---
FieldType: Text
FieldName: client_full_name
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: client_DOB_day
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: client_DOB_month
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: client_DOB_year
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: setting_1_name
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_1_date
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_1_persons_involved
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_1_statement
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_2_name
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_3_name
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_4_name
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_2_date
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_3_date
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_4_date
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_2_persons_involved
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_3_persons_involved
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_4_persons_involved
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_2_statement
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_3_statement
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Text
FieldName: setting_4_statement
FieldFlags: 4096
FieldJustification: Left
---
FieldType: Button
FieldName: supporting_documents
FieldFlags: 49152
FieldJustification: Left
FieldStateOption: Choice1
FieldStateOption: Choice2
FieldStateOption: Choice3
FieldStateOption: Off
---
FieldType: Text
FieldName: signature
FieldFlags: 8388608
FieldJustification: Left
---
FieldType: Text
FieldName: date_signed
FieldFlags: 8388608
FieldJustification: Left