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TVL CapsLET G12 Q3 CSS WEEK 3

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0% found this document useful (0 votes)
158 views17 pages

TVL CapsLET G12 Q3 CSS WEEK 3

Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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12

TECHNICAL VOCATIONAL AND LIVELIHOOD

COMPUTER SYSTEM SERVICING


QUARTER III
Week 3 | Lesson 3

CapSLET
Capsulized Self - Learning
Empowerment
Toolkit

Schools Division Office of Zamboanga City


Region IX, Zamboanga Peninsula
Zamboanga City
S U B JE C T &
G R A D E /L E V E L
T V L -C S S G r. 1 2 Q UAR TER 3 W EEK 3
ID E N T IF Y IN G A N D IS O L A T IN G F A U L T S / P R O B L E M S ( D IA G N O S T IC
TO P IC
S O F T W A R E U T IL IT IE S A N D G A T H E R IN G O F IN F O R M A T IO N )
3 .2 D ia g n o s e fa u lts o r p ro b le m s in th e CODE
L E A R N IN G
c o m p u te r s ys te m s a n d n e tw ork s a c co rd in g to
COM PETENCY
re q u ire m e n ts a n d in lin e w ith th e s ta n d a rd T L E _ IA C S S 9 - 1 2M R C N -
p ro c e d u re s. IIIa-h 4 2
T h e le arn e rs d e m o n s tra te a n u n d e rs ta n d in g o f c o n ce p ts a n d p rin c ip les in
L E A R N IN G m a in ta in in g a n d re p airin g c o m p u te r s ys te m s a n d n e tw ork s.
O B JE C T IV E S

IM P O R TA N T : Do not write anything on this material. Write your answers on the learner’s activity and
assessment sheets provided separately.

UNDERSTAND
D IA G N O S IS A N D ID E N T IF IC A T IO N O F F A U L T Y S Y S T E M
More than 70% of all computer problems are related to cabling and connections. Ensure all cables
are connected and connected firmly. IDE and floppy ribbon cables and power cables can often go
loose. Ensure microprocessor, memory modules, and adapters such as video card are inserted
correctly and do not "pop-up" due to vibration.
Problem 1: System has no power at all. Power light does not illuminate, fan inside the power supply
does not turn on, and indicator light on keyboard does not turn on.
PROBABLE D IA G N O S IS S O L U T IO N
CAUSE
Power cable is Visually inspect Make sure power
unplugged power cable. cable is securely
plugged in.
Defective power Visual inspection Replace cable.
cable or try another
cable.
Power supply Power cable and Contact technical
failure wall socket are support.
OK, but system is
still dead.
Faulty wall outlet; Plug device into Use different
circuit breaker or socket and test. socket, repair
fuse blown outlet, reset
circuit breaker or
replace fuse.
Problem 2: System is inoperative. Keyboard lights are on, power indicator lights are lit, and hard drive
is spinning.

