I-4-1-98.Exhibit - Request for Recording Audit

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

REQUEST FOR RECORDING AUDIT

____________________________
(CLAIMANT)

_____________________________
(SOCIAL SECURITY ACCOUNT NUMBER)

______________________________
(NO. PGS. IN TRANSCRIPT)

______________________________
(DATE)

TO :

Contracts Staff

THRU :

Operations Supervisor _____________________ CCPRB ______

FROM :

_____________________ ROOM _________ (NAME OF TECHNICIAN)

SUBJECT :

Request for Recording Audit

The attached case requires a recording audit for the following reason(s):

_______ Inaudibles or Unintelligibles on page(s) ___________ only.

_______ Expert witness testimony contains inaudibles.

_______ Transcripts contains _________ inaudibles and/or unintelligibles.

_______ Transcript includes blanks or indication of equipment malfunction on page(s) ______.

_______ Testimony lacks continuity on page(s) ____________.

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_______ Case to be returned to me for completion.

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HOT

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EXPEDITE

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