NL 00703.000 Exhibit and Dictated Letters

Subchapter Table of Contents
Section   Latest
Transmittal
NL 00703.005 Exhibit/Dictated Notices TN 36 03-99
CHARTS/INDEXES
NL 00703.010 Usage Chart for Exhibit/Dictated Letters TN 34 05-98
NL 00703.012 Usage Chart for HI/SMI Exhibit Letters TN 31 02-97
EXHIBIT LETTERS
NL 00703.100 Notice to Overpaid Person in Current Pay Status — Adjustment Proposed TN 65 03-15
NL 00703.101 Notice To Overpaid Person In Current Pay Status — Adjustment Proposed — Alien Tax Withholding Involved TN 31 02-97
NL 00703.102 Notice to Overpaid Person in Non-pay Status but Receiving Benefits for Other Beneficiary in Same Household — Refund Requested or Adjustment Proposed TN 65 03-15
NL 00703.103 Notice To Overpaid Person In Nonpay Status But Receiving Benefits For Other Beneficiary In Same Household — Refund Requested And Adjustment Proposed — Alien Tax Withholding Involved TN 31 02-97
NL 00703.104 Notice to Other Beneficiary — Recovery From Overpaid Person Not Possible TN 31 02-97
NL 00703.106 Notice to Overpaid Person in Non-pay Status — Refund Requested TN 67 07-15
NL 00703.107 Notice to Overpaid Person In Nonpay Status — Refund Requested —Alien Tax Withholding Involved TN 30 03-96
NL 00703.108 Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and Who is Currently Receiving Benefits for Beneficiary — Refund Requested or Adjustment Proposed TN 31 02-97
NL 00703.109 Notice To Representative Payee Who Received Overpayment On Behalf Of Beneficiary And Who is Currently Receiving Benefits For Beneficiary — Refund Requested And Adjustment Proposed — Alien Tax Withholding Involved TN 31 02-97
NL 00703.110 Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and Who is Not Currently Receiving Benefits for Beneficiary — Adjustment Proposed Against Representative Payee or Other Beneficiary for Whom Representative Payee is Receiving Benefits TN 69 02-16
NL 00703.111 Notice to Representative Payee Who Received Overpayment On Behalf Of Beneficiary And Who Is Not Currently Receiving Benefits For Beneficiary — Adjustment Proposed Against Representative Payee Or Other Beneficiary For Whom Representative Is Receiving Benefits — Alien Tax Withholding Involved TN 31 02-97
NL 00703.112 Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and Who is Not Currently Receiving Benefits for Beneficiary — Refund Requested TN 69 02-16
NL 00703.113 Notice to Overpaid Person in Railroad Board Certification Cases — Adjustment Proposed TN 31 02-97
NL 00703.114 Followup Notice — Adjustment Proposed — Opportunity For Personal Conference Not Previously Offered — No Underpayment Withholding Involved TN 31 02-97
NL 00703.115 Notice To Representative Payee Who Received Overpayment On Behalf Of Beneficiary And Who Is Not Currently Receiving Benefits For Beneficiary — Refund Requested — Alien Tax Withholding Involved TN 31 02-97
NL 00703.116 Followup Notice — Immediate Adjustment — Opportunity For Personal Conference Previously Given — Underpayment Withholding Involved TN 31 02-97
NL 00703.118 Reconsideration Affirms Overpayment Determination (Reconsideration Only Requested) — Refund Requested — Cross-Program Recovery Possible TN 31 02-97
NL 00703.119 Reconsideration Affirms Overpayment Determination (Reconsideration Only Requested)—Refund Requested and Adjustment Proposed TN 72 04-16
NL 00703.120 Notice to Beneficiary(ies') When a Claim Has Been Filed That Will Require an Adverse Adjustment to the Beneficiary's(ies') Benefits TN 30 03-96
NL 00703.121 Notice to Beneficiary(ies') That His or Her Entitlement May be Reversed or Terminated Because an Adverse Claim Has Been Filed TN 30 03-96
NL 00703.122 Advance Notice - Benefits Will Be Stopped TN 30 03-96
NL 00703.123 Advance Notice - Benefits Will Be Reduced (General) TN 30 03-96
NL 00703.124 Advance Notice to Deported or Removed Number Holder TN 48 12-05
NL 00703.125 Advance Notice to Auxiliary of Deported or Removed Number Holder TN 48 12-05
NL 00703.126 Advance Notice — Non-Receipt of Report to United States TN 31 02-97
NL 00703.127 Checks Stopped — RRB Involved TN 31 02-97
NL 00703.128 Advance Adverse Adjustment — Only Past Due Benefits Affected TN 31 02-97
NL 00703.129 Checks Stopped – RRB Jurisdiction of Survivor Claim TN 52 01-07
NL 00703.130 Final Request for Refund — DOJ Referral Required TN 31 02-97
