<eForms>
	<Header>
		<WebHeader>
			<AddNewReason></AddNewReason>
			<CurrentReason></CurrentReason>
			<StepCount></StepCount>
			<StepNum></StepNum>
			<LastPrompt></LastPrompt>
			<Histories></Histories>
			<FormName></FormName>
			<ReceivedDate></ReceivedDate>
			<SectionName></SectionName>
		</WebHeader>
		<APIHeader>
			<SubmitterClientId></SubmitterClientId>
			<SenderPOI></SenderPOI>
			<SubmitDate></SubmitDate>
		</APIHeader>
		<BatchHeader>
			<SenderPOI/>
			<SubmitDate/>
			<FileName/>
			<EventCount/>
		</BatchHeader>
	</Header>
	<Events>
		<EventCode code="RFA-1LC">
			<TransactionSequenceNumber></TransactionSequenceNumber>
			<WCBCaseID></WCBCaseID>
			<DateOfInjury>
				<DoiMonth></DoiMonth>
				<DoiDay></DoiDay>
				<DoiYear></DoiYear>
			</DateOfInjury>
			<AttestationConfirmationCode></AttestationConfirmationCode>
			<AttorneyLicensedRepFirstName></AttorneyLicensedRepFirstName>
			<AttorneyLicensedRepLastName></AttorneyLicensedRepLastName>
			<AttorneyLicensedRepRnum></AttorneyLicensedRepRnum>
			<AttorneyLicensedRepPhone></AttorneyLicensedRepPhone>
			<AttorneyLicensedRepPhoneExt></AttorneyLicensedRepPhoneExt>
			<AttorneyLicensedRepEmail></AttorneyLicensedRepEmail>
			<Reasons>
				<Reason index="1">
					<ReasonCode></ReasonCode>
					<ReasonCodeCategory></ReasonCodeCategory>
					<ClaimantReducedEarningStatus></ClaimantReducedEarningStatus>
					<PaymentStatus></PaymentStatus>
					<AwardPeriods>
						<AwardPeriod index="1">
							<DisabilityPercentage></DisabilityPercentage>
							<DisabilityFromDate></DisabilityFromDate>
							<DisabilityToDate></DisabilityToDate>
							<IntermittentLostTimeIndicator></IntermittentLostTimeIndicator>
							<IntermittentLostTimeDays></IntermittentLostTimeDays>
							<AwardPeriodExplanations>
								<AwardPeriodExplanation index="1">
									<Explanation></Explanation>
									<ExplanationsSurgeryDt></ExplanationsSurgeryDt>
									<ExplanationsOther></ExplanationsOther>
								</AwardPeriodExplanation>
							</AwardPeriodExplanations>
						</AwardPeriod>
					</AwardPeriods>
					<DisabilityContinuingPaymentIndicator></DisabilityContinuingPaymentIndicator>
					<ReducedEarnings>
						<ReducedEarning index="1">
							<ReducedEarningsFromDate></ReducedEarningsFromDate>
							<ReducedEarningsToDate></ReducedEarningsToDate>
							<ReducedEarningsCurrentEarnings></ReducedEarningsCurrentEarnings>
							<ReducedEarningsRateAmount></ReducedEarningsRateAmount>
						</ReducedEarning>
					</ReducedEarnings>
					<ReducedContinuingPaymentIndicator></ReducedContinuingPaymentIndicator>
					<RaisedBodyPartNotResolved>
						<RaisedBodyPartReasonNotResolvedIndicator></RaisedBodyPartReasonNotResolvedIndicator>
						<BodyPartNotResolvedDecisions>
							<BodyPartNotResolvedDecision index="1">
								<BodyPartNotResolvedDocID></BodyPartNotResolvedDocID>
								<BodyPartNotResolvedFormID></BodyPartNotResolvedFormID>
								<BodyPartNotResolvedReceivedDate></BodyPartNotResolvedReceivedDate>
								<BodyPartNotResolvedDecisionBodyParts>
									<BodyPartNotResolvedDecisionBodyPart index="1">
