Day 75 86 MLQES

Timestamp School Year Check the appropriate boxes only Grade Level to enroll:
8/15/2020 16:16:45 2020-2021 With LRN/ May LRN Grade 1

8/16/2020 19:52:18 2020-2021 No LRN/ Walang LRN Kinder
Last grade level completed: Last school year completed:
Kinder 2019-2020
Grade 1 2019-2020
Grade 1 2019-2020
Grade 1 2018-2019
Grade 1 2019-2020
Grade 2 2019-2020
Grade 2 2019-2020
Grade 3 2019-2020
Grade 4 2018-2019
Grade 3 2019-2020
Grade 5 2019-2020
Grade 5 2019-2020
Grade 5 2019-2020
Grade 5 2018-2019
Grade 6 2019-2020
Non-Graded Not applicable
Non-Graded 2019-2020
Non-Graded 2019-2020
Last School Type Attended: Select school:
Private/ Pribado
Public/ Pampubliko 136644 - Manuel L. Quezon ES
Private/ Pribado
Public/ Pampubliko 223501 - Caloocan North ES
Private/ Pribado
From other division/ Galing sa ibang sangay ng lungsod
Private/ Pribado
Public/ Pampubliko 223501 - Caloocan North ES
Private/ Pribado
Private/ Pribado
Private/ Pribado
Not applicable
Not applicable
Not applicable
Not applicable
Not applicable
Not applicable
Select school: School Type:
406698-St. Dominic Savio Sch. of Kalookan City, Inc.
406726-Immaculada Concepcion College
483651-Mater Fidelis School of Llano Inc.

Public/ Pampubliko

483576-Holy Lady Academy of Caloocan Inc.
483657-Young Generation Academy of Caloocan Inc.
Type-in the Last School Attended and School ID School Address:
107845 - Mangas ES Mangas 1 , Alfonso Cavite

