HI 03094.720 Notice to Living with Spouse Who Does Not Appeal
“Notice to Living With Spouse Who Does Not Appeal” is sent to the living with spouse when an applicant files a request for appeal but the living with spouse does not. This notice is created in the Document Generation System (DGS) used in the Subsidy Appeals Unit.
B. Sample Important Information Notice for Living With Spouse Who Does Not Appeal
Social Security Administration
Medicare Prescription Drug Assistance
SDS return address
Date: November 23, 2005
Social Security Number: 123-00-6789
JOHN Q. PUBLIC
123 MAIN ST
SPRINGFIELD OH 45501
Based on an appeal filed by your spouse, we may change the amount of your subsidy. We are writing to tell you that you can present additional information for us to consider before we make a decision on your spouse’s appeal.
Providing Additional Information
If there is more information you want us to see, please send it to us within 10 days from the date of this notice. You can mail the information to Social Security Administration, (address to be determined) or you can call us at (special 800#). If you need help, you should contact us immediately.
If you do call, please have this letter with you. It will help us answer your questions.
Subsidy Determination Unit Supervisor