NL 00703.000 Exhibit and Dictated Letters

Subchapter Table of Contents
Section Latest
Transmittal
NL 00703.005Exhibit/Dictated NoticesTN 36 03-99
CHARTS/INDEXES
NL 00703.010Usage Chart for Exhibit/Dictated LettersTN 34 05-98
NL 00703.012Usage Chart for HI/SMI Exhibit LettersTN 31 02-97
EXHIBIT LETTERS
NL 00703.100Notice to Overpaid Person in Current Pay Status — Adjustment ProposedTN 65 03-15
NL 00703.101Notice To Overpaid Person In Current Pay Status — Adjustment Proposed — Alien Tax Withholding InvolvedTN 31 02-97
NL 00703.102Notice to Overpaid Person in Non-pay Status but Receiving Benefits for Other Beneficiary in Same Household — Refund Requested or Adjustment ProposedTN 65 03-15
NL 00703.103Notice To Overpaid Person In Nonpay Status But Receiving Benefits For Other Beneficiary In Same Household — Refund Requested And Adjustment Proposed — Alien Tax Withholding InvolvedTN 31 02-97
NL 00703.104Notice to Other Beneficiary — Recovery From Overpaid Person Not PossibleTN 31 02-97
NL 00703.106Notice to Overpaid Person in Non-pay Status — Refund RequestedTN 67 07-15
NL 00703.107Notice to Overpaid Person In Nonpay Status — Refund Requested —Alien Tax Withholding InvolvedTN 30 03-96
NL 00703.108Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and Who is Currently Receiving Benefits for Beneficiary — Refund Requested or Adjustment ProposedTN 31 02-97
NL 00703.109Notice 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 InvolvedTN 31 02-97
NL 00703.110Notice 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 BenefitsTN 69 02-16
NL 00703.111Notice 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 InvolvedTN 31 02-97
NL 00703.112Notice to Representative Payee Who Received Overpayment on Behalf of Beneficiary and Who is Not Currently Receiving Benefits for Beneficiary — Refund RequestedTN 69 02-16
NL 00703.113Notice to Overpaid Person in Railroad Board Certification Cases — Adjustment ProposedTN 31 02-97
NL 00703.114Followup Notice — Adjustment Proposed — Opportunity For Personal Conference Not Previously Offered — No Underpayment Withholding InvolvedTN 31 02-97
NL 00703.115Notice To Representative Payee Who Received Overpayment On Behalf Of Beneficiary And Who Is Not Currently Receiving Benefits For Beneficiary — Refund Requested — Alien Tax Withholding InvolvedTN 31 02-97
NL 00703.116Followup Notice — Immediate Adjustment — Opportunity For Personal Conference Previously Given — Underpayment Withholding InvolvedTN 31 02-97
NL 00703.118Reconsideration Affirms Overpayment Determination (Reconsideration Only Requested) — Refund Requested — Cross-Program Recovery PossibleTN 31 02-97
NL 00703.119Reconsideration Affirms Overpayment Determination (Reconsideration Only Requested)—Refund Requested and Adjustment ProposedTN 72 04-16
NL 00703.120Notice to Beneficiary(ies') When a Claim Has Been Filed That Will Require an Adverse Adjustment to the Beneficiary's(ies') BenefitsTN 30 03-96
NL 00703.121Notice to Beneficiary(ies') That His or Her Entitlement May be Reversed or Terminated Because an Adverse Claim Has Been FiledTN 30 03-96
NL 00703.122Advance Notice - Benefits Will Be StoppedTN 30 03-96
NL 00703.123Advance Notice - Benefits Will Be ReducedTN 30 03-96
NL 00703.124Advance Notice to Deported or Removed Number HolderTN 48 12-05
NL 00703.125Advance Notice to Auxiliary of Deported or Removed Number HolderTN 48 12-05
NL 00703.126Advance Notice — Non-Receipt of Report to United StatesTN 31 02-97
NL 00703.127Checks Stopped — RRB InvolvedTN 31 02-97
NL 00703.128Advance Adverse Adjustment — Only Past Due Benefits AffectedTN 31 02-97
NL 00703.129Checks Stopped – RRB Jurisdiction of Survivor ClaimTN 52 01-07
NL 00703.130Final Request for Refund — DOJ Referral RequiredTN 31 02-97
NL 00703.140Notice of Acceptance of Compromise OfferTN 30 03-96
NL 00703.141Notice of Rejection of Compromise OfferTN 30 03-96
NL 00703.150Windfall Elimination Provision (WEP) Advance NoticeTN 30 03-96
