{\rtf1\mac\ansicpg10000\uc1 \deff0\deflang1033\deflangfe1033{\upr{\fonttbl{\f0\fnil\fcharset256\fprq2{\*\panose 00020206030504050203}Times New Roman;}{\f1\fnil\fcharset256\fprq2{\*\panose 00020b06040202020202}Arial;} {\f5\fnil\fcharset256\fprq2{\*\panose 00020005000000000000}Helvetica;}{\f70\fnil\fcharset256\fprq2 B Helvetica Bold;}}{\*\ud{\fonttbl{\f0\fnil\fcharset256\fprq2{\*\panose 00020206030504050203}Times New Roman;} {\f1\fnil\fcharset256\fprq2{\*\panose 00020b06040202020202}Arial;}{\f5\fnil\fcharset256\fprq2{\*\panose 00020005000000000000}Helvetica;}{\f70\fnil\fcharset256\fprq2 B Helvetica Bold;}}}}{\colortbl;\red0\green0\blue0;\red0\green0\blue255; \red0\green255\blue255;\red0\green255\blue0;\red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;\red128\green0\blue0; 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\ftnbj\aenddoc\ftnrestart\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\hyphcaps0\horzdoc\dgmargin\dghspace120\dgvspace120\dghorigin1440\dgvorigin1440\dghshow0\dgvshow3\jcompress\viewkind1\viewscale150\nolnhtadjtbl \fet0 \sectd \sbknone\linex0\endnhere\sectdefaultcl {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl4 \pnlcltr\pnstart1\pnindent720\pnhang{\pntxta )}}{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (} {\pntxta )}}{\*\pnseclvl8\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}\pard\plain \s15\qc\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \b\f1\lang1033\cgrid {\b0\f70 Prize / Award Submission Worksheet \par }\pard\plain \qc\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f70\fs24 \par }\pard \nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f70\fs24 \par }\pard\plain \s2\keepn\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\outlinelevel1\adjustright\rin0\lin0\itap0 \b\f5\lang1033\cgrid {\b0\f70 CCFC/Referral Representative Information}{\f1 \par }\pard\plain \sl360\slmult0\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\b\f1\fs24 \par }\pard\plain \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx6930\tlul\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid Name\tab Date\tab \par \pard\plain \sl360\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f5\fs24 Company\tab \tab \par Address \tab \tab \par }\pard\plain \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx4680\tx5040\tlul\tx9187\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid City\tab State ____________ ZIP\tab \par \pard \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx4680\tlul\tx5040\tlul\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 Phone \tab Fax\tab {\b \par }\pard\plain \sl360\slmult0\nowidctlpar\tldot\tx4680\tx5040\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 \par }\pard\plain \s1\keepn\nowidctlpar\tldot\tx4680\tx5040\tldot\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid {\f70 Client (Winner) Information \par }\pard \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx6930\tlul\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 {\f1 \par }\pard \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx6930\tlul\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 {Name\tab Date\tab \par }\pard\plain \sl360\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f5\fs24 Address \tab \tab \par }\pard\plain \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx4680\tx5040\tlul\tx9187\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid {City\tab State ____________ ZIP\tab \par }\pard \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx9187\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 {Phone \tab }{\b \par }\pard\plain \sl360\slmult0\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 \par }\pard\plain \s1\keepn\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid {\f70 Prize Information \par }\pard\plain \sl360\slmult0\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 \par }\pard \sl360\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f5\fs24 Company making payments on the winnings\tab \par Exact date prize was won\tab \par Exact total amount won\tab \par Exact annual payment date\tab \par }\pard\plain \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx9187\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid Exact total annual payment amount after tax withholding\tab \par \pard\plain \sl360\slmult0\nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 \par }\pard\plain \s1\keepn\nowidctlpar\tldot\tx9187\tx10800\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid {\f70 Client\rquote s Need \par }\pard\plain \nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 \par }\pard \sl360\slmult0\nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f5\fs24 What is the client\rquote s motivation?\tab \par }\pard\plain \s1\sl360\slmult0\keepn\nowidctlpar\tlul\tx9187\faauto\outlinelevel0\adjustright\rin0\lin0\itap0 \f5\lang1033\cgrid How much cash does the client need? \tab \par \pard\plain \nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid {\f1\fs24 \par }\pard \sl360\slmult0\nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 \par }{\f5 /prize \par }}