DOJ-OGR-00007208.jpg

The image is a scanned document with printed text on it. The text appears to be a list of questions or statements under various headings such as "21" and "22". There are also sections titled "Explanatory Notes", "Instructions for Completing Form 3567-X", and other sections with subheadings like "22.b" and "Explanation of Questions". The text is dense and the quality of the scan is a bit grainy. There are no images or graphics visible in the document.