CD-ROM Guide

Enclosed with your copy of Personal Injury Forms: Discovery and Settlement
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cost to you. The CD-ROM includes a search program that allows you to search
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4. Click OK or press the Enter key.
5. The James Publishing Search program will then start.
OR
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To learn more about the James Publishing Search software, please refer to
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James Publishing Search Tour within the blue pages at the front of your
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5. A directory of the contents of the CD will appear. Double click on the
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drive).

3
5. A directory of the contents of the CD will appear. Double click on the
folder labeled Graphics.
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Single-user disk.
This CD-ROM is licensed to the book purchaser for his or her single-screen use only.

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 James Publishing Search Tour

The James Publishing Search program is a powerful application utilizing the

Alchemy Search software. This tour should point you in the right direction
during your use of the James Publishing Search program.

For more information regarding the use of the James Publishing Search
program, please refer to the Help Menu within the program. To access this
feature, click on Help menu and select Contents.

Getting Started

When you first start the James Publishing Search program, a window will
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of each document. While both the Tree View and Viewer are essential, the
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Buttons

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Change View

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View, Viewer and Profile, respectively.

Print Current Document

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Clicking this button will print the document currently displayed in the Viewer
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Launch Application

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This function is also ideal when you wish to use and manipulate a form file.
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Search

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clicking on the binocular icon at the top left of the Search window. For most
users, the Simple Search will be sufficient.

Previous and Next Document

These buttons allow you to go to the previous or next document according to

the list in the Tree View.

Back and Forward

Just as with your Internet browser, these buttons allow you to go to back and
forth between documents in your viewed document list.

Settings

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The settings function allows you to customize the program to your
preferences on a number of different items.

7
 Frequently Asked Questions:

I clicked OK to run Search.exe but nothing is happening. What do I do?

Sometimes it takes a few minutes for the program to begin running. Please
be patient and wait for the program to begin.

Can I copy the forms on the CD-ROM to my hard drive?

Yes, but you dont need to do so. The CD-ROM serves as a library from which
you may select the forms you need. Copying the forms to your hard drive may
occupy too much of your hard drive space and we advise against copying all
the files to your hard drive for that reason.

Can I share this CD-ROM with other people?

This CD-ROM and its contents are copyrighted by James Publishing, Inc. This
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thereof for republication or distribution is permitted. This CD-ROM is licensed
to the book purchaser for his or her single-screen use only.

Why cant I see a database when I open the Search program?

If no database appears in the Search program, simply click on File in the
menu along the top of the window, then choose Open Database. Click on
Browse then File System and select the CD-ROM drive. Then select the
database titled pid.ald which has a small CD icon next to it and click
Open.

Why am I having formatting problems?

Please be aware that not all computers and printers are set up the same way,
and we have tried to accommodate how the majority of these systems
operate. We cannot anticipate every configuration that may occur, though.
Therefore, how the documents print may be slightly different than how they
appear on screen. You may need to insert or remove page breaks as
necessary to suit your particular printing needs.

Im still having trouble. Is there someone I can contact for technical support?
If you still have questions after reading the entire contents of the blue pages,
you may contact us with any questions. Call us at (714) 755-5450 or send a
detailed email to us at techsupport@jamespublishing.com. Please be very
specific about the problem you are having.

Disclaimer: When running the Search program, first-time users might

encounter a prompt regarding an installation of files onto your computer.
Please note that the program is simply updating existing files on your
computer in order for the search feature to function properly. The program
will not be installed on your computer.

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 Directory of Forms on CD-ROM

File extensions are: .DOC, Microsoft Word and .PDF, Adobe Acrobat.

Word forms

Form Number Form Name

110.2 Client Screening: Initial Telephone Interview (Short Form)
111.1 Client Interview Questionnaire
111.2 Client Interview Form (Short Form)
111.3 Client Information Sheet/Questionnaire Personal Injury
(Non-Death) Case
111.4 Client Information Sheet/Questionnaire Wrongful Death
Case
112 Client Medical History Questionnaire
112.1 Short Form Client Medical History Questionnaire
112.2 Form: Family Medical History Checklist
113 Injury and Pain Evaluation Questionnaire
113.03 Physicians Determination of Effects of Pain
115.2 Form: Alcohol Checklist
115.4 Drug Use Checklist
119.5 Sample Pain Questionnaire
119.6 Checklist on Assessment of Pain Behavior
119.8 Form: Chart on Childhood Illness Checklist
119.9 School Absence Checklist
121 Medical Records Request (HIPAA Compliant)
121.1 HIPAA Compliant Medical Records Request (Alternative
Form)
122 Authorization and Release for Psychiatric Reports and
Records
123 Affidavit Regarding Certification of Records
123.2 State Tax Returns
123.3 Social Security Records
123.3.1 Authorization for Release of Social Security Disability
Records and Reports for Title II and/or Title XVI
123.4 Veterans Administration Records
123.4.1 Alternative Form: Authorization for Release of Veterans
Service Records
123.5 Driving Records
123.6 Criminal/Arrest Records
123.6.1 Authorization for Prison and Parole Records
123.7 Death Certificate and Autopsy Report
123.8 Authorization for Insurance Records
123.8.1 Alternative Form: Authorization for Insurance Records and
Reports
123.9 Authorization to Obtain Department of Health Records and
Reports