NL 00703.140 Notice of Acceptance of Compromise Offer TN 30 03-96
NL 00703.141 Notice of Rejection of Compromise Offer TN 30 03-96
NL 00703.150 Windfall Elimination Provision (WEP) Advance Notice TN 30 03-96
NL 00703.151 Initial Government Pension Offset (GPO) Advance Notice —Current Pay Status TN 30 03-96
NL 00703.152 Initial Government Pension Offset (GPO) Advance Notice —Suspense/Deferred Status TN 30 03-96
NL 00703.153 GPO Advance Notice — Increase In Government Pension — Current Pay Status TN 30 03-96
NL 00703.154 GPO Advance Notice — Increase In Government Pension —Suspense/Deferred Status TN 30 03-96
NL 00703.155 Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Reduced - Current Pay Status TN 47 12-05
NL 00703.156 Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Reduced - Suspense/Deferred Status TN 50 02-06
NL 00703.157 Advance Notice For SSA/Railroad Retirement Board (RRB) Match —Lowered RR Earnings Affect Benefits — Current Pay Status TN 30 03-96
NL 00703.158 Advance Notice For SSA/Railroad Retirement Board (RRB) Match —Lowered RR Earnings Affect Benefits — Suspense/Deferred Status TN 30 03-96
NL 00703.159 Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Terminated - Current Pay Status TN 50 02-06
NL 00703.160 Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Terminated - Suspense/Deferred Status TN 50 02-06
NL 00703.161 Advance Notice For SSA/RRB Retap Alerts - Benefits to be Terminated TN 32 06-97
NL 00703.165 Waiver Notice for Requesting Authorization to Access Financial Information TN 71 04-16
NL 00703.166 Waiver Requested — Refusal to Cooperate — Title II TN 31 02-97
NL 00703.167 Waiver Denial Only — Refund Requested — Title II TN 31 02-97
NL 00703.168 Waiver Denial Only — Current Pay — Title II TN 31 02-97
NL 00703.169 Reconsideration Affirms Overpayment Determination —Reconsideration and Waiver Requested — RSI Cases TN 31 02-97
NL 00703.170 Reconsideration Affirms Overpayment Determination — Waiver Approved — RSI Cases TN 31 02-97
NL 00703.171 Personal Conference and Folder Review Scheduled — Waiver TN 31 02-97
NL 00703.173 Personal Conference and Folder Review Scheduled —Reconsideration TN 31 02-97
NL 00703.174 Personal Conference and Folder Review — Rescheduled TN 31 02-97
NL 00703.176 Confirmation of Telephone Rescheduling of Personal Conference —Person Failed to Appear for Conference — RSI Cases TN 31 02-97
NL 00703.180 Notice of Waiver Approval TN 66 04-15
NL 00703.182 Notice of Waiver Approval — SSI (Domestic) TN 66 04-15
NL 00703.183 Cross-Program Recovery Notices TN 42 11-04
NL 00703.186 SPA Overpayment Notice, Initial Overpayment Notice Previously Sent, No Recovery Action Being Taken, Overpaid Beneficiary in Terminated Status TN 31 02-97
NL 00703.187 Terminated Overpayment Collection - Overpayment Equal to or More than the Current Monthly Payment (No Representative Payee) TN 30 03-96
NL 00703.188 Terminated Overpayment Collection - Overpayment Equal to or More Than the Current Monthly Payment (Representative Payee Involved) TN 30 03-96
NL 00703.189 Terminated Overpayment Collection - Overpayment Amount is Less Than Current Monthly Payment (No Representative Payee) TN 30 03-96
NL 00703.190 Terminated Overpayment Collection - Overpayment Amount is Less Than Current Monthly Payment (Representative Payee Involved) TN 30 03-96
NL 00703.191 Terminated Overpayment Collection - Overpayment on Own SSN Being Recovered (No Representative Payee) TN 30 03-96
NL 00703.192 Terminated Overpayment Collection - Overpayment on Own SSN Being Recovered (Representative Payee Involved) TN 30 03-96
NL 00703.193 Reconsideration and Waiver Denial — Refund Request TN 31 02-97
NL 00703.194 Reconsideration and Waiver Denial — Current Pay TN 31 02-97
NL 00703.195 Partial Waiver Approval with Personal Conference — Refund Requested TN 31 02-97
NL 00703.196 Partial Waiver Approval with Personal Conference — Current Pay TN 31 02-97
NL 00703.197 Reconsideration and Partial Waiver Approval — Refund Request TN 31 02-97
NL 00703.198 Reconsideration and Partial Waiver Approval — Current Pay TN 31 02-97
NL 00703.200 Request for Payment of Misused Funds TN 31 02-97
NL 00703.201 Repayment of Misused Funds — Cover Letter to New Payee TN 31 02-97
NL 00703.202 Misuse Not Established — Notice to Beneficiary or Representative Payee TN 31 02-97
