| Section |
|
Latest
Transmittal |
| NL 00703.005 |
Exhibit/Dictated Notices |
TN 36 03-99 |
| CHARTS/INDEXES
|
| NL 00703.010 |
Usage Chart for Exhibit/Dictated Letters |
TN 34 05-98 |
| NL 00703.012 |
Usage Chart for HI/SMI Exhibit Letters |
TN 77 01-19 |
| NL 00703.050 |
Advance Notice - Benefits Will Be Reduced (Primary Insurance Amount Reduced) |
TN 79 06-20 |
| EXHIBIT LETTERS
|
| NL 00703.100 |
Notice to Overpaid Person in Current Pay Status — Adjustment Proposed |
TN 65 03-15 |
| NL 00703.101 |
Notice To Overpaid Person In Current Pay Status — Adjustment Proposed — Alien Tax
Withholding Involved
|
TN 31 02-97 |
| NL 00703.102 |
Notice to Overpaid Person in Non-pay Status but Receiving Benefits for Other Beneficiary
in Same Household — Refund Requested or Adjustment Proposed
|
TN 65 03-15 |
| NL 00703.103 |
Notice To Overpaid Person In Nonpay Status But Receiving Benefits For Other Beneficiary
In Same Household — Refund Requested And Adjustment Proposed — Alien Tax Withholding
Involved
|
TN 31 02-97 |
| NL 00703.104 |
Notice to Contingently Liable Beneficiary — Recovery From Originally Overpaid Person
Not Possible
|
TN 80 07-20 |
| NL 00703.106 |
Notice to Overpaid Person in Non-pay Status — Refund Requested |
TN 67 07-15 |
| NL 00703.107 |
Notice to Overpaid Person In Nonpay Status — Refund Requested —Alien Tax Withholding
Involved
|
TN 30 03-96 |
| NL 00703.108 |
Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and
Who is Currently Receiving Benefits for Beneficiary — Refund Requested or Adjustment
Proposed
|
TN 31 02-97 |
| NL 00703.109 |
Notice To Representative Payee Who Received Overpayment On Behalf Of Beneficiary And
Who is Currently Receiving Benefits For Beneficiary — Refund Requested And Adjustment
Proposed — Alien Tax Withholding Involved
|
TN 31 02-97 |
| NL 00703.110 |
Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and
Who is Not Currently Receiving Benefits for Beneficiary — Adjustment Proposed Against
Representative Payee or Other Beneficiary for Whom Representative Payee is Receiving
Benefits
|
TN 69 02-16 |
| NL 00703.111 |
Notice to Representative Payee Who Received Overpayment On Behalf Of Beneficiary And
Who Is Not Currently Receiving Benefits For Beneficiary — Adjustment Proposed Against
Representative Payee Or Other Beneficiary For Whom Representative Is Receiving Benefits
— Alien Tax Withholding Involved
|
TN 31 02-97 |
| NL 00703.112 |
Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and
Who is Not Currently Receiving Benefits for Beneficiary — Refund Requested
|
TN 69 02-16 |
| NL 00703.113 |
Notice to Overpaid Person in Railroad Board Certification Cases — Adjustment Proposed |
TN 31 02-97 |
| NL 00703.114 |
Followup Notice — Adjustment Proposed — Opportunity For Personal Conference Not Previously
Offered — No Underpayment Withholding Involved
|
TN 31 02-97 |
| NL 00703.115 |
Notice To Representative Payee Who Received Overpayment On Behalf Of Beneficiary And
Who Is Not Currently Receiving Benefits For Beneficiary — Refund Requested — Alien
Tax Withholding Involved
|
TN 31 02-97 |
| NL 00703.116 |
Followup Notice — Immediate Adjustment — Opportunity For Personal Conference Previously
Given — Underpayment Withholding Involved
|
TN 31 02-97 |
| NL 00703.118 |
Reconsideration Affirms Overpayment Determination (Reconsideration Only Requested)
— Refund Requested — Cross-Program Recovery Possible
|
TN 31 02-97 |
| NL 00703.119 |
Reconsideration Affirms Overpayment Determination (Reconsideration Only Requested)—Refund
Requested and Adjustment Proposed
|
TN 72 04-16 |
| NL 00703.120 |
Notice to Beneficiary(ies') When a Claim Has Been Filed That Will Require an Adverse
Adjustment to the Beneficiary's(ies') Benefits
|
TN 30 03-96 |
| NL 00703.121 |
Notice to Beneficiary(ies') That His or Her Entitlement May be Reversed or Terminated
Because an Adverse Claim Has Been Filed
|
TN 30 03-96 |
| NL 00703.122 |
Advance Notice - Benefits Will Be Stopped |
TN 30 03-96 |
| NL 00703.123 |
Advance Notice - Benefits Will Be Reduced (General) |
TN 30 03-96 |
| NL 00703.124 |
Advance Notice to Deported or Removed Number Holder |
TN 48 12-05 |
| NL 00703.125 |
Advance Notice to Auxiliary of Deported or Removed Number Holder |
TN 48 12-05 |
| NL 00703.126 |
Advance Notice — Non-Receipt of Report to United States |
TN 31 02-97 |
| NL 00703.127 |
Checks Stopped — RRB Involved |
TN 31 02-97 |
| NL 00703.128 |
Advance Adverse Adjustment — Only Past Due Benefits Affected |
TN 106 11-23 |
| NL 00703.129 |
Checks Stopped – RRB Jurisdiction of Survivor Claim |
TN 52 01-07 |
| NL 00703.130 |
Final Request for Refund — DOJ Referral Required |
TN 31 02-97 |
| NL 00703.140 |
Notice of Acceptance of Compromise Offer |
TN 30 03-96 |
| NL 00703.141 |
Notice of Rejection of Compromise Offer |
