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Word allows you to set a custom page size but it doesn't set the printer/printer driver to the custom size when you print. In fact, it may explicitly request Letter size paper.
Result: Letter-size PDFs, no matter what you asked for. And usually any PDFMaker-created links will be in the wrong place.
If you use the AdobePS printer driver in Windows (and possibly on other systems ... I don't know) there's a workaround.
Use the printer driver's Properties page (Start, Settings, Printer, etc) to define a new Custom page size; it should be the same size as you want to use in Word. Give it a name that makes sense to you and save it.
Now start Word. When you choose the AdobePS driver, one of your Word page size options will now be the new custom page size you just set up. Choose this rather than Word's Custom page size.
You should now be able to make PDFs of virtually any custom size you like.
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