Some requestors send the request for certification to the RO. In that situation the
RO:
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•
Will review the consent form to ensure compliance.
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•
Charge and collect the fee based on the current fee schedule. The FeeBayNet program
will be used and the record will be established under the servicing FO.
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•
Will notify the servicing FO by email of the pending action.
The FO will control for receipt of the fee from the requestor. When received, notify
Miranda Mountz in CPS of the receipt by email. Process the fee in the normal manner.
The RO will complete the certification and mail to the requestor.
REQUEST FOR CERTIFICATION
TO: Social Security Administration Date:
RSI Programs Branch
1961 Stout Street Suite 06-145
Denver, CO 80294
ATTN:
Miranda
Mountz
Please certify the photocopies of the attached file.
If you have any questions, please contact ________________________ at phone number:
__________ Office:_________________________
Date Fee Received: ____________________
The file should be returned to the FO ____________________
The file should be returned to the PSC, Wilkes-Barre, etc. __________
The records will be mailed to the requester (attorney, record service, etc.) by the
RO unless indicated.
SPECIAL INSTRUCTIONS:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________