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123.10 Alternative Form: Release of Governmental Agency Records
and Reports
123.11 Authorization for Release of Medicaid Records
123.12 Authorization and Release from Medicare Records
124 Employment Records
124.1 Authorization for Union Records
124.2 Alternative Form: Authorization for Employment Records
125 Education Records
125.1 College/University Records: Authorization to Obtain
College/University Records
125.2 Alternative Form: Authorization for Release of Educational
Records
126 Workers Compensation Records
127 Consent to Release Confidential Information
127.1 Authorization to Provide Health Care Information
128 Affidavit Regarding Certification of Records
131 What to Expect Client Letter
132.1 Client Letter
132.2 Record
132.3 Medical Device Expense Index
132.4 Medication Expense Index
133.1 Change of Circumstances Form
134.1 Client Follow-up Letter
134.2 Questionnaire
201 Accident Information Summary Form
211 Instructions to Investigator
212 Investigation Report Form
212.1 Investigative Report Form: Defense
213 Witness Summary Report
222 Letter to Prospective Lay Witness
223 Letter Explaining Service of Subpoena
223.1 Sample Subpoena
224 Lay Witness Report Form
241 Notice of Representation
242.1 Request to Doctor
242.2 Request to Hospital
243 Request for Medical Report
243.1 Form: Request for Psychological Report
252.1.1 Form: Special Damages Summary
252.3.4 Form: Damages Outline for Loss of Consortium Claims
252.3.5 Marital History Checklist
252.5.8.4 Sample Form: Diagnosis and Classification of Head Injuries
252.5.10.1 Sample Form: Diagnosis and Classification of Fractures
252.5.11 Sample Complaint: Closed Head Injuries and Fractures
252.5.12 Sample Complaint: Hangmans Fracture
252.5.13.1 Sample Form: Diagnosis and Classification of Disc Injury
252.5.15 Sample Complaint: Disc Injury
252.5.16 Sample Complaint: Acute Cervical Spine Injury

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252.5.17 Sample Complaint: Disc Injury (Recurrence and
Aggravation)
252.8.2 Form: Diagnosis of Chronic Pain Syndrome
253 Fee Agreement
254 Agreement with Referring Attorney
254.1 Pro Hac Vice Application
255 Sample: Medical Affidavit
255.1.1 Tracking Information from Health Care Providers Form
255.1.2 Medical Expense Index Form
256 Case Rejection Letter
310 Expert Witness Interview Questionnaire
330 Expert Transmittal Letter
346 Daubert/Kumho Tire Type Interrogatories
350.3 Sample Form: Notice of Deposition of Expert Witness (With
Production of Documents for Deposition)
350.4 Sample Form: Notice of Videotaped Deposition of Expert
Witness (With Production of Documents for Deposition)
351.5.1 Interrogatories to Life Care Planner
351.5.2 Notice of Videotaped Deposition of Life Care Planner (With
Production of Documents for Deposition)
351.7.1 Interrogatories to Vocational Rehabilitation Expert
351.7.2 Sample Form: Notice of Videotaped Deposition of
Vocational Rehabilitation Expert (With Production of
Documents)
351.9.2 Interrogatories to Psychological Expert
351.9.4 Sample Form: Neuropsychiatric Exam
355 Interrogatories to Economist
355.2 Interrogatories to Economist/Accountant
355.3 Sample Form: Notice of Videotaped Deposition to
Economist/Accountant
356.2.1 Interrogatories to Engineer
356.2.2 Notice of Videotaped Deposition to Engineer
356.3.1 Interrogatories to Forensic Safety Analyst
356.3.2 Notice of Videotaped Deposition to Forensic Safety Analyst
357.3 Interrogatories to Ergonomist
357.4 Notice of Videotaped Deposition to Ergonomist
357.6 Interrogatories to Accident Reconstruction Expert
400.3 Sample Form: Notice of Rule 30(b)(6) Deposition
400.4 Motion for a Protective Order (High-Ranking or Apex
Corporate Official Deposition)
403.4 Sample Flowsheet
404.1 Sample Form: Index of Product Liability Records
405.1 Document Control Data Base Format
406 Discovery and Pleadings Log
408.2 Notice of Deposition of Electronic Recordskeeper
408.9 Notice to Avoid Destruction of Electronic Evidence
412.1 Interrogatories to a Spouse
412.2 Interrogatories to a Child
413 Notice of Receipt of Interrogatories