TN 30 03-96 |
| NL 00703.150 |
Windfall Elimination Provision (WEP) Advance Notice |
TN 30 03-96 |
| NL 00703.151 |
Initial Government Pension Offset (GPO) Advance Notice —Current Pay Status |
TN 30 03-96 |
| NL 00703.152 |
Initial Government Pension Offset (GPO) Advance Notice —Suspense/Deferred Status |
TN 30 03-96 |
| NL 00703.153 |
GPO Advance Notice — Increase In Government Pension — Current Pay Status |
TN 30 03-96 |
| NL 00703.154 |
GPO Advance Notice — Increase In Government Pension —Suspense/Deferred Status |
TN 30 03-96 |
| NL 00703.155 |
Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Reduced
- Current Pay Status
|
TN 47 12-05 |
| NL 00703.156 |
Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Reduced
- Suspense/Deferred Status
|
TN 50 02-06 |
| NL 00703.157 |
Advance Notice For SSA/Railroad Retirement Board (RRB) Match —Lowered RR Earnings
Affect Benefits — Current Pay Status
|
TN 30 03-96 |
| NL 00703.158 |
Advance Notice For SSA/Railroad Retirement Board (RRB) Match —Lowered RR Earnings
Affect Benefits — Suspense/Deferred Status
|
TN 30 03-96 |
| NL 00703.159 |
Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Terminated
- Current Pay Status
|
TN 50 02-06 |
| NL 00703.160 |
Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Terminated
- Suspense/Deferred Status
|
TN 50 02-06 |
| NL 00703.161 |
Advance Notice For SSA/RRB Retap Alerts - Benefits to be Terminated |
TN 32 06-97 |
| NL 00703.165 |
Waiver Notice for Requesting Authorization to Access Financial Information |
TN 71 04-16 |
| NL 00703.166 |
Waiver Requested — Refusal to Cooperate — Title II |
TN 31 02-97 |
| NL 00703.167 |
Waiver Denial Only — Refund Requested — Title II |
TN 31 02-97 |
| NL 00703.168 |
Waiver Denial Only — Current Pay — Title II |
TN 31 02-97 |
| NL 00703.169 |
Reconsideration Affirms Overpayment Determination —Reconsideration and Waiver Requested
— RSI Cases
|
TN 31 02-97 |
| NL 00703.170 |
Reconsideration Affirms Overpayment Determination — Waiver Approved — RSI Cases |
TN 31 02-97 |
| NL 00703.171 |
Personal Conference and Folder Review Scheduled — Waiver |
TN 31 02-97 |
| NL 00703.173 |
Personal Conference and Folder Review Scheduled —Reconsideration |
TN 31 02-97 |
| NL 00703.174 |
Personal Conference and Folder Review — Rescheduled |
TN 31 02-97 |
| NL 00703.176 |
Confirmation of Telephone Rescheduling of Personal Conference —Person Failed to Appear
for Conference — RSI Cases
|
TN 31 02-97 |
| NL 00703.180 |
Notice of Waiver Approval |
TN 66 04-15 |
| NL 00703.182 |
Notice of Waiver Approval — SSI (Domestic) |
TN 66 04-15 |
| NL 00703.183 |
Cross-Program Recovery Notices |
TN 102 09-23 |
| NL 00703.186 |
SPA Overpayment Notice, Initial Overpayment Notice Previously Sent, No Recovery Action
Being Taken, Overpaid Beneficiary in Terminated Status
|
TN 31 02-97 |
| NL 00703.187 |
Terminated Overpayment Collection - Overpayment Equal to or More than the Current
Monthly Payment (No Representative Payee)
|
TN 30 03-96 |
| NL 00703.188 |
Terminated Overpayment Collection - Overpayment Equal to or More Than the Current
Monthly Payment (Representative Payee Involved)
|
TN 30 03-96 |
| NL 00703.189 |
Terminated Overpayment Collection - Overpayment Amount is Less Than Current Monthly
Payment (No Representative Payee)
|
TN 30 03-96 |
| NL 00703.190 |
Terminated Overpayment Collection - Overpayment Amount is Less Than Current Monthly
Payment (Representative Payee Involved)
|
TN 30 03-96 |
| NL 00703.191 |
Terminated Overpayment Collection - Overpayment on Own SSN Being Recovered (No Representative
Payee)
|
TN 30 03-96 |
| NL 00703.192 |
Terminated Overpayment Collection - Overpayment on Own SSN Being Recovered (Representative
Payee Involved)
|
TN 30 03-96 |
| NL 00703.193 |
Reconsideration and Waiver Denial — Refund Request |
TN 31 02-97 |
| NL 00703.194 |
Reconsideration and Waiver Denial — Current Pay |
TN 31 02-97 |
| NL 00703.195 |
Partial Waiver Approval with Personal Conference — Refund Requested |
TN 31 02-97 |
| NL 00703.196 |
Partial Waiver Approval with Personal Conference — Current Pay |
TN 31 02-97 |
| NL 00703.197 |
Reconsideration and Partial Waiver Approval — Refund Request |
TN 31 02-97 |
| NL 00703.198 |
Reconsideration and Partial Waiver Approval — Current Pay |
TN 31 02-97 |
| NL 00703.200 |
Request for Payment of Misused Funds |
TN 96 05-23 |
| NL 00703.201 |
Repayment of Misused Funds — Cover Letter to New Payee |
TN 96 05-23 |
| NL 00703.202 |
Misuse Not Established — Notice to Beneficiary and/or New Representative Payee |
TN 96 05-23 |
| NL 00703.203 |
Notice of Misuse Negligence Determination |
TN 31 02-97 |
| NL 00703.204 |
Notice to Representative Payee and Any Former Representative Payee Administering Conserved
Funds When Beneficiary Dies
|
TN 103 09-23 |
| NL 00703.208 |
