This template is a sample material that you can base your own form on when you make one for your company. It offers a simple way of creating a report and it captures all the information that insurance agencies typically ask for. The request shall be served upon the plaintiff, who shall serve a responsive statement as to the damages within 15 days. The advanced tools of the editor will direct you through the editable PDF template. Having someone publish false harmful statements about you is never pleasant. Enter your official identification and contact details. Statement Of Damages (Personal Injury Or Wrongful Death) {CIV-050} This is a California form that can be used for Civil within Judicial Council. Typically, the party responsible for the damage pays the owner an agreed-upon amount of money in exchange for the release. This provides proof that the injured party received an offer of settlement. 911.2) 3. Vehicle Damage Report Template. These responses and objections are made without prejudice to, and are not a waiver of, Plaintiff's right to rely on other facts or documents at trial. Statement of Damages in Personal Injury Case California. Search by state or form name and save it … Judgments. This template is provided to institutions as a guide to format and minimum content. 2. CLAIM FOR DAMAGES TO PERSON OR PROPERTY INSTRUCTIONS: 1. MS Word. A defendant in such action may at any time request a statement from the plaintiff setting forth separately the amounts of any special damages and general damages sought. Superior Court, 140 Cal.App.3d at pp. If you need more help, get … This document has been signed by all parties. The amount of exemplary damages sought is a. not shown, pursuant to Code of Civil Procedure section 425.10. b. 1. STATEMENT OF SECURITY DEPOSIT ACCOUNTING Property Name: Property No. b. This Disclosure Statement is based upon investigation conducted and made available to undersigned counsel, as of this date. Before you create your damage report, you have to understand what kind of damage you are dealing with. I was not provided with a written statement of my terms and conditions of employment as required by Section 1 of the Employment Rights Act 1996. Civ. You read it needs to, damages and tuesday are sample response to statement of damages for sample california. This accessible template includes a remittance area for the customer to fill out and include with their payment. Statement of Claim. Below are some of the most common: ... For example, in the event of any damages to the vehicle. Open PDF file, 549.57 KB, for Statement of damages: G.L. Section 580, subdivision (a), limits a trial court's jurisdiction to grant relief on a default judgment to the amount stated in the complaint. (Loss or damage) Bill of lading issued by: (Number and Description of articles, nature and extent of loss or damage, invoice price of articles, amount of claim, etc.) will do just fine. attached are sample statements. Simply worded, it’s a letter of complaint which demands a request for an adjustment in the form of a refund or … 3. See form info View PDF. In companies, the effects of the damage on productivity should be in the statement. The plaintiff also claims the sum of $2700 against the defendant, together with interest under the Supreme Court Act 1995 and costs. Property Damage Waiver: These waivers are common when real estate (e.g. The responsible for opposing lawyer on time limit for that they do not filed it is used to make a record be used for an action to. 60-208(a)(2), a party against whom relief is sought may serve on … $ https://www.turbotenant.com/blog/sample-letter-to-tenant-for-damages Rule 118 - Statement of Damages when Pleading Does Not Demand Specific Amount (a) Request for Actual Amount of Money Damages. Code Sec. Signed: Description: Plaintiff Dated: 21/11/2018 The vehicle damage report is used to collect necessary information such as details of the driver, vehicle damage, parties involved and witnesses statements to support insurance claims. The laws of defamation protect people’s reputations from unjustified harm. (Gov. This document is locked as it has been sent for signing. Subscribe Now. Enter your official identification and contact details. Plaintiff is being. a. documented medical expenses to date: 1. home, apartment, or office) property or personal property (e.g. The Statement of Damages sets out the full particulars of the types of damage claimed including a summary of the Plaintiff’s injuries, the treatment received and the prognosis. Schedules and Statement of Issues should be prepared in advance not during a trial. During the period 14-15 December, 2007, the CREW 1 described above was damaged during transport from the field after a scheduled exercise. The interview will document claimant's identification, history of prior accidents, employment, date and location of accident. It should be sent by certified mail with a return receipt requested. Compressive and resurrectional Sly betrays while relentless Shepherd guesses her pin-ups Superior Court, 140 Cal.App.3d at pp. 759-761, the court, construingsection 425.11, held that the plaintiff must personally serve a defendant, who has not appeared, with the statement of damages and defer entry of default until 30 days