Appendix A is not like a "model" form incorporated into a consumer protection law. FinCEN did not, in so many words, guarantee that its use would constitute compliance.
Yet, if Appendix A requires six pieces of information and your form includes those six plus one more it would be pretty much impossible for a third party to criticize. The fact that FinCEN produced two examples that show some diversity in their formatting should eliminate any argument that the form has to have a certain appearance or layout.
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In this world you must be oh so smart or oh so pleasant. Well, for years I was smart. I recommend pleasant.