Notice to Former Representative Payee to Continue to Administer Conserved Funds |
TN 103 09-23 |
| NL 00703.211 |
Request for Repayment of Misused Funds - Advanced Notification – Cover Letter To New
Payee
|
TN 44 12-04 |
| NL 00703.212 |
Request For Repayment Of Misused Funds – Advanced Notification |
TN 96 05-23 |
| NL 00703.213 |
Repayment Of Misused Funds Notice To Beneficiary/New Payee |
TN 96 05-23 |
| NL 00703.215 |
Notice Affirming Selection of Representative Payee on Reconsideration |
TN 97 05-23 |
| NL 00703.216 |
Notice Affirming Selection of a Specific Representative Payee on Reconsideration |
TN 97 05-23 |
| NL 00703.256 |
Change to Direct Payment — Child Turns 18 and is a Student |
TN 94 04-23 |
| NL 00703.290 |
Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment
Provision Met-Direct Deposit Involved — Alien Tax Withholding Not Involved
|
TN 35 09-98 |
| NL 00703.291 |
Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment
Provision Met-Direct Deposit Not Involved —Alien Tax Withholding Not Involved
|
TN 35 09-98 |
| NL 00703.292 |
Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment
Provision Met-Direct Deposit Involved — Alien Tax Withholding Involved
|
TN 35 09-98 |
| NL 00703.293 |
Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment
Provision Met-Direct Deposit Not Involved —Alien Tax Withholding Involved
|
TN 35 09-98 |
| NL 00703.294 |
Domestic-To-Foreign Change Of Address — SSA-21 Not In File |
TN 35 09-98 |
| NL 00703.296 |
Foreign Address — Suspension Notice — SSA-21 In File —Exception To Alien Nonpayment
Provision Not Met — Outside the U.S. More Than 6 Months (Payee Version)
|
TN 35 09-98 |
| NL 00703.300 |
Foreign Address — Temporary Move Outside the United States for Less Than 6 Months
— Using U.S. Mailing Address; Beneficiary Under Full Retirement Age — Not Disabled
|
TN 35 09-98 |
| NL 00703.302 |
Foreign Address — Outside U.S. More Than 6 Months — Using U.S. Mailing Address |
TN 30 03-96 |
| NL 00703.304 |
Foreign Address — Suspension Notice — SSA-7161-OCR-SM, SSA-7162-OCR-SM, or SSA-21
Not Returned
|
TN 30 03-96 |
| NL 00703.308 |
Notice to Beneficiary Residing in a Restricted Country Who Plans to Leave His /Her
Country in Order to Collect Accrued Benefits
|
TN 30 03-96 |
| NL 00703.309 |
Beneficiary Planning Trip Abroad — 3 Months or Fewer |
TN 30 03-96 |
| NL 00703.310 |
Change of Address - Foreign to Domestic |
TN 30 03-96 |
| NL 00703.311 |
Miscellaneous Adjustment Notice |
TN 66 04-15 |
| NL 00703.312 |
Miscellaneous Adjustment Notice (Representative Payee) |
TN 66 04-15 |
| NL 00703.313 |
Adjustment - Beneficiary in Conditional or Suspense Status Before and After Action
(No Payment)
|
TN 66 04-15 |
| NL 00703.314 |
Adjustment - Beneficiary in Conditional or Suspense Status Before and After Action
(No Payment; Payee Version)
|
TN 31 02-97 |
| NL 00703.315 |
Adjustment -Beneficiary in Conditional or Suspense Status Before and After Action
(One Check Only)
|
TN 66 04-15 |
| NL 00703.317 |
Recomputation of Benefit Amounts - Beneficiary Is or Will Be In Current Pay After
Action
|
TN 31 02-97 |
| NL 00703.318 |
Transfer of Social Security Payments to the Railroad Retirement Board (RRB) for Certification
to Treasury
|
TN 59 07-12 |
| NL 00703.319 |
Social Security Claim Filed — Transferred to RRB |
TN 31 02-97 |
| NL 00703.320 |
Social Security Claim Filed — Civil Service Pension Involved |
TN 31 02-97 |
| NL 00703.321 |
Notice of Special Check (Preliminary Payment) |
TN 31 02-97 |
| NL 00703.322 |
Reissuance of Lost Check |
TN 31 02-97 |
| NL 00703.323 |
Withholding Requested But Net Benefits Not Enough to Implement |
TN 31 02-97 |
| NL 00703.324 |
Withholding Not Requested — Administrative Error |
TN 31 02-97 |
| NL 00703.325 |
Withholding Requested at a Different Rate — Withholding Error |
TN 31 02-97 |
| NL 00703.330 |
Benefits Stopped (Retroactively or Currently) - Beneficiary Is Not a U.S. Citizen
and 6-Month Period Expired
|
TN 31 02-97 |
| NL 00703.344 |
Letter to Representative Payee — Conserved Funds of $1,500 or More — VA Benefits May
Be Affected
|
TN 30 03-96 |
| NL 00703.345 |
Letter to Successor Payee About Direct Transfer of Conserved Funds |
TN 104 09-23 |
| NL 00703.346 |
Letter to Beneficiary About Direct Transfer of Conserved Funds |
TN 104 09-23 |
| NL 00703.347 |
Letter to Be Sent to New Payee or Beneficiary When SSA Has Abandoned Collection Efforts
to Recover Funds Misused By Former Payee
|
TN 30 03-96 |
| NL 00703.348 |
Notice of Payee's Signature Requirement on Form SSA-623-OCR-SM |
TN 30 03-96 |
| NL 00703.349 |
Notice Regarding the Return of Original Documents to the Payee |
TN 30 03-96 |
| NL 00703.350 |
Accrued Benefits — Total Paid to Representative Payee or Directly to the Beneficiary |
TN 30 03-96 |
| NL 00703.352 |
