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Please explain how you have been harmed by this decision or circumstance [1]) /Type /Annot /StructParent 25 >> endobj 21 0 obj << /AP << /N 89 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 649.56 539.52 673.92] /Subtype /Widget /T (12 Please explain how you have been harmed by this decision or circumstance 2) /TU (12. Please explain how you have been harmed by this decision or circumstance [2]) /Type /Annot /StructParent 26 >> endobj 22 0 obj << /AP << /N 90 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 624.24 539.52 648.6] /Subtype /Widget /T (12 Please explain how you have been harmed by this decision or circumstance 3) /TU (12. Please explain how you have been harmed by this decision or circumstance [3]) /Type /Annot /StructParent 27 >> endobj 23 0 obj << /AP << /N 91 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 598.92 539.64 623.28] /Subtype /Widget /T (12 Please explain how you have been harmed by this decision or circumstance 4) /TU (12. Please explain how you have been harmed by this decision or circumstance [4]) /Type /Annot /StructParent 28 >> endobj 24 0 obj << /AP << /N 92 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 573.72 539.52 598.08] /Subtype /Widget /T (12 Please explain how you have been harmed by this decision or circumstance 5) /TU (12. Please explain how you have been harmed by this decision or circumstance [5]) /Type /Annot /StructParent 29 >> endobj 25 0 obj << /AP << /N 93 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 548.4 539.52 572.76] /Subtype /Widget /T (12 Please explain how you have been harmed by this decision or circumstance 6) /TU (12. Please explain how you have been harmed by this decision or circumstance [6]) /Type /Annot /StructParent 30 >> endobj 26 0 obj << /AP << /N 94 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 485.28 539.52 509.16] /Subtype /Widget /T (13 Please list the MAPP allegedly violated misinterpreted or misapplied 1) /TU (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [1]) /Type /Annot /StructParent 31 >> endobj 27 0 obj << /AP << /N 95 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 459.96 539.52 484.32] /Subtype /Widget /T (13 Please list the MAPP allegedly violated misinterpreted or misapplied 2) /TU (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [2]) /Type /Annot /StructParent 32 >> endobj 28 0 obj << /AP << /N 96 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 434.64 539.52 459] /Subtype /Widget /T (13 Please list the MAPP allegedly violated misinterpreted or misapplied 3) /TU (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [3]) /Type /Annot /StructParent 33 >> endobj 29 0 obj << /AP << /N 97 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 409.44 539.52 433.8] /Subtype /Widget /T (13 Please list the MAPP allegedly violated misinterpreted or misapplied 4) /TU (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [4]) /Type /Annot /StructParent 34 >> endobj 30 0 obj << /AP << /N 98 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 333.48 539.64 357.36] /Subtype /Widget /T (your efforts 1) /TU (your efforts [1]) /Type /Annot /StructParent 35 >> endobj 31 0 obj << /AP << /N 99 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 308.16 539.52 332.52] /Subtype /Widget /T (your efforts 2) /TU (your efforts [2]) /Type /Annot /StructParent 36 >> endobj 32 0 obj << /AP << /N 100 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 282.84 539.52 307.2] /Subtype /Widget /T (your efforts 3) /TU (your efforts [3]) /Type /Annot /StructParent 37 >> endobj 33 0 obj << /AP << /N 101 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 257.64 539.64 282] /Subtype /Widget /T (your efforts 4) /TU (your efforts [4]) /Type /Annot /StructParent 38 >> endobj 34 0 obj << /AP << /N 102 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [230.04 232.32 538.08 256.68] /Subtype /Widget /T (undefined_2) /TU (undefined) /Type /Annot /StructParent 39 >> endobj 35 0 obj << /AP << /N 103 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [154.32 207 539.28 231] /Subtype /Widget /T (With whom did you communicate) /TU (With whom did you communicate) /Type /Annot /StructParent 40 >> endobj 36 0 obj << /AP << /N 104 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 118.2 540.24 142.56] /Subtype /Widget /T (individual with similar experience their addresss and their phone numbers 1) /TU (individual with similar experience, their address\(s\) and their phone number\(s [1]) /Type /Annot /StructParent 41 >> endobj 37 0 obj << /AP << /N 105 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 87 0 R >> /Font << /Helv 88 0 R >> >> /F 4 /FT /Tx /P 72 0 R /Rect [72 92.88 540.24 117.24] /Subtype /Widget /T (individual with similar experience their addresss and their phone