Pt. 60, App. C

14 CFR Ch. I (1-1-19 Edition)

Attachment 4 to Appendix C to Part 60Figure C4H - Sample Continuing Qualification Evaluation Requirements Page
INFORMATION

Continuing qualification Evaluation Requirements
Com leted at conclusion o Initial Evaluation
Continuing qualification evaluations are due as
follows:

Continuing qualification Evaluations to be
conducted each

_ifilLi.nl_ months

_{month)_ and -Section-==="'"(enter or

Allotting ___ hours of FTD time.

Date

Revision:

Continuing qualit1cation Evaluations are to be
conducted each

Continuing qualification evaluations are due as
follows:

_{fill in)_ months. Allotting ___ hours.

_(month)_ and -'=-'-'=-L(enter or

Revision:
Based on (enter reasoning):

Continuing qualit1cation Evaluations are to be
conducted each
-

(fill in)-

Signed:
NSPM

Continuing qualification evaluations are due as
follows:

months. Allotting ___ hours.

Fv::tlm'ltion

Tt

_(month)_ and _(month)_ and _(month)
(enter or strike out, as appropriate)

Leader

Date

418

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