School type: Select school:
School Address to enroll in Select school:
Caloocan city north 111 district
Camia street malaria caloocan city
Camia St,taka malaria caloocan city
Malaria tala caloocan city
Malaria caloocan city
Malaria Caloocan City
Barangay 185, Malaria, Caloocan City
Brgy. 185 Camia st. MALARIA MLQES
camai st. malari brgy. 185
manuel L Quezon Elementary School
Malaria Caloocan City
Camia Street, Barangay 185, Malaria 1427 Caloocan, Philippines
CAMIA ST. BRGY 185 MALARIA CALOOCAN
Camia, street, barangay 185, malaria tala caloocan city
MANUEL L. QUEZON ELEMENTARY SCHOOL
Camia street
Camia st. Barangay 185 malaria caloocan city
Malaria caloocan city
MALARIA CALOOCAN CITY
Caloocan
School Address to enroll in Semester (1st/2nd): Track: Select Strand Select Strand
PSA Birth Certificate No. (if available upon enrolment) 12-digit Learner Reference Number (LRN)
03905-B13ZQ0C
01737B12UU041 136751180043
109326170188
N/A 117874170122
483604180010
223501170213
Not available 483525170011
07501B10TC0A6 483659160009
no b/c 112628140042
136644170314
223501140162
07501B08V8069 483659160021
483576
48657160048
07501B08N60X4 136644140169
N/A
07404B15NC1U0
N/A
LAST NAME FIRST NAME MIDDLE NAME EXTENSION NAME e.g. Jr., III (if applicable)
Caballes Cathlea
Tripulca John cris Torres
Levantino Valerie rose Deniega
Alles Abigael Arcas
Manubay Liam
Bacli Ramjune Cariaga
Rabadon Kassney Lorraine Joy Malogan
Edoria Leigh Nicole Mabbayad
arcilla cris anne valencia
Payabyab Rhycel Rein Rago
Bacli Irish Cariaga
COSIO ZYRA CLARISSE ABENGONA
FELICIANO STEPHANIE JOY TAGALA N/A
GUEVARRA RICAJANE ENRIQUEZ N/A
TAMONDONG ARVIN PARICA
YLAGAN JHON PRINCE ARBOSO
YLAGAN MARK JOSH LOPEZ N/A
DEGUIT DENISE RAMOS
Pascual Jake William Diongson None
Agulto Van klifford Martinez
AGULTO VAN KLIFFORD MAT MARTINEZ
Ferrer Leann Pantaleon
Date of Birth (Month/Day/Year) Age Sex
12/24/2013 6 Female
10/28/2012 7 Female
7/17/2012 8 Female
5/18/2012 8 Female
3/9/2013 7 Male
6/18/2012 8 Male
5/21/2012 8 Female
9/12/2010 9 Female
1/30/2005 15 Female
10/17/2011 8 Male
1/24/2009 11 Female
10/8/2008 11 Female
5/6/2009 11 Female
10/23/2008 11 Female
7/6/2008 12 Male
8/23/2015 5 Female
7/12/2015 5 Male
9/24/2014 5 Female
6/7/2015 5 Male
2/1/2016 4 Male
2/1/2016 4 Male
2/21/2017 5 Female
Belonging to Indigenous Peoples (IP) Community/Indigenous Cultural Community If yes, please specify:
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
No/ Hindi
Mother Tongue: Religion:
Tagalog Christianity
Does the learner have special education needs? (i.e. physical, mental, developmental disability, medical condition, giftedness,
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
If yes, please specify:
Do you have any assistive technology devices available at home? (i.e. screen reader, Braille, DAISY)
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
Yes/ Mayroon
Yes/ Mayroon
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
No/ Wala
If yes, please specify: House Number and Street
Leo street
BLK 22 lot 6 miramonte park
1490 mabuhay street
1256 matahimik street
1362 maligaya street
Blk 12 lot 28 Manggahan
Laptop 695 Oliveros St.
Laptop, Cellphone, tablet Unit C Gov Recio M. Garcia St.