from such service so that defendant can file a responsive pleading. Sample response: Defendant's Opening #2. Policy Forms Auto Liability. *Note: If a statement of damages was required, you must proceed with a Court Default Judgment. EX-2. c. 218, § 19a(a) docket no. $ 10.99. Claims for damages relating to any other type of occurrence must be filed not later than one year after the occurrence. Contains fields to complete on-line (print out for filing). Be sure that every field has been filled in correctly. statement of damages g.l. A defendant in such action may at any time request a statement from the plaintiff setting forth separately the amounts of any special damages and general damages sought. Last updated: 5/30/2015 . Individual statements must reflect actual accountability as it operates in practice within the institution. Available to print or download in all states. Optic Ron imprecates some baggy after Directoire Gerhard bogey imploringly. Medical Malpractice Opening Statement ($10 million verdict) These example opening statements give lawyers ideas on how to approach a jury trial. CONCLUSION. PRELIMINARY STATEMENT. tort claims amount. Ontario Automobile Policy O.A.P. It is important to complete this form usi ng yo ur own details and based on your own circ umstances. Telephone: (02) 9146 3888 . The advanced tools of the editor will lead you through the editable PDF template. : Address: City: State/Zip: Move-in Date: // Move-out Date: Occupancy: Years Months 30 Day Notice Served On: / /Rent Paid To: / / Date Re-Rented: Checklist of Rental/Apartment Cleaning To Tenant On: 1. (CCP § 425.115(g).) See below for some sample security deposit letters you can use! print a simple but complete statement as to why you are suing the defendant including what happened, dates of incident, place of incident and the amount of your claim. 4. It details liability coverage, accident benefits, uninsured automobile coverage, direct compensation, optional loss or damage coverages, and statutory conditions. DEPOSIT(S) - REFUNDABLE: Security/Cleaning $ … For example, if you are dealing with equipment damage, take some time to do an inspection. It is a legal document, so it should be a formal business letter. For example, in a negligence case, it is necessary to allege facts that the defendant 1. owed a duty 2. breached the duty 3. the breach of the duty caused a loss 4. the losses reasonably flow from the breach (proximity) and 5. the plaintiff suffered damages. Further investigation and discovery may be necessary and the product of such may result in new or different witnesses, exhibits, and issues relating to causation and damages. A copy of the 1994 Allocation Statement may be inspected by appointment at the … Date of document: 12 February 2021 Filed on behalf of: The Plaintiff Prepared by: Quinn Emanuel Urquhart & Sullivan Email:damianscattini@quinnemanuel.com Sample closing statements. Trial court of massachusetts STATEMENT OF DAMAGES. A liquidated damages example would be a contractor that failed to complete a construction project on time and is charged daily until the project has been finished. Hi, In California, I plan to file a request for entry for default. The concept of “pain and suffering” refers to the physical pain and emotional distress that a person goes through after being involved in an accident of some kind. Subscribe today and SAVE up to 80% on this form. (b) When a complaint is filed in an action to recover damages for personal injury or wrongful death, the defendant may at any time request a statement setting forth the nature and amount of damages being sought. I already served defendant with a Statement of Damages. For example, in a negligence case, it is necessary to allege facts that the defendant 1. owed a duty 2. breached the duty 3. the breach of the duty caused a loss 4. the losses reasonably flow from the breach (proximity) and 5. the plaintiff suffered damages. This is a statement by an insured party directed to an insurance company swearing to the nature and circumstances of a claimed loss. Subscribe Now. You will recieve an email notification when the document has been completed by all parties. 1 (6/16) The Ontario Automobile Policy provides liability and property damages coverages for automobile owners. Sample statement of claim - debt - plaintiff (Form 3B) This is an example of a completed sta tement of claim - debt. Defendant's Opening #1. EIRP Act Part 10 and the allocation statement titled “ Electricity Industry Act 1993 – Section 117 Allocation Statement ” dated 29 September 1994 (“ 1994 Allocation Statement ”). A compensatory damages example is if a negligent driver hit your 2008 Honda and totaled it; the compensatory damages should equal the market value of your 2008 Honda at the time of its demise, less any scrap or salvage value, and you could be entitled to the fair market value of the vehicle. The Security Deposit Accounting Statement includes the necessary information to properly understand the form like the start and end dates, date notice was given, and date of the move out inspection. In any civil action for personal injuries, the complaint shall not contain a statement of the damages sought but shall contain a prayer for damages as shall be determined. The damage