NL 00703.151Initial Government Pension Offset (GPO) Advance Notice —Current Pay StatusTN 30 03-96
NL 00703.152Initial Government Pension Offset (GPO) Advance Notice —Suspense/Deferred StatusTN 30 03-96
NL 00703.153GPO Advance Notice — Increase In Government Pension — Current Pay StatusTN 30 03-96
NL 00703.154GPO Advance Notice — Increase In Government Pension —Suspense/Deferred StatusTN 30 03-96
NL 00703.155Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Reduced - Current Pay StatusTN 47 12-05
NL 00703.156Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Reduced - Suspense/Deferred StatusTN 50 02-06
NL 00703.157Advance Notice For SSA/Railroad Retirement Board (RRB) Match —Lowered RR Earnings Affect Benefits — Current Pay StatusTN 30 03-96
NL 00703.158Advance Notice For SSA/Railroad Retirement Board (RRB) Match —Lowered RR Earnings Affect Benefits — Suspense/Deferred StatusTN 30 03-96
NL 00703.159Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Terminated - Current Pay StatusTN 50 02-06
NL 00703.160Advance Notice For SSA/Railroad Retirement Board (RRB) Match - Benefits To Be Terminated - Suspense/Deferred StatusTN 50 02-06
NL 00703.161Advance Notice For SSA/RRB Retap Alerts - Benefits to be TerminatedTN 32 06-97
NL 00703.165Waiver Notice for Requesting Authorization to Access Financial InformationTN 71 04-16
NL 00703.166Waiver Requested — Refusal to Cooperate — Title IITN 31 02-97
NL 00703.167Waiver Denial Only — Refund Requested — Title IITN 31 02-97
NL 00703.168Waiver Denial Only — Current Pay — Title IITN 31 02-97
NL 00703.169Reconsideration Affirms Overpayment Determination —Reconsideration and Waiver Requested — RSI CasesTN 31 02-97
NL 00703.170Reconsideration Affirms Overpayment Determination — Waiver Approved — RSI CasesTN 31 02-97
NL 00703.171Personal Conference and Folder Review Scheduled — WaiverTN 31 02-97
NL 00703.173Personal Conference and Folder Review Scheduled —ReconsiderationTN 31 02-97
NL 00703.174Personal Conference and Folder Review — RescheduledTN 31 02-97
NL 00703.176Confirmation of Telephone Rescheduling of Personal Conference —Person Failed to Appear for Conference — RSI CasesTN 31 02-97
NL 00703.180Notice of Waiver ApprovalTN 66 04-15
NL 00703.182Notice of Waiver Approval — SSI (Domestic)TN 66 04-15
NL 00703.183Cross-Program Recovery NoticesTN 42 11-04
NL 00703.186SPA Overpayment Notice, Initial Overpayment Notice Previously Sent, No Recovery Action Being Taken, Overpaid Beneficiary in Terminated StatusTN 31 02-97
NL 00703.187Terminated Overpayment Collection - Overpayment Equal to or More than the Current Monthly Payment (No Representative Payee)TN 30 03-96
NL 00703.188Terminated Overpayment Collection - Overpayment Equal to or More Than the Current Monthly Payment (Representative Payee Involved)TN 30 03-96
NL 00703.189Terminated Overpayment Collection - Overpayment Amount is Less Than Current Monthly Payment (No Representative Payee)TN 30 03-96
NL 00703.190Terminated Overpayment Collection - Overpayment Amount is Less Than Current Monthly Payment (Representative Payee Involved)TN 30 03-96
NL 00703.191Terminated Overpayment Collection - Overpayment on Own SSN Being Recovered (No Representative Payee)TN 30 03-96
NL 00703.192Terminated Overpayment Collection - Overpayment on Own SSN Being Recovered (Representative Payee Involved)TN 30 03-96
NL 00703.193Reconsideration and Waiver Denial — Refund RequestTN 31 02-97
NL 00703.194Reconsideration and Waiver Denial — Current PayTN 31 02-97
NL 00703.195Partial Waiver Approval with Personal Conference — Refund RequestedTN 31 02-97
NL 00703.196Partial Waiver Approval with Personal Conference — Current PayTN 31 02-97
NL 00703.197Reconsideration and Partial Waiver Approval — Refund RequestTN 31 02-97
NL 00703.198Reconsideration and Partial Waiver Approval — Current PayTN 31 02-97
NL 00703.200Request for Payment of Misused FundsTN 31 02-97
