Apple Reference & Presentation Library 8 (Internal Edition)

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MacBinary | 1990-06-24 | 16.5 KB | [STCK/KCFM]
open in:
MacOS 8.1 extracted |
Win98 extracted |
DOS extracted
view JSON data |
view as text

This file was processed as: MacBinary (archive/macBinary).

You can browse this item here: 401(k) Termination
Confidence	Program	Detection	Match Type	Support
`10%`	dexvert	MacBinary `(archive/macBinary)`	fallback	Supported
`100%`	file	MacBinary II, inited, Sat Jun 23 19:03:05 1990, modified Sat Jun 23 19:03:05 1990, creator 'KCFM', type 'STCK', 15748 bytes "401(k) Termination" , at 0x3e04 769 bytes resource	default (weak)
`99%`	file	data	default
`100%`	TrID	MacBinary 2	default (weak)
`100%`	siegfried	fmt/1762 MacBinary (II)	default
`100%`	lsar	MacBinary	default
id metadata
key	value
macFileType	`[STCK]`
macFileCreator	`[KCFM]`
hex view
+--------+-------------------------+-------------------------+--------+--------+
|00000000| 00 12 34 30 31 28 6b 29 | 20 54 65 72 6d 69 6e 61 |..401(k)| Termina|
|00000010| 74 69 6f 6e 00 00 00 00 | 00 00 00 00 00 00 00 00 |tion....|........|
|00000020| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000030| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000040| 00 53 54 43 4b 4b 43 46 | 4d 01 00 00 00 00 00 00 |.STCKKCF|M.......|
|00000050| 00 00 00 00 00 3d 84 00 | 00 03 01 a2 a9 a5 a9 a2 |.....=..|........|
|00000060| a9 a5 a9 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000070| 00 00 00 00 00 00 00 00 | 00 00 81 81 1f 6f 00 00 |........|.....o..|
|00000080| 00 0c 00 02 00 00 00 30 | 00 00 2c d0 00 00 01 de |.......0|..,.....|
|00000090| 00 00 2a 6a 00 00 2a 6c | 00 00 3c 7e 00 00 00 00 |..*j..*l|..<~....|
|000000a0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000000b0| 09 90 0c 60 00 01 00 01 | 00 00 00 00 00 01 00 00 |...`....|........|
|000000c0| 00 00 00 00 00 03 00 01 | 00 00 00 03 00 00 00 48 |........|.......H|
|000000d0| 00 48 00 00 00 00 03 08 | 02 40 ff f8 ff ee 03 10 |.H......|.@......|
|000000e0| 02 52 03 47 05 28 03 fc | 00 02 00 00 00 48 00 48 |.R.G.(..|.....H.H|
|000000f0| 00 00 00 00 03 08 02 40 | 00 01 00 00 00 64 00 00 |.......@|.....d..|
|00000100| 00 01 00 01 01 01 00 00 | 00 01 27 0f 00 01 00 01 |........|..'.....|
|00000110| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 00 19 |........|........|
|00000120| 01 90 00 00 00 00 00 70 | 00 00 00 00 00 00 00 00 |.......p|........|
|00000130| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000140| 00 00 00 00 01 1d 00 01 | 00 06 00 06 40 38 00 00 |........|....@8..|
|00000150| 00 00 00 00 40 38 00 00 | 00 00 00 00 00 1c 00 03 |....@8..|........|
|00000160| 00 01 00 01 00 00 00 03 | 01 26 01 26 00 3c 00 38 |........|.&.&.<.8|
|00000170| 00 01 00 14 00 01 00 0a | 00 01 5f da 00 00 00 15 |........|.._.....|
|00000180| 00 01 00 0c 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000190| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|000001a0| ff ff ff ff ff ff 00 01 | 00 01 00 4d e5 4e 00 4d |........|...M.N.M|
|000001b0| e5 54 00 4a 75 e8 00 4a | 75 e8 00 00 00 00 00 00 |.T.Ju..J|u.......|
|000001c0| 00 01 00 01 00 01 00 01 | 00 01 00 01 00 00 00 00 |........|........|
|000001d0| 00 00 00 01 00 00 00 00 | 00 00 00 00 00 00 00 90 |........|........|
|000001e0| 00 07 00 00 00 01 09 90 | 0c 60 00 20 00 48 0c 3d |........|.`. .H.=|
|000001f0| 09 45 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |.E......|........|
|00000200| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000210| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000220| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000230| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000240| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000250| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|00000260| 00 00 00 34 00 24 00 4c | 0b d0 09 44 00 01 00 01 |...4.$.L|...D....|
|00000270| 00 03 00 01 ff ff ff ff | ff ff ff ff 00 00 00 00 |........|........|
|00000280| 00 00 00 00 00 00 00 01 | 00 28 00 28 00 28 00 28 |........|.(.(.(.(|
|00000290| 00 00 00 00 00 00 00 00 | 00 07 00 00 00 78 00 38 |........|.....x.8|
|000002a0| 00 4c 00 a4 09 44 00 01 | 00 00 ff ff ff ff ff ff |.L...D..|........|
|000002b0| ff ff 00 01 00 00 00 00 | 00 00 00 02 00 38 00 4c |........|.....8.L|
|000002c0| 00 a4 09 44 00 00 00 00 | 00 14 00 0e 00 01 00 00 |...D....|........|
|000002d0| 00 03 00 03 00 01 00 23 | 41 50 50 4c 45 20 20 53 |.......#|APPLE  S|
|000002e0| 41 56 49 4e 47 53 20 20 | 41 4e 44 20 49 4e 56 45 |AVINGS  |AND INVE|
|000002f0| 53 54 4d 45 4e 54 20 50 | 4c 41 4e 00 00 00 00 16 |STMENT P|LAN.....|
|00000300| 00 01 00 00 00 00 00 0f | 00 0c 00 14 01 00 00 0e |........|........|
|00000310| 00 00 00 00 00 00 00 0d | 00 00 00 cc 00 5c 00 94 |........|.....\..|
|00000320| 00 d0 00 fc 00 00 00 00 | 00 00 00 00 00 00 00 02 |........|........|
