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D E L IV E R Y M A N U A L



D E LIV E R Y M A N U A L

B A S E D O N THE WORKS O F

HUBB RD PUBLIC TION



Bridge Publications, Inc.

4751 Fountain Avenue

Los A ngeles, California 90029

ISBN 0-88404-568-4

NEW ERA Publications International, ApS

Store Kongensgade 55

1264 Copenhagen K, Denmark

ISBN 87-7336-727-3

© 199

L. Ron Hubbard LibraryAll R ights R eserved

No part of this book may be reproduced without the

permission of the copyright owner.

This manual is based on the works of L. Ron Hubbard, whodeveloped Scientology® applied religious philosophy. It is

presented to the read er as a record of observations and researchinto the nature of the human mind and spirit, and not as a

statement of claims made by the author. The benefitsand goals of Scientology can be attained only by

the dedicated efforts of the reader.

The Purification Rundown is a religious service

delivered by the Church of Scientology. It is not professed

as a physical handling for bodies nor is any claim made to

that effect. There are no medical recommendations or claims

for the Purif ication Rundown.

No individual should undertake the Purification Rundown orany of its regimens without first consulting and obtaining the

informed approval of a licensed medical practitioner. The

author makes no warranties or representation as to the

effectiveness of the Purification Rundown.

Purification, Purification Rundown and Purif are trademarks for

the detoxification program covered in this manual and are used

as such in the writings of L. Ron Hubbard. They are registered

as service marks and are owned by Religious Technology

Center. These marks may not be used as designations for the

detoxification program given in this work without the prior

consent of Religious Technology Center.

Hubbard, Scientology, E-Meter, Flag , reewindsCelebrity Center and Golden Era Productions are trademarks

and service marks owned by Religious Technology Center and

are used with its permission.

Bridge Publications Inc. is a registered trademark and servicemark and it is owned by Bridge Publications, Inc.

NEW ERA is a trademark and service mark.

Printed in the United States of merica



WARNING

This program can be strenuous and should not be undertaken by any-

one who has a weak heart or who is anemic. It is therefore absolutely essen-

tial that the following rules are strictly adhered to:

1. No one may begin the Purification Rundown without first obtaining

the written approval from a qualified medical doctor.

2. No one with a weak heart or who is anemic may do the Purification

Rundown. These points must be checked as part of the medical doctor s ex-

amination for approval to begin the rundown.

3. People with known heart conditions, high blood pressure, anemia

and certain kidney conditions may do a much less strenuous program of ex-

ercise and nutrition (as worked out for them with a medical doctor) but may

not do the Purification Rundown.

4. Blood pressure checks and checks for anemia are given periodically

as the person goes through the program and if any signs of a weak heart or

anemia should appear, the person is taken off the rundown and handled

medically.



IMPORTANT NOTE

In reading this book, be very certain you never go past a word you do

not fully understand.

The only reason a person gives up a study or becomes confused or un-able to learn is because he or she has gone past a word that was not

understood.

The confusion or inability to grasp or learn comes AFTER a word that

the person did not have defined and understood.

Have you ever had the experience of coming to the end of a page and

realizing you didn't know what you had read? Well, somewhere earlier on

that page you went past a word that you had no definition for or an incorrect

definition for.

Here's an example. It was found that when the crepuscule arrived the

children were quieter and when it was not present , they were much livelier.

You see what happens. You think you don't understand the whole idea, but

the inability to understand came entirely from the one word you could not

define, r pus ul which means twilight or darkness.

It may not only be the new and unusual words that you will have to

look up. Some commonly used words can often be misdefined and so cause

confusion.

This datum about not going past an undefined word is the most impor-

tant fact in the whole subject of study. Every subject you have taken up and

abandoned had its words which you failed to get defined.

Therefore, in studying this book be very, very certain you never go past

a word you do not fully understand If the material becomes confusing or you

can't seem to grasp it, there will be a word just earlier that you have not

understood. Don't go any further, but go back to BEFORE you got into trouble,

find the misunderstood word and get it defined.



A DOCTOR'S EVALUATION OFTHE PURIFICATION PROGRAM

by Gene DenkBachelor of Science, Doctor of Medicine

An Evaluation of a Detoxification Program for Long-Term Stored

Chemicals is the title of a paper first published in 1981 and then appearing

in Medical Hypothesis September 1982 by myself in concert with two col-

leagues: Megan Shields, M.D. and Steven Burton, M.D.

This paper was the result of extensive study and testing of the Purifica-

tion program developed by L. Ron Hubbard. The following are excerpts from

the publication outlining some of our findings:

The purpose of this current study is to evaluate and document

clinically observed physical or psychological changes that oc-

cur upon conclusion of the Purification program. In addition to

clinical evaluations, psychological tests and standard blood

chemistry were performed.

One hundred and three volunteers were selected to represent

varying degrees of drug usage. California guidelines for human

experimentation were followed, and informed consent ob-

tained from all participants. Volunteers were accepted on a first

application received basis, covering the spectrum from heavy

(i.e., frequent heroin usage, hallucinogenics, frequent or severe

use of medical drugs) to no drug usage. Most of the participants

were from the Hollywood population at large and twenty were

from Narconon Los Angeles, a local drug rehabilitation center.

The volunteers were interviewed and demographic data statis-

tical data showing average age, income, education, etc.) was

collected. This data was used to ensure a cross-section of drug

users and of the general population were included in the study.

A large variety of incidents occurred as individuals progressed

through the program which were suggestive of drugs or chemi-

cals being released from the body. There were reports of brief,full-blown LSD trips with hallucinations; some participants

who had had ether (a colorless, sweet-smelling liquid used as

an anesthetic) would smell like ether in the sauna; old injuries

would flare up with swelling or redness along surgery lines and

then resolve over a few days. The flushing that followed inges-

tion of niacin frequently would occur along lines of bathing

suits or old sunburns; this would diminish over a few days



then reoccur in a different pattern. It was not unusual to have a

person reexperience the physical condition associated with tak-

ing a certain drug or anesthetic. For instance one patient

complained of onset of mild pain in the lower right quarter of

the body, nausea, light-headedness and reddening of an old

appendix scar line. This reoccurred the next two days at lessen-

ing severity and then was gone in three days.

The program appears safe as long as done under the care of a

physician. The exercise and sauna are tolerated very well as

long as they are begun on a gradient. As with any major phys-

ical exercise program, however, general physical condition and

physical health need to be monitored. The authors feel this

program is unadvisable for any person with heart disease or

any other major physical disabilities unless directly done under

the supervision of a physician who is willing to work out a spe-

cific exercise, sauna and vitamin program for the patient.

Since the first publication of the above findings, tens of thousands of

people have successfully undergone the Purification program, and the theo-

ries presented in this book are gaining increasing acceptance among medi-

cal doctors and scientists.

Dr. Denk graduated Bachelor of Science from University of M ichigan

and Doctor of Medicine at University of Washington at Seattle. He maintains a

private practice in Los Angeles.



PURIFICATION RUNDOWNPURPOSE

The purpose of the Purification Rundown is to clean out and purify one's

system of all the accumulated impurities such as drugs, insecticides and

pesticides, food preservatives, etc., etc., which by their presence and restimu-

lative effects could prevent or delay freeing the being spiritually through

processing.



PURPOSE OF THE

PURIFICATION RUNDOWNDELIVERY MANUAL

This booklet exists and is used to ensure that a person receiving a Pu-rification Rundown is actually receiving a correct and properly administered

service.

The Purification Rundown consists of very exact steps and procedures,

and it is the responsibility of those delivering it and those receiving it to en-

sure that these steps and procedures are followed to the letter. It is very much

to your benefit to see that this is done.

If you are not being delivered a standard Purification Rundown as out-

lined in this manual, then it is your responsibility as a participant to reportthis to the Religious Technology Center, the proprietor of the service marks

under which the rundown is delivered. Tear-out report sheets are provided in

the booklet for this purpose.



DIRECTIONS

This manual is for your use to ensure that you receive a correct and

properly administered Purification Rundown. It is kept in your own posses-

sion throughout your duration on the rundown. This manual, if followed, will

take you all the way through the Purification Rundown.

The manual consists of: (a) a checklist of actions to get you started

on the rundown; (b) release waivers for you to sign; (c) a medical report form

for your doctor to complete; (d) daily report forms; (e) forms for writing up

any gains or improvements made during the rundown, called Success Story

forms; (f) forms which you can use to get help within the organization if

you are unhappy with your progress or the service you are receiving; and

(g) forms to report nonstandard delivery (as mentioned earlier in this booklet,

under PURPOSE ).

To use this ma nual:

1. Complete the Checklist for Starting the Purification Run-

down (which follows these directions) with the Purification

Rundown in-Charge.

2. Proceed page by page through the booklet, filling out your

daily report forms as you progress on the rundown.

3. As each daily report form is completed, tear it out and give

it to the Purification Rundown In-Charge who oversees your

progress on the program on a day-to-day basis.

(If doing the rundown in a Scientology church or mission, you

must do the rundown right there in the organization and may

not do the rundown in a location remote from where the Purif

I/C can supervise you directly.)

4. The Purif I/C will then fill in his portion of the form and

send it on to the Case Supervisor in your Purification Rundown

folder.

Each person doing the rundown must obtain his own copy of this man-

ual before starting, and use it as he progresses through to completion of therundown. Proper use of the booklet is a key action in ensuring maximum re-

sults are obtained.



CHECKLIST FOR STARTING

THE PURIFICATION RUNDOWN

NAMEDATE

Welcome to the Purification R undown.

The Purification In-Charge (Purif I/C) will see to it that you:

a. have been properly enrolled for the rundown, includ-

ing proper financial arrangements and invoicing, and will

ensure that you have your own personal copies of this deliv-

ery manual, Purification: An illustrated Answer to Drugs, All

About Radiation and Clear Body, Clear Mind: The Effective

Purification Program;

Purif I/C

b. are interviewed with regard to drugs and medicines

you have taken, or any toxic substances or radiation you

may have been exposed to;

Purif I/C

c. sign the Release of Liability, Indemnity Agreement and

Contract, and sign the Medical Declaration for Participa-

tion in Purification Rundown both of which follow this

checklist (these do not replace the Enrollment Agreement

signed earlier at the Registrar);

Purif I/C

d. see a qualified medical doctor to give you a physical

examination in order to determine if you can do the Pu-

rification Rundown and have him complete the Medical

Report which appears in the following pages;

Purif I/C

e. take tests (Oxford Capacity Analysis, which is a person-

ality test, plus an IQ test and an Aptitude test);

Purif I/C

f. read the Purpose of the Purification Rundown and the

Purpose and Directions of this manual and have had any

questions about the rundown or your use of this manual

cleared up;

Purif I/C



g. set a regular schedule for doing the rundown. (N ote: This

schedule will be subject to Case Supervisor approval.)

Purif I/C

The Purif I/C will assign you a twin. Your twin is your partner in doing

the rundown, as described in the picture book.

TWIN'S NAME

Once all of the above steps have been done and the medical doctor has

stated that it is okay for you to undertake this program, then you will be

starting the rundown.

The Purif I/C will ensure that your tests, medical report, etc., are sent to

your Case Supervisor and that he is notified that you're ready to begin.

Purif I/C: When all of the above steps (a) to (g) have been done,

and the person has been assigned a twin, tear out this checklist,

attach the person's schedule, routing form, interview work-

sheets, test results, and Medical Report form and send to the C/S

in the person's Purification Rundown folder. The signed release

waivers are torn out and routed to the Director of Inspections

and Reports for filing in Valuable Documents.

(If this person is going to be receiving auditing on Objective

Processes while on the rundown, you must also ensure that he

understands how this will be scheduled and run.)



RELEASE OF LIABILITY,

INDEMNITY AGREEMENTAND CONTRACT

I, , HEREBYACKNOWLEDGEthat I have

voluntarily applied to participate in a RELIGIOUS SERVICE , known as thePurification Rundown , concerned with freeing up the individual spiritually

from the traumatic or disruptive effects of drugs and toxins on the spirit.

UNDERSTAND THAT THE PURIFICATION RUNDOWN IS

DESIGNED TO GIVE SPIRITUAL AID, IS NOT MEDICAL

TREATMENT NOR IS IT DESIGNED TO PROVIDE ANY PHYS-

ICAL GAINS. PLEASE INITIAL

AM AWARE THAT THE PURIFICATION RUNDOWN ACTIV-

ITIES CONSIST OF RUNNING OR OTHER STRENUOUSACTIVITY TO PROMOTE CIRCULATION, PROLONGED PERI-

ODS IN A SAUNA TO PROMOTE SWEATING, AND

SUGGESTED QUANTITIES OF VITAMINS, MINERALS, AND

OILS. PLEASE INITIAL

AM ALSO AWARE THAT I SHOULD NOT PARTICIPATE IN

THE PURIFICATION RUNDOWN IF I HAVE A WEAK HEART,

HIGH BLOOD PRESSURE, ANEMIA, LIVER DISEASE, DIABE-

TES, OR OTHER CONDITIONS WHICH WOULD MAKE THE

PURIFICATION RUNDOWN ACTIVITIES PARTICULARLY

HAZARDOUS TO ME. PLEASE INITIAL

ACKNOWLEDGING MY AWARENESS AND UNDERSTAND-

ING OF THE ABOVE INITIALED PARAGRAPHS, I AM

VOLUNTARILY PARTICIPATING IN THE PURIFICATION

RUNDOWN ACTIVITIES WITH KNOWLEDGE OF THE PO-

TENTIAL DANGER INVOLVED AND HEREBY AGREE TO

ACCEPT ANY AND ALL RISKS OF INJURY, LOSS, OR DAM-

AGE. PLEASE INITIAL

AS CONSIDERATION for being permitted by the Church ofScenoogy o , (herenater reerredto

as the Church ) to participate in the Purification Rundown and use its facil-

ities and other facilities provided for such purpose, I HEREBY A G R E E T H A T I,

MY HEIRS DISTRIBUTEES , GUARDIANS, LEGAL REPRESEN TATIVES AND

ASSIGNS WILL NOT MAKE CLAIM AGAINST, SUE, ATTACK THE PROPERTY

OF, OR PROSECUTE the Church,Religious Technology Center, Church of

Scientology International, and/or one of its affiliated Churches, Missions,



corporations, associations, partnerships or organizations, and/or their agents,

servants, successors, heirs, executors, or representatives, and/or the owners,

managers, employees, agents or representatives of or associated with any fa-

cilities conducting the Purification Rundown (hereinafter collectively

referred to as the Releasees ) for injury or damage resulting from the negli-

gence or other acts, howsoever caused, by any Releasee or by any employee,

agent or contractor of the Church, its affiliates, or other Releasee, in any wayrelating to my participation in the Purification Rundown.