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PROBABLE D IA G N O S IS S O L U T IO N
CAUSE
Expansion card is Turn off Using even
partially dislodged computer. pressure on both
from expansion Remove the ends of the
slot on the cover of the expansion card,
motherboard. system unit. press down firmly
Check all on expansion
expansion cards card.
to ensure they are
securely seated in
slots.
Defective floppy Turn the system Contact Technical
disk drive or tape off. Disconnect Support.
drive the cables from
one of the floppy
drives. Turn on
the system, check
to see if the
keyboard
operates
normally. Repeat
until you have
located defective
unit.
Defective Turn the Make sure
expansion card computer off. expansion card is
Remove an secure in
expansion card. expansion socket.
Problem 3: System does not boot from hard disk drive, but can be booted from floppy disk drive.
PROBABLE D IA G N O S IS S O L U T IO N
CAUSE
Connector When attempting Check cable
between hard to run the FDISK running form disk
drive and system utility described in to disk controller
board is the HARD DISK on the board.
unplugged. section of the Make sure both
manual you get a ends are securely
message, plugged in; check
INVALID DRIVE the drive type in
SPECIFICATION. the Standard
CMOS Setup (in
your motherboard
manual).
Damaged Hard Format hard disk; Contact Technical
Disk or Disk if unable to do so, Support.
Controller the hard disk may
be defective.
Hard Disk Run the FDISK Backing up the
directory or FAT program, format hard drive is
the hard extremely
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is scrambled drive(See HARD important. All
DRIVE section of Hard Disks are
manual). Copy capable of
your backup data breaking down at
back onto hard anytime.
drive.
Problem 4: System only boots from Floppy Disk. Hard Disk can be read and applications can be
used, but booting from Hard Disk is impossible.
PROBABLE D IA G N O S IS S O L U T IO N
CAUSE
Hard Disk boot Corrupted system Back up data and
program has files applications files.
been destroyed. Reformat the
Hard Drive as
described in the
Hard Drive
section of the
manual. Re-install
applications and
data using
backup disks.
Problem 5: Error message reading "SECTOR NOT FOUND" or other error messages indicators that
certain data is not allowed to be retrieved.
PROBABLE D IA G N O S IS S O L U T IO N
CAUSE
Sector Not Found Hard drive is You may be able
Error likely bad itself. to resolve this
issue by running
scandisk and
having scandisk
mark the sectors
as bad.

S A Q -1: W h at is S can d isk o r C h kd sk?

S A Q -2: W h at is a D iag n o stic S o ftw are?

D ia g n o s tic S o ftw are T o o ls

Diagnostic software is used to identify problems on a computer or piece of equipment. These


programs test the onboard systems for issues and help to alert users of potential problems or
breakdowns. Over the years, these programs have gone from very basic to complex and highly
specialized. With this increase in technology, the skill required to use the software has actually
decreased to the point where most people can use this software with little or no training.

Programs that provide diagnostic information are


common everywhere Something as simple as the oil
light on a car dashboard is a type of diagnostic
software. These hard-coded diagnostic tools
usually monitor one specific part of a larger
piece of equipment and typically are always
operating. While these types of diagnostic
programs are the most common, they are usually

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the least versatile. When people think of true diagnostic software, they usually think of the
types used on computers. These programs monitor the computer for problems involving every aspect
of the machine, from hardware to software—far more complex and versatile than the change oil light.

D is k m a n a g em e n t to o ls :
F d is k - creates and deletes disk partitions.
F o rm a t - prepares a hard drive prior to use.
S c an d is k o r C h k d s k - checks for physical errors on the disk surface.
D e fra g - optimizes use of space on a disk.
D is k C le a n u p - removes unused files.
D is k M a n a g e m en t - creates partitions and formats disks (GUI interface).
S ys te m F ile C h e c ke r (S F C ) – scans the operating system critical files.
L e t’s P ra ctic e !

(A n s w e r o n th e A n s w e r S h e et p ro v id e d fo r A c tiv ity a n d A s s es s m e n t.)

A C T IV IT Y : C ritic al R e vie w : P ro b le m s E n c o u n te re d

D ire c tio n : In th is a c tivity, lis t d o w n a t le a st five (5 ) p ro b le m s, e rro r m e s sa g e s o r in c id e n ts yo u


e n c o u n te re d w h ile w ork in g o r u s in g a c o m p u te r a n d th e a ctio n s ta k e n in e ve ry p ro b le m /erro r
m e s sa g e o r in c id en ts e n c o u n te re d .

P ro b le m s A c tio n s T a k en
E n c o u n te re d
1.
2.
3.
4.
5.

REMEMBER
K ey P o in ts

S o m e D o w n lo a d a b le D ia g n o s tic T o o ls
Y e t A n o th e r C le an er- Protects your PC from browser hijacker, malicious plug-ins, malwares,
adware, various viruses.
A R O 2 0 13- Repairs registry errors, remove "junk" files, and ensure your PC is fully protected.
R e g D o c to r- Improves your system performance and stability by repairing and cleaning the Windows
Registry.
W ise R e g is try C le a n er- Cleans the registry portion of the hard drive
A d va n c e d S ys te m C a re- Tunes up and maintains your PC, with anti-spyware, privacy protection,
and system cleaning functions.
C P U -Z - Accesses various information's about your computer
A d va n c e d S ys te m C a re P ro - Tunes up and maintains your PC automatically
F re e W in d o w R e g is try R e p a ir- Scans, repairs, and optimizes your Windows registry

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TRY
Let’s see how much have you learned today!
(A n s w er o n th e L e a rn er’s A c tivity a n d A s s e s s m en t s h e ets .)

