<center><div style="height:20px;"></div><div style="width:258px; height: 505px; line-height: 83%; margin:auto; background-image:url(http://i62.tinypic.com/2lcmyc3.png)"><center><div style="height:90px;"></div><div style="background: transparent; width: 110px; height: 20px; color: #FFF; font-family: arial; font-size: 15px; letter-spacing: 0px; line-height: 90%; padding-left: 10px; text-align: center; overflow: auto;"><b>Haley</b></div><div style="height:3px;"></div><div style=" width:180px; webkit-border-radius: 10px; -moz-border-radius: 10px; padding: 5px; max-height: 150px; color: #5a5c60; font-family: calibri; font-size: 10px; letter-spacing: 1px; line-height: 95%;  text-align: center; overflow: auto;">_________ 00/00/0000 _________</div>
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