National Review's document, unsurprisingly, is a scan of a color document. How do we know? Because if you simply pull it up in your web browser (which will open the embedded Acrobat Reader) and zoom it up, you will see this:
Note the chromatic aberration. This document is in fact a color scan. And here is a blown-up piece of the so-called "scan" of Obama's document:
Note the absence of chromatic aberration. The Obama White House document is not an unaltered color scan.
Alright...all you have to know about this fraud of a birth certificate you can find in the "Links" window in Adobe Illustrator. Here is a screen cap I got from the info of the background (green layer) of the BC:
Notice the H,V scaling data: this background was scaled to 48% of its original size in the Horizontal and Vertical axes. Now, here is the links data from the black and white "text" overlay:
Notice the H,V scaling data in this link: 24% in H,V of original image. Therefore, if you were to know nothing else about this document, you would know that these two images are from two completely different scans, as it would be impossible to have two different scaling rates from a single scanned document that matched up the way these do in the final composite. Now, as to whether the document was altered in any way: you can find further proof that it was if you open the "Actions" window in Illustrator that saves a history of what was done to the document. Here is that window:
Therefore, was this document altered? You're damn right it was.