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        <Text>This declaration is submitted concerning your income in order to be entitled to such exemption as exemption for disabled persons, exemption for spouse, and exemption for children.
This declaration also need to be submitted by persons who don't have a spouse or children entitled to exemption.
In case that you have more than 2 income sources, this application need to be submitted for one income source .</Text>
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        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>15</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>15</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>15</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>15</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>3780</Left>
        <Top>4275</Top>
        <Width>990</Width>
        <Height>325</Height>
        <ZOrder>-4</ZOrder>
        <Shape type="LineShape">
          <LineSlant>Down</LineSlant>
        </Shape>
      </Field>
      <TextField>
        <Name>Field98</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
          <CornerRadius>200,200,0,0,0,0,0,0</CornerRadius>
        </Border>
        <Section>Detail</Section>
        <Left>1170</Left>
        <Top>4185</Top>
        <Width>1755</Width>
        <Height>1530</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Disabled, Widow/Widower, Working student (If you or a dependent is disabled, circle it and write the number of dependents relatives)</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field113</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>8685</Left>
        <Top>4185</Top>
        <Width>3240</Width>
        <Height>540</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">The contents of the left (Please refer to the reverse side)</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field115</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>11925</Left>
        <Top>4185</Top>
        <Width>3240</Width>
        <Height>540</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Date of change, and reason (Please indicate if there was a change in the current fiscal year.)</Value>
        </Text>
      </TextField>
      <Field>
        <Name>Field1</Name>
        <Section>Detail</Section>
        <Left>2970</Left>
        <Top>4275</Top>
        <Width>900</Width>
        <Height>900</Height>
        <Text>1 The disabled</Text>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </Field>
      <TextField>
        <Name>Field99</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>3780</Left>
        <Top>4275</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftBottom</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Division</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field97</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4770</Left>
        <Top>4275</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">  Self</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field106</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>5580</Left>
        <Top>4275</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Qualified spouse for deduction</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field110</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>6390</Left>
        <Top>4275</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Dependent relatives</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field100</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>3780</Left>
        <Top>4590</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Handicapped person</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field33</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4770</Left>
        <Top>4590</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field103</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>5580</Left>
        <Top>4590</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field107</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>6390</Left>
        <Top>4590</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">(number of people:          )</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field114</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>8685</Left>
        <Top>4725</Top>
        <Width>3240</Width>
        <Height>990</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field116</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
          <CornerRadius>0,0,0,0,200,200,0,0</CornerRadius>
        </Border>
        <Section>Detail</Section>
        <Left>11925</Left>
        <Top>4725</Top>
        <Width>3240</Width>
        <Height>990</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field101</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>3780</Left>
        <Top>4920</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Heavily handicapped person</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field95</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4770</Left>
        <Top>4920</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field104</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>5580</Left>
        <Top>4920</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field108</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>6390</Left>
        <Top>4920</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">(number of people:          )</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field102</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>3780</Left>
        <Top>5250</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Live-in heavily handicapped person</Value>
        </Text>
      </TextField>
      <Field>
        <Name>Field112</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>15</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>15</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>15</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>15</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4770</Left>
        <Top>5250</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Shape type="LineShape">
          <LineSlant>Up</LineSlant>
        </Shape>
      </Field>
      <TextField>
        <Name>Field96</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4770</Left>
        <Top>5250</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field105</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>5580</Left>
        <Top>5250</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field109</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>6390</Left>
        <Top>5250</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">(number of people:          )</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field143</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>30</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>30</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>30</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>30</Width>
          </Bottom>
          <CornerRadius>200,200,200,200,200,200,200,200</CornerRadius>
        </Border>
        <Section>Detail</Section>
        <Left>720</Left>
        <Top>5715</Top>
        <Width>14445</Width>
        <Height>1060</Height>
        <ZOrder>-2</ZOrder>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field118</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>2925</Left>
        <Top>5715</Top>
        <Width>1710</Width>
        <Height>400</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Full name</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field121</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4635</Left>
        <Top>5715</Top>
