The sample document provided is just a sample. The sample document is only meant to provide a guideline on how to make the document.
The Microsoft Word template has been purposefully not provided, as individual situations will vary. You should modify the wording accordingly and make your own document.
It is not a good idea to just fill in the blanks on the Microsoft Word template, as it may create problems and may not even be accepted.
Again, do not simply copy the document and just fill in your name/address. Please, make your own document for the best results.