<SEC-DOCUMENT>0001104659-19-016618.txt : 20190419
<SEC-HEADER>0001104659-19-016618.hdr.sgml : 20190419
<ACCEPTANCE-DATETIME>20190321173342
<PRIVATE-TO-PUBLIC>
ACCESSION NUMBER:		0001104659-19-016618
CONFORMED SUBMISSION TYPE:	CORRESP
PUBLIC DOCUMENT COUNT:		2
FILED AS OF DATE:		20190321

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			ALCON INC
		CENTRAL INDEX KEY:			0001167379
		STANDARD INDUSTRIAL CLASSIFICATION:	OPHTHALMIC GOODS [3851]
		IRS NUMBER:				980205094
		STATE OF INCORPORATION:			V8
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		CORRESP

	BUSINESS ADDRESS:	
		STREET 1:		6201 SOUTH FREEWAY
		CITY:			FORT WORTH
		STATE:			TX
		ZIP:			76134
		BUSINESS PHONE:		817 293 0450

	MAIL ADDRESS:	
		STREET 1:		CHEMIN DE BLANDONNET 8
		STREET 2:		1214 VERNIER
		CITY:			GENEVA
		STATE:			V8
		ZIP:			0000
</SEC-HEADER>
<DOCUMENT>
<TYPE>CORRESP
<SEQUENCE>1
<FILENAME>filename1.htm
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<p align="right" style="margin:0in 0in .0001pt;text-align:right;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">March&nbsp;21, 2019</font></p>
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<p align="center" style="margin:0in 0in .0001pt;text-align:center;"><u><font size="2" face="Times New Roman" style="font-size:10.0pt;">Alcon Inc.<br> Amendment No.&nbsp;4 to Form&nbsp;20-F<br> Filed February&nbsp;28, 2019<br> File No.&nbsp;001-31269</font></u></p>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Dear Ms.&nbsp;Percival:</font></p>
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<p style="margin:0in 0in .0001pt;text-indent:1.0in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Alcon Inc. (the &#147;<u>Company</u>&#148;) has today submitted with the U.S. Securities and Exchange Commission (the &#147;<u>SEC</u>&#148;), via EDGAR, this letter and Amendment No.&nbsp;6 (&#147;<u>Amendment No.&nbsp;6</u>&#148;) to its draft Registration Statement on Form&nbsp;20-F first submitted to the SEC on November&nbsp;13, 2018 (the &#147;<u>Registration Statement</u>&#148;).&#160; This letter and Amendment No.&nbsp;6 set forth the Company&#146;s responses to the comments of the staff of the SEC (the &#147;<u>Staff</u>&#148;) contained in your letter dated March&nbsp;11, 2019 (the &#147;<u>Comment Letter</u>&#148;), relating to Amendment No.&nbsp;4 to the Registration Statement submitted to the SEC on February&nbsp;28, 2019 (&#147;<u>Amendment No.&nbsp;4</u>&#148;).&#160; Clean copies of Amendment No.&nbsp;6 and copies of Amendment No.&nbsp;6 that have been marked to show changes made to Amendment No.&nbsp;4 (the &#147;<u>Marked Registration Statement</u>&#148;) are enclosed for your convenience along with copies of this letter.</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt;text-indent:1.0in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">The numbered paragraphs and headings below correspond to those set forth in the Comment Letter.&#160; Each of the Staff&#146;s comments is set forth in bold, followed by the Company&#146;s response to each comment. Capitalized terms used in this letter but not defined herein have the meaning given to such terms in Amendment No.&nbsp;6. All references to page&nbsp;numbers in these responses are to pages&nbsp;of the Marked Registration Statement.</font></p>
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<p style="margin:0in 0in .0001pt;"><b><u><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">Form&nbsp;20-F amended February&nbsp;28, 2019<br> Failure to comply with law..., page&nbsp;53</font></u></b></p>
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<p style="font-size:10.0pt;margin:0in 0in .0001pt .5in;text-indent:-.3in;"><b><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">1.</font></b><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font><b>We note your response to prior comment 1 providing the aggregate revenue for the referenced geographical locations over the three year period ended December&nbsp;31, 2018.&#160; Tell us the breakdown of revenue for the referenced geographical location for each fiscal year.&#160; Also, ensure that your risk factor</b></p>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;"><b><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">includes a brief discussion of each allegation subject to the investigations you mention.&#160; In this regard, it is unclear whether you are &#147;including&#148; only a partial list of the allegations in your description in the last full sentence on page&nbsp;53 and the second sentence on page&nbsp;54.&#160; Also, specify the nature of allegations regarding the investigation into your &#147;business practices&#148; and &#147;relationships with third-party distributors&#148;.</font></b></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt .5in;text-indent:49.5pt;"><b><i><font size="2" face="Times New Roman" style="font-size:10.0pt;font-style:italic;font-weight:bold;">Response: &#160;</font></i></b>The Company will revise its disclosure on page&nbsp;54 to provide the breakdown of revenue for the referenced geographical location for each fiscal year of the three year period ended December&nbsp;31, 2018 (rather than providing the range for the three-year period).