[104-10225-10003.pdf — page 361]
# SECRET(WHEN FILLED IN)## QUALIFICATIONS SYSTEM RECORD CHANGE### APPLICANT CODING DATA| 1. ID | 2. APPL. NO. 6-DIGITS | 3. NAME MUST CONTAIN 20-DIGITS || ----- | --------------------- | ------------------------------ || <2 •  | •                     | •                              || 4. DATE OF BIRTH | 5. DATE CODED |                                                                                                                                                                              || ---------------- | ------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------- || MO DA YR         | MO DA YR      |                                                                                                                                                                              ||                  |               | THE DATA ABOVE (ITEMS 2 THRU 5) WILL BE FILLED IN WHEN CODING AN APPLICANT FOR THE FIRST TIME, THIS FORM IS THEN ATTACHED TO FORM 1962, MASTER QUALIFICATIONS CODING RECORD. |### LANGUAGE CODING DATA - FORM 444c| 1. ID             | 2. EMPLOYEE NO.  | 3. NAME 3-LETTERS                                                                                       | 4. LANGUAGE DATA CODE BASE CODE | R   | W   | P   | S   | U   | T   | YR  || ----------------- | ---------------- | ------------------------------------------------------------------------------------------------------- | ------------------------------- | --- | --- | --- | --- | --- | --- | --- || <3 •              | •                | •                                                                                                       |                                 |     |     |     |     |     |     |     || 5. DATE SUBMITTED | 6. DATE OF BIRTH |                                                                                                         |                                 |     |     |     |     |     |     |     || MO DA YR          | MO DA YR         | WHEN FORM 444c DENOTES NO LANGUAGE COMPETENCE, ENTER THE FOLLOWING IN ITEM 4: "NO+LANGUAGE" (12-DIGITS) |                                 |     |     |     |     |     |     |     |### LANGUAGE PROFICIENCY TEST DATA| 1. ID                       | 2. EMPLOYEE NO. | 3. NAME 3-LETTERS                                                                         | 4. CODE C-A-D | 5. LANGUAGE DATA BEFORE TEST BASE CODE | R   | W   | P   | S        | U   | T   | YR  |     || --------------------------- | --------------- | ----------------------------------------------------------------------------------------- | ------------- | -------------------------------------- | --- | --- | --- | -------- | --- | --- | --- | --- || <5 •                        | $25658          | Pic                                                                                       | C             | BL18                                   | 4   | 3   | 4   | 4        | 4   | 4   | 59  |     || 6. LANGUAGE DATA AFTER TEST | 7. DATE OF TEST | DATA FOR ITEM 2 THRU 7 IS EXTRACTED FROM FORM 1273, LANGUAGE PROFICIENCY AND AWARDS DATA. |               |                                        |     |     |     |          |     |     |     |     || BASE CODE                   | R               | W                                                                                         | P             | S                                      | U   | T   | YR  | MO DA YR |     |     |     |     || BL18                        | E               | 3                                                                                         | /             | E                                      | 1   | 4   | 68  | 4        | 4   | 4   | 9   | 68  |### QUALIFICATIONS RECORD CHANGE| 1. ID | 2. EMP/APPL NO. | 3. NAME 3-LETTERS | ENTER UNDER "TYPE"- A - ADDITION TO RECORD C - CHANGE TO EXISTING RECORD D - DELETION OF DATA FROM EXISTING RECORD || ----- | --------------- | ----------------- | ------------------------------------------------------------------------------------------------------------------ || <4 •  | •               | •                 |                                                                                                                    || TYPE | BASE | CODE # 1 |     | YR  | BASE | CODE # 2 |     |     |     || ---- | ---- | -------- | --- | --- | ---- | -------- | --- | --- | --- ||      |      | 1        | 2   | 3   |      | 1        | 2   | 3   | YR  || •    | •    | •        | •   | •   | •    | •        | •   | •   |     || •    | •    | •        | •   | •   | •    | •        | •   | •   |     || •    | •    | •        | •   | •   | •    | •        | •   | •   |     || •    | •    | •        | •   | •   | •    | •        | •   | •   |     || •    | •    | •        | •   | •   | •    | •        | •   | •   |     || •    | •    | •        | •   | •   | •    | •        | •   | •   |     || •    | •    | •        | •   | •   | •    | •        | •   | •   |     || •    | •    | •        | •   | •   | •    | •        | •   | •   |     |Form 10-64 1962a 06 JUN 1968 SECRET![group 1 stamp] (6.511)