Rules of Practice and Procedure effective September 15, 2011 - page 74

C
UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS
N
OTICE OF
A
PPEARANCE
,
OAppellant,
OPetitioner,
v.
Docket No. ___________
Secretary of Veterans Affairs , Appellee / Respondent.
1. Please enter my appearance for O the appellant or petitioner
O the Secretary
O the intervenor
O amicus curiae:_____________________________
2. I am:
O
admitted to practice before this Court as: O attorney O non-attorney practitioner
O
awaiting admission to practice; my application was submitted on (date) ________
O
seeking to appear in this case only, under Rule 46(b)(1)(F); my motion is attached.
3. I am:
O
the lead representative of record. I will accept service for the party and will inform
all of the party's co-representatives of matters served upon me.
O
not the lead representative of record, but am joining as co-representative.
O
replacing the lead representative of record, who:
O
has been permitted or is seeking to withdraw.
O
remains as co-representative.
4. If I am representing the appellant, petitioner, or intervenor, my representation is:
O
pursuant to the attached fee agreement. If the fee agreement provides for direct
payment out of past-due benefits under 38 U.S.C. § 5904, a copy has been served
on counsel for the Secretary. If the fee agreement provides for a contingent fee, it
also provides for an offset of any fees awarded under the Equal Access to Justice
Act (EAJA), 28 U.S.C. § 2412(d).
O
without charge to the appellant, petitioner, or intervenor; however it is subject to the
attached retainer agreement.
O
pursuant to the fee/retainer agreement already on record in this case.
_________________________________ ___________________
Signature Date
________________________________ _________________________________
Printed name Veterans Service Org., if R. 46(a)(2)(B) applies
_____________________________
________________________________ __________________________________
Signature and printed name and address of
_______________________________ supervising attorney, if R. 46(a)(2)(A) applies.
Address
_______________________________ ___________________________________
Telephone number Email address
Attachments: [ ] Application and motion to appear under Rule 46(b)(1)(F)
[ ] Fee agreement [ ] Retainer agreement
Form 3
( Rev 11-14)
1...,64,65,66,67,68,69,70,71,72,73 75,76,77,78,79,80,81,82,83,84,...88
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