NL 00703.203 Notice of Misuse Negligence Determination TN 31 02-97
NL 00703.204 Notice to Representative Payee and Any Former Representative Payee Administering Conserved Funds When Beneficiary Dies TN 31 02-97
NL 00703.208 Notice to Former Representative Payee to Continue to Administer Conserved Funds TN 30 03-96
NL 00703.211 Request for Repayment of Misused Funds - Advanced Notification – Cover Letter To New Payee TN 44 12-04
NL 00703.212 Request For Repayment Of Misused Funds – Advanced Notification TN 44 12-04
NL 00703.213 Repayment Of Misused Funds Notice To Beneficiary/New Payee TN 44 12-04
NL 00703.215 Notice Affirming Selection of Representative Payee on Reconsideration TN 30 03-96
NL 00703.216 Notice Affirming Selection of a Specific Representative Payee on Reconsideration TN 30 03-96
NL 00703.256 Change to Direct Payment — Child Turns 18 and is a Student TN 30 03-96
NL 00703.290 Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Involved — Alien Tax Withholding Not Involved TN 35 09-98
NL 00703.291 Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Not Involved —Alien Tax Withholding Not Involved TN 35 09-98
NL 00703.292 Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Involved — Alien Tax Withholding Involved TN 35 09-98
NL 00703.293 Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Not Involved —Alien Tax Withholding Involved TN 35 09-98
NL 00703.294 Domestic-To-Foreign Change Of Address — SSA-21 Not In File TN 35 09-98
NL 00703.296 Foreign Address — Suspension Notice — SSA-21 In File —Exception To Alien Nonpayment Provision Not Met — Outside the U.S. More Than 6 Months (Payee Version) TN 35 09-98
NL 00703.300 Foreign Address — Temporary Move Outside the United States for Less Than 6 Months — Using U.S. Mailing Address; Beneficiary Under Full Retirement Age — Not Disabled TN 35 09-98
NL 00703.302 Foreign Address — Outside U.S. More Than 6 Months — Using U.S. Mailing Address TN 30 03-96
NL 00703.304 Foreign Address — Suspension Notice — SSA-7161-OCR-SM, SSA-7162-OCR-SM, or SSA-21 Not Returned TN 30 03-96
NL 00703.308 Notice to Beneficiary Residing in a Restricted Country Who Plans to Leave His /Her Country in Order to Collect Accrued Benefits TN 30 03-96
NL 00703.309 Beneficiary Planning Trip Abroad — 3 Months or Fewer TN 30 03-96
NL 00703.310 Change of Address - Foreign to Domestic TN 30 03-96
NL 00703.311 Miscellaneous Adjustment Notice TN 66 04-15
NL 00703.312 Miscellaneous Adjustment Notice (Representative Payee) TN 66 04-15
NL 00703.313 Adjustment - Beneficiary in Conditional or Suspense Status Before and After Action (No Payment) TN 66 04-15
NL 00703.314 Adjustment - Beneficiary in Conditional or Suspense Status Before and After Action (No Payment; Payee Version) TN 31 02-97
NL 00703.315 Adjustment -Beneficiary in Conditional or Suspense Status Before and After Action (One Check Only) TN 66 04-15
NL 00703.317 Recomputation of Benefit Amounts - Beneficiary Is or Will Be In Current Pay After Action TN 31 02-97
NL 00703.318 Transfer of Social Security Payments to the Railroad Retirement Board (RRB) for Certification to Treasury TN 59 07-12
NL 00703.319 Social Security Claim Filed — Transferred to RRB TN 31 02-97
NL 00703.320 Social Security Claim Filed — Civil Service Pension Involved TN 31 02-97
NL 00703.321 Notice of Special Check (Preliminary Payment) TN 31 02-97
NL 00703.322 Reissuance of Lost Check TN 31 02-97
NL 00703.323 Withholding Requested But Net Benefits Not Enough to Implement TN 31 02-97
NL 00703.324 Withholding Not Requested — Administrative Error TN 31 02-97
NL 00703.325 Withholding Requested at a Different Rate — Withholding Error TN 31 02-97
NL 00703.330 Benefits Stopped (Retroactively or Currently) - Beneficiary Is Not a U.S. Citizen and 6-Month Period Expired TN 31 02-97
NL 00703.344 Letter to Representative Payee — Conserved Funds of $1,500 or More — VA Benefits May Be Affected TN 30 03-96
NL 00703.345 Letter to Successor Payee About Direct Transfer of Conserved Funds TN 30 03-96
NL 00703.346 Letter to Beneficiary About Direct Transfer of Conserved Funds TN 30 03-96
NL 00703.347 Letter to Be Sent to New Payee or Beneficiary When SSA Has Abandoned Collection Efforts to Recover Funds Misused By Former Payee TN 30 03-96
NL 00703.348 Notice of Payee's Signature Requirement on Form SSA-623-OCR-SM TN 30 03-96