NL 00703.201Repayment of Misused Funds — Cover Letter to New PayeeTN 31 02-97
NL 00703.202Misuse Not Established — Notice to Beneficiary or Representative PayeeTN 31 02-97
NL 00703.203Notice of Misuse Negligence DeterminationTN 31 02-97
NL 00703.204Notice to Representative Payee and Any Former Representative Payee Administering Conserved Funds When Beneficiary DiesTN 31 02-97
NL 00703.208Notice to Former Representative Payee to Continue to Administer Conserved FundsTN 30 03-96
NL 00703.211Request for Repayment of Misused Funds - Advanced Notification – Cover Letter To New PayeeTN 44 12-04
NL 00703.212Request For Repayment Of Misused Funds – Advanced NotificationTN 44 12-04
NL 00703.213Repayment Of Misused Funds Notice To Beneficiary/New PayeeTN 44 12-04
NL 00703.215Notice Affirming Selection of Representative Payee on ReconsiderationTN 30 03-96
NL 00703.216Notice Affirming Selection of a Specific Representative Payee on ReconsiderationTN 30 03-96
NL 00703.256Change to Direct Payment — Child Turns 18 and is a StudentTN 30 03-96
NL 00703.290Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Involved — Alien Tax Withholding Not InvolvedTN 35 09-98
NL 00703.291Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Not Involved —Alien Tax Withholding Not InvolvedTN 35 09-98
NL 00703.292Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Involved — Alien Tax Withholding InvolvedTN 35 09-98
NL 00703.293Domestic-To-Foreign Change Of Address — SSA-21 In File —Exception To Alien Nonpayment Provision Met-Direct Deposit Not Involved —Alien Tax Withholding InvolvedTN 35 09-98
NL 00703.294Domestic-To-Foreign Change Of Address — SSA-21 Not In FileTN 35 09-98
NL 00703.296Foreign 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 00703.300Foreign Address — Temporary Move Outside the United States for Less Than 6 Months — Using U.S. Mailing Address; Beneficiary Under Full Retirement Age — Not DisabledTN 35 09-98
NL 00703.302Foreign Address — Outside U.S. More Than 6 Months — Using U.S. Mailing AddressTN 30 03-96
NL 00703.304Foreign Address — Suspension Notice — SSA-7161-OCR-SM, SSA-7162-OCR-SM, or SSA-21 Not ReturnedTN 30 03-96
NL 00703.308Notice to Beneficiary Residing in a Restricted Country Who Plans to Leave His /Her Country in Order to Collect Accrued BenefitsTN 30 03-96
NL 00703.309Beneficiary Planning Trip Abroad — 3 Months or FewerTN 30 03-96
NL 00703.310Change of Address - Foreign to DomesticTN 30 03-96
NL 00703.311Miscellaneous Adjustment NoticeTN 66 04-15
NL 00703.312Miscellaneous Adjustment Notice (Representative Payee)TN 66 04-15
NL 00703.313Adjustment - Beneficiary in Conditional or Suspense Status Before and After Action (No Payment)TN 66 04-15
NL 00703.314Adjustment - Beneficiary in Conditional or Suspense Status Before and After Action (No Payment; Payee Version)TN 31 02-97
NL 00703.315Adjustment -Beneficiary in Conditional or Suspense Status Before and After Action (One Check Only)TN 66 04-15
NL 00703.317Recomputation of Benefit Amounts - Beneficiary Is or Will Be In Current Pay After ActionTN 31 02-97
NL 00703.318Transfer of Social Security Payments to the Railroad Retirement Board (RRB) for Certification to TreasuryTN 59 07-12
NL 00703.319Social Security Claim Filed — Transferred to RRBTN 31 02-97
NL 00703.320Social Security Claim Filed — Civil Service Pension InvolvedTN 31 02-97
NL 00703.321Notice of Special Check (Preliminary Payment)TN 31 02-97
NL 00703.322Reissuance of Lost CheckTN 31 02-97
NL 00703.323Withholding Requested But Net Benefits Not Enough to ImplementTN 31 02-97
NL 00703.324Withholding Not Requested — Administrative ErrorTN 31 02-97
NL 00703.325Withholding Requested at a Different Rate — Withholding ErrorTN 31 02-97
NL 00703.330Benefits Stopped (Retroactively or Currently) - Beneficiary Is Not a U.S. Citizen and 6-Month Period ExpiredTN 31 02-97
NL 00703.344Letter to Representative Payee — Conserved Funds of $1,500 or More — VA Benefits May Be AffectedTN 30 03-96