										<BodyPartNotResolvedDecisionBodyPartCode></BodyPartNotResolvedDecisionBodyPartCode>
										<BodyPartNotResolvedDecisionBodyPartLocationCode></BodyPartNotResolvedDecisionBodyPartLocationCode>
										<BodyPartNotResolvedDecisionBodyPartFingersToesCode></BodyPartNotResolvedDecisionBodyPartFingersToesCode>
										<BodyPartNotResolvedConsequentialIndicator></BodyPartNotResolvedConsequentialIndicator>
										<BodyPartNotResolvedDecisionAdditionalText></BodyPartNotResolvedDecisionAdditionalText>
									</BodyPartNotResolvedDecisionBodyPart>
								</BodyPartNotResolvedDecisionBodyParts>
							</BodyPartNotResolvedDecision>
						</BodyPartNotResolvedDecisions>
					</RaisedBodyPartNotResolved>
					<RaisedBodyPartDisputed>
						<RaisedBodyPartDisputedIndicator></RaisedBodyPartDisputedIndicator>
						<BodyPartDisputedDecisions>
							<BodyPartDisputedDecision index="1">
								<BodyPartDisputedDocID></BodyPartDisputedDocID>
								<BodyPartDisputedFormID></BodyPartDisputedFormID>
								<BodyPartDisputedHealthCareProviderName></BodyPartDisputedHealthCareProviderName>
								<BodyPartDisputedReceivedDate></BodyPartDisputedReceivedDate>
								<BodyPartDisputedDecisionBodyParts>
									<BodyPartDisputedDecisionBodyPart index="1">
										<BodyPartDisputedDecisionBodyPartCode></BodyPartDisputedDecisionBodyPartCode>
										<BodyPartDisputedDecisionBodyPartLocationCode></BodyPartDisputedDecisionBodyPartLocationCode>
										<BodyPartDisputedDecisionBodyPartFingersToesCode></BodyPartDisputedDecisionBodyPartFingersToesCode>
										<BodyPartDisputedConsequentialIndicator></BodyPartDisputedConsequentialIndicator>
										<BodyPartDisputedDecisionAdditionalText></BodyPartDisputedDecisionAdditionalText>
									</BodyPartDisputedDecisionBodyPart>
								</BodyPartDisputedDecisionBodyParts>
							</BodyPartDisputedDecision>
						</BodyPartDisputedDecisions>
					</RaisedBodyPartDisputed>
					<RaisedBodyPartDeadlineElapsed>
						<RaisedBodyPartDeadlineElapsedIndicator></RaisedBodyPartDeadlineElapsedIndicator>
						<BodyPartDeadlineElapsedBodyParts>
							<BodyPartDeadlineElapsedBodyPart index="1">
								<BodyPartDeadlineElapsedBodyPartCode></BodyPartDeadlineElapsedBodyPartCode>
								<BodyPartDeadlineElapsedBodyPartLocationCode></BodyPartDeadlineElapsedBodyPartLocationCode>
								<BodyPartDeadlineElapsedBodyPartFingersToesCode></BodyPartDeadlineElapsedBodyPartFingersToesCode>
								<BodyPartDeadlineElapsedConsequentialIndicator></BodyPartDeadlineElapsedConsequentialIndicator>
							</BodyPartDeadlineElapsedBodyPart>
						</BodyPartDeadlineElapsedBodyParts>
						<BodyPartDeadlineElapsedAdditionalText></BodyPartDeadlineElapsedAdditionalText>
					</RaisedBodyPartDeadlineElapsed>
					<RaisedBodyPartNotAccepted>
						<RaisedBodyPartNotAcceptedIndicator></RaisedBodyPartNotAcceptedIndicator>
						<LetterSentToCADate></LetterSentToCADate>
						<BodyPartNotAcceptedBodyParts>
							<BodyPartNotAcceptedBodyPart index="1">
								<BodyPartNotAcceptedBodyPartCode></BodyPartNotAcceptedBodyPartCode>