&#160; With respect to the remaining requests, the Company respectfully advises the Staff that the disclosed investigations remain open and no legal proceedings relating to either investigation (either the 2011 investigation or the DOJ/SEC investigation) have been instituted against the Company or its employees to date.&#160; Regarding the 2011 investigation, the Company will revise its disclosure on page&nbsp;53 to delete the &#147;including&#148; references to clarify that the description covers the full scope of the allegations the Company is aware of relating to this investigation.</p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Regarding the DOJ/SEC investigation, the Company respectfully advises the Staff that while certain subpoenas and information requests have been received by the Company with respect to this investigation, no charging documents or formal complaints have been delivered to, and no formal allegations have been made against, the Company with respect to this investigation and the Company is not in a position to speculate as to future developments with respect to the investigation.&#160; Therefore, at this time there is insufficient certainty to provide meaningful additional color to investors on the scope of the investigations and, moreover, given the status of the investigations, such disclosure would be speculative and of limited benefit to investors.</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt;"><b><u><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">Audited Combined Financial Statements for the Year Ended December&nbsp;31, 2018<br> Note 3. Selected critical accounting policies, Revenue Recognition, page&nbsp;F-18</font></u></b></p>
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<p style="font-size:10.0pt;margin:0in 0in .0001pt .5in;text-indent:-.3in;"><b><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">2.</font></b><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font><b>We note from your response to comment 2 that certain of your contracts provide for consideration paid in installments with either fixed term payment terms or usage-based payment terms (i.e., payments through a surcharge on the subsequent purchase price of consumables and/or implantables). Please address the following:</b></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt .75in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font><b>Describe to us in greater detail the usage-based payment terms and how you account for the surcharge on the subsequent purchases.&#160; We note that your disclosure of the common elements of variable consideration on page&nbsp;F-19 does not include discussion of usage-based payment terms, and you do not appear to disclose any contract assets for equipment transferred before payment is due through subsequent usage.</b></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt .75in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font><b>Describe to us the period over which you typically reserve payment for installment sales.</b></p>
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<p style="font-size:10.0pt;margin:0in 0in .0001pt .75in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font><b>Tell us how you applied the guidance in IFRS 15.60-15.65 with respect to the existence of a significant financing component in the contracts.</b></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt .75in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font><b>Tell us your consideration of IFRS 15.119(b)&#146;s requirement to disclose information about the significant payment terms (e.g., when payment is typically due, whether the contract has a significant financing component,&nbsp;etc.) and IFRS 15.129&#146;s requirement to disclose application of the practical expedient related to significant financing components.</b></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt .75in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font><b>Describe to us how the consideration for the equipment sale that represents a surcharge on the subsequent purchase price of consumables and/or implantables is presented in your disclosure of net sales by business franchise on page&nbsp;F-30. In this regard, it is unclear whether the surcharge is captured as part of &#147;Equipment/other&#148; or within the respective &#147;Implantables&#148; or &#147;Consumables&#148; business franchise.</b></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;"><b><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">Please tell us whether the customer has the right to put the equipment back to you and whether you have the right to retake control of the equipment. If so, please explain to us the terms surrounding such right(s)&nbsp;and how you account for these rights.</font></b></p>