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414.1 Sample Letter to Client Notifying of Deposition and
Deposition Instructions
414.2 Deposition Instructions
420 Post Deposition Correspondence to Client
421 Letter of Admonition to Client
431 Notice of Pending Deposition
432 Deposition Instructions
433 Appreciation Letter
441 Order Concerning Confidential Information
442 Confidentiality Agreement Affidavit
443 Confidentiality Agreement and Protective Order
444 Stipulated Protective Order of Confidentiality
445 Sample Tolling Agreement
446 Sample Joint Defense Agreement
451 Letter to Arrange Initial Conference
452 Notice of Pending Deposition
453 Deposition Instructions
461 Discovery
462 Compelling Discovery
463.1 Motion
463.2 Memorandum in Support
464.1 Sample Motion for Protective Order: Deposition at Plaintiffs
Home
464.2 Sample Motion for Protective Order: Deposition at
Defendants Out-of-State Residence, Business or Place of
Employment
465 Precluding Mention of Collateral Source Recovery
466 Pretrial Order
468 Motion to Compel Disclosure of Surveillance Evidence
502 Small Case Settlement Letter
503 Major Case Settlement Letter
504 Sample Settlement Brochure
504.3 Settlement Brochure Cover Letter
511.2 Letter Encouraging Acceptance
511.3 Letter Encouraging Rejection
511.4 Letter Encouraging Reconsideration
511.5 Settlement Withdrawal Letter
512 Authorization to Settle
514 Sample Trust Agreement
520 Offer of Judgment
532.1 Insurance Bad Faith Letter
532.2 Assignment of Bad Faith Claim
541 Dismissal Stipulation
542 General Release
542.1 Release of All Claims (Alternate Form)
542.2 Release Agreement (Alternate Form)
543 Special Release
544 Joint Tortfeasors Release
545 Release Under Motor Vehicle Safety Responsibility Act

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556 Structured Settlement Agreement
556.1 Sample: Structured Settlement Agreement and Release
(Alternate Form)
556.2 Sample: Qualified Assignment, Release and Pledge
Agreement
560.1 Checklist for Uninsured Motorist Arbitration
561 Order Confirming Award
564 Motion to Vacate Award
567 Sample Form: Motion to Obtain Security in Arbitration
577.3 Sample Mediators Letter
577.4 Rules for Mediation
577.5 Agreement for Mediation
577.6 Explanation of the Mediation Process to Clients
577.7 Notifying the Client of the Scheduled Mediation
583.1 Letter to Client Introducing Subject of Financial Consultant
583.2 Letter to Client Confirming Choice of Financial Consultant
583.3 Letter to Consultant
701 Client Interview Questionnaire
702 Expert Witness Intake Sheet: Premises Liability Cases
704.1 Slip and Fall Complaint
704.2 Slip and Fall Complaint-With-Loss-of-Consortium Claim
704.3 Slip and Fall ComplaintNeck, Back and Soft Tissue
Injuries
704.4 Slip and Fall ComplaintFracture
704.5 Slip and Fall ComplaintClosed Head Injury
704.6 Slip and Fall ComplaintDisc Injury With Chronic Pain
704.7 Slip and Fall ComplaintSoft Tissue Injury
710.1 Definitions and Instructions for Interrogatories and
Requests for Production
711 Plaintiff to Defendant
711.1 Plaintiff to Defendant Interrogatories (Alternative Form)
711.2 Plaintiff to Defendant Interrogatories (Construction,
Plant/Factory Refinery, or Oil/Natural Gas Production
Operations)
712 Defendant to Plaintiff
712.1 Defendant to Plaintiff (Alternate Form)
731 Plaintiffs Request
731.1 Plaintiffs Request for Production (Alternate Form)
731.2 Plaintiff to Defendant Requests For Production
(Construction/Job Site, Plant/Factory/ Refinery, or
Oil/Natural Gas Production Operations),
732 Defendants Request
732.1 Defendants Request for Production (Alternative Form)
741 Plaintiffs Request
742 Defendants Request
751 Inspection of Premises
751.1 Sample Form: Motion to Inspect Premises (Alternative
Form)
752 Physical Examination