								<BodyPartNotAcceptedBodyPartLocationCode></BodyPartNotAcceptedBodyPartLocationCode>
								<BodyPartNotAcceptedBodyPartFingersToesCode></BodyPartNotAcceptedBodyPartFingersToesCode>
								<BodyPartNotAcceptedConsequentialIndicator></BodyPartNotAcceptedConsequentialIndicator>
							</BodyPartNotAcceptedBodyPart>
						</BodyPartNotAcceptedBodyParts>
						<BodyPartNotAcceptedAdditionalText></BodyPartNotAcceptedAdditionalText>
					</RaisedBodyPartNotAccepted>
					<RaisedBodyPartEstablishedAmended>
						<RaisedBodyPartEstablishedAmendedIndicator></RaisedBodyPartEstablishedAmendedIndicator>
						<HasBodyPartAcceptedByCA></HasBodyPartAcceptedByCA>
						<CaNotAcceptedLetterSentToCADate></CaNotAcceptedLetterSentToCADate>
						<BodyPartEstablishedAmendedBodyParts>
							<BodyPartEstablishedAmendedBodyPart index="1">
								<BodyPartEstablishedAmendedBodyPartCode></BodyPartEstablishedAmendedBodyPartCode>
								<BodyPartEstablishedAmendedBodyPartLocationCode></BodyPartEstablishedAmendedBodyPartLocationCode>
								<BodyPartEstablishedAmendedBodyPartFingersToesCode></BodyPartEstablishedAmendedBodyPartFingersToesCode>
								<BodyPartEstablishedAmendedConsequentialIndicator></BodyPartEstablishedAmendedConsequentialIndicator>
							</BodyPartEstablishedAmendedBodyPart>
						</BodyPartEstablishedAmendedBodyParts>
						<BodyPartEstablishedAmendedAdditionalText></BodyPartEstablishedAmendedAdditionalText>
					</RaisedBodyPartEstablishedAmended>
					<ParInsurerDocuments>
						<ParInsurerDocument index="1">
							<ParInsParID></ParInsParID>
							<ParInsDocID></ParInsDocID>
							<ParInsFormID></ParInsFormID>
							<ParInsHealthCareProviderName></ParInsHealthCareProviderName>
							<ParInsReceivedDate></ParInsReceivedDate>
						</ParInsurerDocument>
					</ParInsurerDocuments>
					<ParMdoDocuments>
						<ParMdoDocument index="1">
							<ParMdoParID></ParMdoParID>
							<ParMdoDocID></ParMdoDocID>
							<ParMdoFormID></ParMdoFormID>
							<ParMdoHealthCareProviderName></ParMdoHealthCareProviderName>
							<ParMdoReceivedDate></ParMdoReceivedDate>
						</ParMdoDocument>
					</ParMdoDocuments>
					<CISCaseDecisions>
						<CISCaseDecision index="1">
							<CaseDecisionDocID></CaseDecisionDocID>
							<CaseDecisionFormID></CaseDecisionFormID>
							<CaseDecisionReceivedDate></CaseDecisionReceivedDate>
							<DecisionPaymentCategories>
								<DecisionPaymentCategory index="1">
									<PaymentCategory></PaymentCategory>
									<PaymentCategoryOtherText></PaymentCategoryOtherText>
									<UnpaidAmount></UnpaidAmount>
									<UntimelyPaymentAmount></UntimelyPaymentAmount>
									<UntimelyPaymentAmountDate></UntimelyPaymentAmountDate>
								</DecisionPaymentCategory>
							</DecisionPaymentCategories>
						</CISCaseDecision>
					</CISCaseDecisions>
					<ClaimantClassifiedWithPermanentDisability></ClaimantClassifiedWithPermanentDisability>
					<ReleasedClaimantClassifiedWithPermanentDisability></ReleasedClaimantClassifiedWithPermanentDisability>
					<DateReleasedFromIncarceration></DateReleasedFromIncarceration>
