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Screening and Progress Monitoring Student Materials Grades K-1

Math

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v 1.2

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ContentS

Missing number

Practice ................................................................................................................................................ 7Screening: Beginning of Year ............................................................................................................ 9Screening: Middle of Year ................................................................................................................ 13Screening: End of Year ..................................................................................................................... 17Form 1 ............................................................................................................................................... 21Form 2 ............................................................................................................................................... 25Form 3 ............................................................................................................................................... 29Form 4 ............................................................................................................................................... 33Form 5 ............................................................................................................................................... 37Form 6 ............................................................................................................................................... 41Form 7 ............................................................................................................................................... 45Form 8 ............................................................................................................................................... 49Form 9 ............................................................................................................................................... 53Form 10 ............................................................................................................................................. 57Form 11 ............................................................................................................................................. 61Form 12 ............................................................................................................................................. 65Form 13 ............................................................................................................................................. 69Form 14 ............................................................................................................................................. 73Form 15 ............................................................................................................................................. 77Form 16 ............................................................................................................................................. 81Form 17 ............................................................................................................................................. 85Form 18 ............................................................................................................................................. 89Form 19 ............................................................................................................................................. 93Form 20 ............................................................................................................................................. 97

number Identification

Practice ............................................................................................................................................ 103Screening: Beginning of Year ........................................................................................................ 105Screening: Middle of Year .............................................................................................................. 107Screening: End of Year ................................................................................................................... 109Form 1 ............................................................................................................................................. 111Form 2 ............................................................................................................................................. 113Form 3 ............................................................................................................................................. 115Form 4 ............................................................................................................................................. 117Form 5 ............................................................................................................................................. 119Form 6 ............................................................................................................................................. 121Form 7 ............................................................................................................................................. 123Form 8 ............................................................................................................................................. 125Form 9 ............................................................................................................................................. 127Form 10 ........................................................................................................................................... 129Form 11 ........................................................................................................................................... 131Form 12 ........................................................................................................................................... 133Form 13 ........................................................................................................................................... 135Form 14 ........................................................................................................................................... 137Form 15 ........................................................................................................................................... 139Form 16 ........................................................................................................................................... 141Form 17 ........................................................................................................................................... 143Form 18 ........................................................................................................................................... 145Form 19 ........................................................................................................................................... 147Form 20 ........................................................................................................................................... 149

ContentS

Quantity Discrimination

Practice ............................................................................................................................................ 153Beginning of Year ........................................................................................................................... 154Middle of Year ................................................................................................................................ 156End of Year ..................................................................................................................................... 158Form 1 ............................................................................................................................................. 160Form 2 ............................................................................................................................................. 162Form 3 ............................................................................................................................................. 163Form 4 ............................................................................................................................................. 166Form 5 ............................................................................................................................................. 168Form 6 ............................................................................................................................................. 170Form 7 ............................................................................................................................................. 172Form 8 ............................................................................................................................................. 174Form 9 ............................................................................................................................................. 176Form 10 ........................................................................................................................................... 178Form 11 ........................................................................................................................................... 180Form 12 ........................................................................................................................................... 182Form 13 ........................................................................................................................................... 184Form 14 ........................................................................................................................................... 186Form 15 ........................................................................................................................................... 188Form 16 ........................................................................................................................................... 190Form 17 ........................................................................................................................................... 192Form 18 ........................................................................................................................................... 194Form 19 ........................................................................................................................................... 196Form 20 ........................................................................................................................................... 198

MISSInG nUMBeR

PaGe �

Practice

Screening: Beginning of Year......................................................................................................................... 9Screening: Middle of Year ............................................................................................................................ 13Screening: End of Year .................................................................................................................................. 17Form 1 ............................................................................................................................................................ 21Form 2 ............................................................................................................................................................ 25Form 3 ............................................................................................................................................................ 29Form 4 ............................................................................................................................................................ 33Form 5 ............................................................................................................................................................ 37Form 6 ............................................................................................................................................................ 41Form 7 ............................................................................................................................................................ 45Form 8 ............................................................................................................................................................ 49Form 9 ............................................................................................................................................................ 53Form 10 .......................................................................................................................................................... 57Form 11 .......................................................................................................................................................... 61Form 12 .......................................................................................................................................................... 65Form 13 .......................................................................................................................................................... 69Form 14 .......................................................................................................................................................... 73Form 15 .......................................................................................................................................................... 77Form 16 .......................................................................................................................................................... 81Form 17 .......................................................................................................................................................... 85Form 18 .......................................................................................................................................................... 89Form 19 .......................................................................................................................................................... 93Form 20 .......................................................................................................................................................... 97

