NL: Notices, Letters and Paragraphs
TN 23 (12-17)
COPC01 Caption
Other Information
COPD01 Dictated Text
COP001 Copy of Notice to Third Party/ALJ/Attorney or Representative
We are sending a copy of this notice to (1) (2) (3) (4) (5) .
Fill-ins:
(1) claimant name/null
(2) “,”/“and”/null
(3) third party name/ALJ name/null
(4) “and”/null
(5) attorney name/representative name/null