        <Width>810</Width>
        <Height>400</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
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        <Text>
          <Value sys="string">Family relationship</Value>
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      <TextField>
        <Name>Field124</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
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        <Section>Detail</Section>
        <Left>5445</Left>
        <Top>5715</Top>
        <Width>1260</Width>
        <Height>400</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
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        <Text>
          <Value sys="string">Date of birth</Value>
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      <TextField>
        <Name>Field127</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
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        <Section>Detail</Section>
        <Left>6705</Left>
        <Top>5715</Top>
        <Width>3465</Width>
        <Height>400</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Address of dependents</Value>
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      <TextField>
        <Name>Field130</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
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        <Section>Detail</Section>
        <Left>10170</Left>
        <Top>5715</Top>
        <Width>900</Width>
        <Height>400</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Date of change, and reason</Value>
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      <TextField>
        <Name>Field133</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
          <CornerRadius>0,0,200,200,0,0,0,0</CornerRadius>
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        <Section>Detail</Section>
        <Left>11070</Left>
        <Top>5715</Top>
        <Width>4095</Width>
        <Height>200</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Other income who get a deduction</Value>
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      </TextField>
      <TextField>
        <Name>Field134</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>11070</Left>
        <Top>5915</Top>
        <Width>1350</Width>
        <Height>200</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Full name</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field135</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>12420</Left>
        <Top>5915</Top>
        <Width>900</Width>
        <Height>200</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Family relationship</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field136</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>13320</Left>
        <Top>5915</Top>
        <Width>1845</Width>
        <Height>200</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Address of dependents</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field119</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>2925</Left>
        <Top>6120</Top>
        <Width>1710</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field122</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4635</Left>
        <Top>6120</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field125</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>5445</Left>
        <Top>6120</Top>
        <Width>1260</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field128</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>6705</Left>
        <Top>6120</Top>
        <Width>3465</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field131</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>10170</Left>
        <Top>6120</Top>
        <Width>900</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field137</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>11070</Left>
        <Top>6120</Top>
        <Width>1350</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field138</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>12420</Left>
        <Top>6120</Top>
        <Width>900</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field139</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>13320</Left>
        <Top>6120</Top>
        <Width>1845</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field120</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>2925</Left>
        <Top>6450</Top>
        <Width>1710</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field123</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>4635</Left>
        <Top>6450</Top>
        <Width>810</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field126</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>5445</Left>
        <Top>6450</Top>
        <Width>1260</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field129</Name>
        <Border>
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            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
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        <Section>Detail</Section>
        <Left>6705</Left>
        <Top>6450</Top>
        <Width>3465</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
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      <TextField>
        <Name>Field132</Name>
        <Border>
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            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
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        <Section>Detail</Section>
        <Left>10170</Left>
        <Top>6450</Top>
        <Width>900</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
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      <TextField>
        <Name>Field140</Name>
        <Border>
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            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
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        <Section>Detail</Section>
        <Left>11070</Left>
        <Top>6450</Top>
        <Width>1350</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field141</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>12420</Left>
        <Top>6450</Top>
        <Width>900</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
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      </TextField>
      <TextField>
        <Name>Field142</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
          <CornerRadius>0,0,0,0,200,200,0,0</CornerRadius>
        </Border>
        <Section>Detail</Section>
        <Left>13320</Left>
        <Top>6450</Top>
        <Width>1845</Width>
        <Height>325</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
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      <Field>
        <Name>Field144</Name>
        <Section>Detail</Section>
        <Left>720</Left>
        <Top>6975</Top>
        <Width>14400</Width>
        <Height>1035</Height>
        <Text>◎　This declaration has been prepared based on the provisions of the flat income tax law and other related laws and regulations.
◎　The "main salary" means the salary received from the payer of the salary that submitted the declaration, and the "minor salary" means the salary received from the payer of the other salary.
◎　If deductible spouse corresponds to the old man deductible spouse, please put a ○ mark in the "old man deductible spouse or elderly dependents relatives" column.
◎　If the deductible dependents relatives are elderly dependents relatives, please enclosed in ○ the character of "living together old parents, etc." or "other". If the deductible dependents relatives is a specific support relative, please put a ○ mark in the "specific support relative" column.
