NL: Notices, Letters and Paragraphs
TN 30 (03-96)
Document Identifier for Word Processor: E3356
A. EXHIBIT LETTER
We are writing to tell you about extra money we are sending you for (1) .
What We Will Pay and When
(2) is due $(3) . This is the money that the last representative payee saved for (4) and returned to us.
You will get this money over a period of months.
We will send you $(5) each month in addition to the regular check you already get for (6) .
These checks will start (7) and end when all of the extra money is paid to you.
| 3350A | It Is Important To Keep Track of This Money |
| You will need to keep track of how you use all of the money we send you for (1) . That is because every year we will ask you to report on how you used the money. We call this a representative payee accounting. |
If You Have Any Questions
3901C - Domestic
3901D - Foreign
B. REQUESTING INSTRUCTIONS
Send when the conserved amount returned by the former payee is paid to the new representative payee in monthly installments.
Fill-ins:
Full name of beneficiary in the format, Joan Sands
First name of beneficiary if child; if adult, “Mr.” or “Ms.” last name of beneficiary
amount returned by the former payee
him, her
amount of each monthly installment
him or her
-
month, day, year the first installment will be paid in the format, August 10, 1992
Optional Paragraph 3350A:
Beneficiary's first name, if child; if adult, “Mr.” or “Ms.” with last name
Use paragraph 3350A when the type of payee code (TYP) is not SLM.
See NL 00703.005E. for 3901C and D text and fill-in.
C. TYPING INSTRUCTIONS
Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Information for this notice will be shown on Form SSA-573.