TN 31 (02-97)
NL 00703.759 Request to Financial Institution for Correct Beneficiary Address
Document Identifier for Word Processor: E3759
A. EXHIBIT LETTER
|Financial Institution||Claim Number:|
|Street Address||Bank Account No.:|
|City/State/Zip Code|| |
We are writing to ask for some information about (1) , who has direct deposit of (2) Social Security benefit payment with you. We are unable to locate (3) at the address we have in our records:
If we are unable to obtain a current address for (5) , we will stop (6) checks.
What We Need
Please provide the mailing address you have for (7) , (8) , in the space below, and return this letter in the enclosed envelope.
Customer's Current Mailing Address is:
Right To Financial Privacy
A financial institution can provide the Social Security Administration with address information for a title II beneficiary without the person's consent. This conforms with the Right to Financial Privacy Act (12 U.S.C 3414 k.1).
If You Have Any Questions
If you have any questions, or do not have this information please let us know right away. Please include the Social Security claim number shown above in any letter you send us.
B. REQUESTING INSTRUCTIONS
C. TYPING INSTRUCTIONS
The FO or PC should use FO or PC letterhead. Be sure to enclose a return envelope and include all eight fill-ins.