PERSONAL DATA OF THE SUBJECT

Name : Taylor Alison Swift Scars/Marks/Amps. : None

Age : 34 Occupation : Fish Vendor
Gender : Female Tel. No. : 09999999999
Address : Brgy. Inagdangan Norte, Zarraga, Iloilo Educational Attainment : College Graduate
Place of Birth : Brgy. Ilaya, Zarraga, Iloilo Hobbies : Listening to music
Date of Birth : December 13, 1989 Previous Examination : Medical Examination
Civil Status : Single Time Woke Up : 6:15 AM
Dependent(s) : None Wine Taken : None
Height : 5”11 Time Slept Previous Night : 8:00 PM
Weight : 61 kg Last Meal Take : Rice and Fried Fish
Built : Slim Time : 6:45 AM
Religion : Roman Catholic Quality : None
Complexion : Fair Subject Version : None

Behavior:
Initial Interview : Relaxed
Question Interview: Relaxed

During the Test:

Cooperative : Yes, the subject is very cooperative with the interviewer during the test. __
Uncooperative : None__________________________________________________________
Body Movements : None__________________________________________________________
Extreme Nervousness : None__________________________________________________________
Failed to Follow Instruction : None__________________________________________________________
Evasive Tactics:

After the Test:

Leave Room Immediately : None__________________________________________________________
Inquire Results : None__________________________________________________________
Wait for Instruction to Leave : Yes, the subject waited first for further instructions by interviewer before_
she left the interrogation room.____________________________________

Remarks : Cooperative and relaxed during the polygraph examination.

Medicine Taken : None
Dosage : None
Doctor’s Comment : Physically and mentally fit to undergo polygraph examination.

MS. KATY H PERRY

Interviewer