ࡱ> ` $ebjbj 8 >F5F5F58~56t"K,79999:<=7K9K9K9K9K9K9K$Mh|O]KE@>::@>@>]K994K???@>997K?@>7K??B$E97 @"F5P>EFLK0KEP`>P4EPE?@>@>@>]K]K>@>@>@>K@>@>@>@>"""dF5"""F5,: VEHICLE SELF INSURANCE (VSI) CLAIM FORM VSI Claim Number: FORMTEXT      (NHQ CAP/LGT USE ONLY)1. Wing/Region: FORMTEXT      2. Date: FORMTEXT      3. Vehicle Identity Number: FORMTEXT      4. Accident Date: FORMTEXT      5. The following are attached (enter remarks for items not attached): Yes No Remarksa. Copy of CAPF 73 (current month)  FORMCHECKBOX   FORMCHECKBOX   FORMTEXT      b. Copy of CAPF 78  FORMCHECKBOX   FORMCHECKBOX  FORMTEXT      c. Copy of CAPF 79 (if applicable)  FORMCHECKBOX   FORMCHECKBOX  FORMTEXT      d. Copy of police reports (if accomplished)  FORMCHECKBOX   FORMCHECKBOX  FORMTEXT      e. Vehicle and damage photographs  FORMCHECKBOX   FORMCHECKBOX  FORMTEXT      f. Two official repair estimates  FORMCHECKBOX   FORMCHECKBOX  FORMTEXT      g. Copy of commander s action letter  FORMCHECKBOX   FORMCHECKBOX  FORMTERTxzѼ~mVB; h<95\&hSh<95CJOJQJ\^JaJ,hnk hS56CJOJQJ\]^JaJ hShSCJOJQJ^JaJ.jh)3CJOJQJU^JaJmHnHu)jthPCJOJQJU^JaJ h<9hSCJOJQJ^JaJ)jh<9hSCJOJQJU^JaJ&hnk hS5CJOJQJ\^JaJ hS5\&hShS5CJOJQJ\^JaJPRTxlVC$IfgdSlZ$$Ifa$gdSlZhkd$$Ifs'I( t0I(44 sa$$Ifa$lZ$x$Ifa$gdnk lZe"eq[HH$$Ifa$lZ$$Ifa$gdSlZkd$$IfsFs&'f  t0I(    44 saq^$$Ifa$lZkd$$IfsFs&'f  t0I(    44 sa& ( q$Ifgds[lZ$Ifgd..lZhkd$$Ifs('I( t0I(44 sa    " $ ( * , . 4 > @ ۼ͕}ibibQ?0h?CCJOJQJ\^JaJ#h?Ch?CCJOJQJ\^JaJ h?C5CJOJQJ\^JaJ h?C5\&hSh?C5CJOJQJ\^JaJ.jh?CCJOJQJU^JaJmHnHu)jh?CCJOJQJU^JaJ#jh?CCJOJQJU^JaJ hSh?CCJOJQJ^JaJh?CCJOJQJ^JaJ h5Uh?CCJOJQJ^JaJ&h5Uh?C5CJOJQJ\^JaJ( * , q^$Ifgds[lZkd$$IfsF&'/ t0I(    44 sa, . B j l q$Ifgds[lZ$Ifgd..lZhkdf$$Ifs('I( t0I(44 sa@ B D X Z \ f h j l n p r t x z ̷ڟڎzs_XG3̎&hnk h?C5CJOJQJ\^JaJ h?C5CJOJQJ\^JaJ h<95\&hSh<95CJOJQJ\^JaJ h?C5\&hSh?C5CJOJQJ\^JaJ hs[h?CCJOJQJ^JaJ.jh?CCJOJQJU^JaJmHnHu)jh?CCJOJQJU^JaJh?CCJOJQJ^JaJ#jh?CCJOJQJU^JaJ&h5Uh?C5CJOJQJ\^JaJl n p q^$Ifgds[lZkdN$$IfsF&'/ t0I(    44 sap r q$Ifgds[lZ$Ifgd..lZhkd&$$Ifs('I( t0I(44 sa      & ( * , ͸۠ۏ{t{tcQc<۠{)jZh?CCJOJQJU^JaJ#h?Ch?CCJOJQJ\^JaJ h?C5CJOJQJ\^JaJ h?C5\&hSh?C5CJOJQJ\^JaJ hs[h?CCJOJQJ^JaJ.jh?CCJOJQJU^JaJmHnHu)jh?CCJOJQJU^JaJh?CCJOJQJ^JaJ#jh?CCJOJQJU^JaJ# *hs[h?CCJOJQJ^JaJ q^$Ifgds[lZkd$$IfsF@ &'  t0I(    44 sa  * , q$Ifgds[lZ$Ifgd..lZhkd$$Ifs('I( t0I(44 sa, . 