blk 12.lot 7
568 camia st.malaria
Blk12 Lot18 Manggahan
426 V.M GARCIA ST.
1242 ST JOSEPH AVE, BARRACKS II TALA CALOOCAN CITY
701
1338
1495 masaya street sapang alat pangarap caloocan city
620
2255 cby barracks 2
1719 gumamela st.
697 ph12
697PH12
787 hyatt st. Cefels park 3 subdivision caloocan city
Subdivision/ Village/ Zone Barangay City/ Municipality Province
Pangarap subdivision Barangay 181 Caloocan NCR
Subdivision 180 Caloocan Camarines zur
Pangarap villages zone, district 1 Barangay 181 Caloocan NCR 3rd district
Pangarap village 181 Caloocan Caloocan
Pangarap village 181 Caloocan Ncr
Purok 7 Malaria Caloocan City 185 Caloocan Capiz
Bankers Village 184 Caloocan Metro Manila
Bankers Village 2 Brgy. 184 Caloocan Metro Manila
purok 7 brgy. 185 Caloocan bicol
568 camia st malaria 185 Caloocan caloocan
Purok 7 Malaria Caloocan City 185 Caloocan Capiz
BANKERS VILLAGE 2 184 Caloocan METRO MANILA
ZONE 16 186 Caloocan N/A
SAINT MARTHA ST. BARRACKS II Caloocan N/A
PUROK 3 185 Caloocan METRO MANILA
Pangarap village 181 Caloocan Pangasinan
BANKERS VILLAGE 2 184 Caloocan N/A
Purok 6 185 Caloocan Caloocan
Malaria 185 Caloocan Caloocan
Lt6 blk22 pck3 Tala Caloocan Pampanga
LT6 BLK22 PCKG3 TALA Caloocan CALOOCAN
Cefels park 3 subdivision 184 Caloocan NCR
Region Father/ AMA Highest Educational Attainment
NCR – National Capital Region Ronie Casinto Vocational/ Bokasyonal
Region V – Bicol Region Tripulca,christian tud High School graduate/ Sekondarya
NCR – National Capital Region Levantino Valentino Dela Fuente Elementary graduate/ Elementarya
NCR – National Capital Region Alles,Alemart,Domegillo High School graduate/ Sekondarya
NCR – National Capital Region Sotelo, jay mark ardales College graduate/ Kolehiyo
Region VI – Western Visayas Bacli,Roldan T High School graduate/ Sekondarya
NCR – National Capital Region Rabadon, Mauricio Balitao College graduate/ Kolehiyo
NCR – National Capital Region Edoria, Jaymar , Villanueva High School graduate/ Sekondarya
NCR – National Capital Region arcilla,antonio benigno Elementary graduate/ Elementarya
Region III – Central Luzon Payabyab,Ryan,Gepitan High School graduate/ Sekondarya
Region VI – Western Visayas Bacli,Roldan T High School graduate/ Sekondarya
NCR – National Capital Region COSIO, MARK ANGELO, QUINTIA College graduate/ Kolehiyo
NCR – National Capital Region FELICIANO EDWIN MACAYA High School graduate/ Sekondarya
NCR – National Capital Region RUBEN DELA CRUZ GUEVARRA College graduate/ Kolehiyo
Region III – Central Luzon TAMONDONG, ARNEL, AGAPITO High School graduate/ Sekondarya
NCR – National Capital Region YLAGAN KELVIN JAY BUENO High School graduate/ Sekondarya
Region III – Central Luzon YLAGAN MARK KEVIN BUENO Elementary graduate/ Elementarya
NCR – National Capital Region Dante S. deguit College graduate/ Kolehiyo
NCR – National Capital Region Pascual, Joseph B High School graduate/ Sekondarya
NCR – National Capital Region Agulto Marvic Rivera
NCR – National Capital Region AGULTO MARVIC RIVERA Vocational/ Bokasyonal
NCR – National Capital Region Pantaleon, mylene ledesma Others/ Iba pa: _________________
Others:
College undergraduate bs chemistry