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<p style="font-size:10.0pt;margin:0in 0in .0001pt .5in;text-indent:49.5pt;"><b><i><font size="2" face="Times New Roman" style="font-size:10.0pt;font-style:italic;font-weight:bold;">Response:&#160; </font></i></b>The Company advises the Staff that the &#147;usage-based payment terms&#148; are not variable consideration in the measurement of the transaction price for revenue recognition purposes. Usage-based payment terms in installment sales arrangements pertain to the pattern of payment by which the customer pays down its outstanding receivable balance for surgical equipment and as a result, under the terms of the arrangements, do not meet the definition of variable consideration in IFRS 15 paragraphs 50-59 in determining the transaction price.&#160; Therefore, usage-based payment terms are not disclosed on page&nbsp;F-19 in the Company&#146;s revenue policy disclosures as one of the common elements of variable consideration.</p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Because the performance obligations under installment sales arrangements for surgical equipment with usage-based payment terms are satisfied at a point in time, the transaction price under these arrangements is measured and sales are recorded at the date the Company&#146;s performance obligations are met along with a corresponding receivable, which is not a contract asset, recorded for the full amount of the transaction price allocated to the surgical equipment. No contract asset is required to be recognized. The outstanding installment sales receivables, as at December&nbsp;31, 2018 and 2017, are disclosed in the Note 11, <i>Financial and other non-current assets</i> table in the line &#147;Long-term receivables from customers&#148; on page&nbsp;F-41, and in the Note 14, <i>Other current assets</i> table in the line &#147;Current portion of long-term receivables from customers&#148; on page&nbsp;F-44.</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">The financing component of installment sales arrangements is taken into consideration in measuring the transaction price for the effects of the time value of money, based on the period of time for customer repayment and the prevailing market interest rate in the relevant market, in accordance with IFRS 15</font></p>
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<p style="margin:0in 0in .0001pt .5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">paragraphs 60-65.&#160; The financial income component, which is not material (less than USD 20 million per annum), is recognized separately from revenue over the repayment period in &#147;Other Income.&#148;&#160; To enhance disclosures, the Company has revised its Revenue policy disclosure in Note 3, <i>Significant accounting policies </i>(page&nbsp;F-19) to address the Staff&#146;s comment to consider disclosure of the financing component and practical expedient applied to installment sales arrangements with payment terms of one year or less in duration (IFRS 15 paragraphs 63 and 129).</font></p>
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<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Paragraph 119(b)&nbsp;was considered relative to disclosure of significant payment terms.</font></p>
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<p style="font-size:10.0pt;margin:0in 0in .0001pt 1.0in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>The Company disclosed when payment is typically due within the tables in Note 11, <i>Financial and other non-current assets </i>(page&nbsp;F-41) and Note 14,<i> Other current assets</i> (page&nbsp;F-44) which show the bifurcation of current and non-current receivables from customers.&#160; To enhance disclosures, the Company has revised its Revenue policy disclosure in Note 3, <i>Significant accounting policies </i>(page&nbsp;F-19) to address the Staff&#146;s comment and provided additional information on installment sales arrangements within the Revenue policy.</p>
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<p style="font-size:10.0pt;margin:0in 0in .0001pt 1.0in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>The Company disclosed its common elements of variable consideration in Note 3, <i>Significant accounting policies </i>(page&nbsp;F-19).&#160; As discussed above, usage-based payments related to installment sales do not constitute variable consideration and therefore are not included as an element of variable consideration disclosure.</p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;"><u><font size="2" face="Times New Roman" style="font-size:10.0pt;">Recording transactions for surgical equipment installment arrangements with usage-based payment terms</font></u></p>
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<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">The Company recognizes revenue for the surgical equipment upon transfer of control to the customer and when the Company&#146;s performance obligations are met (including delivery, physical installation, and any required training including clinical training) and simultaneously establishes a current and long-term receivable from the customer.</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt 1.0in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>The surgical equipment revenue is reflected in &#147;Equipment/other&#148; in the Company&#146;s disclosure of net sales by business franchise in Note 5, <i>Segment Information</i> (page&nbsp;F-30).&#160; Financing income for installment sales arrangements longer than twelve months is recognized over time in &#147;Other Income&#148; and is not material to Alcon&#146;s financial statements (less than USD 20 million per annum).</p>