MISSInG nUMBeR

1, __, 3 __, 5, 6

MISSInG nUMBeR

PaGe �

Screening: Beginning of Year

__, 3, 4

0, 1, __ 14, __, 16

__, �, 8 4, __, 6

1�, __, 1� 11, 12, __

�, __, � __, 13, 14

15, __, 1� 18, __, 20

__, �, 10 6, __, 8

1, __, 3 11, 12, __

5, 6, __ 13, __, 15

__, �, 8 __, 15, 16

�, __, 11

MISSInG nUMBeR

PaGe 10


2, __, 4 18, 1�, __

5, __, � __, 2, 3

__, 10, 1110 3, __, 5

14, __, 16 8, __, 10

4, 5, __ 12, __, 14

__, 1, 2 �, __, �

__, 5, 6 11, 12, __

16, __, 18 �, __, 11

6, �, __ 13, 14, __

3, 4, __ �, 8, __

MISSInG nUMBeR

PaGe 11


18, 1�, __ 4, __, 6

3, __, 5 __, 1, 2

1�, __, 1� __, �, 8

14, 15, __ __, 11, 12

__, 6, � �, 10, __

MISSInG nUMBeR

PaGe 13

Screening: Middle of Year

2, __, 4 8, �, __

__, 10, 11 10, 11, __

__, 5, 6 12, __, 14

__, 8, � 15, 16, __

16, __, 18 5, 6, __

3, __, 5 __, 1�, 20

11, __, 13 __, 2, 3

1�, 18, __ 14, 15, __

6, __, 8 13, 14, __

0, 1, __ __, �, 8

MISSInG nUMBeR

PaGe 14


15, __, 1� 3, 4, __

�, 10, __ __, 1, 2

18, 1�, __ __,12, 13

14, __, 16 4, __, 6

1, 2, __ __, 1�, 18

12, __, 14 __, 14, 15

2, __, 4 __, 6, �

8, __, 10 �, 8, __

�, __, � 2, 3, __

__, 11, 12 __, 18, 1�

MISSInG nUMBeR

PaGe 15


13, __, 15 14, 15, __

0, __, 2 __, 12, 13

4, 5, __ 16, 1�, __

5, __, � __, �, 10

__, 4, 5 1�, __, 1�

MISSInG nUMBeR

PaGe 1�

Screening: End of Year

1, 2, __ __, 13, 14

1�, __, 1� __, 3, 4

4, __, 6 14, 15, __

__, 12, 13 3, __, 5

1�, 18, __ �, __, 11

__, 6, � 14, 15, __

11, __, 13 __, 1�, 18

5, 6, __ 8, _, 10

2, __, 4 __, 3, 4

16, 1�, __ __, 5, 6

MISSInG nUMBeR

PaGe 18


1�, __, 1� __, 2, 3

16, __, 18 13, 14, __

__, 10, 11 �, __, �

6, �, __ __, 1�, 20

__, 1, 2 �, __, 11

15, 16, __ __, 8, �

1�, __, 1� 13, 14, __

__, 4, 5 11, __, 13

__, 1�, 20 8, __, 10

16, 1�, __ __, 15, 16

MISSInG nUMBeR

PaGe 1�


__, �, 8 13, 14, __

__, 5, 6 3, __, 5

__, 10, 11 2, __, 4

14, 15, __ �, __, 11

__, 6, � 16, 1�, __

MISSInG nUMBeR

Form 1

PaGe 21

13, 14, __ __, �, 8

1, __, 3 18, 1�, __

14, __, 16 __, 11, 12

0, __, 2 1�, 18, __

2, __, 4 __, 18, 1�

__, 8, � 12, 13, __

1�, __, 1� 15, 16, __

__, 4, 5 __, 11, 12

3, __, 5 0, 1, __

�, __, � __, 4, 5

MISSInG nUMBeR

Form 1

PaGe 22

18, __, 20 5, __, �

__, 4, 5 8, �, __

__, �, 8 1, 2, __

6, __, 8 __, 1�, 18

11, 12, __ 10, __, 12

__, 13, 14 6, �, __

__, 15, 16 __, 13, 14

15, __, 1� 10, 11, __

__, 1, 2 16, __, 18

5, 6, __ 15, __, 1�

MISSInG nUMBeR

Form 1

PaGe 23

__, 8, � 13, 14, __

11, __, 13 3, __, 5

__, 14, 15 �, 10, __

5, __, � �, 8, __

__, 12, 13 16, __, 18

MISSInG nUMBeR

Form 2

PaGe 25

__, 1, 2 3, 4, __

8, __, 10 12, 13, __

__, �, 8 16, __, 18

4, 5, __ 1, __, 3

18, 1�, __ __, 3, 4

�, 10, __ 11, __, 13

__, 18, 1� 6, __, 8

__, �, 10 11, 12, __

__, 1�, 20 __, 6, �

16, __, 18 13, 14, __

MISSInG nUMBeR

Form 2

PaGe 26

__, 1�, 18 8, �, __

14, __, 16 __, �, 8

__, 16, 1� 8, __, 10

12, 13, __ 10, __, 12

__, 2, 3 18, 1�, __

0, __, 2 __, 10, 11

6, �, __ __, 11, 12

�, __, 11 12, __, 14

2, 3, __ 0, __, 2

__, 1�, 20 __, 2, 3

MISSInG nUMBeR

Form 2

PaGe 2�

13, 14, __ 6, __, 8

15, 16, __ __, 5, 6

16, __, 18 5, 6, __

__, 3, 4 11, __, 13

12, 13, __ __, 13, 14

MISSInG nUMBeR

Form 3

PaGe 2�

__, �, 8 18, 1�, __

16, __, 18 14, __, 16

__, 4, 5 1, __, 3

5, 6, __ __, 11, 12

�, __, � 14, 15, __

__, 1, 2 12, __, 14

3, 4, __ 8, __, 10

__, 10, 11 13, 14, __

__, 8, � 5, __, �

__, 18, 1� 12, 13, __

MISSInG nUMBeR

Form 3

PaGe 30

15, __, 1� __, 4, 5

�, __, � 18, 1�, __

5, __, � __, 2, 3

6, �, __ __, 1, 2

15, __, 1� 8, �, __

�, __, � 1�, 18, __

__, 12, 13 15, 16, __

1�, __, 1� __, 5, 6

16, __, 18 8, �, __

__, 10, 11 3, __, 5

MISSInG nUMBeR

Form 3

PaGe 31

__, 12, 13 14, __, 16

12, 13, __ __, 2, 3

�, 8, __ 1�, __, 1�

__, 6, � 2, __, 4

__, 1�, 20 4, __, 6

MISSInG nUMBeR

Form 4

PaGe 33

12, 13, __ __, �, 10

1�, __, 1� __, �, 8

15, 16, __ 14, __, 16

__, 4, 5 16, 1�, __

6, __, 8 __, 5, 6

11, __, 13 18, 1�, __

8, __, 10 __, 1, 2

�, 8, __ __, 10, 11

18, __, 20 1, 2, __

6, __, 8 __, 6, �

MISSInG nUMBeR

Form 4

PaGe 34

15, 16, __ __, 10, 11

2, __, 4 13, 14, __

18, 1�, __ __, 12, 13

15, __, 1� __, 8, �

10, __, 12 0, 1, __

6, __, 8 __, 3, 4

�, __, 11 __, 11, 12

16, 1�, __ __, 1�, 20

0, 1, __ __, 14, 15

0, __, 2 __, 13, 14

MISSInG nUMBeR

Form 4

PaGe 35

�, __, 11 6, �, __

__, 8, � 3, __, 5

14, 15, __ 12, __, 14

__, 10, 11 16, __, 18

__, 14, 15 4, 5, __

MISSInG nUMBeR

Form 5

PaGe 3�

1�, 18, __ __, 5, 6

13, __, 15 __, 8, �

1, __, 3 __, 12, 13

3, __, 5 15, 16, __