|00000330| 00 07 00 00 00 56 00 5c | 00 94 00 d0 00 fa 00 01 |.....V.\|........|
|00000340| 00 00 ff ff ff ff ff ff | ff ff 00 01 00 00 00 00 |........|........|
|00000350| 00 00 00 02 00 5c 00 94 | 00 d0 00 fa 00 00 00 00 |.....\..|........|
|00000360| 00 14 00 18 00 00 00 00 | 00 03 00 03 00 01 00 01 |........|........|
|00000370| f0 00 00 00 00 16 00 01 | 00 00 00 00 00 18 00 12 |........|........|
|00000380| 00 14 00 00 00 18 00 00 | 00 00 00 00 00 07 00 00 |........|........|
|00000390| 00 56 00 a1 00 df 00 ba | 00 fc 00 01 00 00 ff ff |.V......|........|
|000003a0| ff ff ff ff ff ff 00 01 | 00 00 00 00 00 00 00 02 |........|........|
|000003b0| 00 a1 00 df 00 ba 00 fc | 00 00 00 00 00 14 00 04 |........|........|
|000003c0| 00 00 00 00 00 03 00 03 | 00 01 00 01 a8 00 00 00 |........|........|
|000003d0| 00 16 00 01 00 00 00 00 | 00 05 00 04 00 14 00 00 |........|........|
|000003e0| 00 04 00 00 00 00 00 00 | 00 01 00 00 00 ac 00 b1 |........|........|
|000003f0| 07 dc 01 41 09 20 00 01 | 00 00 00 00 00 15 00 00 |...A. ..|........|
|00000400| 00 0c 00 00 00 03 00 03 | 00 00 00 01 00 03 00 01 |........|........|
|00000410| 00 00 00 03 00 01 ff ff | ff ff ff ff ff ff 00 00 |........|........|
|00000420| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|00000430| ff ff ff ff 00 90 00 90 | 00 3c 00 34 00 00 00 f4 |........|.<.4....|
|00000440| 00 02 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000450| 00 00 00 00 00 02 00 b2 | 07 dd 00 ed 09 20 01 01 |........|..... ..|
|00000460| 01 01 00 14 00 0a 00 80 | 00 00 00 03 00 03 00 01 |........|........|
|00000470| 00 0d 45 4d 50 4c 4f 59 | 45 45 20 20 4e 4f 2e 00 |..EMPLOY|EE  NO..|
|00000480| 00 00 00 16 00 01 00 00 | 00 00 00 0c 00 09 00 14 |........|........|
|00000490| 00 00 00 0a 00 00 00 00 | 00 00 00 01 00 00 00 a2 |........|........|
|000004a0| 00 b1 06 98 01 41 07 dc | 00 01 00 00 00 00 00 15 |.....A..|........|
|000004b0| 00 00 00 0c 00 00 00 03 | 00 03 00 00 00 01 00 03 |........|........|
|000004c0| 00 01 00 00 00 03 00 01 | ff ff ff ff ff ff ff ff |........|........|
|000004d0| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|000004e0| ff ff ff ff ff ff 00 88 | 00 88 00 3c 00 38 00 00 |........|...<.8..|
|000004f0| 00 f5 00 01 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000500| 00 00 00 00 00 00 00 02 | 00 b2 06 99 00 ed 07 dc |........|........|
|00000510| 01 01 01 01 00 14 00 0a | 00 80 00 00 00 03 00 03 |........|........|
|00000520| 00 01 00 04 44 41 54 45 | 00 00 00 16 00 01 00 00 |....DATE|........|
|00000530| 00 00 00 0c 00 09 00 14 | 00 00 00 0a 00 00 00 00 |........|........|
|00000540| 00 00 00 01 00 00 00 a8 | 01 41 04 df 01 d1 05 de |........|.A......|
|00000550| 00 01 00 00 00 00 00 15 | 00 00 00 0c 00 00 00 03 |........|........|
|00000560| 00 03 00 00 00 01 00 03 | 00 01 00 00 00 03 00 01 |........|........|
|00000570| ff ff ff ff ff ff ff ff | 00 00 00 00 00 00 00 00 |........|........|
|00000580| 00 00 00 03 00 00 ff ff | ff ff ff ff ff ff 00 90 |........|........|
|00000590| 00 90 00 3c 00 34 00 00 | 00 f6 00 06 00 01 00 00 |...<.4..|........|
|000005a0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 02 |........|........|
|000005b0| 01 42 04 e0 01 7d 05 de | 01 01 01 01 00 14 00 0a |.B...}..|........|
|000005c0| 00 80 00 00 00 03 00 03 | 00 01 00 0a 4d 41 49 4c |........|....MAIL|
|000005d0| 20 20 53 54 4f 50 00 00 | 00 16 00 01 00 00 00 00 |  STOP..|........|
|000005e0| 00 0c 00 09 00 14 00 00 | 00 0a 00 00 00 00 00 00 |........|........|
|000005f0| 00 01 00 00 00 a8 01 41 | 07 dc 01 d1 09 20 00 01 |.......A|..... ..|
|00000600| 00 00 00 00 00 15 00 20 | 00 0c 00 00 00 03 00 03 |....... |........|
|00000610| 00 00 00 01 00 03 00 01 | 00 00 00 03 00 01 ff ff |........|........|
|00000620| ff ff ff ff ff ff 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000630| 00 03 00 00 ff ff ff ff | ff ff ff ff 00 94 00 94 |........|........|
|00000640| 00 3c 00 38 00 00 00 f7 | 00 08 00 01 00 00 00 00 |.<.8....|........|
|00000650| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 01 42 |........|.......B|
|00000660| 07 dd 01 7d 09 20 01 01 | 01 01 00 14 00 0a 00 80 |...}. ..|........|
|00000670| 00 00 00 03 00 03 00 01 | 00 09 41 50 50 4c 45 4c |........|..APPLEL|
|00000680| 49 4e 4b 20 00 00 00 16 | 00 01 00 00 00 00 00 0c |INK ....|........|
|00000690| 00 09 00 14 00 00 00 0a | 00 00 00 00 00 00 00 01 |........|........|
|000006a0| 00 00 00 ac 01 41 05 de | 01 d1 07 dc 00 01 00 00 |.....A..|........|
|000006b0| 00 00 00 15 00 00 00 0c | 00 00 00 03 00 03 00 01 |........|........|
|000006c0| 00 01 00 03 00 01 00 00 | 00 03 00 01 ff ff ff ff |........|........|
|000006d0| ff ff ff ff 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|000006e0| 00 00 ff ff ff ff ff ff | ff ff 00 90 00 90 00 3c |........|.......<|