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<p style="font-size:10.0pt;margin:0in 0in .0001pt 1.0in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>The corresponding current- and long-term equipment receivable from the customer are recorded within &#147;Other current assets&#148; and &#147;Financial assets&#148;, respectively.&#160; The Financial assets disclosure in Note 3, <i>Significant accounting policies</i> (page&nbsp;F-16) states that Non-current financial assets include long-term receivables from customers, which are primarily related to surgical equipment sales arrangements.&#160; These long-term receivables are carried at amortized cost which reflects the time value</p>
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<p style="margin:0in 0in .0001pt 1.0in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">of money, less any allowances for uncollectable amounts, which are based on expected credit losses.</font></p>
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<p style="margin:0in 0in .0001pt .5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Upon subsequent sales of consumables and/or implantables, the Company invoices the customer for the consumables and/or implantables at their transaction price. The customer&#146;s periodic invoice also includes a notice for the customer to pay an amount toward the customer&#146;s outstanding surgical equipment receivable balance.&#160; This notice is calculated by amounts pre-determined in the surgical equipment sales agreement (referred to as a &#147;surcharge&#148; by the Company) multiplied by the quantity of consumables and/or implantables in the invoice and is due under normal trade terms.</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt 1.0in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>Revenue is recognized for the consumables and/or implantables at their respective transaction price, adjusted for any variable consideration, and a corresponding trade receivable is established, as control of the consumables and/or implantables has transferred to the customer and the performance obligations have been met.&#160; Revenue for the sale of the consumables and/or implantables is reflected in &#147;Consumables&#148; or &#147;Implantables&#148; in the Company&#146;s disclosure of net sales by business franchise in Note 5, <i>Segment Information</i> (page&nbsp;F-30).</p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="font-size:10.0pt;margin:0in 0in .0001pt 1.0in;text-indent:-.25in;"><font size="2" face="Symbol" style="font-size:10.0pt;">&#183;</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>The portion of the payment related to the payback of the outstanding surgical equipment receivable from the customer (referred to as a &#147;surcharge&#148; by the Company) is applied to the customer&#146;s surgical equipment receivable balance when received.</p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt;text-indent:.5in;"><u><font size="2" face="Times New Roman" style="font-size:10.0pt;">Payment period for surgical equipment installment arrangements</font></u></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Installment sales arrangements for surgical equipment typically range from one to five years in duration, with average payback of between two to three years.&#160; Below are balances for outstanding current- and long-term receivables as disclosed in Note 14, <i>Other current assets</i> (page&nbsp;F-44) and Note 11,<i> Financial and other non-current assets</i> (page&nbsp;F-41), respectively, with current- and long-term representing approximately 45% and 55% of the total balance, respectively.</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
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<tr>
<td width="67%" valign="bottom" style="padding:0in 0in 0in 0in;width:67.88%;">
<p style="margin:0in 0in .0001pt;"><b><font size="1" face="Times New Roman" style="font-size:1.0pt;font-weight:bold;">&nbsp;</font></b></p>    </td>
<td width="2%" valign="bottom" style="padding:0in 0in 0in 0in;width:2.68%;">
<p align="center" style="margin:0in 0in .0001pt;text-align:center;"><b><font size="1" face="Times New Roman" style="font-size:1.0pt;font-weight:bold;">&nbsp;</font></b></p>    </td>
<td width="12%" colspan="2" valign="bottom" style="border:none;border-bottom:solid windowtext 1.0pt;padding:0in 0in 0in 0in;width:12.86%;">
<p align="center" style="margin:0in 0in .0001pt;text-align:center;"><b><font size="1" face="Times New Roman" style="font-size:8.0pt;font-weight:bold;">2018</font></b></p>    </td>
<td width="2%" valign="bottom" style="padding:0in 0in 0in 0in;width:2.68%;">
<p align="center" style="margin:0in 0in .0001pt;text-align:center;"><b><font size="1" face="Times New Roman" style="font-size:1.0pt;font-weight:bold;">&nbsp;</font></b></p>    </td>
<td width="12%" colspan="2" valign="bottom" style="border:none;border-bottom:solid windowtext 1.0pt;padding:0in 0in 0in 0in;width:12.86%;">
<p align="center" style="margin:0in 0in .0001pt;text-align:center;"><b><font size="1" face="Times New Roman" style="font-size:8.0pt;font-weight:bold;">2017</font></b></p>    </td>
<td width="1%" valign="bottom" style="padding:0in 0in 0in 0in;width:1.06%;">