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752.1 Motion for Physical Examination (Alternate Form)
753 Pretrial Discovery Conference
760 Jury Questionnaire (Premises Liability Case)
801 Client Interview Questionnaire
802 Expert Witness Intake Sheet: Product Liability Cases
804.1 Simple Product Liability Complaint
804.2 Multi-Claim Product Liability Complaint
804.3 Product Liability ComplaintAutomobile Accident (Defects
in Design of Safety Belts, Steering Wheel and Steering
Column)
804.4 Product Liability ComplaintAutomobile Accident
(Defective Fuel System)
811 Plaintiff to Defendant Interrogatories
811.1 Environment of Use
811.2 Manufacturing Process
811.3 Distribution and Post-Marketing Phase
811.4 Contention Interrogatories
811.6 SUV Rollover Accident Interrogatories
811.7 SUV Occupant Ejection Interrogatories
811.9 Equipment Rental Interrogatories to Defendant
812 Defendant to Plaintiff Interrogatories
813 Defendants First Set of Contention Interrogatories to
Plaintiff
824 Defendant to Deponent (Plaintiffs Expert)
831 Plaintiffs Request for Production
831.1 SUV Rollover and Occupant Ejection Requests for
Production
832 Defendants Request for Production
832.1 Equipment Rental Request for Production to Defendant
841 Plaintiffs Request for Admissions
842 Defendants Request for Admissions
851 Inspection of Product
852 Physical and Mental Examination
853 Jury Questionnaire in Product Liability Case
865.1 FIFRA Preemption
865.5 Toxic Tort (Toxic Exposure or Pharmaceutical): Client
Questionnaire
866.1 Sample Complaint: Toxic Tort Case
866.2 Toxic Tort Sample Complaint (Alternative Form,
Occupational Exposure Product Liability)
866.3 Toxic Tort Sample Complaint (Alternative Form,
Occupational Exposure Premises Liability)
868.2 Juror Questionnaire in Toxic Tort Case
869.1 Memorandum of Law in Support of Request for Daubert
Hearing
871 Sample Form: Plaintiffs' Interrogatories to Defendant in a
Toxic Tort Case
871.1 Toxic Tort Sample Interrogatories to Defendant (Alternative
Form, Occupational Exposure)

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872 Sample Form: Defendants Interrogatories to Plaintiffs in a
Toxic Tort Case
873 Sample Form: Defendants Request for Production of
Documents to Plaintiffs in Toxic Tort Claim
873.1 Toxic Tort Sample Request for Production to Defendant
(Occupational Exposure)
901 Client Interview Questionnaire: Malpractice Cases
902 Expert Witness Intake Sheet: Malpractice Cases
904.1 Simple Complaint for Medical Malpractice
904.2 Specific Complaint for Medical Malpractice
904.3 Medical Malpractice/Product Liability Complaint
904.4 Complaint for Medical Malpractice: State Court Action
904.5 Complaint for Medical Malpractice: Failure to Diagnose
904.6 Complaint for Medical Malpractice (Negligence, Negligent
Infliction of Emotional Distress and Loss of Consortium
Claims)
904.7 Complaint for Nursing Malpractice
911 Plaintiff to Defendant Physician Interrogatories
912 Plaintiff to Defendant Hospital Interrogatories
913 Defendant to Plaintiff Interrogatories
914 Interrogatories on Nursing Malpractice and Negligence
930 Request for Production
941 Plaintiffs Request for Admissions
942 Defendants Request for Admissions
951 Motion to Inspect Premises
952 Motion for Physical Examination
1001 Client Interview Questionnaire: Security/Police Assault and
Battery Cases
1002 Expert Witness Intake Sheet: Security/Police Assault and
Battery Cases
1003 Case Evaluation Checklist
1004.2 Police Brutality Complaint
1006 Checklist for Dealing With an Unfavorable Police Report
1007.1 Memorandum in Support of Plaintiffs Motion to Compel the
Police Superintendent to Answer Deposition Questions
1008 Sample Juror QuestionnairePolice Brutality Case
1011 Plaintiff to Defendant Officers Interrogatories
1012 Plaintiff to Defendant Municipality Interrogatories
1013 Defendant to Plaintiff Interrogatories
1021 Deposition ChecklistPlaintiff to Deponent
1022 Deposition ChecklistDefendant to Deponent
1024 Checklist for Deposition Examination of Expert in Police
Assault and Battery Cases
1025 Interrogatories to Expert in Police Civil Assault and Battery
Cases
1031 Plaintiffs Request for Production
1032 Defendants Request for Production
1041 Plaintiffs Request for Admissions
1042 Defendants Request for Admissions

