TN 110 (09-23)

SI 00835.382 Form SSA-L5061 (Letter to Landlord Requesting Rental Information)

A. Procedure for when to use Form SSA-L5061

Use Form SSA-L5061 to develop rental subsidy whenever you request rental information from a landlord and it is not feasible to document the issue solely within the SSI Claim System. Instructions for preparing the paper document for mailing and documenting the electronic file are provided below.

B. Procedure for interviewing the landlord

1. Landlord is at the interview or on the telephone

If the landlord is at the interview or on the telephone:

  • Record the landlord’s responses to the rental subsidy issue on the Home Ownership and Rental Liability page. Document on a Report of Contact page in the SSI Claim System (e.g., “CR spoke with landlord about rental subsidy and the Home Ownership and Rental Liability page has been updated.”). No additional documentation (e.g., SSA-L5061) is required.

2. Landlord is not at the interview and not available by telephone:

If the landlord is not at the interview and not available by telephone, use the SSA-L5061:

  • Mark the SSA- L5061 to indicate which questions to answer, and about whom the information is requested before mailing the form to the landlord;

  • In item 1, enter the address of the claimant/recipient;

  • In items 2 and 4, enter the name of the person(s) claiming rental liability; and

  • In item 5, enter any supplemental questions you think are needed for the determination.

3. Electronic documentation

If a paper SSA-L5061 is received from the landlord:

  • Document the landlord’s response on a Report of Contact page in the SSI Claim System and update the Home Ownership and Rental Liability page accordingly.

  • For non-MSSICS cases, fax the SSA-L5061 into the appropriate electronic folder.

  • Do not retain the paper form after the issue has been documented electronically.

For more information on storing forms electronically refer to GN 00301.322 “Retention of Paper Material After Faxing into Either the eDIB folder or Claims Folder using NDRed”.

See OS 15030.187 for Form SSA-L5061.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0500835382
SI 00835.382 - Form SSA-L5061 (Letter to Landlord Requesting Rental Information) - 09/26/2023
Batch run: 09/26/2023
Rev:09/26/2023