IN ADDITION I HEREBY RELEASE AND DISCHARGE THE RELEASEES

from all actions, claims or demands I, my heirs, distributees, guardians, legal

representatives or assigns now have or may hereafter have for injury or dam-

age resulting from my participation in the Purification Rundown . I FURTHER

AGREE TO INDEMNIFY AND SA V E AND HOLD HARMLESS THE RE-

LEASEES and each of them from any loss, liability, damage or cost they may

incur due to my participation in the Purification Rundown and/or due to my

presence or action in or about the Church premises or the facilities providedfor the Purification Rundown and whether caused by the negligence of the

Releasees or otherwise.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDER-

STAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF

LIABILITY INDEMNITY AGREEMENT AND A CONTRACT BETWEEN MY-

SELF AND THE CHURCH AND/OR ITS AFFILIATED ORGANIZATIONS,

AND/OR OTHER INDIVIDUALS, AND UNDERSTAND AND AGREE THAT

THIS RELEASE CONTRACT SHALL BE GOVERNED EXCLUSIVELY BY THE

LAWS OF THIS JURISDICTION, AND SIGN IT OF MY OWN FREE WILL, ON

THSDAYOF20

SGNATURE (Participant) (Signature of Parent orGuardian if Minor)

(Printed Full Nam e)

(HomeSree Address) WtnessSignature Date

(City and State /Country)

Sc,,- opy and PwifKalion Rundown a, i.a.kma,As and -- ma.k, or R'*ous Tech-lo,,, f enoi and a•e uwd with ita Ite .n,ssion Printed n the US



MEDICAL DECLARATION

FOR PARTICIPATION IN

PURIFICATION RUNDOWNTM

,DECLAREASFOLLOWS

1) 1 understand that the Purification Rundown is a RELIGIOUS SERVICE

concerned with freeing up the individual spiritually from the traumatic or

disruptive effects of drugs and toxins to the spirit; and is not intended to

treat, diagnose or cure physical illness or conditions, and that it is not for the

purpose of handling or treatment of any physical or bodily ill or condition I

may now have or may at any time in the future develop, or become aware of,

such being the sole responsibility of myself and my physician.

2) I understand that the Purification Rundown is designed to give SPIR-

ITUAL AID, is not medical treatment nor is it designed to provide any

physical gains.

3) I represent that I am in good physical health, that I am neither preg-

nant nor have any suspected or confirmed heart ailments whatsoever, that I

am not now taking any medication, and that I am fully aware that the Puri-

fication Rundown will be physically strenuous.

4) I further understand that no employee, agent or staff member of the

Churchof Scientology of (herenafter referred to as

the Church ) is authorized by the Church to prescribe for or treat any physi-cal ailments, and that no representations or promises as to physical benefits,

gains, or results have been made by any employee, agent or staff member of

the Church.

5) I hereby represent that prior to starting the Purification Rundown I

provided a licensed medical practitioner (i) all the details of the Purification

Rundown in all particulars, including the requirement that no person with a

weak heart, high blood pressure, anemia, liver disease, or other hazardous

conditions may take the program and (ii) a truthful and complete medical

history, and I did receive from that practitioner written approval to do the

rundown based on his/her assessment that doing the rundown would in no

way endanger or otherwise pose any liability to my physical health and well-

being.

6) I agree that I will seek blood pressure checks and checks for anemia

periodically during the Purification Rundown and if any signs of a weak

heart or anemia appear, I must stop further participation and will seek the



diagnosis of and will rely on my medical doctor for evaluation and resolution

of the condition.

7) I have freely and voluntarily decided to participate in the Purifica-

tion Rundown after having been apprised of all information relevant to it,

and after having been given a complete opportunity to make inquiry both in-

side and outside the Church to obtain any additional facts, opinion or law

which may possibly bear on my decision to participate in the Purification

Rundown.

8) 1 further understand that the Church has relied on my statements con-

tained in this declaration and in the Release of Liability, Indemnity

Agreement and Contract -also, read, understood and signed by me-in ac-

cepting my application to participate in the Purification Rundown.

9) I am signing this declaration after having read and understood it; in

signing it I have not relied on any inducements, promises, or representations

made by the Church; and understand and agree that this declaration shall be

governed exclusively by the laws of this jurisdiction.

D E CLA R E under penalty of perjury under the laws of the(country and state/province) that the foregoing is true and correct and bind-

ing on myself, my heirs, executors, administrators, successors and assigns.

Execuedthsdayo 20a

(Cty) (Sae/PovnceandCounry)

(Sgnaure) Wtness SgnaureDae

(Signature of Parent or Guardian if a Minor)

Yimmlogy n4 P.4-1- RuSoxp are -4rmarks ai i -.- masks d RelrRio^^s irrhno'ogv C- -d a'e ucn wnh A permnsi on Mnn.f ., the US



MEDICAL REPORTCONFIDENTIAL

TO THE APPLICANT

NAME OF PATIENT

to

, hereby give my consent

to fill out the form below

D O C TO R ' S N A M E

giving the details of my present physical condition in connection with my

participation in the Purification Rundown at the Church of Scientology

of

I agree to be responsible for payment of the doctor's fee for this service.

TO THE ATTENDING DOCTOR

Please fill out the form below and return it to the applicant.The contents will be treated in the utmost confidence.

NAME OF PATIENT:

H I S / H E R D A T E OF BIRTH:

1. BLOOD PRESSURE: SYSTOLIC DIASTOLIC

1A. ARE THERE ANY SIGNS OF:

ANEMA Yes NoWEAK HEART Yes No

LIVER DISEASE Yes No DIABETES Yes No

If the answer is yes to any of the above, please specify the relevant details

below.



I B. ARE THERE ANY VITAMIN DEFICIENCIES: Yes No

If yes, please specify the relevant d etails below.

2 HEGHT 3 WEGHT



4. GENERAL APPEARANCE:

5. ANY EVIDENCE OF CARDIOVASCULAR DISEASE: Yes No

If yes, please specify the relevant details on the reverse side

of this form.

6. ANY EVIDENCE OF KIDNEY DISEASE: Yes No

If yes, please specify the relevant details on the reverse side

of this form.

7. GIVEN THAT THE ABOVE NAMED PATIENT INTENDS TO PARTICIPATE

IN A RELIGIOUS SERVICE KNOWN AS THE PURIFICATION RUNDOWN,

WHICH INCLUDES RUNNING OR OTHER STRENUOUS ACTIVITY TO

PROMOTE CIRCULATION, PROLONGED PERIODS IN A SAUNA AT

TEMPERATURES RANGING FROM TO TO PROMOTE PER-SPIRATION, AND SUGGESTED QUANTITIES OF VITAMINS, MINERALS

AND OILS, ARE THERE ANY REASONS WHY IN YOUR OPINION SAIDPATIENT SHOULD NOT PARTICIPATE IN THE PURIFICATION RUN-

DOWN AS DESCRIBED? YES NO

8. ANY SPECIAL RECOMMENDATIONS:

9. ANY SPECIAL PRECAUTIONS:

I HAVE EXAMINED THE ABOVE NAMED PATIENT AND FOUND:

(a) NO MEDICAL REASON WHY HE/SHE SHOULD NOT DO THE PURIFI-

CATION RUNDOWN.

SGNATURE DOCTORSNAME DAT E

(b) HE/SHE IS UNFIT TO DO THE PURIFICATION RUNDOWN. STATER E A S O N S :

SGNATURE DOCTORSNAME DATE



(c) IF THE PERSON IS IN YOUR OPINION NOT FIT ENOUGH AT THEPRESENT TIME TO DO THE PURIFICATION RUNDOWN PLEASE INDI-CATE BELOW YOUR RECOMMENDATIONS CONCERNING AN EXER-CISE PROGRAM AND/OR DIETARY PROGRAM THAT WOULD ENABLEHIM/HER TO ATTAIN A DEGREE OF FITNESS TO COMMENCE THERUNDOWN.

xiemnluR. and Pur li<al ,on R-dann are IiudeTa^V s and xrsica marls .n Kcli Sirs s lechnnk)gi Cen^r, a^^c ai. ixd..yin _ p n ss.a^a Pr,med . h< 1S



PURIFICATION RUNDOWN

DA L Y R EPOR T FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

A T S T A R T

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

D TE

DAY 1

UNITS/MG OF VITAMINS TAKEN TODAY

A D U U

BCOMPLEXE

MG IU

CB

MG MG

MULTI-MINERALS(TABLETS)

NIACIN

(MG)

AMOUNTOFWHATREACTONFANY DDYOUGET

S A L T T A K E N FROM THE NIACIN TODAY?

AMOUNT OFLECITHIN TAKEN

AMOUNT OFPOTASSIUM TAKEN

NUMBER OF GLASSES OF

WATER YOU DRANK TODAY


CAL-MAG YOU DRANK TODAY

ANY CRAVNGSFORANY IF ANY REACTONTO THE NACN WASIT LESS

TYPE OF FOODORDRNK? THANTHE PREVOUSDAY ONTHE PROGRAM?

V E G E T A B L E S E A T E NTODAY (TYPES, AMOUNTS)

NUMBER HOURSOF ANY OTHER VTAMNSTAKEN TODAY?

SLEEPLASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OFRUNNING TODAY

WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,

DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

CONTINUED NEXT PAGE



PACE 2

AMOUNTOFTMEYOUHOURSMNUTES

SWEATED IN THE SAUNA TODAY:

WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,

REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

ANY WINS OR REALIZATIONS THAT OCCURRED?

I ATTEST THAT I I ]AVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY THE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE)

WHEN YOU HAVE FILLED OUT AND SIGNED THIS FORM,

HAND YOUR BOOK IN TO THE PURIF I/C



PAGE 3

THIS SECTION FILLEDOUT BY PU RIF RD I /C:

( 1 ) ENSU RES P C H AS F ILLED O UT ALL P O INT S ABO VE C O RR EC T LY:

(2) ANY SIGNS OF VITAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTED

FOR TI iE C/S:

(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE

PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIA-

TIONS OR ADDITIVES.

PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORTOUT AND SEND TI IEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.

CASE SUPERVISOR:

(1 ) STUDIE S THIS RE PO RT (A L O NG WITH A NY O THE R NEEDED FOLDER STUDY)A N D W R I T E S I N S TR U C T IO N S F O R T H E N E X T D A Y .

(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER

AND SENDS IT TO THE PURIF I/C.

(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTENINSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN

ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES,

C A S E S U P E R V I S O R

DA I F




DA I LY REPO R T FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

I

NAME DATE

TWIN'S

NAME

TIML SIARTED

T O D A YTIME FINISHEDTODAY

DAY 2


A D U U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WFIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN

AMOUNT OF

POTASSIUM TAKEN


Wti\I ER YOU DRANK TODAY



BCOMPLEXE MG IU

C

MG MG

MULTI -MINERALS

(TABLETS)

NIA CIN(MG)

WHAT REACTION (IF ANY) DID YOU GET

FROM THE NIACIN TODAY?




NUMBER HOURSOF ANY OTHER VTAMNSTAKEN TODAY?SLEET LASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OF

RUNNING TODAY

WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

CONTINUED NEXT PAGE



PAGE 2

AMOUNT OF TIME YOU HOURSMNUTES



REA( TIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)


I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY THE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE)

WHEN YOU HAVE FILLED OUT AND SIGNED THIS FORM,HAND YOUR BOOK IN TO THE PURIF I/C



PAGE 3

THIS SE CTION FILLEDOUT BY PURIF RD I /C:

(1) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:


(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTEDFOR THE C/S:

(4) 1 ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE


TIONS OR ADDITIVES.

PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORT

OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.

CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)

AND WRITES INSTRUCTIONS FOR THE NEXT DAY.



(3 ) A TTE STS THA T HE HA S STUDIE D THIS DA IL Y RE PO RT A N D WR ITTE NINSTRUCTIO NS FO R THE PC'S NE XT DA Y O N THE PURIF ICA TIO N RUNDO WNA C C O R D I N G T O S T A N D A R D T E C H , W IT H N O V A R I A T IO N S O R A D D I T I V E S .


D TE




DA ILY R EPORT FORMDAY 3

MUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME D TE

TWINS

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY


A D U U

BCOMPLEXE

MG U

WEIGHT

A T S T A R T

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SALT TAKEN


AMOUNT OF

POTASSIUM TAKEN





ANY CRAVINGS FOR ANY

TYPE OF FOOD OR DRINK?

C B

MG MG

MULTI- MINERALS

(TABLETS)

NIACIN

(MG)

WHAT REACTION (IF ANY) DID YOU GETFROM THE NIACIN TODAY?

IF ANY REACTION TO THE NIACIN, WAS IT LESS

THAN THE PREVIOUS DAY ON THE PROGRAM?


NUMBER HOURS OF

SLEEP LAST NIGHTANY OTHER VITAMINS TAKEN TODAY?WHAT? HOW MUCH?



CONTINUED NEXT PAGE



P A GE 2






I ATTEST TI HAT I HAVE FOLLO\VED ALL INSTRUCTIONS EXACTLY AS GIVEN ME

BY THE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED

OUT BY PURIF RD I/C:

( 1 ) ENSU RES P C HAS F ILLED O UT ALL P O INT S ABO VE C O RREC T LY:


(3) ANY OBSERVATIONS OR DATA ABOUT P C S P R O G R E S S ON THE RD THAT SHOULD BE NOTEDFOR TI IF C/S:


PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIA-TIONS OR ADDITIVES.

PURFCATONI/CDATE



CASE SUPERVISOR:





(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTENINSTRUCI IONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN

ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.


D TE




DAILY R EPOR T FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

N A ME

TIME STARTED

TODAYTIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

A T S T A R T

WEIGHT AT

FINISH

AMOUNT OFOIL CONSUMED

AMOUNT OFS A L T T A K E N



D A T E

DAY 4


A D

I U I U

BCOMPLEXE MG IU

CB

MG MG

MULTI-MINERALS

(TABL ETS)

NIACIN(MG)





NUMBER OF GLASSES OFC A L - M A G Y O U D R A N K T O D A Y

ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN WAS IT LESSTYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM?

VEGETABLES EATENT O DAY ( T YP ES, AMO UNT S)

NUMBER HOURSOF ANY OTHER VTAMNSTAKEN TODAY?SLEEPLASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



P A G E 2

AMOUNT OF TMEYOU HOURS

SWTATFD IN THE SAUNA TODAY:

MINUTES


REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)


I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME


(PC SIGNATURE)




P AG E 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC'S DAILY REPORTOUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.