Accrued Benefits Paid In Monthly Installments to Payee |
TN 105 09-23 |
| NL 00703.354 |
Conserved Benefits — Entire Amount Paid to New Representative Payee or to the Beneficiary |
TN 105 09-23 |
| NL 00703.356 |
Conserved Benefits — Monthly Installments Paid To New Representative Payee |
TN 105 09-23 |
| NL 00703.357 |
Conserved Benefits — Monthly Installments Paid to the Beneficiary |
TN 30 03-96 |
| NL 00703.364 |
Termination of Section 217(b) Benefits Because of VA Pension |
TN 30 03-96 |
| NL 00703.365 |
Adjustment in Benefit Rate Because No longer Entitled Under Section 217(b); Still
Entitled Under Section 217(a) and (e)
|
TN 30 03-96 |
| NL 00703.371 |
Government Pension Offset (GPO) Advance Notice — Effect of Increase in Government
Pension on Social Security Benefits
|
TN 30 03-96 |
| NL 00703.413 |
Notice of Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report
Or Filed Work Report Showing No Earnings -Beneficiary In Suspense Or Terminated Status
|
TN 30 03-96 |
| NL 00703.414 |
Notice of Overpayment Due to Posted Earnings - Beneficiary Did Not File Work Report
Or Filed Work Report Showing No Earnings — Beneficiary In Current Or Deferred Status
|
TN 30 03-96 |
| NL 00703.415 |
Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted
Earnings Exceed Amount Reported — Beneficiary In Suspense or Terminated Status
|
TN 30 03-96 |
| NL 00703.416 |
Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted
Earnings Exceed Amount Reported — Beneficiary In Current Or Deferred Status
|
TN 30 03-96 |
| NL 00703.417 |
Notice of Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report
Or Filed Work Report Showing No Earnings - Monthly Earnings Test Applies — Beneficiary
In Suspense Or Terminated Status
|
TN 30 03-96 |
| NL 00703.418 |
Notice of Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report
or Filed Work Report Showing No Earnings — Monthly Earnings Test Applies — Beneficiary
In Current Or Deferred Status
|
TN 30 03-96 |
| NL 00703.419 |
Notice of Overpayment Due To Posted Earnings — Beneficiary Filed Work Report But Posted
Earnings Exceed Amount Reported — Monthly Earnings Test Applies — Beneficiary In Suspense
Or Terminated Status
|
TN 30 03-96 |
| NL 00703.420 |
Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted
Earnings Exceed Amount Reported — Monthly Earnings Test Applies Beneficiary In Current
Or Deferred Status
|
TN 30 03-96 |
| NL 00703.421 |
TALCMAIL Disability Cessation Overpayment Notice |
TN 58 09-11 |
| NL 00703.452 |
Prorating Current Year Suspensions Notice — (SMI Involved) |
TN 30 03-96 |
| NL 00703.454 |
Prorating Current Year Suspensions Notice — (No SMI Involved) |
TN 30 03-96 |
| NL 00703.456 |
Denial of Request For Prorating Work Suspension |
TN 30 03-96 |
| NL 00703.458 |
Auxiliary Due Full Rate Even Though Earnings Exceed Limit —Readjusted Rate Case —
Beneficiary Receives Full Adjusted Benefit
|
TN 30 03-96 |
| NL 00703.460 |
Suspension Notice (Survivor Cases Only) — Beneficiary Receiving Reduced Rate Because
of Work — Other Beneficiaries Also Working —Domestic
|
TN 30 03-96 |
| NL 00703.461 |
Suspension Notice (Survivor Cases Only) — Beneficiary Receiving Reduced Rate Because
of Work — Other Beneficiaries Also Working —Foreign
|
TN 30 03-96 |
| NL 00703.462 |
Initial Award Suspension Notice — Claimant Does Not Have A Social Security Number
— No Representative Payee
|
TN 30 03-96 |
| NL 00703.463 |
Initial Award Suspension Notice — Claimant Does Not Have A Social Security Number
-Representative Payee Involved
|
TN 30 03-96 |
| NL 00703.470 |
Appeal Requested Before Decision Made On Case |
TN 30 03-96 |
| NL 00703.471 |
Expedited Appeals Process (EAP) Notice - EAP is Denied |
TN 110 03-24 |
| NL 00703.472 |
Expedited Appeals Process (EAP) Notice - Claimant Cancels the EAP Request |
TN 110 03-24 |
| NL 00703.473 |
Good Cause For Late Filing of Reconsideration Request Not Established |
TN 30 03-96 |
| NL 00703.474 |
Reconsideration Affirmation of Prior Decision |
TN 45 07-05 |
| NL 00703.475 |
Expedited Appeals Process (EAP) Notice - Closeout |
TN 110 03-24 |
| NL 00703.480 |
Good Cause Denial Notice for Statutory Benefit Continuation Request |
TN 95 04-23 |
| NL 00703.500 |
Adjustment Notice, Combined Check Reduced — Child's Estimate of Earnings Caused Partial
or Total Deductions
|
TN 30 03-96 |
| NL 00703.502 |
Adjustment Notice — Beneficiary Reduced Earnings to Exempt Amount, Benefit Remains
the Same, Had Received Full Benefit While Working
|
TN 30 03-96 |
| NL 00703.503 |
Adjustment Notice — Beneficiary Reduced Earnings to Exempt Amount, Benefit Remains
the Same, Had Received Full Benefit While Working (Payee Version)
|
TN 30 03-96 |
| NL 00703.504 |
Suspension Notice — Child is Working and Reports Change in Address — Payee Development
Necessary — Domestic
