Dear:
We are writing to tell you we are returning your notice of appointment. We cannot
recognize John Doe, 123 Street, Anytown, New York 12345, as your representative. [We
have suspended John Doe from representing claimants before us for 3 years./We have
disqualified John Doe from representing claimants before us.] His [suspension/disqualification]
will not affect how we decide your claim or any other matter that you have before
us.
[Use this opening paragraph instead of the above if representative is unsuitable: We are writing to tell you we are returning your notice of appointment. We cannot
recognize John Doe, 123 Street, Anytown, New York 12345, as your representative. John
Doe does not qualify to represent claimants before us.]
What Happens Next
You may wish to appoint someone else to represent you. Until you decide whether to
appoint another representative, we will deal directly with you. We will help you with
your claim(s).
John Doe cannot charge a fee to you or anyone else who receives benefits on your record.
If You Have Questions
For general information about Social Security, we invite you to visit our website
at www.socialsecurity.gov on the Internet. For general questions and specific questions about your case, you
may call us toll-free at 1-800-772-1213, or call your local Social Security office
at 555-123-4567. We can answer most questions over the phone. If you are deaf or hard
of hearing, you may call our TTY/TDD number 1-800- 325-0778. If you do call or visit
an office, please have this letter with you. It will help us answer your questions.
Social Security Administration
cc:
Center for Program Support, Region ##
Office of the General Counsel