<p align="center" style="margin:0in 0in .0001pt;text-align:center;"><b><font size="1" face="Times New Roman" style="font-size:1.0pt;font-weight:bold;">&nbsp;</font></b></p>    </td>   </tr>
<tr>
<td width="67%" valign="top" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:67.88%;">
<p style="margin:0in 0in .0001pt 10.0pt;text-indent:-10.0pt;"><b><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">Current   portion of long-term receivables from customers</font></b></p>    </td>
<td width="2%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:2.68%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>
<td width="4%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:4.44%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">USD</font></p>    </td>
<td width="8%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:8.42%;">
<p align="right" style="margin:0in 0in .0001pt;text-align:right;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">133m</font></p>    </td>
<td width="2%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:2.68%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>
<td width="4%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:4.98%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">USD</font></p>    </td>
<td width="7%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:7.88%;">
<p align="right" style="margin:0in 0in .0001pt;text-align:right;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">159m</font></p>    </td>
<td width="1%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:1.06%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="67%" valign="top" style="padding:0in 0in 0in 0in;width:67.88%;">
<p style="margin:0in 0in .0001pt 10.0pt;text-indent:-10.0pt;"><b><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">Long-term   receivables from customers</font></b></p>    </td>
<td width="2%" valign="bottom" style="padding:0in 0in 0in 0in;width:2.68%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>
<td width="4%" valign="bottom" style="padding:0in 0in 0in 0in;width:4.44%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">USD</font></p>    </td>
<td width="8%" valign="bottom" style="padding:0in 0in 0in 0in;width:8.42%;">
<p align="right" style="margin:0in 0in .0001pt;text-align:right;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">164m</font></p>    </td>
<td width="2%" valign="bottom" style="padding:0in 0in 0in 0in;width:2.68%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>
<td width="4%" valign="bottom" style="padding:0in 0in 0in 0in;width:4.98%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">USD</font></p>    </td>
<td width="7%" valign="bottom" style="padding:0in 0in 0in 0in;width:7.88%;">
<p align="right" style="margin:0in 0in .0001pt;text-align:right;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">197m</font></p>    </td>
<td width="1%" valign="bottom" style="padding:0in 0in 0in 0in;width:1.06%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="67%" valign="top" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:67.88%;">
<p style="margin:0in 0in .0001pt 10.0pt;text-indent:-10.0pt;"><b><font size="2" face="Times New Roman" style="font-size:10.0pt;font-weight:bold;">Total</font></b></p>    </td>
<td width="2%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:2.68%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>
<td width="4%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:4.44%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">USD</font></p>    </td>
<td width="8%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:8.42%;">
<p align="right" style="margin:0in 0in .0001pt;text-align:right;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">297m</font></p>    </td>
<td width="2%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:2.68%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>
<td width="4%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:4.98%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">USD</font></p>    </td>
<td width="7%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:7.88%;">
<p align="right" style="margin:0in 0in .0001pt;text-align:right;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">356m</font></p>    </td>
<td width="1%" valign="bottom" bgcolor="#CCEEFF" style="background:#CCEEFF;padding:0in 0in 0in 0in;width:1.06%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>  </table>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt;text-indent:.5in;"><u><font size="2" face="Times New Roman" style="font-size:10.0pt;">Right of return</font></u></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">The customer has the right to return the equipment to the Company up to the point in time that control over the equipment is transferred to the customer. During this period of time, no revenue is recorded by the Company. As the Company informed the Staff in its December&nbsp;27, 2018 response to question number 16 to the Staff&#146;s comment letter dated December&nbsp;10, 2018, surgical</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p align="center" style="font-size:10.0pt;margin:0in 0in .0001pt;text-align:center;">5<a name="PB_5_214731_5796"></a></p>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">equipment revenue is recognized when control is transferred and the Company&#146;s performance obligations are met. Control over surgical equipment is considered transferred to the customer and our performance obligations are met upon completion of the full installment services (including delivery, physical installation, and any required training, including clinical training). The Company&#146;s equipment installment sales arrangements typically include contract termination clauses but do not provide the customer with a substantive right to put the equipment back to the Company after control over the surgical equipment has been transferred to the customer.</font></p>