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1051 Inspection of Premises
1052 Physical Examination
1101 Client Interview Questionnaire: Automobile Accident Cases
1102 Expert Witness Intake Sheet: Automobile Accident Cases
1104.1 Automobile Accident Complaint
1104.2 Automobile Accident Complaint With Loss of Consortium
Claim
1104.3 Automobile Accident ComplaintClosed Head Injury
1104.4 Automobile Accident ComplaintWhiplash Injury
1104.5 Automobile Accident ComplaintWrongful Death
1104.6 Automobile Accident ComplaintCommon Carrier
1111 Defendant to Plaintiff Interrogatories
1112 Plaintiff to Defendant Automobile Owner Interrogatories
1130 Request for Production
1140 Request for Admissions
1140.1 Automobile Collision Requests for Admissions
1141 Request for Admissions: Rear-End Collision Cases
1151 Inspection of Premises
1151.1 Inspection of Vehicle
1152 Physical Examination
1153 Pretrial Discovery Conference
1201 Client Interview Questionnaire: Dram shop/Liquor Liability
1201.1 Client Interview Questionnaire (For Use With Liquor
Establishment)
1201.2 Expert Witness Intake Sheet: Dram shop/Liquor Liability
1202.1 Checklist of Economic/Evaluation Factors
1203 Dram Shop/Liquor Liability Complaint
1203.1 Dram Shop/Liquor Liability ComplaintFederal Court Action
1203.2 Dram Shop/Liquor Liability ComplaintWrongful Death
1204.1 Checklist of Variables
1205.1 Investigation and Evaluation Checklist
1206 Discovery Checklist
1207 Claims Against Social Hosts
1211 Plaintiff to Defendant Tavernkeeper
1212 Plaintiff to Co-Defendant Intoxicated Person
1213 Defendants Interrogatories to Plaintiff
1214 Expert Witness Interrogatories
1221 Deposition ChecklistPlaintiff to Defendant Tavernkeeper
1222 Deposition ChecklistDefendant to Plaintiff
1223 Deposition ChecklistPreparation of Experts
1224 Videotaped Deposition of Expert in Dram Shop/Liquor
Liability Case
1231 Plaintiffs Request for Production
1232 Defendants Request for Production
1241 Plaintiffs Requests for Admissions
1242 Defendants Requests for Admissions
1251 Inspection of Premises
1252 Physical Examination

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1253.1 Sample Memorandum Regarding Conditions for Rule 35
Examination in Liquor Liability
1301 Client Interview Questionnaire: Insurance Bad Faith Cases
1302 Expert Witness Intake Sheet: Insurance Bad Faith Cases
1303.1 Complaint for Bad Faith
1303.2 Complaint for Bad FaithRefusal of Reasonable Settlement
1303.3 Complaint for Bad FaithRefusal to Defend/Indemnify
1303.4 Complaint for Bad FaithCarriers Refusal to Provide
Independent Counsel
1303.5 Complaint for Wrongful Claims Handling
1311 Insured to Insurance Carrier Interrogatories
1312 Insurance Carrier to Insured Interrogatories
1320 Requests for Production
1330 Notice of Videotaped Deposition of Insurance Expert
1341 Plaintiff to Defendant
1342 Defendant to Plaintiff Request for Admissions
1401 Client Interview Questionnaire: Premises Security Cases
1401.2 Expert Witness Intake Sheet: Premises Security Cases
1401.3 Premises Security Expert Witness Transmittal Package
1402.1 Sample Complaint: Landlord Liability
1402.2 Sample Complaint: Hotel/Motel Premises Security
1402.3 Sample Complaint: University Premises Security
1402.4 Sample Complaint: Movie Theatre Premises Security
1402.5 Sample Complaint: Bank Premises Security
1402.6 Sample Complaint: Shopping Mall Premises Security
1402.7 Sample Complaint: Parking Lot Premises Security
1402.8 Sample Complaint: Amusement Park Security
1402.9 Sample Complaint: Bar, Restaurant, or Tavern
1410 Interrogatories
1420 Defendants Interrogatories to Plaintiff
1431 Document Requests: Plaintiff to Defendant
1432 Document Requests: Defendant to Plaintiff
1446 Notice of Videotaped Deposition (With Production of
Documents) to Premises Security Expert
1450 Request for a Physical or Mental Examination
1461 Request for Admissions: Plaintiff to Defendant
1462 Request for Admissions: Defendant to Plaintiff

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