TN 30 (03-96)
NL 00703.814 Notice To Beneficiary — Concurrent Title II/Title XVI Case —Fee Petition Case — Title II Offset Amount Is More Than The Retroactive Title II Benefits Minus The Amount Withheld Toward The Attorney Fee —Offset Action Delayed Pending Field Office (FO) Adjustment
Document Identifier for Word Processor: E3814
A. EXHIBIT LETTER
We recently wrote you that we would withhold part of your Social Security benefits in case we have to pay your lawyer. We are writing now to tell you:
What your total Social Security past-due benefits are (before we reduce them because of the Supplemental Security Income you received), and
The amount we are withholding to pay your lawyer.
Your past-due Social Security benefits are $ (1) for (2) . We usually withhold 25 percent of that amount to pay a lawyer's fee. We withheld $ (3) from your past-due benefits to pay your lawyer.
We told you earlier that we may have to reduce your Social Security benefits for
(4) if you received SSI for those months. We will tell you later how much we must withhold from your Social Security benefits for this period because of the SSI you received.
Information About Lawyer's Fees
If your lawyer wants to charge a fee for his or her services, he or she must ask us in writing to approve the amount of the fee. Your lawyer must give you a copy of his or her fee request and each attachment to the request. If your lawyer does not want to charge a fee, he or she should tell us.
If your lawyer wants us to pay the fee from your withheld benefits, he or she should ask us to approve the fee within 60 days of the date of this letter. If your lawyer:
is finished working on this case and wants to charge a fee, he or she should ask us to approve the amount of the fee right away.
is not finished working on this case and wants to charge a fee, he or she should tell us within 60 days of the date of this letter that he or she will ask for a fee.
does not want to charge a fee or does not want us to pay the fee from the benefits we withheld, he or she should tell us right away.
|C24||We are sending a copy of this notice to (1) .|
If You Have Any Questions
B. REQUESTING INSTRUCTIONS
C24 (1) name of attorney