Effective Dates: 01/26/2015 - Present Previous | Next

TN 34 (05-98)

NL 00703.010 Usage Chart for Exhibit/Dictated Letters

Type Situation/Exhibit Manual Section Document Identifier For Word Processor
ADJUSTMENT Miscellaneous Adjustment NL 00703.311 E3311
​ Miscellaneous Adjustment (Payee) NL 00703.312 E3312
​ Beneficiary in Conditional or Suspense Status Before and After Adjustment Action (No Payment) NL 00703.313 E3313
​ Beneficiary in Conditional or Suspense Status Before and After Adjustment Action (No Payment; Payee) NL 00703.314 E3314
​ Beneficiary in Conditional or Suspense Status Before and After Adjustment Action (One Check Only) NL 00703.315 E3315
​ Recomputation of Benefit Amounts - Beneficiary is or Will be in Current Pay After Action NL 00703.317 E3317
​ Voluntary Tax Withholding Requested — Net Benefits Not Enough to Implement NL 00703.323 E3323
​ Voluntary Tax Withheld — Administrative Error — Withholding Not Requested NL 00703.324 E3324
​ Voluntary Tax Withheld — Withholding Error — Withholding Requested at a Different Rate NL 00703.325 E3325
​ Benefits Stopped (Retroactively or Currently) - Beneficiary is Not a U.S. Citizen and 6-month Period Expired NL 00703.330 E3330
​ Termination of Section 217(b) Benefits Because of VA Pension NL 00703.364 E3364
​ Adjustment in Benefit Rate Because No Longer Entitled Under Section 217(b); Still Entitled Under 217(a) and (e) NL 00703.365 E3365
ADVANCE NOTICE ADVERSE ADJUSTMENT/ ADVERSE CLAIM/ COMPUTER MATCHING Notice to Beneficiary(ies) When a Claim Has Been Filed That Will Require an Adverse Adjustment in the Beneficiary's(ies') Benefits NL 00703.120 E3120
​ Notice to Beneficiary(ies) That Entitlement May be Reversed or Terminated Because an Adverse Claim Has Been Filed NL 00703.121 E3121
​ Advance Notice - Benefits Will Stop NL 00703.122 E3122
​ Advance Notice - Benefits Will Be Reduced NL 00703.123 E3123
​ Due Process Notice to Deported Beneficiary NL 00703.124 E3124
​ Due Process Notice to Auxiliary of Deported Number Holder NL 00703.125 E3125
​ Advance Notice - Nonreceipt of Report to U.S. NL 00703.126 E3126
​ Advance Adverse Adjustment — Only Past Due Benefits Affected NL 00703.128 E3128
​ Advance Notice - Windfall Elimination Provision (WEP) NL 00703.150 E3150
​ Initial Government Pension Offset (GPO) Advance Notice — Current Pay Status NL 00703.151 E3151
​ Initial GPO Advance Notice — Suspense/Deferred Status NL 00703.152 E3152
​ GPO Advance Notice — Increase in Government Pension — Current Pay Status NL 00703.153 E3153
​ GPO Advance Notice — Increase in Government Pension -Suspension/Deferred Status NL 00703.154 E3154
​ Advance Notice for SSA/RRB Match — Benefits to Be Reduced — Current Pay Status NL 00703.155 E3155
​ Advance Notice for SSA/RRB Match — Benefits to Be Reduced — Suspense/ Deferred Status NL 00703.156 E3156
​ Advance Notice for SSA/RRB Match — Lowered RR Earnings Affect Benefits - Current Pay Status NL 00703.157 E3157
​ Advance Notice for SSA/RRB Match — Lowered RR Earnings Affect Benefits — Suspense/Deferred Status NL 00703.158 E3158
​ Advance Notice for SSA/RRB Match — Benefits to Be Terminated - Current Pay Status NL 00703.159 E3159
​ Advance Notice for SSA/RRB Match - Benefits to Be Terminated - Suspense/ Deferred Status NL 00703.160 E3160
​ GPO Advance Notice — Effect of Increase in Government Pension on Social Security Benefits NL 00703.371 E3371
​ Advance Notice to Beneficiary Attaining Age 18 —Representative Payee Still Needed NL 00703.776 E3376
​ Due Process Notice to Disabled NH - Benefits to be Reduced, Further Reduced or Withheld Due to Initial Receipt of or Increase in WC, PDB, BL or FECA Payments NL 00703.511 E3511