A s s e s s m en t: M a tc h in g T yp e
A . D ire c tio n s: M a tc h C o lu m n A w ith C o lu m n B . W rite th e le tte r o f th e c o rre ct a n sw er o n th e
s p a ce p ro vid e d b e fo re e a ch n u m b e r. W rite y o u r a n s w ers o n th e L e a rn er’s A c tiv ity a n d
A s s e ss m en t s h e ets .
ANSW ER C o lu m n A C o lu m n B
1. Creates and deletes disk partitions A. Scan disk
2. Optimizes use of space on a disk B. Format

3. Prepares a hard drive prior to use C. Defrag

4. Removes unused files. D. Disk Cleanup

5. Checks for physical errors on the disk surface E. Fdisk

A s s e s s m en t: M u ltip le C h o ic e
B . D ire c tio n s: C h o o s e th e le tte r o f th e c o rre ct a n sw e r. W rite y o u r a n s w ers o n th e L e a rn er’s
A c tiv ity a n d A s s es sm e n t s h ee ts .
______6. System has no power at all. Power light does not illuminate, fan inside the power supply
does not turn on, and indicator light on keyboard does not turn on. What could be the probable
cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______7. System is inoperative. Keyboard lights are on, power indicator lights are lit, and hard drive
is spinning. What could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______8. System does not boot from hard disk drive, but can be booted from floppy disk drive. What
could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______9. Error message reading "SECTOR NOT FOUND" or other error messages indicators that
certain data is not allowed to be retrieved.What could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______10. System only boots from Floppy Disk. Hard Disk can be read and applications can be used,
but booting from Hard Disk is impossible.What could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Hard Disk boot program has been destroyed.

6|Pa g e
h ttp s ://w w w .slid e sh a re .n e t/s kyro c k e r00 0 4/c o m p u te r-h a rd w are -se rvic in g -
le a rn e rs -m ate ria l-g rad e -1 0
R E F E R E N C E /S

This LR is produced and distributed locally without profit and will be used for
educational purposes only. No malicious infringement is intended by the writer.
D IS C L A IM E R
Credits and respect to the original creator / owner of the materials found in this
learning resource.

Written by:

MA. CARMELA R. MELAD


Teacher – I
SINUNUC NATIONAL HIGH SCHOOL

7|Pa g e
L e a rn e r’s A c tivity a n d A s s e s s m e n t S h e e ts

S U B JE C T TVL-COMPUTER SYSTEM SERVICING


NAM E
Y E A R A N D S E C T IO N
TE A C H E R ’S N A M E
S A Q 1 : W h at is D iag n o sis?
_________________________________________________________________________
_________________________________________________________________________

S A Q 2 : W h at is a D iag n o stic S o ftw are?


_________________________________________________________________________
________________________________________________________________________

L e t’s P ra ctic e !

A C T IV IT Y : C ritic a l R e vie w : P ro b lem s E n c o u n te re d

D ire c tio n : In th is a ctivity, list d o w n a t le a st five (5 ) p ro b le m s , e rro r m e s sa g e s o r in c id en ts yo u


e n c o u n te red w hile w ork in g o r u s in g a c o m p u te r a n d th e a c tio n s ta k e n in e ve ry p ro b le m /e rro r
m e s sa g e o r in c id en ts e n c o u n te red .

P ro b le m s E n c o u n te re d A c tio n s T a ke n

1.

2.

4.

4.

5.

