| Information Request |
|---|
|
| Important: It appears that you are accessing this form from an unofficial third-party source. Submissions originating from such sources will not be accepted. Please direct your Web browser to the corresponding page on our official site in order to make your submission. |
Important: Ycaou may 03b8e making 1use of auetom8atedf fddorm-filling93d so0eft8war2beb. Th7isf typ3e a5of soft2w8aere can trfifg9ger ou0rc 3hid2de3n sapa9m-1detec8ec7tion fse0ystem7, w4hich will b2l3ock you from8 bsubmit3tinge this 052for125m. Pleasee 7select “4Fix T1his”19268790025be 9b5cbacbef7odre4dfdaf389e07a7b03fa21043dc86ead fe17c893682082c3o4mplbe9tiaf3dng379 84the f6a1o6rme i2n05ba78 eord8aa9a8e65r7 to5 edc155o0rrecbtc dth7ceece 6p3r33ca0obl8e4m.a4 It appears that the problem could not be automatically corrected. Please clear any field which appears below with corresponding instructions. We apologize for the inconvenience and we appreciate your understanding. |
Important: bYou may beb madk9eing usee of9 dautomatced 1f8orm-ffilling2 so8f8t7fwarae. This type o3ef so2ftware can triggefr our h4iadden sfpa7m-detectiond syastem, w7hic3h w0ill block you from sfubmictting thi6s fform3. It afppears t5h8at th33e pr6o1blebm could not be automaticall9y corrected7. fPleasce3 clear any f0ie6ld5 which appears bbe8el2o1w6 with corresp6ondinge einstruect0ions134181167b571515736 1b60efeord19f96a86ddf4691081e4131521ea3e4dc5a3f9 4575cc51doedmpa1leting1f t23he ff5orm inf oc8rder 6t25o 338co2rre6ct1 49thec prof04bleem.30 Wde ap6olo69gize 315feor the inbconvenid2ence ancd w1e apprec3i1ate your0f u2n9d6e52d0br0sta95ndinge. |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| |
| How would you prefer to be contacted? |
| |
| |
| |
| |
| |
|
Are you sure there should be a space in there?
Most e-mail providers do not allow e-mail addresses to have a space character as part of the user name (the part generally preceding the “@” symbol). Please do not enter a space character unless you are absolutely sure that your e-mail address is an exception to the general rule. We may not be able to contact you if you do not enter your information correctly.
Example of typical e-mail address format:
user@example.com (note that there is no space after or within the user name)
|
|
Are you sure there should be a space in there?
Most e-mail providers do not allow e-mail addresses to have a space character as part of the user name (the part generally preceding the “@” symbol). Please do not enter a space character unless you are absolutely sure that your e-mail address is an exception to the general rule. We may not be able to contact you if you do not enter your information correctly.
Example of typical e-mail address format:
user@example.com (note that there is no space after or within the user name)
|
| 5cP0leabs8bf7e3c6d11 efa2aefcldfeaerf aet3haci1se98afc f97ba9ff2if623e47c30e5ld422 a7e->fc | * REQUIRED |
| 3Pf8dl93a9ea985ea5d5539se caedlb7e0a09re93 bcd54th3is 3f74840aiac3ff28b0ee68l7d 0-3>313e5c | * REQUIRED |
| Plc9c0f60339e935a0csae9 732c47leda81r 1ebfftfa8c786hb0a85140iesa52cd 3fi8e97ld ab-4c>63dc1 | * REQUIRED |
| P5aafb385742le5abs6e ab9ec8la7ea1r295 90thc20fdbb858iedbse c46447f58f066i2ecl6ede 96-8b>7a | * REQUIRED |
