BASIC (04-00)

VB 05001.020 Notice to Non-Selected Payee or Former Rep Payee

Document Identifier for Word Processor: TITLE 8 NOTICE TO FORMER OR NON-SELECTED PAYEE

A. EXHIBIT LETTER

We have decided that it would be best for __(1)__ to have __(2)__ Special Veterans Benefits (SVB) payments sent to another payee.

[Optional Paragraph #1-sent to former rep payee if refund of conserved funds is required]

If You Have Saved Any Money

While you were __(1)__ representative payee, you may have saved some money for __(2)__. If you have, you should return it to us unless you have already made other plans with us for handling it. The money you will need to return includes:

  • Saved and invested SVB payments.

  • Interest earned from these savings and investments.

  • Money you have left over from any SVB payments we sent you.

  • Any SVB payments you might get after the date of this letter.

How To Pay Us Back

To do this, you can write us a check or money order. Make it out to the Social Security Administration. Be sure to write "Conserved Funds for __(3)__, Special Veterans Benefits" on that check or money order. Please mail it in the enclosed envelope.

[Optional Paragraph #2-sent to former rep payee if refund of conserved funds is required and the address is a foreign one]

Please send your check or money order in United States currency or in local currency equal to the United States dollars. When you pay us in local currency, we use the exchange rate in effect at the time we get your payment. If this causes a difference between the amount you pay us and the amount you owe us, we will let you know. If you cannot mail your payment directly to us, please go to one of the offices shown in the last section "If You Have Questions or Need Help" for help in making the refund.

[Optional Paragraph #3-final accounting is requested]

What You Need To Do

You should send us a final report of how you used the SVB payments you got. Use the form we are sending you to do this.

If You Have Questions or Need Help

  • If you live in Canada, contact any U.S. Social Security office.

  • If you live in Guam, Puerto Rico, Samoa or the U.S. Virgin Islands, you should contact the nearest U.S. Social Security Office.

  • If you live in Mexico, contact any U.S. Social Security office or the nearest United States Embassy or consulate.

  • In the Philippines, please call 523-1001 extensions 2516 or 2645 from 8:00am to 2:00p.m. or write/visit SSA Division, U.S. Department of Veterans Affairs, 1131 Roxas Boulevard, 0930 Manila.

  • In any other country, you should contact the nearest United States Embassy or consulate.

If you call or visit an office, please have this letter with you.

Notice Fill-ins:

  1. (full name of beneficiary)

  2. (his, her)

Optional Paragraph #1 Fill-ins:

  1. (Mr., Ms.) (beneficiary's last name, possessive)

  2. (him, her)

  3. (full name of beneficiary)

B. REQUESTING INSTRUCTIONS

The CPS is responsible for sending this notice.

If a refund of conserved funds is being requested, select Optional Paragraph #1. If the address is foreign, also select Optional Paragraph #2.

If a final accounting is being requested, select Optional Paragraph #3.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/1405001020
VB 05001.020 - Notice to Non-Selected Payee or Former Rep Payee - 06/15/2004
Batch run: 01/27/2009
Rev:06/15/2004