​ Due Process Notice to Disabled NH - Auxiliary Benefits to be Reduced, Further Reduced or Withheld Because of NHs Initial Receipt of or Increase in WC, PDB, FECA or BL Payments (Computer Match Only) NL 00703.512 E3512
​ Due Process Notice to Auxiliary(ies) Benefits to be Reduced, Further Reduced or Withheld Due to NHs Initial Receipt of or Increase in WC, PDB, FECA or BL NL 00703.513 E3513
​ DAA Due Process Suspension Notice - Title II Beneficiary Concurrently Entitled to Title XVI - No Longer in Compliance With Treatment Requirements NL 00703.515 E3515
ANNUAL REPORT Auxiliary Due Full Rate Even Though Earnings Exceed Limit - Readjusted Rate Case NL 00703.458 E3458
​ Suspension Notice to Beneficiary Receiving Reduced Rate Because of Work; Other Beneficiaries are Working NL 00703.460 E3460
​ Combined Check Reduced — Child's Estimate of Earnings Caused Partial or Total Deductions NL 00703.500 E3500
​ Beneficiary Reduced Earnings to Exempt Amount, Benefit Rate Remains Same, Received Full Benefit While Working NL 00703.502 E3502
​ Beneficiary Reduced Earnings to Exempt Amount; Benefit Remains the Same; Received Full Benefit While Working (Payee Version) NL 00703.503 E3503
​ Suspension Notice — Child is Working and Reports Change in Address — Payee Development Necessary — Domestic NL 00703.504 E3504
​ Suspension Notice — Child is Working and Reports Change in Address - Payee Development Necessary - Foreign NL 00703.505 E3505
​ “Good Cause” Established — Penalty Deduction Not Applicable NL 00703.550 E3550
APPEALS Appeal Requested Before Decision Made on Case NL 00703.470 E3470
​ Expedited Appeals Process (EAP) is Denied NL 00703.471 E3471
​ Claimant Cancels Request for Expedited Appeals Process (EAP) NL 00703.472 E3472
​ Good Cause for Late Filing of Reconsideration Request Not Established. NL 00703.473 E3473
​ Reconsideration Affirmation of Prior Decision NL 00703.474 E3474
ATTORNEY REPRESENTATION AND FEES Letter Acknowledging Request for Administrative Review of Authorized Attorney Fee NL 00703.806 E3806
​ 20-Day Close Out Letter, Below Hearing Level NL 00703.808 E3808
​ Withheld Past-Due Benefits Released to Attorney — Concurrent Title II/ Title XVI Case — Offset Information Pending — NH — Fee Agreement Case NL 00703.810 E3810
​ Withheld Past-Due Benefits Released to Attorney — Concurrent Title II/ Title XVI Case — Offset Information Pending - Auxiliary — Fee Agreement Case NL 00703.811 E3811
​ Letter to Attorney, ODAR Authorized Fee, No Past Due Benefits Available (Administrative Error) NL 00703.812 E3812
​ Notice to Beneficiary — Title II Offset Applied — Concurrent Title II/ Title XVI — Fee Petition or Fee Agreement Case NL 00703.813 E3813
​ Notice to Beneficiary — Concurrent Title II/Title XVI Case — Fee Petition Case — Title II Offset Amount More Than Retroactive Title II Benefits Minus Amount Withheld Toward Attorney Fee — Offset Action Delayed Pending FO Adjustment NL 00703.814 E3814
​ Interim Notice of Allowance and Notification to Claimant That 25 Percent of Retroactive Benefits is Being Withheld NL 00703.815 E3815
​ Notice Explaining Disposition of Retroactive Benefits Which Were Withheld NL 00703.816 E3816
​ Retroactive Check Released — No Attorney Fee Charged NL 00703.817 E3817
​ Notice to Beneficiary — Retroactive Check is Being Released; Attorney Fee Request Not Received NL 00703.818 E3818
​ Court Case — Retroactive Benefits Were Withheld Pending Determination on Attorney Fee NL 00703.819 E3819
CHILDHOOD AND/OR DISABILITY BENEFITS CDB Suspension Notice — Benefits Withheld — Beneficiary Own Payee NL 00703.556 E3556
​ CDB Suspension Notice — Benefits Withheld — Beneficiary Has Rep. Payee NL 00703.558 E3558
​ Suspension — Auxiliary Benefits Suspended Because CDB or DIB's Benefits Suspended NL 00703.560 E3560
​ Mother/Father Benefits Stopped — Youngest Child Attained Age 16 - Child Disability Decision Pending NL 00703.561 E3561