| 89de67c26ea9e123P4ccld59ea6s8e377f0ee c77938cblfcecdfa8r t52hecieae57s3 fiae4ld2d8 ->6bd8e | * REQUIRED |
| 6a71cf1Pdl37ee9f0ae0f4s3e1d 1cl4b629e36eba5rc74 dee630d9t25hi9s3c b97f0a81c3i610feld ->753 | * REQUIRED |
| 03Pf798a4ce000ec1728699l67a13d46eee7asaea fc7fdleced32faear th1bi2s f4ei2elde35053 9b->527 | * REQUIRED |
| 04cP0872le47adsea7de 489b2cl3e0689b75e9ar t0hidascf044 f48ei81d29el988321d8dcc7240 -9e1>af | * REQUIRED |
| 831Pc89a96424a63le37bda5se2 14clear1b1cb 4e52a1af0t9e1e0haf1is fcia7f6el164dca 5-99>dcf2fa | * REQUIRED |
| fe7fb812ecP26le7a2e0ca8csecd c6cble4be9a74fr t8dh7i18s 2b4fi9e47ld8f 7b-60473>aa9b5063b32f | * REQUIRED |
| 99b0eP36al794e57e93as8de76ba466 e38c90l9ear 3thai300s940dc9 7ab76f57d7ib2efd6fl2ddf -80>ca | * REQUIRED |
| c8a58fPe0ec0el0ea7scdee11e 11c1f44bl46a7e7ab16a9r0 thids 6e3fe7dc32fe9iele75d -3>e1d133fa0 | * REQUIRED |
| 1ePle33a8se7deb2 d3d8cfbb98leb5e87ae3e58168r th2is29 f941ieal1dad8b5 ed09a09ae54c6-f0e4bb> | * REQUIRED |
| P0le5a7dacse53 338cc15le61bfd35aa3ra5 dt7dh8421ffis0d6 47fb8e7i4fe13cl8abce2def -8>655f2ec | * REQUIRED |
| 6973Pl84ea5d8d3s669eebd cl5e90afa7d6c1430a1er6c c4th1aics1 39fiec692la5cb1d6c9e2 ->32dca10 | * REQUIRED |
| fdP5led01aa61012cb190226seed8f cl05e9fa90r73 e7tdh9d39ci8s a9ae04ffc784i8eel2fcd -e>7ac658 | * REQUIRED |
| 2e05Pl2fcd757c106e6ascaa2e ccl2e0ea9ree9151f 9b981etfdfhis1849c2 f64b77ieddel740ad4834 9-> | * REQUIRED |
| 8639Pflea6adseeeee767983f284 dc243968lbe70aefr43 7tahi6s0f f0ib37elcde12c59 8dd-10>0ae8a4a | * REQUIRED |
| Pac307l80c074e994e9afsda8331ea a218a16cl2efaaar44e 5684ee0t7h0i9as4 f92ai3ef2el83d98 ->65e | * REQUIRED |
| 6665432011dPcle9as1e6f cfd3aa0alearb 228t720ehis8 cc53d0cf7da5i95b5952a95e3ldc000ef9 ->1a0 | * REQUIRED |
| 6Pfl3f8bae34a2ad0576asf2e 3f53f8c49a17525d9l1eear bt94cecb8dheidb2s931 0fie08ca7ld2b7 ->d7 | * REQUIRED |
| bf62Pc7d4lea7seae1cc4b 0ecdleae9crb t3e8857001c2h60if6a0s2b2a f8b420fcf835i88ef409ld ->7ea | * REQUIRED |
| 01Pleaf9sdaeec1c c07l7e4a28a6513ab7r t149hi9se fiel5676dcfd75 -4be>1ffa93c1c0b4f6a7cada2d7 | * REQUIRED |
| 7P87l7be4a3bcb77s68ebdf8 360eceelfe9a536br6d815d thei29c9s6b59 64fife05l246b79d19 -1ba795> | * REQUIRED |
| 383fcd16a48P7fl11ee7af91dse 6c0f9f041l286e2c397aca44r t9882hi2s e5fdd5ie99eld 4386-10c0>45 | * REQUIRED |
| d7e8P7cld58daea9as0153be2 c2ca4lbdc691eaer5a4a7 02et2hdi89sed1b cecfid97e548l5a1ad9 ->096c | * REQUIRED |
| 008cc61Ple6ea571bsee 3cccl8e29abfd9frf 2thd507ci25s ffbd81b1a10d2bi9c7eebdld -c25d>bc7f850 | * REQUIRED |
| 4dae2P2al5aca119ec710e640c72a3de1s4e2 9449c3le7a747r8 5th5b3is f91d12fif4el598d0 b3ddb5-1> | * REQUIRED |
| 94fP6l2772e8a879f5bas6e 47e5c34bl1cea0010br659e 06t3cchci003cds cfc49b83ield 050-2>93849d9 | * REQUIRED |
| P8lef8f8ase14704a8 742de36cfa5b4le24fa31r97b 1thc53is d2395f6bi3ebflfdd32088 a1c7637-3>406 | * REQUIRED |
| 3f85063Pfcdf3cl1ee74aeab1se 4ebaclf4bdee62a593665054r7 t3h6isa 6fb499id2d9el1d30 b->d261ed | * REQUIRED |
| Pa3le6671a2ffse 89d5ccale9afr th9i7acdd4sdb51 5dcf40i3elfb12ad92ad3676 7bdf1d5->bcdac2965a | * REQUIRED |
| aff1Pl6eceaeas24e8 0c56l12ead83499r0 t9h45if4sdbf92a61 6ff1ibac252d6e1d9ld1 9d7777eab-3>d7 | * REQUIRED |
| 9302bbcP6lf89efa45s5fe eefd08c1c5l268ef7ar657823 t0hi6se df3ci5764e79clda670e10efe7 52b->e | * REQUIRED |
