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CERTIFICATE OF AIRCREW QUALIFICATION

TYPE OF CHECK | AFM 60-1 [[box with a typed X]] PROFICIENCY [[box with a typed X]] INSTRUMENT | MAJOR COMMAND [[box with no X]] TACTICAL MISSION | OTHER (Specify) | DATE DUE  18 Jun 68 | DATE COMPLETED 9 Aug 68 |

I. AIRCREW IDENTIFICATION

NAME OF EXAMINEE (Last, First, Middle Initial)
^[[DAVIS, BENJAMAN O.]]
 GRADE ^[[LT/GEN]] AFSN ^[[FR1206]]
DATE OF BIRTH ^[[18 Dec]]

ORGANIZATION ^[[836th Combat Support Group]]
BASE ^[[MacDill Air Force Base, Florida]]
TYPE AIRCRAFT (Model/Series) ^[[T-39/A]]
CREW POSITION ^[[Pilot]]
CREW NUMBER (If applicable) ^[[N/A]]

II. PREREQUISITES
AERONAUTICAL RATING ^[[Command Pilot]]
FLYING TIME CODE ^[[1 Y]]
ELIGIBLE FOR CHECK □ ^[[X]]YES  □ NO
AS OF DATE ^[[17 Jun 68]]
ORGANIZATION ^[[836th Cmbt Spt Gp]]
DATE ^[[12 Aug 68]]
TYPED NAME AND GRADE OF CERTIFYING OFFICIAL
^[[CAROL L. HOLLEY, MAJOR]]
SIGNATURE ^[[Carol L Holley]]


III. QUALIFICATION

GROUND PHASE | FLIGHT PHASE

EXAMINATION/CHECK | DATE | GRADE | MISSION/CHECK | DATE | TIME

^[[PROF. WRITTEN | 17 Aug 68 | Sat. | ANNUAL PROF. | 9 Aug 68 | 1+25]] |

STATUS/GRADE (IAW Command directives) ^[[Q/TAC REG 60-2]]
RESTRICTION (As applicable)^[[None]]
EXPIRATION DATE OF RESTRICTION ^[[N/A]]
INSTRUMENT RATING (Pilot only)
□ ^[[x]] No.1     □ No.2
UPGRADE (Include date) □ No.1
EXPIRATION DATE OF FLIGHT CHECK ^[[18 Jun 68]]

DATE ^[[9 Aug 68]]
NAME AND GRADE OF EXAMINEE (Typed)
^[[BENJAMIN O. DAVIS, LT/GEN]]
SIGNATURE ^[[B.O. Davis, Jr.]]

IV. CERTIFICATION

The above aircrew member has demonstrated [[box with typed X]] satisfactory [[empty box]] unsatisfactory performance and knowledge of procedures, techniques, equipment, and directives which [[box with typed X]] would [[empty box]] would not assure the safe and successful accomplishment of his assigned flying duties.

1 | CHECK AS APPLICABLE (Use reverse side for remarks) [[empty box]] REMARKS | 
ORGANIZATION ^[[836th CSGp]]
DATE ^[[9 Aug 68]]
TYPED NAME AND GRADE OF FLIGHT EXAMINER
^[[NELSON J. SPRAGUE, CAPT]]
SIGNATURE ^[[Nelson J. Sprague]]

2 CHECK APPLICABLE BOX(S) (Use reverse for remarks)
□ REMARKS □ CONCUR □ DO NOT CONCUR
ORGANIZATION ^[[836th CSGp]]
DATE ^[[12 Aug 68]]

TYPED NAME AND GRADE OF REVIEWING OFFICER
^[[RONALD L. EDWARDS, MAJOR]]
SIGNATURE ^[[Carol L. Holley for]]

3 CHECK APPLICABLE BOX(S) (Use reverse for remarks)
□ REMARKS  □ CONCUR  □ DO NOT CONCUR
ORGANIZATION ^[[836th CSGp]]
DATE ^[[13 Aug 68]]
TYPED NAME AND GRADE OF FINAL APPROVING OFFICER ^[[CHARLES A. RILEY, LT COL]]
SIGNATURE ^[[Carol L. Holley for]]


AF FORM 8 MAR 65  PREVIOUS EDITION WILL BE USED.