​ Disability Established for Child Who Has Been Terminated —age 18. Own Payee NL 00703.566 E3566
​ Disability Established for Child Who Has Been Terminated —age 18. Has payee NL 00703.567 E3567
​ Disability Established — Benefits Continued — Child Own Payee NL 00703.568 E3568
​ Disability Established — Benefits Continued — Child Has Payee NL 00703.569 E3569
CLOSE-OUT Title II 6-month Closeout Notice (First Party) NL 00703.740 E3740
​ Title II 6-month Closeout Notice — Inquiry Made on Behalf of Child Under Age 18 or Legally Incompetent Adult NL 00703.741 E3740
​ Title II 6-month Closeout Notice — Inquiry Made on Behalf of Claimant — Not Incompetent or Under Age 18 NL 00703.742 E3742
​ Title II 6-month Closeout Notice — Deceased Claimant NL 00703.743 E3743
​ 6-month Closeout — Doubtful Intent — Potential Auxiliary in Separate Household NL 00703.744 E3744
DEPORTATION Suspension Notice — Beneficiary Deported NL 00703.554 E3554
DISALLOWANCES Auxiliary Not Entitled to Retirement Benefits on Own Record NL 00703.900 E3900
​ Not a Spouse Under the Act NL 00703.901 E3901
​ Miscellaneous Fill-in Letter NL 00703.905 E3905
​ Survivor Disallowance — NH Not Insured NL 00703.907 E3907
​ Disallowance — Date of Birth Not Established NL 00703.909 E3909
​ Auxiliary Disallowance — NH Not Entitled NL 00703.911 E3911
​ Request for Benefit Increase Denied NL 00703.913 E3913
​ Retirement Denial — Lack of Insured Status NL 00703.915 E3915
​ Age Requirement Not Met NL 00703.917 E3917
FOREIGN ADDRESS SSA-21 in File — Direct Deposit —Exception to Alien Nonpayment Provision — No Alien Tax Withholding NL 00703.290 E3290
​ SSA-21 in File — No Direct Deposit — Exception to Alien tax withholding NL 00703.291 E3291
​ SSA-21 in File — Direct Deposit — Exception to Alien Nonpayment Provision — Alien Tax Withholding NL 00703.292 E3292
​ SSA-21 in File — No Direct Deposit — Exception to Alien Nonpayment Provision — Alien Tax Withholding NL 00703.293 E3293
​ SSA-21 Not in File NL 00703.294 E3294
​ Suspension Notice — SSA-21 in File — No Exception To Alien Nonpayment Provision — Outside U.S. More Than 6 Months (Payee Version) NL 00703.296 E3296
​ Temporary Move Outside U.S. — Less Than 6 Months — Using U.S. Mailing Address — Beneficiary Under Age 70 Not Disabled NL 00703.300 E3300
​ Outside U.S. More Than 6 Months — Using U.S. Mailing Address NL 00703.302 E3302
​ Suspension Notice — SSA-7161, SSA-7162, and/or SSA-21 Not Returned NL 00703.304 E3304
​ Notice to Beneficiary Residing in a Restricted Country Who Plans To Leave In Order To Collect Accrued Benefits NL 00703.308 E3308
​ Beneficiary Planning Trip Abroad — 3 Months or Fewer NL 00703.309 E3309
​ Suspension Notice (Survivor Cases Only) — Beneficiary Receiving Reduced Rate Because of Work — Other Beneficiaries Also Working —Foreign NL 00703.461 E3461
FOREIGN WORK Suspension Notice to Beneficiary —Insured Person Working More Than 45 Hours Per Month NL 00703.510 E3510
GARNISHMENT AND TAX LEVY Notice to Beneficiary/payee — Initial Withholding Due to Garnishment — Court Ordered Amount No More Than Federal or State Limits NL 00703.707 E3707
​ Notice to Beneficiary/Payee — Withholding Percentage is Reduced NL 00703.708 E3708
​ Notice to Beneficiary/Payee — Amended Garnishment Order NL 00703.709 E3709
​ Notice to Beneficiary Whose Payments Have Been Garnished NL 00703.710 E3710
​ Notice to Beneficiary/Payee — Initial Withholding Due to Garnishment — Court Ordered Amount More Than Federal or State Limits NL 00703.712 E3712
​ Notice to Beneficiary/Payee — Cost-of-Living Increase in Benefits Affects Garnishment Action NL 00703.714 E3714
​ Notice to Beneficiary/Payee — Garnishment Ended NL 00703.716 E3716
​ Notice to Beneficiary/Payee — Appeal of Garnishment Order Requested NL 00703.722 E3722
