TN 3 (03-95)

GN 03960.095 Exhibit - Example of SSA-795, Statement of Claimant or Other Person (For Use in Requests for Administrative Review Under the Fee Agreement Process)

To view the form, go to SSA-795.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203960095
GN 03960.095 - Exhibit - Example of SSA-795, Statement of Claimant or Other Person (For Use in Requests for Administrative Review Under the Fee Agreement Process) - 06/08/2012
Batch run: 06/08/2012
Rev:06/08/2012