TN 31 (02-97)
NL 00703.709 Notice to Beneficiary/Payee — Amended Garnishment Order
Document Identifier: E3709
A. Exhibit letter
We are writing to tell you about a change in court order number (1) concerning (2) responsibility for child support, alimony, or court ordered victim restitution, and how it affects Social Security payments.
What We Plan To Do
(3) has asked us to take a different amount of money out of the monthly payments. We will now (4) the monthly payments beginning (5) because of this change in the order.
What We Will Take Out
We will take out $ (6) from each monthly payment to collect the amount owed. You will receive a check for $ (7) each month beginning with the check you will receive around (8) .
If You Disagree With This Decision
If you disagree with the decision of (9) , you will need to contact them directly, or have a lawyer do this for you. They can be contacted at this address:
If You Have Any Questions
B. Requesting instructions
case/civil action number
“your”/beneficiary's full name, possessive in format: Robert L. Smith's
name of court or public official/agency in format: The Baltimore County Court
month/year (MM/YYYY) change is effective
dollar amount being withheld
adjusted monthly benefit amount
month/day/year (MM/DD/YYYY) new payment will arrive
name of court or public official/agency, in the same format as fill-in #2
address of court or public official/agency