NL 00703.349 Notice Regarding the Return of Original Documents to the Payee TN 30 03-96
NL 00703.350 Accrued Benefits — Total Paid to Representative Payee or Directly to the Beneficiary TN 30 03-96
NL 00703.352 Accrued Benefits Paid In Monthly Installments to Payee TN 30 03-96
NL 00703.354 Conserved Benefits — Entire Amount Paid to New Representative Payee or to the Beneficiary TN 30 03-96
NL 00703.356 Conserved Benefits — Monthly Installments Paid To New Representative Payee TN 30 03-96
NL 00703.357 Conserved Benefits — Monthly Installments Paid to the Beneficiary TN 30 03-96
NL 00703.364 Termination of Section 217(b) Benefits Because of VA Pension TN 30 03-96
NL 00703.365 Adjustment in Benefit Rate Because No longer Entitled Under Section 217(b); Still Entitled Under Section 217(a) and (e) TN 30 03-96
NL 00703.371 Government Pension Offset (GPO) Advance Notice — Effect of Increase in Government Pension on Social Security Benefits TN 30 03-96
NL 00703.413 Notice of Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report Or Filed Work Report Showing No Earnings -Beneficiary In Suspense Or Terminated Status TN 30 03-96
NL 00703.414 Notice of Overpayment Due to Posted Earnings - Beneficiary Did Not File Work Report Or Filed Work Report Showing No Earnings — Beneficiary In Current Or Deferred Status TN 30 03-96
NL 00703.415 Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted Earnings Exceed Amount Reported — Beneficiary In Suspense or Terminated Status TN 30 03-96
NL 00703.416 Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted Earnings Exceed Amount Reported — Beneficiary In Current Or Deferred Status TN 30 03-96
NL 00703.417 Notice of Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report Or Filed Work Report Showing No Earnings - Monthly Earnings Test Applies — Beneficiary In Suspense Or Terminated Status TN 30 03-96
NL 00703.418 Notice of Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report or Filed Work Report Showing No Earnings — Monthly Earnings Test Applies — Beneficiary In Current Or Deferred Status TN 30 03-96
NL 00703.419 Notice of Overpayment Due To Posted Earnings — Beneficiary Filed Work Report But Posted Earnings Exceed Amount Reported — Monthly Earnings Test Applies — Beneficiary In Suspense Or Terminated Status TN 30 03-96
NL 00703.420 Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted Earnings Exceed Amount Reported — Monthly Earnings Test Applies Beneficiary In Current Or Deferred Status TN 30 03-96
NL 00703.421 TALCMAIL Disability Cessation Overpayment Notice TN 58 09-11
NL 00703.452 Prorating Current Year Suspensions Notice — (SMI Involved) TN 30 03-96
NL 00703.454 Prorating Current Year Suspensions Notice — (No SMI Involved) TN 30 03-96
NL 00703.456 Denial of Request For Prorating Work Suspension TN 30 03-96
NL 00703.458 Auxiliary Due Full Rate Even Though Earnings Exceed Limit —Readjusted Rate Case — Beneficiary Receives Full Adjusted Benefit TN 30 03-96
NL 00703.460 Suspension Notice (Survivor Cases Only) — Beneficiary Receiving Reduced Rate Because of Work — Other Beneficiaries Also Working —Domestic TN 30 03-96
NL 00703.461 Suspension Notice (Survivor Cases Only) — Beneficiary Receiving Reduced Rate Because of Work — Other Beneficiaries Also Working —Foreign TN 30 03-96
NL 00703.462 Initial Award Suspension Notice — Claimant Does Not Have A Social Security Number — No Representative Payee TN 30 03-96
NL 00703.463 Initial Award Suspension Notice — Claimant Does Not Have A Social Security Number -Representative Payee Involved TN 30 03-96
NL 00703.470 Appeal Requested Before Decision Made On Case TN 30 03-96
NL 00703.471 Expedited Appeals Process (EAP) is Denied TN 30 03-96
NL 00703.472 Claimant Cancels Request For Expedited Appeals Process (EAP) TN 30 03-96
NL 00703.473 Good Cause For Late Filing of Reconsideration Request Not Established TN 30 03-96
NL 00703.474 Reconsideration Affirmation of Prior Decision TN 45 07-05
NL 00703.500 Adjustment Notice, Combined Check Reduced — Child's Estimate of Earnings Caused Partial or Total Deductions TN 30 03-96
NL 00703.502 Adjustment Notice — Beneficiary Reduced Earnings to Exempt Amount, Benefit Remains the Same, Had Received Full Benefit While Working TN 30 03-96