					<ClaimantAgreementWithIME></ClaimantAgreementWithIME>
					<AWWForPrimaryEmployer></AWWForPrimaryEmployer>
					<AWWCalculationMethod></AWWCalculationMethod>
					<AWWCalculationOther></AWWCalculationOther>
					<AWWConcurrentEmployers>
						<AWWConcurrentEmployer index="1">
							<AWWForConcurrentEmployer></AWWForConcurrentEmployer>
							<AWWConcurrentCalculationMethod></AWWConcurrentCalculationMethod>
							<AWWConcurrentCalculationOther></AWWConcurrentCalculationOther>
							<AWWConcurrentEmployerName></AWWConcurrentEmployerName>
						</AWWConcurrentEmployer>
					</AWWConcurrentEmployers>
					<AdjustPaymentsOnAWW></AdjustPaymentsOnAWW>
					<SupportingDocumentForConcurrentEmployment></SupportingDocumentForConcurrentEmployment>
					<SupportingDocumentForConcurrentEmploymentInformation></SupportingDocumentForConcurrentEmploymentInformation>
					<TTDDateOfSurgery></TTDDateOfSurgery>
					<ClaimantClassifiedDecisionDate></ClaimantClassifiedDecisionDate>
					<ClaimantClassifiedCondition></ClaimantClassifiedCondition>
					<ClaimantClassifiedDecisions>
						<ClaimantClassifiedDecision index="1">
							<ClassifiedDecisionDocID></ClassifiedDecisionDocID>
							<ClassifiedDecisionFormID></ClassifiedDecisionFormID>
							<ClassifiedDecisionReceivedDate></ClassifiedDecisionReceivedDate>
						</ClaimantClassifiedDecision>
					</ClaimantClassifiedDecisions>
					<MedicalTransportationReimbursementRequestDenied></MedicalTransportationReimbursementRequestDenied>
					<MedicalTransportationReimbursementRequestDeniedUnpaidAmount></MedicalTransportationReimbursementRequestDeniedUnpaidAmount>
					<MedicalTransportationReimbursementRequestSixtyDaysElapsed></MedicalTransportationReimbursementRequestSixtyDaysElapsed>
					<MedicalTransportationReimbursementRequestSixtyDaysElapsedUnpaidAmount></MedicalTransportationReimbursementRequestSixtyDaysElapsedUnpaidAmount>
					<NonMedicalDevicesorServices>
						<NonMedicalDeviceorService index="1">
							<ItemIdentificationInformation></ItemIdentificationInformation>
							<InsurerResponseCode></InsurerResponseCode>
							<MedicalNecessityInDispute></MedicalNecessityInDispute>
							<CostEstimate></CostEstimate>
							<ItemAdditionalInformation></ItemAdditionalInformation>
						</NonMedicalDeviceorService>
					</NonMedicalDevicesorServices>
					<ClaimantAffirmation></ClaimantAffirmation>
					<DateOfHearingMissedOrNotPrepared></DateOfHearingMissedOrNotPrepared>
					<ClaimantDirectedDocumentation></ClaimantDirectedDocumentation>
					<SettledOrDiscontinuedLawsuitDocumentCode></SettledOrDiscontinuedLawsuitDocumentCode>
					<PrecludedViolations>
						<ImeViolationNotScheduledIndicator></ImeViolationNotScheduledIndicator>
						<ImeNotScheduledBoardDirectionDate></ImeNotScheduledBoardDirectionDate>
						<ImeNotScheduledReason></ImeNotScheduledReason>

						<ImeViolationTimelyNoticeIndicator></ImeViolationTimelyNoticeIndicator>

						<ImeViolationLateFilingIndicator></ImeViolationLateFilingIndicator>
						<ImeLateFilingNotServedPeriod></ImeLateFilingNotServedPeriod>
						<ImeLateFilingImeExamDate></ImeLateFilingImeExamDate>

