiiio ie?aiiio aeiaaeeo.

114

Eiia?oeieiee aeiaiai?

14. AeIAeAOEE AeI AeAIIAI AeIAIAI?O
14.1. Aei Aeaiiai Aeiaiai?o aeiaeaooueny:

14.2. Aeiaeaoee aei Aeaiiai Aeiaiai?o neeaaeathoue eiai iaaiaeoiio /anoeio.
TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
i?aiaee eaaeiaiai aaoiiiaiey o i?eaaoii? iniae

199___?.

I?AIAeIAeAAAOeUe:

c iaeiiai aieo, i

I?AIAeA?:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I?AIAeIAeAAAOeUe ia?aaeao, a I?AIAeA? aa?a o oei/aniaa aieiaeiiiy ianooiia iaeii:
1.1. Eaaeiaee aaoiiiaieue ia?ee: ______________________________________________ .
1.2. Aea?aeaaiee iiia?: _________________________________________________________ .

1.3. Aa?oinoue aaoiiiaiey: _______________________________________________________ .

2. IAOA OA II?ssAeIE I?AIAeE

2.1. Aaoiiiaieue, ui i?aiaeoooueny, aoaea aeei?enoiaoaaoeny I?AIAeA?AI aeey neoaeaiaeo
ii?caeie ia?niiaeo inoaiiueiai, a oaeiae aeey aaioaaeiiai ia?aaacaiiy ae?iaieo ?a/ae.

2.2. Oa?eoi?iy neoaeaiaeo ii?caeie aecia/aooueny aaeiiiino?aoeaii-oa?eoi?iaeueieie iaaeaie
___________________________ iaeanoi.

3. II?ssAeIE IA?AAeA*I AAOIIIAIEss A I?AIAeO

3.1. Aaoiiiaieue, ui i?aiaeoooueny, ia?aaeaooueny I?AIAeA?TH i?ioyaii ____________ c
iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o.
3.2. Ia?aaea/a aaoiiiaiey a i?aiaeo caeienithooueny ca aeoii ia?aaea/i.

4. OA?III I?AIAeE

4,1. Oa?iii i?aiaee neeaaeao _______________ ?ieia aiae <___> ______________ 199 __ ?.
aei <___> _______________ 199 __ ?.

5. I?AIAeIA IEAOA OA II?ssAeIE ?IC?AOOIEIA

5.1. I?aiaeia ieaoa anoaiiaethooueny a ?icii?i _________________________ e?a. ia iinyoeue.
5.2. I?aiaeia ieaoa niea/oooueny aioiaeith /a?ac eano I?AIAeA?ss aai ca cayaith I?AIAeI-
AeAAOess a aacaioiaeiaiio ii?yaeeo ia iniaiaee ?aooiie inoaiiueiai a onoaiiai Iuaaeaaieo ia
iiciioa ___________________ /enea eiaeiiai __________________________________ iinyoey.
5.3. ?icii? i?aiaeii? ieaoe iiaeeyaao ia?aaeyaeo o aeiaaeeo ciiie iiiiiaeueiiai ?icii?o
ca?iaioii? ieaoe.

5.4. Ieaoaaei, ia iaoiiaeaii Aeaiei Aeiaiai?ii, I?AIAeA?AI ia caeieniththoueny.

6. I?AAA OA IAIAssCEE I?AIAeIAeAAOess

6.1. I?AIAeIAeAAAOeUe ca Aeaiei Aeiaiai?ii ciaiaycoooueny:

– iaaeaoe a i?aiaeo aaoiiiaieue o oaoii/ii ni?aaiiio noaii;

– caeienithaaoe ?aiiio oa oaoii/ia ianeoaiaoaaiiy aaoiiiaiey;

– caeienithaaoe cai?aaeaiiy aaoiiiaiey III;

– iaaeaoe I?AIAeA?TH iaiaoiaeio aeieoiaioaoeith ia aaoiiiaieue, ui i?aiaeoooueny, oa iaiaoiaeia
i?eeaaeaey;
– naiinoieii caeienithaaoe iaiayceiai aeey aieiaea?y aaoiiiaiey ieaoaaei aei athaeaeaoo.

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Eiia?oeieiee aeiaiai?

7. I?AAA OA IAIAssCEE I?AIAeA?ss

7.1. I?AIAeA? ciaiaycoooueny:
– aeei?enoiaoaaoe aaoiiiaieue, ui i?aiaeoooueny, aeeeth/ii ca eiai oeieueiaei i?ecia/aiiyi

o aiaeiiaiaeiinoi aei i.2 Aeaiiai Aeiaiai?o;

– naio/anii caeienithaaoe i?aiaeii ieaoaaei;

– oiiainoaaoe i?ioieaeoe/ia ianeoaiaoaaiiy oa iioi/iee ?aiiio aaoiiiaiey, ui

i?aiaeoooueny;

– oiiainoaaoe onoiaiiy iani?aaiinoae oa iieiiie aaoiiiaiey;

– ni?eyoe I?AIAeIAeAAOeTH o i?eaeaaiii iaiaoiaeieo aeaoaeae aei aaoiiiaiey oa caianieo

/anoei;

– caeienithaaoe caiiio aeaoaeae oa /anoei aaoiiiaiey;

– caeienithaaoe ca aeaniee ?aooiie cai?aaeaiiy aaoiiiaiey III a ia?iiae aeei?enoaiiy

aaoiiiaiey ca Aeaiei Aeiaiai?ii;
– onoaaoe ianeiaeee aaa?ie oa iioeiaeaeaiue aaoiiiaiey, yei aeieeee iiae /an aenieoaoaoei?

eiai I?AIAeA?AI;
– cano?aooaaoe aaoiiiaieue, ui i?aiaeoooueny, ia oa?iii i?aiaee ca aeaniee ?aooiie.

7.2. I?AIAeA? iao i?aai caeaaaoe aaoiiiaieue o noai?aiaeo eeoa ca caiaeith I?AIAeIAeAAOess.

8. II?ssAeIE IIAA?IAIIss AAOIIIAIEss I?AIAeIAeAAOeTH

8.1. Aaoiiiaieue iiaeiai aooe iiaa?iaiee I?AIAeIAeAAOeTH ii caeii/aiii oa?iiio i?aiaee
ca i.4 Aeaiiai Aeiaiai?o o ni?aaiiio noaii c o?aooaaiiyi ii?iaeueiiai ciino, ui aeiee o
ia?iiae aenieoaoaoei?.

8.2. Iiaa?iaiiy aaoiiiaiey aiaeaoaaooueny ca aeoii.

9. AIAeIIAIAeAEUeIINOUe NOI?II

9.1. I?AIAeA? iana ianooiio aiaeiiaiaeaeueiinoue ca aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy ii nieaoi i?aiaeieo ieaoaaeia iaiy a ?icii?i ________________

aiae noie ai?ao ca eiaeai aeaiue i?ino?i/aiiy;
– o aeiaaeeo iaoeieueiaiai aeei?enoaiiy aaoiiiaiey oo?ao o ?icii?i __________________

aiae eiai aa?oinoi;

9.2. I?AIAeIAeAAAOeUe iana ianooiio aiaeiiaiaeaeueiinoue ca aeiaiai?ii:
– o aeiaaeeo i?ino?i/aiiy ii caea/i aaoiiiaiey a i?aiaeo I?AIAeA?TH oo?ao o ?icii?i __

_________________, yeee oo?eioooueny ic i?aiaeieo ieaoaaeia, iaeaaeieo I?AIAeIAeAAOeTH.

10. IIAeNOAAE AeINO?IEIAIAI ?ICI?AAIIss AeAIIAI AeIAIAI?O

10.1. Aeaiee Aeiaiai? ?ici?aaiith a iaeiinoi?iiiueiio ii?yaeeo ia iiaeeyaao, ca aeiyoeii
aeiaaeeia, eiee iaeia ic noi?ii nenoaiaoe/ii ii?oooo oiiae aeiaiai?o i nai? ciaiaycaiiy.

11. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

12. IIOI OIIAE

12.1. Aeaiee Aeiaiai? neeaaeaiee o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? ic
noi?ii.

12.2. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo ii/aoeo oa?iiio i?aiaee ca i.4 Aeaiiai
Aeiaiai?o.

12.3. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii.

13. AAe?ANE I ?AEAICEOE NOI?II

13.1. I?AIAeIAeAAAOeUe:
Iiooiaa aae?ana oa iiaeaen:

Aeaii ianii?oo: na?iy ________________ ? __________________________________ aeaeaiee
_> ____________ 199 ___ ?. _________________________________________________________ .

14.2. I?AIAeA?:

Iiooiaa aae?ana oa iiaeaen: ________________________________
Oaeaoii __________, oaeaoaei ______________________, oaen
?ic?aooieiaee ?aooiie ? ________________ a aaieo ______

116

IOI

IAeIAeAAAOeUe
-(-………)

—

–________

? “a-:
I?AIAeA?. aieO
a iniai ~~~—~~~___

? i?en?aa~~~~~~-~??I~~~~
ai Aeiai?aii-

O___________ 199___?.

I?AIAeA?:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i
NOAI?AIAeA?: _________________________________________________________________,

a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai aeiai?aiinoi ? _________ aiae <_____> ___________ 199__?., c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. I?AIAeA? ia?aaeao, a NOAI?AIAeA? aa?a o oei/aniaa aieiaeiiiy oa ei?enooaaiiy
iaeii caiaeii c ia?aeieii, ui aeiaeaooueny aei Aeaiiai Aeiaiai?o (Aeiaeaoie ? 1).

1.2. Iaeii, ui i?aiaeoooueny, ciaoiaeeoueny o aieiaeiiii oa ei?enooaaiii I?AIAeA?ss o
aiaeiiaiaeiinoi aei aeiaiai?o i?aiaee ? ______ aiae <____> __________ 199 __ ?. iiae I?AIAeA?AI
i ______________________________________________________, iaaeaei I?AIAeIAeAAAOeUe.

2. IAOA I II?ssAeIE I?AIAeE

3. II?ssAeIE IA?AAeA*I IAEIA A I?AIAeO

3.1. Cacia/aia a i. I Aeaiiai Aeiaiai?o iaeii iiaeiii aooe ia?aaeaia I?AIAeA?AI oa

i?eeiyoa NOAI?AIAeA?AI i?ioyaii _____________________ c iiiaioo _________________ .
3.2. Ia?aaea/a iaeia a i?aiaeo caeienithooueny ca aeoii ia?aaea/i.
3.3. Noi?iie i?e ia?aaea/i iaeia ciaiaycaii ia?aai?eoe ni?aaiinoue iaeia, ui i?aiaeoooueny,

i?i ui a aeoi ia?aaea/i iao aooe cacia/aii.

4. OA?III I?AIAeE

4.1. Oa?iii i?aiaee neeaaeao _____________ c iiiaioo i?eeiyooy iaoeoo, ui i?aiaeoooueny,
ca aeoii i?eeiaiiy.

4.2. Oa?iii i?aiaee iiaea aooe nei?i/aiee eeoa ca caiaeith noi?ii.

5. I?AIAeIA IEAOA OA II?ssAeIE ?IC?AOOIEIA

5.1. NOAI?AIAeA? niea/oo i?aiaeio ieaoo a ?icii?i ___________________________ e?a.
o_______________________________________________________________________(c IAeA).

(oa?iii)

5.2. I?aiaeia ieaoa niea/oooueny a aacaioiaeiaiio ii?yaeeo ia ?ic?aooieiaee ?aooiie
I?AIAeA?ss ia iiciioa /enea eiaeiiai iinyoey.

5.3. I?aiaeia ieaoa ca ocaiaeaeaiiyi noi?ii iiaea aiineoeny a iaoo?aeueiie aai ciioaiie
oi?ii i?iaeoeoaie oa?/oaaiiy, oiaa?aie, iineoaaie.

6. I?AAA OA IAIAssCEE I?AIAeA?ss

6.1. I?AIAeA? iao i?aai caeienithaaoe ia?aai?eo ii?yaeeo aeei?enoaiiy NOAI?AIAeA?AI
iaeia, ui i?aiaeoooueny, o aiaeiiaiaeiinoi aei oiia Aeaiiai Aeiaiai?o.

7. I?AAA OA IAIAssCEE NOAI?AIAeA?ss

7.1. NOAI?AIAeA? ciaiaycoooueny:
– aeei?enoiaoaaoe iaeii, ui i?aiaeoooueny, ca eiai oeieueiaei i?ecia/aiiyi o aiaeiiaiaeiinoi

aei i.2 Aeaiiai Aeiaiai?o;

– oo?eioaaoe iaeii, ui i?aiaeoooueny, o iiaiie ni?aaiinoi.

– caeienithaaoe ca aeaniee ?aooiie i?ioieaeoe/ia ianeoaiaoaaiiy oa iioi/iee ?aiiio

iaeia, ui i?aiaeoooueny;

– ca aeaniee ?aooiie onoaaoe iani?aaiinoi oa iieiiee iaeia.
7.2. Aeiaeaoeiai iaiaycee NOAI?AIAeA?ss:

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8. II?ssAeIE IIAA?IAIIss IAEIA I?AIAeA?TH

8.1. Iiney caeii/aiiy oa?iiio i?aiaee ca Aeaiei Aeiaiai?ii NOAI?AIAeA? ciaiaycaiee
i?ioyaii _______________________ iiaa?iooe iaeii, ui i?aiaeoooueny, I?AIAeA?TH ca aeoii.
8.2. Iaeii, ui i?aiaeoooueny, iiaeiii aooe ia?aaeaii I?AIAeA?TH o ni?aaiiio noaii c
o?aooaaiiyi ii?iaeueiiai ciino.

9. AIAeIIAIAeAEUeIINOUe NOI?II

9.1. I?AIAeA? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:

9.2. NOAI?AIAeA? iana ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:

10. IIAeNOAAE AeINO?IEIAIAI ?ICI?AAIIss AeAIIAI AeIAIAI?O

10.1. Aeaiee Aeiaiai? ?ici?aaiith a iaeiinoi?iiiueiio ii?yaeeo ia iiaeeyaao, ca aeiyoeii
aeiaaeeia, eiee iaeia ic noi?ii nenoaiaoe/ii ii?oooo oiiae aeiaiai?o i nai? ciaiaycaiiy.

10.2. Aeaiee Aeiaiai? i?eieiyo naith aeith o aeiaaeeo ?ici?aaiiy aeiaiai?o i?aiaee iiae
I?AIAeA?AI i I?AIAeIAeAAOeAI aiae <___> ______________ 199 __ ?. c aoaeue-yei? iiaenoaae.
O oeueiio aeiaaeeo NOAI?AIAeA? iao i?aai aeiaaaoe aiae I?AIAeA?ss aiaeoeiaeoaaiiy caeoeia,
caaaeaieo aeino?ieiaei i?eieiaiiyi Aeaiiai Aeiaiai?o.

11. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

12. IIOI OIIAE

12.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

12.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii, a oaeiae oiiaaie aeiaiai?o i?aiaee ? ________ aiae <___> __________
199 __ ?. iiae I?AIAeA?AI i I?AIAeIAeAAOeAI.

12.3. Aeaiee Aeiaiai? ia ciiitho oiia aeiaiai?o i?aiaee ? ________ aiae <___> __________
199 __ ?. iiae I?AIAeA?AI i I?AIAeIAeAAOeAI.

13. AeIAeAOEE AeI AeAIIAI AeIAIAI?O

13.1. Aei Aeaiiai Aeiaiai?o aeiaeaooueny Aeiaeaoie ? 1 .
13.2. Aeiaeaoee aei Aeaiiai Aeiaiai?o neeaaeathoue eiai iaaiaeoiio /anoeio.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

OCAIAeAEAII

I?AIAeIAeAAAOeUe: __
a iniai aee?aeoi?a ________
ui aeio ia iiaenoaai Noaoooo

(iiaia oi?iiaa iaeiaioaaiiy iiaei?eoinoaa)

(I.I.A.)

199 __ ?. I. I.

AeIAIAI?
i?aiaee iaeaaeiaiiy (eiciiaa)

199__?.

AAIE:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

120

Eiia?oeieiee aeiaiai?

I?AIAeA?:
a iniai

ui aeio ia iiaenoaai aeiai?aiinoi ?

199__?., c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. AAIE ia?aaeao, a I?AIAeA? aa?a o oei/aniaa aieiaeiiiy oa ei?enooaaiiy ianooiia

iaeii:

IaeiaioaaiiyEieueeinoueAa?oinoue ca iaeeieoeth (a e?a.)Oa?iii aii?oecaoei?
1.
2.

3.
4.
5.
6.
Onueiai a i?aiaeo ia?aaeaooueny cacia/aia iaeii ia caaaeueio noio __________________ e?a.
1.2. Iaeii, cacia/aia a ioieoi 1.1 Aeaiiai Aeiaiai?o, AAIE i?eaeaaaao o iiaei?eoinoaa-
iinoa/aeueieea ca naie ?aooiie ia oiiaao, ?aiioa ocaiaeaeaieo iiae I?AIAeA?AI i iiaei?eoinoaii-
iinoa/aeueieeii.
1.3. Iaeii, ui ia?aaeaooueny a i?aiaeo, o aeaniinoth AAIEA.

2. IAOA I II?ssAeIE I?AIAeE

3. II?ssAeIE IA?AAeA*I IAEIA A I?AIAeO

3.1. AAIE ia?aaeao I?AIAeA?TH i?aaa i?aaeyaeyoe aeiiae aei iiaei?eoinoaa-iinoa/aeueieea
ca oa?iiiaie, yeinoth oa eiiieaeoiinoth iinoaaee iaeaaeiaiiy, ui i?aiaeoooueny.

3.2. Iiney oeeaaeaiiy aeiaiai?o iinoaaee iaeia AAIE naio/anii iiaiaeiieyo i?i oea
I?AIAeA?ss oa ia?aaeao inoaiiueiio anth iaiaoiaeio aeey io?eiaiiy iaeia aeieoiaioaoeith.

3.3. I?AIAeA? i?ioyaii__________aeiia c aeiy io?eiaiiy iaeaaeiaiiy, ui i?aiaeoooueny,
iiaeao AAIEO eiiith aeoo i?i eiai i?eeiaiiy oa aaiae a aenieoaoaoeith.

3.4. Ii?ooaiiy iiaei?eoinoaii-iinoa/aeueieeii aeiia c yeinoi oa eiiieaeoiinoi iinoaaee
iaeaaeiaiiy, ui i?aiaeoooueny, ia caieueiyo I?AIAeA?ss aiae aeeiiaiiy ciaiaycaiue ca Aeaiei
Aeiaiai?ii.
4. OA?III I?AIAeE

4.1. Iaeii aaaaeaooueny ia?aaeaiei I?AIAeA?TH c iiiaioo iiaeienaiiy aeoo i?eeiaiiy.
4,2. Oa?iii i?aiaee neeaaeao _____________ c iiiaioo i?eeiyooy iaeia, ui i?aiaeoooueny,
ca aeoii i?eeiaiiy.

4.3. Oa?iii i?aiaee iiaea aooe nei?i/aiee eeoa ca caiaeith noi?ii.

5. II?ssAeIE ?IC?AOOIEIA

5.1. I?aiaeia ieaoa aiineoueny I?AIAeA?AI a ianooiiiio ii?yaeeo (c o?aooaaiiyi IAeA):

199?-e?a
199?-e?a
199?-e?a
199?e?a
199?-e?a
Onueiai:e?a,
121

Eiia?oeieiee aeiaiai?

5.2. Aianaiiy i?aiaeieo ieaoaaeia I?AIAeA?AI caeienithooueny uieaa?oaeueii ?iaieie
/anoeaie a ?icii?i 1 /4 aiae ?i/ii? noie i?aiaeii? ieaoe ia iiciioa ________ /enea inoaiiueiai
iinyoey eaa?oaeo.

5.3. I?aiaeia ieaoa niea/oooueny a aacaioiaeiaiio ii?yaeeo ia ?ic?aooieiaee ?aooiie
AAIEO.

5.4. I?aiaeia ieaoa ca ocaiaeaeaiiyi noi?ii iiaea aiineoeny a iaoo?aeueiie aai ciioaiie
oi?ii, i?iaeoeoaie oa?/oaaiiy, oiaa?aie, iineoaaie.

5.5. ?icii? i?aiaeii? ieaoe iiaea aooe ciiiaiee ca caiaeith noi?ii oa a iioeo aeiaaeeao,
ia?aaeaa/aieo caeiiiaeaanoaii.

6. I?AAA OA IAIAssCEE AAIEA

6.1. AAIE iao i?aai caeienithaaoe ia?aai?eo ii?yaeeo aeei?enoaiiy I?AIAeA?AI iaeia,
ui i?aiaeoooueny, o aiaeiiaiaeiinoi aei oiia Aeaiiai Aeiaiai?o.

7. I?AAA OA IAIAssCEE I?AIAeA?ss

7.1. ?ecee aeiaaeeiai? iiaii? aai /anoeiai? ao?aoe aai inoaaiiy iaeia, ui i?aiaeoooueny,

eaaeeoue ia I?AIAeA?I.
7.2. I?AIAeA? ciaiaycaiee cano?aooaaoe iaeii, ui i?aiaeoooueny, i?ioyaii ____________

aeiia iiney eiai io?eiaiiy.
7.3. I?AIAeA? oaeiae ciaiaycoooueny:
– aeei?enoiaoaaoe iaeii, ui i?aiaeoooueny, ca eiai oeieueiaei i?ecia/aiiyi o aiaeiiaiaeiinoi

aei i.2 Aeaiiai Aeiaiai?o;

– naio/anii aiineoe i?aiaeii ieaoaaei;

– oo?eioaaoe iaeii, ui i?aiaeoooueny, o aiaeiiaiaeiinoi aei noaiaea?oia, oaoii/ieo oiia oa

iioi? aeieoiaioaoei? iiaei?eoinoaa-aeaioiaethaa/a;

– ianoe ani aeo?aoe c aenieoaoaoei?, oaoii/iiai ianeoaiaoaaiiy, ?aiiioo iaeia;

– caeienithaaoe ca aeaniee ?aooiie eaiioaeueiee oa iioi/iee ?aiiio iaeia, ui i?aiaeoooueny.
7.4. I?AIAeA? iao i?aai caeaaaoe iaeii, ui i?aiaeoooueny, o noai?aiaeo ca caiaeith

I?AIAeIAeAAOess.

8. II?ssAeIE IIAA?IAIIss IAEIA I?AIAeIAeAAOeTH

8.1. Iiney caeii/aiiy oa?iiio i?aiaee ca Aeaiei Aeiaiai?ii I?AIAeA? ciaiaycaiee
i?ioyaii __________________ iiaa?iooe iaeii, ui i?aiaeoooueny, I?AIAeIAeAAOeTH ca aeoii.

8.2. Iaeii, ui i?aiaeoooueny, iiaeiii aooe ia?aaeaii I?AIAeIAeAAOeTH o ni?aaiiio noaii
c o?aooaaiiyi ii?iaeueiiai ciino.

8.3. Iaeii, ui i?aiaeoooueny, iiaea aooe oaeiae i?eaeaaia I?AIAeA?AI o AAIEA o
aeaniinoue ca oeiiith, ui aecia/aooueny aeiaeaoeiaith oaiaeith noi?ii.

8.4. O aeiaaeeo, eiee I?AIAeA? caeieniea ca aeaniee ?aooiie oa ca caiaeith I?AIAeIAeAAOess
iie?auaiiy, iaaiaeaeieueii aac oeiaee aeey iaeia, ui i?aiaeoooueny, aii ____________ i?aai iiney
i?eieiaiiy aeiaiai?o ia aiaeoeiaeoaaiiy aa?oinoi oeeo iie?auaiue. “” ” ”

9. AIAeIIAIAeAEUeIINOUe NOI?II

9.1. I?AIAeA? iana ia?aae AAIEII ianooiio aiaeiiaiaeaeueiinoue ca Aeaiei Aeiaiai?ii:

– o aeiaaeeo iaiiaiaeiieaiiy AAIEA i?ioyaii _________ aeiia i?i io?eiaiiy iaeia, ui
i?aiaeoooueny, niea/oo oo?ao a ?icii?i ______________________;

– o aeiaaeeo i?ino?i/aiiy a i?eeiyooi iaeia, ui i?aiaeoooueny, niea/oo iaith a ?icii?i
_________________ aiae aa?oinoi iaeia ca eiaeai aeaiue i?ino?i/aiiy;

– o aeiaaeeo i?ino?i/aiiy ii nieaoi i?aiaeieo ieaoaaeia niea/oo iaith a ?icii?i _________
aiae noie ai?ao ca eiaeai aeaiue i?ino?i/aiiy;

– o aeiaaeeo iaoeieueiaiai aeei?enoaiiy iaeia, ui i?aiaeoooueny, niea/oo oo?ao a ?icii?i
_____________________ aiae noie aeiaiai?o.

10. IIAeNOAAE AeINO?IEIAIAI ?ICI?AAIIss AeAIIAI AeIAIAI?O

10.1. Aeaiee Aeiaiai? ?ici?aaiith a iaeiinoi?iiiueiio ii?yaeeo ia iiaeeyaao, ca aeiyoeii
aeiaaeeia, eiee iaeia ic noi?ii nenoaiaoe/ii ii?oooo oiiae aeiaiai?o i nai? ciaiaycaiiy.
10.2. Iioi iiaenoaae:

1 1. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

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Eiia?oeieiee aeiaiai?

12. IIOI OIIAE

12.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

12.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii.

12.3. Oni aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii o eiaeiiio ie?aiiio aeiaaeeo.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

___________________________________?icaeie 8____________________________________

IIAe?ssAe

Aeiaiai? iiae?yaeo o ii?o/ c aeiaiai?ii eoiiaei-i?iaeaaeo iaeiioe?aiioei o aeieiaiio iaiao,
ineieueee iiaea aeei?enoiaoaaoeny i?aeoe/ii o aoaeue-yeie noa?i ainiiaea?/i? aeiyeueiinoi.

Ca aeiaiai?ii iiae?yaeo IIAe?ssAe*EE ciaiaycoooueny ca naie ?ecee aeeiiaoe iaaio ?iaioo
ca caaaeaiiyi CAIIAIEEA c aeei?enoaiiyi nai?o aai eiai iaoa?iaeia, a CAIIAIEE ciai-
aycoooueny i?eeiyoe ?iaioo e iieaoeoe ??.

I?aaeiaoii aeiaiai?o iiae?yaeo o iaaiee ?acoeueoao aeeiiaii? ?iaioe (iai?eeeaae, iiaa,
ia?a?iaeaia aai aiae?aiiioiaaia ?i/). Naia oey ianoaaeia aiae?iciyo aeiaiai? iiae?yaeo aiae aeiaiai?o
c iaaeaiiy iineoa, i?aaeiaoii yeiai o naia iineoaa ye oaea, ui ia ia?aaeaooueny i ia?ic?eaii
iiaycaia c aeiyeueiinoth iineoaiaeaaoey, aeaai (aeea. ?icaeie 6).

sseui i?aaeiao iiae?yaeo aei caea/i eiai CAIIAIEEO aeiaaeeiai caaeioa aai caeii/aiiy
?iaioe noaei iaiiaeeeaei ia c aeie CAIIAIEEA, IIAe?ssAe*EE ia iao i?aaa aeiaaaoe
aeiaai?iaeo ca ?iaioo.

I?aaeiao iiae?yaeo aecia/aooueny caaaeaiiyi CAIIAIEEA, yea oienoooueny aai a oaenoi
aeiaiai?o, aai a aeiaeaoeo aei iueiai.

I?e aeeiiaiii ?iaio ca aeiaiai?ii iiae?yaeo iiaea aooe neeaaeaii oaa?aeee aai i?eaeeciee
eiooi?en. Ca caaaeueiei i?aaeeii, eiooi?en neeaaeaooueny IIAe?ssAe*EEII ye oaoiaoeai a
iaeanoi iaaii? aeiyeueiinoi i ocaiaeaeoooueny ic CAIIAIEEII.

