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ALL INFORMATION CONTAINED . FD-97 (Rev. 1-28-99) HEREIN IS UNCLASSIFIED ° “ DATE lz2-15-2005 BY 60324 uc baw/r POLYGRAPH EXAMINATION Wo ‘SHEET Examination Date 2/28/02 Case ID # 279A-WE-222936 Examinee Name (Last, First, Middle) Ivins, Bruce Edwards Date of Report 3/4/02 Location of Examination bG Ft.Detrick, MD (USAMRID) bIC Date of Birth Place of Birth 4/22/46 Cincinnati, Ohio HT WT Sex Age SSN Marital Status * 5'10" 155 M 55 280-44-5449 Married Current Address ee Phone Number None xamination Retest oO Yes I No Education (Total Years 20 ) (Degrees Obtained) P. hd Microbiology University of Cincinnati 1976 M.S. Microbiology University of Cincinnati 1971 Employment/Military Research Microbiologist US Army Fort Detrick - (USAMRID) Since 1980 Health/Medication b6 bic b7E Arrests/Convictions . j No Arrests/convictions Dae 2/28/02 Timein 12:00 A TimeOuw 12:30 P Date Time In Time Out bIE Date Time In Time Out ZOC Pot Other Total Number of Series Number of Charts b7E Instrument Type es eee Serial Number | | Examination Results Series | {| Series I] Series [ll . Series [V Series V Additional Information Obtained? [[] Yes {X] No Pre-Test Admission (_] Pre-Test Confession = [[] Post-Test Admission [7] Post-Test Contession [7] Comments