CASE SUPERVISOR:




AND SENDS IT TO THE PURIF 11C.

(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN

INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN


CASE SUPERVISOR

D TE




DA ILY RE P ORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWINS

NAME

TIME STARTED

T O D A YTIME FINISHED

TODAY

TOTAL I IME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

S A L T T A K E N

AMOUNT OF

LECITHIN TAKEN

AMOUNT OF

POTASSIUM TAKEN

NUMBER OF GLASSES OFWATER YOU DRANK TODAY

D A T E

DAY 5


A D IU I U

BCOMPLEXE MG IU

C131

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)





ANY CRAVNGSFORANY IF ANY REACT IONTO THE NACN WASIT LESS


V E G E T A B L E S E A T E NTODAY (TYPES, AMOUN IS)

NUMBER HOURSOF ANY OTHER VTAMNSTAKEN TODAY?


HOURS/MINUTES OF

RUNNING FODAY

WHAT DID YOU EXPERIENCE WHILE RUNNING? MENTAL CHANGES PHYSICAL CHANGES REACTIONS,


CONTINUED NEXT PAGE



P AG E 2



WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)


I ATTEST THAT I RAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME


(PC SIGNATURE)




PAGE 3

THIS SECTION FILLEDOUT BY PURIF RD I/C:



(3) ANY OBSERVATIONS OR DATA ABOUT P C S P R O G R E S S ON THE RD THAT SHOULD BE NOTEDFOR THE C/S:



PURFCATONI/CDATE



CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)AND WRITES INSTRUCTIONS FOR THE NEXT DAY.

(2) PUTS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDERAND SENDS IT TO THE PURIF I/C.





D TE




DA ILY R EPOR T FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

N D

TWIN'S

NAME

DAY 6

TMESTARTEDUNTSMGOFVTAMNSTAKENTODAY

T O D A YTMFNSHEDAD

OA Y U U

TOTAL TIMEONBCOMLEXE

PURIF RD TODAY MG U

C B

ATSTART MG MG

WGHTATMLTINERALS

FNSH TABLETS

AMOUNTOFNACNOLCONSUMED MG


SALTTAKENFROMTHENACNTODAY?

AMOUNT OFLECITI LIN TAKEN

AMOUNT OF

POTASSIUM TAKEN

NUMBER OF CLASSES OFWATER YOU DRANK TODAY

NUMBER OF Cl ASSES OF

CAL-MAC, YOU DRANK TODAY



V E G E T A B I F S E A T E NTODAY (TYPES, AMOUNTS)





WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,DISCOMFORTS, FTC. USE MORE PAPER IF NEEDED.)

CONTINUED NEXT PAGE



P A GE 2







(PC SIGNATURE)





DAILY R EPORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

T O D A Y

TIME FINISHEDT O D A Y

TOTAL TIME ONPURIF RD TODAY

WEIGIiTA T S T A R T

WEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN




NUMBER Of GLASSES OF


ANY CRAVINGS FOR ANYTYPE OF FOOD OR DRINK?

VEGETABLES EATENTODAY (TYPES AMOUNTS)

D A T E

DAY 7


AD IU fU

BCOMPLEXE

MG IU

C

MG MG


NIACIN

(MG)


T T F ANY REACTION TO THE NIACIN WAS IT LESSTHAN THE PREVIOUS DAY ON THE PROGRAM?


HOURS/MINUTES OF

RUNNING TODAY



CONTINUED N EX T P A G E



P AG E 2





ANY WINS OR REALIZATIONS IHAT (CCURRED?

I ATTEST TI IAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY THE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE)





P A GE 3


(1) ENSURES PC HAS Ell LED OUT ALL POINTS ABOVE CORRECTLY:





PURFCATONI/CDATE



CASE SUPERVISOR:


AND WRITES INSTRUCT IONS FOR I HE NEXT DAY.






D A T E



SUCCESS STORYPURIFIC TION RUNDOWN

(This form is provided for your use, should you wish to write down any wins,gains or realizations you've had while on the Purification Rundown thus far.)

NAMEDATE

WTNESS DATE

Please hand in your successstory to the Purif I/C.



NOTICE

If, at this stage of your rundown you are unhappy with the service you

are receiving or have not experienced noticeable gains from the rundown,

report to the Qualifications Secretary and hand him this booklet. The Recep-

tionist will direct you to his office if needed.

Instructions to Qual Sec: Interview the person on the E-Meter regarding

his progress or lack of it on the rundown Find out what handlings have been

attempted in the Tech Division to this point Ask questions as needed from

the list below to help isolate the difficulty. Ask additional questions if neces-

sary. When the interview is complete and you have discovered the reason(s)

for the difficulty, thank the pc for his answers, tear out this form, clip all

worksheets to it and place them in the pc's Purification folder.

A. G eneral Progress

1. Tell me about your progress so far on the rundown.

2. What difficulties are you experiencing on the rundown?

B. Schedule

3. Are you on a regular daily schedule for doing the rundown?

W hat is it? If not find out why not.

4. Any bugs on keeping your rundown schedule?

5. Briefly outline your daily personal schedule sleep , meals,

work , transport , free time , etc.).

6. Any problems m aintaining your personal schedule?

7. How many hours of sleep are you actually getting each night?

8. Are you sleeping well? Do you feel rested when you wake up?

C. Exercise and Sauna

9. What sort of exercise are you doing daily?

10. Are you exercising enough to get your circulation going well?

11. Any trouble with the temperature of the sauna?

12. Is the sauna kept c lean?

13. Are salt and potassium tablets available to you in the sauna

area?



D. Vitamins Minerals and Niacin

14. Are you taking all the vitamins directed by the C/S, daily?

15. Any adverse reaction to any of the vitamins?

16. Have your vitamin dosages been increased since the start of

the rundown? Has the increase been on a gradient?

17. Have amounts of each vitamin been increased proportionally,

to your knowledge?

18. Are all vitamins and minerals recommended by the C/S avail-

able for you to take, every day? (i.e., are vitamins kept in

adequate supply?)

19. What sort of reactions have you been having to the niacin?

20. Has your niacin dosage been increased before reactions at an

earlier dosage level had diminished?

E. Diet and Supplements

21. Outline your diet since starting the rundown.

22. Have you made any changes in your diet?

23. What vegetables are you eating daily? How are they cooked?

24. Are you taking the full amount of oil recommended by the C/S

daily?

25. Are you taking the full amount of lecithin recommended by

the C/S d aily?

26. Are you taking the full amount of Cal-Mag recommended by

the C/S daily?

F. Changes Experienced

27. Have you noticed any physical changes since starting the run-

down?

28. Have you noticed any mental or emotional changes, orchanges in attitude since starting the rundown?

29. Have there been any changes in your energy level?

30. Have you noticed any perception changes?

31. Have you had a big win that hasn't been acknowledged?



32 . Have any react ions appe ared that are persisting?

33 . Do you find that you tend to tire out after a certain point whendoing the rundown , and m ake little or no noticeable gain afterthat point for the day?

G. Twin

34. Are there any difficulties with your twin?

35. Has anything occured with your twin that you would like to

make known?

H. Other

3 6. Were you given any special orders by your doctor to be fol-lowed while on the rundown ? Are you following them exa ctly?

37. Is there any sort of health or case activity that you are doing in

addition to the rundown?

38. Has anyone expressed any upset or antagonism regarding your

being on the rundown or invalidated the rundown to you?

39. Have you had any psychiatric treatment drugs shock or insti-

tutional treatment that you haven t mentioned?

40. Do you have any il lness that you haven' t mentioned?

41. Any other difficulties or questions?

42. Anything else that you'd like the C/S to know?

Qua[ Sec

Do a full inspection of the pc's Purification folder and Pur i f Run-

down delivery area and personnel using the Troubleshooting the

Purif icat ion Rundow n Pc Checklist (HCOB 24 Oct. 85R).

Qual Sec

Send the results of the above inspection and the pc's Purificationfolder to the Snr C/S for rapid hand l ing.

Qual Sec

Snr C/ S studies the pc's Purification folder and the data g athered inthis interview and the above inspection and writes crams to correct the

outnesses found.

Snr C/S



Snr C/S writes the next C/S and routes the folder to the Purif I/C via

the Purif C/S.

Snr C/S

Purif I/C sees that any C/S ordered handlings are done.

Purif I/C

This form and all worksheets, etc., connected to it become part of the

pc's P urif folder.



IF YOU ARE NOT BEING DELIVERED A CORRECT, STANDARD PURIFICATION

RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS

THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE THE

PAGE HEADED PURPOSE AT THE BEGINNING OF THIS BOOKLET.)

R O U T E T O : REPOR TS OFFICERRELIGIOUS TECHNOLOGY CENTER

Report of NonstandardPurification Ru ndown Delivery:

NAME DATE

HOME ADDRESS:

PHONE :

NAME OF ORGANIZATION IN WHICH PURIFICATION RUNDOWN IS BEING RECEIVED:

ORGANIZATION ADDRESS:

NAME OF PURIFICATION RUNDOWN IN-CHARGE:

OBSERVATIONS - (BE SPECIFIC , GIVING DATES, TIMES AND DETAILS OF OCCURRENCES BEING

REPORTED, INCLUDING NAMES OF THOSE PRESENT OR INVOLVED. USE EXTRA PAPER IF

N E E D E D . )



ANY ATTEMPTS TO HANDLE OR CORRECT THE SITUATION, AND RESULTS OF SUCH ATTEMPTS:

ANY ADDITIONAL COMMENTS:

SIGNATURE

Your assistance in Keeping Scientology Working is appreciated.

If you have filled out this form, please tear it out and put it in an OUT

basket, or mail it direct to Reports Officer Religious Technology Center, c/o

1710 Ivar Avenue Suite 1100 Los Angeles California 90028-5107.




DA L Y R EPOR T FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME D TE

TWINS

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

DAY 8


A D IU I U

TOTAL TIME ON

PURIF RD TODAY

WEIGHTA T S T A R T

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

S A L T T A K E N

AMOUNT OF

LECITI IIN TAKEN

AMOU N1 OF

POTASSIUM TAKEN

NUMBER OF G L A S S E S O FWATER YOU DRANK TODAY





BCOMPLEXE MG U

CB MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)


IF A NY RE A CTIO N TO THE N IA CIN, WA S IT L E SST H A N T H E P R E V I OU S D A Y O N T H E P R O G R A M ?

V E G E T A B L E S E A T E N

TODAY (TYPES, AMOUNTS)

NUMBER I T O U R S O FSLEEP LAST NIGHT

ANY OTI IER VITAMINS TAKEN TODAY?WHAT? HOW MUCH?

HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



P A G E 2

MOUNTOFTMEYOUHOURSMNUTES

SWFATFD IN THE SAUNA TODAY:

WHAT DID YOU EXPERIENCE W H I L E S W E A T I N G IN T H E S A U N A ? (N O T E A N Y M E N T A L O R P H Y S I CA L C H A N G E S ,REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)



(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONI/CDATE



CASE SUPERVISOR:

(1 ) STUDIE S THIS RE PO RT (A I O NG WITH A NY O TI (E R NE E DE D FO L DE R STUD Y )A N D W R I TE S I N S T R U C T IO N S F O R T H E N E X T D A Y .







DA1 E




DAILY R EPORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAMDAE

TWN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

T O D A Y

TOTAL TIME ON

I'URIF RD TODAY

DAY 9


AD I U I U

BCOMPLEXE MG U

WEIGHT

A T S T A R T

WEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

C

MG MG

MULTI- MINERALS

(TABLETS)

NIACIN

(MG)



AMOUNT OF

LECITHIN TAKEN



NUMBER OF G L A S S E S O FCAL-MAG YOU DRANK TODAY



IF ANY REACTION TO THE NIACIN, WAS IT LESSTHAN THE PREVIOUS DAY ON THE PROGRAM?


NUMBER HOURS OFSLEEP LAST NIGHT

ANY OTHER VITAMINS TAKEN TODAY?

WHAT? I IOW MUCH?

HOURS/MINUTES OF

RUNNING TODAY


CONTINUED N EX T P A G E



P A GE 2



W H A T D I D Y O U E X P E R I E N C E W H I L E S W E A T I N G I N T H E S A U N A ? ( N O T E A N Y M E N T A L O R P H Y S I C A L C H A N G E S ,REAC T IO NS, D ISCO MF O RT S. ETC . USE MO R E P AP ER IF NEEDE D. )


I ATTEST TI (AT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY THE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE )





PAGE3

THIS SECTION FILLED


( 1 ) ENSU RES P C H AS F ILLED O UT ALL P O INT S ABO VE C O RR EC T LY:


(3) ANY OBSERVATIONS OR DATA ABOUT P C S P R O G R E S S ON THE RD THAT SHOULD BE NOTEDFOR THE C/S:



PURFCATONI/CDATE



CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WTH ANY OTIiER NEEDED FOLDER STUDY)AND WRITES INSTRUCTIONS FOR THE NEXT DAY.

(2) PUTS HIS WRITTEN INSTRUCT IONS AND THIS REPORT INTO THE FOLDER






D TE




DA ILY R E P OR T F OR MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAMDAE

TWIN'S

NAME

TIME STARTED

T O D A Y

DAY 10


TMFNSHEDAD

TODAY U U

TOTALTMEONBCOMPLEXE

PURFRDTODAY MG U

C B

ATSTART MG MG

WGHTA MLTINERALS

FNSH TABLETS

AMOUNTOFNACN

OLCONSUMED MG

AMOUNTOFWHATREACFONFANY DDYOUGET



AMOUNT OF

POTASSIUM TAKEN



CAL-MAC; YOU DRANK TODAY





HOURS/MINUTES OF

RUNNING TODAY



CONTINUE) ) NEXT PAGE



P AG E 2



WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)



(PC SIGNATURE)






DA ILY R E P ORT FOR MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWINS

NAME

TIME STARTED

T O D A Y

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUN I OF

S A L T T A K E N




NUMBER OF CI ASSES OF



VEGETABLES EATENTODAY (TYPES , AMOUNTS)

D TE

DAY 11

I UNITS/MG OF VITAMINS TAKEN TODAY D I U IU

BCOMPLEXE MG U

C

MG MG

MULTI-MINERALS

(TABLETS)

NIA CIN(MG)

WI LA] REACTION (IF ANY) DID YOU GET



NUMBER I TOURS OFANYOTHERVTAMNSTAKENTODAY?