?iaioo ii aeeiiaiith caiiaeaiiy IIAe?ssAe*EE i?aaiicoo ia naie ?icnoae. Aii iao i?aai
caeo/eoe aei aeeiiaiiy aeiaiai?o iioeo inia (noaiiae?yaeieeia). I?e oeueiio aii aiaeiiaiaeao ia?aae
CAIIAIEEII ca ?acoeueoaoe ?iaio i aenooiao ia?aae iei a yeinoi aaia?aeueiiai iiae?yae/eea,
a ia?aae noaiiae?yaeieeaie – a yeinoi CAIIAIEEA.

sseui IIAe?ssAe*EE aeiionoea iaaeieiee a ?iaioi, CAIIAIEE iao i?aai aeiaaaoe
aaciieaoiiai aei?aaeaiiy iaaeieieia aai aiaeoeiaeoaaiiy iaiaoiaeieo aeo?ao c ?o aei?aaeaiiy,
aai aiaeiiaiaeiiai ciaioaiiy aeiaai?iaee ca ?iaioo.

Iaeaaaeeeaioee iaiaycie IIAe?ssAe*EEA – caaacia/aiiy caa?aaeaiiy aai?aiiai eiio
CAIIAIEEII iaeia. Aii iana aiaeiiaiaeaeueiinoue ca aoaeue-yei oiouaiiy, ui iioyaee ca niaith
ao?aoo aai iioeiaeaeaiiy oeueiai iaeia.

Cai?iiiiiaaii ieae/a aeiaiai?e iiae?yaeo iinoyoue o niai aeineoue aaeeeo eieueeinoue oiia,
i?ioa, a caeaaeiinoi aiae eiie?aoii? neooaoei? aeayei oiiae iiaeia noi?ioethaaoe ii-iioiio, a aiae
aeayeeo oiia iiaeia aiaeiiaeoeny.

AeIAIAI?
iiae?yaeo

<____>___________ 199___?.

CAIIAIEE:

(iiaia oi?iiaa iaeiaioaaiiy iiaei?eoinoaa)

a iniai aee?aeoi?a
ui aeio ia iiaenoaai
c iaeiiai aieo, i

123

Eiia?oeieiee aeiaiai?
IIAe?ssAe*EE: __

(iiaia oi?iiaa iaeiaioaaiiy iiaei?eoinoaa)

A INIai ____________________________________________________________________________________________________________________,
ui aeio ia iiaenoaai aeiai?aiinoi ? _________ aiae <_____> ___________ 199__?., c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

CAIIAIEE aei?o/ao, a IIAe?ssAe*EE ciaiaycoooueny ca aeaniee ?ecee aeeiiaoe o aiaeiiaiae-
iinoi aei oiia Aeaiiai Aeiaiai?o ?iaioo, a CAIIAIEE ciaiaycoooueny i?eeiyoe oeth ?iaioo oa
iieaoeoe ??.

2. OA?AEOA? ?IAIO, UI AEEIIOTHOUeNss IIAe?ssAe*EEII

(cacia/aooueny oi/ia iaeiaioaaiiy ?iaioe, yeo aeeiioo IIAe?ssAe*EE)

3. AEIIAE CAIIAIEEA AeI I?AAeIAOO IIAe?ssAeO

3.1. I?aaeiaoii iiae?yaeo (?acoeueoaoii aeeiiaieo ?iaio ca Aeaiei Aeiaiai?ii) o:

3.2. Eieueeinii oa?aeoa?enoeee i?aaeiaoo iiae?yaeo: ____________________
3.3. sseinoue i?aaeiaoo iiae?yaeo iiaeiia aiaeiiaiaeaoe ianooiiei aeiiaai:

3.4. IIAe?ssAe*EE ciaiaycaiee noai?i aeeiioaaoe ani aeaciaee CAIIAIEEA c i?eaiaeo
aeeiiaiiy ?iaioe.

3.5. IIAe?ssAe*EE ciaiaycaiee iaaaeii iioi?ioaaoe CAIIAIEEA a oiio aeiaaeeo, yeui
aeio?eiaiiy iei aeaciaie CAIIAIEEA caa?iaeoo i?eaeaoiinoi aai iioeiinoi ?iaioe, ui
aeeiioooueny.

4. IINO?OIAIO, IAOA?IAEE OA OIIAE AEEIIAIIss ?IAIO

4.1. ?iaioe aeeiiothoueny ic iaoa?iaeia CAIIAIEEA ca aeiyoeii oeo iaoa?iaeia, yei ca
oiia Aeaiiai Aeiaiai?o iaaeaa IIAe?ssAe*EE.
4.2. ?iaioa aeeiioooueny ic ianooiieo iaoa?iaeia IIAe?ssAe*EEA:
I, _______________________ a eieueeinoi _____________ oeiia _______________________ .

2. _______________________ a eieueeinoi _____________ oeiia _______________________ .

3. _______________________ a eieueeinoi _____________ oeiia _______________________ .

4.3. sseinoue iaoa?iaeia IIAe?ssAe*EEA iiaeiia aiaeiiaiaeaoe _____________________________

4.4. ?ecee aeiaaeeiai? ao?aoe aai inoaaiiy iaoa?iaeia IIAe?ssAe*EEA c iiiaioo ia?aaea/i

iana ______________________________________________________________________________.
(CAIIAIEE /e IIAe?ssAe*EE)

4.5. CAIIAIEE ia oa?iii aei? aeiaiai?o iaaeao IIAe?ssAe*EEO ianooiiee iino?oiaio oa
iaeaaeiaiiy aeey aeeiiaiiy ?iaio:

I. _______________________ a eieueeinoi _____________ oeiia _______________________ .
2. ______._________________ a eieueeinoi _____________ oeiia _______________________ .
4.6. CAIIAIEE i?ioyaii ______________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o iaaeao
IIAe?ssAe*EEO iaiaoiaeio i?iaeoio aeieoiaioaoeith: e?aneaiiy, c?acee, a oaeiae iioi iaiaoiaeii
aeieoiaioe aeey aeeiiaiiy ?iaio.

4.7. CAIIAIEE ciaiaycoooueny caaacia/eoe IIAe?ssAe*EEO iaiaoiaeii oiiae aeey aeeiiaiiy
?iaio, yei aeeth/athoue a naaa _______________________________________________________ .

4,8. Iaoa?iae, iino?oiaio, iaeaaeiaiiy oa iaiaoiaeii oiiae ca i.i. 4.5-4.7 iiaeiii aooe
iaaeaii IIAe?ssAe*EEO aeey aeeiiaiiy ?iaio ca aeoii i?ioyaii __________ c iiiaioo iiaeienaiiy
Aeaiiai Aeiaiai?o.

4.9. O aeiaaeeo iaaeia?iyeiniinoi iaaeaiiai iaoa?iaeo CAIIAIEE ciaiaycaiee c?iaeoe
caiiio iaoa?iaeo a oa?iii ____________ c iiiaioo iiaiaeiieaiiy eiai IIAe?ssAe*EEII.

5. AEIAAI?IAeA IIAe?ssAe*EEA

5.1. Aa?oinoue oa aeo?aoe ii aeeiiaiith ?iaio aecia/athoueny caiaeii i?eaeeciiai eiooi?eno
(Aeiaeaoie ? 1 aei Aeaiiai Aeiaiai?o).

5.2. O aeiaaeeo iaiaoiaeiinoi ia?aaeueoe i?eaeeciee eiooi?en IIAe?ssAe*EE ciaiaycaiee
ienueiiai iiaiaeiieoe i?i oea CAIIAIEEA i?ioyaii ____________ aeiia.

124

Eiia?oeieiee aeiaiai?

Aei iiaiaeiieaiiy iiaeiii aooe aeiaeaii aeieoiaioe, ui iaa?oioiaothoue iiaeaeuaiiy eiooi?eno.

5.3. CAIIAIEE ciaiaycaiee i?ioyaii ______________ aeiia iiney iiaiaeiieaiiy aeaoe
IIAe?ssAe*EEO aiaeiiaiaeio aiaeiiaiaeue i?i iiaeoaa?aeaeaiiy caiiaeaiiy aai i?i aiaeiiao aiae aeiaiai?o.

5.4. Cia/iei aaaaeaooueny ia?aaeuaiiy i?eaeeciiai eiooi?eno aieueo, iiae ia _________
aiae caaaeueii? noie i?eaeeciiai eiooi?eno.

5.5. Aeo?aoe IIAe?ssAe*EEA aiaeoeiaeiaothoueny iei ic aeiaai?iaee, ui aeiea/oooueny CAIIA-
IEEII.

5.6. Aa?oinoue ?iaio ca Aeaiei Aeiaiai?ii aeacaia aac a?aooaaiiy IAeA (c a?aooaaiiyi
IAeA).

6. AeIIEAOE

6.1. Ca aeino?ieiaa aeeiiaiiy ?iaio aieueo iiae ia ___________ aeiia CAIIAIEE caeienitho
IIAe?ssAe*EEO aeiieaoo a ?icii?i ______________________________________ aiae aa?oinoi ?iaio.

7. II?ssAeIE ?IC?AOOIEIA

7.1. Oa?iiie iieaoe:
– i?ioyaii __________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o – aaain o ?icii?i _______

________________________ e?a.;
– i?ioyaii __________ c iiiaioo iiaeienaiiy aeoo caea/i-i?eeiaiiy ?iaio – inoaoi/iee

?ic?aooiie.
7.2. Ii?yaeie iieaoe:

(iiooiaee,oaeaa?aoiee)

7.3. Aeae ?ic?aooieia:

(aioiaeiaee, aacaioiaeiaee, ciioaiee)

7.4. Oi?ia ?ic?aooieia: __________________________________________________________

(ieaoiaeia aei?o/aiiy, /ae. aeiiaa.aei?o/aiiy, ae?aaeeoea)

7.5. CAIIAIEE iiaeiai iiaiaeiieoe IIAe?ssAe*EEA i?i caeieniaiiy ieaoaaeo a no?ie.
_______________ c iiiaioo ________________ oeyoii.

(oaeaa?aia c iiaiaeiieaiiyi, oaen oa ii.)

7.6. Aeiieaoa ca i.a Aeaiiai Aeiaiai?o aeiea/oooueny a oiio ae ii?yaeeo, ui e iniiaia noia
ieaoaaeo.

8. OA?III AEEIIAIIss ?IAIO

8.1. IIAe?ssAe*EE ciaiaycoooueny ?icii/aoe aeeiiaiiy ?iaio i?ioyaii ________________

c iiiaioo iaaeaiiy iaoa?iaeia, iino?oiaioo oa iaiaoiaeii? aeieoiaioaoei?.
8.2. IIAe?ssAe*EE ciaiaycoooueny aeeiioaaoe ?iaioo i?ioyaii _______________ c i?aaii

aeino?ieiaiai aeeiiaiiy.

8.3. I?iiiaeii oa?iiie: _________________________________________________________ .
8.4. Iiney caeii/aiiy aeeiiaiiy ?iaio IIAe?ssAe*EE ciaiaycaiee ienueiiai iiaiaeiieoe

CAIIAIEEA i?i aioiaiinoue i?aaeiaoo aei caea/i i?ioyaii _______________________________ .

9. EIIO?IEUe CAIIAIEEA CA IA?AAIAII AEEIIAIIss ?IAIO
9.1. IIAe?ssAe*EE ciaiaycoooueny a oa?iii _________ iioi?ioaaoe i?i ia?aaia aeeiiaiiy
?iaio.

9.2. CAIIAIEE iao i?aai aacia?aoeiaeiiai aeinooio aei ?iaio IIAe?ssAe*EEA aeey ia?aai?ee
ia?aaiao oa yeinoi ?iaio, ui aeeiiothoueny.

10. II?ssAeIE CAeA*I-I?EEIAIIss ?IAIO I?AAeIAOO IIAe?ssAeO

10.1. Caea/a-i?eeiaiiy aeeiiaieo ?iaio caeienithooueny noi?iiaie ca aeoii i?ioyaii _______
c iiiaioo iiaiaeiieaiiy CAIIAIEEA i?i aioiaiinoue i?aaeiaoo iiae?yaeo aei i?eeiaiiy.
10.2. Ioieo caea/i-i?eeiaiiy: _____________________________________________________ .
10.3. I?aaeiao iiae?yaeo iiaeiai aooe iaaeaiee CAIIAIEEO o aeaeyaei _______________ .

10.4. Aeinoaaea i?aaeiaoo iiae?yaeo caeienithooueny _______________________________________

(CAIIAIEEII /e IIAe?ssAe*EEII)

ca ?aooiie ________________________ o ianooiiiio ii?yaeeo ____________________________

10.5. A oa?iii ____________________ iiney iiaeienaiiy aeoo caea/i-i?eeiaiiy IIAe?ssAe*EE
ciaiaycaiee iaaeaoe CAIIAIEEO caeeoee iaoa?iaeia, caio i?i aeei?enoaiiy iaoa?iaeo, a
oaeiae ia?aaeaoe inoaiiueiio anth aeieoiaioaoeith oa e?aneaiiy, iaaeaii ca i.4.6 Aeaiiai Aeiaiai?o.

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11. AA?AIOIEII OA?IIIE

Aa?aioieiee oa?iii ca Aeaiei Aeiaiai?ii neeaaeao __________ c iiiaioo ia?aaea/i i?aaeiaoo
iiae?yaeo.

12. OA?III AeI? AeAIIAI AeIAIAI?O

12.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo iiaeienaiiy eiai noi?iiaie oa aeio aei
iiiaioo eiai inoaoi/iiai aeeiiaiiy, aea a aoaeue-yeiio aeiaaeeo aei <____> _______ 199 __ ?.

12.2. Aeaiee Aeiaiai? iiaea aooe i?ieiiaiaaiee ca caiaeith noi?ii.

13. AIAeIIAIAeAEUeIINOUe NOI?II

13.1. Ca ii?ooaiiy oiia Aeaiiai Aeiaiai?o aeiia noi?iia aiaeoeiaeiaoo ni?e/eiaii oeei
caeoee, a oiio /enei ao?a/aio aeaiaeo, a ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.
13.2. IIAe?ssAe*EE ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue: ______________

13.3. CAIIAIEE ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:

13.4. Ca iaeiinoi?iiith iaiaa?oioiaaio aiaeiiao aiae aeeiiaiiy nai?o iaiayceia i?ioyaii
aei? Aeaiiai Aeiaiai?o aeiia noi?iia niea/oo oo?ao o ?icii?i ___________________________ .
13.5. Ca ii?ooaiiy iioeo oiia Aeaiiai Aeiaiai?o aeiia noi?iia iana ianooiio aiaeii-
aiaeaeueiinoue: ________________________________________________________________________.

14. CAAACIA*AIIss CIAIAssCAIUe CAAeAIEI AeIAIAI?II

(iiaeooue ia?aaeaa/aoeny oiiae i?i canoaao, no?aooaaiiy aai ii?o/ieoeoai ? aieo ye CAIIAIEEA, oae i IIAe?ssAe*EEA)

15. II?ssAeIE ?ICAssCAIIss NOIA?A*IE

15.1. Ani noia?a/ee iiae noi?iiaie, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o
aiaeiiaiaeiinoi aei caeiiiaeaanoaa Oe?a?ie a A?aio?aaeiiio noaei (o?aoaenueeiio noaei ic cacia/aiiyi
yeiai eiie?aoiiai o?aoaenueeiai noaeo aai cacia/eoe ii?yaeie oi?ioaaiiy oeueiai o?aoaenueeiai
noaeo).

15.2. Noi?iie aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi noi?iiaie i?ioyaii __________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

16. CIIIA OIIA AeAIIAI AeIAIAI?O

16.1. Oiiae Aeaiiai Aeiaiai?o iathoue iaeiaeiao ciaia ycoaaeueio neeo aeey noi?ii oa iiaeooue
aooe ciiiaii ca acaoiiith caiaeith c iaiayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioo.

16.2. AEiaeia ic noi?ii ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee ae?oai? noi?iie,

17. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie noi?ii ca Aeaiei Aeiaiai?ii o:
IIAe?ssAe*EE: _________________________________________ oaeaoii ________________ .
CAIIAIEE: _________________________________________ oaeaoii ________________ .

12. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

19. IIOI OIIAE

19.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao ii iaeiiio aeey eiaeii? ic
noi?ii.

19.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iia-
aeyinueeei caeiiiaeaanoaii.

19.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

19.4. Ani aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii a eiaeiiio ie?aiiio aeiaaeeo.

19.5. Noi?iie ciaiaycothoueny i?e aeeiiaiii Aeaiiai Aeiaiai?o ia caiaeeoe niia?iaioieoeoai
eeoa aei aeio?eiaiiy aeiia, ui iinoyoueny a Aeaiiio Aeiaiai?i, iiaeo?eioaaoe aeieiai eiioaeoe oa
aaeeaaoe anio iaiaoiaeieo caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?o eiia?oeieieo
cayceia.

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Eiia?oeieiee eiaiai?

20. AeIAeAOEE AeI AeAIIAI AeIAIAI?O
20.1. Aei Aeaiiai Aeiaiai?o aeiaeathoueny:

I. Aeiaeaoie ? 1 ia ___________ noi?.
20.2. Aeiaeaoie aei Aeaiiai Aeiaiai?o neeaaeao eiai iaaiaeoiio /anoeio.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
iiae?yaeo ia eaiioaeueia aoaeiaieoeoai

199 ___ ?.

CAIIAIEE:

a iniai _________
ui aeio ia iiaenoaai _
c iaeiiai aieo, i

IIAe?ssAe*EE:
a iniai _________

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:
I. IIAe?ssAe*EE aa?a ia naaa.

(aoaeiaieoeoai iiaeo,

?icoe?aiiy, ?aeiino?oeoeith, oaoii/ia ica?ioiiy aeith/eo iiaei?eoinoa,

aoaeeieia, nii?oae aai ?oiio /a?a)

ca i?iaeoii, caoaa?aeaeaiei _________________________________________________________ .

(eei caoaa?aeaeaiee i?iaeo, aeaoa caoaa?aeaeaiiy)

2. IIAe?ssAe*EE aa?a ia naaa ciaiaycaiiy caeienieoe ?iaioe, cacia/aii a i. I Aeaiiai
Aeiaiai?o, o aiaeiiaiaeiinoi aei caoaa?aeaeaii? i?iaeoii-eiooi?enii? aeieoiaioaoei?, oeooeueiiai
nieneo, caoaa?aeaeaiiai ____________________________________________________________,

(eei caoaa?aeaeaiee nienie, aeaoa eiai caoaa?aeaeaiiy)

a?aoieii ae?iaieoeoaa aoaeiaaeueii-iiioaaeieo ?iaio o oa?iii aiae <___> _________ 199__?. aei

(IINssOeUe)

<__> _________ 199 __ ?.; caaacia/eoe aeeiiaiiy aoaeiaaeueii-iiioaaeieo ?iaio o aiaeiiaiaeiinoi

(iinyoeue)

aei aoaeiaaeueieo ii?i i i?aaee; caeienieoe iiaeeaiaeoaeueia aei?iaoaaiiy ciiioiaaiiai iei iaeaae-
iaiiy; acyoe o/anoue o eiiieaeniiio aei?iaoaaiii iaeaaeiaiiy; caeaoe ?iai/ie eiiini? ?iaioe
ca Aeaiei Aeiaiai?ii; niieueii ic CAIIAIEEII oa noaiiae?yaeieie i?aaiicaoeiyie aaanoe a
aeith-

(iaeiaioaaiiy iiaee?eainoaa, aoaeeieo, nii?oaee, ?oiio /a?a)

a oeieiio, a oiio /enei ae?iaie/i iiooaeiinoi oa iaoeoe ca ?ieaie:

Iaeiaioaaiiy iiooaeiinoi (iaoeoa),
iaeeieoey aeii?o

Eieueeinoue

Oa?iii oaiaeo
(?ie, iinyoeue)

3. CAIIAIEE ciaiaycoooueny ia?aaeaoe IIAe?ssAe*EEO o anoaiiaeaiiio ii?yaeeo caoaa?ae-
aeaio i?iaeoii-eiooi?enio aeieoiaioaoeith, iaeaaeiaiiy, iaoa?iaee oa ae?iae, caaacia/eoe aiae-
e?eooy oa aacia?a?aiinoue oiiainoaaiiy aoaeiaieoeoaa, naio/anii oeiiieaeooaaoe iaoeoe, yei
iiaeeyaathoue oaiaeo a aeith, eaae?aie, caaacia/eoe oei iaoeoe ne?iaeiith oa aia?ai?ano?naie, i?iaanoe
eiiieaenia aei?iaoaaiiy iaeaaeiaiiy iaoeoia, ui iiaeeyaathoue oaiaeo a aeith, i?eeiyoe aiae

127

Eiia?oeieiee aeiaiai?
IIAe?ssAe*EEA ca aeoii ?iai/i? eiiini? caaa?oaia aoaeiaieoeoai

(iaeiaioaaiiy iiaei?eoinoaa, aoaeeieo, nii?oaee aai ?oiio /a?a)

niieueii c aaia?aeueiei iiae?yae/eeii oa noaiiae?yaeieie i?aaiicaoeiyie oaanoe eiai a aeith o anoa-
iiaeaii oa?iiie oa caeienieoe ia iueiai ?ic?aooiee.

4. Aa?oinoue ?iaio, ui aei?o/athoueny IIAe?ssAe*EEO, ca Aeaiei Aeiaiai?ii iiae?yaeo aecia/aia
ia iiaenoaai aeiaiai?ii? oeiie i neeaaeao ____________ ea?aiaaioeia, a oiio /enei aoaeiaaeueii-
iiioaaeieo ?iaio ____________ ea?aiaaioeia.

5. Iniaeeai oiiae aei Aeaiiai Aeiaiai?o iiae?yaeo ia eaiioaeueia aoaeiaieoeoai: ___________

6. Aeaiee Aeiaiai? iiae?yaeo neeaaeaiee o o?ueio i?eii?ieeao: ii iaeiiio aeey eiaeii? ic noi?ii
oa iaeei aaieo, yeee oiiainoo aoaeiaieoeoai.

7. Aeiaeaoee aei Aeaiiai Aeiaiai?o: Aeieoiaioaoeiy, ui ia?aaeaooueny CAIIAIEEII IIAe?ssAe-
*EEO aeey oeeaaeaiiy aeiaiai?o iiae?yaeo ia eaiioaeueia aoaeiaieoeoai, a?aoie i?iaaaeaeaiiy ao-
aeiaaeueii-iiioaaeieo ?iaio oa ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI? ..;-
iiae?yaeo ia eaiioaeueiaaoae?aiooaaa

i. ____________ . <____> ___________ 199 ___ ?.

CAIIAIEE:
a iniai __________
ui aeio ia iiaenoaai _
c iaeiiai aieo, i

IIAe?ssAe*EE:
a iniai __________

ui aeio ia iiaenoaai ___________________________________________________________________,
c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

I. CAIIAIEE aei?o/ao, a IIAe?ssAe*EE aa?a ia naaa i?iaaaeaeaiiy ?iaio c eaiioaeueiiai

?aiiioo ________________________________________________________________________________

(iaeiaioaaiiy iaoeoa eaiioaeueiiai ?aiiioo)

aiaeiiaiaeii aei caoaa?aeaeaieo i?iaeoia, eiooi?enia, a oaeiae ?iai/eo e?aneaiue ia oei iaoeoe.

2. IIAe?ssAe*EE ciaiaycaiee aeeiiaoe ani iaoiiaeaii aeiaiai?ii ?iaioe oa caeaoe ?o o
caeii/aiiio aeaeyaei a oa?iii aei <____> __________ 199__?. o iiaiie aiaeiiaiaeiinoi aei i?iaeoia,
eiooi?enia, a oaeiae ?iai/eo e?aneaiue, ui ia?aaeathoueny IIAe?ssAe*EEO CAIIAIEEII.

3. CAIIAIEE ciaiaycaiee ia?aaeaoe IIAe?ssAe*EEO o anoaiiaeaiiio ii?yaeeo caoaa?ae-
aeaio i?iaeoii-eiooi?enio aeieoiaioaoeith, iaiaoiaeii aeey i?iaaaeaeaiiy ?iaio iaeaaeiaiiy oa
iaoa?iaee, i?eeiyoe aiae IIAe?ssAe*EEA ca aeoii iaoeo eaiioaeueiiai ?aiiioo oa iieaoeoe
aeeiiaii ?iaioe.

4. Aa?oinoue onio ?iaio, ui aei?o/athoueny IIAe?ssAe*EEO, ca Aeaiei Aeiaiai?ii neeaaeao ____
_____________ e?a.

5. I?e aeeiiaiii Aeaiiai Aeiaiai?o noi?iie ea?othoueny aeith/eie I?aaeeaie i?i iiae?yaeii
aeiaiai?e c aoaeiaieoeoaa, ii?iaoeaieie aeoaie c ieoaiue eaiioaeueiiai aoaeiaieoeoaa, a oaeiae
Iniaeeaeie oiiaaie aei Aeaiiai Aeiaiai?o.
Aeiaeaoee:

I. Iniaeeai oiiae aei Aeaiiai Aeiaiai?o.

2. Aeieoiaioaoeiy, ui ia?aaeaooueny CAIIAIEEII IIAe?ssAe*EEO i?e oeeaaeaiii Aeaiiai
Aeiaiai?o.

3. A?aoie i?iaaaeaeaiiy ?iaio.

4. Ia?aeie iaeaaeiaiiy oa iaoa?iaeia, ui iaaeathoueny CAIIAIEEII, ii?yaeie oa oa?iiie
?o iinoaaee.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

128

Eiia?oeieiee eiaiai?

AeIAIAI?

ia i?iaaaeaiiy iaoeiai-aeineiaeieoeueeeo,
aeineiaeii-eiino?oeoi?nueeeo i oaoiieiai/ieo ?iaio

199___?.

CAIIAIEE: _

a iniai ____________
ui aeio ia iiaenoaai __
c iaeiiai aieo, i

AEEIIAAAOeUe:
a iniai ____________

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. CAIIAIEE aei?o/ao, a AEEIIAAAOeUe aa?a ia naaa i?iaaaeaiiy ianooiieo iaoeiai-
aeineiaeieoeueeeo, aeineiaeii-eiino?oeoi?nueeeo i oaoiieiai/ieo ?iaio: ___________________________

1.2. Ciino oa ianya ?iaioe a oeieiio oa ii aoaiao (?icaeieao) aecia/athoueny ocaiaeaeaiith
noi?iiaie I?ia?aiith, ui aeiaeaooueny aei aeiaiai?o, yea neeaaeao iaaiaeoiio /anoeio Aeaiiai
Aeiaiai?o.

Ca ?iaioaie, ui aeeiiothoueny a oa?iii aieueoa ?ieo, I?ia?aia neeaaeaooueny ia aanue ianya
?iaioe c iaiayceiaei aeaeieaiiyi ianyao aa?oinoi ?iaio iioi/iiai ?ieo, a oaeiae ic cacia/aiiyi

i?ioioiaii? aa?oinoi ?iaio eiaeiiai iiaeaeueoiai ?ieo.

1.3. ?iaioa ca Aeaiei Aeiaiai?ii aeeiioooueny o aiaeiiaiaeiinoi aei ocaiaeaeaiiai noi?iiaie
oaoii/iiai caaaeaiiy, oaoii/ieo, iaoeiaeo i aeiiiii/ieo oa iioeo aeiia.
1.4. Oa?iii aeeiiaiiy anio? ?iaioe aiae ________________ aei ________________ .
Oa?iii aeeiiaiiy ie?aieo aoaiia (?icaeieia, /anoei) ?iaioe aecia/aooueny eaeaiaea?iei
ieaiii (aeiaeaoie).

O aeiaaeeo aeino?ieiaiai aeeiiaiiy ?iaioe AEEIIAAOeAI noi?iie aecia/athoue ii?yaeie
i?eeiaiiy oa iieaoe aeeiiaieo ?iaio.

1.5. sseui a i?ioeani aeeiiaiiy ?iaioe cyniaoooueny iaieio/inoue iaea?aeaiiy iaaaoeaiiai
?acoeueoaoo aai iaaeioeieueiinoue iiaeaeueoiai i?iaaaeaiiy ?iaioe, AEEIIAAAOeUe iao i?aai
i?ecoieieoe ??, iinoaaeaoe i?i oea aei aiaeiia CAIIAIEEA o o?eaeaiiee oa?iii iiney coieiee.

