SAMPLE LETTER - Enter the appropriate fill-in at the
asterisk.
* (Local Address)
* (Date)
* (Judge's Name and Address)
Dear Judge *:
Re: * (Child's Name) Docket No. *
The Supplemental Security Income (SSI) program pays monthly cash benefits to children
with limited income and resources who have been determined to be blind or disabled
under the provisions of the Social Security Act. If the child has countable income,
the amount of the SSI payment is reduced or the child may be found ineligible.
In addition to the income considerations, there is a limit on the value of resources
that an individual can own; presently, the limit for an individual is $2,000. However,
not all of the income and/or resources of the child are necessarily considered (i.e.,
by law, certain items may be excluded from consideration or may not meet the definition
of income and/or resources).
We are in the process of determining *'s (Child's Name) eligibility for SSI, but we
need your help in clarifying the availability of the funds held for * (Child's Name)
under the court order which was issued by you on * (Date). Specifically, we need to
know whether the funds held under your order would be made available for the child’s
support and maintenance if the custodian of the funds submitted a petition to access
the account in order to provide the child with food, clothing, or shelter. If either
the principal or interest were available, the child’s SSI eligibility or payment amount
could be affected. In this context, we note that you approved a petition on * (Date)
for the purpose of providing the child with * (Purpose of Approved Petition).
You may use the space provided on the next page for your response. If you have any
questions, please feel free to contact * (Contact Person in SSA) in the * (Local SSA
Office) Social Security Office on * (Telephone Number).
Sincerely,
(Name)
(Title)
Social Security Administration
* (Local Address)
Re: * (Child's Name) Docket No. *
1. Would you approve a petition for withdrawal of any or all of the funds set aside
for * (Child's Name) for the purpose of providing * (Child's Name) with food, clothing,
or shelter?
PLEASE CIRCLE: YES or NO
2. Is the interest earned on the funds set aside for * (Child's Name) available to
the custodian for use on behalf the child without your approval?
PLEASE CIRCLE: YES or NO
SIGNATURE: __________________________
DATE: ________________________________