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        User Guide - Statement of Family Law Value
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1.   pension plan  Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B  FSCO  1269E 3 1  Page 9 of 11       Queen s Printer for Ontario  2015                   2   If the Family Law Valuation  Date is on or after the Plan  Member s normal Preliminary Value is equal to    F     retirement date under the  pension plan             Calculation 3     Plan Member was not vested on the Family Law Valuation Date   Refer to section 11 of Regulation 287 11    Check    N A    if this calculation does not apply to the Plan Member and do not complete this section    If the Plan Member was not vested under the pension plan as of the Family Law Valuation Date  the  Preliminary Value is determined as if the Plan Member was vested  see Calculations 1 or 2 above   whichever applies  and then reduced by 50 per cent  Note that the 50 per cent reduction does not apply  to surplus payable to the Plan Member  The entire value of any surplus must be added to the Preliminary  Value    Calculation 4     Full or Partial Wind Up   Refer to section 14 of Regulation 287 11     Check    N A    if this calculation does not apply to the Plan Member and do not complete this section     Information about the Plan Member   s Accrued Pension as of the Full or Partial Wind Up Date and  Information about the Plan Member   s Preliminary Value as of the Family Law Valuation Date    Complete the information under these sections if the pension plan was wound up in full or in part  the  Plan Member is inclu
2.  in the Statement     Appendix B     Explanation of Pension Plan Provisions that Apply to the Plan Member as of the  Family Law Valuation Date    Refer to section 24 7 1 of Regulation 287 11     Provide information about the pension plan provisions that apply to the Plan Member or attach them to  the Statement  In the latter case  check the box to indicate that you are attaching the information     Appendix C     Actuarial Assumptions Used in the Calculation of the Family Law Value as of the  Family Law Valuation Date    Refer to section 24 3  of Regulation 287 11     The actuarial methods and assumptions used to determine the Family Law Value must be provided in this  Appendix or attached to the Statement  In the latter case  check the box to indicate that you are attaching  the information    Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B    FSCO  1269E 3 l  Page 5 of 11     Queen s Printer for Ontario  2015    Section 3 2  of Regulation 287 11 requires that section 3500 of the Canadian Institute of Actuaries     Standards of Practice  2010 version  be applied when calculating the Preliminary Value  regardless of  the Family Law Valuation Date  This means that the methods and actuarial assumptions in section 3800  of the Canadian Institute of Actuaries    Standards of Practice or in any older version of the standards of  practice should not be used  even if the Family Law Valuation Date is a date before January 1  2012     If the Plan Member has filed a 
3.  information that must be provided in this Appendix  must be  sufficient for an independent verification of the Preliminary Value and Family Law Value calculations     Information about the Plan Member   s Accrued Pension as of the Family Law Valuation Date for  Calculations 1  2 and 3     Complete the information under this section  Do not complete this section if the pension plan was wound  up in full or in part  the Plan Member is included in the wind up group and the effective date of the wind up  is on or before the Family Law Valuation Date     The Plan Member   s age must be expressed using the method set out in the pension plan  If the pension  plan does not set out a specific method  calculate the age in years and months     Information about any Hybrid Benefit  Entitlement to the Greater of a Defined Benefit or a Defined  Coniribution Benefit      Complete this section  if applicable  Note that this Statement should only be used if the defined benefit is  the greater benefit reported in this section           Step 1     Calculation of Preliminary Value as of the Family Law Valuation Date       Refer to section 24 3  of Regulation 287 11     The Preliminary Value is the total value of the pension accrued by the Plan Member during the period of  his her membership in the pension plan as of the Family Law Valuation Date     The Preliminary Value of the defined benefit must be calculated in accordance with either section 6  if the  Family Law Valuation Date is on or bef
