BASIC (04-14)

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

FORMAL PROTEST

  

  

TO:

DATE:    

FROM:

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 ___________________________________________________________

SSN  _____________________________           

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 Position)

(Insert Office Address)

 
 

(Insert Telephone)

Attachments ( )


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0903001070
NL 03001.070 - Formal Letter Protesting the Department of the Treasury (Treasury) Handwriting Analysis Decision - 04/18/2014
Batch run: 04/18/2014
Rev:04/18/2014