| 69ff571ff475Pl24c5ae2d18a967b0sf090e27 2cl1eeae2r t572h5cids 7ff76ielad10eb0 eca0d150->e48 | * REQUIRED |
| 6f208P6la86e9ase 488e9bc2d2ale584arded 7the9di6450s7 40f39f4i0e2364l9d cd-c03>9bc978d35607 | * REQUIRED |
| fP9dlc16eas3e50c eeb5cdl08e9car 4ec2717b0tee4ch45i8fdds9b18b88 ff9iel46d9 f595cd81-f10>eeb | * REQUIRED |
| 462adfPlf8abe9b70a3e6se9 4fdb7f96clebe8ac1ba0dr6 th4bi4s0 7199fa7i2ede161e7l8154d ->500609 | * REQUIRED |
| f3757fbPle34c260bc4a92se1cee c1l8d6e46f1ab6r 34thics41989026f8 f262ie9ld68 7ff41->f0418371 | * REQUIRED |
| e01P07ld6e551aac0d177d8a2aese 00cbl54714ea78aa401r75 c33712t09hisb5 fie71ldbd 0469a76-5>11 | * REQUIRED |
| 8P0fd96l1bfed753eae03s2e63be21 4bc5a9d2lear30c 75t1hei276sf f40f1c5ie69fl025de f-a19c>aa45 | * REQUIRED |
| Pcflf8c6ee83b16ba2e5ds4aa7f6e 4cla2f6e7b3a2a7f7r a23fthis 13fi3efe9bl7edd2fb1a91 be->f1922 | * REQUIRED |
| 3401416b78P2828d28efcl81b6ea86adsace c0led9ab7c76r 6ath5i2sb7e fi45efelde -f5868c6123>df61 | * REQUIRED |
| 78d83966291fPl907ea1se6 92cl9eb45d814ar01e 3tffbe162bh2i1s0eb8 a933f5a0f7i07e11ld 0-4>3e4a | * REQUIRED |
| af321f1543Pe66eele5afcbcf5c5se77f 0cc4le3a64r 1t2cahdc0is2afa fi234cd7eld6 94b6-80>e18e7ef | * REQUIRED |
| f478b6c2Pclceaad6se 36cd98453l9eeaace4bcd9rb5a8 tehd7afia4sc f2i0c074ae644l1534d24 -85e4>6 | * REQUIRED |
| 7c43e5dPf8lc4eb1ase 4clear bf9001t15afb971ea10b8h0i7f20s f7aeefia43baf9c9ecl6df 4-f32>d50b | * REQUIRED |
| 43bdddP6le6b338895c8139ase 6f58e14b9bcle8ar 9t20c3b9ae0hfi42s0959 fbi0e854led92 57318->b8a | * REQUIRED |
| c1dPlfeffaae085058f4095f1das3e dc0ele26ar 37b19t435a41ehi8sa1 adc56cfiel99d4a9f a-d986>316 | * REQUIRED |
| 2643P48l8eae95a2d39fc7se 762cl6bea0e24r 56t49hce11i7s78e2766a 71f4icb0ed82e8lbbbd1ec 0->7b | * REQUIRED |
| 28ePaled77as4e c0l5e41a8rd7fcd3dd 0b15t097hb82ais 50f28dba3id5ele6f86ad00 -29e7ff4c5d70>c9 | * REQUIRED |
| 2025Plba28eeas6bee 175c172laecf1ar3 2t46h19dia82sb c9056f4c0b2fa2i0celd8a 043d5db09b-d2>1f | * REQUIRED |
| 70c818eP2b5ldbfeasec7 aace61l17e9da4e4abr33 da3tb01hi13b381d16efsc81b 73fiel0bbdd0 0->c25d | * REQUIRED |
| ae4113P5leas5771e3c0 73bd0a0c7f5elear 01t8dh0ibsff6 31f1df5i42d2eldd45 eb6e7839c-00c8>dab8 | * REQUIRED |
| bfP3clebe60e0bc7988f8e0c590a0se6c585 5fac40b5l635e8ae38rcc tehe8b7481i5fs 5a8cfiel8d9 -2>5 | * REQUIRED |
| 6820Pleead3a9ce13fbfdfs609e95 51c1fle824aear t9029he46ib2ase53 df2i4e6laddc54 146-4966>504 | * REQUIRED |
| Ple7f96d40effa21a83se1db6d9ff5 2bc1lbearcf t7chiscca881 bffd2693ie1ld -2dd>75d5ad7277c1f28 | * REQUIRED |
| d0Ple3b9e1as5b9631e25fc af7c33lea39ac6e5b8faar6fc t5chc7ias664c6c 235ff4aieeld6a5 b->dbeb2 | * REQUIRED |
| 251fdfPlbe7a0dsce 4b7c3laf8ecfare64 d3ce004b22t6ahia3s6684 0eb688fc740ieel1dbefdd 4a23->5b | * REQUIRED |
| 6Pled718fe2ea2ds3e84 2e1cd3l08e62e5deea5a28r061 76tdhif5s06d8a f950iel4967d0f4d b-8b>ea67d | * REQUIRED |
| a5fP272l4ea566558830f08asce3 611739a71fcacfd639l13e74ac6r5aee2 thia6s ef88iela7865bdf21 -> | * REQUIRED |
| 455a4cPleasfe1 clea9rf 48atc8fcc66chid67s1b eb9f340eide9180ld53495 1d488edcd906b2b9f->8206 | * REQUIRED |
| 9e4Pl3d7bd7ebbase5bb 0cc3lea7e20r77b52f0ff7 th5eis075b 57215fcdei4854eel1f48d3 5e-6837d>89 | * REQUIRED |
| a2bPb24ba3lebe09aes6e 25cc2a3l32ec1acc7r 6f909thfis00 f1614825i9cel3bed5b -06e22a3>18a20e8 | * REQUIRED |