						<ImeViolationNotServedIndicator></ImeViolationNotServedIndicator>
						<ImeNotServedImeExamDate></ImeNotServedImeExamDate>
						<ImeNotServedRecipients>
							<ImeNotServedRecipient index="1">
								<ImeNotServedFirstName></ImeNotServedFirstName>
								<ImeNotServedLastName></ImeNotServedLastName>
								<ImeNotServedLawFirmName></ImeNotServedLawFirmName>
							</ImeNotServedRecipient>
						</ImeNotServedRecipients>

						<ImeViolationOtherIndicator></ImeViolationOtherIndicator>
						<ImeViolationOtherText></ImeViolationOtherText>
					</PrecludedViolations>
					<ChangeRequests>
						<ChangeEmployerIndicator></ChangeEmployerIndicator>
						<ChangeEmployerRequests>
							<ChangeEmployerRequest index="1">
								<EmployerActionType></EmployerActionType>
								<EmployerName></EmployerName>
								<EmployerAddressStreet1></EmployerAddressStreet1>
								<EmployerAddressStreet2></EmployerAddressStreet2>
								<EmployerAddressCity></EmployerAddressCity>
								<EmployerAddressStateCode></EmployerAddressStateCode>
								<EmployerAddressPostalCode></EmployerAddressPostalCode>
								<EmployerAddressCountry></EmployerAddressCountry>
								<EmployerFEIN></EmployerFEIN>
								<EmployerWCBNumber></EmployerWCBNumber>
								<EmployerDBAName></EmployerDBAName>
								<EmployerPhoneNumber></EmployerPhoneNumber>
								<EmployerSupervisorName></EmployerSupervisorName>
								<EmployerInsurerTpaName></EmployerInsurerTpaName>
							</ChangeEmployerRequest>
						</ChangeEmployerRequests>
						<ChangeInsurerIndicator></ChangeInsurerIndicator>
						<ChangeInsurerRequests>
							<ChangeInsurerRequest index="1">
								<InsurerActionType></InsurerActionType>
								<InsurerName></InsurerName>
								<InsurerNoFaultIndicator></InsurerNoFaultIndicator>
								<InsurerAddressStreet1></InsurerAddressStreet1>
								<InsurerAddressStreet2></InsurerAddressStreet2>
								<InsurerAddressCity></InsurerAddressCity>
								<InsurerAddressStateCode></InsurerAddressStateCode>
								<InsurerAddressPostalCode></InsurerAddressPostalCode>
								<InsurerAddressCountry></InsurerAddressCountry>
								<InsurerPolicyNumber></InsurerPolicyNumber>
								<InsurerEmployerName></InsurerEmployerName>
								<InsurerClaimAdminClaimId></InsurerClaimAdminClaimId>
							</ChangeInsurerRequest>
						</ChangeInsurerRequests>
						<ChangeTpaIndicator></ChangeTpaIndicator>
						<ChangeTpaRequests>
							<ChangeTpaRequest index="1">
								<TPAActionType></TPAActionType>
								<TPAName></TPAName>
								<TPAInsurerName></TPAInsurerName>
							</ChangeTpaRequest>
						</ChangeTpaRequests>
						<ChangeDateOfInjuryIndicator></ChangeDateOfInjuryIndicator>
						<DateOfInjuryUpdate></DateOfInjuryUpdate>
						<ChangeReasonExplanation></ChangeReasonExplanation>
					</ChangeRequests>
					<BeneficiaryChangeSpouseRemarried></BeneficiaryChangeSpouseRemarried>
					<BeneficiaryRemarriedDate></BeneficiaryRemarriedDate>
					<BeneficiaryChangeReachedAge></BeneficiaryChangeReachedAge>
					<BeneficiaryChangedAges>
						<BeneficiaryChangedAge index="1">