numbers 2) /TU (individual with similar experience, their address\(s\) and their phone number\(s [2]) /Type /Annot /StructParent 42 >> endobj 38 0 obj << /AP << /N 106 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 737.64 540.24 762.24] /Subtype /Widget /T (1) /TU ([1]) /Type /Annot /StructParent 43 >> endobj 39 0 obj << /AP << /N 109 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 712.32 540.24 736.92] /Subtype /Widget /T (2) /TU ([2]) /Type /Annot /StructParent 44 >> endobj 40 0 obj << /AP << /N 110 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 687.12 540.24 711.72] /Subtype /Widget /T (3) /TU ([3]) /Type /Annot /StructParent 45 >> endobj 41 0 obj << /AP << /N 111 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 624.24 539.52 648.24] /Subtype /Widget /T (16 Please describe the outcome or remedy you seek for this complaint 1) /TU (16. Please describe the outcome or remedy you seek for this complaint [1]) /Type /Annot /StructParent 46 >> endobj 42 0 obj << /AP << /N 112 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 598.92 539.52 623.52] /Subtype /Widget /T (16 Please describe the outcome or remedy you seek for this complaint 2) /TU (16. Please describe the outcome or remedy you seek for this complaint [2]) /Type /Annot /StructParent 47 >> endobj 43 0 obj << /AP << /N 113 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 573.72 539.52 598.32] /Subtype /Widget /T (16 Please describe the outcome or remedy you seek for this complaint 3) /TU (16. Please describe the outcome or remedy you seek for this complaint [3]) /Type /Annot /StructParent 48 >> endobj 44 0 obj << /AP << /N 114 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 548.4 539.52 573] /Subtype /Widget /T (16 Please describe the outcome or remedy you seek for this complaint 4) /TU (16. Please describe the outcome or remedy you seek for this complaint [4]) /Type /Annot /StructParent 49 >> endobj 45 0 obj << /AP << /N 115 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 523.08 539.52 547.68] /Subtype /Widget /T (16 Please describe the outcome or remedy you seek for this complaint 5) /TU (16. Please describe the outcome or remedy you seek for this complaint [5]) /Type /Annot /StructParent 50 >> endobj 46 0 obj << /AP << /N 116 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [160.174 457.961 540.694 482.321] /Subtype /Widget /T (17 Have you filed this report with any other agency or an attorney Yes No) /TU (17. Have you filed this report with any other agency or an attorney? Yes [ ] No) /Type /Annot /StructParent 53 >> endobj 47 0 obj << /AP << /N 117 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 409.08 540.24 433.32] /Subtype /Widget /T (18 Do you have any suggestion for proposed action to address or resolve the complaintgrievance 1) /TU (18. Do you have any suggestion for proposed action to address or resolve the complaint/grievance [1]) /Type /Annot /StructParent 54 >> endobj 48 0 obj << /AP << /N 118 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 383.76 540.24 408.36] /Subtype /Widget /T (18 Do you have any suggestion for proposed action to address or resolve the complaintgrievance 2) /TU (18. Do you have any suggestion for proposed action to address or resolve the complaint/grievance [2]) /Type /Annot /StructParent 55 >> endobj 49 0 obj << /AP << /N 119 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 358.32 540.24 382.92] /Subtype /Widget /T (18 Do you have any suggestion for proposed action to address or resolve the complaintgrievance 3) /TU (18. Do you have any suggestion for proposed action to address or resolve the complaint/grievance [3]) /Type /Annot /StructParent 56 >> endobj 50 0 obj << /AP << /N 120 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 295.2 540.24 319.44] /Subtype /Widget /T (19 Do you have any additional information and comments use separate sheet if necessary 1) /TU (19. Do you have any additional information and comments \(use separate sheet if necessary [1]) /Type /Annot /StructParent 57 >> endobj 51 0 obj << /AP << /N 121 0 R >> /DA (/Helv 0 Tf 0 g) /DR << /Encoding << /PDFDocEncoding 107 0 R >> /Font << /Helv 108 0 R >> >> /F 4 /FT /Tx /P 73 0 R /Rect [72 269.88 540.24 294.48] /Subtype /Widget /T (19 Do you have any additional information and comments use separate sheet if necessary 2) /TU (19. 