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  <td width=3D43 valign=3Dtop style=3D'width:31.95pt;border-top:none;border=
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  </td>
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 <tr>
  <td width=3D139 valign=3Dtop style=3D'width:103.95pt;border:solid windowt=
ext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
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  <p class=3DMsoNormal><span style=3D'font-size:9.0pt;mso-bidi-font-size:12=
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  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o:p></span></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:36.0pt;border-top:none;border-=
left:none;
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  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
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  </td>
  <td width=3D48 valign=3Dtop style=3D'width:36.0pt;border-top:none;border-=
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  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#65301;</sp=
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  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
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  </td>
  <td width=3D36 valign=3Dtop style=3D'width:27.0pt;border:none;border-righ=
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  </td>
  <td width=3D167 valign=3Dtop style=3D'width:125.1pt;border-top:none;borde=
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  <td width=3D43 valign=3Dtop style=3D'width:31.95pt;border-top:none;border=
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text .5pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
";
  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#65305;</sp=
an><span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
 </tr>
 <tr>
  <td width=3D139 valign=3Dtop style=3D'width:103.95pt;border:solid windowt=
ext 1.0pt;
  border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:s=
olid windowtext .5pt;
  padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal><span style=3D'font-size:9.0pt;mso-bidi-font-size:12=
.0pt;
  font-family:"MS Mincho";mso-ascii-font-family:Century;mso-hansi-font-fami=
ly:
  Century'>&#12495;&#12531;&#12489;&#12523;&#12525;&#12483;&#12463;</span><=
span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:36.0pt;border-top:none;border-=
left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
";
  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#65297;&#65=
296;</span><span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:36.0pt;border-top:none;border-=
left:none;
  border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
";
  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#65297;&#65=
296;</span><span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
  <td width=3D36 valign=3Dtop style=3D'width:27.0pt;border:none;border-righ=
t:solid windowtext 1.0pt;
  mso-border-left-alt:solid windowtext .5pt;mso-border-left-alt:solid windo=
wtext .5pt;
  mso-border-right-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span lan=
g=3DEN-US
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p>&nbsp;</o:p></sp=
an></p>
  </td>
  <td width=3D167 valign=3Dtop style=3D'width:125.1pt;border-top:none;borde=
r-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal><span style=3D'font-size:9.0pt;mso-bidi-font-size:12=
.0pt;
  font-family:"MS Mincho";mso-ascii-font-family:Century;mso-hansi-font-fami=
ly:
  Century'>&#12458;&#12540;&#12488;&#12510;&#12481;&#12483;&#12463;&#12511;=
&#12483;&#12471;</span><span
  style=3D'font-size:8.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
";
  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12520;</sp=
an><span
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
";
  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12531;</sp=
an><span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
  <td width=3D43 valign=3Dtop style=3D'width:31.95pt;border-top:none;border=
-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span lan=
g=3DEN-US
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'>10<o:p></o:p></span><=
/p>
  </td>
  <td width=3D43 valign=3Dtop style=3D'width:31.95pt;border-top:none;border=
-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span lan=
g=3DEN-US
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'>10<o:p></o:p></span><=
/p>
  </td>
 </tr>
 <tr style=3D'mso-yfti-lastrow:yes'>
  <td width=3D139 valign=3Dtop style=3D'width:103.95pt;border:none;mso-bord=
er-top-alt:
  solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal><span lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi=
-font-size:
  12.0pt'><o:p>&nbsp;</o:p></span></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:36.0pt;border:none;mso-border-=
top-alt:
  solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span lan=
g=3DEN-US
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p>&nbsp;</o:p></sp=
an></p>
  </td>
  <td width=3D48 valign=3Dtop style=3D'width:36.0pt;border:none;mso-border-=
top-alt:
  solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
";
  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12288;&#12=
288;&#12288;&#12288;</span><span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
  <td width=3D36 valign=3Dtop style=3D'width:27.0pt;border:none;border-righ=
t:solid windowtext 1.0pt;
  mso-border-right-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span lan=
g=3DEN-US
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p>&nbsp;</o:p></sp=
an></p>
  </td>
  <td width=3D167 valign=3Dtop style=3D'width:125.1pt;border-top:none;borde=
r-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal><span style=3D'font-size:9.0pt;mso-bidi-font-size:12=
.0pt;
  font-family:"MS Mincho";mso-ascii-font-family:Century;mso-hansi-font-fami=
ly:
  Century'>&#12479;&#12452;&#12511;&#12531;&#12464;&#12505;&#12523;&#12488;=
&#38306;&#20418;</span><span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
  <td width=3D43 valign=3Dtop style=3D'width:31.95pt;border-top:none;border=
-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho=
";
  mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#65304;</sp=
an><span
  lang=3DEN-US style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'><o:p></o=
:p></span></p>
  </td>
  <td width=3D43 valign=3Dtop style=3D'width:31.95pt;border-top:none;border=
-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
  mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid window=
text .5pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span lan=
g=3DEN-US
  style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt'>11<o:p></o:p></span><=
/p>
  </td>
 </tr>
</table>

</div>

<p class=3DMsoNormal><span lang=3DEN-US style=3D'font-size:12.0pt'><o:p>&nb=
sp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;font-family:"MS Mincho=
";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#20869;&#2348=
1;&#12363;&#12425;&#12415;&#12427;&#12392;&#27231;&#26800;&#19978;&#12398;&=
#12488;&#12521;&#12502;&#12523;&#12399;&#12411;&#12392;&#12435;&#12393;&#12=
394;&#12356;&#12398;&#12364;&#12431;&#12363;&#12426;&#12414;&#12377;&#12290=
;&#12498;&#12517;&#12540;&#12510;&#12531;&#12456;&#12521;&#12540;&#65288;&#=
12358;&#12387;&#12363;&#12426;&#12511;&#12473;&#65289;&#12364;&#22823;&#213=
22;&#12391;&#12377;&#12290;&#35328;&#12356;&#25563;&#12360;&#12428;&#12400;=
&#26085;&#24120;&#12398;&#28857;&#26908;&#12434;&#30906;&#23455;&#12395;&#1=
2375;&#12390;&#12356;&#12428;&#12400;&#38450;&#12370;&#12427;&#12418;&#1239=
8;&#12364;&#22810;&#12356;&#12398;&#12391;&#12377;&#12290;&#65314;&#65332;&=
#12354;&#12364;&#12426;&#12392;&#12461;&#12540;&#12398;&#38281;&#12376;&#12=
371;&#12415;&#12399;&#38918;&#20301;&#12364;&#23395;&#31680;&#12395;&#12424=
;&#12426;&#20837;&#12428;&#26367;&#12431;&#12427;&#12371;&#12392;&#12399;&#=
12354;&#12387;&#12390;&#12418;&#12289;&#12371;&#12398;&#65298;&#12388;&#123=
91;&#27083;&#25104;&#27604;&#12364;&#65300;&#65304;&#65285;&#12434;&#12375;=
&#12417;&#12427;&#12398;&#12391;&#12377;&#12290;&#20294;&#12375;&#12289;&#1=
2461;&#12540;&#12398;&#38281;&#12376;&#12371;&#12415;&#12399;&#26368;&#3681=
7;&#12522;&#12514;&#12467;&#12531;&#12461;&#12540;&#12398;&#26222;&#21450;&=
#12395;&#12424;&#12426;&#28187;&#23569;&#12375;&#12388;&#12388;&#12354;&#12=
426;&#12414;&#12377;&#12290;&#20107;&#25925;&#12395;&#12424;&#12427;&#20381=
;&#38972;&#12399;&#19968;&#33324;&#36947;&#36335;&#12289;&#39640;&#36895;&#=
36947;&#36335;&#12392;&#12418;&#12395;&#31532;&#65299;&#20301;&#12391;&#123=
63;&#12394;&#12426;&#12398;&#27604;&#29575;&#12434;&#12375;&#12417;&#12390;=
&#12356;&#12414;&#12377;&#12290;</span><span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;font-family:"MS Mincho=
";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12288;&#2615=
2;&#20170;&#12398;&#36947;&#36335;&#20107;&#24773;&#12363;&#12425;&#12289;&=
#25925;&#38556;&#12398;&#38555;&#12398;&#20108;&#27425;&#20107;&#25925;&#12=
395;&#12418;&#30446;&#12434;&#12416;&#12369;&#12427;&#24517;&#35201;&#12364=
;&#12391;&#12390;&#12365;&#12414;&#12375;&#12383;&#12290;&#29305;&#12395;&#=
