NL 00701.036 Form SSA-L223 — Auxiliary Disapproval — N/H Not Entitled

A. Sample form

G-NL_00701.036A

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B. Preparation of form

The source of information for completing the name and address is Form SSA-3428-U2, Determination of Disallowance Coding Sheet.

If a representative payee is involved, add the word “for” after benefits in the first sentence and include the name of the beneficiary. If more than one child beneficiary is involved each child will need a separate notice.

This notice does not require any fill-ins.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701036
NL 00701.036 - Form SSA-L223 -- Auxiliary Disapproval -- N/H Not Entitled - 06/11/2013
Batch run: 06/11/2013
Rev:06/11/2013