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d . ee4m.o 14U{60 LYn?1!lyutou[Unt.iUA1nii.l14ao
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m.m WoaUAJ{Un1t:t1rllu tU ?Uyl mo flUU1UU1JO{Ufll!a?t]1
u.d :1u{runrii!riruriu (rruu a.6.6)) 6u iudurdoudoutorim.d {lriuir.r - riru (a.o.a) ru iudurdaudouuori
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b. uu!n[1r0!:u!5.i/n0at1{01n']5ti'tun.r1uryrf1lJla
sA ! A^ d, i, v < " - Z -6'J. ILUUntlIA{AvOUtl]UAnlUYfl Oa:1.1 [:.rd1Ut Ilt IOul[aFl
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f,rC a ri a airotilir il:o o ar o ao
anrnn'r'hj
1. r{ufirzsrrralrn dru:u.......................or:r.lfilorro:
2. :J:;srn:lurloryraura dru:u.......................nu dru,lu.
3. alirJuu1Ll1iutta{ ::trn:sioor:1,Jfilnwo:,iruru.fi:? r:au
fil{
:J:rmnoaroro &2auo't:'t.t [1] o:
trtr
fi 1 LAYIO{1 a,1 Gl ATO fl Ol laAl tU
,v )i .i !- * .fi aflTu,lJfi'rrn1?rluau I na19fl9!oo1jU dl 1,r{_
UIJNLIU U
trtrEtr
. I .--lJ:3llruyrul [n!tn1:oaioflo :J::rtnr.
uriurn0aa1.....................
lll fl \tlt1 u l$a flor
.:19
tlu................T19
u,!n4u...........................T',Iu
truri.............-................71u
au I (:::.1).......................f.rua as )
ftw?ll ltltu!4nao:n
atul:na ao:a fl1{
6. lurrlnrnautnfioaroro r11rr!J1s.....................uyi.r,yir10rnna1oranru.....................
tr ranru.......................u.ti.: r,irlernnalorytrflJ,lB.
7. nnrneo16lfiHnn::rrdallruua:f,lurna'auuialrj.............................. arir,rl:
st't:'t \: t 0t:
fiToun:
n If,t!nl
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7.2
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g. oaroao 16rfi ::lrrrut gti.uu=rr:.t:rnr::'nnrnrut: aroriatri arirrl:............
-,g. o oraao16ufi irou a*rnr:3a n auniahi .......ua;nrrr:nrirrdr utrnlriiliahidruru. lJ',',r11
to. rJ"rprrarJr::nla.:oaroaoror:.........
1 4. rlr rafi osr o nro solll ri 1n:rfi rir al:J a g'lur'rtrillr f I
t s. n:6rliirit.l o alofl o Rfl 1t{oarofl ola-l:Jifu :lti
16. oaroaohri/oaro<ola'l:JirrJlrsnlr:o:al:':.rrioriruririrn'lruarjl qoroso dru:u.uunl:lu uriurntJ'la1.....................t]u
t?lu.l lj'llJLuaflo ,19
flU
tlutrtrtrtr
tl ,rnag......
nlu$..............................T"tu
6u I (::rl) ....................:1U
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arrr:naao:olqi.
o.1/3
o''t:''t.t Lu o:.-....................-..-fl1l
la. r irlrvr'urriarronoir,r:;u'il.loaroaoro-lua:o ntorolrlrilrla-.::.lill1:,t
oa19l oln'l n aT e aaln ri/u a"o rl :-r: rl :r
i 9. ::rrtu ri ao"r uri ri'r rriuo-: u n-rJ nr: rir,r o ar o solu rili aLi arir.:t:........
u !1t't {1,11.1 Q1n O A1 0 fl O tO SJ
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20. r:.15 ur rri altr uloi :r udr uq aro ao rrir uaro aro rohri/fi a-,r :-lJ :.0
2t. firnriasirlqarosoturilos{onaunaroaorrir vian-r*ririrfia"'rrrrsorio:Li1:lo-rtr lfilnu.
nr:n"rr5oki...... adrrl:
':ngn1t0lA161lnl
(u'1Yr)
earelvrilua-orJiurJlo
(u1n)
9lA G|1,t
(u1?1)
:rs'ld:r sl6irir rdr LLH.c
r sleinir rrir uyiu
:ruleiornuzutnaa
:r ulo"or n fir ! ri:r alohrrirorr r: a: ar o or ar qr
:Tulqirirrfius;TltrLoo'] aao:n
ou "l (;:x'l
:al:rg'ld
t.tl{to au}t1ln,t'11*
rirdrtana"rr ::drfl1A1nfln01.ii10t1?
