Send the FAX form to the appropriate PC as indicated on the FAX form. In addition,
annotate the subsequent blocks on the form with the appropriate case information as
Check the OTHER block on the EXCLUSION CATEGORY.
Add the following in the REMARKS section of the FAX form:
For Re-Suspension of Title II Benefits When the Beneficiary Moves Out of the Second
Circuit After Receiving Fowlkes AR Relief annotate in REMARKS:
“PRIORITY – FOWLKES COURT CASE – SUSPEND BENEFITS EFF MM/YYYY –BENE MOVED OUT OF SECOND