TRY
L e t’s s e e h o w m u c h h a ve yo u le arn e d to d a y!
A s s e s s m en t: M a tc h in g T yp e
A . D ire c tio n s : M a tc h C o lu m n A w ith C o lu m n B . W rite th e le tte r o f th e c o rre ct a n sw er o n th e
s p a ce p ro vid e d b e fo re e a ch n u m b e r.
ANSW ER C o lu m n A C o lu m n B
1. Creates and deletes disk partitions A. Scan disk
2. Optimizes use of space on a disk B. Format

8|Pa g e
3. Prepares a hard drive prior to use C. Defrag
4. Removes unused files. D. Disk Cleanup
5. Checks for physical errors on the disk surface E. Fdisk

A s s e s s m en t: M u ltip le C h o ic e
B . D ire c tio n s : C h o o s e th e le tte r o f th e c o rrec t a n s w er. W rite y o u r a n s w e rs o n th e s p ac e
p ro v id e d fo r.
______6. System has no power at all. Power light does not illuminate, fan inside the power supply
does not turn on, and indicator light on keyboard does not turn on. What could be the probable
cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______7. System is inoperative. Keyboard lights are on, power indicator lights are lit, and hard drive is
spinning. What could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______8. System does not boot from hard disk drive, but can be booted from floppy disk drive. What
could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______9. Error message reading "SECTOR NOT FOUND" or other error messages indicators that
certain data is not allowed to be retrieved.What could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Defective floppy disk drive or tape drive
______10. System only boots from Floppy Disk. Hard Disk can be read and applications can be used,
but booting from Hard Disk is impossible.What could be the probable cause?
a. Power supply failure b. Connector between hard drive and system board is unplugged.
c. Sector Not Found Error d. Hard Disk boot program has been destroyed.

9|Pa g e
Topic: ID E N T IF Y IN G A N D IS O L A T IN G F A U L T S / P R O B L E M S ( D IA G N O S T IC S O F T W A R E
U T IL IT IE S A N D G A T H E R IN G O F IN F O R M A T IO N )
Learning Competency: D ia g n o s e fa u lts o f C o m p u te r S ys te m s a n d N e tw o rk s

ANSWER KEY
S A Q -1 : W h at is S c an d is k o r C h k d s k? A s s e s s m en t: M a tc h in g T yp e
A . D ire c tio n s : M a tc h C o lu m n A w ith C o lu m n
It checks for physical errors on the disk surface.
B W rite th e le tte r o f th e c o rre ct a n s w er o n
th e s p a ce p ro vid e d b e fo re e a ch n u m b e r.
S A Q -2: W h at is a D ia g n o s tic S o ftw are ?
E 1.Creates and deletes disk partitions
Diagnostic software is used to identify problems
on a computer or piece of equipment. These C 2. Optimizes use of space on a disk
programs test the onboard systems for issues
and help to alert users of potential problems or B 3. Prepares a hard drive prior to use
breakdowns.
D 4. Removes unused files.
A C T IV IT Y : Critical Review: Problems A 5. Checks for physical errors on the disk
Encountered surface

D ire c tio n : In th is a ctivity, list d o w n a t lea s t


five (5 ) p ro b le m s , e rro r m e ss a g es o r A s s e s s m en t: M u ltip le C h o ic e
in c id en ts yo u e n c o u n te re d w hile w ork in g o r
B . D ire c tio n s : C h o o s e th e le tte r o f th e
u s in g a c o m p u te r a n d th e a c tio n s ta k e n in
e ve ry p ro b le m /erro r m e s sa g e o r in c id en ts c o rre ct a n sw e r. W rite y o u r a n s w ers o n th e
e n c o u n te re d . s p a ce p ro v id e d fo r.
A 6. System has no power at all. Power light
A n s w ers m a y va ry. does not illuminate, fan inside the power supply
does not turn on, and indicator light on keyboard
does not turn on. What could be the probable
cause?
a. Power supply failure
b. Connector between hard drive and system
board is unplugged.
c. Sector Not Found Error
d. Defective floppy disk drive or tape drive
D 7. System is inoperative. Keyboard lights
are on, power indicator lights are lit, and hard
drive is spinning. What could be the probable
cause?
a. Power supply failure
b. Connector between hard drive and system
board is unplugged.
c. Sector Not Found Error
d. Defective floppy disk drive or tape drive
B 8. system does not boot from hard disk
drive, but can be booted from floppy disk drive.
What could be the probable cause?
a. Power supply failure