|000006f0| 00 34 00 00 00 f8 00 07 | 00 01 00 00 00 00 00 00 |.4......|........|
|00000700| 00 00 00 00 00 00 00 00 | 00 00 00 02 01 42 05 df |........|.....B..|
|00000710| 01 7d 07 dc 01 01 01 01 | 00 14 00 0a 00 80 00 00 |.}......|........|
|00000720| 00 03 00 03 00 01 00 0e | 54 45 4c 45 50 48 4f 4e |........|TELEPHON|
|00000730| 45 20 20 4e 4f 2e 00 00 | 00 16 00 01 00 00 00 00 |E  NO...|........|
|00000740| 00 0c 00 09 00 14 00 00 | 00 0a 00 00 00 00 00 00 |........|........|
|00000750| 00 01 00 00 00 a6 01 41 | 03 49 01 d1 04 14 00 01 |.......A|.I......|
|00000760| 00 00 00 00 00 15 00 00 | 00 0c 00 00 00 03 00 03 |........|........|
|00000770| 00 00 00 01 00 03 00 01 | 00 00 00 03 00 01 ff ff |........|........|
|00000780| ff ff ff ff ff ff 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000790| 00 03 00 00 ff ff ff ff | ff ff ff ff 00 70 00 70 |........|.....p.p|
|000007a0| 00 3c 00 34 00 00 00 f9 | 00 04 00 01 00 00 00 00 |.<.4....|........|
|000007b0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 01 42 |........|.......B|
|000007c0| 03 4a 01 7d 04 14 01 01 | 01 01 00 14 00 0a 00 80 |.J.}....|........|
|000007d0| 00 00 00 03 00 03 00 01 | 00 08 44 49 56 2e 20 4e |........|..DIV. N|
|000007e0| 4f 2e 00 00 00 16 00 01 | 00 00 00 00 00 0c 00 09 |O.......|........|
|000007f0| 00 14 00 00 00 0a 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|00000800| 00 a8 01 41 04 14 01 d1 | 04 df 00 01 00 00 00 00 |...A....|........|
|00000810| 00 15 00 00 00 0c 00 00 | 00 03 00 03 00 00 00 01 |........|........|
|00000820| 00 03 00 01 00 00 00 03 | 00 01 ff ff ff ff ff ff |........|........|
|00000830| ff ff 00 00 00 00 00 00 | 00 00 00 00 00 03 00 00 |........|........|
|00000840| ff ff ff ff ff ff ff ff | 00 90 00 90 00 3c 00 34 |........|.....<.4|
|00000850| 00 00 00 fa 00 05 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00000860| 00 00 00 00 00 00 00 00 | 00 02 01 42 04 15 01 7d |........|...B...}|
|00000870| 04 df 01 01 01 01 00 14 | 00 0a 00 80 00 00 00 03 |........|........|
|00000880| 00 03 00 01 00 09 44 45 | 50 54 2e 20 4e 4f 2e 00 |......DE|PT. NO..|
|00000890| 00 00 00 16 00 01 00 00 | 00 00 00 0c 00 09 00 14 |........|........|
|000008a0| 00 00 00 0a 00 00 00 00 | 00 00 00 01 00 00 00 ac |........|........|
|000008b0| 01 41 00 70 01 d1 03 49 | 00 01 00 00 00 00 00 15 |.A.p...I|........|
|000008c0| 00 00 00 0c 00 00 00 03 | 00 03 00 2a 00 01 00 03 |........|...*....|
|000008d0| 00 01 00 00 00 03 00 01 | ff ff ff ff ff ff ff ff |........|........|
|000008e0| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|000008f0| ff ff ff ff ff ff 01 98 | 01 98 00 3c 00 38 00 00 |........|...<.8..|
|00000900| 00 fb 00 03 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000910| 00 00 00 00 00 00 00 02 | 01 42 00 71 01 7d 03 49 |........|.B.q.}.I|
|00000920| 01 01 01 01 00 14 00 0a | 00 80 00 00 00 03 00 03 |........|........|
|00000930| 00 01 00 0e 45 4d 50 4c | 4f 59 45 45 20 20 4e 41 |....EMPL|OYEE  NA|
|00000940| 4d 45 00 00 00 16 00 01 | 00 00 00 00 00 0c 00 09 |ME......|........|
|00000950| 00 14 00 00 00 0a 00 00 | 00 00 00 00 00 02 00 00 |........|........|
|00000960| 00 22 00 b1 07 dc 00 ee | 07 dc 00 01 00 00 00 03 |."......|........|
|00000970| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000980| 00 00 00 00 00 02 00 00 | 00 22 01 40 07 dc 01 7e |........|.".@...~|
|00000990| 07 dc 00 01 00 00 00 03 | 00 00 00 00 00 00 00 00 |........|........|
|000009a0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 00 00 |........|........|
|000009b0| 00 22 01 3e 05 de 01 7c | 05 de 00 01 00 00 00 03 |.".>...||........|
|000009c0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000009d0| 00 00 00 00 00 02 00 00 | 00 22 01 40 04 de 01 7e |........|.".@...~|
|000009e0| 04 de 00 01 00 00 00 03 | 00 00 00 00 00 00 00 00 |........|........|
|000009f0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 00 00 |........|........|
|00000a00| 00 22 01 3e 04 14 01 7c | 04 14 00 01 00 00 00 03 |.".>...||........|
|00000a10| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000a20| 00 00 00 00 00 02 00 00 | 00 22 01 3e 03 48 01 7c |........|.".>.H.||
|00000a30| 03 48 00 01 00 00 00 03 | 00 00 00 00 00 00 00 00 |.H......|........|
|00000a40| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 07 00 00 |........|........|
|00000a50| 00 68 0b f4 00 4c 0c 3c | 02 38 00 01 00 01 ff ff |.h...L.<|.8......|
|00000a60| ff ff ff ff ff ff 00 01 | 00 00 00 00 00 00 00 02 |........|........|
|00000a70| 0b f4 00 4c 0c 3c 02 38 | 00 00 00 00 00 14 00 0e |...L.<.8|........|
|00000a80| 00 20 00 00 00 01 00 03 | 00 01 00 14 41 70 70 6c |. ......|....Appl|
|00000a90| 65 20 43 6f 6d 70 75 74 | 65 72 2c 20 49 6e 63 2e |e Comput|er, Inc.|
|00000aa0| 00 00 00 16 00 01 00 00 | 00 00 00 0f 00 0c 00 14 |........|........|
|00000ab0| 20 00 00 0e 00 00 00 00 | 00 00 00 07 00 00 00 62 | .......|.......b|