4. Member s entitlement under the pension plan and that the required  appendices have been completed by checking the applicable boxes     Certify the information shown on the Statement by signing and dating it  If the Plan Administrator s  authorized agent or representative has completed and signed this Statement  contact information about  the Plan Administrator s authorized agent or representative must also be provided     Next Steps    Refer to section 26 of Regulation 287 11     In this Part  list the additional information or documents that must be provided before the Family Law  Value can be divided and the former spouse of the Plan Member   s share transferred out of the pension  plan  Some examples that may be listed are  Canada Revenue Agency form s  required for any lump sum  transfers  locking in agreements that must be completed if the former spouse wishes to transfer his her  share of the Family Law Value to a financial institution  or information relating to another registered  pension plan if the former spouse wants to transfer his her share of the Family Law Value to another  pension plan willing to accept it     Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B  FSCO  1269E 3 1  Page 4 of 11     Queen s Printer for Ontario  2015    Appendix A     Plan Membership  Employment and Additional Voluntary Contribution Information  as of the Family Law Valuation Date    Refer to sections 24 2 3  24 5 1 and 2 of Regulation 287 11   Plan Membership and Em
5. cant under  Part C of the Application for Family Law Value  FSCO Family Law Form 1      Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B  FSCO  1269E 3 1  Page 2 of 11     Queen s Printer for Ontario  2015    Complete the information about the Contact Person for the Plan Member if you have received a Contact  Person Authorization  FSCO Family Law Form 3   a certified copy of a power of attorney for property  or a certified copy of the court order that appointed this person     The Plan Administrator must be able to provide a copy of the Statement of Family Law Value  FSCO  Family Law Form 4B  to both the applicant and his her spouse former spouse or to their contact  person s   if any   or the Statement cannot be issued     Part D  Spouse Former Spouse of Plan Member Information    Refer to section 24 2 2 of Regulation 287 11     Complete the information about the spouse former spouse of the Plan Member using the information  provided by the applicant under Part D of the Application for Family Law Value  FSCO Family Law  Form 1      Complete the information about the Contact Person for the soouse former spouse of the Plan Member if  you have received a Contact Person Authorization  FSCO Family Law Form 3   a certified copy of a  power of attorney for property or a certified copy of the court order that appointed this person     The Plan Administrator must be able to provide a copy of the Statement of Family Law Value  FSCO  Family Law Form 4B  to both the ap
6. d in accordance with the terms of the pension plan on the Family Law  Valuation Date and without consideration of future salary  benefits or changes to the  pension plan and regardless of whether the Plan Member is vested under the pension  plan on the Family Law Valuation Date   Assumes that pension will commence  without reduction  at the earliest date when the  Plan Member would be eligible to be paid an unreduced pension if his her employment   plan membership continued on the same plan terms  though with no further accruals  to  that date   Assumes administrator s or employer s consent or deemed consent has been given   If applicable  includes bridging supplemental benefits       Weightings are assigned to Values A  B  and C based on the number of years from the Family Law  Valuation Date to the date the Plan Member would first be eligible  or would have been deemed to be  eligible in accordance with section 6 4  or 6 5  of Regulation 287 11  to retire with an unreduced pension      T    factor   The    T    factor must include one twelfth of a year for each full month of  employment membership during the period     Formula for the Preliminary Value        1   If    T    for the Plan Member  is at least zero but less  0 17 10  x A     4   0 04T  10  x B     6     0 06T  10  x C    than 10       2   If    T    for the Plan Member  is at least 10 but less than   0 3T   2  10  x A     4 8   0 12T  10  x B     7 2   0 18T  10  x C    20          3   If    T    for the Plan M
7. ded in the wind up group  and the effective date of the wind up is on or before the  Family Law Valuation Date  Indicate if the pension plan was wound up in full or in part by checking the  applicable box           Step 2     Calculation of Family Law Value as of the Family Law Valuation Date       Refer to section 24 4  of Regulation 287 11     The Family Law Value is the portion of the Preliminary Value that relates to the period of the spousal  relationship  married or common law  as of the Family Law Valuation Date and must be calculated in  accordance with section 18 of Regulation 287 11  The Family Law Value is the    imputed value    in the  PBA     Formula for the Family Law Value   Preliminary Value   G or Adjusted G    surplus  x H J    H   total credited service accrued by the Plan Member during the period beginning on the starting date of  the spousal relationship and ending on the Family Law Valuation Date   J   total credited service accrued by the Plan Member during the entire period of employment plan  membership as of the Family Law Valuation Date    Note that the ratio H J cannot exceed 1  Use the credited service information that is reported under  Appendix A of this Statement     Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B  FSCO  1269E 3 1  Page 10 of 11     Queen s Printer for Ontario  2015                Step 3      Maximum Amount that May Be Assigned and Transferred to the Former Spouse of the  Plan Member as of the Family Law Val
