TN 30 (03-96)

NL 00703.208 Notice to Former Representative Payee to Continue to Administer Conserved Funds

Document Identifier for Word Processor: E3208

A. EXHIBIT LETTER

Your last report of how you used (1) (2) checks showed that you saved money for
(3) . Even though you no longer (4) payee, we have decided that you may continue to manage these savings.

 

It Is Important To Keep Track of This Money

We may ask you to tell us how you are managing this money. For that reason, you will need to keep track of how you use the savings.

 

Your Responsibilities

Please let the new payee know when there is a change in your address. This is so that you can be reached quickly when (5) needs the money you have saved. If you move, be sure to give us your new address, too. The payee is (6) . (7) can be reached at (8) . We are also sending (9) a copy of this letter.

 

If You Have Any Questions

3901C - Domestic
3901D - Foreign
CC: (10)

B. REQUESTING INSTRUCTIONS

Send to former payee when we decide to let him administer the funds he has saved.

 

Fill-ins:

  1. Full name of beneficiary, possessive

  2. Social Security, Supplemental Security Income, Black Lung (or any combination of these)

  3. him, her

  4. his, her

  5. first name of beneficiary, if child; if adult, “Mr.” or “Ms.” last name

  6. name of current payee

  7. He, She, They

  8. address of current payee

  9. him, her, them

  10. current payee name

Use paragraph 3901D when the former payee lives outside the U.S. Otherwise, use paragraph 3901C. See NL 00703.005E. for 3901C and 3901D text and fill-in.

C. TYPING INSTRUCTIONS

Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards for SSA and BL. Information for this notice will be shown on Form SSA-573. For title XVI, use FO letterhead.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900703208
NL 00703.208 - Notice to Former Representative Payee to Continue to Administer Conserved Funds - 03/04/1996
Batch run: 01/27/2009
Rev:03/04/1996