ft'1111
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:?tJ11uo1ui,
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22. laaolxual,l 6l
23. riln rrsxlalo":-u ouruGhiiirSuua"r o:arrr:ncir rfi unr.:loiyr-ufi uiakj a drll:
25. Lrfftlrafiorr 6'ra:r:otunr:aircJdugiutiuttasoantdu:ruirhrirr.o-un-rfiariaafr.cl:]i:.nl:lonroflsn;aLi............tt,;. I
Ltfi an?1 11l0,l:'ru Lo111.[1e.lla1unur\ruouua30anL:.1u
Ja,lta
a,lxa
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)
ul Bn lYt fl lll{gt',
tr
(.
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{ri a ri a a ir olrJ :-u rl qoT:o ai r a-o fltlstu'ld a'r IR o .......................... oor4is
anutr-r'hj
t. u'ufilr,n,y'arru dr,uru.......................nrrr.:fiIaun:
2. rl::mn:lurlnrlarJra drur .......................ou Cru.:u.
3. olrunururiulauJttrnriontrxfiIoun: druru........................auE. oriryro'ntar ::trnrlurlnnnrruro
anrruil
- I , - q t ) , A -- -t. -5. [tn$l n2l,u]ruylt,lntrfr:J1auf,: uyt[n8-rfiu,rxflnnllo,Jruru.................uvi,:
uunriu tr :ralllalrn rirulu. LLvt,l
tr Tarryrgurnlna"r6g,: druru....-......11yi,: rdr.lotnrlalna............fiItr lalranru druru.....................1ryi.1 rir.lnrnrrslra...............6I
o. I:rsir{oir6llalrrrrurnriul:ldrio{uuu.........
.:r: ::lr nrdl:i1unr:rjii:r,rj:r
o:11:a
0uJo:
atr0t
lJIYI
B.nrrrrrur:cdurlrrafi ns,rro,rI:rdrr-n5tal:J-oou-u.
g. r: r n:gr uu o: qr a"n r*rtt:t a r nr:rin r:dr g'ni:r o.r1:.rs.ir foi'ra-!
, e.4 4 . ;1u. nlrnlio1lanLfluta,i !:ncj1fin?[ourran::y]uoa u,?oaaruarr n[[na-rnu{nTa1:.ladl.r'tt
z. nnr lrr a.:1:.r.r.i'r a"or ' 61.
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tt. rl::f;nGnrnun:nmlnrur:nlunr:rha-n{:rall:lrira-nir6uo.:rtsuralc"iuos.......................n-r
[unriu tr an: druru.
cl?
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tr o-uI(r!:{)........................6i ?u.....................e')
t2. nlldalnrruslnnrdaa-n{ra,:rl::rrn:lunnrraurar-ua:...................... fl1
ttunriu tr an: il'ruru
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tr 6u1(rEi)........................6ruru.....................o"1'tg.:l-oou-un'rirl:rnauarirn-rrdaa-oilurlnrltaurnldrinr:I:.rr.irfl'nir6rt:ta.lrra:.nn drtlu
q'l
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trtr
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trI a. I:rsir fot6riu-I:,: u"n e'of ld,.iruru.
uunriu trtrtro
du 1(::1)o?
In ,iruru.
du j (,:l:{)
n?
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st')
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tr iiu .1 (::1)- -, -.ua:{rJ::nalariyirirrfr ainiornuanranrrsutn,irulu
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t o. I:{sira-q1'fi r slrno:ri arhrlyrririul:,:rirr-o{Lr!u
, Arnu!:;u1 tuTt L5 tunl:n a ffn,l
::u:rrarlunr:eirrfiunr:dasit,:........
t z. n:rfl rjiil :rl:.:s.ir r?f ent^ry n-,r iiJ:J:l
^ :a-Ll't?1 u5LlluviuYtou.
.rlrj::lrrudlflunr::lii:r:J:r......... ........................urr ::u:rrarlunrrl:-l:J:.:............1 B. rrq,.l0n?ixdlriulunr:riarir.rnlii.r:J:ll:ltjran.ihdl asrrarra
ts. n:ddu'r rrl:rijra"oil rnrufiuvillrarj snrufiuviflrrlfiorurrrr:slriurirlafior.c?all:lcirfq{rallrauralfiel:a L! au''lJ L: -_.