NL 00703.503 Adjustment Notice — Beneficiary Reduced Earnings to Exempt Amount, Benefit Remains the Same, Had Received Full Benefit While Working (Payee Version) TN 30 03-96
NL 00703.504 Suspension Notice — Child is Working and Reports Change in Address — Payee Development Necessary — Domestic TN 30 03-96
NL 00703.505 Suspension Notice — Child Is Working and Reports Change in Address — Payee Development Necessary — Foreign TN 30 03-96
NL 00703.510 Suspension Notice to Beneficiary — Insured Person Working More Than 45 Hours Per Month (Foreign Work Test) TN 30 03-96
NL 00703.511 Due Process Notice To Disabled Number Holder (NH)-Benefits To Be Reduced, Further Reduced or Withheld Because of Initial Receipt of or Increase in Workers' Compensation (WC), Public Disability Benefits (PDB), Part C Black Lung (BL) Payments or Federal Employees Compensation Act (FECA) Payments TN 30 03-96
NL 00703.512 Due Process Notice To Disabled NH — Auxiliary Benefits To Be Reduced, Further Reduced, or Withheld Because of NH's Initial Receipt of Or Increase in WC, PDB, FECA or BL Payments (Computer Match Only) TN 31 02-97
NL 00703.513 Due Process Notice to Auxiliary(ies)-Benefits To Be Reduced, Further Reduced or Withheld Because of NHs Initial Receipt of or Increase in WC, PDB, FECA or BL Payments TN 31 02-97
NL 00703.515 DAA Due Process Suspension Notice — Title II Beneficiary — No Longer In Compliance With Treatment Requirements TN 31 02-97
NL 00703.550 “Good Cause” Established — Penalty Deduction Not Applicable TN 30 03-96
NL 00703.554 Suspension Notice — Beneficiary Deported or Removed TN 48 12-05
NL 00703.556 CDB Suspension Notice — Benefits Withheld — Beneficiary Own Payee TN 30 03-96
NL 00703.558 CDB Suspension Notice — Benefits Withheld — Beneficiary Has Representative Payee TN 30 03-96
NL 00703.560 Suspension Notice — Auxiliary Benefits Suspended Because CDBs or DIBs Benefits Suspended TN 30 03-96
NL 00703.561 Mother's/Father's Benefits Stopped-Youngest Child Attained Age 16-Child Disability Decision Pending TN 30 03-96
NL 00703.566 Disability Established for Child Who Terminated-Age 18 — Own Payee TN 30 03-96
NL 00703.567 Disability Established for Child Who Terminated — Age 18-Has Payee TN 30 03-96
NL 00703.568 Disability Established — Benefits Continued — Child Own Payee TN 30 03-96
NL 00703.569 Disability Established — Benefits Continued — Child Has Payee TN 30 03-96
NL 00703.570 CDB Disability Termination — Notice of Cessation —Beneficiary Own Payee TN 30 03-96
NL 00703.572 DIB Termination — Notice of Cessation — Payments to Wife, Widow or Dependent Beneficiaries Terminated TN 30 03-96
NL 00703.580 Notice of Interim Benefits for Administrative Law Judge Cases – Section 8001, P.L. 100-647—Exhibit TN 73 06-16
NL 00703.595 Recovery From Individual Who Withdrew Funds From A Deceased Beneficiary's Bank Account After Death TN 30 03-96
MEDICARE
NL 00703.600 Notice of Award to Medicare Beneficiary (HI/SMI) — Reduced HI Premium — NH, Spouse, Divorced Spouse, Widow(er) or Surviving Divorced Spouse TN 30 03-96
NL 00703.601 Instructions for Preparation of SMI Only Award Notice When a Beneficiary is Eligible for Reduced Premium HI TN 30 03-96
MEDICARE
NL 00703.602 SMI — Reenrollment During the GEP After Prior Enrollment Terminated TN 30 03-96
NL 00703.603 SMI — Enrollment Beyond the Initial Enrollment Period TN 30 03-96
NL 00703.604 SMI — Applied Prior To The Beginning of Initial Enrollment Period TN 30 03-96
NL 00703.605 SMI Denial — Not in General Enrollment Period (GEP) or Special Enrollment Period (SEP) TN 30 03-96
NL 00703.606 SMI Refusal Request Treated As GEP Enrollment TN 30 03-96
NL 00703.609 New Health Insurance Card As A Result of Requested Changes TN 30 03-96
NL 00703.610 Address Change — Returning HI Card TN 30 03-96
NL 00703.616 SMI — Processed Declination of Coverage — Beneficiary In Current Pay Status — Refund Due TN 30 03-96
NL 00703.617 SMI — Processed Declination of Coverage — Beneficiary In Suspense Status — Discard Any Bill For Premiums TN 30 03-96
NL 00703.618 Beneficiary's Refusal of SMI Coverage Not Acceptable — State is Paying Premiums TN 30 03-96
NL 00703.619 HI/SMI — Entitled To Mother's or Widow's Benefits —Coverage Based on Disability — Coverage Begins Within 2 Months After COM TN 30 03-96
NL 00703.620 HI/SMI — Entitled to Mother's or Widow's Benefits —Coverage Based on Disability — Coverage Begins More Than 2 Months After COM TN 30 03-96
