| <html> | |
| <head> | |
| <link href="../generic.css" rel="stylesheet"/> | |
| </head> | |
| <body> | |
| <table id="item1" style="width: 100%"> | |
| <col width="50%"/> | |
| <col width="50%"/> | |
| <tbody> | |
| <tr> | |
| <td> | |
| <p style="text-align: center"> | |
| [] | |
| <br/> | |
| </p> | |
| </td> | |
| <td><p><br/></p></td> | |
| </tr> | |
| <tr> | |
| <td><p><br/></p></td> | |
| <td><p><br/></p></td> | |
| </tr> | |
| </tbody> | |
| </table> | |
| </body> | |
| </html> |