Examiner's Form

Date:May 31, 1987

Examiner's Form, HCO Policy Letter of 4 March 1971.

This form reflects an I & R Interview with Lisa Skonetski at CC Dallas on May 31, 1987, at 4:22 pm.

Under "PC's Statement (Write down exactly what pc says.)", the examiner wrote "NS."

TA Position is given as 3.0.

Under "Pc Indicators", the examiner wrote "BIs (almost frowning)"

"State of Needle" is listed as "Falling", so "F/N Indicated to pc" is marked "no".

Gary Richie, Examiner, signed the form.

FSO 2104