20. arnria r g dunl:rcnfo{ro-utarryrs::raa:1d:lxluzfadr.,l:
J I i I,i r U ' ,- , J j j q re A a ,21. nl nl::anau!:nsJ'rf,o?ro 1a,l! fl!18 01l,g01! l,[fl1::anau030ia{!:!rj:.I?,tuyt'Lfla Ldlunr:au l5adro:oi'al
rirutiu 'iru:u... ...urn ldr:.rrl:: lr nror n ur drlo
zz. I:rcir fi'q {16 1 a.r rr a::r n l'iaor n-r nr:{o n a uri ahi. ......u4:rur:n6rurirrmnlo"fiiaLi......U''I7I
23. rnotgruua:i!n'nrrtt*larnrruinr:s.jrr-n{ta.:I:lrjrfoflrr.ilra",::JiLrl:{rjanr?rfl1110
24. nr:dro"otarrf,u:la :.:cirn'aflylri/uar:Jii.trj:ualllaurnfiHan::nudaf;lu:o{arua:lltulna-r6r,:riahi
a rir.r1:
druru...........................
xJ.1l4
4
25. ol'r rfiura.::l::r1suud3dJ:rna:J ar6flrirrdor-nflun'irvr'aial:,:"r.irs-oi'1firitlra-l ir:J:r
zo. rJ*fiyrinrliua;nlrraur:nlunr:rjrs'sr,:'t arl:,:sJrd'srfllrilla"r i:.r:Jpolrrtsrra lo-iua:usnrf,u tr en:'iruru.
tr In.iru:u
ol.....................61'l
....................-.....n')
tr n:::l'o 'iruru. ... -..... .. .... ...9t?
..........-........o'l
tr n:cia.D'ruru.....................o'l
Lr a sl (ftti) ......01u?u.
zz. I:.r"J.ir s-o i'rl o rlu riir a"r rlfi:l:rl a r rr err r n fil:lr r"n a"o.51ai o'ruru...................
uunriu tr nn: rirulu....
L-l Lft 0'1u1u....., ..q')
o')
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tr a'u j (::1) ..-9l')
za. ulisrrfis:.lriouornqir,:*$'ir,:1:ls.ira'o{rG uacI:,:nira-qflrrilfia"rJilr :.i
tt0fl1el6?rBAr I:odr a"o r1y ritu a-.r :*u rl :o
.....................41u?11.
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29. ujiurrfiar:rrki:rtdrmoll:lrirfo'ir6 uo:I:lcirfo{lrrilyrn".:r.lirrl:l
519fl1t
lt.r3r13ln?rotl
(x'rYr)
I:orira'n'itr ril
na-orJ:"urJ1
(u1Yr)
a G1rt
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nu'ldrtulairirarn:an: 1,l"ruru ol):r ulohr ar n:In f
,iru':u. o"':)t,!
,1U LOR1alntnl:ljA (o'rU?U.................
rru !0Rltr::uruulr !:nsr''lf,o?
t1u lefnft:utuulr !:n nnol
srl)
au sl (:::i)
:r :rg'ld
lrtgolu
t,tute aultun.rlu
riro'rlann"rlJ::dr-io'1n1.!antr1nt?fr11't
n12no
ritir:,:inrrrirt^lvir
ritir,Znltiatltfln
0r.[ 9 (::q)
:1 l1golu:.
;.lu I B e{,t/o1fl 2'l 11 u n1fl
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3 1 . u1 n rrfl u1 f, 16ii1r aunhbitiriuuf,rorsnlr:nsir riunr:1o-n"tuiaLj azirrl:
32. "oolr-urrarrau'nr::udf,u:la;ar:rfof,, d.urr*.................................u.ryl
u.unt!u t{un. nlU1U.................-...............]J'tylt^ ,Jrilufiuriuniuua:nanriuiln:...........................111y1 ulri,:ffluolrrulei
), a ^ - sfl unu[.run un:eantuu............
01u?'t{. IJlYIta .iriruSuriud'uunloanru-uf,n:...........................1J'111 urii,:ffrrrlal:rrild
), A A J T7101uautnu9uu&lnant:JU...........
tr lJT1']
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33. tYtfl:i1au'n1l fr1rJT :nlun, 'tiilu6uriuriulln:oanrdu:ruitrl:turiurirdariarir.rl:.1:-!:.1:,:I:.ls.ir a-q{1i011........., i x,;" J
tlvl d.0 ?r ll11 0 n TT u [o yrlt't:.1'10't u f] ur{ 1{6lu [l 0 3 0 a nL!u
a,rra
0nra
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)
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fl.1eA t tt *;Jn lila n a 6{:1il/gam o0 6{n1}t61{1l{U1 A
IYIFIUlA O'ITRA
t. duvr'nrerrnerura,iru:u...................-...orrrrfiIauo:
2. :J::rrn:luttslt glro,itu1u.......................0u,l"ruru.
o0fi19l
o:? t:au
5. ai lrl;qllytfi'u]a n^sryfla
11€I tO
rflo!'t1{q n
Ylfl9t;1UA0n
c -J6. ft'l1 nlL:11{ LUn'r t0 0 0{ fln1uflt1uula
6ooian-r tr rytfl11fl...............