O oeueiio aeiaaeeo noi?iie ciaiaycaii o 5-aeaiiee oa?iii ?icaeyiooe ieoaiiy i?i aeioeieueiinoue
i?iaeiaaeaiiy ?iaio oa o aeiaaeeo iaaoiaeiinoi oaieoe c eeiiioaiiyi aei aiaeiiaiaeieo i?aaiicaoeee
i?i coieiaiiy ?iaio.

1.6. Aeei?enoaiiy caaa?oaii? iaoeiai-aeineiaeieoeueei?, aeineiaeii-eiino?oeoi?nueei?, oaoiiei-
ai/ii? ?iaioe caeienithooueny CAIIAIEEII ia _________________________________________

(cacia/eoe iiaei?eoinoai, i?aaiicaoeith)

OEssOII _________________________________________________________________________________________________________________________ .

(cacia/eoe, yeei /eiii aoaea aeei?enoiaoaaoeny ?acoeueoao ?iaioe)

Ani aeo?aoe ii inaioiith ?acoeueoaoia aeineiaeaeaiiy iiea/othoueny aaciina?aaeiuei CAIIAIE-
EII o anoaiiaeaiiio ii?yaeeo. AEEIIAAAOeUe iiyeeo aeo?ao c inaioiiy ia iana, ie?ii
aeo?ao c aaoi?nueeiai iaaeyaeo ca inaioiiyi, ui aoiaeyoue aei eiooi?enii? aa?oinoi ?iaioe.

2. AA?OINOUe ?IAIOE OA II?ssAeIE ?IC?AOOIEIA

2.1. Ca aeeiiaii ?iaioe, cacia/aii a i. I aeiaiai?o, CAIIAIEE niea/oo AEEIIAAOeTH
_____________________ (___________________________) e?a. caiaeii eiooi?enieo ?ic?aooieia
(eaeueeoeyoeie), ui aeiaeathoueny aei aeiaiai?o.

2.2. Ia iiciioa iiny/iiai oa?iiio c aeiy iiaeienaiiy aeiaiai?o CAIIAIEE ciaiaycaiee
ia?a?aooaaoe AEEIIAAOeTH aaain o ?icii?i 20% aiae eiooi?enii? aa?oinoi ?iaio, oiaoi _______
_____________ (_______________________) e?a.

O aeiaaeeo, yeui aeeiiaiiy ?iaioe ia?aaeaa/aii aeiaiai?ii a oa?iii aieueoa ?ieo, CAIIA-
IEE ia?a?aoiaoo AEEIIAAOeTH aaain a ?icii?i 25% aiae aa?oinoi ?iaio iioi/iiai ?ieo.

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2.3. I?iiiaeii ieaoaaei CAIIAIEE caeienitho ca ?aooieaie AEEIIAAOess ia iiaenoaai
aeoia, yei neeaaeathoueny noi?iiaie ii ii?i aioiaiinoi ie?aieo aoaiia ?iaioe.

I?e iaaeioeieueiinoi aeeeeeo i?aaenoaaieea CAIIAIEEA (aeaeueiinoue aiaenoaii, iaaaeeeee
ianya oa ii.) ii?yaeie ioi?ieaiiy aeoia aeey caea/i oa i?eeiaiiy ie?aieo aoaiia ?iaioe
aecia/aooueny oaiaeith noi?ii a .

I?e iieaoi i?iiiaeieo ?aooieia CAIIAIEEII oo?eioooueny /anoeia aaaino, ui
aiaeiiaiaeao aa?oinoi aeeiiaii? ?iaioe. Ia?oa oo?eiaiiy aaaino caeienithooueny i?e ia?oie iieaoi
iiney 50% aioiaiinoi iaoeiai-aeineiaeieoeueei?, aeineiaeii-eiino?oeoi?nueei?, oaoiieiai/ii? ?iaioe.
Inoaoi/iee ?ic?aooiie caeienithooueny iiney caea/i oa i?eeiaiiy anio? ?iaioe ic ca?aooaaiiyi
/anoeie aaaino, ui caeeoeeanue, a oaeiae iiney aeiii?aoethaaiiy oaie, yeui aiii iaei iinoea.
?aooiee AEEIIAAOess c aeiaeaieie aei ieo aeoaie i?i aeeiiaio ?iaioo iiea/othoueny
CAIIAIEEII o anoaiiaeaiiio ii?yaeeo.

3. II?ssAeIE CAeA*I I I?EEIAIIss ?IAIO

3.1. I?i caeii/aiiy aeeiiaiiy eiaeiiai aoaio ?iaio, a oaeiae ?iaioe a oeieiio, AEEIIA-
AAOeUe iiaeiai iiaiaeiieoe CAIIAIEEA, iiney /iai noi?iie neeaaeathoue aeainoi?iiiie aeo
i?eeiaiiy oa caea/i o aeaio aai o?ueio i?eii?ieeao, ii iaeiiio aeey eiaeii? ic noi?ii oa aeey
aeiaeaoeo aei ?aooieo o aeiaaeeao, ia?aaeaa/aieo aeaciaeaie aaieo. O aeiaaeeo iacaaacia/aiiy
CAIIAIEEII i?eeiaiiy aoaio ?iaioe i?ioyaii 5 aeiia iiney io?eiaiiy iiaiaeiieaiiy
AEEIIAAAOeUe iao i?aai neeanoe iaeiinoi?iiiie aeo, yeee o iiaenoaaith aeey ?ic?aooieo.
I?eeiaiiy ?iaioe ii aoaiao oa a oeieiio caeienithooueny ca ocaiaeaeaiith I?ia?aiith.

3.2. I?e caaa?oaiii iaoeiai-aeineiaeieoeueeeo ?iaio AEEIIAAAOeUe iiaeao CAIIAIEEO
iaoeiai-oaoii/iee caio i?i aeeiiaio ?iaioo, caeeth/aiiy aenia?oia oa iioi aeieoiaioe (ca
aeiiaith CAIIAIEEA), iaoiiaeaii aeiaiai?ii. O aeiaaeeo, yeui o CAIIAIEEA aeyaeythoueny
caoaaaeaiiy aai i?aoaici? ii aeeiiaiie ?iaioi, eiio iaaeaooueny i?aai cayaeoe ?o AEEIIAAOeTH
i?ioyaii 10 aeiia iiney a?o/aiiy eiio iaoeiai-oaoii/iiai caioo oa iioeo aeieoiaioia.

3.3. sseui i?e i?eeiaiii ?acoeueoaoia aeineiaeii-eiino?oeoi?nueeeo aai oaoiieiai/ieo ?iaio
(?ic?iaie) aoaea aeyaeaia iaaiaeiiaiaeiinoue aeaioiaeaiiai c?acea oaoii/iiio caaaeaiith, oaoii/iei
oa iioei aeiiaai aianeiaeie iacaaeiaieueiiai aeaioiaeaiiy, iiaaii? yeinoi iaoa?iaeo aai
iaaiaeiiaiaeiinoi e?aneaiue oa oaoii/ii? aeieoiaioaoei? iaaeaiiio c?aceo, noi?iiaie neeaaeaooueny
aeainoi?iiiie aeo c ia?aeieii iaiaoiaeieo aeiii?aoethaaiue. I?aoaici? uiaei i?iaaaeaiiy aeiii?aoeth-
aaiue iiaeiii aooe i?aaeyaeaii CAIIAIEEII i?ioyaii 5 aeiia.

3.4, sseui i?e i?eeiaiii c?aceia aoaea aeyaeaia iaiaoiaeiinoue aeiii?aoethaaiiy aai eiino?oe-
oeaieo ciii ie?aieo aoceia oa aeineiaeiiai c?aceo ia aiaeiiio aiae ii/aoeiaiai oaoii/iiai caaaeaiiy,
oaoii/ieo oa iioeo aeiia, a o aiaeiiaiaeiinoi aei oeueiai ciiie e?aneaiue oa oaoii/ieo oiia ia
aeiiao CAIIAIEEA, oei ?iaioe caeieniththoueny ca aeiaeaoeiaith oaiaeith ic cacia/aiiyi oa?iiio
aeeiiaiiy ?iaio oa ?o aa?oinoi.

3.5. sseui iiae /an aeeiiaiiy ?iaioe CAIIAIEE aai AEEIIAAAOeUe ciaeaeooue ca iaiaoiaeia
caiiieoe iaeei aeae ?iaioe iioei, oi oaea caiiia aeiioneaooueny ca ienueiiaith oaiaeith iiae
noi?iiaie o iaaeao aeaii? ?iaioe.

4. AIAeIIAIAeAEUeIINOUe NOI?II

Ca ii?ooaiiy acyoeo ca aeiaiai?ii ciaiaycaiue noi?iie ianooue aiaeiiaiaeaeueiinoue o aiaeiiaiae-
iinoi aei Oeiiaiai iieiaeaiiy i?i ii?yaeie oeeaaeaiiy ainiiaea?nueeeo aeiaiai?ia oa aeaea/i aioo?io-
iueiiiiinoa?nueeeo caiiaeaiue ia i?iaaaeaiiy iaoeiai-aeineiaeieo, aeineiaeii-eiino?oeoi?nueeeo oa
oaoiieiai/ieo ?iaio.

5. IIOI OIIAE

.5.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? c
noi?ii.

5.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyinue-
eei caeiiiaeaanoaii.

5.3, Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

5.4. Ani aei?aaeaiiy ca oaenoii Aeaiiai Aeiaiai?o iathoue th?eaee/io neeo eeoa i?e
acaoiiiio ?o iinaiae/aiii i?aaenoaaieeaie noi?ii o eiaeiiio ie?aiiio aeiaaeeo.

6. OA?III AeI? AeIAIAI?O OA TH?EAeE*II AAe?ANE NOI?II

6.1. Oa?iii aei? Aeaiiai Aeiaiai?o anoaiiaethooueny aiae ________________ aei ___________ .

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Eiia?oeieiee aeiaiai?

7. AeIAeAOEE AeI AeAIIAI AeIAIAI?O

1. Eaeaiaea?iee ieai ?iaioe.

2. Eiooi?en ?iaioe, yea aeeiioooueny.

3. Iioi aeieoiaioe, yeui oea ia?aaeaa/aii aeiaiai?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

__________?icaeie 9__________
IIOI AeIAIAI?II AIAeIINEIE

AeIAIAI?
i?i niieueio aeiyeueiinoue

i.____________ <____>___________ 199___?.

NOI?IIA-1:________________________________________________________________,
a iniai ____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo,

NOI?IIA-2: ___________________________________________________________________,

a iniai _____________________________________________________________________________,
ui aeio ia iiaenoaai Noaoooo, iaaeaei ?acii ca oaenoii Aeaiiai Aeiaiai?o ,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO I OeIEUe AeIAIAI?O

NOI?IIE ca Aeaiei Aeiaiai?ii ciaiaycothoueny oeyoii iaoaeiaiiy iaeia i coneeue niieueii
aeiyoe a noa?i _____________________ aeey aeinyaiaiiy ianooiieo niieueieo ainiiaea?nueeeo oeieae:

2. ACAoIII IAIAssCEE NOI?II

2.1. Aeey nei?ioiai aeinyaiaiiy oeieae ca Aeaiei Aeiaiai?ii NOI?IIE ciaiaycothoueny:
– iaiiithaaoeny iayaiith o ?oiueiio ?icii?yaeaeaiii iioi?iaoeioth c aniaeoia acaoiiiai
iioa?ano;

– a oa?iii ___________ i?iaiaeeoe niieueii eiinoeueoaoei? oa naiiia?e c ocaiaeaeaii? oaiaoeee
aeey iaaiai?aiiy ieoaiue noiinii? aeiyeueiinoi;

– o aeiaaeeo iaiaoiaeiinoi caeienithaaoe acaoiia e?aaeeooaaiiy oa oiiainoaaiiy ia aacaiaenio-
eiaie oa aaciieaoiie iiaenoaai o aiaeiiaiaeiinoi aei oaiae, ui oeeaaeathoueny;

– aeeiioaaoe niieueii caiiaeaiiy oa caiiaeaiiy iaeei iaeiiai c i?aaeiaoo noiinii? aeiyeueiinoi
ia i?ii?eoaoiie oa iieueaiaie iiaenoaai.

2.2. Noiinia aeiyeueiinoue NOI?II aoaea caeienithaaoeny o aiaeiiaiaeiinoi aei
(Aeiaeaoie ? 1), ui aeiaeaooueny aei Aeaiiai Aeiaiai?o, a yeie NOI?IIE aecia/athoue ii?yaeie,
oa?iiie, aoaie oa iioi oiiae noiinii? aeiyeueiinoi.

2.3. O I?ia?aio ?iaio iiaeooue aiineoeny ciiie, aeiiiaiaiiy oa ooi/iaiiy a ii?yaeeo, ui
aecia/aooueny Aeaiei Aeiaiai?ii.

3. IAIAssCEE NOI?IIE-1

NOI?IIA-1 ciaiaycoooueny:

– a oa?iii i?ioyaii _____________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o ia?a?aooaaoe
NOI?III-2 ieaoiaeiei aei?o/aiiyi a?ioiaee aianie a ?icii?i _____________________ e?a.;

– caeienithaaoe o aeiaaeeo iaiaoiaeiinoi aeiaeaoeiao iiaea/o aianeia ia noiinio aeiyeueiinoue
oeyoii ia?a?aooaaiiy a?ioae ia ?ic?aooieiaee ?aooiie NOI?IIE-2 aai oeyoii iieaoe ??
aeo?ao c noiinii? aeiyeueiinoi;

(Iioi ciaiaycaiiy NOI?IIE-1)

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4. IAIAssCEE NOI?IIE-2

NOI?IIA-2 ca Aeaiei Aeiaiai?ii ciaiaycoooueny:

– iiney iiaeienaiiy Aeaiiai Aeiaiai?o iaaaeii i?enooieoe aei caeieniaiiy eiia?oeieieo
i?iaeoia, i?ioiiainiaaieo NOI?IIITH-I;

– aaeeoe caoiaeia ii iaeio aiaeiiaiaeiiai ia?niiaeo aeey aeeiiaiiy ?iaio ca Aeaiei Aeiaiai?ii;

– iaaeaaaoe a oa?iii ____ NOI?III-1 iioi?iaoeith i?i ia?aaia aeeiiaiiy niieueieo i?iaeoia;

– iaaeaaaoe uioeaeiaaa oiiainiai caioe i?i ii?yaeie aeei?enoaiiy eiooia NOI?IIE-1:

(iioi ciaiaycaiiy NOI?IIE-2)

5. AAAeAIIss NIIEUeIEO NI?AA

5.1. Aaaeaiiy niieueieo ni?aa ca Aeaiei Aeiaiai?ii caeienithooueny NOI?IIAIE ca ?o niieue-
iith caiaeith.

5.2. ?ioaiiy i?eeiathoueny ia cai?ao i?aaenoaaieeia NOI?II, aai oeyoii iieooaaiiy
ienueiiai, ii oaeaa?aoo aai oaeno.

5.3. Ea?iaieoeoai noiiniith aeiyeueiinoth ca Aeaiei Aeiaiai?ii, a oaeiae aaaeaiiy niieueieo
ni?aa aei?o/aooueny NOI?III-2.

5.4. NOI?IIA-2 aeio ia iiaenoaai aeiai?aiinoi, yeo NOI?IIA-1 ciaiaycoooueny aeaeaoe
i?ioyaii _____________________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o.

5.5. NOI?IIA-2 o iiaiiaaaeiei i?aaenoaaieeii NOI?IIE-1, ea?oo anioth noiiniith
aeiyeueiinoth oa /eieoue oni iaiaoiaeii th?eaee/ii aei? oa aeoe aeey aeinyaiaiiy iinoaaeaii? ca aeiaiai?ii
oeiei.

5.6. Ani oiiainiai iia?aoei? ii noiiniie aeiyeueiinoi NOI?II caeieniththoueny /a?ac ?ic?aooi-
eiaee ?aooiie NOI?IIE-2.

5.7. NOI?IIA-1 iao i?aai caeienithaaoe eiio?ieue ca aeiyeueiinoth NOI?IIE-2 a ?aieao
Aeaiiai Aeiaiai?o oeyoii ia?aai?ee aooaaeoa?nueeeo oa iioeo aeieoiaioia inoaiiuei?.

5.8. NOI?IIA-2 iao i?aai caeo/aoe aeey aeeiiaiiy nai?o ciaiaycaiue ca Aeaiei Aeiaiai?ii
o?aoio inia, aa?o/e ia naaa aiaeiiaiaeaeueiinoue ia?aae NOI?IIITH-I ca ?oii aei?.

6. AIANEE I *ANOEE NOI?II

6.1. Aianie NOI?IIE-1 – a?ioiai eiooe, iaaeaii NOI?III-2 a ia?iiae aei? Aeaiiai Aeiaiai?o
ia oeiei noiinii? aeiyeueiinoi, a oaeiae ianooiia:

oa yea aeiyeueiinoue NOI?IIE-1 aaaaeaooueny ca aianie)

Ii?yaeie i oa?iiie iiaea/i aianeia:

*anoea NOI?IIE-1 neeaaeao ____________%.
6.2, Aianie NOI?IIE-2 – iniaenoa o?oaeiaa o/anoue, a oaeiae ianooiia:

(cacia/aooueny, yea iaeii
oa yea aeiyeueiinoue NOI?IIE-2 aaaaeaooueny ca aianie)

Ii?yaeie i oa?iiie iiaea/i oa caeieniaiiy aianeia:

*anoea NOI?IIE-2 neeaaeao _____________%.

6.3. I?e ciiii ianyaia ?iaio, ui aeeiiothoueny, NOI?IIE aiinyoue aiaeiiaiaeii ciiie oa
aeiiiaiaiiy aei Aeaiiai Aeiaiai?o, a oiio /enei ooi/ithth/e naith /anoeiao o/anoue a noiiniie
aeiyeueiinoi.

7. NIIEUeIA IAEII NOI?II CA AeAIEI AeIAIAI?II

7.1. A?ioiai oa iaeiiai aianee NOI?II, a oaeiae iaeii, noai?aia aai i?eaeaaia NOI?IIA-
IE a ?acoeueoaoi noiinii? aeiyeueiinoi, neeaaeao ?o niieueio /anoeiao aeaniinoue.

7.2. Niieueia iaeii NOI?II ia/enethooueny ia ie?aiiio aaeaini NOI?IIE-2, yeee aaaeaoueny
a ii?yaeeo, ocaiaeaeaiiio c NOI?IIITH-I.

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8. ?ICIIAeIE ?ACOEUeOAOIA NOIINII? AeIssEUeIINOI

8.1. I?iaeoeoeiy, ui o ?acoeueoaoii noiinii? aeiyeueiinoi, aoaea ?aaeiciaoaaoeny a ianooiiiio
ii?yaeeo:

8.2. Ani aeioiaee, ui io?eiothoueny ca Aeaiei Aeiaiai?ii o ?acoeueoaoi noiinii? aeiyeueiinoi,
aeei?enoiaothoueny a ia?oo /a?ao ia aiaeoeiaeoaaiiy iaoa?iaeueieo cao?ao.

8.3. I?eaooie, ui io?eioooueny NOI?IIAIE aiae noiinii?aeiyeueiinoi, iiaeeyaao ?iciiaeieo
i?iii?oeieii /anoeai, aecia/aiei o i.6 Aeaiiai Aeiaiai?o.

8.4. Iiaeaeooy iiaenoieia noiinii?aeiyeueiinoi i ?iciiaeie i?eaooeo iiae NOI?IIAIE caeienith-
ooueny a oa?iii ia iiaenoaai ie?aiiai aaeaino, yeee neeaaeao NOI?IIA-2.
Aaeain iiaeiai aooe iiaeaiee NOI?III-1 ia iiciioa __-ai /enea eiaeiiai __________ .
8.5. Eiaeia ic NOI?II ia iao i?aaa ?icii?yaeaeaoeny naioth /anoeith o niieueiiio iaeii
aac caiaee iioeo o/anieeia Aeaiiai Aeiaiai?o aei caoaa?aeaeaiiy aaeaino, neeaaeaiiai NOI?IIITH-2,
ca aeiyoeii oio? /anoeie i?iaeoeoei? oa aeioiaeia aiae noiinii? aeiyeueiinoi, yea iaaeoiaeeoue o ?icii?yae-
aeaiiy eiaeiiai c o/anieeia iiney oaeoe/iiai ?iciiaeieo.

8.6. Oaeoe/iee ?iciiaeie i?eaooeo caeienithooueny oeyoii ia?a?aooaaiiy aiaeiiaiaeii? /anoee
i?eaooeo NOI?III-1 oa oo?eiaiiy aiaeiiaiaeii? /anoee i?eaooeo NOI?IIITH-2.

Ii?yaeie i oa?iiie ?iciiaeieo niieueii? i?iaeoeoei? caeienithooueny NOI?IIAIE o aiaeiiaiaeiinoi
aei ie?aieo oaiae.

8.7, Iiiaeaoeoaaiiy i?eaooeo aiae noiinii?aeiyeueiinoi caeienithooueny NOI?IIAIE a ii?yaeeo,
ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.

9. AEO?AOE I CAEOEE NOI?II CA AeAIEI AeIAIAI?II

9.1. Niieueii aeo?aoe oa caeoee NOI?II iie?eaathoueny ca ?aooiie niieueiiai iaeia noi?ii,
io?eiaiiai a ?acoeueoaoi noiinii? aeiyeueiinoi.

9.2. O aeiaaeeo iaaeinoaoiinoi niieueiiai iaeia aeey iie?eooy aeo?ao oa caeoeia, ui aeieeee
a ?acoeueoaoi noiinii? aeiyeueiinoi, oea iie?eooy caeienithooueny iiae NOI?IIAIE i?iii?oeieii
?oiii /anoeai.

9.3. Cao?aoe ia oo?eiaiiy niieueiiai iaeia (a oiio /enei e iaeiiai iiaeaoee) a?aoiaothoueny
i?e aecia/aiii /anoie o/anoi NOI?II a noiiniie aeiyeueiinoi.

9.4. Oaeoe/iee ianya noiinii? aeiyeueiinoi c eiai ?iciiaeieii ca aeaeaie cao?ao iiae
NOI?IIAIE aecia/aooueny a aaeaini, ui neeaaeaooueny NOI?IIITH-2.

10. OA?III AeI? AeAIIAI AeIAIAI?O

10.1. Oa?iii aei? aeiaiai?o neeaaeao c iiiaioo iiaeienaiiy aei <___> ___________ 199 __ ?.
10.2. Aeaiee Aeiaiai? iiaea aooe i?ieiiaiaaiee (i?iaeiaaeaiee) NOI?IIAIE ca acaoiiith
caiaeith ia aecia/aiee aai iaaecia/aiee oa?iii.

10.3. NOI?IIE onaiaeiieththoue, ui ?oiy noiinia aeiyeueiinoue caeienithooueny o neeaaeieo oiiaao
ianoaaieueiiai ?eieo, ui iiaeaeuoo nooiiiue ?eceeo ?oiueiai aiciano. Caiaene NOI?IIE caeeoathoue
ca niaith i?aai ia aeino?ieiaa ?ici?aaiiy Aeaiiai Aeiaiai?o ii iioeaao ciiie aeiiiii/ii?
neooaoei? o e?a?ii, aacia?niaeoeaiinoi oa iaaeioeieueiinoi aaaeaiiy niieueiiai ainiiaea?thaaiiy, a
oaeiae o aeiaaeeo iaiiaeeeainoi caeieniaiiy naio? aeiyeueiinoi ia i?eioeeiao naiiieoiiinoi i
naiioiiainoaaiiy.

A oeueiio aeiaaeeo eiaeia ic NOI?II ciaiaycaia iiaiaeiieoe ae?oao NOI?IIO ca ______ .
Acaoiiaiaeiineie NOI?II i?eieiythoueny oeyoii neeaaeaiiy ie?aii? oaiaee aai aeoo i?i
?ici?aaiiy aeiaiai?o.

10.4. O aeiaaeeo i?eieiaiiy aei? Aeaiiai Aeiaiai?o, iiney aiaeoeiaeoaaiiy NOI?IIAIE o
anoaiiaeaiiio ii?yaeeo ai?aia, eiooe oa iaeii, ui caeeoeeenue, ?iciiaeieythoueny iiae NOI?IIA-
IE i?iii?oeieii ?oiii /anoeai a caaaeueiiio iaeii.

1 1. AIAeIIAIAeAEUeIINOUe NOI?II

11.1. NOI?IIE ca aeaiei Aeiaiai?ii ianooue ianooiio aiaeiiaiaeaeueiinoue:
NOI?IIA-1: ________________________________________________________________________

NOI?IIA-2:

11.2. Aeaiee Aeiaiai? iiaea aooe ?ici?aaiee ca cayaith iaeiio? ic NOI?II o aeiaaeeo iaaeeiiai-
iy ae?oaith NOI?IIITH nai?o ciaiaycaiue. O oeueiio aeiaaeeo ani iaaeaiaeii ianeiaeee ?ici?aaiiy
iieeaaeathoueny ia aeiio NOI?IIO.

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Eiia?oeieiee aeiaiai?

11.3. Ca ii?ooaiiy oiia Aeaiiai Aeiaiai?o aeiia NOI?IIA aiaeoeiaeiaoo ni?e/eiaii
oeei caeoee, a oiio /enei ao?a/aio aeaiaeo, A ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.

12. II?ssAeIE ?ICAssCAIIss NOIA?A*IE
(a?aio?aaeia canoa?aaeaiiy)

12.1. Ani noia?a/ee iiae NOI?IIAIE, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o
aiaeiiaiaeiinoi aei caeiiiaeaanoaa Oe?a?ie a A?aio?aaeiiio noaei (o?aoaenueeiio noaei ic cacia/aiiyi
yeiai eiie?aoiiai o?aoaenueeiai noaeo aai cacia/eoe ii?yaeie oi?ioaaiiy oeueiai o?aoaenueeiai
noaeo).

12.2. NOI?IIE aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi NOI?IIAIE i?ioyaii ____________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

13. CIIIA OIIA AeAIIAI AeIAIAI?O

13.1. Oiiae Aeaiiai Aeiaiai?o iathoue iaeiaeiao ciaiaycoaaeueio neeo aeey NOI?II i iiaeooue
aooe ciiiaii ca acaoiiith caiaeith c iaiayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioo.

13.2. AEiaeia ic NOI?II ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee ae?oai? NOI?IIE.

14. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie NOI?II ca Aeaiei Aeiaiai?ii o:
NOI?IIA-1:_____________________________________ oaeaoii ____________________ .
NOI?IIA-2: _____________________________________ oaeaoii ____________________ .

15. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

16. IIOI OIIAE

16.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
NOI?II.

16.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, NOI?IIE ea?othoueny /eiiei
a?iiaaeyinueeei caeiiiaeaanoaii.

16.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei: eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

16.4. NOI?IIE ciaiaycothoueny i?e aeeiiaiii Aeaiiai Aeiaiai?o ia caiaeeoe niia?iaio-
ieoeoai eeoa aei aeio?eiaiiy aeiia, ui iinoyoueny a Aeaiiio Aeiaiai?i, iiaeo?eioaaoe aeieiai
eiioaeoe oa aaeeaaoe anio iaiaoiaeieo caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?o
eiia?oeieieo cayceia.

17. AeIAeAOEE AeI AeAIIAI AeIAIAI?O

17.1. Aei Aeaiiai Aeiaiai?o aeiaeaooueny:
Aeiaeaoie ? 1 ia __________ noi?.
17.2. Aeiaeaoie aei Aeaiiai Aeiaiai?o neeaaeao eiai iaaiaeoiio /anoeio.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
ia o/anoue o /anoeiaiio aoaeiaieoeoai

199___?.

NOI?IIA-1:
a iniai __________
ui aeio ia iiaenoaai.
c iaeiiai aieo, i

NOI?IIA-2:
a iniai __________

ui aeio ia iiaenoaai
c iioiai aieo,

134

Eiia?oeieiee aeiaiai?

