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You may wish to remove this sample answer document from the booklet to use in a practice test session for the four multiple choice tests Cut Here PLEASE DO NOT WRITE IN THIS AREA BACD E 1 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z A B C D E F G H I J K L M N O P Q R S T U V W X Y Z EXAMINEE STATEMENT CERTIFICATION AND SIGNATURE 1 Read the following Statement By submitting this answer folder I agree to the terms and conditions set forth in the ACT registration booklet or website for this exam including the arbitration and dispute remedy provisions I understand that ACT owns the test questions and responses and affirm that I will not share any test questions responses or essay topics with anyone by any form of communication I understand that assuming anyone else s identity to take this test may violate the law and be subject to legal penalty 2 Copy the Certification shown below only the text in italics on the lines provided Write in your normal handwriting Certification I agree to the Statement above and certify that I am the person whose name and address appear on this form 3 Sign your name as you would any official document and enter today s date Your SignatureToday s Date 2012 by ACT Inc All rights reserved 18097011 215 13W Rev 1IM A 188616 001 654321Printed in U S A NAME MAILING ADDRESS AND TELEPHONE Please print USE A SOFT LEAD NO 2 PENCIL ONLY Do NOT use a mechanical pencil ink ballpoint correction fluid or felt tip pen Last NameFirst NameMI Middle Initial House Number or PO Box or RR No CityState ProvinceZIP Postal Code Area CodeNumberCountry Yes I am testing as a standby DATE OF BIRTH MonthDayYear Jan Feb March April May June July Aug Sept Oct Nov Dec The ACT PLUS WRITING 2012 2013 Answer Folder MATCH NUMBER PAGE 1 STANDBY TESTING Fill in the oval below ONLY if you are testing standby today ACT Inc Confidential Restrict ed when data present ALL examinees must complete block A please print Blocks B C and D are required for all examinees Find the MATCHING INFORMATION on your ticket or standby document Enter it EXACTLY the same way even if any of the information is missing or incorrect Fill in the corresponding ovals If you do not complete these blocks to match your previous information EXACTLY your scores will be delayed up to 8 weeks Block E Fill in the oval ONLY if you are testing standby today Do NOT mark in this shaded area MATCH NAME First 5 letters of last name 73 18263 Preparing ACT 2012 13 5003 AAP Prep for ACT 6 8 12 9 35 AM Page 73 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 5 6 7 8 9 0 A F A F A F A F A F A F A B G B G B G B G B G B G B C H C H C H C H C H C H C D J D J D J D J D J D J D A F A F A F A F A F B G B G B G B G B G C H C H C H C H C H D J D J D J D J D J E K E K E K E K E K A F A F A F A F A F B G B G B G B G B G C H C H C H C H C H D J D J D J D J D J E K E K E K E K E K A F A F A F A F A F B G B G B G B G B G C H C H C H C H C H D J D J D J D J D J E K E K E K E K E K A F A F A F A F A F B G B G B G B G B G C H C H C H C H C H D J D J D J D J D J E K E K E K E K E K A F A F A F A F A F B G B G B G B G B G C H C H C H C H C H D J D J D J D J D J E K E K E K E K E K A F A F A F A F A F B G B G B G B G B G C H C H C H C H C H D J D J D J D J D J E K E K E K E K E K F A F A F A F A F A F A F G B G B G B G B G B G B G H C H C H C H C H C H C H J D J D J D J D J D J D J A F A F A F A B G B G B G B C H C H C H C D J D J D J D F A F A F A F G B G B G B G H C H C H C H J D J D J D J A F A F A F A B G B G B G B C H C H C H C D J D J D J D F A F A F A F G B G B G B G H C H C H C H J D J D J D J A F A F A F A B G B G B G B C H C H C H C D J D J D J D F A F A F G B G B G H C H C H J D J D J A F A F A F A B G B G B G B C H C H C H C D J D J D J D F A F A F A F G B G B G B G H C H C H C H J D J D J D J A F A F A F A B G B G B G B C H C H C H C D J D J D J D F A F A F A F G B G B G B G H C H C H C H J D J D J D J A F A F A F A B G B G B G B C H C H C H C D J D J D J D F A F A F G B G B G H C H C H J D J D J A F A F A F A F A F A F A B G B G B G B G B G B G B C H C H C H C H C H C H C D J D J D J D J D J D J D F A F A F A F A F A F A F G B G B G B G B G B G B G H C H C H C H C H C H C H J D J D J D J D J D J D J A F A F A F A F A F A F A B G B G B G B G B G B G B C H C H C H C H C H C H C D J D J D J D J D J D J D F A F A F A F A F A G B G B G B G B G B H C H C H C H C H C J D J D J D J D J D Incorrect marks Overlapping mark Cross out mark Smudged erasure Mark is too light 62C 62E 64B 64C 64D 64F 65F 66D 67D 68B 68D 68E 69B 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