​ Notice to Court — Garnishment Order — Initial Withholding But Not Paying Receiver NL 00703.723 E3723
​ Notice to Court — Garnishment Order — Initial Withholding NL 00703.724 E3724
​ Notice to Court — Garnishee is Not Entitled to Monthly Benefits NL 00703.725 E3725
​ Notice to Court — Garnishee's Claim for Monthly Benefits Pending NL 00703.726 E3726
​ Notice to Court — Garnishment Order — Incorrect Party Named NL 00703.728 E3728
​ Notice to Court — Garnishment — Noncompliance With a Court Order NL 00703.729 E3729
​ Notice to Court — Initial Withholding But Not Paying Receiver NL 00703.730 E3730
​ Notice to Court — Withholding Percentage is Reduced NL 00703.731 E3731
​ Notice to Court — Increase/Decrease in Benefits NL 00703.732 E3732
​ Notice to Court — Amended Order — Withheld Amount Increased —Court Ordered Amount More Than Maximum Allowed NL 00703.733 E3733
​ Notice to Court — Amended Order — Maximum Amount Already Being Withheld NL 00703.734 E3734
​ Notice to Court — Amended Order — Requested Amount Withheld NL 00703.735 E3735
​ Notice to Court — Garnishment Suspended NL 00703.736 E3736
​ Notice to Court — Garnishment Ends NL 00703.737 E3737
INSTALLMENT PAYMENTS Accrued Benefits - Total Paid to Rep-payee or Beneficiary NL 00703.350 E3350
​ Accrued Benefits Paid in Monthly Installments to Rep-payee NL 00703.352 E3352
​ Conserved Benefits — Entire Amount Paid to New Rep-payee or Beneficiary NL 00703.354 E3354
​ Conserved Benefits — Monthly Installments Paid to New rep-payee NL 00703.356 E3356
​ Conserved Benefits — Monthly Installments Paid to the Beneficiary NL 00703.357 E3357
MISCELLANEOUS Checks Stopped — RRB Involved NL 00703.127 E3127
​ Change of Address — Foreign to Domestic NL 00703.310 E3310
​ Transfer of Social Security Payments to the Railroad Retirement Board (RRB) for Certification to Treasury NL 00703.318 E3318
​ Social Security Claim Filed — Transferred to RRB NL 00703.319 E3319
​ Social Security Claim Filed — Civil Service Pension Involved NL 00703.320 E3320
​ Notice to Beneficiary About Special Check (Preliminary Payment) NL 00703.321 E3321
​ Reissuance of Lost Check NL 00703.322 E3322
​ Initial Award Suspension Notice — Claimant Does Not Have SSN -No Rep-payee NL 00703.462 E3462
​ Initial Award Suspension Notice — Claimant Does Not Have SSN —Rep-payee Involved NL 00703.463 E3463
​ Notice of Abatement - Non-disability Claimant Dies in or Before First Month of Entitlement — Disability Claimant Dies in Waiting Period NL 00703.775 E3775
​ Correspondence Cover Letter NL 00703.807 E3807
​ Benefits Suspended Due to Number Holder’s (NH) Death — Dual Entitlement NL 00703.932 E3932 and E3932.1
​ Cover Notice for Field Office (FO) and Teleservice Center (TSC) to Use When Sending the SSA-4111 NL 00703.933 SSA-4111/L7
OVERPAYMENTS O/P Person — Adjustment Can be Made Against Own Benefits NL 00703.100 E3100
​ O/P Person in Current Pay Status — Adjustment Proposed -Alien Tax Withholding Involved NL 00703.101 E3101
​ O/P Person - in Nonpay Status But Receiving Benefits for Other Beneficiary in Same Household — Refund Requested or Adjustment Proposed NL 00703.102 E3102
​ O/P Person in Nonpay Status but Receiving Benefits for Other Beneficiary in Same Household — Refund Requested and Adjustment Proposed —Alien Tax Withholding Involved NL 00703.103 E3103
​ Notice to Other Beneficiary — Recovery From Overpaid Person Not Possible NL 00703.104 E3104
​ O/P Person — Adjustment Cannot Be Made Against Own Benefits — Own Payee — Request For Refund — Cross-Program Recovery May Be Possible NL 00703.106 E3106
​ O/P Person in Nonpay Status — Refund Requested — Alien Tax Withholding Involved NL 00703.107 E3107
​ O/P Notice to Rep-payee — Currently Receiving Benefits on Behalf of Person Overpaid — Refund Requested — Adjustment Proposed NL 00703.108 E3108