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. O aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o NOI?IIA-1 i?eeiao NOI?IIO-2 o /anoeiaa
aoaeiaieoeoai ia _________(________)__________-eiiiaoio eaa?oe?o a aoaeeieo ca aae?anith:

Ieaiiaa caeii/aiiy aoaeiaieoeoaa oa caea/a aoaeeieo a aenieoaoaoeith: ___________ ?.
2. Ii caeii/aiii aoaeiaieoeoaa aoaeeieo oa caea/i eiai a aenieoaoaoeith NOI?IIA-1 ciaiay-
coooueny ia?aaeaoe NOI?III-2 o aeaniinoue aeuaaeacaio eaa?oe?o i?ioyaii ______ aeiia, iaaeaoe
inoaiiie oni iaiaoiaeii aeieoiaioe ia oeth eaa?oe?o, a oaeiae ni?eyoe inoaiiie a ioi?ieaiii
i?aaa aeaniinoi ia ia?.

3. Iiia?aaeiy aaciaa aa?oinoue eaa?oe?e neeaaeao _________________________ ea?aiaaioeia.
Inoaoi/ia oeiia aoaeiaieoeoaa aecia/aooueny iiney eiai caeii/aiiy oeyoii ?ic?aooieo
oaeoe/ii? aa?oinoi aoaeiaieoeoaa c o?aooaaiiyi eiaoioeioioa iioeyoei?.

Eiaoioeioio iioeyoei? aeey ?ic?aooieia ca Aeaiei Aeiaiai?ii aecia/aooueny NOI?IIAIE o
aiaeiiaiaeiinoi aei aeaieo, ui ioaeieothoueny Aea?aeeiinoaoii i?i ?iaaiue oeii.
Inoaoi/ia oeiia aoaeiaieoeoaa iiaeiia aooe aecia/aia ia iiaenoaai inoaiiuei? i?ioeaioiaee.
4. Aoaie oiiainoaaiiy /anoeiaiai aoaeiaieoeoaa NOI?IIITH-2:

I aoai: ________________________________________________________________ ea?aiaaioeia
i?ioyaii ______________________________________ c iiiaioo iiaeienaiiy Aeaiiai Aeiaiai?o;

2 aoai: ______________________________________________________________ ea?aiaaioeia
a oa?iii __________________________________________________________________________,

5. O aeiaaeeo, yeui noia eiooia, ia?a?aoiaaieo NOI?IIITH-2 a ?aooiie /anoeiaiai
aoaeiaieoeoaa, aoaea ia?aaeuoaaoe oaeoe/io aa?oinoue aoaeiaieoeoaa, oi NOI?IIA-1 ciaiaycoooueny
iaaeaoe NOI?III-2 o aeaniinoue eaa?oe?e aeiaeaoeiai caaaeueiith ieiuath i?iii?oeieii ia?aiea/a-
iiio, yeui oaiaeith NOI?II ia aoaea ia?aaeaa/aii iioa.
6. Aeaiee Aeiaiai? iaae?ao /eiiinoi c iiiaioo iiaeienaiiy eiai NOI?IIAIE i aeio aei ___

-?-
7. Aiaeiiaiaeaeueiinoue noi?ii:

NOI?IIA-2 ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:
– ca i?ino?i/aiiy iiia?aaeiueiai oiiainoaaiiy oa iieaoe aoaeiaieoeoaa iaiy ca eiaeai

aeaiue i?ino?i/aiiy a ?icii?i _______________ aiae noie ai?ao.
NOI?IIA-1 ca Aeaiei Aeiaiai?ii iana ianooiio aiaeiiaiaeaeueiinoue:
– ca i?ino?i/aiiy ii ia?aaea/i eaa?oe? o aeaniinoue NOI?IIE-2 iaiy a ?icii?i ___________

aiaenioea aiae noie ai?ao;
– o aeiaaeeo aeino?ieiaiai ?ici?aaiiy Aeaiiai Aeiaiai?o NOI?IIA-1 niea/oo oo?ao a

?icii?i _____________ aiae noie oaeoe/iiai oiiainoaaiiy, a oaeiae aiaeoeiaeiaoo ae?oaie NOI?III

caciaii caeoee.
O aeiaaeeo nenoaiaoe/iiai ii?ooaiiy oiia Aeaiiai Aeiaiai?o iaeiioth NOI?IIITH ae?oaa

NOI?IIA iao i?aai ?ici?aaoe Aeaiee Aeiaiai? aeino?ieiai ic noyaiaiiyi onio caeoeia, ui

aeieeee.

8. Iioi oiiae:

Aeiaiai? neeaaeaiee o 2-o i?eii?ieeao oa caa?iaaooueny o NOI?II.
NOI?IIE ia iathoue i?aaa ia?aaeaaaoe nai? i?aaa oa iaiaycee ca aeiaiai?ii iioei iniaai

aac ienueiiai? caiaee ae?oai? NOI?IIE.

O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, NOI?IIE ea?othoueny /eiiei caeiiiaeaa-
noaii.
C iiiaioo iaa?aiiy Aeaiei Aeiaiai?ii /eiiinoi ani iiia?aaeii ia?aaiai?e ca iei, aiaeiiaiaeia

aeieiaa eenooaaiiy oa oaiaee ao?a/athoue neeo.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?

iiae iinueeith aaeiiiino?aoeioth oa iiaei?eoinoaii
ia aeeiiaiiy nioeiaeueiiai caiiaeaiiy

i.____________ <____>___________ 199___?.
IOIIOeEIAEIOAO: _____________________________________________________________,

(iaeiaioaaiiy iinaaee, E.1.A.)

135

Eiia?oeieiee aeiaiai?

ui aeio ia iiaenoaai __
c iaeiiai aieo, i

AEEIIAAAOeUe:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iioiai aieo, aeaei ca oaenoii Aeaiiai Aeiaiai?o – ,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

I. NOI?IIE ca Aeaiei Aeiaiai?ii ciaiaycothoueny oeyoii iaoaeiaiiy oiiainia, iaeia
oa coneeue niieueii aeiyoe a noa?i aeeiiaiiy oa?eoi?iaeueiiai nioeiaeueiiai caiiaeaiiy c ?icaeoeo
ioiioeeiaeueiiai aeeoeiaiai aoaeiaieoeoaa oa o niieueiie /anoeiaie o/anoi c aoaeiaieoeoaa ianooiiiai
iaoeoa:

(iaeiaioaaiiy aoaeeieo)
(eieueeinoue eaa?oe?)
(caaaeueia ieiua)
(iioi iaiaoiaeii oa?aeoa?enoeee iaoeoa, ui aoaeoooueny)

2. ACAoIII IAIAssCEE NOI?II

2.1. Aeey nei?ioiai aeinyaiaiiy iaoe ca Aeaiei Aeiaiai?ii NOI?IIE ciaiaycothoueny
iaiiithaaoeny iayaiith a ?o ?icii?yaeaeaiii iioi?iaoeioth c aniaeoia acaoiiiai iioa?ano, i?iaiaeeoe
niieueii ia?aaee, cono?i/i i eiinoeueoaoei?, ni?eyoe iaeei iaeiiio a ?aaeicaoei? Aeaiiai Aeiaiai?o
oniia iayaieie a ?o ?icii?yaeaeaiii caniaaie oa iiaeeeainoyie.

3. IAIAssCEE IOIIOeEIAEIOAOO

3.1. IOIIOeEIAEIOAO ca Aeaiei Aeiaiai?ii ciaiaycoooueny:

3.1.1. Iaaeaoe iaiayceiaa caiiaeaiiy Ioiioeeiaeueiiio iiaei?eoinoao <_____________>
ia aoaeiaieoeoai aeeoeiaiai aoaeeieo o aiaeiiaiaeiinoi aei i. I Aeaiiai Aeiaiai?o.

3.1.2. Aeaeaaoaaoe AEEIIAAOeTH iiaiiaaaeaiiy Aaia?aeueiiai caiiaieea ii aoaeiaieoeoao
aeuaaeacaiiai iaoeoa.

3.1.3. Caaacia/eoe iaaeaiiy AEEIIAAOeTH oeieueiaiai iieueaiaiai e?aaeeoo ia noio _________
_______________ (___________) ea?aiaaioeia aeey aeeiiaiiy iaiaoiaeiiai oiiainoaaiiy ca
Aeaiei Aeiaiai?ii iiae aiaenioeiao noaaeo ia aeua ________ (_____________) aiaenioeia ?i/ieo.

3.1.4. Caaacia/eoe eiio?ieue ca naio/aniei caeo/aiiyi eiooia AEEIIAAOess ia /anoeiao
o/anoue o aoaeiaieoeoai ca Aeaiei Aeiaiai?ii.

3.1.5. Caaacia/eoe eiio?ieue ca ai?iei inaioiiyi eiooia AEEIIAAOess ia aoaeiaieoeoai
aoaeeieo Ioiioeeiaeueiei iiaei?eoinoaii <________________>.

3.1.6. Eii?aeeioaaoe ?ic?aooieiai oa iiae?yaeii acaoiiaiaeiineie iiae AEEIIAAOeAI,
Ioiioeeiaeueiei iiaei?eoinoaii <___________> oa iioeie iiaei?eoinoaaie oa i?aaiicaoeiyie,
ui oae /e iiaeoa aa?ooue o/anoue o ?aaeicaoei? nioeiaeueiiai caiiaeaiiy ca Aeaiei Aeiaiai?ii.

3.1.7. Ii caeii/aiii aoaeiaieoeoaa oa aaiaea iaoeoa a aenieoaoaoeith iaaeaoe AEEIIAAOeTH
_______________________(_____________) ea.i.

4. IAIAssCEE AEEIIAAOess

4.1. AEEIIAAAOeUe ca Aeaiei Aeiaiai?ii ciaiaycoooueny:

4.1.1. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o iaaaeii i?enooieoe aei aeeiiaiiy ooieoeie
Aaia?aeueiiai caiiaieea ii aoaeiaieoeoao aeeoeiaiai aoaeeieo ca i. I Aeaiiai Aeiaiai?o.

4.1.2. Aaeeoe iaiaoiaeieo caoiaeia aeey oeeaaeaiiy aei <___> __________ 199 __ ?. aeiaiai?o
iiae?yaeo ia eaiioaeueia aoaeiaieoeoai c Ioiioeeiaeueiei iiaei?eoinoaii <____________________>.

4.1.3. Aaeeaaoe iaiaoiaeieo caoiaeia ii caeo/aiith noaiiae?yae/eeia aeey aeeiiaiiy iaiaoiaeieo
aoaeiaaeueieo oa eiioiieaoeieieo ?iaio, a oaeiae ocaiaeaeoaaoe e eii?aeeioaaoe ani iaiaoiaeii oaoii/ii
oiiae ii aoaeiaieoeoao aoaeeieo ca i. I Aeaiiai Aeiaiai?o.

4.1.4. Iaaeaaaoe a no?ie IOIIOeEIAEIOAOO iioi?iaoeith i?i ia?aaia aeeiiaiiy niieueiiai
i?iaeoo ii aoaeiaieoeoao aeeoeiaiai aoaeeieo.

4.1.5. Aeei?enoiaoaaoe a?ioiai eiooe oeieueiaiai iieueaiaiai e?aaeeoo, io?eiaii ca i.3.1
Aeaiiai Aeiaiai?o, eeoa aeey aoaeiaieoeoaa aeeoeiaiai aoaeeieo ca i. I Aeaiiai Aeiaiai?o.

136

Eiia?oeieiee eiaiai?

4.1.6. Caeienithaaoe aiaeiiaiaeia oa naio/ania oiiainoaaiiy aoaeiaaeueii-iiae?yaeii? aeiyeueiinoi
Ioiioeeiaeueiiai iiaei?eoinoaa <________________> ia oiiaao aeiaiai?o, oeeaaeaiiai c inoaiiii.

5. OA?III AeI? AeAIIAI AeIAIAI?O

5.1. Oa?iii aei? aeiaiai?o neeaaeao _____ c iiiaioo iiaeienaiiy aei <__> _______ 199 __ ?.
5.2. Aeaiee Aeiaiai? iiaea aooe i?ieiiaiaaiee (i?iaeiaaeaiee) NOI?IIAIE ca acaoiiith
caiaeith ia aecia/aiee aai iaaecia/aiee oa?iii.

6. AIAeIIAIAeAEUeIINOUe NOI?II

6.1. NOI?IIE ca aeaiei Aeiaiai?ii ianooue ianooiio aiaeiiaiaeaeueiinoue:
IOIIOeEIAEIOAO:

AEEIIAAAOeUe:

6.2. Aeaiee Aeiaiai? iiaea aooe ?ici?aaii ca cayaith iaeiio? c NOI?II o aeiaaeeo iaaeeiiaiiy
ae?oaith NOI?IIITH nai?o ciaiaycaiue. O oeueiio aeiaaeeo ani iaaeaiaeii ianeiaeee ?ici?aaiiy
iieeaaeathoueny ia aeiio NOI?IIO.

6.3, Ca ii?ooaiiy oiia Aeaiiai Aeiaiai?o aeiia NOI?IIA aiaeoeiaeiaoo ni?e/eiaii oeei
caeoee, a oiio /enei ao?a/aio aeaiaeo, a ii?yaeeo, ia?aaeaa/aiiio /eiiei caeiiiaeaanoaii.

7. II?ssAeIE ?ICAssCAIIss NOIA?A*IE

7.1, Ani noia?a/ee iiae NOI?IIAIE, c yeeo ia aoei aeinyaiooi caiaee, ?icaycothoueny o
aiaeiiaiaeiinoi aei caeiiiaeaanoaa Oe?a?ie a A?aio?aaeiiio noaei.

7.2. NOI?IIE aecia/athoue, ui ani eiiai?ii i?aoaici? ca Aeaiei Aeiaiai?ii iiaeiii aooe
?icaeyiooi NOI?IIAIE i?ioyaii _________ aeiia c iiiaioo io?eiaiiy i?aoaici?.

8. CIIIA OIIA AeAIIAI AeIAIAI?O

8.1. Oiiae Aeaiiai Aeiaiai?o iathoue iaeiaeiao ciaiaycoaaeueio neeo aeey NOI?II i iiaeooue
aooe ciiiaii ca acaoiiith caiaeith c iaiayceiaei neeaaeaiiyi ienueiiaiai aeieoiaioo.

8.2. AEiaeia ic NOI?II ia iao i?aaa ia?aaeaaaoe nai? i?aaa ca Aeaiei Aeiaiai?ii o?aoie
noi?iii aac ienueiiai? caiaee ae?oai? NOI?IIE.

9. OIIAE OCAIAeAEAIIss CAssCEO IIAE NOI?IIAIE

Iiaiiaaaeieie i?aaenoaaieeaie NOI?II ca Aeaiei Aeiaiai?ii o:
IOIIOeEIAEIOAO: ____________________________ oaeaoii _________________________,
___________________________________________ oaeaoii ______________________.
AEEIIAAAOeUe:______________________________ oaeaoii __________________________,
_______________________________________________ oaeaoii ________________________.

10. INIAEEAI OIIAE AeAIIAI AeIAIAI?O

11. IIOI OIIAE

11.1. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
NOI?II.

11.2. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, NOI?IIE ea?othoueny /eiiei
a?iiaaeyinueeei caeiiiaeaanoaii.

11.3. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

11.4. NOI?IIE ciaiaycothoueny i?e aeeiiaiii Aeaiiai Aeiaiai?o ia caiaeeoe niia?iaioie-
oeoai eeoa aei aeio?eiaiiy aeiia, ui iinoyoueny a Aeaiiio Aeiaiai?i, iiaeo?eioaaoe aeieiai eiioaeoe
oa aaeeaaoe anio iaiaoiaeieo caoiaeia aeey caaacia/aiiy aoaeoeaiinoi oa ?icaeoeo ?o ae?iaie/eo
cayceia.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

137

Eiia?oeieiee aeiaiai?

AeIAIAI?
i?i o?aioeciia

199___?.

EIOeAICIA?:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

EIOeAICIAO: _______________________
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iioiai aieo,
oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. Aeaiee Aeiaiai? oeeaaeaooueny c iaoith oniioiiai caooo oiaa?ia oa iineoa ia ?eieo ___

(cacia/eoe oa?eoi?ith)

i aeieiaiai niia?iaioieoeoaa noi?ii a aeiaiai?i caaeey aeinyaiaiiy iaee?aueo aeiiiii/ieo ?acoeue-
oaoia.

1.2. EIOeAICIAO, a?aoiaoth/e, ui nenoaia ae?iaieoeoaa oa caooo ae?iaia, iicia/aieo
oi?aiaei ciaeii EIOeAICIA?A, iiaeoaa?aeeea naith aenieo yeinoue, aaaeao caeienithaaoe ae?iaie/a
oa aeieiaa niia?iaioieoeoai c EIOeAICIA?II i oei naiei oaieoe o ae?iaieoeoai _______________

(cacia/eoe ae?iae ic iicia/aiiyie)

i a oeie aeiyeueiinoi canoiniaoaaoe niinia i iaoiae ae?iaieoeoaa EIOeAICIA?A oa aeei?enoaoe
oaoii/io aeiiiiiao EIOeAICIA?A.

1.3. Noi?iie a aeiaiai?i iiaiaeeeenue ic oei, ui aiie iathoue ianooiii aeieiai oeiei:
a) ?iciiaeie i?aoei oa niaoeiaeicaoeiy ae?iaieoeoaa;
a) iiaeaeuaiiy ianyaia ae?iaieoeoaa oa ae?iaie/i? i?ia?aie;
a) caaacia/aiiy aeiiiii/iinoi ae?iaieoeoaa ca ?aooiie cieaeaiiy aa?oinoi iaeeieoei i?iaeoeoei?
oa caeoiiaaeueii? oeiie ia ne?iaeio oa ?ai?iaeoeoeieiee iaoa?iae;
a) caieueoaiiy aio/einoi ae?iaieoeoaa oa caooo o aiaeiiaiaeiinoi aei aeiia ?eieo;
ae) oaeaeea inaioiiy iiaeo ae?iaia, yei ei?enoothoueny iiieoii ia ?eieo;
a)____________________________________________________________________________.

2. IEAIOAAIIss AE?IAIEOeOAA I ?ICAEOEO

2.1. Aeey aeinyaiaiiy niieueieo oeieae, caaaeaieo a i. I Aeaiiai Aeiaiai?o, noi?iie aeiiiaeeeny
i?i ianooiia:

a) ?oii aeieiai noinoiee ca aeiaiai?ii aacothoueny ia acaoiiiio niia?iaioieoeoai oa iaaeaiii
aeiiiiiae a uiaeaiiie aeiyeueiinoi;

a) aeey anoaiiaeaiiy oeii o acaoiiiio iaiiii oiaa?aie oa iineoaaie canoiniaothoueny
?eieiai e?eoa?i?;

a) EIOeAICIAO ieaioo ae?iaieoeoai i ?icaeoie ca oaeeiith iaoiaeieiaioth c o?aooaaiiyi
i?iiiceoeie EIOeAICIA?A;

a) noi?iie a aeiaiai?i aeieeaaeooue onio coneeue c oei, uia o noa?i ieaioaaiiy ainiiaea?nueei?
aeiyeueiinoi aoea i?eeiyoa oaeeia iaoiaeieiaiy i caaacia/aia aiaeiiaiaeia eii?aeeiaoeiy ye ia
ae?iaieoeoai, oae i o caooi ae?iaia, yei o i?aaeiaoii niia?iaioieoeoaa ca Aeaiei Aeiaiai?ii.

3. I?AAeIAO O?AIOECIIAA

3.1. I?aaeiaoii Aeaiiai Aeiaiai?o o caeieniaiiy niia?iaioieoeoaa oa iaoaeiaiiy o ae?iaieoeoai
oa caooi caniaia oa i?aoei EIOeAICIAOA i EIOeAICIA?A o aiaeiiaiaeiinoi aei iieiaeaiue aeaii?
noaooi.

3.2. Ae?iaie/ee o?aioeciia o ?aieao iaaeaiiy aeiiiiiae aeey ?icaeoeo ae?iaie/eo
iiooaeiinoae ioiietho:

a) niia?iaioieoeoai o caaacia/aiii oaoii/ieo oiia aeey io?eiaiiy aeicaieo noiniaii iinoey
ae?iaieoeoaa aiae eiiiaoaioieo i?aaiia;

a) ?ic?iaeo i?ia?aie iaa/aiiy ia?niiaeo oa i?aaiicaoeith iaa/aiiy;
a) caaacia/aiiy aeieoiaioaoeioth aeey ioneo i ?iaioe iaoeoa;
a) ?ic?iaeo i?ia?aie ae?iaieoeoaa i ieaio ?iaioe;

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ae) ?aaoethaaiiy ieoaiiy i?i i?aai aeei?enoaiiy oi?iiaiai iaeiaioaaiiy oa caoeniiai
ciaeo;

a) caaacia/aiiy caniaaie i?aoei aeey noiinii? aeiyeueiinoi.

3.3. Caaaeaii caoiaee o i.3.2 neeaaeathoue , yei iaaeao EIOeAICIA?, a ?o aa?oinoue
ca aeiiiaeaiinoth aecia/aooueny o __________________________ .

4. IAIAssCEE EIOeAICIAOA

4.1. EIOeAICIAO ciaiaycaiee iaaeaoe ianooiii caniae aeey caeieniaiiy noiinii? aeiyeueiinoi
a ?aieao o?aioeciiaa:

a) oiiainiai eiooe ia noio _______________________________________________________;
a) ae?iaie/i i?eiiuaiiy i iaeaaeiaiiy;
a) ?iai/o neeo o aiaeiiaiaeiinoi aei iio?aa ae?iaieoeoaa.
4.2. EIOeAICIAO ciaiaycoooueny:
– i?aoethaaoe ca ae?iaie/ith i?ia?aiith EIOeAICIA?A;

– i?aoethaaoe iiae oi?iiaei iaeiaioaaiiyi ______________ oa caoeniei ciaeii _________
ia iiaei?eoinoaao, ui i?aoeththoue c i?aaeiaoii o?aioeciiaa;

– a i?ioeani ae?iaieoeoaa oa caooo caaacia/oaaoe iniaeeao oaaao, yei? iio?aaothoue oiiae,
ia?aaeaa/aii a aeieoiaioaoei? EIOeAICIA?A; .

– caa?iaaoe ye ae?iaie/o oaoiieoeth ani aeaii, yei EIOeAICIA? aecia/eoue ye nae?aoii.
4.3. EIOeAICIAO ciaiaycoooueny ca aeei?enoaiiy iaeaoa iineoa aeiea/oaaoe EIOeAICIA?O
aeiaai?iaeo o aiaenioeao aiae caieaiiaaiiai ianyao aeiyeueiinoi niieueii i?aaiiciaaiiai ae?iaieoeoaa
ci caooii ae?iaia, yei o i?aaeiaoii aeiaiai?o. Ii/aoeiaa aeiaai?iaea iie?eaao aeo?aoe EIOeAI-
CIA?A ca i.3.2 Aeaiiai Aeiaiai?o i neeaaeao______:_________________%.

4.4. EIOeAICIAO ciaiaycaiee aeiea/oaaoe EIOeAICIA?O e iioi/io aeiaai?iaeo (eiiinieii),
yea iie?eaao aeo?aoe ia oaoii/io aeiiiiiao, iineoae ii caooo aioiaeo ae?iaia oa iineoae o
cayceo c i?aaiicaoeioth i?aoei oa ae?iaieoeoaa, ia?aaeaa/aii iiaanoeoeieiith i?ia?aiith aeiaiai?o.

4.5. EIOeAICIAO aiaeoeiaeiaoo aeiiiii/ii iaa?oioiaaii, oaeoe/ii cao?a/aii aeo?aoe ca
iaa/aiiy eaae?ia.
5. IAIAssCEE EIOeAICIA?A

5.1. EIOeAICIA? ciaiaycoooueny iaaeaoe EIOeAICIAOO iaeao iineoa aeey oeieae niieueiiai
niia?iaioieoeoaa oa ae?iaieoeoaa o aiaeiiaiaeiinoi aei Aeaiiai Aeiaiai?o.

5.2. EIOeAICIA? ?ic?iaeyo iiaanoeoeieio i?ia?aio ae?iaieoeoaa oa iaaeao EIOeAICIAOO
anth iaiaoiaeio oaoii/io oa i?aaiicaoeieio aeiiiiiao aeey aeiyeueiinoi, ia?aaeaa/aii? Aeaiei Aeiaiai?ii.
5,3. EIOeAICIA? iaaeao eiiinieii iineoae aeey i?eaeaaiiy iaeaaeiaiiy EIOeAICIAOII i
naio/anii iinoa/ao ae?iaie/ee iaoa?iae o caieaiiaaiie eieueeinoi oa aiaeiiaiaeii? yeinoi ii oeiii

5.4. EIOeAICIA? iaaeanoue iaiaoiaeio aeiiiiiao a ?ic?iaoei oaoiieiai/ii? aeieoiaioaoei? aeey
?iaioe ae?iaie/i? iaeeieoei.

5.5. EIOeAICIA? aoaea iaaeaaaoe iinoieio niaoeiaeueio aeiiiiiao a i?aaiicaoei? ae?iaieoeoaa

i caeienithaaoe iaaeyae ca yeinoth ae?iaia, yei o i?aaeiaoii Aeaiiai Aeiaiai?o.

5.6. EIOeAICIA? aoaea aeaaaoe ?iai/i caaaeaiiy aeey aeeiiaiiy ia?aaeaa/aiiai ianyao
ae?iaieoeoaa o aiaeiiaiaeiinoi aei iiaeeeainoae ae?iaie/i? iaeeieoei.

5.7. EIOeAICIA? aoaea ?aaoey?ii aeiea/oaaoe EIOeAICIAOO aa?oinoue ae?iaia, yei ?aaoey?ii
iinoa/athoueny i ?aono?othoueny o aiaeiiaiaeiinoi aei iieiaeaiue Aeaiiai Aeiaiai?o.

6. NOIINIEE I?AAI AINIIAeA?NUeEI? AeIssEUeIINOI.

6,1. C iaoith oniioii? ainiiaea?nueei? aeiyeueiinoi noi?iie a aeiaiai?i iiaiaeeeeny noai?eoe
noiiniee i?aai ainiiaea?nueei? aeiyeueiinoi – _________________________, yeee o i?aaiii ia?eoao-
iiai neeaaeo, a aieiaa i?ecia/aooueny ic /enea inia, yeeo iaceaao EIOeAICIAO.

6.2. Eiiiaoaioeiy, niinia ?iaioe i i?eeiyooy ?ioaiue noiiniei i?aaiii aoaeooue a?aaoeueiaaii
o niaoeiaeueiiio aeiaeaoeo aei Aeaiiai Aeiaiai?o i ?iai/ie iino?oeoei?, yeo noiiniee i?aai i?eeiao
ca caiaeith noi?ii.

6.3. Noi?iie a aeiaiai?i caiaeii c oei, ui ani nii?ii ieoaiiy aiie aoaeooue iaiaaaoeny
iiia?aaeiuei ae?iooaaoe ae?oaeiii oeyoii ia aaci i?iiiceoeie noiiniiai i?aaio.

7. OA?III AeI?, I?IAeIAAEAIIss OA I?EIEIAIIss AeIAIAI?O,
AIAeIIAA AIAe IUeIAI

7.1. Aeaiee Aeiaiai? oeeaaeaooueny ia ia?iiae ______________________________ ?ieia.
7.2. Aeiaiai? aaoiiaoe/ii i?iaeiaaeoooueny ia ianooiii __________ ?ieia, yeui aoaeue-yeee
c ia?oia?ia ia iiciioa iiae ca 3 iinyoei aei i?eieiaiiy oa?iiio aeiaiai?o ia aiaeiiaeoueny aiae
iueiai o ienueiiaiio aeaeyaei,

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Eiia?oeieiee aeiaiai?