Select
Unemployed due to community quarantine/ Nawalan ng trabaho dahil sa community quarantine
Part time
Full time
Full time
Full time
Self-employed (i.e. family business)/ (hal.:negosyong pampamilya)
Full time
Full time
Not working/ Hindi nagtatrabaho
Full time
Full time
Part time
Full time
Full time
Working from home due to community quarantine? Contact number/s (cellphone/ telephone)
No/ Hindi 09514341194
No/ Hindi 09302856108
No/ Hindi 09389761959
No/ Hindi 09219326243
No/ Hindi 09172738050
No/ Hindi 09129824465
Yes/ Oo 09985738503
No/ Hindi 09278589356
No/ Hindi 09385388724
No/ Hindi 09095574451
No/ Hindi 09129824465
No/ Hindi 09420002575
No/ Hindi 09984067195
No/ Hindi 09995151838
No/ Hindi 09309550429
No/ Hindi 09517882320
09123144357
No/ Hindi 09516291167
No/ Hindi 09215074323
No/ Hindi 09090658745
No/ Hindi 09090658745
Yes/ Oo 09994253537
Mother/ INA Highest Educational Attainment Others:
Edelyn Caballes High School graduate/ Sekondarya
Tripulca,Annabelle torres High School graduate/ Sekondarya
Deniega Rose Flor Basalo High School graduate/ Sekondarya
Nunes,Fhara pable High School graduate/ Sekondarya
Manubay, Abigail manlapig College graduate/ Kolehiyo
Bacli,Irene C High School graduate/ Sekondarya
Rabadon, Anita Malogan College graduate/ Kolehiyo
Mabbayad, Jessa, Laggui High School graduate/ Sekondarya
valencia, cristina moreno High School graduate/ Sekondarya
Rago,Rachelle,Alvarez Vocational/ Bokasyonal
ABENGONA, PAMELA, PALMARES College graduate/ Kolehiyo
N/A Others/ Iba pa: _________________ N/A
JERAMIE ENRIQUEZ GUEVARRA College graduate/ Kolehiyo
PARICA, MARITES, GUINTO High School graduate/ Sekondarya
ARBOSO ROSEMARIE NAVALES High School graduate/ Sekondarya
YLAGAN KATRINA LOPEZ High School graduate/ Sekondarya
Rhea mae r. Deguit College graduate/ Kolehiyo
Diongson, Michelle B. High School graduate/ Sekondarya
Martinez Katrina Rose Manlapaz College graduate/ Kolehiyo
MARTINEZ KATRINA ROSE MANLAPAZ College graduate/ Kolehiyo
Pantaleon, mylene ledesma Vocational/ Bokasyonal
Select
Full time
Full time
Part time
Full time
Full time
Full time
Full time
Working from home due to community quarantine? Contact number/s (cellphone/ telephone)
No/ Hindi 09514341194
Yes/ Oo 09302856108
No/ Hindi 09462833386
No/ Hindi 09219326243
Yes/ Oo 09254872101
No/ Hindi 09077596270
Yes/ Oo 09985738503
No/ Hindi 09669582457
No/ Hindi 09385388724
No/ Hindi 09095574451
No/ Hindi 09077596270
No/ Hindi 09474827488
No/ Hindi N/A
No/ Hindi 09291626698
No/ Hindi 09286025020
No/ Hindi 09129571237
No/ Hindi 09123144357
No/ Hindi 09516291167
No/ Hindi 09979753533
No/ Hindi 09090658745
No/ Hindi 09486413174
Yes/ Oo 09994253537
Guardian/ TAGAPAG- ALAGA Highest Educational Attainment
Caballes Edellyn High School graduate/ Sekondarya
Tripulca,Annabelle torres High School graduate/ Sekondarya
Deniega Rose Flor Basalo High School graduate/ Sekondarya
Espejo,Heide High School graduate/ Sekondarya
Manubay, Abigail m. College graduate/ Kolehiyo
Rabadon, Karen Joy Malogan College graduate/ Kolehiyo
Mabbayad, Jessa, Laggui High School graduate/ Sekondarya
valencia, cristina moreno High School graduate/ Sekondarya
Payabyab,Rachelle,Rago Vocational/ Bokasyonal
COSIO, PAMELA, ABENGONA College graduate/ Kolehiyo
CRUZ IMELDA FELICIANO College graduate/ Kolehiyo
JERAMIE ENRIQUEZ GUEVARRA College graduate/ Kolehiyo
PARICA, MIGUELA, GUINTO Others/ Iba pa: _________________
YLAGAN KELVIN JAY BUENO High School graduate/ Sekondarya
YLAGAN KATRINA LOPEZ High School graduate/ Sekondarya
Rhea mae r. Deguit College graduate/ Kolehiyo
Diongson, Michelle B. High School graduate/ Sekondarya
Agulto Marvic Rivera Vocational/ Bokasyonal
AGULTO MARVIC RIVERA Vocational/ Bokasyonal
Pantaleon, mylene ledesma Others/ Iba pa: _________________
Others:
GRADE 2
College undergraduate bs chemistry

