NM_005188.3:c.1096-1_1096delinsTT is a canonical splice acceptor site variant in CBL, a gene in which loss of function is a well-established mechanism for Noonan syndrome-like/RASopathy disorders (PVS1 at very strong weight, per ClinGen SVI PVS1 framework PMC6185798).¹ The variant is absent from gnomAD v2.1, v4.1, and gnomAD-Canada population databases (allele frequency = 0), meeting PM2 at moderate strength (absent from population controls, below 0.1% threshold).² SpliceAI predicts strong disruption of the canonical splice acceptor site (max delta score 0.99, acceptor loss DS_AL=0.99). This splice prediction evidence is captured by PVS1 and is not separately scored as PP3 per PMC6185798 guidance against double-counting.³ The variant has not been reported in ClinVar, COSMIC, or in any publication identified through literature search. No functional studies, segregation data, or de novo reports are available. Multiple criteria (PS2, PS3, PS4, PM1, PM6, PP1, PP4) remain unassessed due to lack of evidence.⁴ Under ACMG/AMP 2015 generic combination rules (PMID:25741868), one very strong criterion (PVS1) plus one moderate criterion (PM2) supports classification as Likely Pathogenic.⁵