__, 12, 13 15, __, 1�

__, 10, 11 2, __, 4

__, 6, � 1�, 18, __

12, __, 14 __, 1, 2

4, __, 6 �, 8, __

__, 11, 12 13, __, 15

MISSInG nUMBeR

Form 5

PaGe 38

1�, 18, __ 5, __, �

__, 3, 4 13, 14, __

__, �, 10 1�, __, 1�

11, 12, __ __, 2, 3

2, __, 4 �, 10, __

__, 12, 13 �, __, 11

15, 16, __ __, 18, 1�

12, __, 14 16, 1�, __

__, 4, 5 6, __, 8

16, 1�, __ __, 11, 12

MISSInG nUMBeR

Form 5

PaGe 3�

18, __, 20 12, 13, __

__, �, 10 __, 16, 1�

12, __, 14 5, 6, __

16, __, 18 __, 1�, 20

�, 8, __ 4, __, 6

MISSInG nUMBeR

Form 6

PaGe 41

__, 13, 14 6, __, 8

5, 6, __ 15, 16, __

__, 4, 5 �, __, �

__, 1, 2 4, 5, __

__, 3, 4 15, __, 1�

8, �, __ __, 5, 6

1�, __, 1� 3, 4, __

__, 11, 12 8, __, 10

__, 10, 11 16, __, 18

11, 12, __ �, __, 11

MISSInG nUMBeR

Form 6

PaGe 42

__, 4, 5 15, 16, __

6, __, 8 __, 12, 13

__, 2, 3 15, 16, __

14, __, 16 __, 8, �

3, 4, __ 2, __, 4

__, 6, � 14, 15, __

�, 10, __ 12, __, 14

__, 2, 3 4, 5, __

10, __, 12 __, 2, 3

�, __, 11 __, 1�, 20

MISSInG nUMBeR

Form 6

PaGe 43

11, 12, __ 4, __, 6

__, 11, 12 1, 2, __

5, __, � 0, __, 2

__, 14, 15 16, __, 18

8, �, __ __, 5, 6

MISSInG nUMBeR

Form 7

PaGe 45

15, __, 1� 4, 5, __

__, 5, 6 3, 4, __

15, __, 1� __, 1, 2

1�, 18, __ __, 12, 13

16, __, 18 2, 3, __

__, 14, 15 0, __, 2

3, 4, __ __, 15, 16

18, __, 20 15, 16, __

__, �, 8 __, 1�, 18

�, __, � 13, 14, __

MISSInG nUMBeR

Form 7

PaGe 46

3, __, 5 __, �, 10

13, __, 15 __, 4, 5

15, 16, __ 1, __, 3

__, 6, � 16, __, 18

__, 10, 11 4, __, 6

�, 8, __ __, 10, 11

2, __, 4 12, 13, __

__, 1�, 20 14, 15, __

0, __, 2 __, 12, 13

16, 1�, __ 6, __, 8

MISSInG nUMBeR

Form 7

PaGe 4�

12, __, 14 5, __, �

__, 1�, 20 15, 16, __

5, 6, __ __, �, 8

14, __, 16 __, 4, 5

�, __, � 16, 1�, __

MISSInG nUMBeR

Form 8

PaGe 4�

__, 1, 2 11, __, 13

16, 1�, __ 14, __, 16

__, �, 8 18, 1�, __

6, __, 8 __, 1�, 18

10, __, 12 15, 16, __

18, __, 20 __, 16, 1�

__, 14, 15 3, __, 5

10, 11, __ __, 18, 1�

2, __, 4 __, �, 10

1�, 18, __ 13, __, 15

MISSInG nUMBeR

Form 8

PaGe 50

11, 12, __ __, 12, 13

18, 1�, __ __, 5, 6

0, __, 2 4, 5, __

__, 13, 14 5, __, �

15, 16, __ __, �, 8

�, __, 11 0, 1, __

__, 2, 3 11, __, 13

4, 5, __ __, 8, �

16, __, 18 4, __, 6

__, 10, 11 1, 2, __

MISSInG nUMBeR

Form 8

PaGe 51

14, __, 16 __, 4, 5

1, __, 3 __, 11, 12

1�, 18, __ __, 5, 6

12, __, 14 __, 3, 4

11, __, 13 1�, 18, __

MISSInG nUMBeR

Form 9

PaGe 53

8, __, 10 18, 1�, __

__, 12, 13 __, 1, 2

8, �, __ 18, __, 20

0, __, 2 __, 15, 16

5, __, � 16, 1�, __

3, __, 5 __, �, 10

2, __, 4 __, 1�, 18

3, 4, __ __, 14, 15

�, __, 11 8, �, __

__, 1�, 20 13, __, 15

MISSInG nUMBeR

Form 9

PaGe 54

__, 3, 4 0, __, 2

__, 13, 14 15, __, 1�

11, 12, __ __, 18, 1�

14, __, 16 18, 1�, __

12, __, 14 __, 11, 12

16, __, 18 __, 10, 11

�, 8, __ __, 1�, 18

8, __, 10 __, 6 ,�

�, __, 11 13, 14, __

18, __, 20 __, 3, 4

MISSInG nUMBeR

Form 9

PaGe 55

�, __, � 13, 14, __

__, �, 8 0, 1, __

11, __, 13 15, 16, __

__, 6, � 1, __, 3

�, 10, __ __, 12, 13

MISSInG nUMBeR

Form 10

PaGe 5�

__, 4, 5 1�, 18, __

6, __, 8 __, 1�, 18

13, __, 15 __, 1, 2

11, __, 13 12, 13, __

__, 2, 3 13, 14, __

5, __, � __, �, 10

16, 1�, __ 3, __, 5

__, 3, 4 �, __, �

14, 15, __ __, �, 8

13, 14, __ __, 12, 13

MISSInG nUMBeR

Form 10

PaGe 58

18, 1�, __ 8, __, 10

__, 15, 16 �, __, 11

__, 16, 1� 10, __, 12

3, 4, __ __, �, 8

0, __, 2 __, 5, 6

16, 1�, __ 0, 1, __

12, __, 14 __, 11, 12

2, __, 4 __, 1�, 20

5, __, � 18, 1�, __

__, 16, 1� 3, __, 5

MISSInG nUMBeR

Form 10

PaGe 5�

�, 8, __ __, 15, 16

2, 3, __ 0, __, 2

__, 6, � __, 1�, 20

13, __, 15 1�, 18, __

__, 8, � 15, __, 1�

MISSInG nUMBeR

Form 11

PaGe 61

14, __, 16 __, �, 10

1, __, 3 5, 6, __

�, __, � __, 3, 4

8, __, 10 0, 1, __

__, 4, 5 11, __, 13

1�, 18, __ __, 15, 16

6, __, 8 10, 11, __

__, 11, 12 5, __, �

__, �, 10 14, 15, __

__, 6, � 0, __, 2

MISSInG nUMBeR

Form 11

PaGe 62

8, __, 10 __, 14, 15

__, 2, 3 6, �, __

__, 4, 5 1�, 18, __

3, 4, __ __, �, 8

12, __, 14 __, 5, 6

15, __, 1� 2, 3, __

__, 8, � 18, __, 20

1, 2, __ 14, 15, __

8, __, 10 3, __, 5

__, 6, � 11, 12, __

MISSInG nUMBeR

Form 11

PaGe 63

__, 1�, 18 8, �, __

__, 2, 3 �, __, 11

2, __, 4 13, 14, __

__, 1�, 20 6, __, 8

�, 10, __ 0, 1, __

MISSInG nUMBeR

Form 12

PaGe 65

__, 3, 4 __, 13, 14

14, __, 16 12, 13, __

11, __, 13 2, 3, __

3, 4, __ 1, 2, __

2, __, 4 __, 10, 11

4, 5, __ 13, 14, __

__, 12, 13 __, 1�, 20

15, __, 1� 2, 3, __

12, 13, __ �, 10, __

1�, 18, __ __, 10, 11

MISSInG nUMBeR

Form 12

PaGe 66

15, __, 1� 11, 12, __

__, 14, 15 __, 2, 3

4, 5, __ �, __, �

