Company_____________________________	Concur________	Concur w Comment	________	Non-Concur  ______		

Section/
Line #	Comment
Type*	Comment(Please Type in Box)	Suggested Change	Disposition(By D,M&M WG)	

					

Section/
Line #	Comment
Type *	Comment(Please Type in Box)	Suggested Change	Disposition(By DM&M WG)