Notice of Appearance

• Legal Form Number: 3
• Court: United States Court of Appeals For Veterans Claims
• Section: Court of Appeals for Veteran Claims

UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS

NOTICE OF APPEARANCE

, [ ]Appellant,

[ ]Petitioner,

v. Docket No.

Secretary of Veterans Affairs , Appellee / Respondent.

1. Please enter my appearance for [ ] the appellant or petitioner

[ ] the Secretary

[ ] the intervenor

[ ] amicus curiae: .

2. I am:

[ ] admitted to practice before this Court as: [ ] attorney [ ] non-attorney practitioner

[ ] seeking to appear in this case only, under Rule 46(b)(1)(F); my motion is attached.

3. I am:

[ ] 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) in the event the Court awards VA benefits on the claim.

[ ] 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 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 02-20)