12, 13, __, __, 3, 4

13, 14, __ 2, 3, __

__, 12, 13 __, �, 10

16, __, 18 __, 11, 12

__, 1�, 20 1�, __, 1�

__, 1, 2 __, �, 8

__, 13, 14 13, __, 15

MISSInG nUMBeR

Form 12

PaGe 6�

�, 8, __ 11, 12, __

4, __, 6 13, 14, __

__, 2, 3 16, __, 18

4, __, 6 __, 1�, 20

__, 6, � 18, __, 20

MISSInG nUMBeR

Form 13

PaGe 6�

4, __, 6 __, 11, 12

__, 10, 11 12, __, 14

12, 13, __ 0, 1, __

8, __, 10 10, 11, __

__, 18, 1� �, __, 11

13, 14, __ 4, __, 6

15, __, 1� 12, __, 14

12, 13, __ __, 10, 11

3, __, 5 1, 2, __

2, 3, __ 12, __, 14

MISSInG nUMBeR

Form 13

PaGe �0

8, �, __ __, 12, 13

__, 3, 4 �, __, 11

__, 5, 6 5, 6, __

__, 14, 15 0, __, 2

13, __, 15 15, __, 1�

5, 6, __ 10, 11, __

18, __, 20 3, __, 5

6, �, __ 1, __, 3

__, �, 8 __, 1, 2

�, __, � 5, 6, __

MISSInG nUMBeR

Form 13

PaGe �1

__, 8, � __, 16, 1�

14, __, 16 __, �, 8

18, 1�, __ �, __, �

15, __, 1� 2, 3, __

__, 13, 14 __, 15, 16

MISSInG nUMBeR

Form 14

PaGe �3

5, 6, __ 0, 1, __

__, 11, 12 __, �, 8

18, 1�, __ 4, 5, __

__, 13, 14 __, 18, 1�

15, __, 1� __, 13, 14

1�, __, 1� 8, �, __

16, 1�, __ 5, __, �

3, __, 5 __, 1�, 20

18, __, 20 __, 2, 3

__, �, 8 14, 15, __

MISSInG nUMBeR

Form 14

PaGe �4

__, 6, � 15, 16, __

�, __, � 8, __, 10

8, �, __ 13, 14, __

1�, 18, __ 11, 12, __

__, 1�, 18 10, __, 12

__, 13, 14 4, 5, __

8, __, 10 16, 1�, __

0, __, 2 __, 5, 6

18, 1�, __ 10, 11, __

__, 4, 5 __, 8, �

MISSInG nUMBeR

Form 14

PaGe �5

__, 11, 12 �, __, �

5, __, � 4, 5, __

__, 1�, 18 __, 3, 4

__, 10, 11 8, __, 10

__, 13, 14 __, 5, 6

MISSInG nUMBeR

Form 15

PaGe ��

__, 5, 6 __, 3, 4

8, �, __ 10, 11, __

__, 1�, 20 5, __, �

18, 1�, __ 14, __, 16

0, __, 2 15, 16, __

__, 15, 16 10, __, 12

13, 14, __ 12, 13, __

4, 5, __ __, 18, 1�

0, 1, __ 8, __, 10

3, 4, __ __, �, 8

MISSInG nUMBeR

Form 15

PaGe �8

10 ,__, 12 __, 5, 6

15, 16, __ 1�, __, 1�

4, 5, __ 12, __, 14

6, �, __ 1, __, 3

__, 11, 12 2, 3, __

15, 16, __ __, 6, �

__, �, 10 16, 1�, __

12, 13, __ 10, __, 12

18, 1�, __ 15, __, 1�

16, __, 18 1�, __, 1�

MISSInG nUMBeR

Form 15

PaGe ��

__, �, 8 10, 11, __

__, 14, 15 16, 1�, __

__, 1, 2 15, __, 1�

4, 5, __ 3, 4, __

__, 3, 4 1�, __, 1�

MISSInG nUMBeR

Form 16

PaGe 81

__, 10, 11 12, 13, __

8, �, __ __, 12, 13

4, 5, __ __, 18, 1�

12, __, 14 10, __, 12

__, 8, � __, 5, 6

4, 5, __ 0, 1, __

3, __, 5 1, 2, __

3, 4, __ �, 10, __

14, 15, __ 13, __, 15

__, 5, 6 �, __, �

MISSInG nUMBeR

Form 16

PaGe 82

4, 5, __ �, 8, __

�, __, 11 8, __, 10

8, �, __ �, 10, __

__, 14, 15 __, 8, �

11, __, 13 �, 8, __

14, __, 16 15, 16, __

1�, __, 1� 1, __, 3

13, __, 15 1, 2, __

__, 12, 13 10, 11, __

16, 1�, __ 8, �, __

MISSInG nUMBeR

Form 16

PaGe 83

4, __, 6 3, __, 5, __,

__, 6, � �, 8, __

__, 10, 11 14, __, 16

__, �, 10 15, __, 1�

2, __, 4 �, __, �

MISSInG nUMBeR

Form 17

PaGe 85

__, 12, 13 __, 1�, 20

2, __, 4 __, 12, 13

__, 5, 6 12, 13, __

13, __, 15 14, 15, __

2, 3, __ 6, �, __

18, 1�, __ �, 8, __

3, 4, __ 6, __, 8

11, __, 13 __, 2, 3

�, __, � 4, 5, __

0, __, 2 __, 3, 4

MISSInG nUMBeR

Form 17

PaGe 86

18, 1�, __ __, 8, �

1, __, 3 __, �, 8

12, __, 14 6, __, 8

11, 12, __ �, __, 11, __,

__, 13, 14 5, __, �

__, 12, 13 12, 13, __

__, 15, 16 __, 13, 14

4, 5, __ 16, __, 18

15, 16, __ 11, __, 13

11, 12, __ 1�, 18, __

MISSInG nUMBeR

Form 17

PaGe 8�

5, __, � 10, __, 12

16, 1�, __ __, 18, 1�

__, 13, 14 3, 4, __

__, �, 10 __, �, 8

6, �, __ 15, 16, __

MISSInG nUMBeR

Form 18

PaGe 8�

�, 10, __ 12, 13, __

__, 18, 1� 13, 14, __

�, 8, __ __, 15, 16

14, 15, __ �, 10, __

0, 1, __ 1, 2, __

12, 13, __ 2, 3, __

__, �, 8 6, __, 8

4, 5, __ 5, 6, __

14, __, 16 1, __, 3

8, �, __ 0, 1, __

MISSInG nUMBeR

Form 18

PaGe �0

__, 1�, 20 13, __, 15

10, 11, __ 8, �, __

__, 1�, 18 __, 16, 1�

10, __, 12 12, __, 14

3, 4, __ __, 6, �

1, 2, __ 15, 16, __

2, __, 4 �, 10, __

__, 14, 15 �, __, �

6, __, 8 14, 15, __

�, 8, __ __, 1�, 18

MISSInG nUMBeR

Form 18

PaGe �1

18, __, 20 4, __, 6

14, __, 16 4, 5, __

__, 15, 16 __, 13, 14

10, __, 12 8, �, __

5, __, � 11, __, 13

MISSInG nUMBeR

Form 19

PaGe �3

13, 14, __ __, 12, 13

10, 11, __ 0, __, 2

__, 18, 1� __, 12, 13

12, 13, __ 1�, __, 1�

3, 4, __ 11, 12, __

__, 16, 1� 10, 11, __

__, 1, 2 12, 13, __

�, __, 11 14, 15, __

__, 6, � 18, 1�, __

5, 6, __ 10, __, 12

MISSInG nUMBeR

Form 19

PaGe �4

16, __, 18 __, 4, 5

__, 13, 14 18, __, 20

13, __, 15 8, �, __

14, __, 16 16, 1�, __

3, 4, __ 2, __, 4

10, 11, __, __ 6, __, 8

13, 14, __ 6, �, __

4, 5, __ __, 16, 1�

12, __, 14 3, __, 5

