NL 00701.036 Form SSA-L223 β€” Auxiliary Disapproval β€” N/H Not Entitled

A. Sample form

B. Preparation of form

The source of information for completing the name and address is Form SSA-3428-U2, Determination of Disallowance Coding Sheet.

If a representative payee is involved, add the word β€œfor” after benefits in the first sentence and include the name of the beneficiary. If more than one child beneficiary is involved each child will need a separate notice.

This notice does not require any fill-ins.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701036
NL 00701.036 - Form SSA-L223 — Auxiliary Disapproval — N/H Not Entitled - 03/17/1995
Batch run: 06/11/2013
Rev:03/17/1995