BASIC (03-86)

DI 43520.020 Optional Form 41

Prepare this routing and transmittal slip as a cover sheet for an SSA-432-U6/SSA-423A-U5 to inform a DO of INTPSC's development actions on a claim.

This form is preprinted. complete the DO address and DO number and staple it to the DO copy of the SSA-423-U6 or SSA-423-U5.

(See Exhibit E., DI 43520.070).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0443520020
DI 43520.020 - Optional Form 41 - 04/12/2013
Batch run: 04/12/2013
Rev:04/12/2013