1, __, 3 �, __, �

MISSInG nUMBeR

Form 19

PaGe �5

8, __, 10 2, 3, __

__, 12, 13 13, __, 15

12, 13, __ 8, �, __

__, 13, 14 __, 1�, 20

__, 3, 4 __, 10, 11

MISSInG nUMBeR

Form 20

PaGe ��

__, 15, 16 __, 13, 14

6, __, 8 __, 2, 3

16, 1�, __ __, 6, �

__, 5, 6 __, 16, 1�

__, 4, 5 12, __, 14

__, 11, 12 6, �, __

�, 8, __ __, 10, 11

2, __, 4 __, 14, 15

0, __, 2 �, __, �

__, 3, 4 8, __, 10

MISSInG nUMBeR

Form 20

PaGe �8

16, __, 18 __, 1�, 18

�, 8, __ �, 10, __

__, 16, 1� __, 18, 1�

__, 6, � 18, __, 20

5, 6, __ 1, __, 3

15, 16, __, __ 14, __, 16

__, 3, 4 __, 5, 6

__, 1, 2 8, __, 10

12, __, 14 1�, __, 1�

__, 2, 3 __, �, 8

MISSInG nUMBeR

Form 20

PaGe ��

8, __, 10 __, 18, 1�

__, 11, 12 __, 2, 3

6, �, __ 11, 12, __

8, �, __ 4, __, 6

__, 18, 1� 4, 5, __

nUMBeR IDentIFICatIon


PaGe 103

Practice

Screening: Beginning of Year ..................................................................................................................... 105Screening: Middle of Year .......................................................................................................................... 107Screening: End of Year ................................................................................................................................ 109Form 1 .......................................................................................................................................................... 111Form 2 .......................................................................................................................................................... 113Form 3 .......................................................................................................................................................... 115Form 4 .......................................................................................................................................................... 117Form 5 .......................................................................................................................................................... 119Form 6 .......................................................................................................................................................... 121Form 7 .......................................................................................................................................................... 123Form 8 .......................................................................................................................................................... 125Form 9 .......................................................................................................................................................... 127Form 10 ........................................................................................................................................................ 129Form 11 ........................................................................................................................................................ 131Form 12 ........................................................................................................................................................ 133Form 13 ........................................................................................................................................................ 135Form 14 ........................................................................................................................................................ 137Form 15 ........................................................................................................................................................ 139Form 16 ........................................................................................................................................................ 141Form 17 ........................................................................................................................................................ 143Form 18 ........................................................................................................................................................ 145Form 19 ........................................................................................................................................................ 147Form 20 ........................................................................................................................................................ 149