0 q^$Ifgds[lZkd$$IfsF&'/ t0I(    44 sa, . 0 2 4 :  . 0 2 ͹xjZjLj;!jhKhs[OJQJU^JhgpCJOJQJ^JaJhV`5hs[5OJQJ\^Jhs[CJOJQJ^JaJ h5U5\h5UCJOJQJ^JaJ hs[5\&hs[hs[5CJOJQJ\^JaJ hs[hs[CJOJQJ^JaJ&hnk hs[5CJOJQJ\^JaJ hD5CJOJQJ\^JaJ h<95\&hSh<95CJOJQJ\^JaJ h?C5\0 2 hkd $$Ifs'I( t0I(44 sa$Ifgds[lZhkd $$Ifs('I( t0I(44 sa y[ :Vh$If^hgd66lZhkd $$Ifsp'I( t0I(44 sa h$If^hgd'lZ ~ x[@  $Ifgds[lZ  ,$Ifgd5UlZ :V$If^gd66lZhkd $$Ifs'I( t0I(44 sa2 N P R T V r t v z | ~ 󲡏zhaPI h<95\ hs[h<9CJOJQJ^JaJ hs[5\#jhPCJOJQJU^JaJ)j^ hPCJOJQJU^JaJ#jhs[CJOJQJU^JaJ hs[hs[CJOJQJ^JaJhs[CJOJQJ^JaJ!j hPOJQJU^J!jhKhs[OJQJU^J!jv hPOJQJU^JhKhs[OJQJ^J qP  :V$If^gd66lZkd $$IfsF&' t0I(    44 sa H J x[@  $Ifgds[lZ  ,$Ifgd5UlZ :V$If^gd66lZhkd $$Ifs'I( t0I(44 sa    " 6 8 : D F H J ޿~i~Q~@ hs[hs[CJOJQJ^JaJ.jh)3CJOJQJU^JaJmHnHu)jhPCJOJQJU^JaJ#jhs[CJOJQJU^JaJ!jhPOJQJU^J!jhPOJQJU^JhKhs[OJQJ^J!jhKhs[OJQJU^JhgpCJOJQJ^JaJhs[CJOJQJ^JaJ&hnk hs[5CJOJQJ\^JaJJ L N qP  :V$If^gd66lZkd|$$IfsF&' t0I(    44 saJ L N P V v Ϳq_J_)jhPCJOJQJU^JaJ#jhs[CJOJQJU^JaJ!j>hPOJQJU^J!jhPOJQJU^JhKhs[OJQJ^J!jhKhs[OJQJU^JhgpCJOJQJ^JaJhs[CJOJQJ^JaJ&hnk hs[5CJOJQJ\^JaJ h<95\ hs[h<9CJOJQJ^JaJ hs[5\N P  x[@  $Ifgds[lZ  ,$Ifgd5UlZ :V$If^gd66lZhkdT$$Ifs'I( t0I(44 sa       D h j l ͼ{j]Lj]j];j!jhPOJQJU^J!jvhPOJQJU^JhKhs[OJQJ^J!jhKhs[OJQJU^JhgpCJOJQJ^JaJ&hnk hs[5CJOJQJ\^JaJ h<95\ hs[h<9CJOJQJ^JaJ hs[5\ hs[hs[CJOJQJ^JaJhs[CJOJQJ^JaJ#jhs[CJOJQJU^JaJ#jhPCJOJQJU^JaJ  qP  :V$If^gd66lZkd*$$IfsF&' t0I(    44 sa  x[@  $Ifgds[lZ  ,$Ifgd5UlZ :V$If^gd66lZhkd$$Ifs'I( t0I(44 sa &(*FHJLNj˹򨡐ugVI8VIVI!j$hPOJQJU^JhKh'OJQJ^J!jhKh'OJQJU^Jh'CJOJQJ^JaJ&hnk hs[5CJOJQJ\^JaJ h<95\ hs[h<9CJOJQJ^JaJ hs[5\ hs[hs[CJOJQJ^JaJ#jhPCJOJQJU^JaJ#jhs[CJOJQJU^JaJ)jbhPCJOJQJU^JaJhs[CJOJQJ^JaJ qP  :V$If^gd66lZkd$$IfsF&' t0I(    44 sa px[@  $Ifgds[lZ  ,$Ifgd5UlZ :V$If^gd66lZhkd$$Ifs'I( t0I(44 sajlnprϽqjYR>ϯ&hnk hs[5CJOJQJ\^JaJ h<95\ hs[h<9CJOJQJ^JaJ hs[5\ hs[hs[CJOJQJ^JaJ.jh)3CJOJQJU^JaJmHnHu)jhPCJOJQJU^JaJh'CJOJQJ^JaJ#jh'CJOJQJU^JaJhs[CJOJQJ^JaJ!jhKh'OJQJU^J!jhPOJQJU^JqP  :V$If^gd66lZkd$$IfsF&' t0I(    44 sa,TVx[@  $Ifgds[lZ  ,$Ifgd5UlZ :V$If^gd66lZhkd^$$Ifs'I( t0I(44 sa &(*,.BDFPRTVXZ\Ѳ}eTM<5 h<95\ hs[h<9CJOJQJ^JaJ hs[5\ hs[hs[CJOJQJ^JaJ.jh)3CJOJQJU^JaJmHnHu)jhPCJOJQJU^JaJh'CJOJQJ^JaJ#jh'CJOJQJU^JaJhs[CJOJQJ^JaJ!jHhPOJQJU^J!jhKh'OJQJU^J!jhPOJQJU^JhKh'OJQJ^JVXZqP  :V$If^gd66lZkd4$$IfsF&' t0I(    44 saZ\``x[@  $Ifgds[lZ  ,$Ifgd5UlZ :V$If^gd66lZhkd $$Ifs'I( t0I(44 sa\b``` ``````ތފu]LE h'5\ hs[h'CJOJQJ^JaJ.jh)3CJOJQJU^JaJmHnHu)jlhPCJOJQJU^JaJU#jh'CJOJQJU^JaJ!jhPOJQJU^J!jhPOJQJU^JhKh'OJQJ^J!jhKh'OJQJU^Jh'CJOJQJ^JaJ&hnk h'5CJOJQJ\^JaJXT      6. The driver carries private auto collision insurance:  FORMCHECKBOX  Yes  FORMCHECKBOX  NoInsurance will cover the accident:  FORMCHECKBOX  Yes  FORMCHECKBOX  NoIf Yes, specify company, FORMTEXT      and local agent: FORMTEXT      7. I certify that the damage reported in this VSI claim occurred while the vehicle was on an official CAP activity. FORMTEXT       FORMTEXT      NameDuty Title FORMTEXT      Wing CC or Designated Representative SignatureDateCAPF 133, JUL 05 PREVIOUS EDITIONS WILL NOT BE USED AFTER 30 SEP 05 OPR/ROUTING: LGT     ```qZ  $Ifgdnk lZkd$$IfsF&' t0I(    44 sa`` `"`(`````````````````òudSL; hnk h5UCJOJQJ^JaJ hnk 5\ hs[hnk CJOJQJ^JaJ!jhPOJQJU^J!j.hPOJQJU^JhKhnk OJQJ^J!jhKhnk OJQJU^Jhnk CJOJQJ^JaJ hnk hnk CJOJQJ^JaJ&hnk hnk 5CJOJQJ\^JaJ hD5CJOJQJ\^JaJ h<95\ hs[h<9CJOJQJ^JaJ` `` r $Ifgdnk lZhkd$$Ifs'I( t0I(44 sa```{ r h$If^hgdnk lZhkd$$Ifs'I( t0I(44 sa``a{ r h$If^hgdnk lZhkd$$Ifs'I( t0I(44 sa``2a4a6a8aTaVaXabadaaaaaaaaaaaaaaaɼɼ蓅tfTf?T)jH"hPCJOJQJU^JaJ#jhnk CJOJQJU^JaJhnk CJOJQJ^JaJ hnk h5UCJOJQJ^JaJh5UCJOJQJ^JaJ hnk 5\!jx hPOJQJU^J!j hPOJQJU^JhKhnk OJQJ^J!jhKhnk OJQJU^JhR*CJOJQJ^JaJ hnk hnk CJOJQJ^JaJ h5U5\aaaaa{cc r $Ifgdnk lZ r h$If^hgdnk lZhkd $$Ifs'I( t0I(44 saaaaaaqU== r $Ifgdnk lZ r v$If^vgd5UlZkdb!$$IfsFN &'  t0I(    44 saaaaaaaaab b4b6b8bBbDbFbHbJbNbPbRbTbXbbbbž֊u֊žždPBh!CJOJQJ^JaJ&hnk hnk 5CJOJQJ\^JaJ hD5CJOJQJ\^JaJ)jn$hPCJOJQJU^JaJhnk CJOJQJ^JaJ h5U5\ hnk h5UCJOJQJ^JaJh5UCJOJQJ^JaJ hnk 5\ hnk hnk CJOJQJ^JaJ#jhnk CJOJQJU^JaJ.jh)3CJOJQJU^JaJmHnHuaaaaaqU== r $Ifgdnk lZ r v$If^vgd5UlZkd"$$IfsFN &'  t0I(    44 saaabFbHbqU== r $Ifgdnk lZ r v$If^vgd5UlZkd#$$IfsFN &'  t0I(    44 saHbJbLbNbPbqU== r $Ifgdnk lZ r h$If^hgdnk lZkd$$$IfsFN &'  t0I(    44 saPbRb:cqQ r h$If^h`gdnk lZkd%$$IfsFN &'  t0I(    44 sabb:cc@cBcDcXcZc\cfchcjclcnccƿyaL; h<9hR*CJOJQJ^JaJ)jh<9hR*CJOJQJU^JaJ.jh)3CJOJQJU^JaJmHnHu)j|'hPCJOJQJU^JaJhR*CJOJQJ^JaJ#jhR*CJOJQJU^JaJ hR*hR*CJOJQJ^JaJ hR*5\&hnk hR*5CJOJQJ\^JaJ hnk 5\ hnk hnk