Exhibit 22 - FTC-SVC-43 Receiving Report.pdf

FTC-SVC-43 (07/06)

ROLEPLAYER SERVICES

RECEIVING REPORT / TIME AND ATTENDANCE RECORD

NOTE: In order to complete this record, the Instructor must do the following:

1. Record names of roleplayers, note actual arrival time (time in) and actual completion time (time out) for each roleplayer and have roleplayer(s) initial report.

2. Print and sign form in appropriate block below. Include division/agency & phone extension. If required, make copy for division/agency file.

3. Forward the original to the Roleplayer COTR’s Office, SVC, Building 681 no later than COB of the following workday.

DATE: SCENARIO NO. & TITLE:

PROGRAM & CLASS NO: SCHEDULED EXERCISE TIME:

Roleplayer Name

(Please Print)

TIME

IN

TIME

OUT

*ROLEPLAYER

INITIALS

NOTES

Instructor Signature (Print & Sign) Division/Agency Phone Ext.

ORIGINAL: ROLEPLAYER COTR, SVC, BUILDING 681, ROOM B237

*Roleplayers are required to initial record to verify times recorded.

SECTION J - EXHIBIT 22