#### Answer

See picture.

#### Work Step by Step

First, fill out the T/F values for the statement variables. Second, fill out the T/F values for increasing levels of complexity (one operation at a time). Finally, when you can determine the T/F value of the original statement form solely by observing the T/F values of the previous columns, create that column and fill in the values accordingly. Note that a statement form with $n$ statement variables will require $2^{n}$ columns.