CJOJQJ^JaJh!CJOJQJ^JaJ:ccw r h$If^h`gdnk lZhkd&$$Ifs'I( t0I(44 sa>c@cBcjclc{_? r h$If^h`gdnk lZ r $If^gdR*lZ r h$If^hgdR*lZhkd'$$Ifs'I( t0I(44 saccccccccccccccccccccccccսլrr`R=``r)j*hPCJOJQJU^JaJh<9CJOJQJ^JaJ#jh<9CJOJQJU^JaJ hR*hR*CJOJQJ^JaJhR*CJOJQJ^JaJ hR*5\&hnk hR*5CJOJQJ\^JaJ h<9hR*CJOJQJ^JaJ.jh)3CJOJQJU^JaJmHnHu)jh<9hR*CJOJQJU^JaJ)j'hPCJOJQJU^JaJlccc r h$If^h`gdnk lZ r $IfgdR*lZcccK/ r $If^gd5UlZkdh($$Ifsr&&' t0I(44 saccccc&kd)$$Ifs\&&' t0I(44 sa r $Ifgd5UlZ r h$If^h`gdnk lZcccccc r H$If^Hgd<9lZ r h$If^h`gdnk lZ r h$If^hgdR*lZccNdK/ r $If^gd5UlZkd$+$$Ifsr&&' t0I(44 saccNdPdXdZd\d^drd~dddee eeeeeee"e$eɸwokokokokwhF jhF Uh<9hUOJQJ^Jh66OJQJ^Jh<9h<9OJQJ^Jh665OJQJ\^Jh<9h<95OJQJ\^J hR*hR*CJOJQJ^JaJh<9CJOJQJ^JaJ&hnk hR*5CJOJQJ\^JaJhR*CJOJQJ^JaJ hR*5\NdPdZd\d r $If^gdR*lZ r h$If^h`gdnk lZ\d^de eeeeeee^QOOOOOOO `'dgd66kdn,$$Ifs\&&' t0I(44 sa e e"e$e `'dgd666&PP:p?C/ =!8"8#8$8% r$$If!vh5I(#vI(:VZs tI(5I(/  / 4 satDText1$$If!vh55f 5#v#vf #v:VZs tI(55f 5/  / /  / / / 4 sa$$If!vh55f 5#v#vf #v:VZs tI(55f 5/ / / / / / / 4 sar$$If!vh5I(#vI(:VZs( tI(5I(/ /  4 satDText6$$If!vh5/55#v/#v#v:VZs tI(5/55/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs( tI(5I(/ /  4 satDText6$$If!vh5/55#v/#v#v:VZs tI(5/55/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs( tI(5I(/ /  4 satDText6$$If!vh5 55#v #v#v:VZs tI(5 55/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs( tI(5I(/ /  4 satDText6$$If!vh5/55#v/#v#v:VZs tI(5/55/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs( tI(5I(/ /  4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 sar$$If!vh5I(#vI(:VZsp tI(5I(/ /  4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 satDeCheck7tDeCheck8tDText8$$If!vh555#v#v#v:VZs tI(555/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 satDeCheck9vDeCheck10tDText9$$If!vh555#v#v#v:VZs tI(555/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDeCheck11vDeCheck12vDText10$$If!vh555#v#v#v:VZs tI(555/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDeCheck13vDeCheck14vDText11$$If!vh555#v#v#v:VZs tI(555/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDeCheck15vDeCheck16vDText12$$If!vh555#v#v#v:VZs tI(555/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDeCheck17vDeCheck18vDText13$$If!vh555#v#v#v:VZs