​ 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 NL 00703.109 E3109
​ O/P Notice to Rep-payee — Not Currently Receiving Benefits on Behalf of Person Overpaid — Refund Requested — Adjustment Proposed Against Rep-payee or Other Beneficiary(ies) NL 00703.110 E3110
​ Representative Payee Who Received Overpayment on Behalf of Beneficiary and Who is Not Currently Receiving Benefits for Beneficiary —Adjustment Proposed Against Rep-payee or Other Beneficiary for Whom Rep-payee is Receiving Benefits — Alien tax Withholding Involved NL 00703.111 E3111
​ O/P Notice to Rep-payee — Adjustment Cannot be Made Against Own Benefits — Request for Refund — Cross-program Recovery May be Possible NL 00703.112 E3112
​ O/P Person — RRB Paying Benefits on Same A/N and RRB Will Recover O/P NL 00703.113 E3113
​ Follow-up Notice — Adjustment Proposed — Opportunity for Personal Conference Not Previously Offered NL 00703.114 E3114
​ Representative Payee Who Received Overpayment on Behalf of Beneficiary and Who is Not Currently Receiving Benefits for Beneficiary — Refund Requested — Alien tax withholding Involved NL 00703.115 E3115
​ Follow-up Notice — Immediate Adjustment — Opportunity for Personal Conference Previously Given NL 00703.116 E3116
​ Reconsideration Affirms Overpayment Determination (Reconsideration only Requested) — Refund Requested or Cross-Program Recovery Possible NL 00703.118 E3118
​ Reconsideration Affirms Overpayment Determination (Reconsideration Only Requested) — Refund Requested and/or Adjustment Proposed NL 00703.119 E3119
​ Final Request for Refund — DOJ Referral Required NL 00703.130 E3130
​ Notice of Acceptance of Compromise Offer NL 00703.140 E3140
​ Notice of Rejection of Compromise Offer NL 00703.141 E3141
​ Waiver Requested — Refusal to Cooperate NL 00703.166 E3166
​ Waiver Denial Only — Refund Requested NL 00703.167 E3167
​ Waiver Denial Only — Current Pay NL 00703.168 E3168
​ Reconsideration Affirms Overpayment Determination —Reconsideration and Waiver Requested NL 00703.169 E3169
​ Reconsideration Affirms Overpayment Determination — Waiver Approved NL 00703.170 E3170
​ Personal Conference and Folder Review Scheduled —Waiver NL 00703.171 E3171
​ Personal Conference and Folder Review Scheduled —Reconsideration NL 00703.173 E3173
​ Personal Conference and Folder Review Rescheduled NL 00703.174 E3174
​ Confirmation of Telephone Rescheduling of Personal Conference —Person Failed to Appear for Conference — RSI NL 00703.176 E3176
​ Notice of Waiver Approval (SSA and Black Lung) NL 00703.180 E3180
​ Notice of Waiver Approval (SSI-Domestic) NL 00703.182 E3182
​ SPA Overpayment, Initial Overpayment Notice Previously Sent, No Recovery Action Being Taken, Overpaid Beneficiary in Terminated Status NL 00703.186 E3186
​ Terminated Overpayment Collection Overpayment Equal to or More Than Current Monthly Payment NL 00703.187 E3187
​ Terminated Overpayment Collection Overpayment Equal to or More Than Current Monthly Payment (Payee) NL 00703.188 E3188
​ Terminated Overpayment Collection Overpayment Amount Less Than Current Monthly Payment NL 00703.189 E3819
​ Terminated Overpayment Collection — Overpayment Amount is Less Than Current monthly Payment (Payee) NL 00703.190 E3190
​ Terminated Overpayment Collection — Overpayment on Own SSN Being Recovered NL 00703.191 E3191
​ Terminated Overpayment Collection — Overpayment on Own SSN Being Recovered (Payee) NL 00703.192 E3192
​ Reconsideration and Waiver Denial — Refund Request NL 00703.193 E3193
​ Reconsideration and Waiver Denial — Current Pay NL 00703.194 E3194
​ Partial Waiver Approval with Personal Conference — Refund Requested NL 00703.195 E3195
​ Partial Waiver Approval with Personal Conference — Current Pay NL 00703.196 E3196