39640;&#36895;&#36947;&#36335;&#12395;&#12362;&#12369;&#12427;&#25937;&#255=
88;&#20316;&#26989;&#20013;&#12398;&#24460;&#26041;&#35686;&#25106;&#12395;=
&#12388;&#12356;&#12390;&#12399;&#12289;&#65322;&#65313;&#65318;&#12391;&#1=
2399;&#65298;&#21488;&#20307;&#21046;&#12391;&#20986;&#21205;&#12375;&#1239=
0;&#12356;&#12414;&#12377;&#12290;&#19968;&#33324;&#36947;&#36335;&#12395;&=
#12362;&#12356;&#12390;&#12418;&#12381;&#12358;&#12391;&#12377;&#12364;&#12=
289;&#25937;&#25588;&#12434;&#20381;&#38972;&#12373;&#12428;&#12427;&#26041=
;&#12418;&#24460;&#26041;&#12395;&#23550;&#12377;&#12427;&#35686;&#25106;&#=
12399;&#24847;&#22806;&#12392;&#28961;&#38931;&#30528;&#12391;&#12377;&#122=
90;&#23433;&#20840;&#12395;&#23550;&#12377;&#12427;&#32771;&#12360;&#26041;=
&#12434;&#20170;&#19968;&#24230;&#32771;&#12360;&#12390;&#12415;&#12383;&#1=
2356;&#12418;&#12398;&#12391;&#12377;&#12290;</span><span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:16.0pt;mso-bidi-font-size:12.=
0pt;
font-family:"MS Mincho";mso-ascii-font-family:Century;mso-hansi-font-family:
Century'>&#33258;&#21205;&#36554;&#12398;&#23433;&#20840;&#35013;&#20633;</=
span><span
lang=3DEN-US style=3D'font-size:16.0pt;mso-bidi-font-size:12.0pt'><o:p></o:=
p></span></p>

<p class=3DMsoNormal style=3D'margin-left:24.0pt;text-indent:-24.0pt;mso-ch=
ar-indent-count:
-2.0'><span style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-fon=
t-family:
Century;mso-hansi-font-family:Century'>&#12288;&#9679;&#12450;&#12463;&#124=
86;</span><span
style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12452;</span=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#12502;&#12475;&#12540;&#12501;&#12486;</sp=
an><span
style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12452;</span=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#65288;&#33021;&#21205;&#30340;&#12539;&#27=
963;&#30330;&#65289;&#12539;&#12539;&#20107;&#25925;&#12434;&#26410;&#28982=
;&#12395;&#12405;&#12379;&#12368;&#12383;&#12417;&#12398;&#12418;&#12398;&#=
12288;&#12288;&#65313;&#65314;&#65331;&#65295;&#12288;&#65313;&#65332;&#365=
54;&#12471;&#12501;&#12488;&#12525;&#12483;&#12463;&#65295;&#12288;&#65300;=
&#65335;&#65331;&#65295;&#12288;&#12450;&#12463;&#12486;</span><span
style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12452;</span=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#12502;&#12539;&#12469;&#12473;&#12506;&#12=
531;&#12471;</span><span
style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12520;</span=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#12531;&#12288;&#12288;&#12488;&#12521;&#12=
463;&#12471;&#12519;&#12531;&#12467;&#12531;&#12488;&#12525;&#12540;&#12523=
;&#65295;&#12288;&#12495;&#12452;&#12510;&#12454;&#12531;&#12488;&#12473;&#=
12488;</span><span
style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12484;</span=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#12503;&#12521;&#12531;&#12503;</span><span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span lang=3DEN-US style=3D'font-size:12.0pt'><o:p>&nb=
sp;</o:p></span></p>

<p class=3DMsoNormal><span lang=3DEN-US style=3D'font-size:12.0pt'><o:p>&nb=
sp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;font-family:"MS Mincho=
";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12288;&#9679=
;&#12497;&#12483;&#12471;&#12502;&#12475;&#12540;&#12501;&#12486;</span><sp=
an
style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12452;</span=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#65288;&#21463;&#21205;&#30340;&#65289;&#12=
539;&#12539;&#12539;&#19975;&#19968;&#12398;&#26178;&#12398;&#12383;&#12417=
;&#12398;&#20055;&#21729;&#20445;&#35703;&#35013;&#32622;</span><span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;font-family:"MS Mincho=
";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12288;&#1228=
8;&#24231;&#24109;&#12505;&#12523;&#12488;&#65295;&#12288;&#65331;&#65330;&=
#65331;&#12456;&#12450;&#12496;</span><span
style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12484;</span=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#12464;&#65295;&#12288;&#12504;&#12483;&#12=
489;&#12524;&#12473;&#12488;&#65295;&#12288;&#34909;&#31361;&#23433;&#20840=
;&#12508;&#12487;&#12452;</span><span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;font-family:"MS Mincho=
";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12288;&#1228=
8;&#12469;&#12452;&#12489;&#12452;&#12531;&#12497;&#12463;&#12488;&#12499;&=
#12540;&#12512;</span><span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span lang=3DEN-US style=3D'font-size:12.0pt'><o:p>&nb=