SLEEP LASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OF

RUNNING TODAY


CON I INUED NEXT PAGE



P AG E 2



W H A T D I D Y O U E X P E R I E N C E W H I L E S W E A T I N G I N T H E S A U N A ? (N O T E A N Y M E N T A L O R P H Y S I CA L C H A N G E S ,REAC T IO NS, D ISCO MF O RT S, ET C. USE M O RE P AP ER IF NEED ED. )




(PC SIGNATURE)





PAGE 3

THIS SECTION FILLED




(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTEDFOR TI HE C/S:

(4) I ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE


PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND 1 HE PC'S DAILY REPORT


C A S E S U P E R V I S O R :


(2) PU IS HIS WRITTEN INSTRUCTIONS AND TI 1)5 REPORT INTO THE FOLDER




ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR AUDI FIVES.


D TE




DA LY RE P ORT FORMMUST BE FILLED OUT AND TURNED IN TO THE Pl1RIF I/C

NAME

TWIN'S

NAME

TIME STARTEDTODAY

TIME FINISHEDT O D A Y

TO1AL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITHIN TAKEN



WAFER YOU DRANK TODAY



DAY 12


A D

U U

BCOMPLEXE

MG IU

CB

MG MG

MULTI-MINERALS

(TABL ETS)

{N I ACI N( MG)

WHAT REACTION IF ANY) DID YOU GET


ANY CRAVNGSFORANY IF ANY REACTONTO THE NACN WASIT LESSTYPE OF FOODORDRNK? THANTHE PREVOUSDAY ONTHE PROGRAM?


NUMBER FLOURS OF ANY OTHER VTAMNS TAKEN TODAY

SLEEP LAST NIGHT WHAT? HOW MUCH?

HOURS/MINUTES OF

RUNNING TODAY

WHAT DID YOU EXPERIENCE WI TILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,


CONTINUED NEXT PAGE



P A GE 2



WHAT DID YOU EXPERIENCE W H I L E S W E A T I N G IN T H E S A U N A ? (N O T E A N Y M E N T A L O R P H Y S I CA L C H A N G E S ,REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)




(PC SIGNATURE)





P A GE 3

THIS SECTION FILLED


(1) ENSURES PC HAS FIRED OUT ALL POINTS ABOVE CORRECTLY:


(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTEDFOR TI IF C/S:


PURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH. WITH NO VARIA-

TIONS OR ADDITIVES.

PURIFICATION CDA F


CASE SUPERVISOR:



(2) PUTS HIS WRITTEN INS1 RU( TIONS AND THIS REPORT INTO THE FOLDER




ACCORDING TO STANDARD TECI I, WITH NO VARIATIONS OR ADDITIVES.


D LE




DA ILY REPORT FOR MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

T O D A Y

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

A T S T A R T

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

S A L T T A K E N







D TE

DAY 13


AD I U I U

BCOMPLEXE

MG IU

CB

MG MG

MULTI-MINERALS

(TABL ETS)

NIACIN

(MG)




VEGETABLES EATENTODAY ( TYPES AMOUNTS)

NUMBER HOURSOF ANY OTI IER VTAMNSTAKEN TODAY?


HOURS/MINUTES OF

RUNNING TODAY



CONTINUED NEXT PAGE



P A GE 2



W H A T D I D Y O U E X P E R I E N C E W H I L E S W E A T I N G I N T H E S A L I N A ? (N O T E A N Y M E N T A L O R P H Y S I C A L C H A N G E S ,REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)



(PC SIGNATURE)





DA ILY REPOR T FORMDAY 14


NAME D A T E

TWIN'S

NAME

TIME STARTED

T O D A Y

TIME FINISHED

TODAY


AD U I U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

A T S T A R T

WFIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSAIT TAKEN





NUMBER OF CLASSES OF




BCOMPLEXE

MG U

C

MG MG

MULTI- MINERALS

(TABLETS)

NIACIN(MG)



IF ANY REACT ION 10 THE NIACIN, WAS IT LESS



NUMBER HOURS OF

SLEEP LAST NIGHT


WHAT? HOW MUCH?

HOURS' 'MINUTES OF

RUNNING TODAY



CONIINI'FD NEXT PAGE



PACE 2






I ATTEST TI ]AT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME

BY TI IF C/S IN DOING TFIE RUNDOWN TODAY.

(PC SIGNATURE)




P A GE 3

THIS SECTION FILLED





(4) 1 ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THEPURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIA-TIONS OR ADDITIVES.

PURFCATONI/CDATE


CASE SUPERVISOR:








D TE





NAMEDATE

WTNESSDATE

Please hand in your success

story to the Purif I/C.



D. Vitamins, Minerals and Niacin






to your knowledge?



adequate supply?)




E. Diet and Supp lements





daily?

25. Are you taking the full amount of lecithin recommended bythe C/S daily?


the C/S daily?



down?

28. Have you noticed any mental or emotional changes, or

changes in attitude since starting the rundown?






32. Have any reactions appeared that are persisting?

33. Do you find that you tend to tire out after a certain point when

doing the rundown, and make little or no noticeable gain after

that point for the day?

G. Twin



make known?

H. Other

36. Were you given any special orders by your doctor to be fol-

lowed while on the rundown? Are you following them exactly?





39. Have you had any psychiatric treatment, drugs, shock or insti-

tutional treatment that you haven't mentioned?

40. Do you have any i llness that you haven' t mentioned?


42. A nything else that you'd l ike the C/S to know?

Qual Sec

Do a full inspection of the pc s Purification folder and Purif Run-


Purif icat ion Rundow n Pc Checklist (HCOB 24 Oct. 85R).

Qual Sec

S end the results of the above inspection and the pc's Purificationfolder to the Snr C/S for rapid handling.

Qual Sec

Snr C/S studies the pc's Purification folder and the data gathered in

this interview and the above inspection, and writes crams to correct the

outnesses found.

Snr C/S



Snr C/S writes the next C/ S and routes the folder to the Purif I/C via

the Purif C/S.

Snr C/S


Purif I/C


pc's Purif folder.




RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS TO


PAGE HEADED PURPOSE AT THE BEGINNING OF THIS BOOKLET)

R O U T E TO: REPORTS OFFICER

RELIGIOUS TECHNOLOGY CENTER

Report of NonstandardPurification R undown Delivery:

NAME DATE

HOME ADDRESS:

PHONE






N E E D E D . )





SIGNATURE



basket, or mail it direct to Reports Officer, Religious Technology Center, c/o




P A GE 2



WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

ANY WINS OR REALIZATIONS I HAT OCCURRED?

I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY TI iE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE)




P AG E 3

THIS SECTION FILLED





(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THEPURIFICATION RD EXACTLY ACCORDING TO STANDARD TECH, WITH NO VARIA-

TIONS OR ADDITIVES.

PURFCATONI/CDATE



C A S E S U P E R V I S O R :

(1) STUDIES THIS REPORT (ALONG WITH ANY C)TIIER NEEDED FOLDER STUDY)






D A T E




DA LY REPORT FORMDAY 16

MUSI BE I'll LED OUT AND TURNED IN TO THE PURIF I/C

N A ME D A T E

TWIN'S

NAME

TIME STARTED

1 ODAY

TIME FINISHEDTODAY

UNITS/MG OF VITAMINS TAKEN TODAY D I U IU

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

A T S T A R T

\VEIGI IT AT

FINISH


AMOUNT OFS A L T T A K E N

AMOUNT OFLECITI IIN TAKEN

AMOUNT OF

POTASSIUM TAKEN

NUMBI R OF GLASSES OF

W A T E R YOU DRANK TODAY



BCOMPLEXE MG U

CB MG MG

MULTI- MINERALS

(TABLETS)

NIACIN

IMG)


NYCR VNGSFOR NYF NYRE CTONTOTHEIACIN, WAS IT LESSTYPEOF FOODOR DRNK THAN THEPREVOUS DAY ON THEPROGRAM



HOURS/MINUTES OF

RUNNING TODAY


CONTINUFD NEXT PA(;F



PACE 2



WHAT DID YOU EXPERIENCE WHILE SWFATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,


ANY WINS OR REALIZATIONS THAT OCCURRFD?


(PC SIGNATURE )




PAGE 3







PURFCATONI/CDATE



CASE SUPERVISOR:

(1) STUDIES 1 HIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)AND WRITES INSTRUCTIONS FOR THE NEXT DAY.






D TE




DA LY RE P ORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

T O D A Y

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

A T S T A R T

WEIGHT AT

FINISH


MOUNT OF

S LT T KEN

AMOUNT OF

LECITHIN TAKEN




NUMBER OF G L A S S E S O F





NUMBER HOURS OF

SLEEP LAST NIGHT

HOURS/MINUTES OF

RUNNING TODAY

D TE

DAY 17


D

I U I U

BCOMPLEXE MG U

C B

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)






WHAT? HOW MUCH?

WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES , PHYSICAL CHANGES, REACTIONS,


CONTINUED NEXT PAGE



P A GE 2








(PC SIGNATURE)




P A GE 3

THIS SECTION FILLED




(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD THAT SHOULD BE NOTEDFOR TI IF C /S:

(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND f iHS TWIN TODAY ON THE


PURFCATONI/CDATE


CASE SUPERVISOR:

(1 ) STUDIE S THIS RE PO RT (A L O NG WITH A NY O THE R NE E D E D FO L DE R STUDY )AND WRIT ES INST RUC T IO NS F O R T H E NEXT DAY.




ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDI I IVES.

(ASE S(1PFRVISOR

DAT E




DA L Y R EPORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

A T S T A R T

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN






DATE

DAY 18


A D

U U

BCOMPLEXE

MG IU

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)







HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



P A G E 2








(PC SIGNATURE)




PAGE 3

THIS SE CTION FILLEDO U T B Y PURIF RD I /C:






PURFCATONI1/CDATE


CASE SUPERVISOR:


AND WRITES INSTRUCTIONS FOR THE N E X T D A Y .


13) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTEN




DAT F




DA LY REPORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWINS

NAME

TIME STARTED

T O D A Y

TIME FINISHED

TODAY

TOIAL TIME ON

PURIF RD TODAY

WEIGIiTA T S T A R T

WEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

S A L T T A K E N

AMOUNT OF

LECITHIN TAKEN






D TE

DAY 19


AD I U U

BCOMPLEXE

MG IU

CB(MG (MG


NIACIN

(MG)



ANY CRAVNGSFORANY IF ANY REACTONTO THE NACN WASIT LESSTYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM?


NUMBER HOURSOF ANY OTI IER VTAMNSTAKEN TODAY?SLEEPLASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OF

RUNNING TODAYWHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

CONTINUED NEXT PAGE



PAGE 3


(1) ENSURES PC H AS F ILLED O UT ALL P O INT S ABO VE C O RR EC T LY:

( 2) A N Y S I G N S O F V I T A M I N O R M I N E R A L D E F I C IE N C I E S O R I M B A L A N C E S :




PURFCATONI/CDATE



CASE SUPERVISOR:









D A T E




DA ILY REP O RT FO RMDAY 20


NAME DATE

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

UNITS/MG OF VITAMINS TAKEN TODAY D U U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITI LIN TAKENAMOUNT OF

POTASSIUM TAKEN


NUMBER OF GLASSES OFCAL-MAG YOU DRANK TODAY

COMPLEXE

MG U

CB MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)



ANYCRAVNGSFORANYIFANYREACTONTOTHENACN WASITLESS

TYPEOFFOODORDRNK? THANTHEPREVOUSDAYONTHEPROGRAM?

VEGETABLES EATENTODAY (TYPES, AMOUNTS)

NUMBERHOURSOFANYOT JERVTAMNSTAKENTODAY?




CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED


1) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:





TIONS OR ADDITIVES.

PURFCATONI/CDA E

WHEN THIS FORM HAS BEEN FILLED OU1, TEAR IT AND TFIE PC'S DAILY REPORT

OUT AND SEND THEM TO I HE CASE SUPERVISOR IN THE PC'S FOLDER.

CASE SUPERVISOR:

(1) STUL)IES [HIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)


(2) PUTS HIS WRITTEN INSI RUCTIONS AND THIS REPORT INTO THE FOLDERAND SENDS IT TO THE PURIF I/C.

(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTEN

INSTRUCT IONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN

ACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDII IVES.

CASE SUPERVISOR

DALE




DA I LY R EPORT FO R MDAY 21


NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

DATE


AD IU IU

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITHIN TAKEN







COMPLEXE

MG IU

C B

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)





NUMBER I )OURS OF

SLEEP LAST NIGHT


WHAT? HOW MUCH?




CONTINUED NEXT PAGE



PAGE 2







(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED




(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD TI ]AT SHOULD BE NOTED

FOR THE C/S:

(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND THIS TWIN TODAY ON THE


TIONS OR ADDITIVES.

PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND I HE PC'S DAILY REPORT


CASE SUPERVISOR:







CASE SUPERVISOR

DAT F



SUCC ESS STORYPURIFICATION RUNDOWN

(This form is provided for your use, should you wish to write down any wins,

gains or realizations you've had while on the Purification Rundown thus far.)

NAME_DATE

WTNESSDATE

Please hand in your successstory to the Purif I/C.



NOTICE

If, at this stage of your rundown, you are unhappy with the service you





his progress or lack of it on the rundown. Find out what handlings have been

attempted in the Tech Division to this point. Ask questions as needed from





A. General Progress



B. Schedule


What is it? (If not, find out why not.)


5. Briefly outline your daily personal schedule (sleep, meals,

work, transport, free time, etc.).

6. Any problems maintaining your personal schedule?



C Exercise and Sauna

9. W hat sort of exercise are you doing daily?



12. Is the sauna kept clean?


area?









to your knowledge?

18. Are vitamins and minerals recommended by the C/S avail-


adequate supply?)









daily?


the C/S daily?


the C/S daily?



down?

28. Have you noticed any mental or emotional changes or







32. Have any reactions app eared that are persisting?


doing the rundown and m ake little or no notic eable gain after


G. Twin



make known?

H. Other


lowed while on the rundown? A re you following them exac tly?

37. Is there any sort of health or case activity that you are doing inaddition to the rundown?





40. Do you have any illness that you haven't mentioned?



Qual Sec



Purification Rundown Pc Checklist (HCOB 24 Oct. 85R).

Qual Sec

Send the results of the above inspection and the pc's Purification

folder to the Snr C/S for rapid handling.

Qual Sec


this interview and the above inspection, and writes crams to correct the

outnesses found.

Snr C/S




the Purif C/S.

Snr C/S


Purif I/C


pc's Purif folder.



