This graphic is a scanned image of the Form 14634, Suspension Without Appeal Rights 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 boxes for the examiner to select. These choices are worklist/FPC, Transcript, Recheck List and CIB/Outside referral. Under worklist/FPC check box, there are lined spaces for the EFIN(s) to be entered. The right-hand section has lined spaces for TIN(s) to be entered. Underneath the EFINS caption - Suspension Date with an underlined space beside it. Postmark received date with line space beside it.The second section is for T/E Recommendations: across the form is a Pass check box and Fail check box (To D.O.P.) Fail check box (No Appeal Rights). Underneath the T/E Recommendations is the caption - Comments: with space provided. The bottom middle section contains the signature box and the date box.The next section is for the leads recommendation. The top left states Recommendation: across the form is a Pass check box, Fail (To D.O.P.) check box Fail (No Appeal Rights) check box. Underneath the lead’s recommendation is the caption - R/C Provided On All Issues across the form is a Yes check box or No check box. Underneath the R/C Provided On All Issues is the caption - Comments: with space provided. The bottom left is the Level of Infraction box a signature box and date box.The next section is for the OP.MGR/DEPT.MGR. recommendation. The top left states Team Leader Recommendation: across the form is a Pass check box, Fail (To D.O.P.) check box and Fail (No Appeal Rights) check box. Right underneath Team Leader Recommendation this is the caption R/C Provided On All Issues across the form is a Yes check box or No check box. Under R/C Provided On All Issues is the caption Comments: with space provided The bottom left has the Level of Infraction box a signature box and date line box.The last section caption - Special Instructions/Follow-up Actions: in the upper left with space provided. Below this (about five lines down) is the - Date Forwarded to The D.O.P. box. The footer contains - Note: Return To Team Leader After Special Actions Have Been Completed.