It is mandatory that this form be completed after a goal has been found and before any listing is begun.

ALL DONE AT SENS 16 on a Mark IV Meter.

Pc’s Name __________ Date __________

Organization _________________

GOAL FOUND _____________

1. MODEL SESSION REP. RUDS:

Auditor __________

W/Hs __________

PTP __________

2. READ goal to pc:

Reacts __________

Reacts __________

Reacts __________

3. READ GOAL ONCE AND THEN ONE OF THE LAST 30 goals that stayed in well, back and forth, until none of the long list goals react and the goal stays in at Sensitivity 16.

LIST of 30 All Nul __________

READ GOAL TO PC:

Reacts __________

Reacts __________

Reacts __________

4. Is the Instant Read exactly at the end of the last word in the goal or does it occur across the last word? If it occurs at the end of the last word consistently, neither prior nor latent, continue the check. If the read is prior or latent and not exactly at the end of the last word, even when the goal is read several times, do not go on with this check. Do not try to use the fragment to compile a new goal. Continue goals listing.

Use Repetitive Prepcheck System only:

5. On goals is there anything:

• Another has suggested __________
• You have failed to suggest __________
• You have suggested __________
• You have suppressed __________
• You have failed to suppress __________
• You have protested __________
• Another has invalidated __________
• You have invalidated __________
• You have failed to reveal __________
• You have been careful of __________

6. On the goal is there anything:

• Another has suggested __________
• You have failed to suggest __________
• You have suggested __________
• You have suppressed __________
• You have failed to suppress __________
• You have protested __________
• Another has invalidated __________
• You have invalidated __________
• You have failed to reveal __________
• You have been careful of __________

7. READ GOAL TO PC:

Reacts __________

Reacts __________

Reacts __________ (If goal does not react when read in Section G, do Section H.)

8. Do you get a reaction when you ask pc — Has this goal been:

Suppressed __________

Invalidated __________

If no reaction do I.

If reaction, clean with Rep. Prepcheck.

9. Read goal to pc:

Reacts __________

Reacts __________

Reacts __________

10. If reaction is a multiple reaction and not a clean single tick (if needle reacts as a dirty needle on the Instant Read) ask Repetitive “Are you withholding the goal from anyone?” Clean off any read.

11. Read goal to pc:

Reacts __________

Reacts __________

Reacts __________

12. Do Mid Ruds Repetitive.

13. Read goal to pc:

Reacts __________

Reacts __________

Reacts __________

(Note: Do any goal found up to this point, if it got past D above. If the goal does not give a clean single tick every time it is read except against a fast rise, abandon it. If goal reads in Section L use it for listing as it is the goal.)

14. Compose list wording: (Do not change pronouns. If “Myself” or some such word invites you to do so, use the goal just as it is. If goal is negative use just as it is.)

1. Who or what would want to __________
2. Who or what would not want to __________
3. Who or what would oppose __________ (Change verb in goal to “ing” form.)
4. Who or what would not oppose __________ (Change verb in goal to “ing” form.)

Lines formed all reacted like the goal __________

If not do a repetitive check on Mid Ruds and test again. Get pc to agree to lines or find out why not.

When all lines react as an instant read, it is safe to list goal.

Comments: __________

Date __________ Auditor __________