7.3. Aeiaeaoeiai aaoiiaoe/ii i?iaeiaaeaiiy caeieniththoueny ia oeo naieo oiiaao, ui e ca
I.7..2.

7.4. Aiaeiiaa aiae aeiaiai?o ioi?iethooueny ?aeiiaiaeiaaiei eenoii.

7.5. Ii?yae ic aeiaaeeaie i?eieiaiiy aeiaiai?o ca ciinoii i.i.7.1 – 7.4 aoaeue-yea noi?iia
iiaea ?ici?aaoe Aeaiee Aeiaiai? i c i?e/ei, caaaeaieo a ianooiieo ioieoao.

7.6. sseui, ia aeoieo noi?iie, /a?ac iaaeio?eiaiiy aeiaiai?ieo ciaiaycaiue aai o cayceo c
ianoaiiyi ianoaaei ca i.8 Aeaiiai Aeiaiai?o a eiai aeeiiaiii aeieeee o?oaeiiui, yei aaaeooue aei
eiai ?ici?aaiiy, oey noi?iia iiaeiia iai?aaeoe ia?oia?o ienueiiaa iiaiaeiieaiiy ic cacia/aiiyi
i?e/ei, yei oyaiooue ca niaith ?ici?aaiiy aeiaiai?o.

7.7. Noi?iia, yea io?eiaea iiaiaeiieaiiy ca i.7.6 Aeaiiai Aeiaiai?o, ciaiaycaia i?ioyaii
CI aeiia ienueiiai iiaiaeiieoe naith oi/eo ci?o oa iiaeaoe i?iiiceoei? ii eieaiaeaoei? o?oaeiiuia, ui
aeieeee. sseui c oi/ie ci?o noi?ii a aeiaiai?i iaiiaeeeai /aeaoe onoiaiiy i?e/ei o?oaeiiuia,
ui aeieeee, a ?icoiii oa?iiie, oi eiaeia noi?iia iao i?aai ?ici?aaoe aeiaiai? i?ioyaii CI
aeiia c aeiy io?eiaiiy ienueiiaiai iiaiaeiieaiiy, c yeiai aeaeii, ui o?oaeiiui iiaeieaoe iaiiaeeeai.

7.8. O aeiaaeeo ?ici?aaiiy aeiaiai?o ca ciinoii iiia?aaeiio ioieoia noi?iie iiaeiii aeeiiaoe
nai? ciaiaycaiiy, ui aeieeee aei aeaoe ?ici?aaiiy.

7.9. sseui ?ici?aaiiy aeiaiai?o aiaeaoeiny c aeie iaeiio? ic noi?ii, ae?oaa noi?iia iao i?aai
ia aiaeoeiaeoaaiiy caeoeia oa ao?a/aii? aeaiaee ca caaaeueieie i?aaeeaie ciaiaycaeueiiai i?aaa.

8. CAIEUeIAIIss AIAe AIAeIIAIAeAEUeIINOI
(iaia?aai?ia neea oa iioi aeiaaeee)

8.1. EIOeAICIA? i EUAICIAO iiaeooue aooe caieueiaii aiae aiaeiiaiaeaeueiinoi o iaaieo
aeiaaeeao, yei ianoaee iacaeaaeii aiae aiei noi?ii a aeiaiai?i.

8.2. Iiaenoaaith aeey caieueiaiiy aiae aiaeiiaiaeaeueiinoi aeciathoueny ianoaaeie, ui aeeeeeaii
iiaeiyie, yei ia caeaaeaoue aiae aiei noi?ii i yeeo ia iiaea a oieeiooe i aeia?iniainia noi?iia. Oei
ianoaaeie ianoaee iiney oeeaaeaiiy aeiaiai?o i caaaaeathoue eiai iiaiiio aai /anoeiaiio
aeeiiaiith.

8.3. Aeiaaeeaie iaia?aai?ii? neee aaaaeathoueny: aieia oa aioiii aei?, iianoaiiy, iiaieicaoeiy,
caaanoiaea, aiiaeaiiy, iiaeaaea, aeaooe, aei?iaeii i?eaiaee oa i?e?iaeii eaoano?ioe, aeoe i?aaiia
aeaaee, yei aieeaathoue ia aeeiiaiiy ciaiaycaiue, oa ani iioi iiaei?, yei eiiiaoaioiee a?aio?aaeiee
noae aeciao aeiaaeeaie iaia?aai?ii? neee.

9. ?ICAssCAIIss NOIA?A*IE

9.1. Ani eiiai?ii noia?a/ee, ui aeieeee c Aeaiiai Aeiaiai?o aai o cayceo c iei, noi?iie
aoaeooue iaiaaaoeny ae?iooaaoe ca aeiiiaeaiinoth.

9.2. sseui noi?iiai ia aaeanoueny aeinyaoe caiaee ca aeiiiaeaiinoth, aeey ?icaycaiiy noia?a/ee
aiie caa?oathoueny aei _____________, yeee i ?icaycoo noia?a/eo.

9.3. Noi?iie ciaiaycothoueny aeeiiaoe ?ioaiiy ____________ a oa?iii, yeee aeacaiee a
naiiio ?ioaiii.

10. CAEETH*II IIEIAEAIIss

10.1. Aeaiee Aeiaiai? iaae?ao /eiiinoi iiney eiai iiaeienaiiy oiiaiiaaaeaieie i?aaenoaaie-
eaie EIOeAICIA?A i EIOeAICIAOA.

10.2. Ciiie oa aeiiiaiaiiy aei Aeaiiai Aeiaiai?o iiaeooue aooe c?iaeaii eeoa a ienueiiaiio
aeaeyaei.

10.3. Aeiaeaoee i i?ioieiee iiaeooue ciiithaaoe aai aeiiiaithaaoe Aeaiee Aeiaiai? ca oiiae,
ui aiie iiaeienaii i?aaenoaaieeaie iaio noi?ii.

10.4. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

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Eiia?oeieiee aeiaiai?

AeIAIAI?

i?i caoeno eiia?oeieii? iioi?iaoei?
(i?i eiioiaeaioeieiinoue)

i. ____________ <____> ___________ 199 ___ ?.

NOI?IIA, ssEA ?ICE?EAAo:

a iniai ________________________
ui aeio ia iiaenoaai ______________
c iaeiiai aieo, i

NOI?IIA, ssEA IAeA?AEOo: _
a iniai _________________________

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. NOI?IIA, ssEA ?ICE?EAAo, ia?aaeao NOI?III, ssEA IAeA?AEOo, iaaio iioi?iaoeith,
yeo aaaaeao eiioiaeaioeieiith aai nae?aoii oi?ie, a naia oaeo, ui noinoooueny:

NOI?IIA, ssEA IAeA?AEOo, iiaea io?eiaoe oeth iioi?iaoeith aeey oeieae:

Ia?aaea/a iioi?iaoei? iaoiiaeaia niia?iaiIEIIOAII NOI?II I

2. IAIAssCEE NOI?II

Noi?iie iiaeoaa?aeaeothoue ?icoiiiiy aaaeeeainoi ieoaiiy oa iiaiaeaeothoueny acyoe ia naaa
ianooiii ciaiaycaiiy:

2.1. I?ioyaii ______ ?ieia c aeaoe oeeaaeaiiy Aeaiiai Aeiaiai?o NOI?IIA, ssEA IAeA?AEOo,
ia aoaea ?icaieiooaaoe iiyei? iioi?iaoei?, io?eiaii? iath aiae NOI?IIE, ssEA ?ICE?EAAo,
ui o nae?aoii oi?ie aai eiioiaeaioeieiith, aoaeue-yeie iioie iniai, iiaei?eoinoao, i?aaiicaoei?,
oi?ii i ia aoaea aeei?enoiaoaaoe oeth iioi?iaoeith aeey naio? aeanii? aeaiaee, ca aeiyoeii oeiei, yea
iacaaia aeua o yaiiio aeaeyaei.

2.2. NOI?IIA, ssEA IAeA?AEOo, aoaea aeio?eioaaoeny oaeiai ae nooiaiy nae?aoiinoi c
iaoith oieeiaiiy ?icaieioaiiy aai aeei?enoaiiy oeio? iioi?iaoei?, eio?iai NOI?IIA, ssEA
IAeA?AEOo, aeio?eioaaeany a a ?icoiiie ii?i noiniaii naio? aeanii? eiioiaeaioeieii? aai oaei?,
yea o nae?aoii oi?ie, iioi?iaoei? oaeiai ae nooiaiy aaaeeeainoi.

3. INIAEEAI OIIAE

3.1. Aoaeue-yea iioi?iaoeiy, ia?aaea/a yei? ioi?ieaia a ienueiiaiio aeaeyaei oa aiaeianaia
iaiia noi?iiaie aei aeiaiai?o, aaaaeaooueny eiioiaeaioeieiith aai nae?aoii oi?ie (i?ioieie i?i
ia?aaea/o iioi?iaoei?, Aeiaeaoie ? 1).

3.2. Iioi?iaoeiy ia aoaea aaaaeaoeny eiioiaeaioeieiith aai nae?aoii oi?ie i NOI?IIA,
ssEA IAeA?AEOo, ia aoaea iaoe iiyeeo ciaiaycaiue aiaeiinii aeaii? iioi?iaoei?, yeui aiia
caaeiaieueiyo iaeei c ianooiieo ioieoia:

– aaea aiaeiia NOI?III, ssEA IAeA?AEOo;

– o aai noao i?eethaeii aiaeiiith a ?acoeueoaoi iaai?ii?, iaaeaaei? aai iaaienii? aei? NOI?IIE,
ssE/, ?ICE?EAAo;

– eaaaeueia io?eiaia aiae o?aouei? noi?iie aac iaiaaeaiiy i aac ii?ooaiiy aeiaiai?o;

– iaaeaia o?aoie noi?iii NOI?IIITH, ssEA ?ICE?EAAo, aac aiaeiai/iiai iaiaaeaiiy
ia i?aaa o?aouei? noi?iie;

– iacaeaaeii ?ic?iaeaia NOI?IIITH, ssEA IAeA?AEOo, ca oiiae, ui iniaa aai iniae,
ui ?? ?ic?iaeee, ia iaee aeinooio aei eiioiaeaioeieii? aai oaei?, yea o nae?aoii oi?ie, iioi?iaoei?;
– aeicaieaia aei aeioneo ienueiiaei aeicaieii NOI?IIE, ssEA ?ICE?EAAo;

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Eiia?oeieiee aeiaiai?

– ?ice?eoa o?yaeiai ia aeiiao o?yaeiaiai i?aaio i NOI?IIA, ssEA IAeA?AEOo, aeieeaaeao
iaeneiaeueieo coneeue, uia aeiaeoeny iiaiaeaeaiiy c oeioth iioi?iaoeioth, ye c eiioiaeaioeieiith
aai oaeith, yea o nae?aoii oi?ie, aai yeui ?? ?ice?eooy aeiaaao Caeii.

4. AIAeIIAIAeAEUeIINOUe NOI?II
4.1. NOI?IIA, ssEA IAeA?AEOo, aoaea aiaeiiaiaeaeueia ca:

a) iaiaaienia ?icaieioaiiy aai aeei?enoaiiy eiioiaeaioeieii? iioi?iaoei?, yeui aiia ia
aeio?eioooueny oaeiai ae aenieiai nooiaiy iaa?aaeiinoi, yeiai aiia a aeio?eioaaeany o ?icoiieo
iaaeao noiniaii naio? aeanii? eiioiaeaioeieii? aai oaei?, yea o nae?aoii oi?ie, iioi?iaoei?
aiaeiai/ii? aaaeeeainoi, i, iiney aeyaeaiiy iaiaaieniiai ?icaieioaiiy aai aeei?enoaiiy oeio?
iioi?iaoei?, ia iaiaaaooueny i?eieieoe ?? iaiaaienia ?icaieioaiiy aai aeei?enoaiiy;

a) ianaieoeiiiiaaia ?icaieioaiiy aai aeei?enoaiiy eiioiaeaioeieii? aai oaei?, yea o
nae?aoii oi?ie, iioi?iaoei? iniaaie, yei i?aoeththoue aai i?aoethaaee ia ia? ca iaeiii, yeui ?e
ia aaeaooueny ioi?iiyoe oeth iioi?iaoeith c oaeei aea aenieei nooiaiai ?aoaeueiinoi, yeiai aiia
a aeio?eioaaeany o ?icoiieo iaaeao noiniaii naio? aeanii? eiioiaeaioeieii? aai oaei?, yea o
nae?aoii oi?ie, iioi?iaoei? aiaeiai/ii? aaaeeeainoi.

4.2. NOI?IIA, ssEA IAeA?AEOo, i?ecia/ao aeacaio ieae/a iniao nai?i Aiaeiiaiaeaeueiei
ca nae?aoiinoue aeey io?eiaiiy ca ?? aei?o/aiiyi anio? eiioiaeaioeieii? aai oaei?, yea o nae?aoii
oi?ie, iioi?iaoei? caiaeii c aeiaiai?ii. NOI?IIA, ssEA IAeA?AEOo, iiaea ciiieoe naiai Aiaeii-
aiaeaeueiiai ca nae?aoiinoue oeyoii ienueiiaiai iiaiaeiieaiiy NOI?IIE, ssEA ?ICE?EAAo,
i?i iiy oa aae?ano ?? ciiao i?ecia/aiiai Aiaeiiaiaeaeueiiai ca nae?aoiinoue o ___-aeaiiee oa?iii
iiney i?ecia/aiiy.

4.3. Any iioi?iaoeiy, yea aeaeaooueny NOI?IIITH, ssEA ?ICE?EAAo, NOI?III, ssEA IAeA?-
AEOo, a aoaeue-yeie oi?ii caiaeii c aeiaiai?ii, aoaea i caeeoeoueny aeeeth/iith aeaniinoth NOI?I-
IE, ssEA ?ICE?EAAo, i aeaii oa aoaeue-yei ?o eiii? iiaeiii iaaaeii iiaa?oaoeny NOI?III, ssEA
?ICE?EAAo, ca ienueiiaith aeiiaith aai cieuoaaoeny ia ?icnoae NOI?IIE, ssEA ?ICE?EAAo.

5. ?ICE?EOOss IIOI?IAOeI?

5.1. AEiaeia ic noi?ii ia aoaea ?icaieiooaaoe oaeo inioaaiiy aeiaiai?o aac iiia?aaeiuei?
caiaee ae?oai? noi?iie.

5.2. Aeiaiai? ia iiaea aooe aei?o/aiee aai ia?aaeaiee NOI?IIITH, ssEA IAeA?AEOo, a
neeo Caeiio aai ciiie ea?iaieoeoaa. Aoaeue-yea ni?iaa NOI?IIE, ssEA IAeA?AEOo, aei?o/eoe
aeiaiai? aac iiia?aaeiuei? ienueiiai? caiaee NOI?IIE, ssEA ?ICE?EAAo, aoaea iaaeieniith. sseui
o?aoy noi?iia o/eieoue iicia aai iioo th?eaee/io aeith ia i?aaeiao ?ice?eooy aoaeue-yei?
eiioiaeaioeieii? iioi?iaoei?, NOI?IIA, ssEA IAeA?AEOo, iaaaeii iiaiaeiieoue NOI?IIO, ssEA
?ICE?EAAo, i caaacia/eoue ?e a ?icoiieo iaaeao oaeo aeiiiiiao, yei? NOI?IIA, ssEA
?ICE?EAAo, aoaea aeiaaaoe aeey caiiaiaaiiy ?icaieioaiith.

6. NIAOeIAEUeII IIEIAEAIIss

Aeaiee Aeiaiai? iiaeeyaao th?enaeeeoei? oa oeoia/aiith o aiaeiiaiaeiinoi aei caeiiia __________

6.1. Noi?iia, yea aea?aea a aoaeue-yeiio iiciai aai noaeiaiio ?icaeyaei iiae noi?iiaie,
yeee aeoieao ic Aeaiiai Aeiaiai?o aai iiaycaiee c iei, aoaea iaoe i?aai ia aiaeoeiaeoaaiiy a
?icoiieo iaaeao aiii?a?ia ?? aaeaieaoai oa aeo?ao, caciaieo o cayceo c aoaeue-yeei oaeei
iiciaii aai noaeiaei ?icaeyaeii.

6.2. O aeiaaeeo anoaiiaeaiiy aeie NOI?IIE, ssEA IAeA?AEOo, o ?icaieioaiii eiioi-
aeaioeieii? aai oaei?, yea o nae?aoii oi?ie, iioi?iaoei?, NOI?IIA, ssEA ?ICE?EAAo, ia
aeaniee ?icnoae iao i?aai aiaeoeiaeoaaoe caeoee, caciaii o cayceo c ?icaieioaiiyi aai aeei-
?enoaiiyi oeio? iioi?iaoei? aai io?eioaaoe aiae NOI?IIE, ssEA IAeA?AEOo, oo?ao o ?icii?i,
iaoiiaeaiiio ienueiiaei /eiii i?e ia?aaea/i iioi?iaoei?.

7. IIOI OIIAE

7.1. Aeaiee Aeiaiai? neeaaeaiee o 2-o i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

7.2. Ani onii canoa?aaeaiiy ca Aeaiei Aeiaiai?ii ia iathoue neee. Aeiaiai? iiaea aooe
aeaeiciiiaiee aai aeiiiaiaiee eeoa a ienueiiaie oi?ii, iiaeienaiie iaiia noi?iiaie.

7.3. Aeaiee Aeiaiai? oeeaaeaiee ia oa?iii aiae <___> __________ 199__?. aei <___> ________
199 __ ?.

7.4. Aiaeiiaiaeaeueiee ca nae?aoiinoue _________________________________________________ .

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

142

Eiia?oeieiee aeiaiai?

AeIAIAI?
ia o/anoue o eiia?oeieiie aenoaaoei

i. ____________ <____> ___________ 199 ___ ?.

I?AEIIIOAO:
a iniai aee?aeoi?a

ui aeio ia iiaenoaai Noaoooo, c iaeiiai aieo, i

O*ANIEE: ____________________________________________________________________,
a iniai _________________________________________________________________________________,
ui aeio ia iiaenoaai aeiai?aiinoi ? _________ aiae <_____> ___________ 199__?., c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

O*ANIEE iaaeao aeey aeniiioaaiiy ia eiia?oeieii-oi?aiaiio caoiaei c?acee naio? i?iaeoeoei?
i oiaa?ia, a I?AEIIIOAO i?aaiicoo aenoaaeaiiy oeeo oiaa?ia oa i?iaeoeoei?, ni?eyo oeeaaeaiith
acaoiiaeaiaeieo oaiae iiae O*ANIEEII oa o?aoiie iniaaie, a oaeiae iaaeao O*ANIEEO aeiaeaoeiai
iineoae.

2. IAIAssCEE I?AEIIIOAOA
I?AEIIIOAO ca Aeaiei Aeiaiai?ii ciaiaycaiee:

– caaacia/eoe oiiae aeey oniioiiai ooieoeiiioaaiiy caoiaeo;
– iaaeaoe o/anieeo iaiaoiaeii i?eiiuaiiy – _____._____________________________________

(neeaae, noiaeua, aeaiiino?aoeieiee iaeaeai/ee, neoaeaiaa i?eiiuaiiy c oaeaoiiii)

– caaacia/eoe oiiae aeey iaeaieueo aoaeoeaiiai aeniiioaaiiy c?aceia i?iaeoeoei? oa oiaa?ia
O*ANIEEA _______________________________.________________________________________,

(inaioeaiiy, aeecaei, aeinooi, iieaae/eee oa ii.)

– aeeth/eoe aiaeiiinoi i?i O*ANIEEA oa eiai i?iaeoeoeith i oiaa?e aei eaoaeiaia i i?iniaeoia
caoiaeo;

– i?aaiicoaaoe aiaeiiaiaeia ?aeeaiia ioi?ieaiiy aeaiiino?aoeieieo iaeaeai/eeia O*ANIEEA
ic aeanieo iaoa?iaeia;

– iaaeaoe ei?enooaaiiy oaeaeniei oa oaeaoaeniei cayceii;

– aa?aiooaaoe caa?aaeaiiy c?aceia i?iaeoeoei? i oiaa?ia O*ANIEEA, a oaeiae iioiai iaeia
ia oa?ioi?i? I?AEIIIOAOA.

(O oeie noaooi noi?iie iiaeooue iae?aco iaoiiaethaaoe oiiae aeniiioaaiiy).

3. IAIAssCEE O*ANIEEA

O*ANIEE ciaiaycoooueny:

– a oa?iii ______________ aei ii/aoeo ooieoeiiioaaiiy caoiaeo iaaeaoe I?AEIIIOAOO
aiaeiiinoi, iaiaoiaeii aeey eiai o/anoi a caoiaei, ?icii? iio?iaieo aeaiiino?aoeieieo iaeaeai/eeia,
oiiae aeniiioaaiiy, caa?iaaiiy, a oaeiae iioo iioi?iaoeith ia aeiiao I?AEIIIOAOA;

– a oa?iii aei _______ iaaeaoe o ?icii?yaeaeaiiy I?AEIIIOAOA c?acee i?iaeoeoei? i oiaa?ia;

– caaacia/eoe iiae /an ?iaioe caoiaeo noi?iaiae aeaiiino?aoei? aeniiiaoia iiyniaiiyie nai?o
oaoiaoeia.

4. II?ssAeIE IIEAOE IINEOA I?AEIIIOAOA

O*ANIEE caeienitho ianooiio iieaoo:

– aianie ia i?aai o/anoi ____________________________________________________ e?a.

– iieaoa ca i?aiaeo i?eiiuaiiy ______________________________________________ e?a.

– iieaoa ca ioi?iio e caa?iaaiiy c?aceia i?iaeoeoei? i oiaa?ia _____________________ e?a.

Onueiai ……………………………………….. (c o?aooaaiiyi IAeA).

O*ANIEE iiea/oo I?AEIIIOAOO _____________________ aiae noie anio oaiae, oeeaaeaieo
iiae /an caoiaeo.

5. II?ssAeIE ?IC?AOOIEIA

Oa?iii iieaoe: _______________________________________________________________.
Oi?ia ?ic?aooieia: _____________________________>______________________________ .

143

Eiia?oeieiee aeiaiai?

6. OA?IIIE CA AeAIEI AeIAIAI?II

6.1. Aeaiee Aeiaiai? aeio c iiiaioo eiai iiaeienaiiy aei caaa?oaiiy caoiaeia aei <_ __ aeniiiaoe iiaeiii aooe aeaacaii c oa i a aiaeiiaiaeaeueiinoue noi ca aeaiei aeiaiai ianooue ianooiio aiaeiiaiaeaeueiinoue: o iioi oiiae aeaiee iaae iiiaioo iiaeienaiiy eiai aeio aei inoaoi aeeiiaiiy aea aoaeue-yeiio aeiaaeeo> __________ 199 __ ?.

8.2. Aeaiee Aeiaiai? neeaaeaii o aeaio i?eaiiaeueieo i?eii?ieeao, ii iaeiiio aeey eiaeii? ic
noi?ii.

8.3. O aeiaaeeao, ia ia?aaeaa/aieo Aeaiei Aeiaiai?ii, noi?iie ea?othoueny /eiiei a?iiaaeyi-
nueeei caeiiiaeaanoaii.

8.4. Iiney iiaeienaiiy Aeaiiai Aeiaiai?o ani iiia?aaeii ia?aaiai?e ca iei, eenooaaiiy,
iiia?aaeii oaiaee oa i?ioieiee i?i iaii?e c ieoaiue, ui oae /e iiaeoa noinothoueny Aeaiiai
Aeiaiai?o, ao?a/athoue th?eaee/io neeo.

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
no?aooaaiiy iaeia

199

NO?AOOAA*:
a iniai

ui aeio ia iiaenoaai
c iaeiiai aieo, i

NO?AOOAAEUeIEE:
a iniai

ui aeio ia iiaenoaai
c iioiai aieo,

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. NO?AOOAA* ciaiaycoooueny aiaeoeiaeoaaoe NO?AOOAAEUeIEEIAI a iaaeao no?aoiai?
noie caeoee, yeeo aii caciaa, aiae iioeiaeaeaiiy, cieuaiiy, ao?aoe a ?acoeueoaoi iiaeaaei, e?aaeiaeee
ci ceiiii, iia?aaoaaiiy, ?icaith ianooiiiai iaeia NO?AOOAAEUeIEEA:

Ia?aeie iaeia NO?AOOAAEUeIEEANo?aoiaa noiaNo?aoiaee ieaoiaeNo?aoiaa aiaeoeiaeoaaiiy
Anueiai:

no?ie aiae aeiy iiaeienaiiy Aeaiiai Aeiaiai?o

2. NO?AOOAAEUeIEE ciaiaycoooueny:
a) caieaoeoe NO?AOOAA*AAI a
iaoiiaeaiee no?aoiaee ieaoiae;

a) iiaiaeiieoe NO?AOOAA*AAI iaaaeii i?i ani ianoaaeie, ui aieeaathoue ia nooiiiue
?eceeo ianoaiiy no?aoiaiai aeiaaeeo (ciiie o iaeaaeiinoi iaeia, oiaoi caea/a a i?aiaeo, ia
caa?iaaiiy, o canoaao, ia?aiaeaaeiaiiy oiui);

144

Eiia?oeieiee aeiaiai?

a) aeio?eioaaoeny anoaiiaeaieo i?aaee aenieoaooaaiiy iaeia, caaacia/oaaoe eiai caa?a-
aeaiiy;

a) i?e iioeiaeaeaiii, cieuaiii aai ao?aoi iaeia aianeiaeie no?aoiai? iiaei?:
iaaaeii (ia iiciioa 3 aeia, ?aooth/e c aeiy, eiee aii aeiciaany aai iaa aeiciaoeny i?i aeacaii
ianoaaeie) iiaiaeiieoe i?i oea NO?AOOAA*AAI;

aaeeoe anio iiaeeeaeo caoiaeia aeey iiia?aaeaeaiiy i ciaioaiiy caeoeia, a?yooaaiiy iaeia;
iiaiaeiieyoe aei eiiiaoaioieo i?aaiia (iieioeith, aea?aeiiaeaaeiiaaeyae, aaa?ieii neoaeae oiui)
i?i no?aoiai iiaei?, ia aeiaaeie ianoaiiy yeeo i?iaiaeeoueny no?aooaaiiy ca Aeaiei Aeiaiai?ii;

caa?iaaoe iaeii, ui iino?aaeaeaei, yeui oea ia noia?a/eoue aaciaoei, aei iaeyaeo eiai i?aaenoaa-
ieeii NO?AOOAA*A a oiio aeaeyaei, o yeiio aiii aeyaeeiny iiney no?aoiai? iiaei?.

3. I?e iaaeeiiaiii ciaiaycaiue, cacia/aieo o iiaeioieoao – ioieoo 2 Aeaiiai Aeiaiai?o,
NO?AOOAA* iao i?aai aeino?ieiai ?ici?aaoe aeiaiai? aai i?ecoieieoe eiai aeith, a, yeui
iaaeeiiaiiy ciaiaycaiue aeyaeoueny iiney ianoaiiy no?aoiai? iiaei? i oea aieeia ia aeieeiaiiy
caeoeia aai caieueoaiiy ?o ?icii?o – aiaeiiaeoe NO?AOOAAEUeIEEIAI o aeieaoi no?aoiaiai
aiaeoeiaeoaaiiy.

4. I?e iaaeeiiaiii ciaiaycaiue, cacia/aieo o iiaeioieoi ioieoo 2 Aeaiiai Aeiaiai?o,
NO?AOOAA* iao i?aai aiaeiiaeoe o aeieaoi no?aoiaiai aiaeoeiaeoaaiiy, yeui noaia iaiiaeeeaei
anoaiiaeaiiy oaeoo, i?e/ei aai iioeo ianoaaei ianoaiiy no?aoiai? iiaei?, ?icii?o caeoeia.

5. NO?AOOAA* ciaiaycoooueny aeieaoeoe NO?AOOAAEUeIEEIAI no?aoiaa aiaeoeiaeoaaiiy
o aiaeiiaiaeiinoi aei oiia Aeaiiai Aeiaiai?o.
6. No?ie aei? Aeaiiai Aeiaiai?o: aiae ______________________ aei ______________________ .

