I-4-2-100.Exhibit - Analysis of Request for Voluntary Remand

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

ANALYSIS OF REQUEST FOR VOLUNTARY REMAND

TO: AAJ

FROM: Hearings and Appeals Analyst
[Branch], Phone [User keys in number]

CLAIMANT: [Claimant Name]

SSN: [SSN]

CIRCUIT: [User keys in Circuit]

COURT: [User keys in abbrev.]

CLAIM TYPE: [User keys in claim type(s)]

1

This analysis is required by a memo dated [User keys in date] from [User chooses only one: a. OGC Answer Section b. OGC, Baltimore c. Regional Counsel, Region [User keys in Number].

RECOMMENDATION:

2

[User keys in analysis]

3

Please indicate if you

AGREE _______________ DISAGREE _______________

__________________________________ _________________

Administrative Appeals Judge                               Date