Select
Full time
Part time
Full time
Full time
Full time
Working from home due to community quarantine? Contact number/s (cellphone/ telephone) Select
No/ Hindi 09514341194 No/ Hindi
Yes/ Oo 09302856108 No/ Hindi
How does your child go to school? Choose all that applies.
public commute (land/ water)/ sumasakay sa pampublikong sasakyan (panlupa o pantubig)
walking/ naglalakad, public commute (land/ water)/ sumasakay sa pampublikong sasakyan (panlupa o pantubig)
walking/ naglalakad
school service/ may tagahatid
walking/ naglalakad
family-owned vehicle/ may sasakyang pampamilya, school service/ may tagahatid
walking/ naglalakad
walking/ naglalakad
walking/ naglalakad
walking/ naglalakad, family-owned vehicle/ may sasakyang pampamilya
walking/ naglalakad
walking/ naglalakad
Kinder Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11
3 1 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 1 1 2
0 0 1 0 1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 1 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0 0 0
0 0 0 1 0 0 1 0 0 0 0 0
0 0 0 0 0 0 1 0 0 0 1 0
0 0 0 0 0 0 1 0 0 0 0 0
0 0 0 0 0 0 1 0 0 0 0 0
0 0 1 0 0 0 0 1 0 0 0 0
1 0 0 3 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0
1 0 0 0 0 0 0 0 0 0 0 0
1 0 0 1 0 0 0 0 0 0 0 0
1 0 0 1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 1 0 0 0 0
Grade 12 Others (ie college, vocational, etc)
0 0
0 0
0 0
0 0
0 0
0 1
0 1
0 0
0 0
0 0
0 1
0 0
0 1
0 0
1 1
0 0
0 0
0 1
0 0
0 0
0 0
0 0
Who among the household members can provide instructional support to the child’s distance learning? Choose all that applies.
parents/ guardians/ magulang o tagapag-alaga, extended members of the family/ iba pang kamag-anak
parents/ guardians/ magulang o tagapag-alaga
parents/ guardians/ magulang o tagapag-alaga, grandparents/ lolo o lola, able to do independent learning/ may kakayahang ma
parents/ guardians/ magulang o tagapag-alaga, elder siblings/ nakatatandang kapatid
parents/ guardians/ magulang o tagapag-alaga, grandparents/ lolo o lola
parents/ guardians/ magulang o tagapag-alaga, elder siblings/ nakatatandang kapatid, extended members of the family/ iba pa
parents/ guardians/ magulang o tagapag-alaga, extended members of the family/ iba pang kamag-anak
elder siblings/ nakatatandang kapatid
What devices are available at home that the learner can use for learning? Check all that applies. Others:
none/ wala
smartphone
smartphone
non-cable TV, smartphone, tablet
cable TV, smartphone, tablet, desktop computer, laptop
non-cable TV, basic cellphone
smartphone, laptop
non-cable TV, smartphone, tablet, desktop computer, laptop
basic cellphone, smartphone
basic cellphone, laptop
non-cable TV, basic cellphone
laptop
smartphone, desktop computer N/A
non-cable TV, smartphone NONE
smartphone
none/ wala
smartphone
smartphone
smartphone N/A
smartphone, tablet
Do you have a way to connect to the internet?
No/ Wala
Yes/ Mayroon
Yes/ Mayroon
Yes/ Mayroon
Yes/ Mayroon
No/ Wala
Yes/ Mayroon
Yes/ Mayroon
No/ Wala
Yes/ Mayroon
No/ Wala
Yes/ Mayroon
Yes/ Mayroon
Yes/ Mayroon
No/ Wala
No/ Wala
No/ Wala
No/ Wala
Yes/ Mayroon
Yes/ Mayroon
Yes/ Mayroon
Yes/ Mayroon
Choose all that applies
own mobile data/ sariling mobile data

