TN 37 (03-03)

A. BACKGROUND

The servicing field offices are responsible for re-certifying continuing eligibility of each fee for service payees within the specified timeframes.

When requesting re-certification information for the site visits or mail-in reviews, the FO’s will use this letter with the language specified.

B. EXHIBIT LETTER

This is a very important letter in connection with your organization’s status as a “Fee-for-Service” representative payee. We must re-certify all fee for service organizations periodically to ensure they continue to be in compliance with statutory requirements to act in that capacity. Our records show that (1) is now scheduled for the re-certification.

Optional Paragraph 1

For site visit certifications:

We have set up an appointment to visit your office on (2)

between the hours of (3). During this visit, we will be reviewing the following documentation to ensure that you continue to qualify as a Fee-for-Service organizational payee:

(4)

Please have these documents available for our review.

Fill-Ins

1. Name of organizational payee

2. Date of appointment

3. Hours of appointment, format “time and time”

4. List of items needed such as bond, license, list of beneficiaries served, and any other documentation the reviewers may deem necessary to perform the review.

Optional Paragraph 2

For mail-in certifications:

We need the following information from you in order to conduct this review. Please mail all the items listed below, as of (1)

Things we need:

(2)

We must see the original document(s) or a certified copy of this item(s). We cannot accept photocopies. We will return these items to you.

We must receive the above documentation in this office no later than (3). If we do not receive the aforementioned information by the due date, we may have to cancel your authorization to collect a fee for payee services.

Fill-ins

1. Date showing period of review or date of last certification

2. List of items needed such as bond, license, list of beneficiaries served, and any other documentation the reviewers may deem necessary to perform the review

3. Give close-out date.

If you have any questions or any scheduling conflicts, please contact us at the address and phone number listed above, and ask for (Name of reviewer).

Signature,

District Manager,