​ Reconsideration and Partial Waiver Approval — Refund Requested NL 00703.197 E3197
​ Reconsideration and Partial Waiver Approval — Current Pay NL 00703.198 E3198
​ Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report or Filed Work Report Showing No Earnings — Beneficiary in Suspense or Terminated Status NL 00703.413 E3413
​ Overpayment Due to Posted Earnings — Beneficiary Did not File Work Report or Filed Work Report Showing No Earnings — Beneficiary in Current or Deferred Status NL 00703.414 E3414
​ Overpayment Due to Posted Earnings — Beneficiary Filed Work Report but Posted Earnings Exceed Amount Reported — Beneficiary in Suspense or Terminated Status NL 00703.415 E3415
​ Overpayment Due to Posted Earnings — Beneficiary Filed Work Report but Posted Earnings Exceed Amount Reported - Beneficiary in Current or Deferred Status NL 00703.416 E3416
​ 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 NL 00703.417 E3417
​ 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 NL 00703.418 E3418
​ 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 NL 00703.419 E3419
​ 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 NL 00703.420 E3420
PARTIAL AWARD Partial Award Follow-up Notice; No Change in Benefits NL 00703.772 E3772
PRORATING WORK SUSPENSIONS Prorating Involves Current Year Benefits — SMI Involved NL 00703.452 E3452
​ Prorating Involves Current Year Benefits — No SMI Involved NL 00703.454 E3454
​ Denial of Request for Prorating - Work Suspensions NL 00703.456 E3456
RECLAMATION Recovery From Individual Who Withdrew Funds From a Deceased Beneficiary's Bank Account After Death; Individual is Not Receiving Benefits NL 00703.595 E3595
REPRESENTATIVE PAYEE Request for Repayment of Misused Funds NL 00703.200 E3200
​ Repayment of Misused Funds — Cover Letter to New Payee NL 00703.201 E3201
​ Misuse Not Established — Notice to Beneficiary and/or Representative Payee NL 00703.202 E3202
​ Notice of Misuse Negligence Determination NL 00703.203 E3203
​ Notice to Payee and Any Former Payee Administering Conserved Funds When Beneficiary Dies NL 00703.204 E3204
​ Notice to Former Payee to Continue to Administer Conserved Funds NL 00703.208 E3208
​ Notice Affirming Selection of Representative Payee Selection on Reconsideration NL 00703.215 E3215
​ Notice Affirming Selection of a Specific Representative Payee on Reconsideration NL 00703.216 E3216
​ Change to Direct Payment - Child Turns Age 18 and is a Student NL 00703.256 E3256
​ Letter to Representative Payee — Conserved Funds of $1500 or More — VA Benefits May Be Affected NL 00703.344 E3344
​ Letter to Successor Payee — Direct Transfer of Conserved Funds NL 00703.345 E3345
​ Letter to Beneficiary — Direct Transfer of Conserved Funds NL 00703.346 E3346
​ Letter to New Payee or Beneficiary When SSA Has Abandoned Efforts to Recover Funds Misused by Former Payee NL 00703.347 E3347
​ Notice of Payee's Signature Requirement on Form SSA-623-OCR-SM NL 00703.348 E3348
​ Notice Regarding Return of Original Documents to Payee NL 00703.349 E3349
​ Advance Notice to Legally Competent SSI Recipient Who is Not a Drug Addict or Alcoholic About the Person Being Appointed as Representative Payee — Initial Claim NL 00703.763 E3763
​ Advance Notice to Legally Competent SSI Recipient Who is Not a Drug Addict or Alcoholic About the Person Being Appointed as Representative Payee — Postentitlement Claim NL 00703.765 E3765
​ Advance Notice to Legally Competent Adult or Emancipated Minor About Payee Selection — Title II Initial Claim NL 00703.767 E3767
​ Advance Notice to Legally Competent Adult or Emancipated Minor About Payee Selection — Title II Postentitlement Claim NL 00703.768 E3768
​ Advance Notice to Legal Guardian, Parent or Person Standing in Place of Parent — If Not Proposed Payee NL 00703.769 E3769