							<BeneficiaryChangedAgeName></BeneficiaryChangedAgeName>
							<BeneficiaryChangedAgeValue></BeneficiaryChangedAgeValue>
							<BeneficiaryChangedAgeDateReached></BeneficiaryChangedAgeDateReached>
						</BeneficiaryChangedAge>
					</BeneficiaryChangedAges>
					<BeneficiaryChangeNotStudent></BeneficiaryChangeNotStudent>
					<BeneficiaryChangedNotStudents>
						<BeneficiaryChangedNotStudent index="1">
							<BeneficiaryChangedNotStudentName></BeneficiaryChangedNotStudentName>
							<BeneficiaryChangedNotStudentDate></BeneficiaryChangedNotStudentDate>
						</BeneficiaryChangedNotStudent>
					</BeneficiaryChangedNotStudents>
					<BeneficiaryChangeIsStudent></BeneficiaryChangeIsStudent>
					<BeneficiaryChangedIsStudents>
						<BeneficiaryChangedIsStudent index="1">
							<BeneficiaryChangedIsStudentName></BeneficiaryChangedIsStudentName>
							<BeneficiaryChangedIsStudentDate></BeneficiaryChangedIsStudentDate>
						</BeneficiaryChangedIsStudent>
					</BeneficiaryChangedIsStudents>
					<BeneficiaryChangeNotLocated></BeneficiaryChangeNotLocated>
					<BeneficiaryChangedNotLocateds>
						<BeneficiaryChangedNotLocated index="1">
							<BeneficiaryChangedNotLocatedName></BeneficiaryChangedNotLocatedName>
						</BeneficiaryChangedNotLocated>
					</BeneficiaryChangedNotLocateds>
					<BeneficiaryChangePassedAway></BeneficiaryChangePassedAway>
					<BeneficiaryChangedPassedAways>
						<BeneficiaryChangedPassedAway index="1">
							<BeneficiaryChangedPassedAwayName></BeneficiaryChangedPassedAwayName>
							<BeneficiaryChangedPassedAwayDate></BeneficiaryChangedPassedAwayDate>
						</BeneficiaryChangedPassedAway>
					</BeneficiaryChangedPassedAways>
					<BeneficiaryChangeOther></BeneficiaryChangeOther>
					<BeneficiaryChangeOtherInformation></BeneficiaryChangeOtherInformation>
					<AdditionalInformation></AdditionalInformation>
					<ExpeditedHearingRequested></ExpeditedHearingRequested>
				</Reason>
			</Reasons>
			<SupportingDocuments>
				<UploadedDocuments>
					<UploadedDocument index="1">
						<UploadFormId></UploadFormId>
						<UploadDocumentFormName></UploadDocumentFormName>
						<UploadFileName></UploadFileName>
						<UploadFileType></UploadFileType>
						<UploadHealthCareProviderName></UploadHealthCareProviderName>
						<UploadServiceDate></UploadServiceDate>
						<UploadFileSize></UploadFileSize>
						<UploadDocumentDescription></UploadDocumentDescription>
						<UploadSupportingDocumentImage></UploadSupportingDocumentImage>
					</UploadedDocument>
				</UploadedDocuments>
				<ReferencedDocuments>
					<ReferencedDocument index="1">
						<ReferenceDocumentId></ReferenceDocumentId>
						<ReferenceFormId></ReferenceFormId>
						<ReferenceServiceDate></ReferenceServiceDate>
						<ReferenceDocumentReceivedDate></ReferenceDocumentReceivedDate>
					</ReferencedDocument>
				</ReferencedDocuments>
			</SupportingDocuments>
			<AdditionalProposedFinding>
				<AdditionalProposedFindingNO></AdditionalProposedFindingNO>
				<AdditionalProposedFindingANCR></AdditionalProposedFindingANCR>
				<AdditionalProposedFindingBodyParts>
