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The exmXX4 rip I o yef will make the following eont-Fibutions towaM 44:A4m health-4 [Formatted:Indent:First line: 0" <br /> in > ity :;vill $20 000 of basie life ifistifanee f6f ftill time <br /> > <br /> Formatted:Justified <br /> inelttdinbcx%eOltat-Libtitions to the H.R.A.N.F.B.A.or-H.S.A.afe listed below. <br /> Formatted:Justified,Indent:Left: 0" <br /> Formatted:Justified,Indent:Left: 0.5" <br /> T /y 1 -L , /� /�t to ^ /�/� . 0; ' Formatted:Justified <br /> H YYl'Ny n !d f N■ 1t 7 eaptrlb7 t o 1s�l 1�151•111• A d <br /> T __J j� <br /> a H N'1Yn11 yee and Spouse City eontfibution <br /> i $1 1 n4 10- ANA <br /> F� ;1PT City Pontfibution;s$1 260.Gv;med <br /> . <br /> uv n l�r>�un �r <br /> n��. . H.S.A.� <br /> of 14.S.A—. <br /> All f mily plans «411 rvno,v e $1 9 .00 pe f month t��v-vvaf the <br /> iT-T.T?,n,N.R.B.A..,r <br /> ' Formatted:Normal, No bullets or numbering <br /> a� Formatted:Normal,Justified,Indent:Left: 0.25", No <br /> • bullets or numbering <br /> Of Formatted:Indent:Left: 0.75" <br /> Formatted:Justified,Indent:Left: 0.75",First line: 0" <br /> pfoyide in <br /> this Seetion c ,he waive <br /> caro- eoye f n o- E mpl, <br /> ----r- <br /> .4 (Formatted:Justified <br /> Formatted:Right,Right: 0" <br /> 51 <br />