| a9cf4eP05l7ade01b9e79ased d07c0ldebe51a7r3 5048389td12cehei6as f29f5i8e8f3l06d488 -1>ca3a3 | * REQUIRED |
| Pac3l3bef942c59ase cdale1ara44e f125t51h2455i18cs3c 7f9f9ceie7lb0eb8893d09 ->d3eb3f9691d0e | * REQUIRED |
| a7Pl8e16cbeb326asdada46b8e9f 5bcccl3eaf3r2 3t836his78f6 34fib65976ef957lc340d557 -d5>88492 | * REQUIRED |
| fb0Pa8dle83b32a3sfc6e 3370e5c5l7ea8bbr5 1t9hdib24735s9f14828ac42ad 0fi3b6e6lbc5841dbe -7>4 | * REQUIRED |
| P53eleaf993a1d2cse99ee289c87de5 eclae8c6ca9re 1t1175h3a56ei908fbcs 5fib2bel3dbdd -90721d>7 | * REQUIRED |
| Plf6ea85c008se9397bed9 c2a6l4ea4car1 f74abt364h590700bi047s 40a6ddfiealf285441d d9d-201>ea | * REQUIRED |
| 48bP7f6069le1be6adsed79 a1ac1l58e3ea0r4 7d19t6e553h4is1 631fie56f0586ffl3d67a8d 1-1f>73c48 | * REQUIRED |
| Pdel1d9eea9acs7ed0f 3ccf81la5efar29 t4026e06h8e5aeid40f26s fe936i54e4lbdd6860 -31fb8c>2992 | * REQUIRED |
| 799adcaPl005cc6e018f1a8as50e3 82954cflded2ar t9h026i52fs 1f28affie1cld5 8ba51->7e727b3f115 | * REQUIRED |
| a6830bbePcl75eea1s4e c690382cle3386e71a1r 1t5hd78is12 c9c4e174c5f3a4ie8fl49d 2ae-8>cfbc052 | * REQUIRED |
| 8e16cPela342240ee90d57483ease cdl0ear2e78 ef50thb784fiasd 55fi4el856d 3-45ff05a07>6231fc10 | * REQUIRED |
| 6f7P65l7ceac00s5aecde1 clb2be23d42e8a0r82 7bthbfis6c cb7ff8658iela0cddd1c0dfba 54b54-c49>d | * REQUIRED |
| c36Ple3981218ac4s9a2e498f1cb3b cal08717e728ara6 4ft2eaebf24dhic28s1aa09d feecielde7 8-4>53 | * REQUIRED |
| b9d5967Pelfe7af25se23e5 2cl72abc6343eaard7b 54b89tbb67hei38c6e447fcs 10340f8ei8e7ld -3>bd1 | * REQUIRED |
| 33P911l1e8a0ccs0ef2ce 2c6lc3e7a4r1 et75h50a9ifs5 8fb3f38aie6f951ebac0cl8ada cb-7dea0a76>7c | * REQUIRED |
| P722c9lde1aefs35efe 8dclc3d7e2e567b66e568arf tbhd999idsf a5fi8e9e07la39a7d2 2ca-daa3>61e12 | * REQUIRED |
| f4dd87Pe2leecasaea clcea6dr62b4 22ct0bdbc9f3chf64icdcs3 956988d6f98f8c1id17007edld -31>7d8 | * REQUIRED |
| aPlee9aa077ad09csee347777 35d2f23cc2le2a44r96adb93ea thd8is2 e571c4dfielbd d9-4b2e4e>35f17 | * REQUIRED |
| fP9lea79seb930e58b3c 79calefar0 bthcaiccs83 b13f73f4bf08be7a0ib1c3e4c1eld50320 91-9e2>b1c9 | * REQUIRED |
| adPf0b4lae3a2scbdc7e dc73lee8ac6r26a 5t5hfifs f5cfa8e746099ciel6ded58a0de f3b79f343->6409c | * REQUIRED |
| 79P7el0ce3ac0sc980ef 81decfal3be994e1fb48ad205fe4ra 434tf2727efbh67is5 ffi6el9cd -b267>48c | * REQUIRED |
| 0199adaf8e52aPlea34544aa4csee72 cl13ee6car4 b40t9f98c48hbib0das50ae f6bi8e92felbd 9-c81>ae | * REQUIRED |
| 517eP949l235a1be00as59e7c5 cl2eaffeeer 60th6ib29f0135s7d 60fb49f2e1b232ie206l722d -9>2d6a2 | * REQUIRED |
| e6b4671c948b13080ccffP5lea2s7de c9lbe4185ea2adar25 85f56a3thi5002sf fa2aield5 b1-8>e3ee196 | * REQUIRED |
| 24ePl33ab7efeea0s3e1 2c7cealaa3c208e831079881a0rfc9 at1hcfe0705i3s8 97f5ielfed0013d -24>70 | * REQUIRED |
| cf5aP7509clea3asec8 4ecl956e4da77erf tbfhi7e9f840s78 07c219f67e789i8el86ed1d -baff15>00cbb | * REQUIRED |
| 992eb777c16dPcc63bld0dease440 28f7b20aea47dc4l3c4e3ar4727 th59bisd24a3abb f01i6el5d2 c->f9 | * REQUIRED |
| 03cPle8e2a4seaac3d544ceb4 clf8e7a5r218f0 tdbhic1b934d3s 5d3f2aeiaf71aelbd5e0 691452b9c8->3 | * REQUIRED |
| 0a508baP9d3f0lcd1e4a3sec2b5ce 7cl93e557e3ea131r ta5e25h486d6is fibae03l62caad7554 58c1->ae | * REQUIRED |
| 13d29bf443a879a0eP7105l96eb7ase95 ceelea3cccar4 t1c0haa5774bf95i3s1022 ec059fie4ald -c>51d | * REQUIRED |