					<AdditionalProposedFindingBodyPart index="1">
						<AdditionalProposedFindingBodyPartCode></AdditionalProposedFindingBodyPartCode>
						<AdditionalProposedFindingBodyPartLocationCode></AdditionalProposedFindingBodyPartLocationCode>
						<AdditionalProposedFindingBodyPartFingersToesCode></AdditionalProposedFindingBodyPartFingersToesCode>
					</AdditionalProposedFindingBodyPart>
				</AdditionalProposedFindingBodyParts>
				<AdditionalProposedFindingBodyPartAdditionalText></AdditionalProposedFindingBodyPartAdditionalText>
				<AdditionalProposedFindingAWW></AdditionalProposedFindingAWW>
				<EstablishAWWResultInAdjustmentIndicator></EstablishAWWResultInAdjustmentIndicator>
				<EstablishAWWPrimaryEmployerDollarAmount></EstablishAWWPrimaryEmployerDollarAmount>
				<EstablishAWWCalculationMethod></EstablishAWWCalculationMethod>
				<EstablishAWWCalculationMethodOther></EstablishAWWCalculationMethodOther>
				<EstablishAWWConcurrentEmployment></EstablishAWWConcurrentEmployment>
				<AdditionalProposedFindingAwardLostWageBen></AdditionalProposedFindingAwardLostWageBen>
				<ALWBContinuingPaymentIndicator></ALWBContinuingPaymentIndicator>
				<AdditionalProposedFindingAwardPeriods>
					<ALWBAwardPeriod index="1">
						<AwardPeriodFromDate></AwardPeriodFromDate>
						<AwardPeriodToDate></AwardPeriodToDate>
						<AwardPeriodFreeText></AwardPeriodFreeText>
						<AwardPeriodDesignations>
							<AwardPeriodDesignation index="1">
								<AwardPeriodDesignationCode></AwardPeriodDesignationCode>
								<AwardPeriodDisabilityPercentage></AwardPeriodDisabilityPercentage>
								<AwardPeriodRequiredRate></AwardPeriodRequiredRate>
								<AwardPeriodReimburseEmployerIndicator></AwardPeriodReimburseEmployerIndicator>
								<AwardPeriodAwardIndicator></AwardPeriodAwardIndicator>
								<AwardPeriodRequiredNumberofDays></AwardPeriodRequiredNumberofDays>
							</AwardPeriodDesignation>
						</AwardPeriodDesignations>
					</ALWBAwardPeriod>
				</AdditionalProposedFindingAwardPeriods>
				<AdditionalProposedFindingAttorneyFeeReq></AdditionalProposedFindingAttorneyFeeReq>
			</AdditionalProposedFinding>
			<Certification>
				<CertificationCode></CertificationCode>
				<DiscussPersonContactedFirstName></DiscussPersonContactedFirstName>
				<DiscussPersonContactedLastName></DiscussPersonContactedLastName>
				<DiscussPersonContactedOrganizationName></DiscussPersonContactedOrganizationName>
				<DiscussPersonContactedDate></DiscussPersonContactedDate>
				<AttemptedCertificationContacts>
					<AttemptedContact index="1">
						<PersonContactedFirstName></PersonContactedFirstName>
						<PersonContactedLastName></PersonContactedLastName>
						<PersonContactedNameUnknown></PersonContactedNameUnknown>
						<PersonContactedOrganizationName></PersonContactedOrganizationName>
						<PersonContactedDate></PersonContactedDate>
						<PersonContactedPhoneNumber></PersonContactedPhoneNumber>
						<PersonContactedEmail></PersonContactedEmail>
					</AttemptedContact>
				</AttemptedCertificationContacts>
			</Certification>
		</EventCode>
	</Events>
</eForms>