|
TN 30 03-96 |
| NL 00703.505 |
Suspension Notice — Child Is Working and Reports Change in Address — Payee Development
Necessary — Foreign
|
TN 30 03-96 |
| NL 00703.510 |
Suspension Notice to Beneficiary — Insured Person Working More Than 45 Hours Per Month
(Foreign Work Test)
|
TN 30 03-96 |
| NL 00703.511 |
Due Process Notice To Disabled Number Holder (NH)-Benefits To Be Reduced, Further
Reduced or Withheld Because of Initial Receipt of or Increase in Workers' Compensation
(WC), Public Disability Benefits (PDB), Part C Black Lung (BL) Payments or Federal
Employees Compensation Act (FECA) Payments
|
TN 30 03-96 |
| NL 00703.512 |
Due Process Notice To Disabled NH — Auxiliary Benefits To Be Reduced, Further Reduced,
or Withheld Because of NH's Initial Receipt of Or Increase in WC, PDB, FECA or BL
Payments (Computer Match Only)
|
TN 31 02-97 |
| NL 00703.513 |
Due Process Notice to Auxiliary(ies)-Benefits To Be Reduced, Further Reduced or Withheld
Because of NHs Initial Receipt of or Increase in WC, PDB, FECA or BL Payments
|
TN 31 02-97 |
| NL 00703.515 |
DAA Due Process Suspension Notice — Title II Beneficiary — No Longer In Compliance
With Treatment Requirements
|
TN 31 02-97 |
| NL 00703.550 |
“Good Cause” Established — Penalty Deduction Not Applicable |
TN 30 03-96 |
| NL 00703.554 |
Suspension Notice — Beneficiary Deported or Removed |
TN 48 12-05 |
| NL 00703.556 |
CDB Suspension Notice — Benefits Withheld — Beneficiary Own Payee |
TN 30 03-96 |
| NL 00703.558 |
CDB Suspension Notice — Benefits Withheld — Beneficiary Has Representative Payee |
TN 30 03-96 |
| NL 00703.560 |
Suspension Notice — Auxiliary Benefits Suspended Because CDBs or DIBs Benefits Suspended |
TN 30 03-96 |
| NL 00703.561 |
Mother's/Father's Benefits Stopped-Youngest Child Attained Age 16-Child Disability
Decision Pending
|
TN 30 03-96 |
| NL 00703.566 |
Disability Established for Child Who Terminated-Age 18 — Own Payee |
TN 30 03-96 |
| NL 00703.567 |
Disability Established for Child Who Terminated — Age 18-Has Payee |
TN 30 03-96 |
| NL 00703.568 |
Disability Established — Benefits Continued — Child Own Payee |
TN 30 03-96 |
| NL 00703.569 |
Disability Established — Benefits Continued — Child Has Payee |
TN 30 03-96 |
| NL 00703.570 |
CDB Disability Termination — Notice of Cessation —Beneficiary Own Payee |
TN 99 08-23 |
| NL 00703.572 |
DIB Termination — Notice of Cessation — Payments to Spouse, Deceased Spouse or Dependent
Beneficiaries Terminated
|
TN 99 08-23 |
| NL 00703.580 |
Notice of Interim Benefits for Administrative Law Judge Cases – Section 8001, P.L.
100-647—Exhibit
|
TN 73 06-16 |
| NL 00703.595 |
Recovery From Individual Who Withdrew Funds From A Deceased Beneficiary's Bank Account
After Death
|
TN 30 03-96 |
| NL 00703.596 |
Lump Sum Death Payment-Potential Eligibility |
TN 76 12-18 |
| MEDICARE
|
| NL 00703.600 |
Notice of Award to Medicare Beneficiary (HI/SMI) — Reduced HI Premium — NH, Spouse,
Divorced Spouse, Widow(er) or Surviving Divorced Spouse
|
TN 30 03-96 |
| NL 00703.601 |
Instructions for Preparation of SMI Only Award Notice When a Beneficiary is Eligible
for Reduced Premium HI
|
TN 30 03-96 |
| NL 00703.604 |
SMI — Applied Prior To The Beginning of Initial Enrollment Period |
TN 30 03-96 |
| NL 00703.605 |
SMI Denial — Not in General Enrollment Period (GEP) or Special Enrollment Period (SEP) |
TN 30 03-96 |
| NL 00703.606 |
SMI Refusal Request Treated As GEP Enrollment |
TN 30 03-96 |
| NL 00703.609 |
New Health Insurance Card As A Result of Requested Changes |
TN 30 03-96 |
| NL 00703.610 |
Address Change — Returning HI Card |
TN 30 03-96 |
| NL 00703.616 |
SMI — Processed Declination of Coverage — Beneficiary In Current Pay Status — Refund
Due
|
TN 30 03-96 |
| NL 00703.617 |
SMI — Processed Declination of Coverage — Beneficiary In Suspense Status — Discard
Any Bill For Premiums
|
TN 30 03-96 |
| NL 00703.618 |
Beneficiary's Refusal of SMI Coverage Not Acceptable — State is Paying Premiums |
TN 30 03-96 |
| NL 00703.619 |
HI/SMI — Entitled To Mother's or Widow's Benefits —Coverage Based on Disability —
Coverage Begins Within 2 Months After COM
|
TN 30 03-96 |
| NL 00703.620 |
HI/SMI — Entitled to Mother's or Widow's Benefits —Coverage Based on Disability —
Coverage Begins More Than 2 Months After COM
|
TN 30 03-96 |
| NL 00703.621 |
R-HI/R-SMI — Award Based on Transplant or Dialysis, Entitlement Dates are the Same
or Later Than D-HI/D-SMI Coverage (Conversion Notice)
|
TN 68 09-15 |
| NL 00703.622 |
Ineligible for HI/SMI Coverage Due to DWB Termination |
TN 30 03-96 |
| NL 00703.623 |
Ineligible for HI/SMI Coverage Because DIB Ceased |
TN 30 03-96 |
| NL 00703.624 |
DIB to RIB Conversion — Full Retirement Age PAC Reduction |
TN 30 03-96 |
| NL 00703.625 |
Withdrawal From SMI — Entitlement to CHAMPUS or CHAMPVA |