8. e  The rules for maximum transfer limit set out in section 8517 of the Income Tax Act  Canada   Regulations do not apply to the former spouse     Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B  FSCO  1269E 3 1  Page 3 of 11     Queen s Printer for Ontario  2015    Part F  Pension Fund Status    Refer to section 24 7 2 of Regulation 287 11     The transfer ratio of the pension plan as of the valuation date of the most recent valuation report made  under section 3 or 14 of Ontario Regulation 909 must be reported in this Part     Note that it is the transfer ratio of the pension plan on the date when payment is to be made to the former  spouse of the Plan Member that determines any limits on the payment  If the former spouse submits an  Application to Transfer the Family Law Value  FSCO Family Law Form 5  to the Plan Administrator   the Plan Administrator should explain any payment restrictions to the former spouse  e g  reason for the  restriction  when the final payment will be made  etc       Part G  Certification by the Plan Administrator or Plan Administrator   s Agent or Representative    Refer to section 24 8  of Regulation 287 11     Complete the date when the completed Application for Family Law Value  FSCO Family Law Form 1   was received from the applicant  The Plan Administrator must provide this Statement to both the applicant  and his her spouse former spouse within 60 days of receiving a completed application     Confirm the nature of the Plan 
9. ember  is at least 20 but less than         0 45T     5  10  x A     6   0 18T  10  x B     9   0 27T  10  x C          Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B    FSCO  1269E 3 l     Page 8 of 11       Queen s Printer for Ontario  2015             30          4   If    T    for the Plan Member  is 30 or more        0 85 x A     0 06 x B     0 09 x C           Calculation 2     Family Law Valuation Date is after the Plan Member   s Early Unreduced Retirement  Date    Refer to section 7 of Regulation 287 11 for the calculation details  The information provided below  is only a summary     Check    N A    if this calculation does not apply to the Plan Member and do not complete this section     The Preliminary Value is the sum of the weighted average of 2 commuted values  Values B and F         Value e Determined as if the Plan Member had terminated employment plan membership on the      B    Family Law Valuation Date   e Determined in accordance with the terms of the pension plan on the Family Law  Valuation Date and without consideration of future salary  benefits or changes to the  pension plan and regardless of whether the Plan Member is vested under the pension  plan on the Family Law Valuation Date   e _ Assumes that pension will commence on the normal retirement date          Value e Determined as if the Plan Member had terminated employment plan membership on the   ES Family Law Valuation Date   e Determined in accordance with the terms of the 
10. fy who the  applicant is     If an applicant has completed Appendix A of the Application for Family Law Value  FSCO Family Law  Form 1  because there are two proposed Family Law Valuation Dates  you must prepare two Statements  of Family Law Value  FSCO Family Law Form 4B   The applicant and his her spouse former spouse  are entitled to receive both Statements  each showing a different Family Law Value based on one of the  two proposed Family Law Valuation Dates     Complete the information related to the starting date of the spousal relationship using the information  provided by the applicant under Part E of the Application for Family Law Value  FSCO Family Law  Form 1      Complete the Family Law Valuation Date using the information provided by the applicant under Part F of  the Application for Family Law Value  FSCO Family Law Form 1      Information about the Family Law Value and the maximum amount that may be assigned and transferred  to the former spouse of the Plan Member should be completed at the very end  Appendix E  Worksheet  for Family Law Value Calculations  of this Statement must be completed first     Part B  Pension Plan Information    Refer to section 24 2 1 of Regulation 287 11   Complete the pension plan information  Section 8 of the PBA sets out who can be the Plan Administrator     Part C  Plan Member Information    Refer to section 24 2 2 of Regulation 287 11     Complete the information about the Plan Member using the information provided by the appli