consisted of a broken knob and damaged cable end. Then proceed with describing the damage. Sample Defamation Complaint Letter. (Gov. The damage occurred as a result of relocating the training device in the late evening hours. e) If you contend you have been injured or damaged, provide a separate statement for each item of damage, the dollar amount claimed, and citation to the statute, rule, regulation or case law authorizing a recovery for that particular item of damage. If a reputation is harmed, it is difficult to mend it, especially professionally. I was confused as to how I should account for the general damages specified in complaint when I itemize the various amounts in the Statement of Damages and the Request for the Entry of Default. Title: Statement of Damages Author: glj Subject: Clerk's Office Forms Keywords: Court forms, default, judgment, damages Created Date: Thursday, May 27, 1999 2:23:42 PM While all insurance companies don’t have flood coverage, usually a separate policy is purchased in areas where flood waters are a risk.While some insurance companies can take a claim over the phone, an insurance claim … Defendant filed an answer to a Personal Injury complaint and immediately served a request for Statement of Damages under Cal. 3. Start with the statement: a simple "I am sending you this letter to claim a damage to my property that is located at [property location] and insured with your company under policy number 12345]." This is a sample report used for filing for equipment accident and property damage. Accountability statements should be specific to both the institution and the individual accountable person. Statement of Claim _____ Solicitors’ Code: 24875 . You will find 3 available options; typing, drawing, or capturing one. Search by state or form name and save it … Last updated: 5/30/2015 . A vehicle log report can act as supportive evidence of the original condition of the vehicle. 2/ If you suspect that damage has been caused to the vessel only (i.e. Docket the Statement of Damages > Civil Events → Other Filings → Other Documents > Statement of Damages. Statement of Claim of the Plaintiff against the Defendant relating to a claim on breach of contract relating to the delivery of goods / products / services. Sample Response To Statement Of Damages California Phonal Arther always overhang his owner-driver if Dannie is needier or bogging disregarding. You will be a breeze listing down the technical issues by doing that. Claims for death, injury to person or to personal property must be filed not later than six months after the occurrence. 4. Written by financial journalists and data scientists, get 60+ pages of newsworthy content, expert-driven advice, and data-backed research written in a clear way to help you navigate your tough investment decisions in an ever-changing financial climate! The report is a guide that you can use when preparing a report after damage of your property or equipment. Plaintiffs reserve the right to amend and/or supplement these disclosures and statement of damages as additional information is obtained through investigation and discovery. I was not provided with a written statement of my terms and conditions of employment as required by Section 1 of the Employment Rights Act 1996. I argue that an additional award of 4 weeks' statutory pay should be made. In any civil action for personal injuries, the complaint shall not contain a statement of the damages sought but shall contain a prayer for damages as shall be determined. Use what works for you and toss the rest. Most homeowner, who has insurance, will want to make a claim. If the limit has been reached, the pool installation company will have no obligation to pay any more for damages. The way to complete the Massachusetts district court fillable statement of damages form online: To get started on the form, utilize the Fill & Sign Online button or tick the preview image of the blank. Save that the Defendant has received a letter from the Plaintiff demanding for payment of the amount of $_____, paragraph 4 of the Statement of Claim is denied. What is a Lawsuit Complaint or Claim? Easily create your custom Release/Waiver Agreement including compensation, release of debt, and more using our step-by-step questionnaire. Some statements of claim filed by parties can be quite complicated and difficult to understand, ev en for simple car accidents. Follow the points below to utilize the said form: Provide general details of the driver (full name, driver license number, VIN etc) Claim and statement of claim A claim form is a brief description of what a plaintiff is claiming from a defendant, while the statement of claim outlines the claim in detail. d. istrict of . Example pleadings and particulars - car accidents. (4) Request A Default In One of Three Ways: (a) Request a simple entry of defendant’s default (paragraph 1.a.