3 6


PaGe 105


2 6 18 34 63 4 8

11 1� 82 5� 23 � 14

� 1 13 41 5 3� 26

3 10 6 �2 �3 58 0

3 15 31 2� 1� 4 1

48 12 8 20 11 3� 63

�4 36 5 � 6� 16 1

53 2� 18 10 14 �4 �

4� 38 26 12 100 4� 33

35 11 22 5� 6� 13 2�


PaGe 10�


2 10 31 15 20 84 13

0 � 40 65 1� 46 5

32 �1 14 �6 1 43 5�

4 3� 100 4� 12 34 6

3 16 41 50 6� 44 1�

15 33 �4 14 4� � 6

�8 0 31 53 11 38 8

20 �3 8� 6 5 1 �

8 42 14 35 48 10 5�

12 2 43 62 16 �6 13


PaGe 10�


5 12 8 2 54 1� 11

22 5 1 3� 84 6 24

63 41 18 0 �6 45 31

3 � 38 5� 40 2� 44

32 23 82 4� 8� 28 18

61 21 1� 8 �4 48 30

15 � 1 �4 3 1� 15

�6 14 2 10 42 11 13

36 � 65 16 20 13 52

14 3� 81 10 4 60 33


Form 1

PaGe 111

8 23 15 � 52 �2 13

26 8 40 16 3� 6 2�

61 5 5� 1� 22 10 �8

4 44 1 68 51 1� 63

0 25 1� 43 3 8� �

12 82 30 2 15 18 42

� �6 5 45 �4 12 24

18 6 13 32 1� �2 10

4� 16 4 11 38 20 1

50 �1 2 33 48 2� 0


Form 2

PaGe 113

� 42 20 66 24 52 13

16 61 5 1 36 0 44

34 12 48 �� 82 12

31 �8 40 1� 53 45 43

�3 11 18 3� 35 3� �

� 4� 4� 15 21 10 5�

1� 25 2 20 68 8� 1�

23 5 8 11 �5 32 18

2� �5 15 3 81 13 4

14 10 1� 4 8 2 33


Form 3

PaGe 115

6 13 38 0 16 51 11

25 �� 1 3� 2 64 4

46 42 1� 81 � 20 4

8 �8 5 4� 14 20 24

12 15 �1 3� 13 5� 1�

�8 2� 5 �2 61 � 50

�1 48 � 4� 53 28 15

18 54 34 41 65 40 23

6 31 10 0 21 43 83

� 11 2� 1 1� 18 8�


Form 4

PaGe 11�

0 15 2 1� 25 � 8

68 13 24 46 �2 3� 26

11 15 43 1� �3 2 34

84 � 20 14 2� 11 53

1 � 41 48 �4 13 16

3� 45 1� 23 62 18 4�

54 12 3 5 31 4 10

�8 8� 4 44 6 42 32

6� 3 30 6 4� 5 �

21 12 22 5� 10 14 65


Form 5

PaGe 11�

� 2� 2 5 18 88 6

52 32 1 1� 2� 12 43

65 5 41 3� 1 5� �2

8 86 48 15 13 83 1�

45 11 4 66 31 3 4�

6 0 8 �1 22 0 11

46 82 1� 42 16 �� 4

28 13 25 62 34 � 6�

33 18 4 24 3 46 5�

12 14 20 23 3� 15 4�


Form 6

PaGe 121

5 41 � 62 2 15 43

54 �� 36 0 32 �6 14

31 1� �1 23 5� 1� 44

13 5� 2� 18 34 20 13

8 2 12 1 0 68 �3

� 42 83 16 4� 6 4

14 1� 11 86 21 4� 15

�4 10 5 8 46 16 28

11 �2 35 10 33 40 3

24 84 4 18 3 3� ��


Form 7

PaGe 123

3 12 8 2� 1� 6� �

�1 31 13 �6 32 � 5�

2 15 1� 6 18 16 54

8� 4 15 �8 2 84 1

30 13 � 65 4� 25 10

16 20 14 24 4� 20 32

5 40 11 28 10 12 62

82 3� 2� 35 1� � 18

3� 21 11 1� 22 26 13

46 14 4 33 55 6 45


Form 8

PaGe 125

2 1� 23 5 11 12 61

14 51 2 43 13 �8 15

1� � 41 58 4 �2 1�

2� 10 20 35 64 45 �3

15 28 55 26 30 � 44

16 81 5 50 8 18 11

13 10 6� 3 � 0 4�

22 6 �6 31 14 1� �4

12 40 3 �4 0 3� 83

8 25 �0 6 3� 53 16


Form 9

PaGe 12�

10 41 6 84 3 3� 4

20 2 10 24 13 6� 5

36 �2 25 45 16 5� 5

2� � 12 �4 14 35 1�

1 53 31 3 15 12 �

14 23 60 3� 13 32 �

0 5� 1� � 2� �0 4

0 11 34 3� 63 42 1�

2 8 �6 11 �� 1� 46

83 4� 15 1 6 43 20


Form 10

PaGe 12�

4 1� 5� 18 21 12 22

83 6 62 � 16 14 2

6 8� 3 0 38 28 �4

� 3 43 16 22 85 42

� 1� �1 41 32 44 �

6� 20 8� �4 4� �3 1�

10 56 35 5 11 14 85

36 4 8� 1� 15 54 12

40 3� 1 46 2� 26 13

24 �2 10 33 11 3� 8

25


PaGe 131

Form 11

8 2� 1� 5 33 � 26

1� 5� 10 45 6 13 �

28 23 4� 11 16 4 2�

1� 38 63 �� 15 1 44

6 16 3� 8 11 4� 51

2 81 32 25 18 36 4

� 46 0 58 14 6� 18

31 3 2� � 22 13 4�

5 �3 100 36 1� 2� 24

1 3� 32 15 3 20 88


PaGe 133

Form 12

� 26 44 3� 12 0 21

�� 1� 8 12 50 4

�1 1� 3 41 � 5 11

6 81 32 66 50 3� �1

2 33 63 �� 1 5 �

3 1 32 30 � 15 �6

1� 38 15 36 16 13 4

2� 33 16 5� 6 2 3�

8 24 4 54 42 2 �

68 4� 4 68 �8 12 1�


PaGe 135

Form 13

� 13 38 1� 3 �5 14

22 23 13 62 8 38 1

33 40 16 2 20 50 16

0 81 4� 15 26 � 12

18 6 38 42 86 18 4

� 2 1� 100 15 62 60

28 38 1� 4 1� 38 3

14 �3 6 3� 50 15 �5

1� 0 2� 16 63 58 83

20 �5 15 34 � 45 22


PaGe 13�

Form 14

6 16 15 41 �6 38 22

5 �4 83 0 20 �4 18

41 58 50 12 � 10 50

33 40 3 24 45 5� 20

5� �8 26 36 60 53 6

1� � 32 8 14 2 22

31 3� 1� 15 16 0 �4

24 51 23 5� 1 23 11

15 0 21 3 64 6 12

4 1� 2 14 1� 36 41


PaGe 13�

Form 15

6 1� 8 55 26 5 28

43 16 10 15 45 26 3

42 16 2 41 48 0 1

8� �6 18 21 35 16 11

10 18 2 �0 23 14 5

12 �� 61 36 28 18 30

40 24 1 4� 1� 81 8

�3 14 15 5� 10 3� 41

15 3 83 1� 14 �5 30

18 45 �� 0 16 14 22


PaGe 141

Form 16

3 � 2 12 34 60 4

6 20 � 2� 5 21 1

�6 46 32 28 �3 13 8

14 3� 10 � 26 10 30

4� �1 43 � 15 63 30

15 2� 20 4 �8 42 3�

3 33 1� �5 2 1� �2

34 28 6 36 �6 46 45

13 0 65 44 1� 8 54

4 5� 0 31 � 4 10


PaGe 143

Form 17

� 38 23 8 33 15 53

1 3 �6 45 26 22 4

15 14 �3 6 � 24 6�

8 65 12 14 53 61 5

6 30 5� 3 2� 21 8

24 40 55 26 10 4 0

51 5 8 36 � 1� 81

3 22 5 23 20 24 50

�5 2 33 50 1� 46 ��

8 1 �4 15 12 13 1�


PaGe 145

Form 18

1 12 8 21 11 30 �8

33 4� 44 66 � � 3

46 4 36 6 4� �1 45

32 0 14 5 10 � 62

11 23 2 48 32 1 12

2 11 5 14 3 1� 18

15 88 5 �� 44 13 55

20 �2 83 � 0 28 24

1 36 1� 48 16 6 20

2 �0 8 82 2� 14 38


PaGe 14�

Form 19

4 50 1� � � � 10

5 64 � 81 1� �� 1�

14 50 3� 12 8 5 1

�� 6 21 65 32 2� 42

4� 0 1� 5 34 �6 38

20 3 54 86 10 12 0

44 8 1 85 16 18 28

51 14 31 4 �0 56 28

10 33 13 11 3 45 38

�8 4 22 13 1� 46 14


PaGe 14�

Form 20

8 24 20 46 14 10 0

1� � 0 2� 22 41 28

1� �� 21 �� 15 5 6

4 1� 86 64 11 1 2�

3� 2 3� 4 �1 23 �3

22 � 18 5 0 42 5�

4� 61 40 25 13 3 1�

12 � 6 16 1� 15 58

12 �0 8 5 35 44 46

32 5 �0 4 88 60 0

QUantItY DISCRIMInatIon

Practice

PaGe 153


Beginning of Year ....................................................................................................................................... 154Middle of Year ............................................................................................................................................. 156End of Year .................................................................................................................................................. 158Form 1 .......................................................................................................................................................... 160Form 2 .......................................................................................................................................................... 162Form 3 .......................................................................................................................................................... 163Form 4 .......................................................................................................................................................... 166Form 5 .......................................................................................................................................................... 168Form 6 .......................................................................................................................................................... 170Form 7 .......................................................................................................................................................... 172Form 8 .......................................................................................................................................................... 174Form 9 .......................................................................................................................................................... 176Form 10 ........................................................................................................................................................ 178Form 11 ........................................................................................................................................................ 180Form 12 ........................................................................................................................................................ 182Form 13 ........................................................................................................................................................ 184Form 14 ........................................................................................................................................................ 186Form 15 ........................................................................................................................................................ 188Form 16 ........................................................................................................................................................ 190Form 17 ........................................................................................................................................................ 192Form 18 ........................................................................................................................................................ 194Form 19 ........................................................................................................................................................ 196Form 20 ........................................................................................................................................................ 198