TH?eaee/ii aae?ane, aaieianueei ?aeaiceoe i iiaeiene noi?ii

AeIAIAI?
iiae?yaeo c oei/aniaei o?oaeiaei (oai?/ei) eieaeoeaii

i. ____________ <____> ___________ 199 ___ ?.

(iacaa i?aaiicaoei?)

iaaeaei , a iniai
ui aeio ia iiaenoaai __________

(I.I.A., iaeai)

(noaoooo, iieiaeaiiy)

c iaeiiai aieo, i oei/aniaee o?oaeiaee (oai?/ee) eieaeoea, iaaeaei , a iniai

(I.I.A.)

ui aeio ia iiaenoaai ?ioaiiy caaaeueieo cai?ia OOE, c iioiai aieo,
oeeaee Aeaio Oaiaeo i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. CAIIAIEE aei?o/ao, a OOE aa?a ia naaa ciaiaycaiiy aeeiiaoe ianooiio ?iaioo:

(oa?aeoa? oa aeaee ?iaioe)

1.2. OOE aeeiioo ?iaioo i caeao CAIIAIEEIAI ie?aii ?? aoaie o aiaeiiaiaeiinoi aei oaoii/iiai

caaaeaiiy oa eaeaiaea?iiai ieaio, ui aeiaeathoueny aei aeiaiai?o i o eiai iaaiaeoiiith /anoeiith.
1.3. No?ie aeeiiaiiy ?iaioe.

Ii/aoie – ________________________________________________________________________.
Caeii/aiiy – __________________________________________________________________.

OOE iao i?aai aeino?ieiaiai aeeiiaiiy ?iaioe.
1.4. ?acoeueoaoe ?iaioe iaaeathoueny o aeaeyaei ________________________________________

(oi?ia iaiioy ?iaioe)

Ie?aii aoaie ?iaioe ioi?ieythoueny:

(aeae ioi?ieaiiy)

145

Eiia?oeieiee aeiaiai?

1.5. ?iaioa aaaaeaooueny aeeiiaiith iiney iiaeienaiiy aeoo i?eeiaiiy (oaoii/iiai aeoo
cai?iaaaeaeaiiy) i?aaenoaaieeii CAIIAIEEA.

1.6. CAIIAIEE ciaiaycoooueny naio/anii i?eeiyoe e iieaoeoe aeeiiaio ?iaioo.

2. OIIAE AEEIIAIIss ?IAIOE

2.1. Aeey aeeiiaiiy ?iaio CAIIAIEE caaacia/oo OOE iaiaoiaeieie i?eiiuaiiyie,
caniaaie, iaoa?iaeaie, iaeaaeiaiiyi i eiiieaeooth/eie ae?iaaie aiaeiiaiaeii aei iieno, ui
aeiaeaooueny aei aeiaiai?o.

2.2. *eaie OOE aeeiiothoue ?iaioo ca naie ?ecee o aieueiee aiae iniiaii? ?iaioe /an.
2.3. Ea?iaiee OOE, ia?aiee caaaeueieie cai?aie eiai /eaiia (ui canaiae/oooueny ?oiiie
iiaeienaie o Aeaiiio Aeiaiai?i), i?aaiiciaoo anth ?iaioo i iana ia?niiaeueio aiaeiiaiaeaeueiinoue ca
?? ?acoeueoaoe, naio/aniinoue i yeinoue aeeiiaiiy ?iaioe.

2.4. OOE naiinoieii aecia/ao neeaae aeeiiaaoeia, ?iciiaeieyo iiae ieie iaiaycee oa
eieaeoeaio aeiaai?iaeo.

2.5. OOE iaaeao CAIIAIEEIAI caioe i?i aeeiiaii ?iaioe a no?ie, anoaiiaeaiee o
aeiaiai?i (eaeaiaea?iiio ieaii).

2.6. OOE ciaiaycaiee naio/anii i yeinii aeeiiaoe i ia?aaeaoe CAIIAIEEIAI i?iiiaeii
oa eiioeaai ?acoeueoaoe ?iaio.

2.7. Ii caeii/aiii ?iaioe OOE iaaeao CAIIAIEEIAI caio i?i aeei?enoaii iaoa?iaeueii-
oaoii/ii ?ano?ne i iiaa?oao ?o ?aooee CAIIAIEEO.

3. AIAeIIAIAeAEUeIINOUe NOI?II

3.1, O aeiaaeeo iaaeeiiaiiy ciaiaycaiue eiaeia ic noi?ii iao i?aai aeino?ieiai ?ici?aaoe
aeiaiai? c iiaiaeiieaiiyi iioi? noi?iie ca _____________________________________________ .

(AeIIA, IINssOeIA)

3.2. O aeiaaeeo ianaio/aniiai ii/aoeo ?iaio aai ?o aeeiiaiiy ic nooooaei ii?ooaiiyi
no?ieia, ia?aaeaa/aieo aeiaiai?ii (eaeaiaea?iei ieaiii), CAIIAIEE iao i?aai aeino?ieiai
?ici?aaoe aeiaiai? c i?aaeyaeaiiyi aeiia i?i aiaeoeiaeoaaiiy caeoeia.

3.3. a) O aeiaaeeo aeiiouaiiy OOE aiaeoeeaiue aiae oiia aeiaiai?o aai aeyaeaiiy iioeo
iaaeieieia, ui iiai?oothoue ?iaioo, CAIIAIEE iao i?aai ciaiaycaoe OOE onoiooe ?o o ________
no?ie ca naie ?aooiie.

a) OOE aiaeoeiaeiaoo CAIIAIEEIAI aeo?aoe, yei aii iiiin ii onoiaiith aeiiouaieo OOE
ii?ooaiue i iaaeieieia o ?iaioi.

a) I?e aeyaeaiii aeacaieo ii?ooaiue, iaaeieieia, yei iiai?oothoue ?iaioo (?acoeueoaoe ?iaioe),
aeiaai?iaea OOE ciaiooooueny ia _______________________________________________ e?a. (%).

3.4. I?e ii?ooaiiyo, anoaiiaeaieo Aeaiei Aeiaiai?ii (eaeaiaea?iei ieaiii) no?ieia,
OOE niea/oo oo?ao (iaonoieeo) a ?icii?i ____________ e?a. (%) ca eiaeiee aeaiue i?ino?i/aiiy.

3.5. Ca iayaiinoi nooooaeo aiaeoeeaiue aiae aeiaiai?o aai iioeo nooooaeo iaaeieieia CAIIAIEE
iao i?aai ?ici?aaoe aeiaiai? c i?aaeyaeaiiyi aeiia i?i aiaeoeiaeoaaiiy caeoeia.

3.6. I?e iaaeeiiaiii i.2.7. Aeaiiai Aeiaiai?o noyaoooueny oo?ao (iaonoieea) o ?icii?i
_____________________________ e?a. (%).

3.7. Nieaoa oo?aoia, iaonoieee ia caieueiyo noi?iie aiae aeeiiaiiy ciaiaycaiue.

4. NOIA AEIAAI?IAeAEAIIss OA II?ssAeIE ?IC?AOOIEIA

4.1. Ca aeeiiaiiy ?iaioe ca Aeaiei Aeiaiai?ii CAIIAIEE aeiea/oo OOE o aeaeyaei
aeiaai?iaee noio a ?icii?i ________________ e?a. Aeieaoa caeienithooueny ia iiaenoaai i?ioieieo
?iciiaeieo aeiaai?iaee.

4,2. Noia aeiaai?iaee iiaeeyaao aeieaoi OOE i?ioyaii ______aeiia iiney caeii/aiiy ?iaioe.
4.3. Iioi oiiae __________________________________________________________________

Aei aeiaiai?o aeiaeathoueny:

1) eaeaiaea?iee ieai ic cacia/aiiyi no?ieia caea/i ie?aieo aoaiia ?iaioe;

2) aeienea c i?ioieieo caaaeueieo cai?ia i?i ia?aiiy ea?iaieea OOE.
Aeaiee Aeiaiai? neeaaeaii o aeaio i?eii?ieeao, iaeei c yeeo caa?iaaooueny o CAIIAIEEA,
a ae?oaee o ea?iaieea OOE.

Aiae iniae CAIIAIEEA __________________________________________________________
Ea?iaiee OOE ___________________________________________________________________
I?icaeua, iiy, ii-aaoueeiai ____________________________________________________

___________ ianii?o – na?iy _________ ? _________ aeaeaiee <___> ________ 199__?.
(iiaeien)

EEI _______________________________________________________________________________________________________________

146

Eiia?oeieiee aeiaiai?

*eaie OOE

I?IOIEIE

?iciiaeieo aeiaai?iaee iiae o/anieeaie
oei/aniaiai o?oaeiaiai (oai?/iai) eieaeoeao

ii aeiaiai?o ?

aiae

? ? i/iI?icaeua, iiy, ii aaoueeiaiIanii?o (na?iy, iiia?)Aae?anaNoia aeieaoeIiaeien

Ea?iaiee OOE

(IIAeIEN)

Nae?aoa? cai?ia

(iiaeien)

O?OAeIAA OAIAeA

199

(iacaa iiaei?eoinoaa)

a iniai

(E.I.A., iinaaea)

ui aeio ia iiaenoaai

(noaoooo, iieiaeaiiy)

iaaeaei , c iaeiiai aieo, i a?.

(I.I.A., aeaii ianii?oo)

iaaeaei , c iioiai aieo,
oeeaee Aeaio Oaiaeo i?i ianooiia:

1. I?AAeIAO AeIAIAI?O

1.1. CAIIAIEE aei?o/ao, a AEEIIAAAOeUe i?eeiao ia naaa ciaiaycaiiy aeeiiaoe
ianooiii ?iaioe __________________________________________________________________

(oa?aeoa? i aeae ?iaioe)

o no?ie aei

1.2. ?iaioa iao aiaeiiaiaeaoe ianooiiei aeiiaai;

1.3. CAIIAIEE caaacia/oo AEEIIAAOess anii iaiaoiaeiei aeey aeeiiaiiy ?iaioe,
ia?aaeaa/aii? Aeaiei Aeiaiai?ii.

1.4. CAIIAIEE ciaiaycaiee naio/anii i?eeiyoe e iieaoeoe ?iaioo.

2. ?ICII? I II?ssAeIE IIEAOE

2.1. Ca aeeiiaio ?iaioo CAIIAIEE aeiea/oo AEEIIAAOeAAI ________________ e?a.
2.2. Iieaoa aiaeaoaaooueny ia iiciioa ________________ aiae aeiy i?eeiyooy ?iaioe.

147

Eiia?oeieiee aeiaiai?

3. AIAeIIAIAeAEUeIINOUe NOI?II

3.1. Noi?iie ianooue iaoa?iaeueio aiaeiiaiaeaeueiinoue ca iaaeeiiaiiy aai iaiaeaaeia aeeiiaiiy
iieeaaeaieo ia ieo ciaiaycaiue o aiaeiiaiaeiinoi aei /eiiiai caeiiiaeaanoaa.

4. AeINO?IEIAA ?ICI?AAIIss AeIAIAI?O

4.1. O aeiaaeeo ii?ooaiiy iaeiioth ic noi?ii ciaiaycaiue ca aeiaiai?ii iioa noi?iia iao
i?aai ?ici?aaoe eiai a iaeiinoi?iiiueiio ii?yaeeo.

5. IIOI OIIAE

5.1. Nii?e ca Aeaiei Aeiaiai?ii ?icaeyaeathoueny noaeii.
5.2._____________________________________________

Aae?ane noi?ii

CAIIAIEE ______________________________________________________
AEEIIAAAOeUe ___________________________________________________
Iiaeiene noi?ii
CAIIAIEE________ AEEIIAAAOeUe.

AeIAIAI?
i?i iiaio iiaeeaiaeoaeueio iaoa?iaeueio aiaeiiaiaeaeueiinoue

i. ____________ <____> ___________ 199 ___ ?.

(iacaa iiaei?eoinoaa)

C iaoith caaacia/aiiy caa?aaeaiiy iaoa?iaeueieo oeiiiinoae, yei iaeaaeaoue.
ea?iaiee iiaei?eoinoaa aai eiai canooiiee _______________________________
iaaeaei , c iaeiiai aieo, i i?aoeiaiee.

(aiaeaeieo, naeoei?, neeaaeo)

(i?icaeua, iiy, ii aaoueeiai)

iaaeaei , c iioiai aieo, oeeaee Aeaio Oaiaeo i?i ianooiia:
I. I?AOeIAIEE, ui caeiao iinaaeo ______________________________, aai aeeiioo ?iaioo

(iacaa ?iaioe)
(caa?aaeaiiyi, ia?iaeith, i?iaeaaeai (aiaeioneii),

, aaciina?aaeiuei iiaycaio c

ia?aaacaiiyi aai canoinoaaiiyi o i?ioeani ae?iaieoeoaa ia?aaeaieo eiio iaoa?iaeueieo oeiiiinoae)

i?eeiao ia naaa iiaio iaoa?iaeueio aiaeiiaiaeaeueiinoue ca iacaaacia/aiiy caa?aaeaiiy aai?aieo
eiio iiaei?eoinoaii iaoa?iaeueieo oeiiiinoae, i o cayceo c aeeeaaeaiei ciaiaycoooueny:

a) aeaaeeeai noaaeoeny aei ia?aaeaieo eiio ia caa?aaeaiiy aai iioeo oeieae iaoa?iaeueieo
oeiiiinoae iiaei?eoinoaa i aaeeaaoe caoiaeia aeey iiia?aaeaeaiiy caeoeia;

a) naio/anii iiaiaeiieyoe ea?iaieoeoai iiaei?eoinoaa .i?i ani ianoaaeie, ui caa?iaeothoue
caaacia/aiith caa?aaeaiiy aai?aieo eiio iaoa?iaeueieo oeiiiinoae;

a) aanoe iaeie, neeaaeaoe i ia?aaeaaaoe o aecia/aiiio ii?yaeeo oiaa?ii-a?ioiai oa iioi
caioe i?i ?oo oa ?aooee aai?aieo eiio iaoa?iaeueieo oeiiiinoae;
a) a?aoe o/anoue a iiaaioa?ecaoei? aai?aieo eiio iaoa?iaeueieo oeiiiinoae.
2. IIAeI?EoINOAI ciaiaycoooueny:

a) noai?thaaoe i?aoeiaieeiai oiiae, iaiaoiaeii aeey ii?iaeueii? i?aoei i caaacia/aiiy iiaiiai
caa?aaeaiiy aai?aieo eiio iaoa?iaeueieo oeiiiinoae;

a) ciaeiieoe i?aoeiaieea c /eiiei caeiiiaeaanoaii uiaei iaoa?iaeueii? aiaeiiaiaeaeueiinoi
i?aoeiaieeia ca caeoee, iaianaii iiaei?eoinoao, onoaiiai, i?aaiicaoei?, a oaeiae c /eiieie
iino?oeoeiyie, ii?iaoeaaie oa i?aaeeaie caa?aaeaiiy, i?eeiaiiy, ia?iaee, i?iaeaaeo (caooo),
ia?aaacaiiy aai canoinoaaiiy o i?ioeani ae?iaieoeoaa ia?aaeaieo eiio iaoa?iaeueieo oeiiiinoae;
a) i?iaiaeeoe o anoaiiaeaiiio ii?yaeeo iiaaioa?ecaoeith iaoa?iaeueieo oeiiiinoae.

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Eiia?oeieiee eiaiai?

3. O aeiaaeeo iacaaacia/aiiy c aeie I?AOeIAIEEA caa?aaeaiiy aai?aieo eiio iaoa?iaeueieo
oeiiiinoae, aecia/aiiy ?icii?ia caeoeia, caaaeaieo iiaei?eoinoao, oa ?o aiaeoeiaeoaaiiy aiaeaoaaooueny
o aiaeiiaiaeiinoi aei /eiiiai caeiiiaeaanoaa.

4. I?AOeIAIEE ia iana iaoa?iaeueii? aiaeiiaiaeaeueiinoi, yeui caeoee caaaeaii ia c eiai
aeie.

5. Aeiy Aeaiiai Aeiaiai?o ?iciianthaeaeoooueny ia aanue /an ?iaioe c aai?aieie I?AOeIAIEEIAI
iaoa?iaeueieie oeiiiinoyie IIAeI?EoINOAA.

6. Aeaiee Aeiaiai? neeaaeaii a aeaio i?eii?ieeao, c yeeo ia?oee ciaoiaeeoueny o ea?iaieea
IIAeI?EoINOAA, a ae?oaee o I?AOeIAIEEA.

?aeaiceoe Iiaeiene
noi?ii Aeiaiai?o noi?ii Aeiaiai?o

IIAeI?EoINOAI
I?AOeIAIEE ___

I.I.

AeIAIAI?
i?i eieaeoeaio iaoa?iaeueio aiaeiiaiaeaeueiinoue

i. ____________ <____> ___________ 199 ___ ?.
C iaoith caaacia/aiiy caa?aaeaiiy iaoa?iaeueieo oeiiiinoae IIAeI?EoINOAI.

a iniai eiai ea?iaieea _______________________.________________________________

(i?icaeua, iiy, ii aaoueeiai)

iaaeaei , c iaeiiai aieo, i *EAIE EIEAEOEAO

(iacaa iiaei?eoinoaa)

(iacaa aiaeaeieo, aeieueieoei, naeoei?, neeaaeo oiui)

iaaeaei , a iniai ea?iaieea eieaeoeao

(i?icaeua, iiy, ii aaoueeiai, iinaaea)

oeeaee Aeaiee Aeiaiai? i?i ianooiia:

1. CAAAEUeII IIEIAEAIIss

1.1. EIEAEOEA i?eeiao ia naaa eieaeoeaio iaoa?iaeueio aiaeiiaiaeaeueiinoue ca iacaaac-

ia/aiiy caa?aaeaiiy iaeia oa iioeo oeiiiinoae, ia?aaeaieo eiio aeey

(iaeiaioaaiiy aeaeo ?iaio)

a ea?iaieoeoai IIAeI?EoINOAA ciaiaycoooueny noai?thaaoe EIEAEOEAO oiiae, iaiaoiaeii
aeey iaeaaeiiai aeeiiaiiy i?eeiyoeo ciaiaycaiue caiaeii .aeiaiai?o.

1.2. I?e ciiii ea?iaieoeoaa EIEAEOEAO aai i?e aeaoooi c EIEAEOEAO iiiaae 50% aiae
eiai ii/aoeiaiai neeaaeo aeiaiai? iao aooe ia?aioi?ieaii.

1.3. Aeiaiai? ia ia?aioi?iethooueny i?e aeaoooi ci neeaaeo EIEAEOEAO ie?aieo i?aoeiaieeia
aai i?eeiyooi aei EIEAEOEAO iiaeo i?aoeiaieeia. O oaeeo aeiaaeeao i?ioe iiaeieno aeaoeiai
/eaia EIEAEOEAO aeacoooueny aeaoa eiai aeaoooy, a iiaii?eeiyoee i?aoeiaiee iiaeienoo aeiaiai?
i aeacoo aeaoo anooio aei EIEAEOEAO.

2. I?AAA OA IAIAssCEE *EAIIA EIEAEOEAO
OA EA?IAIEOeOAA IIAeI?EoINOAA

2.1. *eaie EIEAEOEAO iathoue i?aai:

a) a?aoe o/anoue o i?eeiaiii oeiiiinoae oa caeienithaaoe acaoiiee eiio?ieue ca ?iaioith ii
caa?aaeaiith, ia?iaoei, i?iaeaaeo (aiaeioneo), ia?aaacaiith aai canoinoaaiith o i?ioeani ae?iaieoeoaa
oeiiiinoae;

a) a?aoe o/anoue a iiaaioa?ecaoei? oeiiiinoae, ia?aaeaieo EIEAEOEAO;
a) ciaeiieoeny ic caioaie i?i ?oo oa ?aooeaie ia?aaeaieo EIEAEOEAO oeiiiinoae;
a) o iaiaoiaeieo aeiaaeeao aeiaaaoe aiae ea?iaieoeoaa IIAeI?EoINOAA i?iaaaeaiiy iiaaioa?e-
caoei? ia?aaeaieo EIEAEOEAO oeiiiinoae;

ae) cayaeyoe ea?iaieoeoao IIAeI?EoINOAA i?i aiaeaiae /eaiia EIEAEOEAO, a oiio /enei
ea?iaieea EIEAEOEAO, yei, ia ?o aeoieo, ia iiaeooue caaacia/eoe caa?aaeaiiy oeiiiinoae.

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Eiia?oeieiee aeiaiai?

2.2. *eaie EIEAEOEAO ciaiaycaii:

a) aeaaeeeai noaaeoeny aei oeiiiinoae i aaeeaaoe caoiaeia aeey iiia?aaeaeaiiy caeoeia;
a) o anoaiiaeaiiio ii?yaeeo aanoe iaeie, neeaaeaoe i naio/anii iaaeaaaoe caioe i?i ?oo oa
?aooee oeiiiinoae;

a) naio/anii iiaiaeiieyoe ea?iaieoeoai IIAeI?EoINOAA i?i ani ianoaaeie, ui caa?iaeothoue
caaacia/aiith caa?aaeaiiy oeiiiinoae.
2.3. Ea?iaieoeoai IIAeI?EoINOAA ciaiaycaia:

a) noai?thaaoe EIEAEOEAO oiiae, iaiaoiaeii aeey caaacia/aiiy iiaiiai caa?aaeaiiy
oeiiiinoae;

a) naio/anii aaeeaaoe caoiaeia aeey aeyaeaiiy oa onoiaiiy i?e/ei, ui ia?aoeiaeaeathoue
caaacia/aiith EIEAEOEAII caa?aaeaiiy oeiiiinoae, aeyaeyoe eiie?aoieo inia, aeiieo o
iaianaiii caeoeia, i i?eoyaaoe ?o aei anoaiiaeaii? caeiiiaeaanoaii aiaeiiaiaeaeueiinoi;

a) ciaeiieoe EIEAEOEA c /eiiei caeiiiaeaanoaii noiniaii iaoa?iaeueii? aiaeiiaiaeaeueiinoi
?iaioieeia i neoaeaiaoeia ca caeoee, caaaeaii IIAeI?EoINOAO, a oaeiae c /eiieie iino?oeoeiyie
oa i?aaeeaie i?eeiaiiy, caa?aaeaiiy, ia?iaee, i?iaeaaeo (caooo), ia?aaacaiiy aai canoinoaaiiy
o i?ioeani ae?iaieoeoaa oeiiiinoae oa ?o iaeieo;

a) caaacia/oaaoe EIEAEOEAO oiiae, iaiaoiaeii aeey naio/aniiai iaeieo oa caioiinoi i?i
?oo oa ?aooee ia?aaeaieo eiio oeiiiinoae;

ae) ?icaeyaeaoe ieoaiiy i?i iaa?oioiaaiinoue aeiia /eaiia EIEAEOEAO uiaei i?iaaaeaiiy
iiaaioa?ecaoei? oeiiiinoae;

o) ?icaeyaeaoe iiaiaeiieaiiy /eaiia EIEAEOEAO i?i ianoaaeie, ui caa?iaeothoue caa?aaeai-
ith oeiiiinoae, i aaeeaaoe caoiaeia aeey onoiaiiy oeeo ianoaaei.

3. II?ssAeIE AAAeAIIss CAIOO OA IAEIEO

3.1. I?eeiaiiy oeiiiinoae, aaaeaiiy iaeieo i iaaeaiiy caioiinoi i?i ?oo oeiiiinoae
caeienithooueny o anoaiiaeaiiio ii?yaeeo ea?iaieeii EIEAEOEAO.

3.2. Ieaiiai iiaaioa?ecaoei? oeiiiinoae, ia?aaeaieo EIEAEOEAO, i?iaiaeyoueny a no?iee,
aecia/aii i?aaeeaie aioo?ioiueiai o?oaeiaiai ?icii?yaeeo.

Iicaieaiiai iiaaioa?ecaoei? i?iaiaeyoueny i?e ciiii ea?iaieea EIEAEOEAO, i?e aeaoooi c
EIEAEOEAO iiiaae 50% eiai /eaiia, a oaeiae ia aeiiao iaeiiai aai eieueeio /eaiia EIEAEOEAO.

3.3. Caioe i?i ?oo oa ?aooee oeiiiinoae iiaeienothoueny ea?iaieeii EIEAEOEAO oa a
ii?yaeeo /a?aiainoi iaeiei c /eaiia EIEAEOEAO.

Ciino caioo iaieiooooueny anii /eaiai EIEAEOEAO.

4. AIAeOEIAeOAAIIss CAEOEIA

4.1. Iiaenoaaith aeey i?eoyaiaiiy /eaiia EIEAEOEAO aei iaoa?iaeueii? aiaeiiaiaeaeueiinoi o
iaoa?iaeueii caeoee, caaaeaii ianoa/ath, yea iiaeoaa?aeaeoooueny iiaaioa?icaoeieiith aiaeiiinoth.

4.2. I?eoyaiaiiy EIEAEOEAO aei iaoa?iaeueii? aiaeiiaiaeaeueiinoi i?iaaaeeoueny ea?iaieoeoaii
IIAeI?EoINOAA iiney i?iaaaeaiiy ia?aai?ee i?e/ei ooai?aiiy caeoeia c o?aooaaiiyi
ienueiiaeo iiyniaiue, iaaeaieo /eaiaie EIEAEOEAO, a a iaiaoiaeieo aeiaaeeao oaeiae aeniiaeia
iacaeaaeieo aenia?oia.

4.3. *eaie EIEAEOEAO caieueiythoueny aiae aiaeoeiaeoaaiiy caeoeia:
a) yeui aoaea anoaiiaeaii, ui caeoee caaaeaii ia c ?oiuei? aeie;

a) yeui aoaeooue anoaiiaeaii eiie?aoii aeioaaooei caaaeaieo caeoeia c /enea /eaiia aeaiiai
EIEAEOEAO.

4.4. Aecia/aiiy ?icii?ia caeoeia, caaaeaieo EIEAEOEAII IIAeI?EoINOAO, a oaeiae
ii?yaeie eiai aiaeoeiaeoaaiiy ?aaoethooueny /eiiei caeiiiaeaanoaii.

4,5. Caeoee, caaaeaii EIEAEOEAII IIAeI?EoINOAO, ui iiaeeyaathoue aiaeoeiaeoaaiith,
?iciiaeieythoueny iiae /eaiaie aeaiiai EIEAEOEAO i?iii?oeieii iiny/iiio iinaaeiaiio ieeaaeo
oa oaeoe/ii aiaei?aoeueiaaiiio /aniai ca ia?iiae aiae inoaiiuei? iiaaioa?ecaoei? aei aeiy aeyaeaiiy
caeoeia.

Aeiaiai? iaaoaao /eiiinoi c ________________ i aeio ia aanue ia?iiae ?iaioe EIEAEOEAO c
ia?aaeaieie eiio oeiiiinoyie ia aeaiiio IIAeI?EoINOAI.

Aeiaiai? neeaaeaii a aeaio i?eii?ieeao, c yeeo ia?oee ciaoiaeeoueny o ea?iaieea IIAeI?EoI-
NOAA, a ae?oaee o ea?iaieea EIEAEOEAO.

Iiaeiene:

IIAeI?EoINOAI ___________________________________________________________
EA?IAIEE EIEAEOEAO _________________________________________________________
*EAIE EIEAEOEAO_________________________________________________________

150

Eiia?oeieiee aeiaiai?

C?ACEE AeIEOIAIOIA
AeEss IOI?IEAIIss I?EEIAIIss
I?IAeOEOeI? (OIAA?IA)
CA EIEUeEINOTH OA ssEINOTH

Iaeiaioaaiiy
io?eioaa/a __
Aae?ana _______

CAOAA?AeAEOTH
Ea?iaiee iiaei?eoinoaa

<___> ___________ 199 __ ?.

AEO
?ice?eooy aaaiio (eiioaeia?o, aaoioo?aiio)

199 __ ?.

Iinoea neeaaeaiiy aeoo _______________________________
Eiiiniy o neeaaei ______________________________________
?ice?eea aaaii (eiioaeia?, aaoioo?aii) _____________________
ui iaaeieoia ca ____________________ iaeeaaeiith ______ aiae ___________ 199__?.

