NL 03001.070 Formal Letter Protesting the Department of the Treasury (Treasury) Handwriting Analysis Decision
A. When to use notice
Use this letter when the beneficiary or recipient is filing a formal protest of the handwriting analysis decision made by the Treasury.
B. Formal protest letter
Department of the Treasury
Social Security Administration
Bureau of Fiscal Service
(Insert local address)
Philadelphia Financial Center
13000 Townsend Rd
Philadelphia, PA 19154
The following claimant is filing a formal protest on the handwriting analysis made by your office.
BENEFICIARY / RECEIPIENT’S NAME ______________________________
BENEFICIARY / RECEIPIENT’S ADDRESS ___________________________________________________________
PROGRAM (check one): ____ SSI (Title XVI) or _____ SSA (Title II) _____
CHECK NUMBER __________ CHECK SYMBOL ____________
CHECK DATE__________ CHECK AMOUNT ____________
ADDITIONAL INFORMATION __________________________
BENEFICIARY / RECEIPIENT’S SIGNATURE _________________
Please contact the person named below if you have any questions.
(Insert Employee’s Name)
(Insert Office Address)
Attachments ( )