2 � 5 3



PaGe 154

� 2 13 18 6 4

3 � 11 5 2 8

6 1 15 1� � 3

0 2 18 12 5 8

10 � 3 � 13 1�

4 5 16 12 � 10

1 0 6 14 1� 4

8 13 � 6 18 1�

3 0 5 � 14 11

12 16 8 � 4 6


PaGe 155

End of BOY Form


1 0 5 � 3 2

16 1� � 4 2 8

6 3 2 10 13 11

5 8 � 1 6 �

5 3 15 1� 1 6

� 8 2 6 16 12

1 � � 5 3 14

2 0 4 � 8 �

6 � 18 1� � 13

10 2 6 1� 5 4


PaGe 156


8 3 11 1� � 5

2 � 13 � 6 8

� 4 12 16 6 4

1 3 15 2 0 8

10 0 4 16 8 5

3 4 18 � 6 �

1 0 14 1� 5 2

3 5 15 4 4 8

4 0 3 12 � 1

3 8 1� 8 4 �


PaGe 15�

End of MOY Form


� 5 6 1� 8 2

� 10 16 13 0 �

6 2 14 18 � 8

4 5 20 11 2 �

� 2 1 11 � 3

1 � 18 5 5 10

8 5 � 14 1 0

8 � 12 2 6 �

� 3 16 1� 6 3

0 5 13 11 � 8


PaGe 158


2 8 3 2 6 8

� 1 11 13 � 8

0 1 10 5 3 1�

4 1 5 � 1� 10

3 5 1� 18 0 8

8 � 18 1� 8 2

6 1� 2 1 1 4

5 0 � 8 15 �

2 6 6 4 4 11

� 6 4 10 14 11


PaGe 15�

End of EOY Form


� 10 4 3 2 6

5 4 0 13 10 2

6 � 6 4 3 �

� 1 15 1� � 2

2 13 6 2 4 �

10 3 � 13 11 4

1 8 13 3 3 5

10 1 3 5 � 6

2 16 1� 6 6 �

� 2 1 6 � 5


PaGe 160

Form 1

5 � 6 2 4 �

� 4 16 4 1 10

� 2 � 0 1 3

8 � 1 5 3 1

5 8 1� � 2 4

� 3 � 15 � �

2 16 � 4 4 1�

10 4 1 3 18 6

1 5 3 2 6 �

8 � 2 10 1� 12


PaGe 161

End of Form 1

Form 1

2 � 15 1 1 2

� 4 8 18 6 0

2 � 13 3 1 10

8 5 6 1� 10 3

3 � � 2 � 10

5 3 13 20 3 0

1 � 2 1 10 2

4 8 6 0 4 �

1� 15 � 11 8 2

5 � 1� 8 4 5


PaGe 162

Form 2

2 8 4 0 2 5

5 4 2 10 � 4

6 � 5 2 2 11

11 5 4 6 14 �

6 10 16 5 3 �

8 5 6 10 5 3

0 16 10 4 3 6

� 1 6 8 13 2

3 � 5 3 � 18

8 2 1 � 8 �


PaGe 163

End of Form 2

Form 2

� � 15 14 1 3

� 4 3 1� 2 0

6 � 16 14 3 5

8 0 6 12 10 3

6 � 1� 10 2 4

� 5 4 16 4 2

� 5 18 1� 2 8

3 0 1 2 10 �

3 � 12 10 0 3

� � 1 11 � 6


PaGe 164

Form 3

10 � 6 � � 5

5 � � 4 6 10

8 5 4 8 � 2

3 8 � 2 1� 1�

3 � 20 10 6 10

8 2 12 18 8 4

4 6 6 2 11 1�

10 3 � 6 18 10

� 8 � 2 2 11

6 2 2 5 11 4


PaGe 165

End of Form 3

Form 3

2 4 18 13 8 �

4 2 10 11 10 3

4 5 15 2 1 5

10 � 2 � 11 8

5 8 11 3 4 5

5 2 11 13 5 0

4 � 12 10 1 2

� 4 2 8 6 5

� 1� 20 12 4 6

8 3 � 12 5 3


PaGe 166

Form 4

0 8 10 � 1 4

8 5 16 1� 8 5

� 10 8 4 2 12

4 2 3 � 16 5

6 � 18 14 4 �

� 4 8 1� 18 8

15 1� 8 4 0 3

10 5 5 � 1� 1

4 � 5 4 1 10

2 0 5 � 15 0


PaGe 16�

End of Form 4

Form 4

3 4 14 2 1 �

5 1 12 15 5 2

3 8 11 8 0 5

10 2 5 11 � 2

6 � 12 13 2 10

8 5 6 � 8 5

2 6 14 2 0 10

1 0 5 8 4 3

1 18 1� 0 5 10

4 2 16 3 1 10


PaGe 168

Form 5

1 6 � 2 5 6

2 1 1 12 8 3

2 4 5 4 0 18

� � 2 6 1� 18

4 5 1� 1� 4 5

8 4 0 � 3 1

2 1� 5 4 3 18

4 3 � � 1� 15

1 � 1 0 � 13

5 4 5 � 15 14


PaGe 16�

End of Form 5

Form 5

0 1 13 � 4 6

1 0 2 1� 8 4

1 � � 8 2 6

3 2 3 4 13 5

� � 8 5 3 6

8 3 1 6 � 6

1 10 � 6 2 10

6 3 4 � 5 4

15 18 14 15 5 2

2 � 10 5 2 3


PaGe 1�0

Form 6

2 1 2 8 10 2

0 1 20 18 0 �

6 1 5 8 12 �

1 8 5 4 4 12

6 3 2 12 4 3

5 8 18 8 4 �

4 0 � � 16 5

2 3 8 5 1 �

3 1 1 � 5 1

2 6 6 5 6 11


PaGe 1�1

End of Form 6

Form 6

� 1 5 20 2 1

3 � 14 � 0 �

6 3 � � 10 4

3 � 5 1 4 �

3 2 10 16 � 3

0 2 5 3 � 0

8 � 6 14 10 8

3 4 � 0 0 6

14 � 2 1� 10 3

1 10 20 � 3 8


PaGe 1�2

Form 7

1 2 � 0 2 6

8 5 8 14 � 5

1 6 6 3 11 13

� 1 5 � 13 4

4 8 � 0 3 8

10 5 13 14 � 0

0 8 10 1 12 18

� 4 3 4 1 0

4 � 4 3 12 1�

8 5 3 5 � 2


PaGe 1�3

End of Form 7

Form 7

1 � 1� 16 5 6

� 3 � 12 8 6

4 � 5 0 6 10

3 1 13 15 � 6

1 4 13 12 0 2

3 1 0 4 5 4

� 8 � 3 0 1

5 3 4 8 � 4

5 14 15 5 2 6

4 8 0 � 10 �


PaGe 1�4

Form 8

6 � � 5 1 3

4 1 � 8 4 0

5 � 2 1 5 �

8 1 6 � 13 11

8 � 18 14 2 5

� 8 4 � 8 3

11 � � 8 1 2

6 1 2 10 12 4

3 4 8 2 3 �

2 0 1 � 11 �


PaGe 1�5

End of Form 8

Form 8

4 1 3 1� 10 4

� 8 10 � � 8

� 3 1 8 6 1

5 � 2 1 1 �

8 � 3 � 6 1

4 8 15 4 4 6

5 1 1� � � �

3 8 5 4 8 6

11 3 � 10 10 5

� 8 1� 15 0 �


PaGe 1�6

Form 9

� 2 4 5 � 8

3 10 � 6 3 6

� 4 5 � 4 5

� 8 4 8 1� �

2 3 15 2 2 �

6 5 10 11 6 1

12 18 10 � 1 4

10 3 � � � 6

1 5 � 2 4 14

5 2 5 6 16 5


PaGe 1��

End of Form 9

Form 9

6 � 10 4 1 6

� � 1 6 � 4

1 5 18 2 8 10