​ Authorized Fee Notice to Beneficiary or Person Standing in Place of Beneficiary NL 00703.770 E3770
​ Notice to Beneficiary or Person Standing in Place of Beneficiary About Revocation of Fee NL 00703.771 E3771
​ Reply to Show Cause Order NL 00703.773 E3773
​ Change in Authorized Fee — Notice to Beneficiary or Person Standing in Place of Beneficiary NL 00703.774 E3774
​ Advance Notice to Beneficiary Attaining Age 18 — Representative Payee Still Needed NL 00703.776 E3776
​ Final Notice to the Former Representative Payee, or the Non-Selected Payee Applicant When Another Payee is Appointed NL 00703.821 E3821
​ Final Notice to Legally Competent Adult or Emancipated Minor of Payee Selection NL 00703.822 E3822
​ Notice to Child Beneficiary Who Was His/Her Own Payee or Legally Incompetent Adult Beneficiary When Representative Payee Appointed NL 00703.823 E3823B
​ Final Notice of Payee Appointment to Parent, Person Standing in Place of Parent, Legal Guardian or Attorney Representative Who is Also an Unsuccessful Applicant NL 00703.824 E3824
​ Notice to Legally Competent Adult Beneficiary or Emancipated Minor Who Has A Payee and is Denied Direct Payment NL 00703.825 E3825
​ 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 the Beneficiary NL 00703.826 E3826
​ Notice to Child or Incompetent Adult Beneficiary Who Has a Representative Payee and Is Denied Direct Payment NL 00703.827 E3827
​ Notice to Parent, Person Standing in Place of Parent, or Legal Guardian of a Minor Beneficiary That His/Her Benefits Will be Paid Directly to the Minor, Rather Than a Payee NL 00703.828 E3828
​ Cover Letter to Qualified Organization About Payment For Representative Payee Services NL 00703.940 E3940
​ Enclosure With Cover Letter to Qualified Organizations — Notice Explaining Fees NL 00703.941 E3941
​ Enclosure With Cover Letter to Qualified Organizations — Notice Explaining Fee Authorization NL 00703.942 E3942
​ Notice Authorizing Organization to Collect a Fee NL 00703.943 E3943
​ Notice to Organization Denying Request to Collect a Fee NL 00703.944 E3944
​ Enclosure with Authorization Notice — Explanation of Fees NL 00703.945 E3945
​ Notice Affirming Decision Not to Allow Organization to Collect Fee for Representative Payee Services NL 00703.948 E3948
​ Revocation Notice to Organization NL 00703.949 E3949
​ Notice to Creditor Organization NL 00703.950 E3950
TERMINATION Termination Letter to Representative Payee When Beneficiary Dies NL 00703.924 E3924
​ Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce - Domestic NL 00703.925 E3925
​ Benefits to Young Spouse, Mother/Father Terminate - Child Attains Age 16 - Domestic NL 00703.927 E3927
​ Benefits to Child Terminate Age 18/19, Domestic or Foreign NL 00703.929 E3929
​ Benefits to Student Terminate — No Longer in Full-Time Attendance NL 00703.931 E3931
​ Request to Employer For Debtor Address NL 00703.758 E3758
​ Request to Financial Institution For Correct Beneficiary Address NL 00703.759 E3759
UNDELIVERABLE MAIL Undeliverable Mail — Advance Notice That We Will Stop Benefits NL 00703.760 E3760
​ Advance Notice That We Will Stop Benefits — SSA-1588, Beneficiary Recontact Report, Returned Undeliverable NL 00703.761 E3761
​ Withdrawal — Repayment-New Benefit NL 00703.700 E3700
​ Withdrawal — Repayment-Auxiliary NL 00703.701 E3701
WITHDRAWAL Withdrawal — 30-Day Closeout NL 00703.702 E3702
​ Withdrawal After Disallowance NL 00703.705 E3705
​ Withdrawal Notice to RRB — Withdrawal Approved - No Entitlement Under SSA NL 00703.706 E3706
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To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900703010
NL 00703.010 - Usage Chart for Exhibit/Dictated Letters - 01/26/2015
Batch run: 07/02/2026
Rev:01/26/2015