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<!--115-->
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=<X-FC-ITEM DATA[Charset]>">
<title><X-FC-FIELD 1204 STRING>: <X-FC-FIELD LANG.115.1001.9 STRING></title>
<style type="text/css">
<!--
<!--#include virtual="/.templates/GlobalStyles.inc"-->
-->
</style>
</head>
<body bgcolor="<X-FC-FIELD PREFS.5600 DEFAULT="#FFFFFF" RGB>" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<form action="<X-FC-OBJURL SLASH>FormEdit"><!--#set var="NavPosition" value="<X-FC-FIELD PREFS.5513 DEFAULT=2 NUMBER>"-->
<!--#if expr="$NavPosition==2"--><!--#set var="TABLEWIDTH" value="100%"--><!--#else--><!--#set var="TABLEWIDTH" value="<X-FC-FIELD PREFS.5720 DEFAULT="100%" STRING>"--><!--#endif-->
<!--#if expr="!$NavPosition==2 && <X-FC-FIELD PREFS.5707 LENGTH>"-->
<table width="<!--#echo var="TABLEWIDTH"-->" cellpadding="0" cellspacing="0" border="0">
<tr>
        <td align="center"><a href="<X-FC-FIELD PREFS.5709 STRING>"><img src="/Images/<X-FC-FIELD PREFS.5707 STRING>" alt="<X-FC-FIELD PREFS.5708 STRING>" vspace="10" border="0"></a></td>
</tr>
</table><!--#endif-->
<!--#if expr="$NavPosition==0"--><!--#include virtual="/.templates/toolbars/NavForm.inc" --><!--#elif expr="$NavPosition==2"--><!--#include virtual="/.templates/toolbars/NavFormSide.inc"--><!--#elif expr="$NavPosition==3"--><!--#include virtual="/.templates/toolbars/NavFormText.inc" --><!--#endif-->
<table bgcolor="<X-FC-FIELD PREFS.5601 DEFAULT="#C0C0C0" RGB>" width="<!--#echo var="TABLEWIDTH"-->" cellpadding="0" cellspacing="0" border="0">
<tr>
        <td bgcolor="<X-FC-FIELD PREFS.5600 DEFAULT="#FFFFFF" RGB>" colspan="2"><img src="/images/pixel.gif" width="1" height="1" border="0"></td>
</tr>
<tr>
        <td colspan="2"><table bgcolor="<X-FC-FIELD PREFS.5603 DEFAULT="#555555" RGB>" cellpadding="2" cellspacing="0" border="0">
        <tr>
                <td>&nbsp;</td>
                <td><img src="/Icons/9124" alt="<X-FC-FIELD 1204 STRING>" width="16" height="11" border="0"></td>
                <td id="title1" nowrap><X-FC-FIELD LANG.115.1001.9 STRING></td>
                <td  width="100%">&nbsp;</td><!--#if expr="!$ENABLED && <X-FC-PERMISSIONS Edit> || <X-FC-PERMISSIONS Write> && @indexOf('<X-FC-OBJURL>', '/FormEdit')==-1"-->
                <td><input type="submit" value="<X-FC-FIELD LANG.7530.3 STRING>"></td><!--#endif-->
                <td>&nbsp;</td>
        </tr>
        </table></td>
</tr>
<tr>
        <td>&nbsp;</td>
        <td><table cellpadding="2" cellspacing="0" border="0">
        <tr>
                <td colspan="4"><img src="/images/pixel.gif" width="1" height="3" border="0"></td>
        </tr>
        <tr>
                <td id="plain" nowrap><X-FC-FIELD LANG.115.1226.9 STRING></td>
                <td id="plain" nowrap><X-FC-FIELD 1223 DEFAULT=0 LIST FORM></td>
                <td align="right"><!--#if expr="<X-FC-FIELD 1227 DEFAULT=0 NUMBER>"--><img src="/Icons/15001" width="10" height="10" border="1"><!--#else--><img src="/Images/pixel.gif" width="10" height="10" border="1"><!--#endif--></td>
                <td id="plain" nowrap><X-FC-FIELD LANG.115.1227.9 STRING></td>
        </tr>
        <tr>
                <td id="plain" nowrap><X-FC-FIELD LANG.115.1006.9 STRING></td>
                <td id="plain" colspan="3" nowrap><X-FC-FIELD 1204 STRING></td>
        </tr>
        <tr>
                <td id="plain" nowrap><X-FC-FIELD LANG.115.1020.9 STRING></td>
                <td id="plain" colspan="3" nowrap><X-FC-FIELD 1252 STRING></td>
        </tr>
        <tr>
                <td id="plain" nowrap><X-FC-FIELD LANG.115.4000.9 STRING></td>
                <td id="plain" colspan="3" nowrap><X-FC-FIELD 1255 STRING></td>
        </tr>
        <tr>
                <td id="plain" nowrap><X-FC-FIELD LANG.115.1000.9 STRING></td>
                <td id="plain" colspan="3"><X-FC-FIELD 1236 STRING></td>
        </tr>
        </table></td>
</tr>
<tr>
        <td colspan="2"><img src="/Images/pixel.gif" width="1" height="3" border="0"></td>
</tr>
</table><!--#if expr="$NavPosition==2"-->
        </td>
</tr>
</table><!--#elif expr="$NavPosition==1"-->
<!--#include virtual="/.templates/toolbars/NavPermissions.inc"--><!--#elif expr="$NavPosition==4"-->
<!--#include virtual="/.templates/toolbars/NavPermissionsText.inc"--><!--#endif-->
</form><!--#if expr="$SRVR_ERR_FCPCODE"-->
<script language="JavaScript">
alert("<!--#echo var="SRVR_ERR_FCPREASON"--> [<!--#echo var="SRVR_ERR_FCPCODE"-->]");
</script><!--#endif-->
</body>
</html>