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Subject to applicable local laws, the Company&#146;s right to retake control of equipment is limited to cases of material breach by the customer (e.g., from nonpayment).</font></p>
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<p align="center" style="font-size:10.0pt;margin:0in 0in .0001pt;text-align:center;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">*</font><font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>*<font size="1" style="font-size:3.0pt;">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160; </font>*</p>
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<p align="center" style="font-size:10.0pt;margin:0in 0in .0001pt;text-align:center;">6<a name="PB_6_214803_2897"></a></p>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p style="margin:0in 0in .0001pt .5in;text-indent:.5in;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">On behalf of the Company, please allow us to express our appreciation of your attention to this matter.&#160; Should you have any questions or comments with respect to this response letter, please contact D. Scott Bennett at 212-474-1132.</font></p>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Sincerely,</font></p>    </td>   </tr>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>   </tr>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>   </tr>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">D.   Scott Bennett</font></p>    </td>   </tr>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Heather   Percival</font></p>    </td>
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<p style="margin:0in 0in .0001pt 20.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Division of Corporation Finance</font></p>    </td>
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<p style="margin:0in 0in .0001pt 30.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Office of Electronics and Machinery</font></p>    </td>
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<p style="margin:0in 0in .0001pt 40.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Securities and Exchange Commission</font></p>    </td>
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<p style="margin:0in 0in .0001pt 50.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">100 F Street, NE</font></p>    </td>
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<p style="margin:0in 0in .0001pt 60.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Washington, D.C. 20549-0001</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">VIA   EDGAR AND OVERNIGHT DELIVERY</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Copy   to:</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
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<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
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<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>   </tr>
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<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Mr.&nbsp;Royce   Bedward</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt 20.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">General Counsel</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt 30.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Alcon Inc.</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt 40.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">Chemin de Blandonnet 8</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt 10.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt 50.0pt;text-indent:-10.0pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">1714 Vernier, Geneva,   Switzerland</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>
<tr>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>    </td>   </tr>
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<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">VIA E-MAIL</font></p>    </td>
<td width="50%" valign="top" style="padding:0in 0in 0in 0in;width:50.0%;">
<p style="margin:0in 0in .0001pt;"><font size="2" face="Times New Roman" style="font-size:1.0pt;">&nbsp;</font></p>    </td>   </tr>  </table>
<p style="margin:0in 0in .0001pt 27.35pt;text-indent:-27.35pt;"><font size="2" face="Times New Roman" style="font-size:10.0pt;">&nbsp;</font></p>
<p align="center" style="font-size:10.0pt;margin:0in 0in .0001pt;text-align:center;">7<a name="PB_7_215015_3020"></a></p>
<div style="margin:0in 0in .0001pt;"><hr size="3" width="100%" noshade align="left" style="color:#010101;"></div>
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end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