11. he Family Law Valuation Date     Check the    Yes    box if the Plan Member is entitled to receive a share of surplus from the pension plan   Otherwise  check the    N A    box and do not complete this section     If the surplus amount is not known at the time when this Statement is being prepared  provide the  relevant details of the surplus application  e g  information about the surplus sharing agreement  etc       If the Plan Member s surplus entitlement is known at the time when this Statement is being prepared  the  surplus amount must be added to the Preliminary Value of the pension benefits in accordance with  section 15 of Regulation 287 11     Pension Plan Amendments Before the Family Law Valuation Date     Check the    Yes    box if the Plan Member belongs to a class of employees that received  or will be  receiving  payment s  resulting from amendmenit s  to the pension plan related to cost of living  adjustments during the last three fiscal years of the pension plan before the Family Law Valuation Date   Otherwise  check the    N A    box and do not complete this section     If applicable  provide an explanation of the amendmeni s   If there is more than one  start with the  amendment made in the most recent fiscal year   Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B    FSCO  1269E 3 I  Page 6 of 11     Queen s Printer for Ontario  2015    Appendix E     Worksheet for Family Law Value Calculations    Note  A completed Statement  including the
12. he defined benefit is the greater benefit  In determining which of the two  benefits is the greater benefit  compare the termination value of each benefit as of the Family Law  Valuation Date  In other circumstances  refer to the list of the Financial Services Commission of Ontario   s   FSCO  Family Law Forms and use the statement that applies to the Plan Member     The information provided in this Statement is required for the court order  family arbitration award or  domestic contract that will provide for any division of the Family Law Value and to complete an  Application to Transfer the Family Law Value  FSCO Family Law Form 5      Upon receipt of a completed Application for Family Law Value  FSCO Family Law Form 1  the Plan  Administrator must provide a copy of this Statement  at the same time  to both the applicant and the  applicant   s spouse former spouse  within 60 days  in accordance with section 67 2 9  of the PBA and  section 25 of Regulation 287 11     If the Plan Administrator is not the employer  e g  as in the case of a multi employer pension plan   the  Plan Administrator will need to obtain information from the employer to complete this Statement  In such  cases  the Plan Administrator must make best efforts to obtain the necessary information from the  employer in order to provide a copy of this Statement to both the applicant and the applicant   s spouse  within the 60 day period     If the Application for Family Law Value  FSCO Family Law Form 1  is no
13. nd C    These calculations are based on different assumptions about when the Plan Member will start his her    pension        Value        A       Determined as if the Plan Member had terminated employment plan membership on the  Family Law Valuation Date   Determined in accordance with the terms of the pension plan on the Family Law  Valuation Date and without consideration of future salary  benefits or changes to the  pension plan and regardless of whether the Plan Member is vested under the pension  plan on the Family Law Valuation Date   Includes the commuted value of any ancillary benefit for which  as of the Family Law  Valuation Date  the member has met all eligibility requirements to exercise the right to  receive the benefit   Assumes that the pension will commence on the date that results in a pension with the  greatest commuted value       Value e  66 B       Determined as if the Plan Member had terminated employment plan membership on the  Family Law Valuation Date   Determined in accordance with the terms of the pension plan on the Family Law  Valuation Date and without consideration of future salary  benefits or changes to the  pension plan and regardless of whether the Plan Member is vested under the pension  plan on the Family Law Valuation Date   Assumes that pension will commence on the normal retirement date          Value e  Gd eau       Determined as if the Plan Member had terminated employment plan membership on the  Family Law Valuation Date   Determine
14. ore the Plan Member   s Early Unreduced Retirement Date  or  section 7  if the Family Law Valuation Date is after the Plan Member   s Early Unreduced Retirement Date   of Regulation 287 11  It also includes any surplus payable to the Plan Member in accordance with section  15 of Regulation 287 11  Note that additional voluntary contributions  if any  are not included in the  Preliminary Value     Complete      i  Calculation 1  if the Family Law Valuation Date is on or before the Plan Member   s Early Unreduced  Retirement Date  or Calculation 2  if the Family Law Valuation Date is after the Plan Member   s Early  Unreduced Retirement Date  and also Calculation 3 for non vested Plan Members    OR    ii  Calculation 4  if the pension plan was wound up in full or in part  the Plan Member is included in the  wind up group and the effective date of the wind up is on or before the Family Law Valuation Date      Calculation 1     Family Law Valuation Date is on or before the Plan Member   s Early Unreduced  Retirement Date    Refer to section 6 of Regulation 287 11 for the calculation details  The information provided below  is only a summary     Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B  FSCO  1269E 3 1  Page 7 of 11     Queen s Printer for Ontario  2015       Check    N A    if this calculation does not apply to the Plan Member and do not complete this section     The Preliminary Value is the sum of the weighted average of 3 commuted values  Values A  B a