|00000ac0| 0b f4 08 1c 0c 3c 09 44 | 00 01 00 00 ff ff ff ff |.....<.D|........|
|00000ad0| ff ff ff ff 00 01 00 00 | 00 00 00 00 00 02 0b f4 |........|........|
|00000ae0| 08 1c 0c 3c 09 44 00 00 | 00 00 00 14 00 0a 00 00 |...<.D..|........|
|00000af0| 00 00 00 02 00 03 00 01 | 00 0d 53 41 56 36 30 30 |........|..SAV600|
|00000b00| 20 28 39 2f 39 30 29 a7 | 00 00 00 16 00 01 00 00 | (9/90).|........|
|00000b10| 00 00 00 0c 00 09 00 14 | 00 00 00 0a 00 00 00 00 |........|........|
|00000b20| 00 00 00 01 00 00 00 b2 | 01 d1 00 70 02 61 02 14 |........|...p.a..|
|00000b30| 00 01 00 00 00 00 00 15 | 00 00 00 0c 00 00 00 03 |........|........|
|00000b40| 00 03 00 01 00 01 00 03 | 00 01 00 00 00 03 00 01 |........|........|
|00000b50| ff ff ff ff ff ff ff ff | 00 00 00 00 00 00 00 00 |........|........|
|00000b60| 00 00 00 03 00 00 ff ff | ff ff ff ff ff ff 00 88 |........|........|
|00000b70| 00 88 00 3c 00 38 00 00 | 01 00 00 09 00 01 00 00 |...<.8..|........|
|00000b80| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 02 |........|........|
|00000b90| 01 d2 00 71 02 0d 02 14 | 01 01 01 01 00 14 00 0a |...q....|........|
|00000ba0| 00 a0 00 00 00 03 00 03 | 00 01 00 13 48 4f 4d 45 |........|....HOME|
|00000bb0| 20 54 45 4c 45 50 48 4f | 4e 45 20 20 4e 4f 2e f0 | TELEPHO|NE  NO..|
|00000bc0| 00 00 00 16 00 01 00 00 | 00 00 00 0c 00 09 00 14 |........|........|
|00000bd0| 20 00 00 0a 00 00 00 00 | 00 00 00 01 00 00 00 aa | .......|........|
|00000be0| 01 d1 05 cb 02 61 09 20 | 00 01 00 00 00 00 00 15 |.....a. |........|
|00000bf0| 00 00 00 0c 00 00 00 03 | 00 03 00 00 00 01 00 03 |........|........|
|00000c00| 00 01 00 00 00 03 00 01 | ff ff ff ff ff ff ff ff |........|........|
|00000c10| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|00000c20| ff ff ff ff ff ff 01 98 | 01 98 00 3c 00 38 00 00 |........|...<.8..|
|00000c30| 01 01 00 0c 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000c40| 00 00 00 00 00 00 00 02 | 01 d2 05 cc 02 0d 09 20 |........|....... |
|00000c50| 01 01 01 01 00 14 00 0a | 00 80 00 00 00 03 00 03 |........|........|
|00000c60| 00 01 00 0c 48 2e 52 2e | 20 4c 49 41 49 53 4f 4e |....H.R.| LIAISON|
|00000c70| 00 00 00 16 00 01 00 00 | 00 00 00 0c 00 09 00 14 |........|........|
|00000c80| 00 00 00 0a 00 00 00 00 | 00 00 00 01 00 00 00 b8 |........|........|
|00000c90| 01 d1 02 14 02 61 04 14 | 00 01 00 00 00 00 00 15 |.....a..|........|
|00000ca0| 00 00 00 0c 00 00 00 03 | 00 03 00 00 00 01 00 03 |........|........|
|00000cb0| 00 01 00 00 00 03 00 01 | ff ff ff ff ff ff ff ff |........|........|
|00000cc0| 00 00 00 00 00 00 00 00 | 00 00 00 03 00 00 ff ff |........|........|
|00000cd0| ff ff ff ff ff ff 01 98 | 01 98 00 3c 00 38 00 00 |........|...<.8..|
|00000ce0| 01 02 00 0a 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000cf0| 00 00 00 00 00 00 00 02 | 01 d2 02 15 02 0d 04 14 |........|........|
|00000d00| 01 01 01 01 00 14 00 0a | 00 80 00 00 00 03 00 03 |........|........|
|00000d10| 00 01 00 1a 20 20 20 53 | 4f 43 49 41 4c 20 20 20 |....   S|OCIAL   |
|00000d20| 53 45 43 55 52 49 54 59 | 20 20 20 4e 4f 2e 00 00 |SECURITY|   NO...|
|00000d30| 00 16 00 01 00 00 00 00 | 00 0c 00 09 00 14 00 00 |........|........|
|00000d40| 00 0a 00 00 00 00 00 00 | 00 07 00 00 00 56 05 1e |........|.....V..|
|00000d50| 04 27 05 5d 08 b1 00 01 | 00 00 ff ff ff ff ff ff |.'.]....|........|
|00000d60| ff ff 00 01 00 00 00 00 | 00 00 00 02 05 1e 04 27 |........|.......'|
|00000d70| 05 5d 08 b1 00 00 00 00 | 00 14 00 0c 00 00 00 00 |.]......|........|
|00000d80| 00 01 00 02 00 01 00 01 | 2e e4 00 00 00 16 00 01 |........|........|
|00000d90| 00 00 00 00 00 0c 00 09 | 00 14 00 00 00 0c 00 00 |........|........|
|00000da0| 00 00 00 00 00 07 00 00 | 00 58 06 a6 01 07 06 dd |........|.X......|
|00000db0| 01 2f 00 01 00 00 ff ff | ff ff ff ff ff ff 00 01 |./......|........|
|00000dc0| 00 00 00 00 00 00 00 02 | 06 a6 01 07 06 dd 01 2f |........|......./|
|00000dd0| 00 00 00 00 00 15 00 0c | 00 00 00 00 00 01 00 01 |........|........|
|00000de0| 00 01 00 03 09 09 09 00 | 00 00 00 16 00 01 00 00 |........|........|
|00000df0| 00 00 00 0e 00 0a 00 15 | 00 00 00 0c 00 00 00 00 |........|........|
|00000e00| 00 00 00 07 00 00 00 80 | 02 6c 00 9b 02 b4 09 05 |........|.l......|
|00000e10| 00 01 00 00 ff ff ff ff | ff ff ff ff 00 01 00 00 |........|........|
|00000e20| 00 00 00 00 00 02 02 6c | 00 9b 02 b4 09 05 00 00 |.......l|........|
|00000e30| 00 00 00 14 00 0c 00 01 | 00 00 00 01 00 03 00 01 |........|........|
|00000e40| 00 2b 49 2e 20 20 54 45 | 52 4d 49 4e 41 54 49 4f |.+I.  TE|RMINATIO|
|00000e50| 4e 20 44 41 54 45 3a 20 | 44 49 53 54 52 49 42 55 |N DATE: |DISTRIBU|
|00000e60| 54 49 4f 4e 20 45 4c 45 | 43 54 49 4f 4e 1c 00 00 |TION ELE|CTION...|
|00000e70| 00 16 00 01 00 00 00 00 | 00 0c 00 09 00 14 01 00 |........|........|