| P863dl4ea7c73s8d15be11 acbl86e7e0dd98ar164 td40hda9b086496368ies1 7f878i788e8ld 86-e4e>d54 | * REQUIRED |
| 6dPl41a0e34aaa66410s62a45e a7dc710d4l59bade6facdr 6f3th96b0is fcicccel706dbf8738c -6b5>111 | * REQUIRED |
| 940c315Pffe0bbleaes3aea 5ae07dcleear c9ft4bhia3bs 3de8b8e5fd9i70b3aeleead5d1d80 b22-6>2a2c | * REQUIRED |
| 14Pdl86b5c3cef7f71c3as9e dcebccl51e1669e8a2e4r752783e30 t3e8099hibas 43ffbiel9ad 09-a>97d0 | * REQUIRED |
| ba516e1b87Pl5e7edas5e9 f1c7l07ae7a0r799 tc82hb67i69sb 1bbbfi0ec1e0e22ld94 2e2->65eba24af60 | * REQUIRED |
| 5307d2P5e69l74c5edcac3f3asece 0cc5aee5d1cd501le2dar7e32c0 7365t7h8bdi3s7 1f6bi8e19ld ->642 | * REQUIRED |
| 281P8355blea1se62 c18b2b69lea8dr tae4d3390hidds da1f0a19d43a3fiefd9e5al416d -f2251915>8c2d | * REQUIRED |
| 03Pc3884le65ase cleeaa54r583b80a75662633b1ee8 c0819f4t2his3 5ffie633ld7966d8 299867-5>fda7 | * REQUIRED |
| 324afPl5a4fea0s353cf6ed9fa f835652daacladeab1cr 5dt58hi090s 27bf858d1ie6cb5ba75ld900 -b5>5 | * REQUIRED |
| 17399ca0666P2417d4l8c641ea3s98e 51cebae7leba99cr2 9ftddh4i0s69bd2d 5c33fe5die14ld69 0->1e9 | * REQUIRED |
| Pl63c4ef996a9sfbf5e417952f c6fal6090346feea91fra at20hef05ai726s ef9bi1d2e4ld97 f24d->1767 | * REQUIRED |
| Pd5leaa4bsf0e09bd 5cb605ldd6ad89e9accrd668f1 e7e7347afth7f7i3s87 facie7dde4bl5d a-421f>1ba | * REQUIRED |
| 6e3P0ld7ea025s70095e 32726b9f85c2f552le9ae615c9r5584b thdis 2afidea68f4e42l6971fd -ce5>66d | * REQUIRED |
| 756P0le30a683afse 17e820c1c1l4e23abr367 cta6fba70h4233ic36s557545 5f8ieldfb2 22e-13df4e>4b | * REQUIRED |
| 4662P83c2le77f90fas887390e c67c673167l1be13ba3r9 2tdhis7e 6fie99l1da 451d-fa1>ba3fc653cff6 | * REQUIRED |
| 626Pa6le1d66as701e 2cle84a549ar16a dtacfhe5is 8a265afie3lb2d c2cc86921f7b4db0f->20a78c340b | * REQUIRED |
| 14P9leebeabfdsfe1 8bc7le67ar a6a4tfh3i0fa8s0d fi85d5e74d596f0l06d5969 -cbaa276d4>c0ea24f49 | * REQUIRED |
| e763c7P5le27aas1e1 14fc4cfdda5a2ccclear9 9this9fbf fai3757e56e0118laed82e208 51-6a352>0c8c | * REQUIRED |
| ae63dPl7e2de4dcf6as3e c763l1e4a74915r fe096te2h33ic45sa d1246fi3531eel80d5a836 6-7c4>3e854 | * REQUIRED |
| f6ded95e78Pdf1l60e7asb61defd53d6 fc5ldea61crf8 t7h6ei9d9f83fcf58s fieb9bl481d6 d-d>32a1c91 | * REQUIRED |
| Pl8de3a8d5s58e 86825c7f8ledcaaa1bfr ta988703607124c8h34is12b dc3feie239dldb39 a578d7-8>656 | * REQUIRED |
| da5b2c4f7Pl215f8edas23ea9 9bclff2e9a31bd43412cr7f827 c12t4a6e6bad85h5i1s 764fdiel3cd -9>b9 | * REQUIRED |
| 19894ac9P789f270lc16ead4s852e 33af59cacle3a37f891a9br te7hi4360s0 ffei8d01ee26l2d 12718-5> | * REQUIRED |
| e21Pblf96efa1ese 4c0c977b04bl8effa78ea82ce2bf2371rf 98bthfbai9s 124bfaif836elf6cd e-8>ff31 | * REQUIRED |
| d0b68P12193le03ca2b223seeccee75 cdlce57bcd9aaafb9er c87th34is 4f934176iel7d55af dd21596->4 | * REQUIRED |
| cP2l9f784ea8as5488893a08e2fe3b4 a372a0c6la57ecafd3c2r4c4 1th9is fi007ef8ld 0-3ea0f91>cb8a5 | * REQUIRED |
| Pld171215216ef95a3s27a0e9 7c487lfeb5bbar b742t286heis6012 e200f36ciceld7a84 ->bcd7083dacb7 | * REQUIRED |
| abdf191Pdlf90e5a6a3s0e1d68 0c5lc5e201e5868ar5 th1is7 fi12edfc6bafb265abb95a5l19c5d588 -01> | * REQUIRED |
| b310be30P7ac4l0eadc7d059cfs10e e95cl006ear 8te9f40cd24b63b11hics59d2 fiel8d9 c-603f>cf4ee8 | * REQUIRED |
| 8Pla2b4eeaaf0s1ee578d 95c6l50e4a1f72cfar5 tc961e4hf28icbs b761a3fielfedb 9fbf91a->407b6e5c | * REQUIRED |
