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DETAIL VIEW CHECKLIST, ^ <br /> Page 3 <br /> Claim No. Jr IClaimant Name: <br /> r <br /> QCl) A' O <br /> DATE ACTION/RESPONSE <br /> i <br /> Af <br /> / -ziy <br /> i <br /> l/ Z-�9 Z5- _ <br /> I /Z6 J <br /> I <br /> I i <br /> I <br /> Continued on Reverse <br /> � i <br /> I <br /> a ' <br /> ii Claimant in Corrective Action Compliance � <br /> II <br /> Claimant NOT in Corrective Action Compliance at the Time of this Review-90 Day Letter Required <br /> i <br /> r7Claimant NOT in Corrective Action Compliance-Recommend Rejection <br /> a /—7 <br /> LEA))-,�GENCIIJIGNATURE DATE li <br /> I <br /> CLAIMS REVIEWER SIGNATURE DATE <br /> i <br /> I� <br /> USTCF025.DET. (Rev. 1/95) <br />