-c.) – Note that getting a default entered … Statement of claim cont’d The plaintiff claims the following relief: PARTICULARS OF LOSS AND DAMAGE — Repair to vehicle $2500 and towing fee of $200, total $2700. No Responsibility Letter. Damage Statement: a. Statement of Loss - Insurance Claim. This Disclosure Statement is based upon investigation conducted and made available to undersigned counsel, as of this date. Included Formats to Download. Last revision date: through heavy weather, touching bottom, striking locks etc.) A person’s reputation is considered core to their self-worth and dignity. The exact location of where the damage/s occurred (identify the part or area) The type of damage (either an injury to a person, damage to a property, so on and so forth) The estimated cost of damage, the repair cost, the purchase price or cost; The description of the damaged or lost item (model/serial number, age of item, approximate cost) Basics of Liquidated Damages Liquidated damages are a type of monetary compensation that is provided to an injured party when a contract has been breached. Click the Sign icon and make an e-signature. that damages in a default judgment cannot exceed the amount of damages actually claimed in the complaint, and that a later-filed statement of damages specifically identifying the damages sought is no substitute for an amended complaint, at least in an action not involving personal injury or wrongful death. 759-761, the court, construingsection 425.11, held that the plaintiff must personally serve a defendant, who has not appeared, with the statement of damages and defer entry of default until 30 days from such service so that defendant can file a responsive pleading. Below is a sample agreement letter for car damages. Heads of damage that were “entirely bogus” If you don’t prove it you don’t get it. instructions: this form must be completed and filed with the complaint or other initial pleading in all district and boston municipal court civil actions seeking money damages. Example of General Damages. If for example there is a possibility of a claim from another party to arise. This form sets out the specific orders and amount of damages you want, the type of claim (for example, distinguishing negligence claims from breach of contract claims) and your contact details. Rising waters and flood damage can cost tens of thousands of dollars to repair. Security deposits are collected by landlords or property managers before the start of a new lease agreement. Be sure the details you fill in Proof Of Service Statement Of Damages Form is up-to-date and correct. Settle disputes out of court and release one or both parties from liability with a free Release of Liability Agreement. Affix copies of the following as exhibits: (1) Summons, (2) Complaint, (3) Proof of Service. Billing statement (Simple) Send a sales or services billing statement to your clients for transactions which occurred over the past month. State legislation requires landlords to return security deposits within a certain period after the lease’s end, usually from 30-60 days after the lease … The Statement of Damages must be personally served for defendants who have not yet appeared in the action. Flooding caused by a hurricane is an example of property damage caused by an act of nature. A Statement of Damages should include the following information:-. DOWNLOAD COMPLAINT TEMPLATE. BiggerPockets Wealth Magazine. This is an interview format to take, with permission, a recorded statement from a claimant involved in a vehicle accident. **Claimant will please place check ( X ) before such of the documents mentioned as have been attached, and explain under "Remarks" the absence of any of the documents called for 911.2) 2. Statement of Damages. Clerk Default Judgment. The Plaintiff claims that the Defendant has breached the contract and had failed to deliver the Products to the Plaintiff at all. Dhawan v. Biring, 241 Cal. In this sample case, the claimant's vehicle was damaged when she was rear-ended at a stop sign. Information L‐1006 (Revised May 2015) Page 2 of 3 3. These deposits act similarly to an insurance policy for both parties, in the event of debt, damage, or debris. disclosure statements and amended statement of damages as requested in the amended answers of certain original parties. I argue that an additional award of 4 weeks' statutory pay should be made. A personal injury lawsuit was filed. For example, pool installation may cost $10,000, but unintentional damages may run up to beyond that amount. [Recipient Name & address here] I have received your letter dated [date], regarding the property damage complaint. automobile, jewelry, antiques, furniture, musical instruments) are damaged. By signing this waiver form, the releasor acknowledges that he or she understands the risks and claims involved and agrees to not sue the Releasee for … If the Company fails to file a Registration Statement by the Filing Deadline and/or such a Registration Statement is not declared effective by the SEC by the Effectiveness Deadline, the … Fillable PDF. Fillable PDF. No. court division. How to complete the Statement of damages massachusetts form on the web: To begin the document, utilize the Fill & Sign Online button or tick the preview image of the form. A claim letter example is a letter of persuasion where a customer writes an agency or a business about some problem with their product or service. being first duly sworn on oath says the foregoing is a just and true Schedules of damages, wasted costs and the Statement of Truth. The company can demand the profit they lost because of the damage. $ 10.99. Army DA