I-4-4-105. Exhibit - Court Case Route Slip

[ ] EXCEPTIONS RECEIVED

[ ] FAVORABLE DEC. SAMPLE CASE

RE

(SSN)

FINAL AC ACTION

INTERMEDIATE

OTHER

[ ] DECISION

[ ] FAV UNF FF

[ ] REMAND

[ ] NOTICE DECLIN. TO TAKE JURIS.

[ ] PROPOSED DECISION

[ ] PROPOSED REMAND

[ ] MSS REF

[ ]

[ ] LETTER/MEMO

[ ] OTHER/NAN

ROUTING

ROOM

BLDG

INT

REMARKS

FROM

DATE

PHONE

BRANCH

ROOM