10 | P a g e
b. Connector between hard drive and system
board is unplugged.
c. Sector Not Found Error
d. Defective floppy disk drive or tape drive
C 9. Error message reading "SECTOR NOT
FOUND" or other error messages indicators that
certain data is not allowed to be retrieved.What
could be the probable cause?
a.Power supply failure
b.Connector between hard drive and system
board is unplugged.
c. Sector Not Found Error
d. Defective floppy disk drive or tape drive
D 10. System only boots from Floppy Disk.
Hard Disk can be read and applications can be
used, but booting from Hard Disk is
impossible.What could be the probable cause?
a. Power supply failure
b. Connector between hard drive and system
board is unplugged.
c. Sector Not Found Error
d. Hard Disk boot program has been destroyed.

11 | P a g e
NOTE:
Standards in writing the EPP/TLE/TVL CapsLET
 Use long bondpaper
 Arial font style
 12 font size
 .5 margins in all sides

12 | P a g e
Republic of the Philippines
Department of Education
Division of Zamboanga City

EVALUATION TOOL FOR CONTENT AND LAYOUT & DESIGN


CAPSULIZED SELF-LEARNING EMPOWERMENT TOOLKIT (CapSLET)

Learning Area: __________________________________ Grade Level: ____________


Title: ___________________________________________________________________
Quarter: _________________________________________________________________
Week: ___________________________________________________________________
Learning Competency: _________________________________________________________

Instructions:

1. Read carefully the learning resource (LR) page by page to evaluate the LR for compliance to standards
indicated in the criterion items under each factor below.
2. Put a check mark (/) in the appropriate column beside each criterion item. If your answer is NO, cite
specific page/s, briefly indicate the errors found, and give your recommendations in the attached
Summary of Findings form.
3. Write Not Applicable (NA) for criterion items that does not apply in the LR evaluated.

Standards /Criterion Items Yes No


CONTENT
Factor I. Intellectual Property Rights Compliance
1. The learning resource has no copyright violations.
2. The copyrighted texts and visuals used in the LR are
cited.
3. The copyrighted materials used in the LR are accurately
cited.
4. The references are properly cited in the Reference/s box
using the DepEd LR Referencing Guide.
Note: At least 3 criterion items must be marked YES to Complied Not
indicate compliance to this factor. Complied

Factor II. Learning Competencies


1. Content is consistent with the targeted DepEd Most
Essential Learning Competencies (MELCs) intended for
the learning area and grade level.
2. The MELC is subtasked into learning objectives based
on the Compressed Curriculum Guide Syllabus (CCGS)
of a specific learning area.

Note: These 2 criterion items must be marked YES to Complied Not


indicate compliance to this factor. Complied

Factor III. Instructional Design and Organization


1. The LR contributes to the achievement of specific
objectives of the learning area and grade level for which
it is intended.
2. Sequencing of contents and activities from
UNDERSTAND, REMEMBER and TRY within each
13 | P a g e
lesson facilitates achievement of objectives.
3. Content is suitable to the target learner’s level of
development, needs, and experience.
4. Content reinforces, enriches, and / or leads to the
mastery of the targeted learning competencies intended
for the learning area and grade level.
5. The LR develops higher cognitive skills (e.g., critical
thinking skills, creativity, learning by doing, problem
solving) and 21st century skills.
6. The LR enhances the development of desirable values
and traits such as: (Mark the appropriate box with an
“X” applicable for values and traits only)

Note: At least 5 criterion items must be marked YES to Complied Not


indicate compliance to this factor. Complied

Factor IV. Instructional Quality


1. Content and information are accurate.
2. Content and information are up-to-date.
3. The LR is free from any social content violations.
4. The LR is free from factual errors.
5. The LR is free from computational errors (if applicable)
6. The LR is free from grammatical errors.
7. The LR is free from typographical errors.
Note: At least 6 criterion items must be marked YES to Complied Not
indicate compliance to this factor. Complied

Factor V. Assessment
1. The LR provides useful measures and information that
help the teacher evaluate learner’s progress in mastering
the target competencies.
2. Assessment aligns with the learning competency/ies.

