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[[9 column table]]
[[preprinted form]]
BLIND | NIGHT | DAY | AIRLINE | CLASS I | CLASS II | CLASS III | ^[[LINK TRAINER}} | REMARKS | CERTIFIED BY
[[preprinted]]
65:33 | 95:29 | 1363:17 | 102:20 | 138:52 | 1180:41 | 112:08 | 27:05 |   |
:25 |   | :25 |   |   |   |   | :25 | Expmtl Bracketing |  
:15 |   | :15 |   |   |   |   | :15 | Loop Orientation | 
:30 |   | :30 |   |   |   |   | :30 | Bent Beams - |
[[double line]]
7:30 | 2:49 | 9:39 | 7:18 | 0 | 0 | 7:18 | 5:10 |   |
[[double line]]

66:43 | 95:29 | 1364:27 | 102:20 | 138:52 | 1180:41 | 112:08 | 28:15 |


[[signed]]Joseph D. Mountain[[/signed]]
[[preprinted]]SIGNATURE OF PILOT[[/preprinted]]