This graphic is a scanned image of Form 14628, Initial Suitability Recommendation which contains no data. The heading section contains the following information. The left-hand side of this section has four categories preceded by an un-filled check box for the examiner to select. These choices are worklist/FPC, Transcript, Recheck List and NAASDC/Outside Referral. In the middle part of this section for the EFIN(s) to be entered. The right-hand section has lined spaces for the TIN(s) to be entered. The left-hand side there is an un-filled box titled No other EFINS.The second section is for the recommendation. The top left states T/E Recommendation: across the form is a Pass check box or Fail check box. Under the T/E Recommendation is the caption - Comments: with space provided. Next section is for - Prior History (Late-Filing/Late-Paying) across the form is a Yes check box or No check box. Right Under the Prior History is the caption - List All Non-Compliance Issues: with space provided. The bottom middle of this section contains the signature box and date box.The next section is for the lead’s recommendation. The top left states Lead T/E or Team Leader Recommendation: across the form is a Pass box or Fail box. Under the Lead T/E or Team Leader Recommendation is the caption - Comments: with space provided. Below this is the Level of Infraction box then Signature box and Date box.The last section contains the caption - Special Instructions/Follow-up Actions: with space provided. The footer contains - Note: Return To Team Leader After Special Actions Have Been Completed.