I-4-1-91.Exhibit - Sample Annotated Exhibit List — Non-Six Part Folder

Last Update: 9/13/05 (Transmittal I-4-15)

LIST OF EXHIBITS

Claimant:                     [Claimant Name]                               SSN:             [SSN]

[Cross-ref Name:]       [Xname]                                            [Xref SSN:] [XSSN]

 

Exh. No.                           Description                                                           No. of Pages

 

[Exh No.]                           [Description of Exhibit]                                         [No. of Pages]

 

     [Each subsequent page displays the same heading as above]