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Dates and frequency the event\(s\) occurred) /K 398 0 R >> endobj 320 0 obj << /Type /StructElem /S /Form /P 182 0 R /Pg 71 0 R /Alt (undefined) /K 399 0 R >> endobj 321 0 obj << /Type /StructElem /S /Form /P 182 0 R /Pg 71 0 R /Alt (sheet\(s [1]) /K 400 0 R >> endobj 322 0 obj << /Type /StructElem /S /Form /P 182 0 R /Pg 71 0 R /Alt (sheet\(s [2]) /K 401 0 R >> endobj 323 0 obj << /Type /StructElem /S /Form /P 182 0 R /Pg 71 0 R /Alt (sheet\(s [3]) /K 402 0 R >> endobj 324 0 obj << /Type /StructElem /S /Form /P 182 0 R /Pg 71 0 R /Alt (sheet\(s [4]) /K 403 0 R >> endobj 325 0 obj << /Type /StructElem /S /Form /P 182 0 R /Pg 71 0 R /Alt (sheet\(s [5]) /K 404 0 R >> endobj 326 0 obj << /Type /StructElem /S /Form /P 182 0 R /Pg 71 0 R /Alt (sheet\(s [6]) /K 405 0 R >> endobj 327 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (12. Please explain how you have been harmed by this decision or circumstance [1]) /K 406 0 R >> endobj 328 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (12. Please explain how you have been harmed by this decision or circumstance [2]) /K 407 0 R >> endobj 329 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (12. Please explain how you have been harmed by this decision or circumstance [3]) /K 408 0 R >> endobj 330 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (12. Please explain how you have been harmed by this decision or circumstance [4]) /K 409 0 R >> endobj 331 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (12. Please explain how you have been harmed by this decision or circumstance [5]) /K 410 0 R >> endobj 332 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (12. Please explain how you have been harmed by this decision or circumstance [6]) /K 411 0 R >> endobj 333 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [1]) /K 412 0 R >> endobj 334 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [2]) /K 413 0 R >> endobj 335 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [3]) /K 414 0 R >> endobj 336 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (13. Please list the MAPP allegedly violated, misinterpreted, or misapplied [4]) /K 415 0 R >> endobj 337 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (your efforts [1]) /K 416 0 R >> endobj 338 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (your efforts [2]) /K 417 0 R >> endobj 339 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (your efforts [3]) /K 418 0 R >> endobj 340 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (your efforts [4]) /K 419 0 R >> endobj 341 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (undefined) /K 420 0 R >> endobj 342 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (With whom did you communicate) /K 421 0 R >> endobj 343 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (individual with similar experience, their address\(s\) and their phone number\(s [1]) /K 422 0 R >> endobj 344 0 obj << /Type /StructElem /S /Form /P 234 0 R /Pg 72 0 R /Alt (individual with similar experience, their address\(s\) and their phone number\(s [2]) /K 423 0 R >> endobj 345 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt ([1]) /K 424 0 R >> endobj 346 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt ([2]) /K 425 0 R >> endobj 347 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt ([3]) /K 426 0 R >> endobj 348 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (16. Please describe the outcome or remedy you seek for this complaint [1]) /K 427 0 R >> endobj 349 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (16. Please describe the outcome or remedy you seek for this complaint [2]) /K 428 0 R >> endobj 350 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (16. Please describe the outcome or remedy you seek for this complaint [3]) /K 429 0 R >> endobj 351 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (16. Please describe the outcome or remedy you seek for this complaint [4]) /K 430 0 R >> endobj 352 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (16. Please describe the outcome or remedy you seek for this complaint [5]) /K 431 0 R >> endobj 353 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /K 432 0 R >> endobj 354 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /K 433 0 R >> endobj 355 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (17. Have you filed this report with any other agency or an attorney? Yes [ ] No) /K 434 0 R >> endobj 356 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (18. Do you have any suggestion for proposed action to address or resolve the complaint/grievance [1]) /K 435 0 R >> endobj 357 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (18. Do you have any suggestion for proposed action to address or resolve the complaint/grievance [2]) /K 436 0 R >> endobj 358 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (18. Do you have any suggestion for proposed action to address or resolve the complaint/grievance [3]) /K 437 0 R >> endobj 359 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (19. Do you have any additional information and comments \(use separate sheet if necessary [1]) /K 438 0 R >> endobj 360 0 obj << /Type /StructElem /S /Form /P 257 0 R /Pg 73 0 R /Alt (19. 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