15. pension plan on the Family Law  Valuation Date and without consideration of future salary  benefits or changes to the  pension plan and regardless of whether the Plan Member is vested under the pension  plan on the Family Law Valuation Date   e Determined assuming that the Plan Member   s pension will commence on the Family Law  Valuation Date   e If the Plan Member would have been entitled to bridging benefits on the Family Law  Valuation Date had he she been in receipt of a pension on that date  the commuted value  of the bridging benefits is included          Weightings are assigned to Values B and F based on the ratio of    e The number of years from the Family Law Valuation Date to the Plan Member s normal retirement  date under the pension plan     E    Factor   and   e The number of years from the date the Plan Member would first be eligible  or would have been  deemed to have been eligible in accordance with section 6 4  or  5  of Regulation 287 11  to retire  with an unreduced pension to the Plan Member   s normal retirement date under the pension plan     D     factor      The    D    and    E    factors must include one twelfth of a year for each full month of employment membership  during the applicable periods     Formula for the Preliminary Value           1   If    D    for the Plan Member  is greater than zero  and  the Family Law Valuation  Date is before the Plan  1     0 6 x E D  x B    0 6 x E D  x F  Member   s normal  retirement date under the           
16. plicant and his her spouse former spouse or to their contact  person s   if any   or the Statement cannot be issued     Part E  Transfer Options for the Former Spouse of the Plan Member    Refer to section 24 6  of Regulation 287 11     Check the transfer option s  that is are available to the former spouse of the Plan Member  Note that not  all options can be offered to the former spouse     Any entitlement that the former spouse may have to a commutation of a small amount is to be determined  based on the value of his her share of the Family Law Value and based on the YMPE as at the Family  Law Valuation Date  The small amount is not to be determined based on the total Family Law Value  i e   the amount before division      If the Plan Member has made an application to the Plan Administrator in circumstances of shortened life  expectancy  determine if sections 12 or 13 of Regulation 287 11 apply  If the conditions under sections 12  or 13 have been satisfied  the Plan Member   s pension benefits must be paid to both the Plan Member  and the Plan Member   s former spouse on an unlocked basis     There will be no transfer options if the Plan Member terminates employment or plan membership and  his her pension entitlement is paid out in full from the pension plan between the time this Statement is  issued and the time the former spouse of the Plan Member gives the completed Application to Transfer  the Family Law Value  FSCO Family Law Form 5  to the Plan Administrator     Not
17. ployment Information as of the Family Law Valuation Date     Complete the information about the Plan Member   s employment membership in the pension plan  based  on the status of Plan Member on the Family Law Valuation Date and the date s  the Plan Member  became a former member and or retired member  if applicable  after the Family Law Valuation Date     Complete the information about the Plan Member   s credited service  When calculating the period of  credited service  use the method set out in the pension plan  If the pension plan does not set out a  specific formula  indicate the period of credited service in years and months     Indicate whether any purchased pension credits  resulting from buybacks or asset transfers  have been  included in the Family Law Value     Report the pensionable average annual salary if the Plan Member s salary is required in the pension  formula     Indicate if the Plan Member was vested on the Family Law Valuation Date   Additional Voluntary Contributions  AVCs  Information as of the Family Law Valuation Date    AVCs are reported for disclosure purposes only  AVCs must not be including in the Preliminary Value in  accordance with section 3 3  of Regulation 287 11  As provided in section 67 3 6  of the PBA  AVCs are  not subject to the 50 per cent maximum division rule  The payment of AVCs is subject to terms of the  pension plan     Note  Excess member contributions do not apply to active members  Therefore  this information is not  reported
