Title: AMDISA Screen five . Description: This represents a screen shot of AMDISA screen five appeals information. Line 1 consist of AMDISA, 12 X’s, 1 space, literal MFT, 1 space, 2 X’s, 2 spaces, literal TX-PRD, 1 space, 6 X’s, 1 space, literal *PLAN- RPT- NUM, 1 space, 3 X’s, 3 spaces, literal NM-CTRL, 1 space, 4 X’s and literal *PDT*. Line 2 consist of literal PRIMARY-NAME, 1 space, 35 X’s, 15 spaces, literal JULIAN-DT, Line 3 consist of 26 spaces, literal *APPEALS SECTIONS* and 37 spaces. Line 4 consist of literal APPL-CD, 1 space, 3 X’s, 28 spaces, literal PRIOR-APPL-CD, 1 space, 3 X’s and 24 spaces. Line 5 consist of literal APPL-CLOSING-CD, 1 space, 2 X’s, 1 space, 18 X’s, 2 spaces, literal APPL-TRANSFER-DT, 1 space, 2 X’s, forward slash, 2 X’s, forward slash 4 X’s, and 14 spaces. Line 6 consist of literal APPEALS-RESULTS-AMT, 1 space, dollar sign, 2 X’s, coma, 3 X’s, coma, 3 X’s, coma, 3 X’s, minus sign, 4 spaces, literal COUNSEL-RESULTS-AMT, 1 space, dollar sign, 2 X’s, coma, 3 X’s, coma, 3 X’s, coma, 3 X’s, minus sign, 3 spaces . Line 7 consist of literal APPL-ADJ-AMT, 1 space, dollar sign, 2 X’s, coma, 3 X’s, coma, 3 X’s, coma, 3 X’s, minus sign and 51 spaces. Line 8 consist of literal CNSL-ADJ-AMT, 1 space, dollar sign, 2 X’s, coma, 3 X’s, coma, 3 X’s, coma, 3 X’s, minus sign and 51 spaces. Line 9 consist of literal APPL-GRADE, 1 space, 1 X, 7 spaces, literal APPL-TIME, 1 space, 4 X’s, 1 space, 1 X, 9 spaces, literal CNSL-GRADE, 1 space, 1 X, 9 spaces, literal CNSL-TIME, 1 space, 4 X’s, 1 space and 1 X. Line 10 consist of literal APPL-CLAIM-AMT, 1 space, dollar sign, 3 X’s, coma, 3 X’s, coma, 3 X’s, minus sign and 52 spaces. Line 11 consist of literal APPL-CLAIM-AMT, 1 space, dollar sign, 3 X’s, coma, 3 X’s, coma, 3 X’s, minus sign and 52 spaces. Line 12 consist of literal EXAM-CLAIM-AMT, 1 space, dollar sign, 3 X’s, coma, 3 X’s, coma, 3 X’s, minus sign and 52 spaces. Line 13 consist of literal APPL-EXTRACT-PRD, 1 space, 6 X’s, and 58 spaces. Lines 14-22 are blank. Line 23 consist of 57 spaces, literal *PCC, 1 space, 2 X’s, 1 space, 4 X’s, 1 space, literal SC, 1 space, 2 X’s, 1 space and 4 X’s, Line 24 consist of literal EMP, minus sign, pound sign, 10 X’s, 1 space, literal PAGE, 1 space, 005, literal OF, 1 space, 007, 1 space, literal NEXT PAGE XX and 36 spaces.