TN 4 (05-95)
Identifies those individuals, including representative payees, who should be sent
a Spanish notice (NL 00601.600).
Indicates the need for Spanish notices by inserting the remark “Spanish Notice Required” in item 34 of the SSA-831-U3 and in item 24 of the SSA-832-U3 and SSA-833-U3 (DI 11010.345E.3.).
Handle, as usual, notices that can be computer generated. These will not require any
Apply the following to manual notices prepared by FOs, DDSs and PCs.
Prepare an English and Spanish notice if a Spanish version of an English language
form notice is available. (Spanish language versions of title II and title XVI initial
and reconsideration form notices and title XVI State supplementation/Medicaid paragraph
riders are currently available.)
Prepare the personalized attachment in English in all cases (except in Puerto Rico).
Type any additional paragraphs in English on the personalized attachment, “O” Rider (Para. 800), or on the Medicaid/State supplementation rider.
NOTE: If a word processor is used rather than a rider, insert the correct information.
If a claimant moves to another State and a Spanish Medicaid/State supplementation
rider is not available, type the appropriate paragraphs in English on the personalized
attachment, or on “O” Rider (Para. 800).
Use a Spanish cover notice if a Spanish language form is unavailable. The cover letter
explains that the claimant should request assistance in translating the English form.
Assemble the completed English and Spanish notices in the following bottom-to-top
English form notice
English Medicaid/State supplementation rider, if applicable
Spanish form notice
Spanish Medicaid/State supplementation rider
Spanish cover notice (if Spanish form notice is unavailable). See NL 00603.110B.2.e. above.
NOTE: The notice should be assembled in the individual's reading order (i.e., Spanish followed
If the letter will be dictated, prepare an English notice with a Spanish cover sheet
if the text of the notice must be typed on a blank form notice, i.e., personalized
Prepare the English notice following existing instructions.
Type the name, address, claim number and date (same date as English notice and typed
after the word “FECHA” on the Spanish language cover notice.)
Attach the Spanish notice to the front of the English notice.
When applicable, mail the letters to the claimant or his/her representative.
Attach a copy of the Spanish cover notice to the copy of the English notice and prong
file both on the right side of the folder.
Include both the English and Spanish versions of the appropriate pamphlet(s) with