18. shortened life expectancy application and the conditions set out in sections  12 or 13 of Regulation 287 11 have been satisfied  the Preliminary Value is the same as the commuted  value as determined under section 49 of the PBA  based on the shortened life expectancy of the Plan  Member     Appendix D     Full or Partial Plan Wind up Surplus Plan Amendments    Refer to sections 24 7 3 to 24 7 6 of Regulation 287 11   Information about the full or partial wind up of the pension plan     Check the    Yes    box if the pension plan has been wound up in full or in part  the Plan Member is included  in the wind up group  and the effective date of the wind up is on or before the date when this  Statement is issued  Otherwise  check the    N A    box and do not complete this section     If the pension plan has been wound up in full or in part  the Plan Member is included in the wind up group   and the effective date of the wind up is on or before the Family Law Valuation Date  the Preliminary  Value of the pension benefits is the same as the wind up value  i e  the commuted value  of the pension  benefits  accumulated with interest from the effective date of the wind up to the Family Law Valuation  Date  in accordance with section 14 of Regulation 287 11     If the effective date of the wind up or partial wind up is after the Family Law Valuation Date  the  Preliminary Value is determined without reference to the wind up or partial wind up     Surplus Application Made On or Before t
19. t complete  the Plan  Administrator may complete the Plan Administrator Request for Information Payment of Fee  FSCO  Family Law Form 1A  to inform the applicant of any deficiencies  The 60 day period will start from the  day the Plan Administrator receives a correctly completed Application for Family Law Value  FSCO  Family Law Form 1  accompanied by all required documents and the fee  if any     Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B    FSCO  1269E 3 I  Page 1 of 11     Queen s Printer for Ontario  2015    The Plan Administrator may insert relevant information  e g  bar codes  plan name or registration number   etc   in the    For Plan Administrator Use    box     Note  This form must not be altered in any manner  However  the Plan Administrator or its  authorized agent or representative may pre populate the form with plan specific information  e g   name and registration number of the pension plan  etc  and may post these pre populated forms  on their own website  It is the responsibility of the Plan Administrator  however  to ensure that the  current version of this form  i e  the version that is posted on FSCO   s website  is always provided  to applicants  It is essential that Plan Administrators check FSCO   s website from time to time to  ensure that the current form is used     Part A  Family Law Value    Refer to section 24 of Regulation 287 11     Complete the information about the Plan Member and his her spouse former spouse  and identi
20. uation Date       Refer to section 67 3 6  of the PBA     Report the maximum amount of the Family Law Value that may be assigned and transferred to the former  spouse of a Plan Member  The former spouse cannot be entitled to more than 50 per cent of the Family  Law Value     Effective date  2015 03 19  User Guide for FSCO Family Law Form 4B  FSCO  1269E 3 1  Page 11 of 11     Queen s Printer for Ontario  2015       
21. von ee User Guide  N Cah of Ontario Statement of Family Law Value  Na Active Plan Member with a    Ontario    Defined Benefit  FSCO Family Law Form 4B    Information About This Statement    This form is to be completed by the pension plan administrator or the Plan Administrator   s  authorized agent or representative  Plan Administrator   The information provided in this User  Guide is in summary form only and should not be substituted for a complete review of the  applicable provisions of the Ontario Pension Benefits Act  PBA  and Ontario Regulation 287 11   Regulation 287 11  made thereunder  It is the responsibility of the Plan Administrator to ensure  compliance with the statute and regulation     This form is a Statement of Imputed Value prescribed under section 24 of Regulation 287 11  The  imputed value for family law purposes under section 67 2 5  of the PBA is called the Family Law Value in  this Statement  The Family Law Value must be calculated as of the Family Law Valuation Date  determined in accordance with section 67 1 of the PBA     This Statement applies to a member of a pension plan  Plan Member  who has not terminated  employment or plan membership as of the Family Law Valuation Date  i e  for an active member  and  who has only a defined benefit under the pension plan  It also applies to an active Plan Member who has  a hybrid benefit  entitlement to the greater of a defined benefit or a defined contribution benefit  and on  the Family Law Valuation Date t
    
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