IF Y OU ARE NOT BEING DELIVERED A CORRECT, STANDARD PURIFICATION

RUNDOWN THIS FORM MAY BE USED FOR REPORTING THE FULL FACTS



R O U T TO: REPORTS OFFICERRELIGIOUS TECH NOLOGY CENTER

Report of NonstandardPurification Rundown Delivery:

NAME DATE

HOME ADDRESS:

PHONE :





REPORTED, INCLUDING NAMES OF THOSE PRESENT OR INVOLVED. USE EXTRA PAPER IFNEEDED.)





SIGNATURE




1710 Ivar Avenue, Suite 1100, Los Angeles, California 90028-5107.




DA ILY RE P O RT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHTAT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN









NUMBER HOURS OF

SLEEP LAST NIGHT


DATE

DAY 22


AD U U

BCOMPLEXE

MG IU

C B

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)



IF ANY REACTION TO THE NIACIN WAS IT LESSTHAN THE PREVIOUS DAY ON THE PROGRAM?

ANY OTHER VITAMINS TAKEN TODAY?WHAT? HOW MUCH?


CONTINUED NEXT PAGE



PAGE 2


SWFATFD IN THE SAUNA TODAY-




I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY TI IF C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNAL URE)




PAGE 3



(2) ANY SIGNS OF VI IAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:

(3) ANY OBSERVATIONS OR DATA ABOUT PC S PROGRESS ON THE RD THAT SHOULD BE NOTEDFOR THE C/S:



TIONS OR ADDITIVES.

PURFCATONI/CDATE



CASE SUPERVISOR:





INSTRUCTIONS FOR THE PC S NEXT DAY ON THE PURIFICATION RUNDOWN


(ASE SUPERVISOR

DATE




DA I LY R EPORT FO R MDAY 23

MUSE BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME DATE

TWIN'S

NAME

TIME STARTED

I ODAY

I IME FINISHED

TODAY


AD

I U IU

IOIAL TIME ONP(1RIF RD TODAY

W'EIGI)TAT START

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SAI T TAKEN

AMOUNT OF

LECITHIN TAKEN

AMOUNT OF

POTASSIUM TAKEN





BCOMPLEXE

MG U

CBE MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

IMG)

WI EAT REACTION (IF ANY) DID YOU GET




VEGETABLES EATENTODAY ( f YPES, AMOUNTS)

NUMBERIiOURSOFANYOTHERVTAMNSTAKENTODAY?

SLEEPLASTNG ITWHAT?I OWMUCH?

HOURS' 'MINUTES OFRUNNING TODAY

WHAT DID YOU EXPERIENCE WHILE RUNNING ? MENTAL CHANGES , PHYSICAL CHANGES, REACTIONS,DISCOMFORTS FTC. USE MORE PAPER IF NEEDED.)

CONTINUED NEXT PAGE



PACE 2





ANY WINS OR REALIZATIONS II ]AT OCCURRED?


(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONI/CDATE



CASE SUPERVISOR:







CASE SUPERVISOR

DATE




DA I LY R EPORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH


AMOUNT OFSALT TAKEN







DATE

DAY 24


AD I U I U

COMPLEXE

MG IU

CB MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)





NUMBERHOURSOF NYOTHERITAMINS TAKEN TODAY?




CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED


(I) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:





PURFCATONI/CDATE



CASE SUPERVISOR:








CASE SUPERVISOR

DATE




DA ILY R E P O R T FORMDAY 25


NAME DATE

TWIN'S

NAME

TIME STARTED

TODAYTIME FINISHEDTODAY


D

I U I U

TOTAL TIME ON

PURIF RD TODAY

WEIGHTAT START

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITI UIN TAKEN

AMOUNT OF

POTASSIUM TAKEN





BCOMPLEXE MG IU

CB

MG MG

MULTI -MINERALS

(TABLETS)

NIACIN

(MG)






NUMBERHOURSOFANYOTHERVTAMNSTAKENTODAY?




CONTINUED NEXT PAGE



PAGE 2


SWFATFD IN THE SAUNA TODAY-



ANY WINS OR REALIZATIONS THAT O((URRED?


BY T I I E C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE;




PAGE 3

THIS SECTION FILLED


(I) ENSURES P( HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:



FOR THE C/S:



TIONS OR ADDITIVES.

PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT, LEAR IT AND THE PC'S DAILY REPORT


CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTI iER NEEDED FOLDER STUDY)



AND SENDS IT TO TI IE PURIF 1/C.


INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICAl ION RUNDOWN

ACCORDING TO STANDARD T ECI i, WITH NO VARIAI IONS OR ADDITIVES.

CASE SUPERVISOR

DATE




DA I LY RE P ORT FO R MMUSI BE FILLED OUT AND TURNED IN TO THE PU RIF I/C

NAMDAE

TWIN'S

NAME

DAY 26


TODAY

TMFNSHEDAD

TODAY U U

TOTALTMEONBCOMPLEXEPURFRDTODAY MG U

ASTARG MG

WGHTATMLTMINERALS

FINISH TABLETS)

AMOUNTOFNACNOLCONUMD MG



A,NIOU N I OFLE( ITI iIN TAKEN











HOURS/MINUTES OF

RUNNING TODAY



CONI INCED NEXT PAGE



PAGE 2








(PC SIGNATURE)





PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONI/CDATE



CASE SUPERVISOR:








CASE SUPERVISOR

DATE




DAILY R EPORT FO R MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWI N'SNAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH


AMOUNT OF

SALT TAKEN

AMOUNT OFLECITI UN TAKEN

AMOUNT OF

POTASSIUM TAKEN







NUM ER FiOURS OF

S P L ST NIGI IT


DATE

DAY 27


D

I U I U

COMPLEXE

MG U

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)

WI ]AT REACTION (IF ANY) DID YOU GETFROM THE NIACIN TODAY?




WHAT? HOW MUCH?



CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED


(1) ENS[:RFS PC I LAS FILLED OUT ALL POINTS ABOVE CORRECTLY:



(4) I ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON TI LE


TIONS OR ADDITIVES.

PURIIICATION CDATF



CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)AND WRITES INSTRUCT IONS FOR THE NEXT DAY.



(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTENINSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICAI ION RUNDOWN


(ASE SUPERVISOR

DATE




DA ILY REPO RT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHEDTODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN

AMOUNT OF

POTASSIUM TAKEN




CAL-MAC YOU DRANK TODAY



NUMBER I IOURS OF

SLEEP LAST NIGHT


DATE

DAY 28


AD IU IU

COMPLEXE

MG IU

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)






WHAT? HOW MUCH?

I


CONTINUED NEXT PAGE



PAGE 2


SWFATED IN THE SAUNA TODAY:





(PC SIGNAL URL)




PAGE 3

THIS SECTION FILLED


(I) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:



(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON TI iE


PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND THE PC S DAILY REPORTOUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC S FOLDER.

CASE SUPERVISOR:




AND SENDS IT TO TI HE PURIF I/C.


INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWNACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.

CASE SUPERVISOR

DAL E



SUCC ESS STORYPURIFICATION RUNDOWN

(This form is provided for your use, should you wish to write down any wins,

gains or realizations you've had while on the Purification Rundown thus far.)

NAMEDATE

WTNESSD TE





NOTICE












A. General Progress



B. Schedule









C Exercise and Sauna






area?







G. Twin



make known?

H. Other


lowed while on the rundown? Are you following them exactly?










Qual Sec

Do a full inspection of the pc's Purification folder and Purif Run-


Purification Rundown Pc Checklist (HCOB 24 Oct. 85R).

Qual Sec



Qual Sec


this interview and the ab ove inspection, and w rites crams to correct theoutnesses found.

Snr C/S



Snr C/S writes the next C/S and routes the folder to the Purif I/C viathe Purif C/S.

Snr C/S

Purif I/C sees that any C/S ordered hand lings are done.

Purif I/C


pc's Purif folder.




RUNDOWN THIS FORM MA Y BE USED FOR REPORTING THE FULL FACTS TO

THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE TIIE


ROUTE TO : REPORTS OFFICERRELIGIOUS TECHNOLOGY CENTER

Report of NonstandardPu rific ation Ru ndown Delivery:

NAME DATE

HOME ADDRESS:

PHONE :









DA ILY RE P O RT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I /C

N ME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHEDTODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN




CAL-MAC YOU DRANK TODAY



NUMBER IiOURS OF

SLEEP LAST NIGHT

HOURS/MINUTES OF

RUNNING TODAY

DATE

DAY 29


A(I U)

B COMPLEX(MG)

D(IU)

E I U )

C(MG)

MULTI-MINERALS

(TABLETS)

NIACINL(MG)

(MG)






WHAT? HOW MUCH?


CONTINUED NEXT PAGE



PACE 2

AMOUNT OF TIME YOU HOURSMNUTESSWFATFI7 IN THE SAUNA TODAY:

WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY M ENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)




(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURIFICATION CDATE


OUT AND SEND THEM TO THE CASE SUPERVISOR IN [HE PC'S FOLDER.

CASE SUPERVISOR:








CASE SUPERVISOR

DAT E




DA I LY REPOR T FO R MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

N D E

TWIN'S

NAME

DAY 30

T IME STARTED UNITS/MG OF VITAMINS TAKEN TODAY

TODAY

TMFNSHEDAD

TODAY IIU I U

TOTAL IIMEONBCOMLEXE

PURIF RDTOAY MG U

ASTARG MG

WGHTATMLTMINERALS

FINISH (TABLETS)

AMOUNTOFNACN

OLCONUMD MG

AMOUN OFWHATREACTON FANY DDYOUGET



AMOUNT OF

POTASSIUM TAKEN








NUMBERI FOURSOFANYOTHERVTAMNSTAKENTODAY?


HOURS/MINUTES OF

RUNNING TODAY

1VHAT DID YOU EXPERIENCE W'ITILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,


CONTINUED NFXI I'AGF



PAGE 2








(PC SIGNATURE)

WHEN YOU HAVE FILLED OUT AND SIGNED THIS FORM,HAND YOUR BOOK IN TO THE PURIF IK




DA I LY REPORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I /C

NAME DATE

TWIN'S

NAME

TIME STARTED

TODAY

DAY 31


TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN



WVATER YOU DRANK TODAY

NUMBER OF GLASSES OFCAL-MAC; YOU DRANK TODAY

AD I U I U

BCOMPLEXE

MG IU

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)

WHAT REACI ION (IF ANY) DID YOU GETFROM THE NIACIN TODAY?




NUMBERI TOURSOFI ANYOTHERVTAMNSTAKENTODAY?





CONTINUED NEXT PAGE



PACE 2

OUNTOFTMEYOUHOURSMNUTES

EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,

EACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

THAT OCCURRED?


(PC SIGNATURE)





PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONI/CDA E


CASE SUPERVISOR:




INSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWNACCORDING 10 STANDARD TECI I, WITH NO VARIATIONS OR ADDITIVES.

CASE SUPERVISOR

DAT E



PAGE 2





ANY WINS OR RLALIZATIONS THAT OCCURRED?

I ATTEST TIiAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME


(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED


(1) ENSURES P( HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:



FOR THE C/S:

(4) I ATTEST THAT I HAVE SUPERVISEI) THIS PC AND HIS TWIN TODAY ON THE


TIONS OR ADDITIVES.

PURFCATONI/CDATE



CASE SUPERVISOR:





(3) ATTESTS TI ]AT IIE HAS STUDIED THIS DAILY REPORT AND WRITTEN


ACCORDING 10 STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.

CASE SUPERVISOR

DATE




DAILY R EPORT FO R MDAY 33

MUST 13F FILLED OU I AND TURNED IN TO TFiE PURIF I/C

NAME DATE

TWIN'S

NAM E

TIME STARTED

TODAYUNITS/MG OF VITAMINS TAKEN TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGIIT

AT START

WEIGHT AT

FINISH


AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITHIN TAKEN





CAL-MAG YOU DRAN K TODAY

D

U U

COMPLEXE

MG IU

C B

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN(MG)




TYPEOFFOODORDRNK? THANTHEPREVOUSDAYONT EPROGRAM?

VEGFTABI ES EATENTODAY (TYPES, AMOUNTS)



HOURS/MINUTES OF

RUNNING TODAY

WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,UISCOMFORTS, EIC. USE MORE PAPER IF NEEDED.)

CON IIN UED NEXT PAGE



PACE 2

OUNTOFTMEYOUHOURSMNUTES

WEATED IN THE SAUNA TODAY:

HAT D ID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY M ENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)



(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED







PURFCATONI/CDATE



CASE SUPERVISOR:








CASE SUPERVISOR

DATE




DA ILY RE P O RT FORMMUST BE FILLED OUI AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

FODAY

TIME FINISHED

I ODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH


AMOUNT OFSALT TAKEN


AMOUNT OF

POTASSIUM TAKEN



NUMBER OF GI ASSES OF





NUMBER I ]OURS OF

SLEEP LAST NIGHT

IiOURS/MINUTES OF

RUNNING TODAY

DATE

DAY 34


D

U U

COMPLEXE

MG U

C B

MG MG

MULTI-MINERALS

TABLETS)

L

NIACIN

(MG)

WHAT REACTION (IF ANY) DID YOU GETI FROM THE NIACIN TODAY?

LIF ANY REACTION TO [HE NIACIN, WAS IT LESS



WHAT? HOW MUCH?


CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED







PURFCATONI/CDATE


CASE SUPERVISOR:


AND WRITFS INSTRUCTIONS FOR THE NEXT DAY.



ACCORDING FO STANDARD TECH, WITH NO VARIAI IONS OR ADDITIVES.

CASE SUPERVISOR

DATE




DA I LY RE P ORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

I ODAY

TIME FINISHED

1 ODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH


AMOUNT OF

SAIT TAKEN

D

I U I U

COMPLEXE

MG IU

C B

MG MG


NIACIN

(MG)



AMOUNT OF

LECITHIN TAKEN




NUMBEROFGLASSESOF




VEGETABLESEATEN

TODAY (TYPES, AMOUNTS)

NUMBERI TOURSOFANYOTHERVTAMNSTAKENTODAY?


HOURS/MINUTES OF

RUNNING TODAY

WHAT DID YOU EXPERIENCE WI TILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,

DIS( OMFORTS, ETC. USE MORE PAPER IF NEEDED.)

DAY 35

DATE


CONTINUED NEXT PAGE



PAGE 2

AMOUNTOFTMEYOUHOURS

SWEATED IN THE SAUNA TODAY:MIND FES




I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY TI iE C/S IN DOING THE RUNDOWN TODAY.

