As we told you in an earlier letter, we have chosen (1) to be your representative payee. Your representative payee will get your checks each
month and will use this money for your needs.
Information About Your Checks
|| (1) sending your regular monthly check of $ (2) to (3) around (4) .
|We (1) $ (2) to (3) for you around (4) . We will begin sending your regular monthly check of $ (5) to (6) around (7) .
|We are enclosing a copy of a letter that we sent to your representative payee. Please
be sure to read it. If you disagree with anything in this letter, you can ask for
an appeal. If you want to request an appeal, please contact one of our offices. We
can help you complete the required form.
If You Have Any Questions
3901C - Domestic
3901D - Foreign