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1. LAST NAME, FIRST NAME, MIDDLE INITIAL 2.

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THIS IS A WORK OF FICTION
PERSONAL DATA
1. LAST NAME, FIRST NAME, MIDDLE INITIAL 2. PROFESSION (RANK IF APPLICABLE)
3. EMPLOYER 4. NATIONALITY
5. SEX 6. AGE AND D.O.B. 7. EDUCATION AND OCCUPATIONAL HISTORY
STATISTICAL DATA
8. STATISTICS SCORE ×5 DISTINGUISHING FEATURES
Strength (STR)
Constitution (CON)
Dexterity (DEX)
Intelligence (INT)
Power (POW)
Charisma (CHA)
9. DERIVED ATTRIBUTES MAXIMUM CURRENT
Hit Points (HP)
Willpower Points (WP)
Sanity Points (SAN)
Breaking Point (BP)
10. PHYSICAL DESCRIPTION
F M
PSYCHOLOGICAL DATA
11. BONDS SCORE
12. MOTIVATIONS AND MENTAL DISORDERS
13. INCIDENTS OF SAN LOSS WITHOUT GOING INSANE
APPLICABLE SKILL SETS
Accounting (10%)
First Aid (10%)
Ride (10%)
Alertness (20%)
Forensics (0%)
Science (0%):
Anthropology (0%)
Heavy Machinery (10%)
Archeology (0%)
Heavy Weapons (0%)
Search (20%)
Art (0%):
History (10%)
SIGINT (0%)
HUMINT (10%)
Stealth (10%)
Artillery (0%)
Law (0%)
Surgery (0%)
Athletics (30%)
Medicine (0%)
Survival (10%)
Bureaucracy (10%)
Melee Weapons (30%)
Swim (20%)
Computer Science (0%)
Military Science (0%):
Unarmed Combat (40%)
Craft (0%): Unnatural (0%)
Navigate (10%) Foreign Languages and Other Skills:
Criminology (10%)
Occult (10%)
Demolitions (0%)
Persuade (20%)
Disguise (10%)
Pharmacy (0%)
Dodge (30%)
Pilot (0%):
Drive (20%)
Firearms (20%)
Psychotherapy (10%)
Check a box when you attempt to u
se a skill and fail. After the session, add 1D4−1 to each checked skill and erase all checks.
Violence adapted Helplessness adapted
THIS IS A WORK OF FICTION
INJURIES
14. WOUNDS AND AILMENTS
Has First Aid been attempted since the last injury? yes: only Medicine, Surgery, or long-term rest can help further
EQUIPMENT
15. ARMOR AND GEAR
Body armor reduces
the damage of all attacks except Called Shots and successful Lethality rolls.
16. WEAPONS SKILL % BASE RANGE DAMAGE ARMOR PIERCING
LETHALITY %
KILL RADIUS AMMO
(a)
(b)
(c)
(d)
(e)
(f)
(g)
REMARKS
17. PERSONAL DETAILS AND NOTES 18. DEVELOPMENTS WHICH AFFECT HOME AND FAMILY
19. SPECIAL TRAINING SKILL OR STAT USED
Please indicate why this agent was recruited and why the agent agreed to be recruited.
20. AUTHORIZING OFFICER 21. AGENT SIGNATURE
112382DD 315
TOP SECRET//ORCON//SPECIAL ACCESS REQUIRED-DELTA GREEN
AGENT DOCUMENTATION SHEET
UNITED STATES
FORM
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Completed 7 May 2021

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