NL 00703.345Letter to Successor Payee About Direct Transfer of Conserved FundsTN 30 03-96
NL 00703.346Letter to Beneficiary About Direct Transfer of Conserved FundsTN 30 03-96
NL 00703.347Letter to Be Sent to New Payee or Beneficiary When SSA Has Abandoned Collection Efforts to Recover Funds Misused By Former PayeeTN 30 03-96
NL 00703.348Notice of Payee's Signature Requirement on Form SSA-623-OCR-SMTN 30 03-96
NL 00703.349Notice Regarding the Return of Original Documents to the PayeeTN 30 03-96
NL 00703.350Accrued Benefits — Total Paid to Representative Payee or Directly to the BeneficiaryTN 30 03-96
NL 00703.352Accrued Benefits Paid In Monthly Installments to PayeeTN 30 03-96
NL 00703.354Conserved Benefits — Entire Amount Paid to New Representative Payee or to the BeneficiaryTN 30 03-96
NL 00703.356Conserved Benefits — Monthly Installments Paid To New Representative PayeeTN 30 03-96
NL 00703.357Conserved Benefits — Monthly Installments Paid to the BeneficiaryTN 30 03-96
NL 00703.364Termination of Section 217(b) Benefits Because of VA PensionTN 30 03-96
NL 00703.365Adjustment in Benefit Rate Because No longer Entitled Under Section 217(b); Still Entitled Under Section 217(a) and (e)TN 30 03-96
NL 00703.371Government Pension Offset (GPO) Advance Notice — Effect of Increase in Government Pension on Social Security BenefitsTN 30 03-96
NL 00703.413Notice of Overpayment Due to Posted Earnings — Beneficiary Did Not File Work Report Or Filed Work Report Showing No Earnings -Beneficiary In Suspense Or Terminated StatusTN 30 03-96
NL 00703.414Notice of Overpayment Due to Posted Earnings - Beneficiary Did Not File Work Report Or Filed Work Report Showing No Earnings — Beneficiary In Current Or Deferred StatusTN 30 03-96
NL 00703.415Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted Earnings Exceed Amount Reported — Beneficiary In Suspense or Terminated StatusTN 30 03-96
NL 00703.416Notice of Overpayment Due to Posted Earnings — Beneficiary Filed Work Report But Posted Earnings Exceed Amount Reported — Beneficiary In Current Or Deferred StatusTN 30 03-96
NL 00703.417Notice 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 StatusTN 30 03-96
NL 00703.418Notice 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 StatusTN 30 03-96
NL 00703.419Notice 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 StatusTN 30 03-96
NL 00703.420Notice 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 StatusTN 30 03-96
NL 00703.421TALCMAIL Disability Cessation Overpayment NoticeTN 58 09-11
NL 00703.452Prorating Current Year Suspensions Notice — (SMI Involved)TN 30 03-96
NL 00703.454Prorating Current Year Suspensions Notice — (No SMI Involved)TN 30 03-96
NL 00703.456Denial of Request For Prorating Work SuspensionTN 30 03-96
NL 00703.458Auxiliary Due Full Rate Even Though Earnings Exceed Limit —Readjusted Rate Case — Beneficiary Receives Full Adjusted BenefitTN 30 03-96
NL 00703.460Suspension Notice (Survivor Cases Only) — Beneficiary Receiving Reduced Rate Because of Work — Other Beneficiaries Also Working —DomesticTN 30 03-96
NL 00703.461Suspension Notice (Survivor Cases Only) — Beneficiary Receiving Reduced Rate Because of Work — Other Beneficiaries Also Working —ForeignTN 30 03-96
NL 00703.462Initial Award Suspension Notice — Claimant Does Not Have A Social Security Number — No Representative PayeeTN 30 03-96
NL 00703.463Initial Award Suspension Notice — Claimant Does Not Have A Social Security Number -Representative Payee InvolvedTN 30 03-96
NL 00703.470Appeal Requested Before Decision Made On CaseTN 30 03-96
NL 00703.471Expedited Appeals Process (EAP) is DeniedTN 30 03-96
NL 00703.472Claimant Cancels Request For Expedited Appeals Process (EAP)TN 30 03-96
NL 00703.473Good Cause For Late Filing of Reconsideration Request Not EstablishedTN 30 03-96
NL 00703.474Reconsideration Affirmation of Prior DecisionTN 45 07-05