3. Assessment provides clear instructions in the TRY


section.
4. Assessment provides correct answer/s.
Note: All criterion items must be marked YES to indicate Complied Not
compliance to this factor. Complied

Factor VI. Readability


1. Vocabulary level is adapted to target users’ experience
and understanding.
2. Length of sentences is suited to the comprehension level
of the target user.
3. Sentences and paragraph structures are varied and
appropriate to the target user.
4. Lessons, instructions, exercises, questions, and activities
are clear to the target user.
5. The LR provides appropriate mother tongue for the
target user.

14 | P a g e
Note: At least 4 criterion items must be marked YES to Complied Not
indicate compliance to this factor Complied

LAYOUT AND DESIGN


Factor I. Physical Attributes
1. All necessary elements are complete.
2. Cover elements are correct and complete. (i.e., w/ grade
indicator & learning area, CapsLET title, quarter,
headings, division tagline)
3. The CapsLET follows the prescribed learning area color.
4. The LR observes correct pagination.
5. Contains accurate learning competency and code.
Note: All criterion items must be marked YES to indicate Complied Not
compliance to this factor Complied

Factor II. Layout and Design


1. The LR follows the prescribed CapsLET template.
(maximum of 10 pages and minimum of 3 pages)
2. The LR follows the prescribed CapsLET paper size
(long bond paper - 21.59cm x 33.02cm).
Note: All items be marked YES to indicate compliance to this Complied Not
factor. Complied

Factor III. Typographical Organization


1. The LR uses appropriate font size (12 or 14) and styles
(Calibri Body, Arial or Times New Roman).
2. The LR follows the rules in the use of boldface and
italics.
Note: All criterion items must be YES to indicate compliance Complied Not
to this factor. Complied

Factor IV. Visuals


1. It contains visuals that illustrate and clarify the concept.
2. It has images that are easily recognizable.
3. Layout is appropriate to the child.
4. Text and visuals are properly placed.
Note: All criterion items must be marked YES to indicate Complied Not
compliance to this factor. Complied

Recommendation: (Please put a check mark (/) in the appropriate box.)

Minor revision. This material is found compliant to the minimum requirements in all six factors. Revision
based on the recommendations included in the Summary of Content Findings form and LR with marginal notes
must be implemented.

Major revision. This material is non-compliant to the requirements in one or more factors. Revision based on
the recommendations included in the Summary of Content Findings form and LR with marginal notes must be
implemented.

For field validation. This material is found compliant to all factors with NO corrections.

I certify that this evaluation report and the recommendation(s) in the summary report are my own and have been
made without any undue influence from others.

Name/s Signature/s

15 | P a g e
Evaluator/s: SALVADOR G. FORGOSA ________________________

JAMES B. DE LOS REYES ________________________

DR. LAARNI V. MIRANDA ________________________

Date accomplished: ___________________________

Note:
This tool is anchored on the Guidelines in ADM Content Evaluation, Guidelines in ADM
Layout Evaluation and Level 2 DepEd Evaluation Rating Sheet for 2 DepEd Evaluation Rating
Sheet for Story Books and Big Books.
.

Summary of Content Findings, Corrections and Review for Locally Developed


CapSLET

Title of the CapSLET: ____________________ Grade Level: ______


Quarter: ___________________________
Week: _____________________________
Part of the Brief Specific Put a check mark
CapSLET/ description recommendatio
Paragraph of Errors/ ns for
/ Line / Findings/ improving the
Page Observatio identified Not
number (in ns criterion Implement
Implement
chronologic ed
ed
al order)

Legend: (Type of Error) C - Content, L – Language, DL – Design and Layout

Other Findings: Write additional comments and recommendations not captured


in the evaluation tools used.

16 | P a g e
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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Prepared by: Date accomplished:
_________________________ _____________________
(Signature Over Printed Name)

17 | P a g e

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