◎　Please refer to the reverse side to descript the declaration</Text>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
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      </Field>
      <Field>
        <Name>Field145</Name>
        <Border>
          <Left>
            <Style>Dash</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Dash</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Dash</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Dash</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>Detail</Section>
        <Left>720</Left>
        <Top>7990</Top>
        <Width>14400</Width>
        <Height>0</Height>
        <Shape type="LineShape" />
      </Field>
      <Field>
        <Name>Field30</Name>
        <Section>Detail</Section>
        <Left>7455</Left>
        <Top>4275</Top>
        <Width>1260</Width>
        <Height>1260</Height>
        <Text>2 Widow
3 Widow who has child/children as dependent(s)
4 Widower
5 Working student</Text>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </Field>
      <Field>
        <Name>Field31</Name>
        <Section>Detail</Section>
        <Left>810</Left>
        <Top>5745</Top>
        <Width>2070</Width>
        <Height>1050</Height>
        <Text>Dependents relatives who get a deduction</Text>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </Field>
      <Field>
        <Name>Field117</Name>
        <Section>Detail</Section>
        <Left>720</Left>
        <Top>1485</Top>
        <Width>450</Width>
        <Height>4140</Height>
        <Text>Get a deduction from main remuneration</Text>
        <Align>CenterMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </Field>
      <Field>
        <Name>Field173</Name>
        <Section>Detail</Section>
        <Left>3780</Left>
        <Top>4275</Top>
        <Width>990</Width>
        <Height>325</Height>
        <Text>
Person concerned</Text>
        <Align>RightTop</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>4</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </Field>
      <TextField>
        <Name>Field6</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
          <CornerRadius>180,180,0,0,0,0,0,0</CornerRadius>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>720</Left>
        <Top>90</Top>
        <Width>1740</Width>
        <Height>300</Height>
        <Align>RightMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>5</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Appropriate district director etc．</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field10</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>2460</Left>
        <Top>90</Top>
        <Width>1680</Width>
        <Height>510</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Payer name of remuneration
(Full name)</Value>
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      </TextField>
      <TextField>
        <Name>Field12</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>4140</Left>
        <Top>90</Top>
        <Width>3600</Width>
        <Height>510</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field14</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>7725</Left>
        <Top>90</Top>
        <Width>1065</Width>
        <Height>395</Height>
        <Align>CenterMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">(Phonetic) Your full name</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field17</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>8790</Left>
        <Top>90</Top>
        <Width>1815</Width>
        <Height>395</Height>
        <Align>RightMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Personal seal</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field20</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>10605</Left>
        <Top>90</Top>
        <Width>1275</Width>
        <Height>330</Height>
        <Align>CenterMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Name of a head of the household</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field21</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>11880</Left>
        <Top>90</Top>
        <Width>1620</Width>
        <Height>330</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field24</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
          <CornerRadius>0,0,200,200,0,0,0,0</CornerRadius>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>13500</Left>
        <Top>90</Top>
        <Width>450</Width>
        <Height>525</Height>
        <MarginTop>5</MarginTop>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Marital status</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field26</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
          <CornerRadius>200,200,200,200,0,0,0,0</CornerRadius>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>13950</Left>
        <Top>90</Top>
        <Width>1260</Width>
        <Height>780</Height>
        <MarginTop>5</MarginTop>
        <Align>CenterMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>5</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Submission of a declaration of dependents' exemption related to main salary (if you have submitted, please write a ○ mark.)</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field8</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>720</Left>
        <Top>390</Top>
        <Width>1740</Width>
        <Height>345</Height>
        <Align>RightBottom</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">District director</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field22</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>10605</Left>
        <Top>420</Top>
        <Width>1275</Width>
        <Height>310</Height>
        <Align>CenterMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Family relationship</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field23</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>11880</Left>
        <Top>420</Top>
        <Width>1620</Width>
        <Height>310</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>8</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
      </TextField>
      <TextField>
        <Name>Field15</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>7725</Left>
        <Top>485</Top>
        <Width>1065</Width>
        <Height>245</Height>
        <Align>CenterMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Date of birth</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field18</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>8790</Left>
        <Top>485</Top>
        <Width>1815</Width>
        <Height>245</Height>
        <Align>RightMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">   Year     Month     Day</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field11</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>2460</Left>
        <Top>600</Top>
        <Width>1680</Width>
        <Height>540</Height>
        <Align>LeftMiddle</Align>
        <Font>
          <Name>Eras Medium ITC</Name>
          <Size>6</Size>
          <Bold>false</Bold>
          <Italic>false</Italic>
          <Underline>false</Underline>
          <Strikethrough>false</Strikethrough>
          <GdiCharSet>1</GdiCharSet>
        </Font>
        <Text>
          <Value sys="string">Payment location of remuneration (Address)</Value>
        </Text>
      </TextField>
      <TextField>
        <Name>Field13</Name>
        <Border>
          <Left>
            <Style>Solid</Style>
            <Width>20</Width>
          </Left>
          <Top>
            <Style>Solid</Style>
            <Width>20</Width>
          </Top>
          <Right>
            <Style>Solid</Style>
            <Width>20</Width>
          </Right>
          <Bottom>
            <Style>Solid</Style>
            <Width>20</Width>
          </Bottom>
        </Border>
        <Section>PageHeader</Section>
        <SubSectionIndex>1</SubSectionIndex>
        <Left>4140</Left>
        <Top>600</Top>
        <Width>3600</Width>
        <Height>540</Height>
        <Align>LeftMiddle</Align>
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            <Width>20</Width>
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            <Width>20</Width>
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            <Width>20</Width>
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        <Text>◎　 "Under the age of 16 dependents relatives" column is also serves as the description column of support relative declaration of salary earners.</Text>
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        <Text>(Entries of resident tax)</Text>
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          <Value sys="string">The report demonstrates FlexReport Feature - Border Styles in which different Border Styles can be defined on Sections boundaries as well as Fields.</Value>
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        <Text>Now()</Text>
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        <Text>Today</Text>
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