TN 30 03-96 |
| NL 00703.626 |
Notice When Claimant Protests Amount of Premium Bill (Withdrawal Model Letter) |
TN 30 03-96 |
| NL 00703.627 |
Notice When Claimant's Correspondence Contains an Incorrect Claim Number |
TN 30 03-96 |
| NL 00703.628 |
Notice When Claimant Protests Termination |
TN 30 03-96 |
| NL 00703.629 |
General “Check Box” Notice |
TN 31 02-97 |
| NL 00703.630 |
HI/SMI — Government Medicare — Coverage Based on Disability — Coverage Begins More
Than 2 Months After Current Operating Month
|
TN 68 09-15 |
| NL 00703.631 |
Initial LESSDO Notice (MBA Less than SMI Premium) |
TN 81 07-20 |
| NL 00703.632 |
MBA Less than SMI Premium (LESSDO) - No Prior Year Premium Balance |
TN 81 07-20 |
| NL 00703.633 |
MBA Less than SMI Premium (LESSDO) - Prior Year Premium Balance Less than 3 Months |
TN 81 07-20 |
| NL 00703.634 |
MBA Less than SMI Premium (LESSDO) - Prior Year Premium Balance Equals 3 (or more)
Months
|
TN 81 07-20 |
| NL 00703.635 |
MBA Less than SMI Premium (LESSDO) - Failure to Bill - More than 6 Months Past Due
Premiums
|
TN 81 07-20 |
| NL 00703.636 |
MBA Less than SMI Premium (LESSDO) - Failure to Bill - Equitable Relief Period Ends |
TN 88 10-22 |
| NL 00703.640 |
Medicare Development Notice |
TN 92 11-22 |
| NL 00703.700 |
Withdrawal — Repayment — NH |
TN 74 07-18 |
| NL 00703.701 |
Withdrawal — Repayment — NH and Auxiliary(ies) |
TN 30 03-96 |
| NL 00703.702 |
Withdrawal — 30 Day Final Request |
TN 85 04-22 |
| NL 00703.703 |
Withdrawal Denial |
TN 64 07-14 |
| NL 00703.705 |
Withdrawal After Disallowance |
TN 30 03-96 |
| NL 00703.706 |
Withdrawal Notice to RRB — Withdrawal Approved — No Entitlement Under SSA |
TN 30 03-96 |
| NL 00703.707 |
Notice to Beneficiary/Payee — Initial Withholding Due to Garnishment — Court Ordered
Amount No More Than Federal or State Limits
|
TN 30 03-96 |
| NL 00703.708 |
Notice to Beneficiary/Payee — Withholding Percentage is Reduced |
TN 30 03-96 |
| NL 00703.709 |
Notice to Beneficiary/Payee — Amended Garnishment Order |
TN 31 02-97 |
| NL 00703.710 |
Notice to Beneficiary/Payee — Payments May Be Garnished |
TN 38 06-03 |
| NL 00703.711 |
Notice to Potential Beneficiary/Payee — Payments May Be Garnished If Claim is Approved |
TN 38 06-03 |
| NL 00703.712 |
Notice to Beneficiary/Payee — Initial Withholding Due to Garnishment — Court Ordered
Amount More Than Federal or State Limits
|
TN 30 03-96 |
| NL 00703.714 |
Notice to Beneficiary/Payee — Cost-of-Living Increase in Benefits Affects Garnishment
Action
|
TN 30 03-96 |
| NL 00703.716 |
Notice to Beneficiary/Payee — Garnishment Ended |
TN 33 02-98 |
| NL 00703.717 |
Notice to the Court – Amended Garnishment Order |
TN 83 10-20 |
| NL 00703.718 |
Notice to the Court – Garnishment Amount Does Not Equal Requested Amount |
TN 83 10-20 |
| NL 00703.719 |
Notice to the Court – Garnishment Terminated Because of a Stop Order |
TN 83 10-20 |
| NL 00703.720 |
Notice to the Court – Garnishment Amount Changed Due to Another Court Order |
TN 83 10-20 |
| NL 00703.722 |
Notice to Beneficiary/Payee — Regarding Appeal of Garnishment Order |
TN 33 02-98 |
| NL 00703.723 |
Notice to Court — Garnishment Order — Initial Withholding |
TN 31 02-97 |
| NL 00703.724 |
Notice to Court — Garnishee Is Not Entitled to Monthly Benefits |
TN 90 11-22 |
| NL 00703.725 |
Notice to Court — Garnishee's Claim for Monthly Benefits Pending |
TN 38 06-03 |
| NL 00703.726 |
Notice to Court — Garnishment Order — Improper Service of Court Order |
TN 38 06-03 |
| NL 00703.728 |
Notice to Court — Garnishment Order — Noncompliance with a Court Order |
TN 31 02-97 |
| NL 00703.729 |
Notice to Court — Garnishment Ends, We've Paid the Receiver Too Much |
TN 30 03-96 |
| NL 00703.730 |
Notice to Court — Initial Withholding But Not Paying Receiver |
TN 30 03-96 |
| NL 00703.731 |
Notice to Court — Withholding Percentage is Reduced |
TN 30 03-96 |
| NL 00703.732 |
Notice to Court — Increase/Decrease in Benefits |
TN 30 03-96 |
| NL 00703.733 |
Notice to Court — Amended Order — Withheld Amount Increased —Court Ordered Amount
More Than Maximum Allowed
|
TN 30 03-96 |
| NL 00703.734 |
Notice to Court — Amended Order — Maximum Amount Allowed Already Being Withheld |
TN 30 03-96 |
| NL 00703.735 |
Notice to Court — Amended Order — Requested Amount Withheld |
TN 30 03-96 |
| NL 00703.736 |
Notice to Court — Garnishment Suspended |
TN 30 03-96 |
| NL 00703.737 |
Notice to Court — Garnishment Ends |
TN 30 03-96 |
| NL 00703.740 |
Title II 6-Month Closeout Notice (First Party) |
TN 30 03-96 |
| NL 00703.741 |
Title II 6-Month Closeout Notice — Inquiry Made On Behalf of Child Under Age 18 or
Legally Incompetent Adult
|
TN 30 03-96 |
| NL 00703.742 |
Title II 6-Month Closeout Notice — Inquiry Made On Behalf of Claimant - Not Incompetent
