, 28 U.S.C. 2871 et seq., 28 C.FA Part 14. 8. Principal Purpose: The information requested is to be used in evaluating claims. C. Routine Use: See the Notices of Systems of Records for the agency to whom you are submitting this form for this information. D. Effect of Failure to Respond Disclosure is voluntary. However, failure

S.C. 2671 et seq., 28 C.F.R. Part 14. ACT NOTICE B. MindedPurpose: The inky:nolo° requested iv to be used In evaluating dolma C. Routine Use: See the Notices of Systems of Records la the agency to whom you am sulanttelig IMP:Int& thiS Information. 0. Med of Feeure to Raspier!: (Mclean is voluntary. However. faro to supply ale