I-1-7-90.Exhibit - Sample Court Case Flag/Alert

REVIEW  PSC  DOC  TOE  ALERT DATE  RESPONSE DATE  OLD BOAN/PAN

OFFICE

SSN (BOAN OR PAN)     NAME    BIRTH DATE       EFERENCE #

                      FOLDER LOCATION INFORMATION

CAN/HUN    BIC/MFT     CATG   TITLE   SITE   COMP DATE   ACN

PAYEE ADDRESS

ALL CLAIM FILE(S) SHOULD BE SHIPPED TO THE FOLLOWING ADDRESS FOR SCREENING:

Social Security Administration
Office of Appellate Operations
Attn: Executive Director's Officer, Class Action Coordinator
6401 Security Blvd
Baltimore, MD 21235-6401

(Case Locator Code Y46)

IF UNABLE TO LOCATE THE CLAIM FILE(S), FORWARD A RECONSTRUCTION REQUEST TO THE SERVICING FIELD OFFICE.

*NOTE: A separate screening sheet must be prepared for each CAN/HUN printed above.