BASIC (04-14)

A. When to use letter

Use this cover letter to request a handwriting analysis from the Treasury in limited payability cases per GN 02401.910. Include the technician’s name, address and phone number for contact purposes.

NOTE: You must include this cover notice to complete the package you send to Treasury. If this notice is omitted, Treasury will return the entire package.

B. Cover letter for limited payability cases requesting handwriting analysis from the Department of the Treasury (Treasury)

Request for Handwriting Examination

To: Date:

Department of the Treasury

Bureau of Fiscal Service

Philadelphia Financial Center

13000 Townsend Rd

Philadelphia, PA 19154

From:

Agency Case Contact Information

Name Phone Fax

Return Address

LIMITED PAYABILITY CASE

We are referring this case to you for a handwriting analysis in order to decide if SSA should take action on this individual’s record.

Payee Name and Account/ID Number:

Questioned Items (Please list individually):

Standard (Please list individually):

Any Other Instructions: