TN 13 (11-10)

SI 02003.050 Exhibits of Forms SSA-8125 and SSA-L8125-F6 for Exception Cases and Proration Cases

Use the instructions to process the eIAR exception cases described in SI 02003.023.

NOTE: The SSA-8125 is obsolete due to the implementation of electronic Interim Assistance Reimbursement system (eIAR). This reference is retained in POMS because the form may be encountered in pipeline cases.

A. Exhibit of SSA-8125 (SSI Notice of Interim Assistance Reimbursement)

G-SSA-8125-1

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G-SSA-8125-2

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B. Exhibit of SSA-L8125-F6 (Notice of Interim Assistance Reimbursement)

G-SSA-L8125-F6-1

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G-SSA-L8125-F6-2

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G-SSA-L8125-F6-3

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G-SSA-L8125-F6-4

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G-SSA-L8125-F6-5

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G-SSA-L8125-F6-6

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To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502003050
SI 02003.050 - Exhibits of Forms SSA-8125 and SSA-L8125-F6 for Exception Cases and Proration Cases - 02/05/2013
Batch run: 02/05/2013
Rev:02/05/2013