Notice of Appearance

Legal Form Number3
CourtUnited States Court of Appeals For Veterans Claims
SectionCourt 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)

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