sp;</o:p></span></p>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;font-family:"MS Mincho=
";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12288;&#1228=
8;&#36554;&#12398;&#29305;&#24615;&#12434;&#30693;&#12427;&#12371;&#12392;&=
#12399;&#22823;&#20999;&#12391;&#12377;&#12364;&#12289;&#38480;&#30028;&#12=
434;&#36229;&#12360;&#12390;&#12398;&#20351;&#29992;&#12399;&#12384;&#12417=
;&#12391;&#12377;&#12290;&#12371;&#12398;&#20013;&#12391;&#12489;&#12521;&#=
12452;&#12496;&#12540;&#12364;&#21807;&#19968;&#20986;&#26469;&#12427;&#234=
33;&#20840;&#23550;&#31574;&#12399;&#12471;&#12540;&#12488;&#12505;&#12523;=
&#12488;&#12384;&#12369;&#12391;&#12377;&#12290;</span><span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal><span lang=3DEN-US style=3D'font-size:12.0pt'><o:p>&nb=
sp;</o:p></span></p>

<p class=3DMsoNormal><span lang=3DEN-US style=3D'font-size:12.0pt'><o:p>&nb=
sp;</o:p></span></p>

<p class=3DMsoNormal style=3D'text-indent:12.0pt;mso-char-indent-count:1.0'=
><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#9679;&#12471;&#12540;&#12488;&#12505;&#125=
23;&#12488;&#30528;&#29992;&#29575;&#24180;&#24230;&#27604;&#36611;</span><=
span
lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<table class=3DMsoNormalTable border=3D1 cellspacing=3D0 cellpadding=3D0
 style=3D'margin-left:40.95pt;border-collapse:collapse;border:none;mso-bord=
er-alt:
 solid windowtext .5pt;mso-padding-alt:0mm 4.95pt 0mm 4.95pt;mso-border-ins=
ideh:
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 <tr style=3D'page-break-inside:avoid'>
  <td width=3D139 valign=3Dtop style=3D'width:104.05pt;border:solid windowt=
ext 1.0pt;
  mso-border-alt:solid windowtext .5pt;padding:0mm 4.95pt 0mm 4.95pt'>
  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:C=
entury;
  mso-hansi-font-family:Century'>&#30528;&#29992;&#29575;</span><span
  lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>
  </td>
  <td width=3D173 colspan=3D2 valign=3Dtop style=3D'width:129.95pt;border:s=
olid windowtext 1.0pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:C=
entury;
  mso-hansi-font-family:Century'>&#24179;&#25104;&#65297;&#65301;&#24180;</=
span><span
  lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>
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  <td width=3D168 colspan=3D2 valign=3Dtop style=3D'width:126.0pt;border:so=
lid windowtext 1.0pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:C=
entury;
  mso-hansi-font-family:Century'>&#24179;&#25104;&#65297;&#65302;&#24180;</=
span><span
  lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>
  </td>
 </tr>
 <tr style=3D'page-break-inside:avoid;height:17.25pt'>
  <td width=3D139 valign=3Dtop style=3D'width:104.05pt;border:solid windowt=
ext 1.0pt;
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olid windowtext .5pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:C=
entury;
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  style=3D'font-size:12.0pt'><o:p></o:p></span></p>
  </td>
  <td width=3D89 valign=3Dtop style=3D'width:66.95pt;border-top:none;border=
-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
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text .5pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:C=
entury;
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  </td>
  <td width=3D84 valign=3Dtop style=3D'width:63.0pt;border-top:none;border-=
left:none;
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text .5pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:C=
entury;
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  </td>
  <td width=3D84 valign=3Dtop style=3D'width:63.0pt;border-top:none;border-=
left:none;
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text .5pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
  style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:C=
entury;
  mso-hansi-font-family:Century'>&#24859;&#30693;</span><span lang=3DEN-US
  style=3D'font-size:12.0pt'><o:p></o:p></span></p>
  </td>
  <td width=3D84 valign=3Dtop style=3D'width:63.0pt;border-top:none;border-=
left:none;
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text .5pt;
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  <p class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><span
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entury;
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  </td>
 </tr>
 <tr style=3D'page-break-inside:avoid;height:18.75pt'>
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ext 1.0pt;
