I-2-6-93.Exhibit – Deposition Transcript

TRANSCRIPT

Deposition of______________________________________________________________
(Name)

Taken at
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
(Address)

Taken on
________________________________________________________________________

(Month, Day, Year)

APPEARANCES: (List Names

___________________________________________________

___________________________________________________

___________________________________________________

___________________________________________________

(continues next page)

The following is a transcript of the deposition of _____(name)_____ , taken by (name), Administrative Law Judge, of the Office of Hearings Operations, Social Security Administration, on (date), at (city and State), in the case of (name), claimant and wage earner, who claims disability insurance benefits on Social Security number __________________ . Notice of the time and place of taking the deposition was given to all parties in the case. The claimant, (name), was not present at the taking of the deposition which commenced at (time), on (date).

(Transcribe verbatim the Administrative Law Judge's opening statement.)

(name) , having been duly sworn, testified as follows:

EXAMINATION BY THE ADMINISTRATIVE LAW JUDGE

Q.____________________________________________________________________

____________________________________________________________________

A.____________________________________________________________________

____________________________________________________________________

(A complete verbatim transcript of all the testimony.)

(The testimony was completed at (hour), (date).)

I have read the foregoing and hereby certify that it is a true and complete record of the questions and answers constituting the examination of the witness.