UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS NOTICE OF APPEARANCE , v. Secretary of Veterans Affairs 1. [ ]Appellant, [ ]Petitioner, Docket No. , Appellee / Respondent. 2. Please enter my appearance for [ ] the appellant or petitioner [ ] the Secretary [ ] the intervenor [ ] amicus curiae: . I am: [] admitted to practice before this Court as: [ ] attorney [ ] non-attorney practitioner [] awaiting admission to practice; my application was submitted on (date) [] seeking to appear in this case only, under Rule 46(b)(1)(F); my motion is attached. I am: [] [] [] 3. 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. not the lead representative of record, but am joining as co-representative. replacing the lead representative of record, who: [ ] has been permitted or is seeking to withdraw. [ ] remains as co-representative. 4. If I am representing the appellant, petitioner, or intervenor, my representation is: [] 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 and expenses awarded under the Equal Access to Justice Act (EAJA), 28 U.S.C. § 2412(d). [] without charge to the appellant, petitioner, or intervenor; however it is subject to the attached retainer agreement. [] pursuant to the fee/retainer agreement already on record in this case. /s/ Signature Printed name Date Veterans Service Org., if R. 46(a)(2)(B) applies. ______________________________________ Address Signature and printed name and address of supervising attorney, if R. 46(a)(2)(A) applies. Telephone number Attachments: [] [] Email address Application and motion to appear under Rule 46(b)(1)(F) Fee agreement [ ] Retainer agreement Form 3 (Rev 11-14) American LegalNet, Inc. www.FormsWorkFlow.com