or Under Age 18
|
TN 100 08-23 |
| NL 00703.743 |
Title II 6-Month Closeout Notice — Deceased Claimant |
TN 30 03-96 |
| NL 00703.744 |
6-Month Closeout Notice - Doubtful Intent to File For Benefits —Potential Auxiliary
in Separate Household
|
TN 33 02-98 |
| NL 00703.745 |
IRS Request For Levy |
TN 33 02-98 |
| NL 00703.746 |
IRS Levy Implemented |
TN 33 02-98 |
| NL 00703.747 |
Notification to IRS - Levy Ceasing |
TN 33 02-98 |
| NL 00703.748 |
Exemption From Levy - Exemption Statement |
TN 33 02-98 |
| NL 00703.749 |
Exemption From Levy - Personal Exemption Amount |
TN 33 02-98 |
| NL 00703.750 |
Imposition of Levy Against Full Monthly Benefit Payment |
TN 33 02-98 |
| NL 00703.751 |
Protesting Levy |
TN 33 02-98 |
| NL 00703.752 |
Imposition of Levy Against Part of Monthly Benefit Payment |
TN 33 02-98 |
| NL 00703.753 |
Notification to Beneficiary -Levy Ceasing |
TN 33 02-98 |
| NL 00703.758 |
Request to Employer for Debtor Address |
TN 31 02-97 |
| NL 00703.759 |
Request to Financial Institution for Correct Beneficiary Address |
TN 98 05-23 |
| NL 00703.760 |
Undeliverable Mail — Advance Notice that We Will Stop Benefits |
TN 31 02-97 |
| NL 00703.761 |
Advance Notice That We Will Stop Benefits — SSA-1588, Beneficiary Recontact Report,
Returned Undeliverable
|
TN 31 02-97 |
| NL 00703.763 |
Representative Payee Advance Notice for Title XVI Initial Claim Situations |
TN 31 02-97 |
| NL 00703.765 |
Representative Payee Advance Notice for Title XVI Postentitlement Situations |
TN 31 02-97 |
| NL 00703.767 |
Representative Payee Advance Notice for Title II Initial Claim Situations |
TN 30 03-96 |
| NL 00703.768 |
Representative Payee Advance Notice for Title II Postentitlement Situations |
TN 30 03-96 |
| NL 00703.769 |
Representative Payee Advance Notice to Legal Guardian, Parent or Person Standing in
Place of Parent — If Not Proposed Payee
|
TN 30 03-96 |
| NL 00703.770 |
Representative Payee — Authorized Fee Notice to Beneficiary or Person Standing in
Place of Beneficiary
|
TN 31 02-97 |
| NL 00703.771 |
Representative Payee — Notice to Beneficiary or Person Standing in Place of Beneficiary
About Revocation of Fee
|
TN 31 02-97 |
| NL 00703.772 |
Partial Award Follow-up Notice, No Change in Benefits |
TN 31 02-97 |
| NL 00703.773 |
Reply to Show Cause Order |
TN 31 02-97 |
| NL 00703.774 |
Representative Payee — Change in Authorized Fee — Notice to Beneficiary or Person
Standing in Place of Beneficiary
|
TN 31 02-97 |
| NL 00703.775 |
Notice of Abatement — Non-Disability Claimant Dies In Or Before First Month of Entitlement
— Disability Claimant Dies In The Waiting Period
|
TN 31 02-97 |
| NL 00703.776 |
Advance Notice to Beneficiaries Attaining Age 18 —Representative Payee Still Needed |
TN 31 02-97 |
| ATTORNEY FEE NOTICES
|
| NL 00703.806 |
Letter Acknowledging Request for Administrative Review of Authorized Attorney Fee |
TN 31 02-97 |
| NL 00703.807 |
Correspondence Cover Letter |
TN 31 02-97 |
| NL 00703.808 |
20-Day Close-Out Letter, Below Hearing Level |
TN 31 02-97 |
| NL 00703.810 |
Withheld Past-Due Benefits Released to Attorney — Concurrent Title II and Title XVI
Case — Offset Information Pending —Number Holder (NH) -Fee Agreement Case
|
TN 31 02-97 |
| NL 00703.811 |
Withheld Past-Due Benefits Released to Attorney — Concurrent Title II and Title XVI
Case — Offset Information Pending —Auxiliary Beneficiary(ies) — Fee Agreement Case
|
TN 31 02-97 |
| NL 00703.812 |
Failure to Withhold Past-due Benefits for Direct Payment to a Representative (Administrative
Error)
|
TN 63 05-14 |
| NL 00703.813 |
Notice to Beneficiary in Concurrent Title II and Title XVI Cases Where We Applied
Title II Offset and there is a Fee Petition or Fee Agreement
|
TN 70 03-16 |
| NL 00703.814 |
Notice To Beneficiary — Concurrent Title II/Title XVI Case —Fee Petition Case — Title
II Offset Amount Is More Than The Retroactive Title II Benefits Minus The Amount Withheld
Toward The Attorney Fee —Offset Action Delayed Pending Field Office (FO) Adjustment
|
TN 30 03-96 |
| NL 00703.815 |
Interim Notice of Allowance and Notification to Claimant that 25 percent of Retroactive
Benefits Is Being Withheld
|
TN 30 03-96 |
| NL 00703.816 |
Notice Explaining Disposition of Withheld Retroactive Benefits |
TN 70 03-16 |
| NL 00703.817 |
Retroactive Check Released — No Fee Charged for Services Performed on Your Claim |
TN 30 03-96 |
| NL 00703.818 |
Notice to Beneficiary — Retroactive Check is Being Released; Request for Approval
of a Fee for Representing a Claimant Not Received
|
TN 34 05-98 |
| NL 00703.819 |
Court Case — Retroactive Benefits Were Withheld Pending Determination on Attorney
Fee
|
TN 34 05-98 |
| FORMAL REPRESENTATIVE PAYEE NOTICES
|
| NL 00703.821 |