NL 00703.621 R-HI/R-SMI — Award Based on Transplant or Dialysis, Entitlement Dates are the Same or Later Than D-HI/D-SMI Coverage (Conversion Notice) TN 68 09-15
NL 00703.622 Ineligible for HI/SMI Coverage Due to DWB Termination TN 30 03-96
NL 00703.623 Ineligible for HI/SMI Coverage Because DIB Ceased TN 30 03-96
NL 00703.624 DIB to RIB Conversion — Full Retirement Age PAC Reduction TN 30 03-96
NL 00703.625 Withdrawal From SMI — Entitlement to CHAMPUS or CHAMPVA TN 30 03-96
NL 00703.626 Notice When Claimant Protests Amount of Premium Bill (Withdrawal Model Letter) TN 30 03-96
NL 00703.627 Notice When Claimant's Correspondence Contains an Incorrect Claim Number TN 30 03-96
NL 00703.628 Notice When Claimant Protests Termination TN 30 03-96
NL 00703.629 General “Check Box” Notice TN 31 02-97
NL 00703.630 HI/SMI — Government Medicare — Coverage Based on Disability — Coverage Begins More Than 2 Months After Current Operating Month TN 68 09-15
NL 00703.700 Withdrawal — Repayment — NH TN 74 07-18
NL 00703.701 Withdrawal — Repayment — NH and Auxiliary(ies) TN 30 03-96
NL 00703.702 Withdrawal — 30 Day Closeout TN 30 03-96
NL 00703.703 Withdrawal Denial TN 64 07-14
NL 00703.705 Withdrawal After Disallowance TN 30 03-96
NL 00703.706 Withdrawal Notice to RRB — Withdrawal Approved — No Entitlement Under SSA TN 30 03-96
NL 00703.707 Notice to Beneficiary/Payee — Initial Withholding Due to Garnishment — Court Ordered Amount No More Than Federal or State Limits TN 30 03-96
NL 00703.708 Notice to Beneficiary/Payee — Withholding Percentage is Reduced TN 30 03-96
NL 00703.709 Notice to Beneficiary/Payee — Amended Garnishment Order TN 31 02-97
NL 00703.710 Notice to Beneficiary/Payee — Payments May Be Garnished TN 38 06-03
NL 00703.711 Notice to Potential Beneficiary/Payee — Payments May Be Garnished If Claim is Approved TN 38 06-03
NL 00703.712 Notice to Beneficiary/Payee — Initial Withholding Due to Garnishment — Court Ordered Amount More Than Federal or State Limits TN 30 03-96
NL 00703.714 Notice to Beneficiary/Payee — Cost-of-Living Increase in Benefits Affects Garnishment Action TN 30 03-96
NL 00703.716 Notice to Beneficiary/Payee — Garnishment Ended TN 33 02-98
NL 00703.722 Notice to Beneficiary/Payee — Regarding Appeal of Garnishment Order TN 33 02-98
NL 00703.723 Notice to Court — Garnishment Order — Initial Withholding TN 31 02-97
NL 00703.724 Notice to Court — Garnishee Is Not Entitled to Monthly Benefits TN 38 06-03
NL 00703.725 Notice to Court — Garnishee's Claim for Monthly Benefits Pending TN 38 06-03
NL 00703.726 Notice to Court — Garnishment Order — Improper Service of Court Order TN 38 06-03
NL 00703.728 Notice to Court — Garnishment Order — Noncompliance with a Court Order TN 31 02-97
NL 00703.729 Notice to Court — Garnishment Ends, We've Paid the Receiver Too Much TN 30 03-96
NL 00703.730 Notice to Court — Initial Withholding But Not Paying Receiver TN 30 03-96
NL 00703.731 Notice to Court — Withholding Percentage is Reduced TN 30 03-96
NL 00703.732 Notice to Court — Increase/Decrease in Benefits TN 30 03-96
NL 00703.733 Notice to Court — Amended Order — Withheld Amount Increased —Court Ordered Amount More Than Maximum Allowed TN 30 03-96
NL 00703.734 Notice to Court — Amended Order — Maximum Amount Allowed Already Being Withheld TN 30 03-96
NL 00703.735 Notice to Court — Amended Order — Requested Amount Withheld TN 30 03-96
NL 00703.736 Notice to Court — Garnishment Suspended TN 30 03-96
NL 00703.737 Notice to Court — Garnishment Ends TN 30 03-96
NL 00703.740 Title II 6-Month Closeout Notice (First Party) TN 30 03-96
NL 00703.741 Title II 6-Month Closeout Notice — Inquiry Made On Behalf of Child Under Age 18 or Legally Incompetent Adult TN 30 03-96
NL 00703.742 Title II 6-Month Closeout Notice — Inquiry Made On Behalf of Claimant - Not Incompetent or Under Age 18 TN 30 03-96
NL 00703.743 Title II 6-Month Closeout Notice — Deceased Claimant TN 30 03-96
NL 00703.744 6-Month Closeout Notice - Doubtful Intent to File For Benefits —Potential Auxiliary in Separate Household TN 33 02-98
NL 00703.745 IRS Request For Levy TN 33 02-98
NL 00703.746 IRS Levy Implemented TN 33 02-98
NL 00703.747 Notification to IRS - Levy Ceasing TN 33 02-98