IPC SIGNATURE)




PAGE 3

THIS SECTION FILLED







PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUI, FEAR LF AND THE PC'S DAILY REPORTOUT AND SEND THEM TO TI IF CASE SUPERVISOR IN THE PC'S FOLDER.

CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)AND WRITES INSTRUCI IONS FOR THE NEXT DAY.

(2) PUNS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER


(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTEN

INSTRUCTIONS FOR THE PC'S NEXT DAY ON TI IE PURIFICATION RUNDOWN


CASE SUPERVISOR

DATE



SUCCESS STORYPURIFICATION RUNDOWN

(This form is provided for your use, should you w ish to write down any wins,gains or realizations you'v e had w hile on the Purification Rundow n thus far.)

NAMEDATE

WTNESSD TE





NOTICE












A. General Progress


2. W hat difficulties are you experiencing on the rundow n?

B. Schedule


W hat is it? (If not, find out why n ot.)



work, transport, free time, etc.).6. Any problem s m aintaining you r personal schedu le?









area?







the rundown? H as the increase been on a gradient?


to your knowledge?



adequate supply?)

19. W hat sort of reactions have you bee n having to the niacin?

20. Has your niacin dosage been increased before reactions at anearlier dosage level had diminished?

E. Diet and Su pplements





daily


the C/S daily?


the C/S daily?



down?

28. Have you noticed any mental or emotional changes, orchanges in attitude since starting the rund own?



31. Have you had a big win that hasn t been acknowledged?







G. Twin

34. Are there any difficu lties with you r twin?


make known?

H. Other


lowed while on the rundown? A re you following them exactly?










Qual Sec

Do a full inspection of the pc's Purification folder and Pu r if Run-


Pu rif icat ion Ru ndown Pc Checklist (HCOB 24 Oct. 85R).

Qual Sec



Qual Sec


this interview and the above inspection, and w rites crams to correct theoutnesses found.

Snr C/S




the Purif C/S.

Snr C/S


Purif I/C


pc's Purif folder.



IF YOU ARE NOT BEING DELIVERED A CORRECT STANDARD PURIFICATION

RUNDOWN THIS FORM MAY BE USED FOR REPORTING TI IE FULL FACTS TO



ROUTE T O: REPOR TS OFFICERRELIGIOUS TECHNOLOGY CENTER

Report of NonstandardPu rific ation Ru ndown Delivery:

NAME DATE

HOME ADDRESS:

PHONE :






NEEDED.)





SIGNATURE


It you have filled out this form, please tear it out and put it in an OUT


1710 Ivar Avenue , Suite 1100, Los Angeles, California 90028-5107.




DA ILY R E P O R T FORMMUST BE F ILLED OUT AND TURNED IN TO TI IL PURIF I/C

NAME

TWIN'S

NAME

TIME STARTEDTODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN





TD ATE

DAY 36


D

IU I U COMPLEXE

MG IU

CB MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)






NUMBERHOURSO ANYOTHERVTAMNSTAKENTODAY?


HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



PAGE 2


SIVFATFD IN THE SAUNA TODAY:



ANY WINS OR REALIZATIONS I HAT OCCURRLD?

I ATTEST TI IAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY THE C.S IN DOING THE RUNDOWN TODAY.

(PC SIGNAI URLi




PAGE 3

THIS SECTION FILLED


(1) ENSURES PC HAS Ell LED OUT ALL POINTS ABOVE CORRECTLY:

(2) ANY SIGNS OF VITAMIN OR MINFRAI DEFICIENCIES OR IMBALANCES:

(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD Tf HAT SHOULD BE NOTED

FOR THE C/S:

(T) 1 ATTEST THAI I HAVE SUPERVISED TI IIS PC AND I IIS TWIN TODAY ON THE


PURFCATONUCDATF

WHEN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND 1HE PC'S DAILY REPORT


CASE SUPERVISOR:



AND SENDS IT 10 THE PURIF I/C.

(3) ATTESTS THAT HE HAS STUDIED THIS DAIIY REPORT AND WRITTENINSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN

ACCORDING TO STANDARD I ECH, WIl H NO VARIATIONS OR ADDITIVES.

CASE S[PERVISOR

DA1 F




DA ILY R E P O R T F O R MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

N D

TWIN'S

NAME

DAY 37


TODAY

TMFNSHEDAD

TODAY U

TOTAL TIMEONBCOMLEXE

PURERDTODAY MG U

ATSTAR MG MG

WEGHTATMULTMNERA S

FNSH TABES

AMOUNTOFNACN

OLCONUMD MG

AMOUNTOFW{ATREACTONFANY DDYOUGET

SALTTAKENI FROMTI IFNA INI ODAY?

AMOUNT OF

LECITI TIN TAKEN






TYPE OF FOOD ORDRNK?THANHE PREVIOUS DAY ON THE PROGRAM?


NUNBFRHOURSOFANYOT TERVTAMNSTAKENTODAY?

SLEEPLASTNGHTWHAT?I OWMUCF?

HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



PACE 2


SWEATFD IN THE SAMNA TODAY:

WHAT DID YOU EXPERIENCE WHILE SWEATING IN TI IF SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,


ANY WINS OR REALIZATIONS THAI OCC URRED?


(PC SIGNATURE)





PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONI/CDATE



CASE SUPERVISOR:







CASE SUPERVISOR

DATE




DA ILY R E P O RT FO RMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHEDTODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGI I FAT START

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SALT TAKEN

AMOUNT OFLECITI IIN TAKEN

AMOUNT OFPOIASSIUM TAKEN




DATE

DAY 38


D

U U

BCOMPLEXE

MG IU

CB MG MG


NIACIN(MG)



ANYCRAVNGSFORANYIFANYREACTONTOTHENACN 1VASITLESS



NUMBERFLOURSOFANYOT IERVTAMNSTAKENTODAY?SLEEPLASTNGHTWHAT?HOWMUCH?

HOURS/MINUI ES OF

RUNNING TODAY

WHAT DID YOU EXPERIENCE \VI III F RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

CONTINUED NEXT PAGE



PAGE 2







(PC SIGNATURE)




PACE 3

THIS SECTION FILLED


(1 I ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:


(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD TI ]AT SHOULD BE NOTED

FOR THE C/S:



TIONS OR ADDITIVES.

PURFCATONI/CDATE

WHEN THIS FORM HAS BEEN FILLED OUT TEAR IT AND THE PC'S DAILY REPORT

OUT AND SEND I I IEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.

CASE SUPERVISOR:

(1) STUDIES 1 HIS REPORT (ALONG WITH ANY OTI IER NEEDED FOLDER STUDY)


(2) PUIS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER


(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTENINSTRI,IC[IONS FOR THE PC'S NEXT DAN' ON THE PURIFICATION RUNDOWN


CASE SUPERVISOR

DATE




DA ILY RE P ORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME DATE

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

DAY 39

UNITS,/MG OF VITAMINS TAKEN TODAY

D

I U IU

TOTAL TIME ON

PURIF RD TODAY

WEIGHTAT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN







COMPLEXE

MG IU

C

MG MG


NIACIN

(MG)




VEGETABLES EATENTODAY ( TYPES, AMOUNTS)

NUMBER I (OURS OF

SLEEP LAST NIGHT

ANY OTHER VITAMINS TAKEN TODAY?WHAT? HOW MUCH?

HOURS/MINUTES OF

RUNNING TODAY

WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANCES, PHYSICAL CHANGES, REACTIONS,


CONIINUED NEXT PAGE



PACE 2





ANY WINS OR REALIZATIONS I I IAT OCCURRED?


BY TILE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE)




PAGE 3






PURIFICATION RD EXACTLY ACCORDING TO STANDARD T FCH, WITH NO VARIA-

TIONS OR ADDITIVES.

PURFCATONI/CDATE

Wi-1EN THIS FORM HAS BEEN FILLED OUT, TEAR IT AND IHE PC'S DAILY REPORTOUT AND SEND THEM TO THE CASE SUPERVISOR IN THE PC'S FOLDER.

CASE SUPERVISOR:

(1) STUDIES T I iBS REPORT (ALONG WITH ANY OTI iER NEEDED FOLDER STUDY)


(2) PUTS IilS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER


(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTENINSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWN


CASE SUPERVISOR

DATE




DA ILY REP O RT FO RMMUST BE FILLED OUT AND TURNED IN TO TI iE PURIF I/C

NAME

T\VIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGIIT

T ST RT

\VEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

AMOU N I OF

SALT TAKEN

AMOUNT OF

LECITHIN TAKEN

AMOU N F OFPOTASSIUM TAKEN




CAI -MAG YOU DRANK TODAY




NUMBER I IOURS OFSLEEP LAST NIGHT

HOURS,'MINUT ES OF

RUNNING TODAY

DAY 40


D

I U IU

BCOMPLEXE

MG U

CB MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)



IF ANY REACTION TO TI IE NIACIN, WAS IT LESS

THAN THE PREVIOUS L)AY ON THE PROGRAM?

ANY OTI TER VITAMINS TAKEN TODAY?

WHAT? HOW MUCH?



CONTINUED NEXT PAGE



PACE 2

AMOUNT OF TIME YOU HOURSMNUTESSWEATED IN THE SAUNA TODAY:



ANY WINS OR REALIZATIONS THAT OCCURRED,

I ATTEST TI IAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY THE C/S IN DOING THE RUNDOWN TODAY.

(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED



(2) ANY SIGNS OF VLIAMIN OR MINERAL DEFICIENCIES OR IMBALANCES:


FOR THE C/S:



TIONS OR ADDITIVES.

PURFCATONI/CDATE


OUT AND SEND THEM TO THE CASE SUPERVISOR IN I I IF PC'S FOLDER.

CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTIiER NEEDED FOLDER STUDY)


(2) PUTS IiIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER



ACCORDING 1-0 STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.

CASE SUPERVISOR

DATE




DA ILY R EPORT FO R MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

MME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGI T

T ST RT

WEIGHT AT

FINISH

AMOUNT OfOIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN



\VAT ER YOU DRANK TODAY





NUMBER I (OURS OF

SLEEP LAST NIGHT

HOURS/MINUTES OF

RUNNING TODAY

DATE

DAY 41


COMPLEXE

MG U

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)





WI ]AT? HOW MUCH?



CONTINUFD NEXT PAGE



PAGE 2






I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCT IONS EXACTLY AS GIVEN ME

RY THE C/S IN DOING 1 HE RUNDOWN TODAY.

(PC SIGNATUREI





PAGE 3

THIS SECTION FILLED




(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RI) THAT SI IOULD BE NOTEDFOR TI IF C/S:

(4) I ATTEST THAT I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON TI IF


TIONS OR ADDITIVES.

PURFCATONI/CDATE


OUT AND SEND THEM TO THE CASE SUPERVISOR IN T IIE PC'S FOLDER.

CASE SUPERVISOR:

(1) STUDIES 11IIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)


(2) PU IS HIS WRITTEN INSTRUCTIONS AND THIS REPORT INTO THE FOLDER



INSTRUCTIONS FOR TI IE PC'S NEXT DAY ON TI iE PURIFICAHON RUNDOWN


CASE SUPERVISOR

DATE




DA I LY R E P O RT F O RMDAY 42

MUST BE FILLED OU f AND TURNED IN TO THE PURIF I/C

NAME DATE

TWIN'S

NAME

I IME STARTED

TODAY

TIME FINISHED

TODAY


TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN





BCOMPLEXE

MG U

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN(MG)






NUMBERHOURSOFANYOTHERVTAMNSTAKENTODAY?SLEEPLASTNGHTWHAT?OWMUCH?

HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED



(2) ANY SIGNS OF VITAMIN OR MINERAI DEFICIENCIES OR IMBALANCES:


(4) 1 ATTEST THAI I HAVE SUPERVISED THIS PC AND HIS TWIN TODAY ON THE

PURIFICATION RD EXACTLY ACCORDING TO SIANDARD TECH, WITH NO VARIA-TIONS OR ADDITIVES.

PURFCATONI/CDATE


OUT AND SEND THEM TO THE CASE SUPERVISOR IN [HE PC'S I OLDER.

CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTI IER NEEDED FOLDER STUDY)

AND WRITES INSTRU( IIONS FOR THE NEXT DAY.

(2) PUTS HIS WRITTEN INSTRUCT IONS AND THIS REPORT INTO THE FOLDERAND SENDS IT TO THE PURIF I/C.



ACCORDING TO STANDARD TECH, Willi NO VARIATIONS OR ADDITIVES.

CASE SUPERVISOR

DATE



NOTICE





Instructions to Qual Sec: Interview the person on the E-Meter regardinghis progress or lack of it on the rundown. Find out what handlings have been






A. General Progress



B. Schedule












It 4 ..... a.. ...I I . . th tho tamriornti iro of the cat inn?








17. Have amounts of each vitamin been increased proportionally,to your knowledge?



adequate supply?)









daily

25. Are you taking the full amount of lecithin recommended bythe C/S d aily?


the C/S daily?



down?

28. Have you noticed any mental or emotional changes, or








33. Do you find th t you tend to tire out fter cert in point when

doing the rundown and make little or no noticeable gain after

that point for the day

G. Twin



make known?

H. Other

36. Were you g iven any special orders by your do ctor to be followed w hile on the rundown Are you following them exactly?


addition to the rundow n?




tutional treatment that you haven t mentioned?

40. Do you have any illness that you haven t mentioned?


42. Anything else that you d like the C/S to know?

Qua l Sec



Purification Rundown Pc Checklist HCOB 24 Oct. 85R).

Qual Sec

Send the results of the above inspection and the pc s Purification

folder to the Snr C/ S for rapid handling.

Qual Sec

Snr C/S studies the pc s Purification folder and the data gathered in

this interview and the above inspection and writes crams to correct the

outnesses found.

Snr C/S




the Purif C/S.

Snr C/S


Purif I/C

This form and all worksheets, etc., connected to it become part of thepc s Pu rif folder.



IF Y OU ARE NOT BEING DELIVERED A CORRECT STANDARD PURIFICATION


THE REPORTS OFFICER OF THE RELIGIOUS TECHNOLOGY CENTER. (SEE TI IE


R O U T E T O : REPORTS OFFICERRELIGIOUS TECHNOLOGY CENTER

Report of NonstandardPurification Rundown Delivery:

NAME:

HOME ADDRESS:

DATE:

PHONE




OBSERVATIONS - BE SPECIFIC , GIVING DATES, TIMES AND DETAILS OF OCCURRENCES BEING





DA I LY RE P O R T FORMDAY 43


NAME D TE

TWIN'S

NAME

TIME ST RTED

TODAY

TIME FINISHEDTODAY


D

U U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN








COMPLEXE

MG IU

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)






NUMBERHOURSOFANYOTHERVTAMNSTAKENTODAY?SLEEPLASTNGHTWHAT?HOWMUCH?



CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONICDATE


OUT AND SEND THEM TO THE CASE SUPERVISOR IN THE I'C'S FOLDER.

CASE SUPERVISOR:

(1) STUDIES THIS RFPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)AND WRITES INSTRUCTIONS FOR THE NEXT DAY.






CASE SUPERVISOR

DATE




DA I LY R EPO R T FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME D TE

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

DAY 44


D

I U TU

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITHIN TAKEN








NUMBER HOURS OFSLEEP LAST NIGHT


BCOMPLEXE MG IU

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)





WHAT? HOW MUCH?

WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.

CONTINUED NEXT PAGE



PAGE 2


SWEATFD IN THE SAUNA TODAY:





(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED





(4) I ATTEST THAT I HAVE SUPERVISED TI IIS PC AND HIS TWIN TODAY ON THE


PURFCATONICDATE


CASE SUPERVISOR:







CASE SUPERVISOR

D TE




DAILY R EPORT FORMDAY 45

MUSL BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME DATE

TWIN'S

NAME

TIME STARTED

TODAYTIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OF

SALT TAKEN


D

U U

COMPLEXE

MG U

C B

MG MG


NIACIN

(MG)



AMOUNT OF

POTASSIUM TAKEN






TYPE OF FOOD OR DRINK?IF ANY REACTION TO THE NIACIN, WAS IT LESS





WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PHYSICAL CHANGES, REACTIONS,DISCOMFORTS, ETC. USE MORE PAP ER IF NEED ED .)

CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED







PURFCATONICDATE



CASE SUPERVISOR:


AND WRITES INSTRUCT IONS FOR THE NEXT DAY.


AND SENDS IT TO THE PURIF UC.


ACCORDING TO STANDARD TECI1, WITH NO VARIATIONS OR ADDITIVES.

CASE SUPERVISOR

D TE




DA I LY R EPORT FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

DAY 46


D

IU I U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITI LIN TAKEN







BCOMPLEXE MG I U

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)




THAN TI IF PREVIOUS DAY ON THE PROGRAM?


NUMBERIOURSOFANYOTHERVTAMNSTAKENTODAY?


HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONICDATE


CASE SUPERVISOR:








CASE SUPERVISOR

DAT E




DAI L Y R EPORT FO R MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN


NUMBE R OF GLASSES OFWATER YOU DRANK TODAY

NUMBER OF GLASSES OFCAL-MAC YOU DRANK TODAY



NUMBER HOURS OF

SLEEP LAST NIGHT


DATE

DAY 47


D

U I U

COMPLEXE

MG IU

C B

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN(MG)






WHAT? HOW MUCH?


CONTINUED NEXT PAGE



PAGE 2



WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY M ENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)



(PC SIGNAFURE)




PAGE 3

THIS SECTION FILLED







PURFCATONICDATE



CASE SUPER VISO R :






CASE SUPERVISOR

D TE




DA I LY RE P ORT FORMMUST BE FR I ED OUT AND TURNED IN TO THE PURIF I/C

NAME DATE

TWIN'S

NAME

TIME ST RTED

TODAY

MIME FINISHED

I ODAY

DAY 48


AD U U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITHIN TAKEN

AMOUNT OF

POTASSIUM TAKEN







COMPLEXE

MG U

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)

WHAT REACTION ( IF ANY) DID YOU GE TFROM THE NIACIN TODAY?







CONTINUED NEXT PAGE



PAGE 2



WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY M ENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS, ETC. USE MORE PAP ER IF NEEDED.)

ANY WINS OR REALIZATIONS IHAT OCCURRED?


(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED







TIONS OR ADDITIVES.

PURFCATONICDATE



CASE SUPERVISOR:

(1) STUDIES THIS REPORT (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)AND WRITES INSTRUCTIONS FOR THE NE XT DAY.






CASE SUPERVISOR

DATE




DAILY RE P ORT FORMDAY 49


NAME D TE

TWIN'S

NAME

TIME STARTED

TODAY


TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

T ST RT

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SALT TAKEN

AMOUNT OF

LECITHIN TAKEN

AMOUNT OF

POTASSIUM TAKEN







D

I U I U

BCOMPLEXE MG U

C(MG)

MULTI- MINERALS(TABLETS)

B)

(MG)

NIACIN

(MG)






NUMBEROURSOFANYOTHERVTAMNSTAKENTODAY?SLEEPLASTNGHTWHAT?HOWMUCH?




CONTINUED NEXT PAGE



P A CE 2







(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED


(1) ENSURES P C HAS FILLED OUT ALL POINTS ABOVE CORRECTLY:



FOR THE C/S:



PURFCATONICDATE



CASE SUPERVISOR:

(1) STUDIES THIS R E P O R T (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)




(3) ATTESTS THAT HE HAS STUDIED THIS DAILY REPORT AND WRITTENINSTRUCTIONS FOR THE PC'S NEXT DAY ON THE PURIFICATION RUNDOWNACCORDING TO STANDARD TECH, WITH NO VARIATIONS OR ADDITIVES.

CASE SUPERVISOR

DATE



SUCCESS STOR YPURIFIC TION RUNDOWN


N MED TE

WTNESSD TE

P lease hand in your successstory to the Purif I/C.



NOTICE












A. General Progress

1. Tell me about your progress so far on the rundow n.


B. Schedule

3. Are you on a regu lar daily schedule for doing the rundown?W hat is it? ( If not, find out w hy not.)













area?









to your knowledge?



adequate supply?)









daily?


the C/S daily?


the C/S daily?



down?

28. Have you noticed any mental or emotional changes or




31. Have you had a big win that hasn t been acknowledged?







G. Twin



make known?

H. Other


lowed while on the rundown? A re you following them e xactly?









42. Anything else that you'd l ike the C /S to know?

Qual Sec

Do a full inspection of the pc s Pu rification folder and P urif Run-down delivery area and personnel using the Troubleshooting the

P ur if ica tion Rundow n P c Checklist (HCOB 24 Oct. 85R).

Qual Sec



Qual Sec

Snr C/S studies the pc s Purification folder and the data gathered in

this interview and the ab ove inspection and writes crams to correct theoutnesses found.

Snr C/S




the Purif C/S.

Snr C/S


Purif I/C


pc's P urif folder.



IF YOU ARE NOT BEING DELIVERED A CORRECT STANDARD PURIFICATION




ROUTE T O: R EP ORTS OFFICERRELIGIOUS TECHNOLOGY CENTER

R eport of NonstandardPurification Rundown Delivery:

NAME DATE

HOME ADDRESS:

PHONE :










SIGNATURE



basket, or mail it direct to Reports Officer R el igious Technolog y Center, c/o





DA ILY R E P O R T F O RMMUST BE FILLED OUT AND TURN ED IN TO THE PURIF I /C

NAME DATE

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

DAY 50


D

PU U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT ATFINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SALT TAKEN

MOUNT OF

LECITHIN T KEN



WAFER YOU DRANK TODAY

NUMBER OF CLASSES OF




COMPLEXE

MG U

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN(MG)






HOURS/MINUI ES OF

RUNNING TODAY



CONTINUED NEXT PAGE



PAGE 2






I ATTEST TI-SAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME


(PC SIGNATURE)




PAGE 3





FOR THE C/S:



TIONS OR ADDITIVES.

PURFCATONICDATE



CASE SUPER VISO R :








CASE SUPERVISOR

DA 1 F




DA ILY R EPO R T FORMDAY 51

MUSE BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME DATE

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY


D

U U

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN








BCOMPLEXE MG U

C

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)





VEGETABLES EATENTODAY (TYPES AMOUNTS)

NUMBERHOURSOFANYOTERVTAMNSTAKENTODAY?SLEEPLASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OF

RUNNING TODAY



CONTINUED NEXT PAGE



PAGE 2


SWFATED IN THE SAUNA TODAY-




I ATTEST THAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN MEBY TI iE C/S IN DOING TFiE RUNDOWN TODAY.

(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED







PURFCATONICDATE


CASE SUPERVISOR:


AND WRITES INSTRUCT IONS FOR THE NEXT DAY.



(3) ATTESTS THAI HE HAS STUDIED THIS DAILY REPORT AND WRITTENINSTRUCTIONS FOR THE PC'S NEXT DAY ON TI IE PURIFICATION RUNDOWN


CASE SUPERVISOR

D TE




DA ILY R E P O RT FO RMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

I ODAY

TIME FINISHE

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGI IT

AT START

WEIGI IT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OFSALT TAKEN

AMOUNT OF

LECITI TIN TAKEN





CAL-R-IAG YOU DRANK TODAY

D TE

DAY 52


D

U U

BCOMPLEXE MG I U

CB

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)


ANYCRAVNGSFORANYFANYREACTONTOTHENACN WASTLESS

TYPE OF FOOD OR DRINK?THANTHEPREVOUSDAYONTHEPROGRAM?



HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



PAGE 2








(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED


(1) ENSURES PC HAS FILLED OUT ALL POINTS ABOVE CORRE CTLY:





PURFCATONICDATE



CASE SUPERVISOR:

(1) STUDIES THIS R E P O R T (ALONG WITH ANY OTHER NEEDED FOLDER STUDY)






CASE SUPERVISOR

D TE




DA ILY RE P O R T FORM

I

MUSI BE FIILED OUT AND TURNED IN TO THE PURIF I /C

N ME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGI IT

AT START

WEIGHT ATFINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN




DATE

DAY 53


D

U U

BCOMPLEXE MG IU

C B

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)

WHAT REACTION (IF ANY) DID YOU GETFROM THE NIACIN FORAY?

ANY CRAVINGS FOR ANY IF ANY REACTION TO THE NIACIN, WAS IT LESSTYPE OF FOOD OR DRINK? THAN THE PREVIOUS DAY ON THE PROGRAM?



NUMBFRHOURSOFANYOTHERVTAMNSTAKENTODAY?SLEEPLASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OF

RUNNING TODAY


CONTINUED NEXT PAGE



PAGE 2



WHAT DID YOU EXPERIENCE W HILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR P HYSICAL CHANGES,REACTIONS, DISCOMFORTS. ETC. USE MORE PAPER IF NEEDED.)



(PC SIGNATURE)




PAGE 3


1) ENSURES P HAS FILLED OUT ALL POIN IS ABOVE CORRECTLY:





PURFCATONICDATE



CASE SUPERVISOR:







CASE SUPERVISOR

DAT F




DA ILY RE P O R T FORMMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

N M

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ONPURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OFSALT TAKEN

AMOUNT OF

LECITHIN TAKEN









NUMBER HOURS OF

SLEEP LAST NIGHT

HOURS/MINUTES OF

RUNNING TODAY

DATE

DAY 54


D

I U IU

COMPLEXE

MG U

CB

MG MG


NIACIN

(MG)






WHAT? HOW MUCH?



CONTINUED NEXT PAGE



PAGE 2

AMOUNTOFTMEYOUHOURS MINUTES






(PC SIGNATURE;




PAGE

THIS SECTION FILLED




(3) ANY OBSERVATIONS OR DATA ABOUT PC'S PROGRESS ON THE RD TI TAT SHOULD BE NOTED

FOR THE C/S:



PURFCATONICDATE


OUT AND SEND THEM TO I HE CASE SUPERVISOR IN 1 HE PC'S FOLDER.

CASE SUPERVISOR:





ACCORDING TO STANDARD TECH, WITI I NO VARIATIONS OR ADDITIVES.

CASE SUPERVIS( )R

DA IE




DAILY R EPORT FORMMUSE BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

1IME STARTED

TODAY

I IME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGHT

AT START

WEIGHT AT

FINISH


AMOUNT OF

SALT TAKEN

AMOUNT OFLECITI UIN TAKFN








NUMBER HOURS OF

SLEEP LAST NIGHT

HOURS/MINUTES OF

RUNNING TODAY

DATE

DAY 55


D

I U IU

COMPLEXE

MG IU

C

MG MG

MULTI-MINERALS

(TABLETS)

NIACIN

(MG)

WI ]AT REACTION (IF ANY) DID YOU GET




WHAT? HON MUCH?



CONTINUED NFXT PAGE



PAGE 2



WHAT DID YOU EXPERIENCE WHILE SWEATING IN THE SAUNA? (NOTE ANY MENTAL OR PHYSICAL CHANGES,REACTIONS, DISCOMFORTS, ETC. USE MORE PAP ER IF NEEDED.)

ANY WINS OR REALIZATIONS I HAT OCCURRED?



(PC SIGNATURE)




NOTICE CONCERNING LENGTH

OF PURIFICATION RUNDOWN

Pc's Name

Purification C/S: Pc's Purification folder and Purif Rundown deliveryarea and personnel are to be closely inspected at this point for any out-tech

that may be causing an overextended rundown, using the Troubleshooting the

Purification Rundown Pc Checklist (HCOB 24 Oct. 85R). A thorough check

for exact tech application is to be done at this time.

Are there any points found in the inspection done per the

Troubleshooting the Purification Rundown Pc Checklist that re-

quire handling?

Purif C/S

On inspection of the pc's folder, is the pc making gainson the rundown?

Purif C/S

Are there any persisting bad indicators that have not been

handled?

Purif C/S

If the answer to any of the above is nonoptimum, a full

Folder Error Summary is done.

Purif C/S

Pc is programed for handling of errors found in the Folder

Error Summary.

Purif C/S

Program is approved (after study of the folder and Folder

Error Summary) by the Senior C/S, or amended as needed.

Sn r C/S

N eeded handlings are done to proper results.

Purif C/S

Pc is continued on the rundown (or sent to declare if

found to have com pleted).

Purif C/S

WHEN Ti ]IS FORM HAS BEEN FILLED OUT,TEAR IT OUT AND PLACE IN THE PC'S FOLDER.




DA I LY R E P O RT FO R MMUST BE FILLED OUT AND TURNED IN TO THE PURIF I/C

NAME

TWIN'S

NAME

TIME STARTED

TODAY

TIME FINISHED

TODAY

TOTAL TIME ON

PURIF RD TODAY

WEIGI IT

AT START

WEIGHT AT

FINISH

AMOUNT OF

OIL CONSUMED

AMOUNT OF

SALT TAKEN

AMOUNT OFLECITI LIN TAKEN








DATE

DAY 56


D

I U IU

COMPLEXE

MG U

C

MG MG


NIACIN

(MG)



IF ANY REACTION TO THE NIACIN, 1%AS IT LESS


NUMBERI OURSOFANYOTTERVTAMNSTAKENTODAY?SLEEPLASTNGHTWHAT?HOWMUCH?