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olid windowtext .5pt;
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entury;
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65289;</span><span
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  </td>
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-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
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text .5pt;
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entury;
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left:none;
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text .5pt;
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entury;
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an
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left:none;
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text .5pt;
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left:none;
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text .5pt;
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entury;
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ext 1.0pt;
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olid windowtext .5pt;
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entury;
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  <td width=3D89 valign=3Dtop style=3D'width:66.95pt;border-top:none;border=
-left:
  none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1=
.0pt;
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text .5pt;
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entury;
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an
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left:none;
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text .5pt;
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entury;
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left:none;
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text .5pt;
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entury;
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left:none;
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text .5pt;
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entury;
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 </tr>
</table>

<p class=3DMsoNormal><span style=3D'font-size:12.0pt;font-family:"MS Mincho=
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style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
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lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:11.95pt;mso-para-margin-left:1.14=
gd'><span
style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#12288;&#12456;&#12450;&#12496;&#12483;&#12=
464;&#12398;&#26222;&#21450;&#12399;&#30446;&#12434;&#35211;&#24373;&#12427=
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<p class=3DMsoNormal style=3D'margin-left:11.95pt;mso-para-margin-left:1.14=
gd;
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<p class=3DMsoNormal style=3D'margin-left:11.95pt;mso-para-margin-left:1.14=
gd;
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style=3D'font-size:12.0pt'><o:p>&nbsp;</o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:11.95pt;mso-para-margin-left:1.14=
gd;
text-indent:12.0pt;mso-char-indent-count:1.0'><span style=3D'font-size:12.0=
pt;
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lang=3DEN-US style=3D'font-size:12.0pt'><o:p></o:p></span></p>

<p class=3DMsoNormal style=3D'margin-left:47.95pt;mso-para-margin-left:2.28=
gd;
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font-family:"MS Mincho";mso-ascii-font-family:Century;mso-hansi-font-family:
Century'>&#12288;&#12288;&#33258;&#20998;&#12398;&#36554;&#12434;&#20351;&#=
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08;&#12398;&#20181;&#26041;&#12434;&#35226;&#12360;&#12427;&#12418;&#12398;=
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lang=3DEN-US style=3D'font-size:12.0pt'>OIL</span><span style=3D'font-size:=
12.0pt;
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pan><span
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style=3D'font-size:9.0pt;mso-bidi-font-size:12.0pt;font-family:"MS Mincho";
mso-ascii-font-family:Century;mso-hansi-font-family:Century'>&#12484;</span=
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style=3D'font-size:12.0pt;font-family:"MS Mincho";mso-ascii-font-family:Cen=
tury;
mso-hansi-font-family:Century'>&#12471;&#12515;&#12540;&#28082;&#31561;&#12=
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