� 6 3 16 4 3

0 8 16 14 8 �

10 � 0 16 8 5

0 5 1� 14 � 6

4 2 4 8 2 1

16 1� � � 1 2

� 8 4 10 � 5


PaGe 1�8

Form 10

0 1 5 1 2 4

5 3 12 14 6 3

1 8 � 4 2 1�

8 3 2 4 10 1

� 10 4 1 3 8

3 1 � 18 � 0

3 15 4 0 5 �

6 4 � � 1� 12

2 4 5 2 11 14

5 � 2 5 14 5


PaGe 1��

End of Form 10

Form 10

2 10 13 � 0 2

3 1 11 16 10 5

4 � 11 3 1 6

10 � 1 4 11 �

1 � 18 1� 3 8

3 0 � 13 3 1

2 4 6 5 4 6

� 2 5 � 6 3

15 18 14 13 3 4

� 6 5 15 � 1


PaGe 180

Form 11

3 5 1� 12 6 8

11 � 4 2 3 6

1 0 5 � 12 �

2 1� 3 1 6 5

15 1� � 8 10 5

6 4 � 3 1� 20

2 8 13 � 6 15

14 12 8 � 2 3

� 5 16 18 13 11

� 6 10 � 3 5


PaGe 181

End of Form 11

Form 11

� 4 15 1� 18 12

8 3 6 � 5 1

0 8 3 2 � �

13 11 4 8 5 2

6 10 8 3 5 �

11 6 2 � 18 14

� 10 8 5 2 6

11 3 5 8 � 12

6 1 0 5 � 4

14 1� 20 1� 3 �


PaGe 182

Form 12

4 10 � 3 0 1

3 2 4 10 � 4

3 � 1� 4 5 �

1� 2 4 6 8 0

� 1� 4 2 5 12

8 4 � 12 1� 5

� 14 � 8 1 6

� 0 2 8 5 2

0 4 6 1 3 6

8 5 12 13 10 3


PaGe 183

End of Form 12

Form 12

3 4 10 2 2 4

12 � 10 15 10 �

0 8 1� 8 15 1�

20 12 8 � 10 0

3 8 16 12 6 �

� 0 0 2 4 1

1 5 10 1 � 10

4 3 6 10 10 0

5 14 � 6 5 �

3 2 16 1� 1� 0


PaGe 184

Form 13

6 12 � 0 5 1�

� 6 � 10 10 6

� 10 1� � 3 5

4 1 5 8 � �

1 8 1� 2 � 8

6 1 0 2 3 1

1 4 13 10 2 1�

8 0 2 3 16 15

3 � � 2 8 10

10 2 3 6 1� 3


PaGe 185

End of Form 13

Form 13

1� 1� 8 6 1 10

3 2 3 8 1� 14

13 1� 6 2 5 �

8 0 12 18 � 1

2 � 3 2 0 3

� 2 5 6 8 5

8 11 � 2 3 6

20 3 3 10 14 3

8 15 5 3 1 �

10 1 2 1� 5 1


PaGe 186

Form 14

4 6 � 2 10 1�

� 3 5 � � 4

12 16 11 � � �

18 13 3 � 1� 11

5 16 5 1 1 �

8 6 2 10 10 �

1 8 � 5 6 10

16 2 0 � 6 2

0 8 10 6 � �

12 � 6 � 10 0


PaGe 18�

End of Form 14

Form 14

0 1 � 1 0 1�

5 1 � 8 8 4

11 15 � 6 2 6

18 1� 2 8 1� 5

� 8 12 � 11 13

� 3 1 � � 6

0 6 12 10 � 14

4 1 3 � � 3

2 6 10 2 3 8

1� 12 1 8 4 0


PaGe 188

Form 15

2 6 � 1 0 10

14 13 3 � 3 2

2 � � 2 1 5

18 14 3 8 11 4

5 10 8 3 0 �

� 4 1 2 1� 14

1 5 6 2 3 6

3 0 � 10 10 0

5 1� � 5 0 4

10 4 6 8 8 4


PaGe 18�

End of Form 15

Form 15

2 1� � 6 0 20

1� � 4 5 3 1

0 � � 0 3 5

5 2 1 3 4 1

2 3 16 10 2 4

6 0 12 20 � 5

6 10 4 2 0 6

10 4 4 � 4 2

6 � � 3 11 1�

20 12 6 10 10 3


PaGe 1�0

Form 16

5 10 1� 18 2 6

� � 0 1 1� 2

6 � 8 1 5 �

� 0 3 5 10 �

0 10 � 1 1 6

8 1 15 1� 4 3

1 3 � 3 16 18

8 3 3 4 5 4

6 10 � 4 3 4

14 � � 10 15 14


PaGe 1�1

End of Form 16

Form 16

8 � 5 1 1 4

4 2 5 13 6 2

4 8 14 � 0 15

� 5 8 � 1� 13

4 16 � 0 8 10

3 2 0 10 � 5

6 8 6 4 2 6

� 2 0 6 12 2

0 8 10 � 2 6

1� � 6 8 10 5


PaGe 1�2

Form 17

� 10 13 0 3 16

13 � 8 � 3 0

� 8 15 � 2 �

� 8 5 � � 4

1� 18 1� 14 1 2

11 6 6 10 5 4

6 8 14 � 2 10

� 2 3 � 8 2

5 10 15 8 4 10

� � 5 6 5 3


PaGe 1�3

End of Form 17

Form 17

3 � 10 6 5 �

6 3 3 6 � �

4 8 2 0 13 20

8 1 3 10 4 3

6 10 18 14 3 5

� 5 1 12 3 2

� 10 8 3 0 �

5 4 1 3 4 1

3 6 10 � 2 10

4 3 3 � 10 6


PaGe 1�4

Form 18

5 6 18 13 6 10

� 3 � 15 10 6

4 10 6 1 1 5

4 0 5 10 6 2

� 10 1� 11 16 1�

� 4 4 5 16 0

2 6 18 14 11 18

� 1 0 6 � 1

2 8 10 3 � 14

16 � 5 � 20 15


PaGe 1�5

End of Form 18

Form 18

0 6 � 3 3 8

8 2 0 5 8 1

8 1� � 5 8 1�

18 11 4 8 � 6

4 20 � 0 6 10

� 0 6 8 � 0

3 4 � 3 3 4

10 1 1 4 2 1

14 18 3 0 3 6

� � 0 � 14 13


PaGe 1�6

Form 19

1 � 10 3 6 10

8 � 0 6 4 2

2 5 13 6 16 18

14 � 10 15 � 4

3 13 5 3 11 18

4 2 0 � 4 3

3 4 10 4 6 �

4 1 6 10 11 �

4 5 18 14 5 8

8 4 5 8 13 �


PaGe 1��

End of Form 19

Form 19

1 3 � 5 0 �

14 11 0 3 4 3

6 10 6 0 4 1�

10 3 10 16 � 5

2 6 4 3 5 �

1� 16 3 6 8 6

5 8 6 3 1 3

� 6 4 5 8 1

3 6 � 2 15 1�

6 3 2 4 � 2


PaGe 1�8

Form 20

0 4 10 0 � 10

� 5 0 � � 0

3 � 15 � 2 5

8 6 2 � 10 6

0 6 15 3 3 6

� 8 0 � 14 13

2 � 10 1 3 4

1� 0 0 5 20 1

10 20 1� 15 0 1

16 0 2 5 6 3


PaGe 1��

End of Form 20

Form 20

4 12 6 3 1� 18

11 5 5 15 3 1

0 5 8 � 5 8

� 8 5 11 4 2

2 6 10 6 � 10

� � 8 10 11 3

6 � 8 1 1 1�

4 1 2 5 � 4

1 � 6 1 3 10

2 1 6 8 5 4

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