tI(555/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDeCheck19vDeCheck20vDText14$$If!vh555#v#v#v:VZs tI(555/  / /  / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDeCheck21vDeCheck22r$$If!vh5I(#vI(:VZs tI(5I(/ /  4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDeCheck23vDeCheck24r$$If!vh5I(#vI(:VZs tI(5I(/ /  4 sa$$If!vh5 55#v #v#v:VZs tI(5 55/ / / / / / / 4 savDText15$$If!vh5 55#v #v#v:VZs tI(5 55/  / /  / / / 4 sa$$If!vh5 55#v #v#v:VZs tI(5 55/  / / / / / 4 savDText16$$If!vh5 55#v #v#v:VZs tI(5 55/  / /  / / / 4 sa$$If!vh5 55#v #v#v:VZs tI(5 55/  / / / / / 4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 sar$$If!vh5I(#vI(:VZs tI(5I(/ /  4 savDText17vDText18H$$If!vh55555#v#v#v#v#v:VZs tI(55555/  / / / / / / /  / / / 4 sa$$If!vh5555#v#v#v#v:VZs tI(5555/ / / / / / / 4 savDText19H$$If!vh55555#v#v#v#v#v:VZs tI(55555/  / / / / / / /  / / / 4 sa$$If!vh5555#v#v#v#v:VZs tI(5555/ /  / / / /  / 4 sa[8@8 Normal_HmH sH tH Z@Z  Heading 1$<@&5CJ KH OJQJ\^JaJ \@\  Heading 2$<@& 56CJOJQJ\]^JaJV@V  Heading 3$<@&5CJOJQJ\^JaJJ@J  Heading 4$<@&5CJ\aJN@N  Heading 5 <@&56CJ\]aJH@H  Heading 6 <@&5CJ\aJB@B  Heading 7 <@&CJaJH@H  Heading 8 <@&6CJ]aJN @N  Heading 9 <@&CJOJQJ^JaJDAD Default Paragraph FontRi@R  Table Normal4 l4a (k(No List 4@4 Header  !4 @4 Footer  !DT@D  Block Textx]^2B@"2  Body Textx<P@2<  Body Text 2 dx>Q@B>  Body Text 3xCJaJPM@!RP Body Text First Indent `HC@bH Body Text Indenthx^hTN@arT Body Text First Indent 2 `RR@R Body Text Indent 2hdx^hTS@T Body Text Indent 3hx^hCJaJ8"8 Caption xx5\2?@2 Closing ^44  Comment Text$L@$ DateRYR  Document Map-D M OJQJ^J<[@< E-mail Signature4+4  Endnote Text p$@p Envelope Address!!@ &+D/^@ CJOJQJ^JaJF%@"F Envelope Return" OJQJ^J626  Footnote Text#:`@B:  HTML Address$6]Je@RJ HTML Preformatted% OJQJ^J: : Index 1&8^`8: : Index 2'8^`8: : Index 3(X8^X`8: : Index 4) 8^ `8:: Index 5*8^`8:: Index 6+8^`8:: Index 7,x8^x`8:: Index 8-@8^@`8:: Index 9.8^`8H!bH  Index Heading/5OJQJ\^J4/@4 List0h^h`82@8 List 21^`83@"8 List 328^8`84@28 List 43^`85@B8 List 54^`:0@R:  List Bullet 5 & F>6@b>  List Bullet 2 6 & F>7@r>  List Bullet 3 7 & F>8@>  List Bullet 4 8 & F>9@>  List Bullet 5 9 & FBD@B  List Continue:hx^hFE@F List Continue 2;x^FF@F List Continue 3<8x^8FG@F List Continue 4=x^FH@F List Continue 5>x^:1@:  List Number ? & F>:@>  List Number 2 @ & F>;@>  List Number 3 A & F><@">  List Number 4 B & F >=@2>  List Number 5 C & F l-Bl  Macro Text"D  ` @ OJQJ^J_HmH sH tH I@R Message HeadergE8$d%d&d'd-DM NOPQ^8`CJOJQJ^JaJ<^@b<  Normal (Web)FCJaJ>@r>  Normal Indent G^4O@4  Note HeadingH<Z@<  Plain TextI OJQJ^J0K@0  SalutationJ6@@6  Signature K^NJ@N SubtitleL$<@&a$CJOJQJ^JaJT,T Table of AuthoritiesM8^`8L#L Table of FiguresNp^`pV>@V TitleO$<@&a$5CJ KHOJQJ\^JaJ P.P  TOA HeadingPx5CJOJQJ\^JaJ&& TOC 1Q.. TOC 2 R^.. TOC 3 S^.. TOC 4 TX^X.. TOC 5 U ^ .. TOC 6 V^.. TOC 7 W^.. TOC 8 Xx^x.. TOC 9 Y@^@r@r S Table Grid<:VZ0aZ_H z()*<PQRSjklmn`abcst$%&'(p8LMNOP  uvwx#$%&'()'(-./c'sc's{s ss^s jsc'sIs7ss^c'sIs7ss^c's sss^c'sIs7ss^c'sc's^c's/ec'v:^sss^c'ssss^c'ssss^c'ssss^c'ssss^c'ssss^c'ssss^c'sc's^c's^c's^ sss^ sss^ sss sss^ sssc'sc's^ss(sss^s(sssss(sss_s(sss{`'PS()*<PQRSjklmn`abcst$%&'(p8LMNOP  uvwx#$%&'()'(-./00 0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 @0 y0@0y0@0y0@0y0@0y0;< @ , 2 J j\``abcc$e!#&),/48;@CI( , l p , 0 J N  VZ````aaaaHbPb:c>clcccccNd\de$e  "$%'(*+-.35679:<=>?ABDEFGHJKL"e <HN "L\^np|$&68DJr JZ`p!FFFFFG$G$FG$G$FG$G$FG$G$FG$G$FG$G$FG$G$FG$G$G$G$FFFFF@  @H 0(  0(  B S  ? Text1Text6Check7Check8Text8Check9Check10Text9Check11Check12Text10Check13Check14Text11Check15Check16Text12Check17Check18Text13Check19Check20Text14Check21Check22Check23Check24Text15Text16Text17Text18Text19<L^p&8rJ` O#]o%7K [q"*<ndt(/ |H},Z~ư«m fVz|R,F ^`.^`.88^8`.^`.^`OJQJ^Jo(^`OJQJ^Jo(88^8`OJQJ^Jo(^`OJQJ^Jo(hh^h`.hh^h`OJQJ^Jo((~}|~}|~}|~}| 6 D66, `..n , nk N$%`r%'R*Z1V`5<9S5Us[QQ_!,c#lgpcr{ah{HU?CwSU j;W=F J-@)3PKP4zXU6]n!tb1#m)*<PQRSjklmn`abcst$%&'(p8LMNOP  uvwx#$%&'()'(-./@ INPII@`` ` ```UnknownGz Times New Roman5Symbol3& z Arial5& zaTahoma?5 z Courier New"hNZ&NZ&   $I4r4d3!?QQ_*'VEHICLE SELF INSURANCE (VSI) CLAIM FORM jsanderson jsanderson4         Oh+'0 0< \ h t (VEHICLE SELF INSURANCE (VSI) CLAIM FORM jsanderson capf133.dot jsanderson2Microsoft Office Word@F#@ >~@Dt"@Dt"՜.+,0D px  $J. SandersonCivil Air Patrol, Inc.  (VEHICLE SELF INSURANCE (VSI) CLAIM FORM Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMOPQRSTUVWXYZ[\]^_`abcdfghijklmnopqrstuvwxyz{|}~Root Entry F "Data Nj-1TableePPWordDocument8SummaryInformation(DocumentSummaryInformation8CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q