|00000e80| 00 0c 00 00 00 00 00 00 | 00 01 00 00 01 2a 02 fc |........|.....*..|
|00000e90| 00 d8 03 52 08 21 00 01 | 00 00 00 00 00 14 00 01 |...R.!..|........|
|00000ea0| 00 0c 00 00 00 01 00 01 | 00 01 00 01 00 04 00 00 |........|........|
|00000eb0| 00 00 00 00 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000ec0| 00 00 00 00 00 00 00 00 | 00 03 00 00 ff ff ff ff |........|........|
|00000ed0| ff ff ff ff 00 1c 07 0c | 00 1c 00 1c 00 00 01 03 |........|........|
|00000ee0| 00 0d 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000ef0| 00 00 00 00 00 02 02 fc | 01 15 03 53 08 22 01 00 |........|...S."..|
|00000f00| 81 81 00 14 00 0c 00 00 | 00 00 00 01 00 03 00 02 |........|........|
|00000f10| 00 8b 20 20 49 20 65 6c | 65 63 74 20 74 6f 20 72 |..  I el|ect to r|
|00000f20| 65 63 65 69 76 65 20 61 | 20 73 69 6e 67 6c 65 20 |eceive a| single |
|00000f30| 63 61 73 68 20 70 61 79 | 6d 65 6e 74 20 77 69 74 |cash pay|ment wit|
|00000f40| 68 69 6e 20 31 32 20 77 | 65 65 6b 73 20 6f 66 20 |hin 12 w|eeks of |
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|00001ea0| 00 14 00 0c 00 01 00 00 | 00 01 00 01 00 01 00 32 |........|.......2|
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|00001ef0| 00 14 01 00 00 0c 00 00 | 00 00 00 00 00 01 00 00 |........|........|
|00001f00| 01 00 06 8c 00 db 06 d4 | 08 54 00 01 00 00 00 00 |........|.T......|
|00001f10| 00 15 00 00 00 0c 00 00 | 00 03 00 01 00 01 00 01 |........|........|
|00001f20| 00 04 00 00 00 00 00 00 | 00 01 00 00 00 00 00 00 |........|........|
|00001f30| 00 00 00 00 00 00 00 00 | 00 00 00 01 00 03 00 00 |........|........|
|00001f40| ff ff ff ff ff ff ff ff | 01 26 07 48 00 34 00 34 |........|.&.H.4.4|
|00001f50| 00 00 01 15 00 10 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00001f60| 00 00 00 00 00 00 00 00 | 00 02 06 8c 01 0c 06 d5 |........|........|
|00001f70| 08 55 01 00 81 81 00 14 | 00 0c ff 00 00 00 00 01 |.U......|........|
|00001f80| 00 01 00 01 00 3a 49 20 | 44 4f 20 77 61 6e 74 20 |.....:I |DO want |
|00001f90| 46 65 64 65 72 61 6c 20 | 20 49 6e 63 6f 6d 65 20 |Federal | Income |
|00001fa0| 54 61 78 20 77 69 74 68 | 68 65 6c 64 20 66 72 6f |Tax with|held fro|
|00001fb0| 6d 20 6d 79 20 77 69 74 | 68 64 72 61 77 61 6c 2e |m my wit|hdrawal.|
|00001fc0| 00 00 00 3e 00 03 00 00 | 00 00 00 0c 00 09 00 14 |...>....|........|
|00001fd0| 00 00 00 0c 00 00 00 00 | 00 00 00 00 00 02 00 0c |........|........|
|00001fe0| 00 09 00 14 01 00 00 0c | 00 00 00 00 00 00 00 00 |........|........|
|00001ff0| 00 05 00 0c 00 09 00 14 | 00 00 00 0c 00 00 00 00 |........|........|
|00002000| 00 00 00 01 00 00 01 2e | 06 d0 00 db 07 1c 08 54 |........|.......T|
|00002010| 00 01 00 00 00 00 00 15 | 00 00 00 0c 00 00 00 03 |........|........|
|00002020| 00 01 00 01 00 01 00 04 | 00 00 00 00 00 00 00 01 |........|........|
|00002030| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002040| 00 01 00 03 00 00 ff ff | ff ff ff ff ff ff 01 26 |........|.......&|
|00002050| 07 48 00 38 00 38 00 00 | 01 16 00 11 00 01 00 00 |.H.8.8..|........|
|00002060| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 02 |........|........|
|00002070| 06 d0 01 0c 07 1d 08 55 | 01 00 81 81 00 14 00 0c |.......U|........|
|00002080| ff 00 00 00 00 01 00 01 | 00 01 00 3f 49 20 44 4f |........|...?I DO|
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|000020b0| 69 74 68 68 65 6c 64 20 | 66 72 6f 6d 20 6d 79 20 |ithheld |from my |
|000020c0| 77 69 74 68 64 72 61 77 | 61 6c 2e 00 00 00 00 66 |withdraw|al.....f|
|000020d0| 00 05 00 00 00 00 00 0c | 00 09 00 14 00 00 00 0c |........|........|
|000020e0| 00 00 00 00 00 00 00 00 | 00 02 00 0c 00 09 00 14 |........|........|
|000020f0| 01 00 00 0c 00 00 00 00 | 00 00 00 00 00 09 00 0c |........|........|
|00002100| 00 09 00 14 00 00 00 0c | 00 00 00 00 00 00 00 00 |........|........|
|00002110| 00 0d 00 0c 00 09 00 14 | 01 00 00 0c 00 00 00 00 |........|........|
|00002120| 00 00 00 00 00 0e 00 0c | 00 09 00 14 00 00 00 0c |........|........|
|00002130| 00 00 00 00 00 00 00 01 | 00 00 00 fe 07 84 00 db |........|........|
|00002140| 07 dc 08 54 00 01 00 00 | 00 00 00 15 00 00 00 0c |...T....|........|
|00002150| 00 00 00 03 00 01 00 01 | 00 01 00 04 00 00 00 00 |........|........|
|00002160| 00 00 00 01 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002170| 00 00 00 00 00 01 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00002180| ff ff 01 26 07 48 00 3c | 00 38 00 00 01 17 00 12 |...&.H.<|.8......|
|00002190| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000021a0| 00 00 00 02 07 84 01 0c | 07 dd 08 55 01 00 81 81 |........|...U....|
|000021b0| 00 14 00 0c ff 00 00 00 | 00 01 00 01 00 01 00 37 |........|.......7|
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|000021f0| 64 72 61 77 61 6c 2e 14 | 00 00 00 3e 00 03 00 00 |drawal..|...>....|