NL 00703.500Adjustment Notice, Combined Check Reduced — Child's Estimate of Earnings Caused Partial or Total DeductionsTN 30 03-96
NL 00703.502Adjustment Notice — Beneficiary Reduced Earnings to Exempt Amount, Benefit Remains the Same, Had Received Full Benefit While WorkingTN 30 03-96
NL 00703.503Adjustment Notice — Beneficiary Reduced Earnings to Exempt Amount, Benefit Remains the Same, Had Received Full Benefit While Working (Payee Version)TN 30 03-96
NL 00703.504Suspension Notice — Child is Working and Reports Change in Address — Payee Development Necessary — DomesticTN 30 03-96
NL 00703.505Suspension Notice — Child Is Working and Reports Change in Address — Payee Development Necessary — ForeignTN 30 03-96
NL 00703.510Suspension Notice to Beneficiary — Insured Person Working More Than 45 Hours Per Month (Foreign Work Test)TN 30 03-96
NL 00703.511Due 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) PaymentsTN 30 03-96
NL 00703.512Due 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 00703.513Due 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 PaymentsTN 31 02-97
NL 00703.515DAA Due Process Suspension Notice — Title II Beneficiary — No Longer In Compliance With Treatment RequirementsTN 31 02-97
NL 00703.550“Good Cause” Established — Penalty Deduction Not ApplicableTN 30 03-96
NL 00703.554Suspension Notice — Beneficiary Deported or RemovedTN 48 12-05
NL 00703.556CDB Suspension Notice — Benefits Withheld — Beneficiary Own PayeeTN 30 03-96
NL 00703.558CDB Suspension Notice — Benefits Withheld — Beneficiary Has Representative PayeeTN 30 03-96
NL 00703.560Suspension Notice — Auxiliary Benefits Suspended Because CDBs or DIBs Benefits SuspendedTN 30 03-96
NL 00703.561Mother's/Father's Benefits Stopped-Youngest Child Attained Age 16-Child Disability Decision PendingTN 30 03-96
NL 00703.566Disability Established for Child Who Terminated-Age 18 — Own PayeeTN 30 03-96
NL 00703.567Disability Established for Child Who Terminated — Age 18-Has PayeeTN 30 03-96
NL 00703.568Disability Established — Benefits Continued — Child Own PayeeTN 30 03-96
NL 00703.569Disability Established — Benefits Continued — Child Has PayeeTN 30 03-96
NL 00703.570CDB Disability Termination — Notice of Cessation —Beneficiary Own PayeeTN 30 03-96
NL 00703.572DIB Termination — Notice of Cessation — Payments to Wife, Widow or Dependent Beneficiaries TerminatedTN 30 03-96
NL 00703.580Notice of Interim Benefits for Administrative Law Judge Cases – Section 8001, P.L. 100-647—ExhibitTN 73 06-16
NL 00703.595Recovery From Individual Who Withdrew Funds From A Deceased Beneficiary's Bank Account After DeathTN 30 03-96
MEDICARE
NL 00703.600Notice of Award to Medicare Beneficiary (HI/SMI) — Reduced HI Premium — NH, Spouse, Divorced Spouse, Widow(er) or Surviving Divorced SpouseTN 30 03-96
NL 00703.601Instructions for Preparation of SMI Only Award Notice When a Beneficiary is Eligible for Reduced Premium HITN 30 03-96
MEDICARE
NL 00703.602SMI — Reenrollment During the GEP After Prior Enrollment TerminatedTN 30 03-96
NL 00703.603SMI — Enrollment Beyond the Initial Enrollment PeriodTN 30 03-96
NL 00703.604SMI — Applied Prior To The Beginning of Initial Enrollment PeriodTN 30 03-96
NL 00703.605SMI Denial — Not in General Enrollment Period (GEP) or Special Enrollment Period (SEP)TN 30 03-96
NL 00703.606SMI Refusal Request Treated As GEP EnrollmentTN 30 03-96
NL 00703.609New Health Insurance Card As A Result of Requested ChangesTN 30 03-96
NL 00703.610Address Change — Returning HI CardTN 30 03-96
NL 00703.616SMI — Processed Declination of Coverage — Beneficiary In Current Pay Status — Refund DueTN 30 03-96
NL 00703.617SMI — Processed Declination of Coverage — Beneficiary In Suspense Status — Discard Any Bill For PremiumsTN 30 03-96
NL 00703.618Beneficiary's Refusal of SMI Coverage Not Acceptable — State is Paying PremiumsTN 30 03-96