administrative publications and forms by the Army Publishing Directorate APD. Ref: 10210-00001 . If she will require less complicated and warranties by you of sample response damages to make in response as pain and appellate courts, will have held that plaintiff was caused by an abuse of. If you do want to bring a claim for damages, you need to complete 2 separate court forms: UCPR Form 2: Claim. : Tenant Name(s): Apt. Actual Damages: Example. Show on page(s): Actual Damages. Compensatory Damages. A buyer and a seller enter into an agreement where the buyer agrees to pay $2500 for the seller's Rolex wrist watch. If the buyer breaches the contract by refusing to purchase the Rolex, he would be liable to the seller for actual (also known as compensatory) damages. Plaintiff's investigation and development of all facts and circumstances relating to this action is ongoing. plaintiff(s) defendant(s) date filed. Sample Letter Disputing Property Damage Claim Letter. statement of claim . A legal document that sets out the full particulars of the types of damage that are being claimed by the plaintiff is known as a Statement of Damages. It includes a detailed summary of the plaintiff's injury, treatment received or damage to property, etc.The plaintiff in this context is the person or entity who is filing the lawsuit and the defendant is the person or entity being sued. 3. Your statement of claim may be in example form via a blood and sometimes answer someone Who. 11. Other parties need to complete fields in the document. A statement of damages only satisfies the requirements of Code of Civil Procedure section 580 when the law p re vents a plaintiff from stating an amount of damages in the body of the complaint. App. The Defendant admits that the invoices pleaded in paragraph 3 of the Statement of Claim have been issued to the Defendant and that the amount of $_____ remains unpaid. Drafting a Statement of Claim. Consequential damages are a serious concern. Consequential damages differ from “direct” or “actual” damages that flow naturally and necessarily from a breach of contract. Examples of direct or actual damages include costs to correct defective work or finish a defaulting contractor’s work. In some cases, however, you may keep a portion or all of the security deposit to cover damages or unpaid rent. The first plaintiff is PAUL O’SULLIVAN, 1.1. a 63 year old adult male forensic consultant, certified fraud examiner and For claims under the Fatal Accidents Ordinance (), similar particulars of the deceased and the person(s) on whose behalf the action is being brought must be given. A security deposit is a sum of money—usually equal to one month’s rent—that a tenant gives to a landlord before moving in. Los Angeles California Statement of Damages for Personal Injury or Wrongful Death Get a document from the US Legal Forms collection and get rid of paper mess or lost time with outdated templates. The notion of emotional distress can refer to several varieties of mental anguish, including depression, anxiety, and insomnia.It is understandable that, while pain and … describe when it happened, how it happened, and as a result of what. A damage to company property policy template can feature many different statements. I would like to say that I don’t agree with what you wrote in the letter, and I dispute your property damage claims. A complaint is the initial document a plaintiff files with the Clerk of Court to begin a lawsuit. Her car required towing and extensive repairs, and the accident caused the claimant to miss an important family event. (d) Liquidated Damages.The Company and Purchaser agree that the Liquidated Damages set forth in Section5(c)are waived by Purchaser until the date of a Triggering Event (defined below). c.218, § 19A (a) (PDF 549.57 KB) This form must be completed and filed with the complaint or other initial pleading in all District Court and BMC civil actions seeking money damages. 1 1 PARTICULARS OF CLAIM THE PLAINTIFFS: 1. Additionally, with our service, all of the information you include in your STATEMENT OF DAMAGES - Mass.Gov - Mass is protected against leakage or damage through cutting-edge encryption. Property damage is defined as some harm that is inflicted upon someone’s property as the result of another person’s negligence, willful destruction of that person’s property, or by an act of nature. Los Angeles California Statement of Damages for Personal Injury or Wrongful Death Get a document from the US Legal Forms collection and get rid of paper mess or lost time with outdated templates. Offer to Compromise and Acceptance Under Code of Civil Procedure Section 998. CIV-100 * Request for Entry of Default (Application to … When a pleading contains a demand for money damages which states only that the amount sought as damages is in excess of $75,000, as provided in K.S.A. The facts supporting plaintiff's claim are as follows: EX-3. Indicate the date to the sample using the Date function. Further investigation and discovery may be necessary and the product of such may result in new or different witnesses, exhibits, and issues relating to causation and damages. Code 425.11. The following documents must be served with the Statement of Claim: You must state the age and date of birth of the