|00002200| 00 00 00 0c 00 09 00 14 | 00 00 00 0c 00 00 00 00 |........|........|
|00002210| 00 00 00 00 00 02 00 0c | 00 09 00 14 01 00 00 0c |........|........|
|00002220| 00 00 00 00 00 00 00 00 | 00 05 00 0c 00 09 00 14 |........|........|
|00002230| 00 00 00 0c 00 00 00 00 | 00 00 00 01 00 00 01 2a |........|.......*|
|00002240| 07 c8 00 db 08 14 08 54 | 00 01 00 00 00 00 00 15 |.......T|........|
|00002250| 00 00 00 0c 00 00 00 03 | 00 01 00 01 00 01 00 04 |........|........|
|00002260| 00 00 00 00 00 00 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00002270| 00 00 00 00 00 00 00 00 | 00 01 00 03 00 00 ff ff |........|........|
|00002280| ff ff ff ff ff ff 01 26 | 07 48 00 38 00 38 00 00 |.......&|.H.8.8..|
|00002290| 01 18 00 13 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000022a0| 00 00 00 00 00 00 00 02 | 07 c8 01 0c 08 15 08 55 |........|.......U|
|000022b0| 01 00 81 81 00 14 00 0c | ff 00 00 00 00 01 00 01 |........|........|
|000022c0| 00 01 00 3b 49 20 44 4f | 20 4e 4f 54 20 77 61 6e |...;I DO| NOT wan|
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|00002300| 00 00 00 66 00 05 00 00 | 00 00 00 0c 00 09 00 14 |...f....|........|
|00002310| 00 00 00 0c 00 00 00 00 | 00 00 00 00 00 02 00 0c |........|........|
|00002320| 00 09 00 14 01 00 00 0c | 00 00 00 00 00 00 00 00 |........|........|
|00002330| 00 09 00 0c 00 09 00 14 | 00 00 00 0c 00 00 00 00 |........|........|
|00002340| 00 00 00 00 00 0d 00 0c | 00 09 00 14 01 00 00 0c |........|........|
|00002350| 00 00 00 00 00 00 00 00 | 00 0e 00 0c 00 09 00 14 |........|........|
|00002360| 00 00 00 0c 00 00 00 00 | 00 00 00 07 00 00 01 96 |........|........|
|00002370| 05 84 00 db 06 20 08 e0 | 00 01 00 00 ff ff ff ff |..... ..|........|
|00002380| ff ff ff ff 00 01 00 00 | 00 00 00 00 00 02 05 84 |........|........|
|00002390| 00 db 06 20 08 e0 00 00 | 00 00 00 14 00 0c 00 00 |... ....|........|
|000023a0| 00 00 00 01 00 01 00 03 | 01 42 49 20 75 6e 64 65 |........|.BI unde|
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|00002410| 77 69 74 68 68 65 6c 64 | 20 74 68 61 74 20 49 20 |withheld| that I |
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|00002440| 75 6e 64 65 72 20 74 68 | 65 20 65 73 74 69 6d 61 |under th|e estima|
|00002450| 74 65 64 20 74 61 78 20 | 70 61 79 6d 65 6e 74 20 |ted tax |payment |
|00002460| 72 75 6c 65 73 2e 20 20 | 49 66 20 74 68 69 73 20 |rules.  |If this |
|00002470| 73 65 63 74 69 6f 6e 20 | 20 20 20 20 20 20 20 20 |section |        |
|00002480| 69 73 20 6c 65 66 74 20 | 62 6c 61 6e 6b 2c 20 74 |is left |blank, t|
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|000024a0| 68 68 65 6c 64 2e 20 20 | 53 74 61 74 65 20 69 6e |hheld.  |State in|
|000024b0| 63 6f 6d 65 20 74 61 78 | 20 77 69 6c 6c 20 6f 6e |come tax| will on|
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|000024d0| 66 20 61 70 70 6c 69 63 | 61 62 6c 65 20 66 6f 72 |f applic|able for|
|000024e0| 20 79 6f 75 72 20 73 74 | 61 74 65 2e 00 00 00 16 | your st|ate.....|
|000024f0| 00 01 00 00 00 00 00 0c | 00 09 00 14 00 00 00 0c |........|........|
|00002500| 00 00 00 00 00 00 00 07 | 00 00 00 70 07 30 00 db |........|...p.0..|
|00002510| 07 6b 03 a4 00 01 00 00 | ff ff ff ff ff ff ff ff |.k......|........|
|00002520| 00 01 00 00 00 00 00 00 | 00 02 07 30 00 db 07 6b |........|...0...k|
|00002530| 03 a4 00 00 00 00 00 15 | 00 0c 00 04 00 00 00 01 |........|........|
|00002540| 00 01 00 01 00 1c 53 74 | 61 74 65 20 49 6e 63 6f |......St|ate Inco|
|00002550| 6d 65 20 54 61 78 20 57 | 69 74 68 68 6f 6c 64 69 |me Tax W|ithholdi|
|00002560| 6e 67 00 00 00 16 00 01 | 00 00 00 00 00 0e 00 0a |ng......|........|
|00002570| 00 15 04 00 00 0c 00 00 | 00 00 00 00 00 07 00 00 |........|........|
|00002580| 00 72 06 30 00 db 06 6b | 03 a4 00 01 00 00 ff ff |.r.0...k|........|
|00002590| ff ff ff ff ff ff 00 01 | 00 00 00 00 00 00 00 02 |........|........|
|000025a0| 06 30 00 db 06 6b 03 a4 | 00 00 00 00 00 15 00 0c |.0...k..|........|
|000025b0| 00 04 00 00 00 01 00 01 | 00 01 00 1e 46 65 64 65 |........|....Fede|
|000025c0| 72 61 6c 20 49 6e 63 6f | 6d 65 20 54 61 78 20 57 |ral Inco|me Tax W|
|000025d0| 69 74 68 68 6f 6c 64 69 | 6e 67 00 00 00 16 00 01 |ithholdi|ng......|
|000025e0| 00 00 00 00 00 0e 00 0a | 00 15 04 00 00 0c 00 00 |........|........|
|000025f0| 00 00 00 00 00 02 00 00 | 00 22 01 ce 04 14 02 0c |........|."......|
|00002600| 04 14 00 01 00 00 00 03 | 00 00 00 00 00 00 00 00 |........|........|
|00002610| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 02 00 00 |........|........|
|00002620| 00 22 01 ce 02 14 02 0c | 02 14 00 01 00 00 00 03 |."......|........|
|00002630| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002640| 00 00 00 00 00 08 00 00 | 01 7c 09 a8 05 fc 0a c8 |........|.|......|
|00002650| 08 c4 00 01 00 00 00 00 | 00 03 00 00 00 01 00 00 |........|........|