NL 00703.619HI/SMI — Entitled To Mother's or Widow's Benefits —Coverage Based on Disability — Coverage Begins Within 2 Months After COMTN 30 03-96
NL 00703.620HI/SMI — Entitled to Mother's or Widow's Benefits —Coverage Based on Disability — Coverage Begins More Than 2 Months After COMTN 30 03-96
NL 00703.621R-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 00703.622Ineligible for HI/SMI Coverage Due to DWB TerminationTN 30 03-96
NL 00703.623Ineligible for HI/SMI Coverage Because DIB CeasedTN 30 03-96
NL 00703.624DIB to RIB Conversion — Full Retirement Age PAC ReductionTN 30 03-96
NL 00703.625Withdrawal From SMI — Entitlement to CHAMPUS or CHAMPVATN 30 03-96
NL 00703.626Notice When Claimant Protests Amount of Premium Bill (Withdrawal Model Letter)TN 30 03-96
NL 00703.627Notice When Claimant's Correspondence Contains an Incorrect Claim NumberTN 30 03-96
NL 00703.628Notice When Claimant Protests TerminationTN 30 03-96
NL 00703.629General “Check Box” NoticeTN 31 02-97
NL 00703.630HI/SMI — Government Medicare — Coverage Based on Disability — Coverage Begins More Than 2 Months After Current Operating MonthTN 68 09-15
WITHDRAWAL LETTERS
NL 00703.700Withdrawal — Repayment — NHTN 30 03-96
NL 00703.701Withdrawal — Repayment — NH and Auxiliary(ies)TN 30 03-96
NL 00703.702Withdrawal — 30 Day CloseoutTN 30 03-96
NL 00703.703Withdrawal DenialTN 64 07-14
NL 00703.705Withdrawal After DisallowanceTN 30 03-96
NL 00703.706Withdrawal Notice to RRB — Withdrawal Approved — No Entitlement Under SSATN 30 03-96
NL 00703.707Notice to Beneficiary/Payee — Initial Withholding Due to Garnishment — Court Ordered Amount No More Than Federal or State LimitsTN 30 03-96
NL 00703.708Notice to Beneficiary/Payee — Withholding Percentage is ReducedTN 30 03-96
NL 00703.709Notice to Beneficiary/Payee — Amended Garnishment OrderTN 31 02-97
NL 00703.710Notice to Beneficiary/Payee — Payments May Be GarnishedTN 38 06-03
NL 00703.711Notice to Potential Beneficiary/Payee — Payments May Be Garnished If Claim is ApprovedTN 38 06-03
NL 00703.712Notice to Beneficiary/Payee — Initial Withholding Due to Garnishment — Court Ordered Amount More Than Federal or State LimitsTN 30 03-96
NL 00703.714Notice to Beneficiary/Payee — Cost-of-Living Increase in Benefits Affects Garnishment ActionTN 30 03-96
NL 00703.716Notice to Beneficiary/Payee — Garnishment EndedTN 33 02-98
NL 00703.722Notice to Beneficiary/Payee — Regarding Appeal of Garnishment OrderTN 33 02-98
NL 00703.723Notice to Court — Garnishment Order — Initial WithholdingTN 31 02-97
NL 00703.724Notice to Court — Garnishee Is Not Entitled to Monthly BenefitsTN 38 06-03
NL 00703.725Notice to Court — Garnishee's Claim for Monthly Benefits PendingTN 38 06-03
NL 00703.726Notice to Court — Garnishment Order — Improper Service of Court OrderTN 38 06-03
NL 00703.728Notice to Court — Garnishment Order — Noncompliance with a Court OrderTN 31 02-97
NL 00703.729Notice to Court — Garnishment Ends, We've Paid the Receiver Too MuchTN 30 03-96
NL 00703.730Notice to Court — Initial Withholding But Not Paying ReceiverTN 30 03-96
NL 00703.731Notice to Court — Withholding Percentage is ReducedTN 30 03-96
NL 00703.732Notice to Court — Increase/Decrease in BenefitsTN 30 03-96
NL 00703.733Notice to Court — Amended Order — Withheld Amount Increased —Court Ordered Amount More Than Maximum AllowedTN 30 03-96
NL 00703.734Notice to Court — Amended Order — Maximum Amount Allowed Already Being WithheldTN 30 03-96
NL 00703.735Notice to Court — Amended Order — Requested Amount WithheldTN 30 03-96
NL 00703.736Notice to Court — Garnishment SuspendedTN 30 03-96
NL 00703.737Notice to Court — Garnishment EndsTN 30 03-96
NL 00703.740Title II 6-Month Closeout Notice (First Party)TN 30 03-96
NL 00703.741Title II 6-Month Closeout Notice — Inquiry Made On Behalf of Child Under Age 18 or Legally Incompetent AdultTN 30 03-96
NL 00703.742Title II 6-Month Closeout Notice — Inquiry Made On Behalf of Claimant - Not Incompetent or Under Age 18TN 30 03-96