| f9abP39lecads4e3c192 7a6f2cel00eeara abth97ibbcs fbf7ie7l621d9e7e a2025-c31e818d8d>d5c63bf | * REQUIRED |
| 6851P15a34l1e4ce8badd5s4e c67c718l71eea7br f819fth3bis c697faie4412l6d7fe 44-76>bc2c4b4652 | * REQUIRED |
| cP4bclea2s843fbce2 3cleear 6ft2his 1433df049id624592a5a2fc35214d3a0feffl5d a0d-007>ec05d5e | * REQUIRED |
| 73b9b761cf4188P7ld52dead06s216e c639419alce1abr d50t69hia2es f8abf8d7fi2d5ae42alc79d e-4>f | * REQUIRED |
| 114e966620b4a5302cPle1a5se fc34l5e8bbafcr 087t8hd3i0s17cf e354ef1f8ie7dfcdf2eal9dd8 8->382 | * REQUIRED |
| 0Pf96d050ebledafs2eac1e33 41c93d3f038l8ec395ar cetf8983heebd0bi4s26e 4a6f50febie8ld 5-49b> | * REQUIRED |
| d6Pld1ea544467s3e56 be0abe447122c6laec548b8af842397r8f6c dthe5ifbs7f d3fic67ea7lde -0>5cd8 | * REQUIRED |
| 59Ple79fa5ees8e5977f8ecc7 clfeb6ear1a7 be9d8teh80a09ec91fif16s6d2 6aff2i6e57lddddec -3a>cd | * REQUIRED |
| a3eca62P459ld99e87207f4aesbed81e4 acl48e1451eda0r02c6 d649tbhai79e2s a1f6iealde6 -960e>eb0 | * REQUIRED |
| 330509Pl1ef3asb8ee74 3c5lb2077468026265e7ar4067 0a9b3acc7at59hica2s1 06ffi8eel2d -53>f8b6e | * REQUIRED |
| 3017P17lf8a7b3e4e0247a607sfea3 487dcle1ar84 bthf368bfifs594 af6fb3ie0484le3d0e 1-df03>76be | * REQUIRED |
| 07fP66le7b71ba5sec 4cdbdb0c9leda1r thci65b6sd 98dc5fbi887el283d1f5 -9ab>b4bcb4925765b75b93 | * REQUIRED |
| 6P90cefl86ee1da0sb52e3d68 c1elea2aef96er b88e54teh4ies1ebf c0f38aiebe5albd46f 7-19b>279ec0 | * REQUIRED |
| 44cf3ebP7dl4ead5s11e63 cleae94d7ra ete1h6a36i4177s e4fif151eae8elcd -109fddd09>9a16ba88c6d | * REQUIRED |
| 379c1P76e7l4e4b4e3f0ab2a9seab3ebd c4f2f8l53a6eafrb34 26ft2dhfais76a547 fielda1 75->4d77173 | * REQUIRED |
| 7d8cP841elea6805se ecblbeaa98337r2f8 cca2dt72df0h2ie3s4 fica245el718d836 1f5f-15>d42f5a9f2 | * REQUIRED |
| 4929342Pae0c7fl0efas6e1ad35d2c dc00lb5e65a2br8 t9315h8i3ae1s fiebe879ld 3a-6fd0b682>c915ee | * REQUIRED |
| dPl2ceasf9b12e6eb00 eb32c5c4l6ea3rc972 a4t0h56i633bsa65e7 fi7ec6fe7bldf522d -82ff54>bc72a1 | * REQUIRED |
| cafd08Pl2ef645as2396930e 4c7lec6a07dr b9t9ehb0i5s 0907162f8iel4904d1e3 42870-00>e4a1763af0 | * REQUIRED |
| 661P9cle50831a4se cle6ea057r0e6 aa3aat61hf0185i5as d9b746437f560d5511ie1l85e4da 46-7>1e82b | * REQUIRED |
| bc27b740a9803bPc4lfbea6944abs14e267 7cl8ea3r6 ct4he4is fi9abb5217db47de6l8df -816ade34>366 | * REQUIRED |
| dbf5360Pb2lcb1ed4aa73se37e267 c88lc2e14eb0a1r8 t7h3eiafs27d 143f2640223i09e5lf1948d eb86-> | * REQUIRED |
| cba150P67lae299a8s4e dc7l226e0efffc6e98a1cr272c22a3 1t51dahis6 b6a68f8926eib9edeld0 -86e>f | * REQUIRED |
| 6190P5559b29lea2c37s274ece52705e 7559c3a3le6c5a8rceb fe9etdh1i2s fi9ede2lc39d cb0-33b>acad | * REQUIRED |
| 66Pl3ebeec8a5asa9e a94befc3l1fe812ab2ecrfc711 ta52hisf1e6a fai79el6f5d2 8df->a210bfed237b1 | * REQUIRED |
| 0fP3leaf07f533sd44ed9112 9ac29ea3508el79974e1303c57a3r t753hids9 f7218i3446eld ba3e47e->82 | * REQUIRED |
| 6c25e1c5Pl2c4d0abe1a8se f6a7cl847ea86a8979fb45rae0 tc5hids4 f0b5fecai5ec32ldf 6-6>29df4ad0 |
* REQUIRED |
| 83b9Pl3ea50se0e223ee c709l2ea8dcbabacdrbe79 te1h5isd4 f7101d98a46bfc8ieff76elbc1fed 8182-> |
* REQUIRED |
| 24eP9l2ea2a463ds02b12efb9dc1 05ce0b44l0e76da65dr4a3 69thdiesedf1c27c 9fie4l6dd4 -8d390>f65 |
* REQUIRED |
| 34be00aPfdable69d5af44se c41lf07f62efaar7c2 28dtf6hi16f9s f654i8a77eld6 8206->4e373a3144bc | * REQUIRED |