own mobile data/ sariling mobile data, other places outside the home with internet connection (library, barangay/ municipal hall,
own broadband internet (DSL, wireless fiber, satellite)/ sariling DSL, WIFI o satellite

none/ wala

What distance learning modality/ies do you prefer for your child? Others:
modular learning/ pagkatutong modyular
online learning
online learning, modular learning/ pagkatutong modyular
online learning, television/ telebisyon, modular learning/ pagkatutong modyular
online learning
modular learning/ pagkatutong modyular N/A
online learning NONE
online learning, modular learning/ pagkatutong modyular N/A
What are the challenges that may affect your child’s learning process through distance education? Choose all that applies.
difficulty in independent learning/ nahihirapang mag-aral nang mag-isa
unstable mobile/ internet connection/ Hindi maayos na koneksiyon sa cellphone/internet
lack of available gadgets/ equipment/ kawalan ng gadgets/kagamitan
lack of available gadgets/ equipment/ kawalan ng gadgets/kagamitan, insufficient load/ data allowance/ kakulangan sa badyet p
conflict with other activities (i.e., house chores)/ may mga kasabay na ibang gawaing bahay, distractions (i.e., social media, noi
insufficient load/ data allowance/ kakulangan sa badyet para sa load/data, difficulty in independent learning/ nahihirapang mag-
difficulty in independent learning/ nahihirapang mag-aral nang mag-isa, conflict with other activities (i.e., house chores)/ may m
insufficient load/ data allowance/ kakulangan sa badyet para sa load/data, unstable mobile/ internet connection/ Hindi maayos
unstable mobile/ internet connection/ Hindi maayos na koneksiyon sa cellphone/internet, conflict with other activities (i.e., house
distractions (i.e., social media, noise from community/neighbor)/ mga sagabal sa pag-aaral(hal.:social media, ingay mula sa kom
unstable mobile/ internet connection/ Hindi maayos na koneksiyon sa cellphone/internet, difficulty in independent learning/ nahi
unstable mobile/ internet connection/ Hindi maayos na koneksiyon sa cellphone/internet
Others: Printed Name of Parent/Guardian Date Email Address
Edellyn Caballes 1/29/1996
Annabelle tripulca 4/25/1982 Belle torres
Rose Flor B.Deniega 8/16/2020 levantinorose9@gmail.com
tractions (i.e., so Espejo ,heide 8/18/2020 Espejoheide09@gmail.com
MANUBAY, ABIGAIL M. 8/25/2020 Manubay.abigail@yahoo.com
bal sa pag-aaral(ha Bacli,Irene C 8/16/2020 Roldantenonasbacli27@gmail.com
Anita Malogan Rabadon 8/17/2020 karenrabadon@gmail.com
JESSA L. MABBAYAD 8/19/2020 jessamabbayad@gmail.com
valencia, cristina moreno 8/22/2020 angelosanchez7325@gmail.com
Rachelle Rago Payabyab 8/25/2020 nayrpayabyab05@gmail.com
bal sa pag-aaral(ha Bacli,Irene C 8/16/2020 Roldantenonasbacli27@gmail.com
PAMELA COSIO 8/17/2020 VISITELLA@GMAIL.COM
N/A EDWIN M. FELICIANO 8/17/2020 mheng_029@yahoo.com.ph
NONE JERAMIE ENRIQUEZ GUEVARRA 8/18/2020 jem_happy23
TAMONDONG, MARITES, P 8/17/2020 teamyey71@gmail.com
ROSE MARIE N ARBOSO 8/16/2020
YLAGAN KATRINA LOPEZ 8/17/2020
RHEA MAE R. DEGUIT 8/19/2020 pisanostroy21@gmail.com
N/A Michelle B. Diongson 8/21/2020 michellediongson@gmail.com
Marvic Agulto 8/24/2020 Buldits_08@yahoo.com
MARVIC RIVERA AGULTO 8/24/2020 Buldits_08@yahoo.com
Mylene L. Pantaleon 8/25/2020 mylenepantaleon@yahoo.com

Day 75 86 MLQES

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Day 75 86 MLQES

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Timestamp School Year Check the appropriate boxes only Grade Level to enroll:

8/15/2020 16:16:45 2020-2021 With LRN/ May LRN Grade 1

406726-Immaculada Concepcion College

483651-Mater Fidelis School of Llano Inc.

406726-Immaculada Concepcion College

406726-Immaculada Concepcion College

107845 - Mangas ES Mangas 1 , Alfonso Cavite

College undergraduate bs chemistry

College undergraduate bs chemistry

own mobile data/ sariling mobile data

own mobile data/ sariling mobile data

own mobile data/ sariling mobile data

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