TN 29 (03-09)
GN 00605.360 Preparation of the Representative Payee Report Form
When requesting a final accounting, the technician must enter certain identifying
information on the form before mailing it to the payee. Fill in the following fields
on the form as instructed:
Payee’s name and address
Enter the Payee legend as it appeared on the MBR or SSR prior to the payee’s termination.
Enter the period for which the payee must account.
The “FROM” date is the month after the date of selection of the former payee.
The “TO” date is the month the change of payee or payee termination action is taken.
A technician can often derive the FROM and TO dates by reviewing the SSR or MBR. If
the dates cannot be determined by reviewing the payment records, the technician should:
Go to SSA Main Menu, select 9 (Master File Query) and hit Enter;
Select 17 (QRSL Inquiry Response) on the Master File Query menu, input the SSN and
Input “I” (HIST PAYEE/ADDRESS) under the “Selection” column for the beneficiary on
the “QUERY RESPONSE SELECTION LIST” screen and hit Enter.
The “FROM DATE” for the report period will be the month after the date shown in the
“PAYEE 1 DATE” on the HPNA (Historical Payee Name Address) screen.
Social Security Number
Enter the Social Security Number (SSN) under which the beneficiary receives benefits.
For concurrent cases, enter the Title XVI SSN.
Enter the beneficiary’s full name.
Enter for the beneficiary:
Beneficiary Identification Code (BIC) for Title II cases
Individual Recipient Identification Code (ID) for Title XVI cases, and
ID and BIC for concurrent cases
Processing Center (PC)
For Title II cases, enter the number of the PC servicing the claim.
District office (DO) code
Enter the code of the servicing field office.
Beneficiary Social Security Number (BSSN)
Enter the beneficiary’s SSN if it differs from the claim number under which the beneficiary
Enter the Total Accountable Amount (TAA) in Item 3 of the report form. This amount
represents the total amount paid to the beneficiary during the time shown in the “Report
Period” section and any conserved funds that were reported previously by the former
payee. When computing the TAA remember to subtract any checks that the former payee
returned to SSA.
After entering the required data, mail the final accounting report form to the former
representative payee with instructions to complete and return it to the FO.