Iiaeiene inia, yei a?aee o/anoue o neeaaeaiii aeoo:

(________________)

(I.I.A.)

(___________________________)
(I.I.A.)

151

Eiia?oeieiee aeiaiai?

Iaeiaioaaiiy
io?eioaa/a __
Aae?ana _______

CAOAA?AeAEOTH
Ea?iaiee iiaei?eoinoaa

<___> __________ 199 __ ? ____________ 199 ?.

Iinoea neeaaeaiiy aeoo i?eeiaiiy i?iaeoeoei? (oiaa?ia)
*an ii/aoeo i?eeiaiiy i?iaeoeoei? (oiaa?ia)
*an caeii/aiiy i?eeiaiiy
Eiiiniy o neeaaei:

(iinaaea, iinoea ?iaioe, i?icaeua, iiy, ii aaoueeiai)

ca o/anoi i?aaenoaaieea iinoa/aeueieea, iacaoeieaaeaii? i?aaiicaoei?, a?iiaaenueeinoi

(iinaaea, iacaa iiaei?eoinoaa, iiy, ii aaoueeiai, i?icaeua)

153

Eiia?oeieiee aeiaiai?
Aeaoa i ? iinaiae/aiiy i?aaenoaaieea iinoa/aeueieea (iacaeaaeii? i?aaiicaoei?, a?iiaaenueeinoi)

Eiiiniy iciaeiieaia c Iino?oeoeioth i?i ii?yaeie i?eeiaiiy i?iaeoeoei? ae?iaie/i-oaoii/iiai
i?ecia/aiiy i oiaa?ia ia?iaeiiai niiaeeaaiiy ca eieueeinoth oa yeinoth.
Iacaa iinoa/aeueieea.

Iacaa oa aae?ana aiaei?aaieea (ae?iaieea)

ieea)

Aeaoa i iiia? oaeaoiiia?aie aai oaeaa?aie i?i aeeeee i?aaenoaaieea ae?iaieea (iinoa/aeue-

Aeaoa oa ? ?aooieo-oaeoo?e
Aeaoa oa ? o?ainii?oii? iaeeaaeii?
Noaioeiy i aeaoa aiaei?aaeaiiy

Noaioeiy i?ecia/aiiy oa /an i?eaoooy aaioaaeo
*an aeaea/i aaioaaeo i?aaiii o?ainii?oo

*an ?ice?eooy aaaiia, eiioaeia?a, aaoioo?aiia oa?e
Aeaoa neeaaeaiiy eiia?oeieiiai aeoo

Noai oa?e, oiaeiaee, ia?ei?oaaiiy, ieiiae

Iayaiinoue iaeoaaeueieo y?eeeia

Ca aeieoiaioaie iinoa/aeueieeia cacia/aeiny:

Iaeiaioaaiiy i?iaeoeoei? oa eieueeinoue iinoeue oa?eIaeeieoey aeii?thaaiiyCa o?ainii?oiith iaeeaaeiithCa ?aooieii, iaeoaaeueiei eenoii
eieueeinouenoiaeieueeinouenoia
12

Oaeoe/ii aeyaeeiny:

Iaeiaioaaiiy i?iaeoeoei?Iaeeieoey aeii?oOaeoe/ii iaaeieoei?icoiaeaeaiiy
eieueeinoueo oiio /enei a?ae aai aieiaaeeeoeeianoa/a
eieueeinouenoiaeieueeinouenoiaeieueeinouenoia
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sseei /eiii aecia/aii eieueeinoue i?iaeoeoei?, yei? a?aeoo

Aeaoaeueiee iien aeyaeaieo aeaoaeoia oa ?o oa?aeoa?

Iiia?e AINOia, oaoii/ii oiiae, e?aneaiiy, ca yeeie caeienithaaeany ia?aai?ea yeinoi
i?iaeoeoei? ________________________________________________________________________

Aeniiaie eiiini? i?i i?e/eie ianoa/i, iaaeeeoeia, aith oa a?aeo i?iaeoeoei?:

*eaie eiiini? iiia?aaeaeaii i?i aiaeiiaiaeaeueiinoue ca iiaeienaiiy aeoo, yeee iinoeoue aeaii,
ui ia aiaeiiaiaeathoue aeieniinoi.

154

Eiia?oeieiee aeiaiai?

Iiaeiene /eaiia eiiini?:

1.___________________________ 2.
3. ___________________________ 4.

I?aaenoaaiee iinoa/aeueieea
(iacaoeieaaeaii? i?aaiicaoei?,
a?iiaaenueeinoi): ___________________

Iaeiaioaaiiy
io?eioaa/a __
Aae?ana _______

CAOAA?AeAEOTH
Ea?iaiee iiaei?eoinoaa

199__?.

AEO
i?eeiaiiy i?iaeoeoei? (oiaa?ia) ca yeinoth

199 __ ?.

Iinoea neeaaeaiiy aeoo i?eeiaiiy i?iaeoeoei? (oiaa?ia)
*an ii/aoeo i?eeiaiiy i?iaeoeoei? (oiaa?ia) ________
*an caeii/aiiy i?eeiaiiy _____________________
Eiiiniy o neeaaei: _______________________________

(i?icaeua, iiy, ii aaoueeiai, iinaaea, iinoea ?iaioe)

Aeaoa i ? iinaiae/aiiy i?aaenoaaieea iinoa/aeueieea (iacaeaaeii? i?aaiicaoei?, a?iiaaenueeinoi)

Eiiiniy iciaeiieaia c Iino?oeoeioth i?i ii?yaeie i?eeiaiiy i?iaeoeoei? ae?iaie/i-oaoii/iiai

i?ecia/aiiy i oiaa?ia ia?iaeiiai niiaeeaaiiy ca yeinoth.
Iacaa iinoa/aeueieea ________________________________________________________________
Iacaa oa aae?ana aiaei?aaieea (ae?iaieea) ___________________________________________
Aeaoa i iiia? oaeaoiiia?aie aai oaeaa?aie i?i aeeeee i?aaenoaaieea aiaei?aaieea (ae?ia-
ieea) ______________________________________________________________________________
Aeaoa oa iiia? aeiaiai?o (ia?yaeo) ia iinoaaeo i?iaeoeoei? (oiaa?ia) ________________________
Aeaoa oa iiia? ?aooieo-oaeoo?e ________________________________________________
Aeaoa oa iiia? o?ainii?oii? iaeeaaeii? ______________________________________________
Noaioeiy i aeaoa aiaei?aaeaiiy _______________________________________________________
Noaioeiy (ii?o, i?enoaiue) i?ecia/aiiy i aeaoa i?eaoooy i?iaeoeoei? (oiaa?ia) _______________
*an aeaea/i aaioaaeo i?aaiii o?ainii?oo ________________________________________________
*an ?ice?eooy aaaiia, eiioaeia?a, aaoioo?aiia oa iioeo iieiiaiaaieo o?ainii?oieo

caniaia ____________________________________________________________________________
Aeaoa i iiia? eiia?oeieiiai aeoo _____________________________________________________
*an aeinoaaee aaioaaeo ia neeaae io?eioaa/a ______________________________________
Oiiae caa?aaeaiiy i?iaeoeoei? ia neeaaei io?eioaa/a aei neeaaeaiiy aeoo ___________________

Noai oa?e oa oiaeiaee ia iiiaio iaeyaeo i?iaeoeoei?, ciino ciaiioiueiai ia?ei?oaaiiy
oa?e, o /e?e oa?i, oiaeiaoei i?aaeyaeaii aeey iaeyaeo i?iaeoeoeith (aiaei?aaieea /e ae?iaieea) ___

Aeaoa ?ice?eooy oa?e oa oiaeiaee _______________________,_________________________
Caoaaaeaiiy c ia?ei?oaaiiy, oa?e, oiaeiaee, a oaeiae eieueeinoue i?iaeoeoei?, yei? noinoooueny
eiaeai ic aeyaeaieo iaaeieieia __________________________________________________________

sseui i?iaiaeeeany aeai?eiaa ia?aai?ea i?iaeoeoei? (ia yeie iiaenoaai: AINO, oaoii/ii oiiae,
iioi iaiayceiai i?aaeea, aeiaiai?) – ii?yaeie aiaeai?o i?iaeoeoei?________________________________

155

Eiia?oeieiee aeiaiai?

Ca /e?ie ieiiaaie (aiaei?aaieea /e i?aaio o?ainii?oo) aiaeaaioaaeaia i iaaeieoea i?iaeoeoeiy,
ni?aaiinoue ieiia, aiaeaeoee ia ieo _____________________________________________________

O?ainii?oia aai aiaei?aaieoeueea ia?ei?oaaiiy iinoeue (ca aeieoiaioii i oaeoe/ii)

Iayaiinoue aai aiaenooiinoue iaeoaaeueieo y?eeeia, ieiia ia ie?aieo iinoeyo

Aiaeiioea i?i aeaea/o aaioaaeo a ii?yaeeo no.

Noaoooo caeicieoeue

(iayaiinoue, aiaenooiinoi.)

Eieueeinoue (aaaa), iiaia iaeiaioaaiiy i ia?aeie i?iaeoeoei?, i?aaeyaeaii? aei ia?aai?ee, a
oaeiae oaeoe/ii ia?aai?aii?.

?? i/iIaeiaioaaiiy i?iaeoeoei?Iaeeieoey aeii?oOeiiaCa aeieoiaioaie iinoa/aeueieeaOaeoe/ii iaaeieoei
onueiaio oiio /enei a?ae aai aie
eieueeinouenoiaeieueeinouenoiaeieueeinouenoia
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Aeacaoe i?iaeoeoeith, aaooiie yei? ia aiaeiiaiaeao aaooieo, cacia/aiiio o aeieoiaioi, ui
iinaiae/oo ?? yeinoue.

Aeaoaeueiee iien aeyaeaieo iaaeieieia oa ?o oa?aeoa? _________________________________
Iiaenoaae, ca yeeie i?iaeoeoeiy ia?aaiaeeoueny o ieae/ee aaooiie, c iineeaiiyi ia noaiaea?o,
oaoii/ii oiiae, iioi iaiayceiai i?aaeea _______________________________________________

Eieueeinoue iaeiiieaeoii? i?iaeoeoei?, ia?aeie /anoei, aoceia i aeaoaeae, yeeo ia aenoa/ao, oa
?o aa?oinoue __________________________________________________________________________
Iiia?a AINOia, oaoii/ieo oiia, e?aneaiiy, c?aceia (aoaeiiia), ca yeeie caeienithaaeany
ia?aai?ea yeinoi i?iaeoeoei?__________________________________________________________

Iiia? a?aeoaaeueieea iiaei?eoinoaa-ae?iaieea i?iaeoeoei?, yeui ia i?iaeoeoei? oaeee iiia?
iayaiee.

*e c?iaeaii aiaeai? c?aceia (i?ia) i eoaee ?o iai?aaeaii

Iioi aeaii, yei, ia aeoieo eiiini?, iaioiaeii cacia/eoe a aeoi aeey iiaeoaa?aeaeaiiy iaiaeaaeii?
yeinoi ___________________________________________________________________________

Aeniiaee eiiini? i?i oa?aeoa? aeyaeaieo aeaoaeoia a i?iaeoeoei? oa i?e/eie ?o iiyae

*eaie eiiini? iiia?aaeaeaii i?i aiaeiiaiaeaeueiinoue ca iiaeienaiiy aeoo, ui iinoeoue aeaii, yei
ia aiaeiiaiaeathoue aeieniinoi.

Iiaeiene /eaiia eiiini?:

1.
3.

2.
4.

I?aaenoaaiee iinoa/aeueieea
(iacaoeieaaeaii? i?aaiicaoei?,
a?iiaaenueeinoi):.

(iiaeien)

156

Eiia?oeieiee aeiaiai?

AEO
aiaeai?o c?aceia (i?ia)

Eiiiniy o neeaaei:

(i?iiaeua I iiaia)

(ieaa iinoa/aeueieea)

199 __ ?. c?iaeea aiaeai? i?ia i?iaeoeoei?, ui iaaeieoea aiae __________
ca ?aooieii-oaeoo?ith ? ____ aiae <__> _____________ 199 __ ?.

I?iaeoeoeiy iaaeieoea ia neeaae io?eioaa/a

<___> ______________ 199__?. a eieueeinoi __________ iinoeue, aaaith ______________ ea.
C?acee (i?iae) aiaeae?aeeny c iinoeue _____________________________________________

AINO (iiia?, aeaoa)

C?acee (i?iae) aiaeia?aii ianooiiei /eiii: _____________________________
(iienaoe, ye aiaeae?aeeny i?iae)

C?acee (i?iae) caaacia/aii aoeeaoeaie ic cacia/aiiyi ___________________

(oi aeacaii ia aoeeaoeao)
C?acee (i?iae) iia/aoaii (iieiiaiaaii) _________

(/eoth ia/aoeith aai ieiiaith, aiaeaeoee ia ieiiaao)

Iioi aeaii i?i c?acee:

C?acee (i?iae) aiaeia?aii a eieueeinoi __________ oo.
Iaeai c?acie ia?aaeaii ia caa?iaaiiy io?eioaa/aai ___

(aeacaoe eiio: i?icaeua, iinaaea)

Ae?oaee c?acie iai?aaeaii c aeoii ae?iaieeiai (aiaei?aaieeiai)
Aeiaeaoeiai c?acee

(aiaeae?aeeny /i ii)
C?acee caeaii ia aiaeic (aei?iaoaaiiy) _____________

(cacia/eoe eoaee)

Iiaeiene /eaiia eiiini?:

157

Eiia?oeieiee aeiaiai?

C?ACEE I?AOAICIE
(c eiiaioa?yie)

I?aoaiciy – oea aeiiaa uiaei aeia?iaieueiiai onoiaiiy ii?ooaiue caeiiiaeaanoaa.
I?aoaici? iai?aaeythoueny ?aeiiaiaeiaaieie oa oeiiieie eenoaie, iiaeooue aooe a?o/aii
iiae ?icieneo.
O i?aoaici? cacia/aooueny:

iacaa iiaei?eoinoaa, onoaiiae, i?aaiicaoei?, yei i?aaeyaeee i?aoaicith, a oaeiae iacaa
iiaei?eoinoaa, i?aaiicaoei?, onoaiiae, aei yeeo i?aaeyaeythoueny i?aoaici?, ?o aae?ana, iiia? i?aoaici?,
aeaoa i?aaeyaeaiiy;

ianoaaeie, ui aoee iiaenoaaith aeey i?aaeyaeaiiy i?aoaici? i yei iiaeoaa?aeaeothoue aeeeaaeaii
o i?aoaici? ianoaaeie; noia aeiia cayaieea oa ?ic?aooiie oeeo aeiia;

i?aoaiciy iiaeiia iinoeoe a niai iineeaiiy ia ii?iaoeaii aeoe, aeiaiai? aai iioi
i?aaionoaiia/i aeieoiaioe, a oaeiae iiooiai ieaoiaeii ?aeaiceoe cayaieea i?aoaici?.

Aei i?aoaici? iiaeiii aooe aeiaeaii ani iaiaoiaeii i?eaiiaeueii aeieoiaioe aai caai?aii iaeaaeiei
/eiii eiii? oeeo aeieoiaioia, i?i ui cacia/aooueny o aeiaeaoeo.

I?aoaiciy iao aooe iiaeienaia ea?iaieeii aai canooiieeii ea?iaieea iiaei?eoinoaa,
i?aaiicaoei?, onoaiiae.

Aei i?aoaici?, yea iai?aaeyooueny ia?aaicieeiai aaioaaeo, aeiaeathoueny eeoa i?eaiiaeueii
aeieoiaioe.

Aiaeiiaiaeue ia i?aoaicith aeaooueny o. ienueiiaie oi?ii i iiaeienoooueny ea?iaieeii aai
canooiieeii ea?iaieea i?aaiicaoei?, a?iiaaeyieiii-iiaei?eoioeai.

O aiaeiiaiaei ia i?aoaicith cacia/aooueny: i?e iiaiiio aai /anoeiaiio caaeiaieaiii i?aoaici? –
aeciaia noia, iiia? i aeaoa ieaoiaeiiai aei?o/aiiy ia ia?aeac oeio? noie aai no?ie i niinia
caaeiaieaiiy i?aoaici?, yeui aiia ia iiaeeyaao a?ioiaie ioeiioei; i?e iiaiie aai /anoeiaie aiaeiiai
aiae caaeiaieaiiy i?aoaici? – iioeae aiaeiiae ic iineeaiiyi ia aiaeiiaiaeia caeiiiaeaanoai i aeieace,
ui iinoyoue iiaenoaae aeey aiaeiiae; ia?aeie aeiaeaieo aei aiaeiiaiaei ia i?aoaicith aeieoiaioia, iioeo
aeieacia.

I?e caaeiaieaiii i?aoaici?, ui iiaeeyaao a?ioiaie ioeiioei, aei aiaeiiaiaei ia i?aoaicith aeiaeaooueny
aei?o/aiiy aaieo ia ia?aeac a?ioiaeo eiooia c aiaeiioeith i?i aeeiiaiiy (acyooy aei aeeiiaiiy).

I?e iiaiie aai /anoeiaie aiaeiiai o caaeiaieaiii i?aoaici? cayaieeo iathoue aooe iiaa?iooi
i?eaiiaeueii aeieoiaioe, yei aoee aeiaeaii aei i?aoaici?, a oaeiae iai?aaeaii aeieoiaioe, ui
iaa?oioiaothoue aiaeiiao, yeui ?o iaiao o cayaieea i?aoaici?.

Aiaeiiaiaeue ia i?aoaicith aiaei?aaeyooueny ?aeiiaiaeiaaiei aai oeiiiei eenoii, ii oaeaa?aoo,
oaeaoaeio, a oaeiae c aeei?enoaiiyi iioeo caniaia cayceo, ui caaacia/othoue oienoaaiiy
aiaei?aaeaiiy aiaeiiaiaei ia i?aoaicith, aai a?o/aooueny iiae ?icieneo.

O aeiaaeeo iiaii? aai /anoeiai? aiaeiiae o caaeiaieaiii i?aoaici? aai iaiaea?aeaiiy a no?ie
aiaeiiaiaei ia i?aoaicith cayaiee iao i?aai iiaeaoe iicia aei A?aio?aaeiiai noaeo.

Aeaoa
?_

Ea?iaieeo
Aae?ana _

I?AOAICIss

i?i nieaoo iaonoieee ca iaaeiiinoaaeo
(i?ino?i/aiiy iinoaaee) i?iaeoeoei?

Noia ________________ e?a.

O aiaeiiaiaeiinoi aei oeeaaeaiiai aeiaiai?o ? ________ aiae <___> _______________ 199__?.

Aaoa iiaei?eoinoai ciaiaycaii aoei iinoaaeoe iai a _______________ 199 __ ?.

(ee?oae, iinyoeue)

(iaeiaioaaiiy i?iaeoeoei?, oiaa?o)

o eieueeinoi _______________ ia noio __________________________ e?a.
Oaeoe/ii ca aeacaiee ia?iiae iinoueeaii _____________________________ a eieueeinoi

(iaeiaioaaiiy i?iaeoeoei?, oiaa?o)

ia noio ______________________ e?a.

158

Eiia?oeieiee aeiaiai?

Oaeei /eiii, Aaie iaaeiiinoaaeaii o aecia/aiee ca aeiaiai?ii no?ie

(iaeiaioaaiiy i?iaeoeoei?, oiaa?o)

a eieueeinoi ____________ ia noio ___________________ e?a.

O aiaeiiaiaeiinoi aei aeeeaaeaiiai i ea?oth/enue.______________.__________________________
_______________________________________________, i?ioo i?iaanoe aeiiinoaaeo i?iaeoeoei?
i ia?a?aooaaoe ia iao ?ic?aooieiaee ?aooiie ? ___________ a _______________________

(iacaa aaieo)

i. ________________ iaonoieeo a ?icii?i ______ aiaenioeia, ui neeaaea noio _____________ e?a.
Aeiaeaoie:

1. Eiiiy aeiaiai?o ? ________ aiae <___> ______________ 199 __ ?.

2. ?ic?aooiie iaonoieee.

3. ?aono? ?aooieia ia aiaeaaioaaeaio i?iaeoeoeith (oiaa?).

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee: _

Aeaoa
?_

Eiio _
Aae?ana

I?AOAICIss
uiaei nieaoe aa?oinoi i?iaeoeoei? (oiaa?ia), yei? ia aenoa/ao

Noia ________________ e?a.

Ca ___________________ iaeeaaeiith ? _________ aiae <___> _______________ 199 __ ?.

(aeae iaeeaaeii?)

ia iaoo aae?ano iaaeieoea aiaeaaioaaeaia Aaie i?iaeoeoeiy (oiaa?) ___________________________,

(iaeiaioaaiiy)

ui iiea/aiee iaie ca ?aooieii ? __________ aiae <___> _______________ 199 __ ?.
Aaioaae i?eaoa ______________________________________________________________________

(noai aaaiio aai eiioaeia?o, ieiia, ia?eoaaiiy oioi)

i aeaeaiee caeicieoeath aac ia?aai?ee a ii?yaeeo no. ________ Noaoooo caeicieoeue, i?i ui naiae/eoue
aiaeiioea noaioei? i?ecia/aiiy ia cai?ioi caeicie/ii? iaeeaaeii?.
Iiae /an i?eeiaiiy aaioaaeo ca o/anoi i?aaenoaaieea ___________________________________

(a?iiaaenueeinoi, iioi? i?aaiicaoei?)

aoei aeyaeaii ianoa/o _______________________________________________________________

(iaeiaioaaiiy i?iaeoeoei?, oiaa?o)

a eieueeinoi ________________ ia noio ________________________________________________ e?a.
I?ineii aa?oinoue i?iaeoeoei?, yei? ia aenoa/ao, a noii ________________________ e?a. ic
ia?aooaaiiyi _______% ?i/ieo o noii ______________ e?a. ca ei?enooaaiiy /oaeeie eiooaie,
a anueiai _____________ e?a. ia?a?aooaaoe ia iao ?ic?aooieiaee ?aooiie ? ____________
a __________________________________________ i. ______________ .

(iacaa aaieo)

Aeiaeaoie:

1. Caeicie/ia iaeeaaeia ? _____ aiae <___> ______________ 199 __ ?.

2. Aeo i?eeiaiiy ? ________ aiae <___> ______________ 199 __ ?.

3. Iinaiae/aiiy ia i?aaenoaaieea a?iiaaenueeinoi (iioi? i?aaiicaoei?) ? _________ aiae <__>
______________199 __ ?.

4. ?ic?aooiie noie i?aoaici?.

5. Oaeaa?aia i?i aeeeee aaioaaeiaiaei?aaieea.

6. Iioi aeieoiaioe, ui iaa?oioiaothoue i?aoaicith ia __________ noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

21 159

Eiia?oeieiee aeiaiai?

Aeaoa
?_

Oi?aaeiiith caeicieoei
Aae?ana ____________

I?AOAICIss
uiaei ianaio/aniinoi aeinoaaee aaioaaeo caeicieoeath

Noia ________________ e?a.

Caiaeii aeiaiai?o ? _________ aiae <___> ______________ 199__?. ia iaoo aae?ano
<___ ______________ __ aoei aiaeaaioaaeaii ca caeicie iaeeaaeiith _________ aiae> ______________ 199__?. i?iaeoeoeith _______________________________________ .

(iaeiaioayiiy)

Aaioaae caiaeii c ?ic?aooieii, ui aeiaeaooueny, aeinoaaeaii ic caiiciaiiyi ia _________ aeia.

O aiaeiiaiaeiinoi aei _______________________________________ Aai ia?aoiaoooueny oo?ao
o ?icii?i ________ aiaenioeia aiae i?iaicii? noie, ui neeaaeao a noii _________________ e?a.
Ia iiaenoaai aeeeaaeaiiai i ea?oth/enue no. _________, i?ioo ?icaeyiooe iaoo i?aoaicith i
ia?a?aooaaoe ia iao ?ic?aooieiaee ?aooiie __________ o _______________ i. __________

(iacaa aaieo)

noio _________________________ e?a. oo?ao ca ianaio/anio aeinoaaeo aaioaaeo.
Aeiaeaoie:

I. Eiiiy aeiaiai?o.

2. I?eaiiaeueia caeici. iaeeaaeia ? ________ aiae <___> _______________ 199__ ?.

3. ?ic?aooiie noie i?aoaici?.

4. Aiaeiiinoue iiaea/i, i?eae?aiiy aaaiiia.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

Aeaoa
?_

Oi?aaeiiith caeicieoei

Aae?ana ____________
Aaioaaeiaiaei?aaieeiai
Aae?ana: ____________

I?AOAICIss

aei Oi?aaeiiiy caeicieoeue oa iinoa/aeueieea o cayceo
c ianoa/ath (iioeiaeaeaiiyi, inoaaiiyi, ao?aoith) aaioaaeo

Noia _________________ e?a.

O aiaeiiaiaeiinoi c aeiaiai?ii ? ___________ aiae <___> ____________. 199 __ ?.
aaioaaeiaiaei?aaieeii ia iaoo aae?ano ca caeici. iaeeaaeiith ? ____ aiaeaaioaaeaii i?iaeoeoeith
(oiaa?e) ____________________, o aaaiii (eiioaeia?i) _________________________________
ca ieiiaith ____________________________________ (aiaei?aaieea, ia?aaicieea).

I?e aeaea/i c ia?aai?eith aaioaaeo, o cayceo c (iani?aaia ia?aaacaiiy, ii?ooaiiy ieiia,
oaoii/ia iani?aaiinoue o?ainii?oiiai caniao) _________________________________________,
anoaiiaeaii ianoa/o (inoaaiiy, iioeiaeaeaiiy, ao?aoa aaioaaeo) a eieueeinoi _________ . Aa?oinoue
ianoa/i aiaeiiaiaeii aei aeiaeaiiai ?ic?aooieo neeaea ____________________ e?a. Ianoa/o i?iaeoeoei?
(oiaa?o) iiaeoaa?aeaeaii eiia?oeieiei aeoii ? _____ aiae <___> _______________ 199__?. (o
aeiaaeeo aiaeiiae noaioei? aiae neeaaeaiiy eiia?oeieiiai aeoo – nea?aith ia iiy ia/aeueieea aiaeaeieaiiy
aei?iae oa aeoii i?eeiaiiy). Iioeiaeaeaiiy aaioaaeo oa ooeiiea iiaeoaa?aeaeaii aeoii aenia?oece
? ______ aiae <___> ______________ 199 __ ?.
?aooiie iinoa/aeueieea ? _______ aiae <___> _____________ 199 __ ?. iiea/aii iiaiinoth.

160

Eiia?oeieiee aeiaiai?

Ia iiaenoaai no. __________ Noaoooo caeicieoeue i?ioo ia?a?aooaaoe aa?oinoue ianoa/i (ao?a-
/aiiai, iioeiaeaeaiiai, ciiniaaiiai aaioaaeo) ______________ e?a. ia iao ?ic?aooieiaee ?aooiie

?_________________ a _____________________________________________________________

(iacaa aaieo)

i. __________, i __________% ?i/ieo, ii/eiath/e aiae aeiy i?aaeyaeaiiy i?aoaici? aei aeiy
ia?a?aooaaiiy a?ioae ia iao ?ic?aooieiaee ?aooiie.
Aeiaeaoie:

1. Caeici. iaeeaaeia ? ________ aiae <___> ______________ 199 __ ?.

2. Eiia?oeieiee aeo ? ________ aiae <___> ______________ 199 __ ?.

3. Aeo aenia?oece.

4. ?aooiie iinoa/aeueieea ? ________ aiae <___> _______________ 199 __ ?.

5. ?ic?aooiie noie i?aoaici?.

6. Iioi aeieoiaioe, ui iaa?oioiaothoue i?aoaicith ia _________ noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

Aeaoa
?_

Eiio _
Aae?ana

I?AOAICIss

aei aaoio?ainii?oiiai iiaei?eoinoaa i?i ianoa/o aaioaaeo
i?e oeaio?aeiciaaiie aeinoaaoei

Noia __________________ e?a.

