LOS SANTOS EMERGENCY SERVICES OFFICIAL DOCUMENT, PAGE 1 FORM LSESPTRBASICEVAL001 www.lossantosemergencyservices.

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LOS SANTOS EMERGENCY SERVICES INSTRUCTION EVALUATION FORM PTRBASIC

FORM: FORM #: COURSE ID: LSESPTRBASICEVAL001 INTENTIONALLY LEFT BLANK PTRBASIC001 PERSONNEL: DATE: EVALUATOR: (FIRSTNAME LASTNAME) (MM.DD.YY) (RANKABRV. FIRSTNAME LASTNAME) BY THE ORDER OF: REMARKS: RGX (REMARKS) This form is intended and required for use of evaluation by the evaluator of an official evaluation as set by Course PTRBASIC001. All content of this document is identified and determined official with authorization by the publishing or submission of this document. Seek course information in LSESPTRBASICINSGUIDE001. I authorize and signify complete permission and decision in the completion and submission of this form and all of its content to be integral, consistent, full, and professional. I understand all responsibilities, as well as logistics of the process of instruction, and that this cannot be discarded or voided unless recognized by LSS as an unfit submission because of format or content.

GENERAL INFORMATION PERSONNEL: (FIRSTNAME LASTNAME) TYPE: (T) DATE: COURSE: PTRBASIC001 EVALUATOR: (RANKABRV. FIRSTNAME LASTNAME) EVALUATION SCORES VEHICLE OPERATION: (##) /20 ** CONDUCT: (##) /5 ARMS OPERATION: (##) /10 COMMUNICATION: (##) /20 ** SITUATIONAL COMPREHENSION: (##) /40 * NAVIGATION: (##) /5 REMARKS TOTAL SCORE: (##) /100 *** PASS: (X) **** FAIL: (X) **** REMARKS: (REMARKS) COURSE FOR FURTHER TRAINING: (COURSENAMEHERE) **** RETRAINING DATE: (MM.DD.YY) **** REQUIRED EVENTS: (##) **** EVALUATOR: (RANKABRV. FIRSTNAME LASTNAME) BY THE ORDER OF: RGX COPYRIGHT 2013 LOS SANTOS EMERGENCY SERVICES CLAN All elements and features of the creation of this document with the exception of trademarked and rights reserved materials are created and utilized intentionally for relations with the Los Santos Emergency Services Clan solely. Any and all portions of this document may be modified, released, exhibited, shared, or presented any method with appropriate authorization from the creator of the document of Command Corps personnel. All properties in terms of creation or content are considered classified otherwise.

LOS SANTOS EMERGENCY SERVICES OFFICIAL DOCUMENT, PAGE 2 FORM LSESPTRBASICEVAL001 www.lossantosemergencyservices.com

* in this document signifies a score of at least 20 is required to pass the evaluation. ** in this document signifies a score of at least 12 is required to pass the evaluation. *** in this document signifies a score of at least 80 is required to pass the evaluation. **** in this document signifies input/modification is optional.

COPYRIGHT 2013 LOS SANTOS EMERGENCY SERVICES CLAN All elements and features of the creation of this document with the exception of trademarked and rights reserved materials are created and utilized intentionally for relations with the Los Santos Emergency Services Clan solely. Any and all portions of this document may be modified, released, exhibited, shared, or presented any method with appropriate authorization from the creator of the document of Command Corps personnel. All properties in terms of creation or content are considered classified otherwise.