Final Notice to the Former Representative Payee, or the Non-Selected Payee Applicant
When Another Payee is Appointed
|
TN 34 05-98 |
| NL 00703.822 |
Final Notice to Legally Competent Adult or Emancipated Minor of Payee Selection |
TN 34 05-98 |
| NL 00703.823 |
Notice to Child Beneficiary Who Was His/Her Own Payee or Legally Incompetent Adult
Beneficiary When Representative Payee Appointed
|
TN 34 05-98 |
| NL 00703.824 |
Final Notice of Payee Appointment to Parent, Person Standing in Place of Parent, Legal
Guardian or Attorney Representative Who Is Also an Unsuccessful Applicant
|
TN 34 05-98 |
| NL 00703.825 |
Notice to Legally Competent Adult Beneficiary or Emancipated Minor Who has a Payee
and is Denied Direct Payment
|
TN 34 05-98 |
| NL 00703.826 |
Notice to Parent, Person Standing in Place of Parent, or Legal Guardian That the Beneficiary's
Benefits Will Continue to be Paid to the Same Representative Payee or Directly to
Beneficiary
|
TN 34 05-98 |
| NL 00703.827 |
Notice to Child or Incompetent Adult Beneficiary Who Has a Representative Payee and
Is Denied Direct Payment
|
TN 34 05-98 |
| NL 00703.828 |
Notice to Parent, Person Standing in Place of Parent, or Legal Guardian of a Minor
Beneficiary That the Beneficiary's Benefits Will Be Paid Directly to the Minor, Rather
Than a Representative Payee
|
TN 34 05-98 |
| DISALLOWANCE EXHIBIT NOTICES
|
| NL 00703.900 |
Disallowance — Auxiliary Not Entitled to Retirement Benefits on Own Record |
TN 31 02-97 |
| NL 00703.901 |
Disallowance Not a Spouse Under the Act |
TN 53 05-09 |
| NL 00703.905 |
Disallowance Miscellaneous Fill-in Letter |
TN 53 05-09 |
| NL 00703.907 |
Survivor Disallowance — NH Not Insured |
TN 36 03-99 |
| NL 00703.909 |
Disallowance — Date of Birth Not Established |
TN 101 08-23 |
| NL 00703.911 |
Auxiliary Disallowance — NH Not Entitled |
TN 30 03-96 |
| NL 00703.913 |
Request for Benefit Increase Denied |
TN 30 03-96 |
| NL 00703.915 |
Retirement Denial — Lack of Insured Status |
TN 30 03-96 |
| NL 00703.917 |
Disallowance — Age Requirement Not Met |
TN 30 03-96 |
| TERMINATION EXHIBIT NOTICES
|
| NL 00703.920 |
Instructions for Inclusion of Overpayment Language in Termination Notices |
TN 36 03-99 |
| NL 00703.923 |
Benefits to Mother/Father or Young Spouse Terminate — Child Beneficiary Dies — Foreign |
TN 36 03-99 |
| NL 00703.924 |
Termination Letter to Representative Payee When Beneficiary Dies — Domestic or Foreign |
TN 36 03-99 |
| NL 00703.925 |
Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce
— Domestic
|
TN 30 03-96 |
| NL 00703.926 |
Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce
— Foreign
|
TN 30 03-96 |
| NL 00703.927 |
Benefits to Mother/Father, or Wife, Husband, Former Wife or Former Husband Terminate
— Child Attains Age 16 — Domestic
|
TN 107 01-24 |
| NL 00703.928 |
Benefits to Mother/Father, or Wife, Husband, Former Wife or Former Husband Terminate
— Child Attains Age 16 -Foreign
|
TN 30 03-96 |
| NL 00703.929 |
Benefits to Child Terminate — Age 18/19 — Domestic or Foreign |
TN 89 11-22 |
| NL 00703.930 |
Benefits to student terminate — Deemed age 19 — Domestic or foreign |
TN 93 11-22 |
| NL 00703.931 |
Benefits to Student Terminate — No Longer in Full — Time Attendance |
TN 91 11-22 |
| NL 00703.932 |
Benefits Suspended Due to Number Holder’s (NH) Death - Dual Entitlement |
TN 75 12-18 |
| NL 00703.933 |
Cover Notice for Field Office (FO) and Teleservice Center (TSC) to Use When Sending
the SSA-4111
|
TN 54 06-09 |
| NL 00703.940 |
Cover Letter to Organizations Inquiring About Payment for Representative Payee Services |
TN 51 11-06 |
| NL 00703.941 |
Fees for Representative Payee Services |
TN 41 09-04 |
| NL 00703.942 |
Explanation of Documents Needed to Collect a Fee for Representative Payee Services |
TN 51 11-06 |
| NL 00703.943 |
Notice Authorizing Organization to Collect a Fee |
TN 41 09-04 |
| NL 00703.944 |
Notice to Organization Denying Request to Collect a Fee |
TN 31 02-97 |
| NL 00703.945 |
Explanation of Fees for Representative Payee Services |
TN 41 09-04 |
| NL 00703.946 |
Notice of Fee for Service (FS) Site Review or Recertification Scheduling |
TN 37 03-03 |
| NL 00703.948 |
Review Decision Notice to Organization |
TN 31 02-97 |
| NL 00703.949 |
Revocation Notice to Organization |
TN 31 02-97 |
| NL 00703.950 |
Notice to Creditor Organization |
TN 31 02-97 |
| NL 00703.954 |
Expedited Reinstatement (EXR) Initial Reinstatement Period (IRP) Benefit Change Letter |
TN 46 09-05 |
| NL 00703.956 |
Expedited Reinstatement (EXR) Award Notice |
TN 49 02-06 |
| NL 00703.963 |
Notification of Withholding to Collect a Civil Monetary Penalty (and Assessment) |
TN 55 05-10 |
| NL 00703.965 |
Civil Monetary Penalty (CMP) Call-In Letter |
TN 57 03-11 |
| NL 00703.966 |
Petersen Acquiescence Ruling (AR) Notices |
TN 60 12-12 |