NL 00703.748 Exemption From Levy - Exemption Statement TN 33 02-98
NL 00703.749 Exemption From Levy - Personal Exemption Amount TN 33 02-98
NL 00703.750 Imposition of Levy Against Full Monthly Benefit Payment TN 33 02-98
NL 00703.751 Protesting Levy TN 33 02-98
NL 00703.752 Imposition of Levy Against Part of Monthly Benefit Payment TN 33 02-98
NL 00703.753 Notification to Beneficiary -Levy Ceasing TN 33 02-98
NL 00703.758 Request to Employer for Debtor Address TN 31 02-97
NL 00703.759 Request to Financial Institution for Correct Beneficiary Address TN 31 02-97
NL 00703.760 Undeliverable Mail — Advance Notice that We Will Stop Benefits TN 31 02-97
NL 00703.761 Advance Notice That We Will Stop Benefits — SSA-1588, Beneficiary Recontact Report, Returned Undeliverable TN 31 02-97
NL 00703.763 Representative Payee Advance Notice for Title XVI Initial Claim Situations TN 31 02-97
NL 00703.765 Representative Payee Advance Notice for Title XVI Postentitlement Situations TN 31 02-97
NL 00703.767 Representative Payee Advance Notice for Title II Initial Claim Situations TN 30 03-96
NL 00703.768 Representative Payee Advance Notice for Title II Postentitlement Situations TN 30 03-96
NL 00703.769 Representative Payee Advance Notice to Legal Guardian, Parent or Person Standing in Place of Parent — If Not Proposed Payee TN 30 03-96
NL 00703.770 Representative Payee — Authorized Fee Notice to Beneficiary or Person Standing in Place of Beneficiary TN 31 02-97
NL 00703.771 Representative Payee — Notice to Beneficiary or Person Standing in Place of Beneficiary About Revocation of Fee TN 31 02-97
NL 00703.772 Partial Award Follow-up Notice, No Change in Benefits TN 31 02-97
NL 00703.773 Reply to Show Cause Order TN 31 02-97
NL 00703.774 Representative Payee — Change in Authorized Fee — Notice to Beneficiary or Person Standing in Place of Beneficiary TN 31 02-97
NL 00703.775 Notice of Abatement — Non-Disability Claimant Dies In Or Before First Month of Entitlement — Disability Claimant Dies In The Waiting Period TN 31 02-97
NL 00703.776 Advance Notice to Beneficiaries Attaining Age 18 —Representative Payee Still Needed TN 31 02-97
ATTORNEY FEE NOTICES
NL 00703.806 Letter Acknowledging Request for Administrative Review of Authorized Attorney Fee TN 31 02-97
NL 00703.807 Correspondence Cover Letter TN 31 02-97
NL 00703.808 20-Day Close-Out Letter, Below Hearing Level TN 31 02-97
NL 00703.810 Withheld Past-Due Benefits Released to Attorney — Concurrent Title II and Title XVI Case — Offset Information Pending —Number Holder (NH) -Fee Agreement Case TN 31 02-97
NL 00703.811 Withheld Past-Due Benefits Released to Attorney — Concurrent Title II and Title XVI Case — Offset Information Pending —Auxiliary Beneficiary(ies) — Fee Agreement Case TN 31 02-97
NL 00703.812 Failure to Withhold Past-due Benefits for Direct Payment to a Representative (Administrative Error) TN 63 05-14
NL 00703.813 Notice to Beneficiary in Concurrent Title II and Title XVI Cases Where We Applied Title II Offset and there is a Fee Petition or Fee Agreement TN 70 03-16
NL 00703.814 Notice To Beneficiary — Concurrent Title II/Title XVI Case —Fee Petition Case — Title II Offset Amount Is More Than The Retroactive Title II Benefits Minus The Amount Withheld Toward The Attorney Fee —Offset Action Delayed Pending Field Office (FO) Adjustment TN 30 03-96
NL 00703.815 Interim Notice of Allowance and Notification to Claimant that 25 percent of Retroactive Benefits Is Being Withheld TN 30 03-96
NL 00703.816 Notice Explaining Disposition of Withheld Retroactive Benefits TN 70 03-16
NL 00703.817 Retroactive Check Released — No Fee Charged for Services Performed on Your Claim TN 30 03-96
NL 00703.818 Notice to Beneficiary — Retroactive Check is Being Released; Request for Approval of a Fee for Representing a Claimant Not Received TN 34 05-98
NL 00703.819 Court Case — Retroactive Benefits Were Withheld Pending Determination on Attorney Fee TN 34 05-98
FORMAL REPRESENTATIVE PAYEE NOTICES
NL 00703.821 Final Notice to the Former Representative Payee, or the Non-Selected Payee Applicant When Another Payee is Appointed TN 34 05-98
NL 00703.822 Final Notice to Legally Competent Adult or Emancipated Minor of Payee Selection TN 34 05-98
NL 00703.823 Notice to Child Beneficiary Who Was His/Her Own Payee or Legally Incompetent Adult Beneficiary When Representative Payee Appointed TN 34 05-98
