I-2-6-95.Sample - Front of Cassette/CD Storage Envelope

Last Update: 9/2/05 (Transmittal I-2-64)

FRONT OF CASSETTE STORAGE ENVELOPE

Claimant's Name __________________ Claim Number __________________

Date and Time __________________ City _____________________________

ALJ __________________________ HA ______________________________

Claimant Represented by ___________________________________________

Witnesses _________________________, _____________________________

Cassette [CD] No._____ of _____

0 Identification of Case

0

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- Opening Statement by ALJ

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- CL re-exam by ALJ

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- CL re-exam by Atty

5

5

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- Exhibits 1-22 received

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- Exhibit 23 received

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10

10 Witnesses Mrs. Jane Roe

- CL Sworn Exam by ALJ

- Sworn and exam by ALJ

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15

15

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20

20

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- Mrs. Jane Roe exam by Atty

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25

25

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30 Exam by Atty

30

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- Hearing recessed

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35

35

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40

40

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45

45 Continued to Cassette #2

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