Aaoei iiaei?eoinoaii i?eeiyoi aiae _______________________________________________
aeey aeinoaaee ia iaoo aae?ano oeaio?aeiciaaiith aeinoaaeith ca oiaa?ii-o?ainii?oiith iaeeaaeiith
? _________ aiae <___> ______________ 199 __ ?. i?iaeoeoeiy (oiaa?e) _____________________
a eieueeinoi ___________________ ia noio_______________________________________ e?a.

I?e i?eeiaiii aaioaaeo aiae aiaeiy aaoiiaoeie aeyaeaii ianoa/o ____________ a eieueeinoi
______________ ia noio __________________ e?a., ui canaiae/oooueny iiaeienii o oiaa?ii-
o?ainii?oiie iaeeaaeiie, caai?aiie aiaeioi aaoiiaoeie oa iaoei i?aaenoaaieeii (o aeiaaeeo
aiaeiiae aiaeiy aaoiiaoeie neeaaeaooueny aeo i ?iaeoueny caien o iaeeaaeiie aaioaaeiio?eioaa/ai).
Aa?oinoue i?iaeoeoei?, yei? ia aenoa/ao, caiaeii c aeiaeaiei ?ic?aooieii neeaaeao _______ e?a.
?aooiie iinoa/aeueieea ? ____ aiae <___> ______________ 199 __ ?. iiea/aii iiaiinoth.
Ea?oth/enue no. ______ Noaoooo aaoiiiaieueiiai o?ainii?oo Oe?a?ie, i?ioo ia?a?aooaaoe
aa?oinoue i?iaeoeoei? (oiaa?o), yei? ia aenoa/ao, _____________ e?a., a oaeiae _______% ?i/ieo,
ii/eiath/e aiae aeiy i?aaeyaeaiiy i?aoaici? aei aeiy ia?aooaaiiy eiooia ia iao ?ic?aooieiaee
?aooiie. ? _______________ a ________________________ i. _____________ .

(iacaa aaieo)
Aeiaeaoie:

1. Oiaa?ii-o?ainii?oia iaeeaaeia ? _______ aiae <___> _______________ 199 __ ?.

2. ?aooiie iinoa/aeueieea.

3. Aeo i?eeiaiiy i?iaeoeoei? ca eieueeinoth (o aeiaaeeo aiaeiiae aiaeiy aiae naiae/aiiy caieno a
iaeeaaeiie).

4. ?ic?aooiie noie i?aoaici?.

5. Iioi aeieoiaioe, ui iiaeoaa?aeaeothoue i?aoaicith ia noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

161

Eiia?oeieiee aeiaiai?

Aeaoa
?

Eiio _
Aae?ana

I?AOAICIss

uiaei noyaiaiiy oo?aoo oa caeoeia ca iinoa/aiiy iaia?eiaaii? i?iaeoeoei?,
a oaeiae i?iaeoeoei? (oiaa?o) aac oa?e aai a iaiaeaaeiie oa?i (oiaeiaoei)

Noia _________________ e?a.

Ca iaeeaaeiith ?________ aiae <___> ______________ 199__?. ia iaoo aae?ano iaaeieoea
aiaeaaioaaeaia Aaie i?iaeoeoeiy (oiaa?e) __________________________ o eieueeinoi ____________
ia noio ___________________________ e?a.

Aao ?aooiie ? ______ aiae <___> _______________ 199 __ ?. iaie iiea/aii iiaiinoth.
Caiaeii c aeiaiai?ii ? _____ aiae <___> _____________ 199 __ ?., AINOo, OO, INOo ______
______________________ i?iaeoeoeiy iiaeiia aiaeaaioaaeoaaoeny ____________________________

I?e i?eeiaiii ca yeinoth anoaiiaeaii, ui i?iaeoeoeiy (oiaa?e) ia ia?eiaaii, iaaeieoee
aac oa?e (oiaeiaee) aai a iaiaeaaeiie oa?i (oiaeiaoei) ____________________________________,
ui iiaeoaa?aeaeoooueny aeoii ? _____ aiae <___> ______________ 199 __ ?., neeaaeaiei ca o/anoi
i?aaenoaaieea ____________________________________________________________________,
iinaiae/aiiy ? ___ aiae <___> ______________ 199 __ ?.

Ea?oth/enue _____________._______:___________________________________________,
i?ioo nieaoeoe oo?ao o noii ____________________________ e?a., aiaeoeiaeoaaoe caeoee a
noii ____________________ e?a. caiaeii c eaeueeoeyoeioth, a anueiai __________________ e?a., yei

ia?a?aooaaoe ia iao ?ic?aooieiaee ?aooiie ? ___________ a _______________ i. _______ .

(iacaa aaieo)

Aeiaeaoie:

1. Iaeeaaeia ? _____ aiae <___> ______________ 199__?.

2. Aeo i?eeiaiiy ? ____ aiae <___> ______________ 199 __ ?.

3. Iinaiae/aiiy i?aaenoaaieea ______________ ? _____ aiae <___> ___________ 199 __ ?.

4. Oaeaa?aia i?i aeeeee i?aaenoaaieea iinoa/aeueieea.

5. ?ic?aooiie noie i?aoaici?.

6. Aeienea c aeiaiai?o, AINO, OO.

7. Eaeueeoeyoeiy.

8. Iioi aeieoiaioe, ui iaa?oioiaothoue i?aoaicith ia ________ noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

Aeaoa ___________________ Eiio _
? _____________________ Aae?ana

I?AOAICIss
i?i nieaoo oo?aoo ca i?ino?i/eo iiaa?iaiiy (iaiiaa?iaiiy) oa?e

Noia _________________ e?a.
Ca iaeeaaeiith ? ______ aiae <___> ___________ 199__?. Aai aoei aiaeaaioaaeaii ___

(iaeiaioaaiiy i?iaeoeoei?, oiaa?o)

(iaeiaioaaiiy oa?e)

Caiaeii c aeiaiai?ii (na?oeoieaoii) ? ________ aiae <___> ___________ 199 __ ?. _____

_____________________________________ o eieueeinoi _______ iiaeeyaao iiaa?iaiith a no?ie aei

(iaeiaioaaiiy oa?e)

AeI <_____> ___________________ 199 ___ ?.

Oaeoe/ii ____________________________ Aaie iiaa?iooi <___> _________ 199__?.

(iaeiaioaaiiy oa?e)

162

Eiia?oeieiee aeiaiai?

a eieueeinoi ______________________________, ia iiaa?iooi.

(eieueeinoue)

O aiaeeiaiaeiinoi aei _______________________ oa aeiaiai?o ? _____ aiae <___> ___________

199__?. i?ineii iaiiaa?iooi____________o eieueeinoi___________aiaeaaioaaeeoe ia iaoo

(iaeiaioaaiiy oa?e)

aae?ano iaaaeii i nieaoeoe oo?ao o ?icii?i ________________ e?a. caiaeii c aeiaeaiei ?ic?aooieii.
Aeacaio noio i?ineii i?a?a?aooaaoe ia iao ?ic?aooieiaee ?aooiie ? _______________
a ____________________________________________ i. _____________________ .

(iacaa aaieo)

Aeiaeaoie:

1. Eiiiy ?aooieo i?i aiaeaaioaaeaiiy i?iaeoeoei? (oiaa?o) a oa?i.

2. Eiiiy aeiaiai?o (na?oeoieaoo).

3. Eiiiy aeieoiaioia i?i oaeoe/ii aeaoe iiaa?iaiiy oa?e.

4. ?ic?aooiie noie i?aoaici?.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

(iiaeien)

Aeaoa
?_

Eiio _
Aae?ana

I?AOAICIss
i?i noyaiaiiy oo?aoo ca iinoaaeo iaeiiieaeoii? i?iaeoeoei?, ?? aa?oinoi

Noia _________________ e?a.

Caiaeii c aeiaiai?ii ? _____ aiae <___> _____________ 199__?. ca iaeeaaeiith ? _____
aiae <___> ______________ 199__?.. ia iaoo aae?ano Aaie aoei iinoaaeaii i?iaeoeoeith (oiaa?)

(iaeiaioaaiiy)

a eieueeinoi ________________________________ ia noio ___________________________ e?a.
Aaioaae i?eaoa.

(noai ieiia)

o aaaiii (eiioaeia?i) ca

(noai ieiia)

ieiiaaie ________________________________________ o _____________________ oiaeiaoei,

(aiaei?aaieea, caeicieoei) (noai oiaeiaee)

Aao ?aooiie ? _____ aiae <___> ______________ 199 __ ?. iiea/aii iiaiinoth.
I?e i?eeiaiii.

(iaeiaioaaiiy i?iaeoeoi, oiaa?o)

anoaiiaeaii

(iien iaeiiieaeoii? i?iaeoeoei?)

ui iiaeoaa?aeaeoooueny aeoii ? _____ aiae <___> ______________ 199 __ ?., neeaaeaiei ca

o/anoi i?aaenoaaieea _________________________________________________________________,

(a?iiaaenueeinoi, iioi? i?aaiicaoei?)

ui aeio ia iiaenoaai iinaiae/aiiy ? _____ aiae <___> ______________ 199 __ ?.

A?aoiaoth/e aeeeaaeaia oa o aiaeiiaiaeiinoi aei _______________________________________
i?iiiioth Aai aeioeiiieaeooaaoe i?iaeoeoeith (oiaa?), aai ia?a?aooaaoe ia iao ?ic?aooieiaee

?aooiie ? ____________ o _________________________ i._______________ aa?oinoue iiea/aii?

(iacaa aaieo)

iaeiiieaeoii? i?iaeoeoei? ______________ e?a., oo?ao o ?icii?i _________________ aiaenioeia,
ui neeaaeao ________________________ e?a., a anueiai ________________________________ e?a.

Aeiaeaoie:

1. Eiiiy aeiaiai?o.

2. Aeo i?eeiaiiy i?iaeoeoei? (oiaa?o) ? ____ aiae <__> _____________ 199 __ ?.

3. Iinaiae/aiiy i?aaenoaaieea ? _____ aiae <___> _______________ 199 __ ?.

4. Oaeaa?aia i?i aeeeee iinoa/aeueieea i aeioeiiieaeooaaiiy i?iaeoeoei?.

5. Iaeeaaeia ? ________________________ .

22 163

Eiia?oeieiee aeiaiai?

noyaiooe c aiaeiiaiaea/a iaonoieeo a noii _____________ e?a. i iiaa?iaiiy aeo?ao ia aea?aeaaia
ieoi ________________ e?a.

Aeiaeaoie:
I. Eiiiy i?aoaici? oa aeieac aiaeineaiiy ?? aiaeiiaiaea/o.

2. Eiiiy aiaeiiaiaei ia i?aoaicith (yeui o).

3. Eiii? aeiaiai?o.

4. Aeienea i niaoeeoieaoei?.

5. ?ic?aooiie iaonoieee.

6. Iiooiaa eaeoaioeiy ia aiaeineaiiy eiii? iiciaii? cayae aiaeiiaiaea/o.

7. Aei?o/aiiy i?i ia?a?aooaaiiy aea?aeieoa.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

Aei iaeaniiai A?aio?aaeiiai noaeo

Aeaoa
?_

Aae?ana:

Iiceaa/:__________
Aae?ana:___________
Aaieianueei ?aeaiceoe
Aiaeiiaiaea/:________
Aae?ana:___________
Aaieianueei ?aeaiceoe

IICIAIA CAssAA
i?i noyaiaiiy aa?oinoi i?iaeoeoei? (oiaa?o), yei? ia aenoa/ao

Noia ____________________________________ e?a.

I?e i?eeiaiii i?iaeoeoei? (oiaa?ia), yea i?eaoea ia iaoo aae?ano ca iaeeaaeiith ? _____
aiae <___> ______________ 199__?. o aaaiii (eiioaeia?i, aaoioo?aiii) ?_____, aiaei?aaeaiiio

(iaeiaioaaiiy iioaaeiaiaee?aaieea)

anoaiiaeaii ianoa/o ___________________________ ia noio _______________________ e?a.,

(iaeiaioaaiiy i?iaeoeoei?)

ui iiaeoaa?aeaeoooueny aeoii i?eeiaiiy ? _______ aiae <___> _______________ 199 __ ?.,
neeaaeaiei ca o/anoi i?aaenoaaieea .

(a?iiaaenueei?, iioi? i?aaiicaoei?)

Ianoa/a aiaeaoeany aianeiaeie

(cacia/eoe i?e/eie)

?aooiie aiaeiiaiaea/a ? ______ aiae <___> ______________ 199__?., aenoaaeaiee ca iinoaaeaio
i?iaeoeoeith (oiaa?), iaie iiea/aii iiaiinoth.

Cayaeaio iaie i?aoaicith ? ______ aiae <___> _______________ 199 __ ?. aiaeiiaiaea/
aiaeoeeea (caeeoea aac aiaeiiaiaei) c ianooiieo iioeaia: __________________________________ .
Aaaaeaoii aiaeiiao aiaeiiaiaea/a aiae caaeiaieaiiy i?aoaici? iaiaa?oioiaaiith ______________

(cacia/eoe i?e/eie)

Ia iiaenoaai aeeeaaeaiiai oa ea?oth/enue _____________________________________________,
i?ineii noyaiooe c aiaeiiaiaea/a ia iaoo ei?enoue _____________________ e?a., ui neeaaeathoue
aa?oinoue i?iaeoeoei?, yei? ia aenoa/ao, __________% ?i/ieo ca ei?enooaaiiy /oaeeie eiooaie
a noii _________________ e?a., i o iiaa?iaiiy aeo?ao ia aea?aeaaia ieoi ____________ e?a.,
a anueiai __________________ e?a.

Aeiaeaoie:
I. Eiiiy i?aoaici? oa aeieac ?? aiaei?aaeaiiy aiaeiiaiaea/o.

166

Eiia?oeieiee aeiaiai?

2. Aiaeiiaiaeue ia i?aoaicith.

3. Aeo i?eeiaiiy i?iaeoeoei? ? _______ aiae <___> _______________ 199 __ ?.

4. Iinaiae/aiiy i?aaenoaaieea a?iiaaenueeinoi (iioi? i?aaiicaoei?).

5. ?ic?aooiie noie i?aoaici?.

6. Aei?o/aiiy i?i ia?a?aooaaiiy aea?aeieoa.

7. Aeieac aiaeineaiiy eiii? iiciaii? cayae aiaeiiaiaea/o.

8. Iioi aeieoiaioe, ui iaa?oioiaothoue iiciaii aeiiae, ia __________ noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

(iiaeien)

Aei iaeaniiai A?aio?aaeiiai noaeo

Aeaoa
?_

Aae?ana:

Iiceaa/:__________
Aae?ana:___________
Aaieianueei ?aeaiceoe
Aiaeiiaiaea/:________
Aae?ana:___________
Aaieianueei ?aeaiceoe

IICIAIA CAssAA

i?i noyaiaiiy aa?oinoi ianoa/i aaioaaeo
i?e ia?aaacaiii aaioaaeia aaoio?ainii?oii

Noia _____________________________________ e?a.

I?e i?eeiaiii i?iaeoeoei? (oiaa?o), yeo aeinoaaea aiaeiiaiaea/ ia aaoiiaoeii ?

ca oiaa?ii-o?ainii?oiith iaeeaaeiith ? _____ aiae <___> ______________ 199__?. a ii?yaeeo
oeaio?aeiciaaieo ia?aaacaiue aaioaaeia, anoaiiaeaii ianoa/o _________ iinoeue aaaith _______ .

Oaeo ianoa/i canaiae/aiee ?icieneith i?eeiaeueieea aaioaaeo oa aiaeiy ia oiaa?ii-o?ainii?o-
iie iaeeaaeiie, a oaeiae i?eeiaeueii-caeaaaeueiei aeoii, neeaaeaiei ca o/anoi oeo naieo inia.

Cayaeaio iaie i?aoaicith ? _____ aiae <___> ______________ 199 __ ?. i?i iieaoo
aa?oinoi aaioaaeo, yeiai ia aenoa/ao, aiaeiiaiaea/ aiaeoeeea (caeeoea aac aiaeiiaiaei) c ianooiieo
iioeaia: ___________________________________________________________________________.
Aaaaeaoii aiaeiiao aiaeiiaiaea/a aiae caaeiaieaiiy i?aoaici? iaiaa?oioiaaiith _______________

(cacia/eoe i?e/eie)

Ia iiaenoaai aeeeaaeaiiai oa ea?oth/enue no. ________ Noaoooo aaoiiiaieueiiai o?ainii?oo,
i?ineii noyaiooe c aiaeiiaiaea/a ia ei?enoue iiceaa/a __________________________ e?a., ui
neeaaeathoue aa?oinoue aaioaaeo, yeiai ia aenoa/ao, _______% ?i/ieo a noii _____________ e?a.
ca ei?enooaaiiy /oaeeie eiooaie i o aiaeoeiaeoaaiiy aeo?ao ia aea?aeaaia ieoi __________
_______ e?a., a anueiai ____________________ e?a.

Aeiaeaoie;
I. Eiiiy i?aoaici? oa aeieac ?? aiaei?aaeaiiy aiaeiiaiaea/o.

2. Aiaeiiaiaeue ia i?aoaicith.

3. Oiaa?ii-o?ainii?oia iaeeaaeia ? _____ aiae <___> _______________ 199 __ ?.

4. I?eeiaeueii-caeaaaeueiee aeo.

5. Eiiiy ?aooieo.
6, Aeieac aiaei?aaeaiiy eiii? iiciaii? cayae aiaeiiaiaea/o.

7. Aei?o/aiiy i?i ia?a?aooaaiiy aea?aeieoa.

8. Iioi aeieoiaioe, ui iaa?oioiaothoue iiciaii aeiiae, ia _________ noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

167

Eiia?oeieiee aeiaiai?

Aei iaeaniiai A?aio?aaeiiai noaeo

Aeaoa
?_

Aae?ana:

Iiceaa/:__________
Aae?ana:___________
Aaieianueei ?aeaiceoe
Aiaeiiaiaea/:_________
Aae?ana:___________
Aaieianueei ?aeaiceoe
Niaiaeiiaiaea/:______
Aae?ana:___________
Aaieianueei ?aeaiceoe

IICIAIA CAssAA

aei aaioaaeiaiaei?aaieea oa Oi?aaeiiiy caeicieoeue
i?i noyaiaiiy aa?oinoi aaioaaeo, yeiai ia aenoa/ao

Noia ____________________________________ e?a.

Caiaeii aeiaiai?o ? _____ aiae <___> ______________ 199__?. aaioaaeiaiaei?aaieeii
____________________ ia iaoo aae?ano aiaeaaioaaeaii i?iaeoeoeith (oiaa?e). I?e ia?aai?oei oa
aeaea/i aaioaaeo, yeee iaaeieoia ca caeicie/iith iaeeaaeiith ? _____ aiae <___> _______________
199__?. o aaaiii (eiioaeia?i) ___________ anoaiiaeaii ianoa/o i?iaeoeoei? (oiaa?ia) _________
a eieueeinoi ____________ iinoeue, aaaith ________________________ .

Ianoa/o i?iaeoeoei? (oiaa?o) iiaeoaa?aeaeaii,eiia?oeieiei aeoii ? _________ aiae <___>
______________199 __ ?.

Aa?oinoue ianoa/i aaioaaeo caiaeii ?ic?aooieo neeaaeao ____________________________ e?a.
Iaoo i?aoaicith ? _____ aiae <___> _______________ 199 __ ?. i?i noyaiaiiy aa?oinoi
aaioaaeo, yeiai ia aenoa/ao, aiaeiiaiaea/ai aiaeoeeaii (caeeoaii aac aiaeiiaiaei) c iioeaia: ________

Niaiaeiiaiaea/ai aiaeoeeaii (caeeoaii aac aiaeiiaiaei) c iioeaia: __________________________ .
Aaaaeaoii aiaeoeeaiiy i?aoaici? aiaeiiaiaea/ai i niaiaeiiaiaea/ai iaiaa?oioiaaiei c ianooiieo
iiaenoaa: ________________________________________________________________________.

Ea?oth/enue no. ______ Noaoooo caeicieoeue, i?ineii noyaiooe c aeiii? noi?iie ia ei?enoue
iiceaa/a aa?oinoue aaioaaeo, yeiai ia aenoa/ao, a noii _________________ e?a. oa aeo?aoe ia
aea?aeieoi ____________________ e?a.

I?e caaeiaieaiii iiciao c ia?aaicieea i?ineii noyaiooe oaeiae ___________________%
?i/ieo, a i?e caaeiaieaiii iiciao c aaioaaeiaiaei?aaieea ________% ?i/ieo ca ei?enooaaiiy
/oaeeie a?ioiaeie eiooaie.

Aeiaeaoie:

1. Eiiiy i?aoaici? oa eaeoaioei?, ui iiaeoaa?aeaeothoue ?? aiaei?aaeaiiy aiaeiiaiaea/o oa
niaiaeiiaiaea/o.

2. Aiaeiiaiaei ia i?aoaicith.

3. Caeici. iaeeaaeia ? _____ aiae <___> _______________ 199__?.

4. ?aooiie __________________________________.

5. Eiia?oeieiee aeo ? _____ aiae <___> ______________ 199 __ ?.

6. ?ic?aooiie noie iiciao.

7. Eaeoaioei? iai?aaeaiiy eiii? iiciaiio caya aiaeiiaiaea/o oa niaiaeiiaiaea/o.

8. Aei?o/aiiy ia iieaoo aea?aeieoa.

9. Iioi aeieoiaioe, ui iaa?oioiaothoue iiciaii aeiiae, ia ____________ noi?iieao.

Ea?iaiee iiaei?eoinoaa

168

Eiia?oeieiee aeiaiai?

aai eiai canooiiee:

Aei iaeaniiai A?aio?aaeiiai noaeo

Aeaoa
?_

Aae?ana:

Iiceaa/:__________
Aae?ana:___________
Aaieianueei ?aeaiceoe
Aiaeiiaiaea/:________
Aae?ana:___________
Aaieianueei ?aeaiceoe

IICIAIA CAssAA
i?i noyaiaiiy oo?aoo oa caeoeia
ca iinoaaeo iaaeia?iyeinii? i?iaeoeoei? (oiaa?ia)

Noia __________________________________ e?a.

eieueeinoi

Caiaeii c iaeeaaeiith ? _____ aiae <___> _____________ 199 __ ?. aiaeiiaiaea/ iinoaaea iai
ueeinoi ___________________________________________________________________

(iaeiaioaaiiy i?iaeoeoei?, oiaa?o)

ia noio _____________________________ e?a.

?aooiie aiaeiiaiaea/a ? _____ aiae <___> _____________ 199 __ ?. iaie iiea/aii iiaiinoth.
I?e i?eeiaiii i?iaeoeoei? (oiaa?ia) ca yeinoth anoaiiaeaii ____________________________,

(iien iaaeia?iyeinii? i?iaeoeoei??

ui iiaeoaa?aeaeoooueny aeoii ? _____ aiae <___> ______________ 199 __ ?., neeaaeaiei ca o/anoi

i?aaenoaaieea _____________________________________________, ui aeio ia iiaenoaai iinaiae/aiiy

(a?iiaaenueeinoi, iioi? i?aaiicaoei?)

? _____ aiae <___> ______________ 199 __ ?.

Cayaeaio iaie i?aoaicith ? _____ aiae <___> _______________ 199 __ ?. aiaeiiaiaea/ai
aiaeoeeaii (caeeoaii aac aiaeiiaiaei) c ianooiieo iioeaia: ________________________________ .
Aaaaeaoii aiaeiiao aiaeiiaiaea/a aiae caaeiaieaiiy i?aoaici? iaiaa?oioiaaiith: ____________

(cacia/eoe i?e/eie)

Ia iiaenoaai aeeeaaeaiiai oa ea?oth/enue _____________, i?ineii noyaiooe c aiaeiiaiaea/a
ia iaoo ei?enoue oo?ao o noii ______________ e?a., caeoee a noii ________________ e?a., a
anueiai _________________ e?a. oa o aiaeoeiaeoaaiiy aeo?ao ia aea?aeieoi ________________ e?a.

Aeiaeaoie:

I. Eiiiy i?aoaici? oa aeieac ?? aiaei?aaeaiiy aiaeiiaiaea/o.

2. Aiaeiiaiaeue ia i?aoaicith.

3. Aeo i?eeiaiiy ? _____ aiae <___> ______________ 199 __ ?.

4. Iinaiae/aiiy i?aaenoaaieea a?iiaaenueeinoi (iioi? i?aaiicaoei?) ? ________ aiae <___>
______________ 199 __ ?.

5. ?ic?aooiie oo?aoo.

6. Eaeueeoeyoeiy ?icii?o caeoeia.

7. Aei?o/aiiy i?i ia?a?aooaaiiy aea?aeieoa.

8. Aeieac aiaei?aaeaiiy iiciaii? cayae aiaeiiaiaea/o.

9. Iioi aeieoiaioe, ui iaa?oioiaothoue iiciaii aeiiae, ia __________ noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

169

Eiia?oeieiee aeiaiai?

Aei iaeaniiai A?aio?aaeiiai noaeo

Aeaoa
?_

Aae?ana:

Iiceaa/:__________
Aae?ana:___________
Aaieianueei ?aeaiceoe
Aiaeiiaiaea/:________
Aae?ana:___________
Aaieianueei ?aeaiceoe

IICIAIA CAssAA
i?i noyaiaiiy oo?aoo ca i?ino?i/eo iiaa?iaiiy (iaiiaa?iaiiy) oa?e

Noia ________________________________ e?a.

Ca ?aooieii ? ____ aiae <___> __________ 199__?., o aiaeiiaiaeiinoi aei aeiaiai?o ?.
aiae <___> ___________ 199__?., aiaeiiaiaea/o aoei aiaeaaioaaeaii ________________________

(iaeiaioaaiiy i?iaeoeoei?, oiaa?o)

(iaeeaioaaiiy oa?e)

Caiaeii c cacia/aiei aeiaiai?ii ? _____ aiae <___> ______________ 199__?.

___________________________________________ o eieueeinoi__________________

(iaeiaioaaiiy oa?e)

iiaeeyaaei iiaa?iaiith ia iiciioa <___> ______________ 199__?.

Oaeoe/ii oa?o iiaa?iooi <___> _______________ 199__?. o eieueeinoi ____
c i?ino?i/aiiyi _________ aeiia, ia iiaa?iooi

(OIEIiINI,)

Cayaeaio iaie i?aoaicith ? _____ aiae <___> _______________ 199 __ ?. i?i nieaoo
oo?aoo ca i?ino?i/eo iiaa?iaiiy (iaiiaa?iaiiy) oa?e aiaeiiaiaea/ai aiaeoeeaii (caeeoaii
aac aiaeiiaiaei) c ianooiieo iioeaia: _________________________________________________ .
Aaaaeaoii aiaeiiao aiaeiiaiaea/a aiae caaeiaieaiiy i?aoaici? iaiaa?oioiaaiith ______________

(cacia/eoe i?e/eie)

Ia iiaenoaai aeeeaaeaiiai oa ea?oth/enue ______________________________________________
oa Iino?oeoeioth i?i ii?yaeie iiaa?iaiiy oa?e c-iiae _____________________________________,

(iaeiaioaaiiy i?iaeoeoei?)

i?ineii noyaiooe c aiaeiiaiaea/a ia ei?enoue iiceaa/a oo?ao o noii _____________________ e?a.
Aeiaeaoie:

I. Eiiiy i?aoaici? oa aeieac ?? aiaei?aaeaiiy.

2. Aiaeiiaiaeue ia i?aoaicith.

3. Eiiiy aeiaiai?o ? _____ aiae ___> _______________ 199 __ ?.

4. Eiiiy ?aooieo ? _____ aiae <___> _______________ 199__?.

5. Aeieac aiaei?aaeaiiy eiii? iiciaii? cayae aiaeiiaiaea/o.

6. Aei?o/aiiy i?i ia?a?aooaaiiy aea?aeieoa.

7. Iioi aeieoiaioe, ui iaa?oioiaothoue iiciaii aeiiae, ia _________ noi?iieao.

Ea?iaiee iiaei?eoinoaa
aai eiai canooiiee:

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