| 083P23l8ea76b29fasb29ea 7c4l3ee0b7aac6ar2e8 6t5h3779ea60i30s67 fdfieel93dd25c5b55 0f-075>0 | * REQUIRED |
| 2P917l443f5e1asfe c95lfecc9ar26e ac49td83cffh657e3ieebd7sf ffd0c5feiel4dd d05-8016>04254c7 | * REQUIRED |
| a47604d7f100f3Ple918ca638es06e5 cl4ee93baaa7er 3f0fthbc9icas123f5 1a36fibb93el9d1e a3->724 | * REQUIRED |
| 3179160ba1Pl10ease5ecc4844 d934c57le88a5877rc52 f3tahf45i2e364asbf98 fd88feiea3lf09ad ->f2 | * REQUIRED |
| ae86fePd6la2ea48sbe 0577f28d4ac8le4far0 te285e5858e04hia3s77 7fi9delc8df b-c4ef82f2f>a29c4 | * REQUIRED |
| 1c5d4dfPl89deaac8ee544s01ea17 50clae889areb29 tchisec7c8e9 fi542efl9d8fdf222d e97b3fc7-4>d | * REQUIRED |
| 4ebPlbcecas3e e7cbl39917e5acfr th07ai063s1e ab1465fec58137ie03ee8lb7dd -58ea01bb3>bd260097 | * REQUIRED |
| 6Plea22354se5213160f737042 9f0cdf9l30ea8car 1eb5this 55f516ai3678efa95ddl4d1c57 e0-b31>3f7 | * REQUIRED |
| 445083e53Pelec8b1asef659 9f692fcc1lfeaa4rba 1tb3e3051hce43fis bb30df1ieddl81046d1f8 73a->5 | * REQUIRED |
| 659a43Pbal77ea78se a7f0fcaleeacc666r173 tfb0h43fdi8593s 28050fe2f4ibe40lda 6f6410b16546->4 | * REQUIRED |
Important: 21Y4ou may be m312akf0ing use odf2 4edauto4mated fodrm-filling scobftwaree. 9Thic8s 1tbfypeb69 of softwar1e4 efcan tr5cigbger 0oubr hidd3en s4fpam-fdetectidone sc7ystem, 42which w5ill0 6block cyou9 efr5om esubmditt0ing tdhis form. 4P0lea3se s2elect “cFi27x This”b6c5610009 4e0be9b627733ffa3e407f45b9c9a9ae0261oa0bfr0ef9 165a388b28b4591c90bom3p86l33183eting 40th2ef for512c1m3505d 1cd8bicn 983or5ad2er tdo 5corrbeebc8t1 t07he9e p9rfo5b866le5damc.2d209 It appears that the problem could not be automatically corrected. Please clear any field which appears above with corresponding instructions. We apologize for the inconvenience and we appreciate your understanding. |
Important: Youa may db56e meak4ingc use3 of auct3bo6mated form-c8fillin0g software. 7Th0is t5ype of s5oftwadre c5an t8rigg0er our h1idden spa4m8-det4fection s4fystem, which will block4 you f5ro3m s2ubmittidn1g this form. 5It appears t2hat the 9pfrobl9aem4 c7could1 not be 2automaticall3y cor3r2ected. Plfease cl5ear 0any fie3ld whiceh ap9apears above with aco1rrespondin8g9f instbeructionsf026482e4724 0a81eb1f7b585906bc708ec2e8c1ff2bff8o218drb248e4 3f11d43694c9com0pd36let8ingf t7h94e f2orm in e0orde6rc to c855eo31rr6bbe4ct thea prdoeblem.e W5fe1 9ap3bf5ologizc0e for the inbcb2onveni1ence ad3nadd wea a1pp8reci4da6te6 youra unfdedrs578tandin67g.f9 |
| Important: It appears that you are accessing this form from an unofficial third-party source. Submissions originating from such sources will not be accepted. Please direct your Web browser to the corresponding page on our official site in order to make your submission. |
|
Online Privacy Statement
This privacy policy is in effect for bakersacres.com.
Protecting your privacy is important to us. We hope that the following statement will help you to understand how we collect, use, and safeguard the information conveyed to us through this Web site.
I. Information gathered from visitors
As with other Web sites, any information which is sent from your Web browser (or other Web client) to our server and any connection details, such as the originating IP address and the time of each request, may be logged, or, in some circumstances, may be relayed (such as through a contact form) via e-mail.
