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[[preprinted]] CERTIFICATE OF AIRCREW QUALIFICATION TYPE OF CHECK AFM 60-1 □ ^[[X]] PROFICIENCY □ INSTRUMENT MAJOR COMMAND □ TACTICAL MISSION OTHER (Specify) ^[[ANNUAL]] DATE DUE ^[[18 Jun 68]] DATE COMPLETED ^[[13 Jun 68]] AIRCREW IDENTIFICATION NAME OF EXAMINEE (Last, First, Middle Initial) ^[[DAVIS, BENJAMIN O.]] GRADE ^[[LT/GEN]] AFST ^[[FR1206]] DATE OF BIRTH ^[[18 Dec]] ORGANIZATION ^[[Hq 13th AF, PACAF, (636 BDOE) BASE ^[[CLARK AB, APO SF 96274]] TYPE OF AIRCRAFT (Model/Series) ^[[T-39/A]] CREW POSITION ^[[PCP]] CREW NUMBER (If applicable) II. PREREQUISITES AERONOUTICAL RATING ^[[Comd Pilot]] FLYING STATUS CODE ^[[1Y]] ELIGIBLE FOR CHECK □ ^[[X]] YES □ NO AS OF DATE ^[[3 Jun 68]] ORGANIZATION ^[[636 CSG (BDOE)]] DATE ^[[3 Jun 68]] TYPED NAME AND GRADE OF CERTIFYING OFFICIAL ^[[WILLIAM S. FULLER, LT COL, USAF]] SIGNATURE ^[[William S Fuller]] III. QUALIFICATION GROUND PHASE PILOT PHASE EXAMINATION/CHECK ^[[Written Proficiency]] DATE ^[[3 Jun 68]] GRADE ^[[100%]] MISSION/CHECK ^[[Proficiency Eval]] DATE ^[[13 Jun 68]] TIME ^[[1430]] STATUS/GRADE (IAW Command directives) ^[[(PACAFR 60-10) Qual]] RESTRICTION (As applicable) ^[[None]] EXPIRATION DATE OF RESTRICTION ^[[N/A]] INSTRUMENT RATING (Pilot only) □ No.1 □ No.2 UPGRADE (Include date) □ No.1 EXPIRATION DATE OF FLIGHT CHECK ^[[18 Jun 69]] DATE ^[[13 Jun 68]] NAME AND GRADE OF EXAMINEE (Typed) ^[[BENJAMIN O. DAVIS, LT/GEN, USAF]] SIGNATURE ^[[Benjamin O. Davis, Jr.]] IV. CERTIFICATION The above aircrew member has demonstrated □ ^[[x]] satisfactorily □ unsatisfactorily performance and knowledge of procedures, techniques, equipment, and directives which □ [[x]] would □ would not assure the safe and successful accomplishment of his assigned flying duties. 1 CHECK AS APPLICABLE (Use reverse side for remarks) □ REMARKS ORGANIZATION ^[[636 CSG (BDOF)]] DATE ^[[13 Jun 68]] TYPED NAME AND GRADE OF FLIGHT EXAMINER ^[[GERALD K. TAYLOR, LT COL, USAF]] SIGNATURE ^[[Gerald K Taylor]] 2 CHECK THE APPLICABLE BOX(S) (Use reverse for remarks) □ REMARKS □ ^[[X]] CONCUR □ DO NOT CONCUR ORGANIZATION ^[[636 CSG (BDOE)]] DATE ^[[14 Jun 68]] TYPED NAME AND GRADE OF REVIEWING OFFICER ^[[WILLIAM S. FULLER, LT COL, USAF]] SIGNATURE ^[[William S Fuller]] 3 CHECK APPLICABLE BOX(S) (Use reverse for remarks) □ REMARKS □ ^[[X]] CONCUR □ DO NOT CONCUR ORGANIZATION ^[[636 CSG (BDO)]] DATE ^[[15 Jun 69]] TYPED NAME AND GRADE OF FINAL APPROVING OFFICER ^[[CLYDE A HARTSHORN, LT COL, USAF]] SIGNATURE ^[[Clyde A Hartshorn]] AF Form 8 Mar 65 PREVIOUS EDITION WILL BE USED.