NL 00703.743Title II 6-Month Closeout Notice — Deceased ClaimantTN 30 03-96
NL 00703.7446-Month Closeout Notice - Doubtful Intent to File For Benefits —Potential Auxiliary in Separate HouseholdTN 33 02-98
NL 00703.745IRS Request For LevyTN 33 02-98
NL 00703.746IRS Levy ImplementedTN 33 02-98
NL 00703.747Notification to IRS - Levy CeasingTN 33 02-98
NL 00703.748Exemption From Levy - Exemption StatementTN 33 02-98
NL 00703.749Exemption From Levy - Personal Exemption AmountTN 33 02-98
NL 00703.750Imposition of Levy Against Full Monthly Benefit PaymentTN 33 02-98
NL 00703.751Protesting LevyTN 33 02-98
NL 00703.752Imposition of Levy Against Part of Monthly Benefit PaymentTN 33 02-98
NL 00703.753Notification to Beneficiary -Levy CeasingTN 33 02-98
NL 00703.758Request to Employer for Debtor AddressTN 31 02-97
NL 00703.759Request to Financial Institution for Correct Beneficiary AddressTN 31 02-97
NL 00703.760Undeliverable Mail — Advance Notice that We Will Stop BenefitsTN 31 02-97
NL 00703.761Advance Notice That We Will Stop Benefits — SSA-1588, Beneficiary Recontact Report, Returned UndeliverableTN 31 02-97
NL 00703.763Representative Payee Advance Notice for Title XVI Initial Claim SituationsTN 31 02-97
NL 00703.765Representative Payee Advance Notice for Title XVI Postentitlement SituationsTN 31 02-97
NL 00703.767Representative Payee Advance Notice for Title II Initial Claim SituationsTN 30 03-96
NL 00703.768Representative Payee Advance Notice for Title II Postentitlement SituationsTN 30 03-96
NL 00703.769Representative Payee Advance Notice to Legal Guardian, Parent or Person Standing in Place of Parent — If Not Proposed PayeeTN 30 03-96
NL 00703.770Representative Payee — Authorized Fee Notice to Beneficiary or Person Standing in Place of BeneficiaryTN 31 02-97
NL 00703.771Representative Payee — Notice to Beneficiary or Person Standing in Place of Beneficiary About Revocation of FeeTN 31 02-97
NL 00703.772Partial Award Follow-up Notice, No Change in BenefitsTN 31 02-97
NL 00703.773Reply to Show Cause OrderTN 31 02-97
NL 00703.774Representative Payee — Change in Authorized Fee — Notice to Beneficiary or Person Standing in Place of BeneficiaryTN 31 02-97
NL 00703.775Notice of Abatement — Non-Disability Claimant Dies In Or Before First Month of Entitlement — Disability Claimant Dies In The Waiting PeriodTN 31 02-97
NL 00703.776Advance Notice to Beneficiaries Attaining Age 18 —Representative Payee Still NeededTN 31 02-97
ATTORNEY FEE NOTICES
NL 00703.806Letter Acknowledging Request for Administrative Review of Authorized Attorney FeeTN 31 02-97
NL 00703.807Correspondence Cover LetterTN 31 02-97
NL 00703.80820-Day Close-Out Letter, Below Hearing LevelTN 31 02-97
NL 00703.810Withheld Past-Due Benefits Released to Attorney — Concurrent Title II and Title XVI Case — Offset Information Pending —Number Holder (NH) -Fee Agreement CaseTN 31 02-97
NL 00703.811Withheld Past-Due Benefits Released to Attorney — Concurrent Title II and Title XVI Case — Offset Information Pending —Auxiliary Beneficiary(ies) — Fee Agreement CaseTN 31 02-97
NL 00703.812Failure to Withhold Past-due Benefits for Direct Payment to a Representative (Administrative Error)TN 63 05-14
NL 00703.813Notice to Beneficiary in Concurrent Title II and Title XVI Cases Where We Applied Title II Offset and there is a Fee Petition or Fee AgreementTN 70 03-16
NL 00703.814Notice 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) AdjustmentTN 30 03-96
NL 00703.815Interim Notice of Allowance and Notification to Claimant that 25 percent of Retroactive Benefits Is Being WithheldTN 30 03-96
NL 00703.816Notice Explaining Disposition of Withheld Retroactive BenefitsTN 70 03-16
NL 00703.817Retroactive Check Released — No Fee Charged for Services Performed on Your ClaimTN 30 03-96
NL 00703.818Notice to Beneficiary — Retroactive Check is Being Released; Request for Approval of a Fee for Representing a Claimant Not ReceivedTN 34 05-98