|00002660| 00 00 00 00 00 00 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00002670| ff ff 00 00 00 01 00 00 | 00 00 00 00 00 00 00 60 |........|.......`|
|00002680| 00 00 00 48 00 01 00 00 | 01 19 00 00 00 01 00 34 |...H....|.......4|
|00002690| ff ff ff ff ff ff ff ff | ff ff ff ff ff ff ff ff |........|........|
|000026a0| aa 55 aa 55 aa 55 aa 55 | 00 04 00 02 00 01 00 14 |.U.U.U.U|........|
|000026b0| 00 01 0a e1 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000026c0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 3c |........|.......<|
|000026d0| 00 02 00 00 00 00 00 00 | 00 32 01 01 01 01 00 14 |........|.2......|
|000026e0| 00 0c 00 00 00 00 00 01 | 00 01 00 03 00 04 4c 69 |........|......Li|
|000026f0| 73 74 00 00 00 16 00 01 | 00 00 00 00 00 0c 00 09 |st......|........|
|00002700| 00 14 00 00 00 0c 00 00 | 00 00 00 00 00 01 02 c8 |........|........|
|00002710| 00 4f 0d 68 00 00 00 00 | 00 00 00 00 00 00 00 00 |.O.h....|........|
|00002720| 00 a4 02 72 01 73 02 ba | 02 25 00 01 00 00 00 00 |...r.s..|.%......|
|00002730| 00 14 00 00 00 0c 00 00 | 00 01 00 01 00 00 00 01 |........|........|
|00002740| 00 06 00 01 00 00 00 03 | 00 01 00 00 00 00 00 00 |........|........|
|00002750| 00 00 00 00 00 00 00 00 | 00 00 00 02 00 03 00 00 |........|........|
|00002760| ff ff ff ff ff ff ff ff | 0a 09 06 0d 0a 68 08 d4 |........|.....h..|
|00002770| 00 00 01 1a 00 01 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002780| 00 00 00 00 00 00 00 00 | 00 02 09 a9 05 fd 0a 08 |........|........|
|00002790| 08 c4 01 01 01 01 00 14 | 00 0c 00 00 00 00 00 01 |........|........|
|000027a0| 00 01 00 01 00 06 43 6f | 6c 75 6d 6e 00 00 00 16 |......Co|lumn....|
|000027b0| 00 01 00 00 00 00 00 0c | 00 09 00 14 00 00 00 0c |........|........|
|000027c0| 00 00 00 00 00 00 00 01 | 00 00 00 ae 01 d1 04 14 |........|........|
|000027d0| 02 61 05 cb 00 01 00 00 | 00 00 00 15 00 00 00 0c |.a......|........|
|000027e0| 00 00 00 03 00 03 00 00 | 00 01 00 03 00 01 00 00 |........|........|
|000027f0| 00 03 00 01 ff ff ff ff | ff ff ff ff 00 00 00 00 |........|........|
|00002800| 00 00 00 00 00 00 00 03 | 00 00 ff ff ff ff ff ff |........|........|
|00002810| ff ff 00 b4 00 b4 00 3c | 00 38 00 00 01 1b 00 0b |.......<|.8......|
|00002820| 00 01 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002830| 00 00 00 02 01 d2 04 15 | 02 0d 05 cb 01 01 01 01 |........|........|
|00002840| 00 14 00 0a 00 80 00 00 | 00 03 00 03 00 01 00 10 |........|........|
|00002850| 54 45 52 4d 49 4e 41 54 | 49 4f 4e 20 44 41 54 45 |TERMINAT|ION DATE|
|00002860| 00 00 00 16 00 01 00 00 | 00 00 00 0c 00 09 00 14 |........|........|
|00002870| 00 00 00 0a 00 00 00 00 | 00 00 00 02 00 00 00 22 |........|......."|
|00002880| 01 ce 04 14 02 0c 04 14 | 00 01 00 00 00 03 00 00 |........|........|
|00002890| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000028a0| 00 00 00 02 00 00 00 22 | 01 ce 05 cb 02 0c 05 cb |......."|........|
|000028b0| 00 01 00 00 00 03 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|000028c0| 00 00 00 00 00 00 00 00 | 00 00 00 07 00 00 00 6e |........|.......n|
|000028d0| 0b e4 03 36 0c 2f 06 5a | 00 01 00 00 ff ff ff ff |...6./.Z|........|
|000028e0| ff ff ff ff 00 01 00 00 | 00 00 00 00 00 02 0b e4 |........|........|
|000028f0| 03 36 0c 2f 06 5a 00 00 | 00 00 00 15 00 0c 00 00 |.6./.Z..|........|
|00002900| 00 00 00 01 00 01 00 01 | 00 1a 42 65 6e 65 66 69 |........|..Benefi|
|00002910| 74 73 20 2d 20 4d 61 69 | 6c 20 53 74 6f 70 20 2d |ts - Mai|l Stop -|
|00002920| 20 33 39 47 00 00 00 16 | 00 01 00 00 00 00 00 13 | 39G....|........|
|00002930| 00 0e 00 14 01 00 00 12 | 00 00 00 00 00 00 00 01 |........|........|
|00002940| 00 00 01 a4 03 79 00 d8 | 04 1c 08 21 00 01 00 00 |.....y..|...!....|
|00002950| 00 00 00 14 00 01 00 0c | 00 00 00 01 00 01 00 01 |........|........|
|00002960| 00 01 00 04 00 00 00 00 | 00 00 00 01 00 00 00 00 |........|........|
|00002970| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 03 |........|........|
|00002980| 00 00 ff ff ff ff ff ff | ff ff 00 1c 07 0c 00 1c |........|........|
|00002990| 00 1c 00 00 01 1c 00 0e | 00 01 00 00 00 00 00 00 |........|........|
|000029a0| 00 00 00 00 00 00 00 00 | 00 00 00 02 03 79 01 15 |........|.....y..|
|000029b0| 04 1d 08 22 01 00 81 81 | 00 14 00 0c 00 00 00 00 |..."....|........|
|000029c0| 00 01 00 01 00 03 01 06 | 20 20 49 20 65 6c 65 63 |........|  I elec|
|000029d0| 74 20 74 6f 20 72 6f 6c | 6c 6f 76 65 72 20 6d 79 |t to rol|lover my|
|000029e0| 20 66 75 6e 64 73 20 64 | 69 72 65 63 74 6c 79 20 | funds d|irectly |
|000029f0| 74 6f 20 61 20 46 69 64 | 65 6c 69 74 79 20 49 52 |to a Fid|elity IR|
|00002a00| 41 2e 20 20 41 20 46 69 | 64 65 6c 69 74 79 20 49 |A.  A Fi|delity I|
|00002a10| 52 41 20 72 6f 6c 6c 6f | 76 65 72 20 61 70 70 6c |RA rollo|ver appl|
