I-3-0-96. Exhibit – Claim File Search Checklist

Last Update: 9/08/05 (Transmittal I-3-36)

CLAIM FILE SEARCH CHECKLIST

Name          ______________________

SSN     ___________________________

Claim Type ______________________

X-Ref ____________________________

Application Date __________________

Request for Review Date ___________

Hearing Decision Date _____________

RR Timely Yes            No

The Disability Program Branch of the Office of Appellate Operations has attempted to locate this claim folder; however, we are unable to locate it at this time.

Signature_______________________________________ Date _____________________