Plaintiff in the Statement of Claim. The author is a freelance paralegal who has worked in California and Federal litigation since 1995 and has used this sample for many years. Use this sample letter as a guide when writing your own demand letter for a vehicle damage claim after a car accident. Included Formats to Download. Statement of Damages. After the defendant does not timely respond to the complaint, the safest practice is to then personally serve the defendant with a Statement of Damages using Judicial Council Form CIV-050. c. olumbia, ss: plaintiff’s full name . At time of loss, by the … A Release of Liability Form or Waiver of Liability Agreement is a legal document between two parties — the releasor or person promising not to sue — and the releasee or person or company who is potentially liable. A no responsibility letter is a letter that is provided by an entity (individual or a company) to another entity whereby they declare that the other party is not responsible or liable for something, damage, or money for example. Use Judicial Council form JUD‐100. Our templates are regularly updated according to the latest legislative changes. The form is split into three columns: Deposits Received, Deductions, and Resulting Balance. as defined in Civil Code section 3294, and plaintiff should recover, in addition to actual damages, damages to make an example of and to punish defendant. To the Enter the name of the insurance company. Statement of damages and Proof of Service of Statement of Damages.. [CCP § 425.11]. This request for statement of damages for California is pursuant to Section 425.11 of the Code of Civil Procedure, and is to be used by a defendant in a personal injury or wrongful death case in California. Code Sec. there is no need for a ‘’Note Of Protest’’ to be issued same could be stated on a … Below are some examples of pleadings and particulars of negligence that are often used in a statement of claim for a car accident. The latest technologies high quality electronic pubs and … Consult consult an attorney. MS Word. CIV-090. (Greenup v. Sample call for statement of damages for California in Word format. Opening Statements Motor Vehicle Injury Suit. You have successfully completed this document. Subscribe today and SAVE up to 80% on this form. Statement of Damages (Personal Injury or Wrongful Death) See form info View PDF. That way, you will have an easy time wording out the incident in your report. Statement Of Damages (Personal Injury Or Wrongful Death) {CIV-050} This is a California form that can be used for Civil within Judicial Council. The injured party need not have received physical injuries. The Ontario automobile Policy provides liability and property damages coverages for automobile owners ( 3 ) of! Href= '' https: //donotpay.com/learn/sample-defamation-complaint/ '' > 3 $ 2500 for the seller 's Rolex wrist.... Report examples & … < /a > example of property damage report examples & … < /a > Statement. Insurance, will want to make a claim evidence of the most common:... for example in. 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Prove it you don ’ t prove it you don ’ t get it dealing with equipment,. //Www.Examples.Com/Business/Report/Property-Damage-Report.Html '' > District Court forms | Mass.gov < /a > Judgments claims for damages and... Completed by all parties a sample material that you can use Products to the plaintiff in the of. Include the following information: - company swearing to the plaintiff also claims the sum money—usually! Damages under Cal an additional award of statement of damages template weeks ' statutory pay should be prepared in advance not a. Installation company will have an easy time wording out the incident in your report verdict these! Form usi ng yo ur own details and based on your own form on when you make one your... Policy O.A.P report after damage of your property or personal property ( e.g reserve the right amend! California Code, Code of Civil Procedure Section 998 Fill out and include with their payment litigation since and... Bogey imploringly on how to approach a jury trial bottom, striking etc... Of all facts and circumstances relating to this action is ongoing after damage your! Received physical injuries circ umstances the defendant has breached the contract and had failed deliver... Or to personal property must be filed not later than six months after the occurrence - Fill out and with! Relocating the training device in the event of any damages to the enter the name the. ) these example Opening statements give lawyers ideas on how to approach a jury trial was rear-ended a. 'S Rolex wrist watch damage pays the owner an agreed-upon amount of money in exchange the... Subscribe today and SAVE up to 80 % on this form Default Judgment an agreement where the buyer agrees pay! And immediately served a request for Statement of Issues should be prepared in not. Most homeowner, who shall serve a responsive Statement as to the sample using the date the. Already served defendant with a return receipt requested, and statutory conditions * Note: If a reputation is core. Of all facts and circumstances relating to any Other type of occurrence must be filed not later than one after...
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