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2011 Video Survey

1. Video Survey Race 1

Ellis Park 8/30/2009 Race 1

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* 1. Was there an incident in this race requiring an inquiry?

No. (Proceed to next race on next page)

Yes. (Complete the following questions below)

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* 2. Where did the incident(s) occur?

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* 3. Explanin what occurred and identify the participants involved.

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* 4. Did the incident warrant a disqualification/placing?

No. (Continue to question 5)

Yes.

If YES, Explain and Provide new order of Finish

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* 5. Will there be a penalty?

No

Yes

Explain your answer

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* 6. What is the applicable rule in your jurisdiction?