NL 00703.824 Final Notice of Payee Appointment to Parent, Person Standing in Place of Parent, Legal Guardian or Attorney Representative Who Is Also an Unsuccessful Applicant TN 34 05-98
NL 00703.825 Notice to Legally Competent Adult Beneficiary or Emancipated Minor Who has a Payee and is Denied Direct Payment TN 34 05-98
NL 00703.826 Notice to Parent, Person Standing in Place of Parent, or Legal Guardian That the Beneficiary's Benefits Will Continue to be Paid to the Same Representative Payee or Directly to Beneficiary TN 34 05-98
NL 00703.827 Notice to Child or Incompetent Adult Beneficiary Who Has a Representative Payee and Is Denied Direct Payment TN 34 05-98
NL 00703.828 Notice to Parent, Person Standing in Place of Parent, or Legal Guardian of a Minor Beneficiary That the Beneficiary's Benefits Will Be Paid Directly to the Minor, Rather Than a Representative Payee TN 34 05-98
DISALLOWANCE EXHIBIT NOTICES
NL 00703.900 Disallowance — Auxiliary Not Entitled to Retirement Benefits on Own Record TN 31 02-97
NL 00703.901 Disallowance Not a Spouse Under the Act TN 53 05-09
NL 00703.905 Disallowance Miscellaneous Fill-in Letter TN 53 05-09
NL 00703.907 Survivor Disallowance — NH Not Insured TN 36 03-99
NL 00703.909 Disallowance — Date of Birth Not Established TN 30 03-96
NL 00703.911 Auxiliary Disallowance — NH Not Entitled TN 30 03-96
NL 00703.913 Request for Benefit Increase Denied TN 30 03-96
NL 00703.915 Retirement Denial — Lack of Insured Status TN 30 03-96
NL 00703.917 Disallowance — Age Requirement Not Met TN 30 03-96
TERMINATION EXHIBIT NOTICES
NL 00703.920 Instructions for Inclusion of Overpayment Language in Termination Notices TN 36 03-99
NL 00703.923 Benefits to Mother/Father or Young Spouse Terminate — Child Beneficiary Dies — Foreign TN 36 03-99
NL 00703.924 Termination Letter to Representative Payee When Beneficiary Dies — Domestic or Foreign TN 36 03-99
NL 00703.925 Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce — Domestic TN 30 03-96
NL 00703.926 Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce — Foreign TN 30 03-96
NL 00703.927 Benefits to Mother/Father, or Wife, Husband, Former Wife or Former Husband Terminate — Child Attains Age 16 — Domestic TN 30 03-96
NL 00703.928 Benefits to Mother/Father, or Wife, Husband, Former Wife or Former Husband Terminate — Child Attains Age 16 -Foreign TN 30 03-96
NL 00703.929 Benefits to Child Terminate — Age 18/19 — Domestic or Foreign TN 30 03-96
NL 00703.930 Benefits to student terminate — Deemed age 19 — Domestic or foreign TN 30 03-96
NL 00703.931 Benefits to Student Terminate — No Longer in Full — Time Attendance TN 30 03-96
NL 00703.932 Benefits Suspended Due to Number Holder’s (NH) Death - Dual Entitlement TN 54 06-09
NL 00703.933 Cover Notice for Field Office (FO) and Teleservice Center (TSC) to Use When Sending the SSA-4111 TN 54 06-09
NL 00703.940 Cover Letter to Organizations Inquiring About Payment for Representative Payee Services TN 51 11-06
NL 00703.941 Fees for Representative Payee Services TN 41 09-04
NL 00703.942 Explanation of Documents Needed to Collect a Fee for Representative Payee Services TN 51 11-06
NL 00703.943 Notice Authorizing Organization to Collect a Fee TN 41 09-04
NL 00703.944 Notice to Organization Denying Request to Collect a Fee TN 31 02-97
NL 00703.945 Explanation of Fees for Representative Payee Services TN 41 09-04
NL 00703.946 Notice of Fee for Service (FS) Site Review or Recertification Scheduling TN 37 03-03
NL 00703.948 Review Decision Notice to Organization TN 31 02-97
NL 00703.949 Revocation Notice to Organization TN 31 02-97
NL 00703.950 Notice to Creditor Organization TN 31 02-97
NL 00703.954 Expedited Reinstatement (EXR) Initial Reinstatement Period (IRP) Benefit Change Letter TN 46 09-05
NL 00703.956 Expedited Reinstatement (EXR) Award Notice TN 49 02-06
NL 00703.963 Notification of Withholding to Collect a Civil Monetary Penalty (and Assessment) TN 55 05-10
NL 00703.965 Civil Monetary Penalty (CMP) Call-In Letter TN 57 03-11
NL 00703.966 Petersen Acquiescence Ruling (AR) Notices TN 60 12-12

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900703000
NL 00703.000 - Exhibit and Dictated Letters - Table of Contents - 06/30/2016
Batch run: 06/30/2016
Rev:06/30/2016