TN 31 (02-97)

NL 00703.770 Representative Payee — Authorized Fee Notice to Beneficiary or Person Standing in Place of Beneficiary

(GN 00506.140B.)

Document Identifier for Word Processor: E3770

A. EXHIBIT LETTER

We are writing to let you know that (1) has been approved to collect a fee from (2) monthly benefits for serving as (3) representative payee. They can begin collecting these fees in (4) .

 

What (5) Representative Payee Can Collect

(6) representative payee may collect a fee of 10 percent of (7) total monthly benefits, but no more than $ (8) each month.

 

If You Have Any Questions

3765C

B. REQUESTING INSTRUCTIONS

  • Send this notice to inform a legally competent adult, emancipated minor, legal guardian, or parent or person standing in place of parent when the representative payee has been authorized to collect a fee.

  • Show the title of the officer and the name of the institution or entity. Do not show the name of such officer.

  • Refer to NL 00703.765 for 3765C text and fill-ins.

  • The fee amounts for fill-in (8) will change each year beginning 1996, subject to the Consumer Price Index.

     

Fill-ins:

  1. Name of representative payee

  2. your, name of beneficiary (possessive)

  3. your, his, her

  4. month/year organization can begin collecting fees from this beneficiary

  5. Your, His, Her

  6. Your, first name of beneficiary (possessive)

  7. your, his, her

  8. maximum non-DAA amount, maximum DAamount

C. TYPING INSTRUCTIONS

This notice will be sent by the FO. It may be reproduced on FO letterhead.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900703770
NL 00703.770 - Representative Payee -- Authorized Fee Notice to Beneficiary or Person Standing in Place of Beneficiary - 02/18/1997
Batch run: 01/27/2009
Rev:02/18/1997