Send when the entire amount of conserved benefits returned by the former representative
payee is being paid to the new payee or to the beneficiary.
Leave blank in direct pay cases. Otherwise, show:
“for name of beneficiary” in the format, for John Davies
Amount of conserved fund payment
month, day, year payment is due in the format of July 3, 1992
your, beneficiary first name, possessive in the format, John's, if child; if adult,
“Mr.” or “Ms.” last name, possessive, in format Mr. Davis'
Optional Paragraph 3350A:
Beneficiary's first name, if child; “Mr.” or “Ms.” last name if adult.
Use paragraph 3350A only when we pay the conserved benefits to a representative payee
and the type of payee code (TYP) is not SLM.
See NL 00703.005E. for 3901C and D text and fill-in.