! a!o
tr aL qt
7. riiraisi.innrufllrutlra
A8. $1nfr o1 r*rLrost-ooi an-lrytslra a-u fi aoruaurulralarrrerlra,itu.tu.
d*-f,ua;frra:r4r,:fflna'fidonlnLrf,l1']f iru:u.........................fiInrr.re:
- i q 'i A ^ 3 i - J a
9. fl'r Ltolurasrnqilul a00st{LlJufln1un'u1uu1a rru fi1o1n un,:.tu fi1L1ili1u [u6h{n{1u gng iiruru.........r.n1 uyrglrao:tdrir uarn rrr ii.o rl'ulo
10. tl-urqrl utiuufianrururrpraldlunrri!,ilirusiarfllud':rxug 2 flu:nlo.rnr:6lcirrf,unr:,iru:u......uri4 floiufl-l'rll]r'ralfriuornrrriirlo
ttd{ lanru,iruru..............ur4.1
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I 1. n:Jlr'1lflno ufiRoluru.lultlalrirlronr:lflouroduluril.r::u: 2 flu:naa,:nr:drrfiunr:
12. d?nu:nlaJn'r:rfloer'rrfiunr:cirlt'rirulunr:drrfiu,rruria{corutruruurnlf,riuornulei,:1o
t1u n1, iiru:nrin lurmy
nsld,-..
oant!uflrn1u'r.t1lrn1nnlrd1n 1uri{riraodr r
2^e antugrnu?,hnfl{ln1,
:2 t1U [6
fluo1g
rir{r.:r}:6ro.i
Rlrnu',l.J2atl11l[1t4
fi1!2utnaa:Jo:
fl1:nt,1flU1lj',tn
n'l2ic
rirriaruflr
mrflall'lolI
oanruuelg
ri1lm'nu,:
f}1 [l{v{']
rirrirri:::Jr
6u 1(::r1)
?2&i']UO1g:.
zlu 16310/nln2.]rluo'ru
fl.1t3
t3. lrn.IJxer:J"ryurarorulurirsalnr:rirrfiunr:fionr:c''ilnrj *lrrruru!raiurn:nr:o:t:1unr::0.:iu,rf,1j.rslYluuu..
,-),!ua:lt],!fl .tL,:uIfrl.t:Jf,uuu1n:J'3f,]l]Jrun1.lllaru
14. ryrfi !.rdfl 'toi''rifi anrururulr osnur:nrirrirl:lo1uifi t a_.....................14.:n'tto1tuu,:']u loulJt\tullllllltu!1u1l
druru.......................................u'tyr 6ea"nrrrJiurrfir:.rrirl:rnidaudiu:ru:ur.:iaun:un:6qliua"ofl r ;u!rf uurhl:Eylieiarudlfiunrriaaas.............-.
1s. ryrf,xlanlo'hi:ioorirvruluid... - Jd...110,:n1:o1lu1{{1u Loull6TULnUr LqLUnl:R{11u
qa1l..... 111h
16. loaorTluau I ..
.t6ru.............................
t 7. rnryrc!ralo":':J aul61r'ririuua"r o:nrrr:oc,irrfiunr:lsin"ufi riakj. .........atirr1:
18i - - a- J: .
:J0n!utyrf,,J''tfl !n1::l,iuflu:!u!u't?yli diu2u._._
uunriu tr tnun.
..........-.-................u'111
...drueu. ...1J17tta )rirao-uriunluun:oanrfiuia:...........................u.n4 ulrairrirra{lgki
), - A - I11i1uol$.tunuua:aantIU............
tnun. o'tulu. lJIYI,-
llUflUL{UO1{[AlOanLlU fl ';!1I UnnnYluTJanrlu to), A ^ e tnnluftuLil{91{ua!oan!!g
tr t,tun.........t-nlunutil{ouua!oanr u!la
;, a ^ - sTrnlunul.Jugruu8:o anl!u
..-..................Cru:u.............,..................-u1?l
...'r..rrr ul eir fi url a,::r utri
tr
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tnun. dru:u. !1r,r,A ,;iiruSuriui'uun:oanrfuil0!...........................u.ul una.rrxlnanfluli
), A - - Urn1uflut{un uasq0nt!0.........._.
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