HOURS/MINUTES OF

RUNNING TODAY

WHAT DID YOU EXPERIENCE WHILE RUNNING? (MENTAL CHANGES, PI IYSICAL CHANGES, REACTIONS,DISCOMFORTS, ETC. USE MORE PAPER IF NEEDED.)

CONTINUED NEXT PAGE



PAGE 2






I ATTEST TI iAT I HAVE FOLLOWED ALL INSTRUCTIONS EXACTLY AS GIVEN ME


(PC SIGNATURE)




PAGE 3

THIS SECTION FILLED





NOTICE TO THE PRECLEAR

You have now used the lastdaily report form in this book.If you have not yet completedthe rundown, please go to thebookstore or receptionist andpurchase another copy of thebook, so that you will haveproper forms for use in con-tinuing.

NOTICE TO PURIF I/C

This is the last daily report

form in this book . Once it isfilled out, send it to the C/Sand ensure that the pc ob tainsanother copy of this manual

so that he will have proper

forms to use in continuing therundown.



TIONS OR ADDITIVES.

PURFCATONICDATE


CASE SUPERVISOR:







CASE SUPERVISOR

D TE



(There are two copies of this form provided. Please use carbon paper.)

PC EXAMINATIONFORM FOR DECLARE OF COMPLETIONOF THE PURIFICATION RUNDOWN

Pc or Pre-OTNamDae

Qa DvTm

DO YOU HAVE ANY DOUBTS OR RESERVATIONS CONCERNING

ATTESTING TO COMPLETION OF THE PURIFICATION RUNDOWN?

WOULD YOU LIKE TO ATTEST TO COMPLETION OF THE PURIFICATION

RUNDOWN?

TA POSITION AND ANY BD PC INDICATORS

STATE OF NE EDLE

F/N INDICATED TO PC? EXAMINER

TEAR OUT THIS FORM AND PUT IT IN THE PC'S FOLDER.



(There are two copies of this form provided Please use carbon paper.)

ATTESTATION AT CERTSAND AWARDS

We are not concerned with handling bodies with the Purification Run-

down. Our concern is freeing th e individual up spiritually. The only dosages

recommended are those classified as food. There are no medical recommen-

dations or claims for it. The only claim is future spiritual improvement.

his data is released as a record of researches and results noted. It can-

not be construed as a recommendation of medical treatment or medication

and it is undertaken or delivered by anyone on his own responsibility.

I havingcompletedthe Purifica-

tion Rundown, do hereby attest by my signature below that I have, through

undergoing the actions of the Purification Rundown, achieved FREEDOM

FROM THE RESTIMULATIVE EFFECTS OF DRUGS AND TOXIC RESIDU-

ALS to my complete satisfaction.

This statement is made entirely on my own cognizance and without

reservation.

PRECLEARSGNATUREDATE

WITNESS, C A PURIFICATION I/CS NAME

TEAR OUT THIS FORM AND PUT IN THE PC'S FOLDER.



ATTESTATION AT CERTSAND AWARDS

We are not concerned with handling bodies with the Purification Run-

down. Our concern is freeing the individual up spiritually. The only dosages

recommended are those classified as food. There ate no medical recommen-

dations or claims for it. The only claim is future spiritual improvement.

This data is released as a record of researches and results noted. It can-

not be construed as a recommendation of medical treatment or medication

and it is undertaken or delivered by anyone on his own responsibility.

I havingcompletedthe Purifica-

tion Rundown, do hereby attest by my signature below that I have, through

undergoing the actions of the Purification Rundown, achieved FREEDOM

FROM THE RESTIMULATIVE EFFECTS OF DRUGS AND TOXIC RESIDU-

ALS to my complete satisfaction.

This statement is made entirely on my own cognizance and without

reservation.

PRECLEARSGNATUREDATE

WITNESS, C A PURIFICATION I/CS NAME

TEAR OUT THIS FORM AND FILE IN CERTS AND AWARDS FILES.




N MED TE

WTNESSD TE

Tear out this form and send

it to the Success O fficer



LIVE LIFE WITH CERTAINTY

"When we say that somebody should be in present time

we mean he should be in communication with his envi-ronment. We mean, further, that he should be in communi-cation with his environment as it exists, not as it existed."

L. Ron Hubbard

Upon successful completion of the Purification program you will

be free of the numbing effects of toxic residues from drugs and chemi-

cals. In this new state you will be at the point where you can take ac-

tion to restore your full awareness of the world around you and

sharpen your abilities to think clearly perceive and act with certainty.

The step for you to take after the Purification program is the

OBJECTIVESCoAWCowse

A Co-audit is a team of any two people who are helping each other

reach a better life with Scientology processing.

TRs (training regimens or routines ) are practical drills that put you

at cause over communication-he key to success in all human relation-

ships.

Objective Processing Objectives ) is a special program that puts you

in touch with and in control of the physical universe-including your

own body.

The TRs and Objectives Co-audit Course will put powerful tools in

your hands so you can restore your awareness of present time and live

a fuller more vibrant life

Learn how to operate better and more efficiently.

Become more aware of the world around you.

Gain control of your life

Contact the Registrar at the Church of Scientology and sign up for

the TRs and Objectives Co-audit Course NOW.



C H U RCH A ND

ORGA NI ZAT O N AD D R ESS L S T

Clearwater Florida 346 16 L o n IslandUnited States g

Church of Scientology Church of Scientology lbuquerque Flag Ship Service Organization 64 Bethpage RoadChurch of Scientology c/o Freewinds Relay Office Hicksville, New York 118018106 Menaul Blvd. N.E. 1 18 N . Fort Harrison AvenueAlbuquerque, New Mexico Clearwater Florida 346 1587110

Los Angeles and vicinity

Columbus Church of ScientologyA t l a n t a Church of Scientology 4810 Sunset BoulevardChurch of Scientology 30 North High Street Los Angeles California 900271611 Mt. Vernon Rd. Columbus Ohio 43215

Dunwoody, Georgia 3033 8

Church of ScientologyD a l l a s 1451 Irvine BoulevardAustin

f Church of Scientology Tustin, California 92680Church o Scientology2200 Guadalupe Celebrity Centre Dallas

Austin Texas 78705 1850 Buckner Boulevard Church of Scientology

1277 East Colorado BoulevardDallas Texas 75228

B a t t le C r e e k

Pasadena, California 91 106

Church of Scientology66 East Michigan Avenue Denver Church of ScientologyBattle Creek Michigan 49017 15643 Sherman Way

Church of ScientologyVan Nuys California 9140 6

Boston 3385 S. Bannock

Church of Scientology Englewood, Colorado 801 10 Church of Scientology448 Beacon Street

Boston Massachusetts 021 15 DetroitAmerican Saint Hill

Organization

BuffaloChurch of Scientology

1413 L Ron Hubbard Way321 Williams Street

Church of Scientology

Royal Oak Michigan 480 67Los Angeles, California 90027

836 M ain Street

Buffalo, New York 1420 2 Honolulu Church of Scientology

American Saint Hill FoundationChicago Church of Scientology

1413 L Ron Hubbard WaChurch of Scientology 1 148 Bethel Street

y

3009 North Lincoln Avenue Honolulu, Hawaii 968 13 Los Angeles, California 90027

Chicago Il linois 6065 7Kansas City Church of Scientology

Cincinnati Advanced Organization ofChurch of Scientology Los AngelesChurch of Scientology

215 West 4th Street 5th Floor3619 B roadway 1306 L . Ron Hubbard Way

Cincinnati, Ohio 4520 2 Kansas City, Missouri 641 11 Los Angeles, California 90027

Clearwater Las VegasChurch of Scientology

Church of Scientology Church of Scientology Celebrity Centre International

Flag Service Organization 846 East Sahara Avenue 5930 Franklin Avenue210 South Fort Harrison Avenue Las Vegas, Nevada 891 04 Hollywood, California 9002 8



L o s G a to s Phoenix Tampa

Church of Scientology Church of Scientology Church of Scientology

650 Saratoga Avenue 2702 N. 44th St, Suite A100 3102 N H avana Avenue

San Jose, California 951 17 Mesa, Arizona 850 38 Tampa, Florida 3360 7

Miami P o r t l a n dW ashington, DC

h h f l Founding Church of ScientologyChurch of Scientology urc Scientoo ogy

120 Giralda Avenue 708 S. West Salmon St. of Washington, DC

Florida 3313 4oral Gables Portland, Oregon 97205 1701 20 th Street N.W.

Washington, DC 2000 9Minneapolis

Church of Scientology Sacramento P uerto Rico

Twin C ities Church of Scientology Hato Rey1011 Nicollet Mall 825 15 th Street Church of S cientologyMinneapolis, Minnesota 5540 3 Sacramento, California 958 14 272 JT Piniero Avenue

Hyde P a rk Ha to R eyMountain View Salt Lake City

Puerto Rico 00918Church of Scientology Church of Scientology

117 E asy Street 1931 S 1100 East

Mountain View, California

Salt Lake City, Utah 84106 anada

94043 E d m o n t o n

N a s h v i l l e San Diego Church of S cientology10206 106th Street N.W.Church of Scientology Church of Scientology

Edmonton AlbertaCelebrity Centre Nashville 1330 4th Ave.

Canada T5J 1 H71907 Old Murfreesboro Pike San Diego, California 9210 1

Nashville, Tennessee 37217 Kitchener

San Francisco Church of S cientologyNew Haven 104 King St. West

Church of Scientology OntarioitchenerChurch of Scientology 701 Montgomery Street

Canada N2G 2K6909 W halley Avenue San Francisco, California 941 11New Haven, Connecticut 065 15 Montreal

New York City San Jose Church of S cientology4489 Pa ineau Street h f

Church of Scientology pScientourc o ogy

Montreal Quebec227 W est 46th Street 80 E . Rosemary

Canada H2H 1T7San Jose California 95112

New York City, New York

10036S a n t a a r b a r a

Ottawa

Church of Scientology Church of Scientology Church of S cientology

Celebrity Centre New York 524 State Street150 Rideau Street, 2nd Floor

65 East 82nd Street Santa Barbara CaliforniaOttawa, Ontario

New York City, New York 10028

93101Canada K1 N 5X6

Orlando Q u e b e cSeattle Church of S cientology

Church of Scientology

1830 East Colonial DriveChurch of Scientology 350 B d Chareste Est

2226 3rd Avenue Quebec, QuebecOrlando, Florida 32803

Seattle, Washington 98121 Canada G1 K 3H5

Philadelphia TorontoChurch of Scientology St. Louis Church of S cientology1315 Race Street Church of Scientology Yonge Street, 2nd FloorPhiladelphia, Pennsylvania 6901 Delmar Boulevard Toronto, Ontario

19107 University City, Mssouri 63130 Canada M4Y 2A7



Vancouver P l m o u t hFrance

Church of Scientology Church of Scientology401 West Hasting Street 41 Ebrington Street AngersVancouver British Columbia

Plymouth Devon Church of ScientologyCanada V6B 1 L5

England PL4 9AA 6, avenue Montaigne

Winnipeg 49100 Angers, France

Church of Scientology SunderlandClermont - Ferrand

315 Garry Street, Suite 210

Wi i M i bChurch of Scientology

Church of Scientologynn peg, an to a

Canada R3B 2G751 Fawcett Street 6, rue Dulaure

Sunderland, Tyne and Wear 63000 Clermont-Ferrand,

United Kingdom England SRI IRS France

Birmin h m Lyona AustriaCh h f S Church of Scientologurc entoc ogy

Viennay

Albert House, 3rd Floor 3, place des Capucins

24 Albert Street Church of Scientology 69001 Lyon, France

Birmin ham E n land B4 7UD Capistrangsasse, 4g gParis

1070 Vienna, AustriaBrighton Church of Scientology

Church of Scientology7 rue Jules CesarChurch of Scientology Celebrity Centre Vienna

Third Floor 75012 Paris, FranceSenefeldergasse 11/5

79-83 North Street 1100 Wien, Austria Church of ScientologyBrighton, England BN1 1Z A Celebrity Centre Paris

East GrinsteadBelgium 69, rue Legendre

75017 Paris, FranceChurch of Scientology B r u s s e l sSaint Hill Foundation Saint- Etienne

Church of ScientologySaint Hill Manor

6 1 rue du P rince RoyalChurch of Scientology

East G rinstead West Sussex

24 rue Marengo1 5 Bruxelles Belgium

England RH 19 4JY

42000 Saint-Etienne, France

Advanced Organization Denmark GermanySaint Hill

Saint Hill Manor AarhusB e r l i n

East Grinstead, West SussexChurch of Scientology Church of ScientologyEngland RH 19 4JY Vester AIIe 26 SponholzstraBe 51-52

Edinburgh800 0 Aarhus C, Denmark 12159 Berlin, Germany

Hubbard Academy of openhagen DusseldorfP e r s o n a l i n d e p e n d e n c e

Church of Scientology Church of Scientology20 Southbridge

Store Kongensgade 55 Friedrichstral3e 28Edinburgh Scotland EH1 1 L L

1264 Copenhagen K, Denmark 40217 Dusseldorf, Germany

L o n d o n Church of Scientology Church of Scientology

Church of Scientology Gamm el Kongevej 3-5, 1 Celebrity Centre Dusseldorf

68 Tottenham Court Road 1610 Copenhagen V, Denmark LuisenstraBe 23

London, England W1 P OBB 40215 Dusseldorf, GermanyChurch of Scientology

Manchester Advanced Organization Frankfurt

Church of Scientology Saint Hill for Europe and Africa Church of Scientology

258 Deansgate Jernbanegade 6 KaiserstraBe 49

Mancheste r, Eng land M3 4BG 1 608 Copenhagen V , D enmark 603 29 Frankfurt, Germany



e r n Syd ney Harare

Church of Scientology Church of Scientology Church of ScientologyMuhlemattstr. 31, Postfach 38 4 201 C astlereagh Street 404-409 Pockets Building

300 0 Bern 14, Switzerland Sydney, New South Wales 2000 50 Jason Moyo Avenue

Australia Harare ZimbabweGeneva

Church of Scientology Church of Scientology Johannesburg

12 rue des Acacias Advanced Organization Saint HillChurch of Scientology

1227 Carou eAustralia, New Zealand and

g et Houseth Floor BudGeneva Switzerland Oceania g

130 Main Street