TN 30 (03-96)
Document Identifier for Word Process: E3609
Thank you for advising us of the change required on the health insurance card you
received. We have taken the necessary steps to correct the information.
You will receive a new card shortly to replace the one which is incorrect.
This notice is used to notify a beneficiary that a new HI card will be sent to him/her
with the changes requested.
Information for this letter will be shown on Form SSA-573. The name and address, if
not given, can be taken from the latest Form SSA-3926-C2 in file.