NL 00703.819Court Case — Retroactive Benefits Were Withheld Pending Determination on Attorney FeeTN 34 05-98
FORMAL REPRESENTATIVE PAYEE NOTICES
NL 00703.821Final Notice to the Former Representative Payee, or the Non-Selected Payee Applicant When Another Payee is AppointedTN 34 05-98
NL 00703.822Final Notice to Legally Competent Adult or Emancipated Minor of Payee SelectionTN 34 05-98
NL 00703.823Notice to Child Beneficiary Who Was His/Her Own Payee or Legally Incompetent Adult Beneficiary When Representative Payee AppointedTN 34 05-98
NL 00703.824Final Notice of Payee Appointment to Parent, Person Standing in Place of Parent, Legal Guardian or Attorney Representative Who Is Also an Unsuccessful ApplicantTN 34 05-98
NL 00703.825Notice to Legally Competent Adult Beneficiary or Emancipated Minor Who has a Payee and is Denied Direct PaymentTN 34 05-98
NL 00703.826Notice 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 BeneficiaryTN 34 05-98
NL 00703.827Notice to Child or Incompetent Adult Beneficiary Who Has a Representative Payee and Is Denied Direct PaymentTN 34 05-98
NL 00703.828Notice 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 PayeeTN 34 05-98
DISALLOWANCE EXHIBIT NOTICES
NL 00703.900Disallowance — Auxiliary Not Entitled to Retirement Benefits on Own RecordTN 31 02-97
NL 00703.901Disallowance Not a Spouse Under the ActTN 53 05-09
NL 00703.905Disallowance Miscellaneous Fill-in LetterTN 53 05-09
NL 00703.907Survivor Disallowance — NH Not InsuredTN 36 03-99
NL 00703.909Disallowance — Date of Birth Not EstablishedTN 30 03-96
NL 00703.911Auxiliary Disallowance — NH Not EntitledTN 30 03-96
NL 00703.913Request for Benefit Increase DeniedTN 30 03-96
NL 00703.915Retirement Denial — Lack of Insured StatusTN 30 03-96
NL 00703.917Disallowance — Age Requirement Not MetTN 30 03-96
TERMINATION EXHIBIT NOTICES
NL 00703.920Instructions for Inclusion of Overpayment Language in Termination NoticesTN 36 03-99
NL 00703.923Benefits to Mother/Father or Young Spouse Terminate — Child Beneficiary Dies — ForeignTN 36 03-99
NL 00703.924Termination Letter to Representative Payee When Beneficiary Dies — Domestic or ForeignTN 36 03-99
NL 00703.925Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce — DomesticTN 30 03-96
NL 00703.926Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce — ForeignTN 30 03-96
NL 00703.927Benefits to Mother/Father, or Wife, Husband, Former Wife or Former Husband Terminate — Child Attains Age 16 — DomesticTN 30 03-96
NL 00703.928Benefits to Mother/Father, or Wife, Husband, Former Wife or Former Husband Terminate — Child Attains Age 16 -ForeignTN 30 03-96
NL 00703.929Benefits to Child Terminate — Age 18/19 — Domestic or ForeignTN 30 03-96
NL 00703.930Benefits to student terminate — Deemed age 19 — Domestic or foreignTN 30 03-96
NL 00703.931Benefits to Student Terminate — No Longer in Full — Time AttendanceTN 30 03-96
NL 00703.932Benefits Suspended Due to Number Holder’s (NH) Death - Dual EntitlementTN 54 06-09
NL 00703.933Cover Notice for Field Office (FO) and Teleservice Center (TSC) to Use When Sending the SSA-4111TN 54 06-09
NL 00703.940Cover Letter to Organizations Inquiring About Payment for Representative Payee ServicesTN 51 11-06
NL 00703.941Fees for Representative Payee ServicesTN 41 09-04
NL 00703.942Explanation of Documents Needed to Collect a Fee for Representative Payee ServicesTN 51 11-06
NL 00703.943Notice Authorizing Organization to Collect a FeeTN 41 09-04
NL 00703.944Notice to Organization Denying Request to Collect a FeeTN 31 02-97
NL 00703.945Explanation of Fees for Representative Payee ServicesTN 41 09-04
NL 00703.946Notice of Fee for Service (FS) Site Review or Recertification SchedulingTN 37 03-03
NL 00703.948Review Decision Notice to OrganizationTN 31 02-97
NL 00703.949Revocation Notice to OrganizationTN 31 02-97
NL 00703.950Notice to Creditor OrganizationTN 31 02-97
NL 00703.954Expedited