TN 2 (09-11)

NL 00720.110 COP Copy of Notice

COP001 COPY OF NOTICE SENT (C24)

(Requested/Generated)

Caption: None

We are sending a copy of this notice to  (1)   (2)   (3)   (4)   (5)  .

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: your representative

Fill-in (2) - Systems Generated

Choice 1: null

Fill-in (3) - Systems Generated

Choice 1: null

Fill-in (4) - Systems Generated

Choice 1: null

Fill-in (5) - Systems Generated

Choice 1: null

COP002 COPY OF NOTICE SENT TO THE ATTORNEY (C26)

(Requested/Generated)

Caption: None

Enclosed is a copy of the letter we sent to  (1) 

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Full name

COP013 BENEFICIARY REQUESTS COPIES OF AWARD NOTICE TO BE SENT TO EMPLOYER AND/OR UNION (C31)

(Requested)

Caption: None

As  (1)  asked, we sent information about  (2)  claim to  (3)  .

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: you

Choice 2: beneficiary's name

Fill-in (2) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (3) - Requested As A Language

Choice 1: Name of employer or union

COP014 COPY OF THE NOTICE SENT TO APPOINTED REPRESENTATIVES WHEN THE BENEFICIARY NOTICE INCLUDE ENCLOSURES

(Generated)

Caption: None

We also sent  (1)  the publications shown in the Enclosure(s) block at the bottom of the letter. You can view these publications on our website at www.socialsecurity.gov or you may call us at 1-800-772-1213 to request copies.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary Name


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900720110
NL 00720.110 - COP Copy of Notice - 05/20/2013
Batch run: 05/20/2013
Rev:05/20/2013