HTTP cookies may be used in order to recall visitor preferences when interacting with this Web server and to enhance the quality of our service.
Where registration is required, applicable details submitted by the user will be stored permanently on the server. Additional collected information may be associated with user accounts in order to enhance the quality of our service.
Details and content which are voluntarily provided, such as contact information and answers to survey questions, may also be permanently stored.
II. How the information is used
The information is used in order to enrich the end-user experience when connecting to this Web server and to enhance the quality of our service.
Except in cases where the visitor makes contrary request, we may use provided contact information in order to communicate with said visitor in the future and we may share some visitor details with third-parties.
We reserve the right to retain and share applicable information for and with law enforcement officials and legal counsel, if compelled or motivated to do so.
We also reserve the right to check connection details against third-party blacklists, in order to maintain the security and availability of our service.
Where applicable, payment card numbers, security codes, and expiration dates will be transferred securely and in real-time to an online payment processor in order to authorize the transaction and will not be stored on this server.
III. Opting-out or updating information
If you wish to have any associated account or information removed from or updated on this server, or to opt-out of specific usage for that data, you may use any appropriate contact method or details provided through this Web site to communicate those wishes to the site owner or to the site administrator. If you are unable to find appropriate contact method or details through this Web site, you may use publicly-available WHOIS information, pursuant to same and other applicable restrictions. Requests will generally be processed within one business day.
IV. Inquiring about stored details or about this privacy statement
You may use any appropriate contact method or details provided through this Web site to communicate applicable questions to the site owner or to the site administrator. If you are unable to find appropriate contact method or details through this Web site, you may use publicly-available WHOIS information, pursuant to same and other applicable restrictions. Inquiries will generally be processed within one business day.
V. Security of service and confidentiality of data
In order to protect the integrity of data destined for, residing on, and outgoing from this server, we have implemented strict security policies and we perform daily vulnerability audits. Any financial transaction initiated through this Web site will be secured using high-grade encryption.
All recorded visitor data is considered to be confidential. Such data will be accessible only to authorized personnel and entities.
VI. Updates to this document
This document may be updated from time to time; please revisit this page in order to stay informed about our current policies.
|
|