|00002a20| 69 63 61 74 69 6f 6e 20 | 20 20 20 20 20 20 20 20 |ication |        |
|00002a30| 20 20 20 09 09 6d 75 73 | 74 20 62 65 20 63 6f 6d |   ..mus|t be com|
|00002a40| 70 6c 65 74 65 64 2e 20 | 20 54 68 65 20 46 69 64 |pleted. | The Fid|
|00002a50| 65 6c 69 74 79 20 49 52 | 41 20 72 6f 6c 6c 6f 76 |elity IR|A rollov|
|00002a60| 65 72 20 61 70 70 6c 69 | 63 61 74 69 6f 6e 20 77 |er appli|cation w|
|00002a70| 69 6c 6c 20 62 65 20 73 | 65 6e 74 20 74 6f 20 79 |ill be s|ent to y|
|00002a80| 6f 75 20 77 69 74 68 69 | 6e 20 74 77 6f 20 09 09 |ou withi|n two ..|
|00002a90| 09 09 09 09 09 09 77 65 | 65 6b 73 20 6f 66 20 74 |......we|eks of t|
|00002aa0| 68 65 20 72 65 63 65 69 | 70 74 20 6f 66 20 74 68 |he recei|pt of th|
|00002ab0| 69 73 20 66 6f 72 6d 20 | 69 6e 20 43 75 70 65 72 |is form |in Cuper|
|00002ac0| 74 69 6e 6f 20 42 65 6e | 65 66 69 74 73 2e 00 00 |tino Ben|efits...|
|00002ad0| 00 16 00 01 00 00 00 00 | 00 0c 00 09 00 14 00 00 |........|........|
|00002ae0| 00 0c 00 00 00 00 00 00 | 00 00 00 00 00 03 00 00 |........|........|
|00002af0| 00 34 00 10 00 10 0c 50 | 09 80 00 01 00 00 00 03 |.4.....P|........|
|00002b00| 00 01 ff ff ff ff ff ff | ff ff 00 00 00 00 00 00 |........|........|
|00002b10| 00 00 00 00 00 01 00 28 | 00 28 00 28 00 28 00 00 |.......(|.(.(.(..|
|00002b20| 00 00 00 00 00 00 00 07 | 00 00 00 a2 01 6c 00 10 |........|.....l..|
|00002b30| 01 d8 09 80 00 01 00 00 | ff ff ff ff ff ff ff ff |........|........|
|00002b40| 00 01 00 00 00 00 00 00 | 00 02 01 6c 00 10 01 d8 |........|...l....|
|00002b50| 09 80 00 00 00 00 00 15 | 00 0c 00 00 00 00 00 03 |........|........|
|00002b60| 00 03 00 01 00 4e 50 4c | 45 41 53 45 20 55 53 45 |.....NPL|EASE USE|
|00002b70| 20 54 48 45 20 54 41 42 | 20 4b 45 59 20 54 4f 20 | THE TAB| KEY TO |
|00002b80| 4d 4f 56 45 20 46 52 4f | 4d 20 20 46 49 45 4c 44 |MOVE FRO|M  FIELD|
|00002b90| 20 54 4f 20 46 49 45 4c | 44 20 57 48 45 4e 20 46 | TO FIEL|D WHEN F|
|00002ba0| 49 4c 4c 49 4e 47 20 4f | 55 54 20 54 48 49 53 20 |ILLING O|UT THIS |
|00002bb0| 46 4f 52 4d 00 00 00 16 | 00 01 00 00 00 00 00 0e |FORM....|........|
|00002bc0| 00 0a 00 15 00 00 00 0c | 00 00 00 00 00 00 00 07 |........|........|
|00002bd0| 00 00 00 c0 00 3c 00 10 | 00 d0 06 2b 00 01 00 00 |.....<..|...+....|
|00002be0| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002bf0| 00 02 00 3c 00 10 00 d0 | 06 2b 00 00 00 00 00 14 |...<....|.+......|
|00002c00| 00 00 00 01 00 00 00 03 | 00 03 00 03 00 58 53 41 |........|.....XSA|
|00002c10| 56 49 4e 47 53 20 20 41 | 4e 44 20 49 4e 56 45 53 |VINGS  A|ND INVES|
|00002c20| 54 4d 45 4e 54 20 50 4c | 41 4e 0d 41 50 50 4c 49 |TMENT PL|AN.APPLI|
|00002c30| 43 41 54 49 4f 4e 20 46 | 4f 52 20 50 41 59 4d 45 |CATION F|OR PAYME|
|00002c40| 4e 54 20 54 4f 20 54 45 | 52 4d 49 4e 41 54 49 4e |NT TO TE|RMINATIN|
|00002c50| 47 20 45 4d 50 4c 4f 59 | 45 45 2f 42 45 4e 45 46 |G EMPLOY|EE/BENEF|
|00002c60| 49 43 49 41 52 59 00 00 | 00 2a 00 02 00 00 00 00 |ICIARY..|.*......|
|00002c70| 00 0f 00 0c 00 14 01 00 | 00 0e 00 00 00 00 00 00 |........|........|
|00002c80| 00 00 00 1d 00 0c 00 09 | 00 14 01 00 00 0c 00 00 |........|........|
|00002c90| 00 00 00 00 00 07 00 00 | 00 b4 01 fc 00 a7 03 48 |........|.......H|
|00002ca0| 05 67 00 01 00 00 ff ff | ff ff ff ff ff ff 00 01 |.g......|........|
|00002cb0| 00 00 00 00 00 00 00 02 | 01 fc 00 a7 03 48 05 67 |........|.....H.g|
|00002cc0| 00 00 00 00 00 15 00 0c | 00 01 00 00 00 03 00 03 |........|........|
|00002cd0| 00 05 00 5f 46 4f 52 20 | 48 45 4c 50 20 43 41 4c |..._FOR |HELP CAL|
|00002ce0| 4c 20 54 48 45 20 42 45 | 4e 45 46 49 54 53 20 48 |L THE BE|NEFITS H|
|00002cf0| 45 4c 50 20 44 45 53 4b | 3a 0d 0d 4d 4f 4e 44 41 |ELP DESK|:..MONDA|
|00002d00| 59 20 54 4f 20 46 52 49 | 44 41 59 0d 28 34 30 38 |Y TO FRI|DAY.(408|
|00002d10| 29 20 39 37 34 2d 32 32 | 37 35 0d 37 3a 30 30 20 |) 974-22|75.7:00 |
|00002d20| 41 4d 20 20 74 6f 20 20 | 35 3a 33 30 20 50 4d 20 |AM  to  |5:30 PM |
|00002d30| 50 53 54 00 00 00 00 16 | 00 01 00 00 00 00 00 0e |PST.....|........|
|00002d40| 00 0a 00 15 01 00 00 0c | 00 00 00 00 00 00 00 00 |........|........|
|00002d50| 00 2a ff ff ff f9 00 05 | 00 01 ff f2 00 00 00 00 |.*......|........|
|00002d60| 00 03 00 00 00 00 00 01 | 00 00 00 00 00 00 00 00 |........|........|
|00002d70| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002d80| 00 00 00 00 00 00 00 00 | 00 00 01 03 00 06 00 01 |........|........|
|00002d90| 00 0b 00 00 00 00 00 01 | 00 00 00 00 00 01 00 00 |........|........|
|00002da0| 00 02 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00002db0| 00 00 00 43 53 65 6c 65 | 63 74 20 74 68 69 73 20 |...CSele|ct this |
|00002dc0| 63 68 65 63 6b 62 6f 78 | 20 69 66 20 79 6f 75 20 |checkbox| if you |
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+--------+-------------------------+-------------------------+--------+--------+