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:
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•
Saved and invested SVB payments.
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•
Interest earned from these savings and investments.
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•
Money you have left over from any SVB payments we sent you.
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•
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
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•
If you live in Canada, contact any U.S. Social Security office.
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•
If you live in Guam, Puerto Rico, Samoa or the U.S. Virgin Islands, you should contact
the nearest U.S. Social Security Office.
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•
If you live in Mexico, contact any U.S. Social Security office or the nearest United
States Embassy or consulate.
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•
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.
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•
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:
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(1)
(full name of beneficiary)
-
Optional Paragraph #1 Fill-ins:
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(1)
(Mr., Ms.) (beneficiary's last name, possessive)
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-
(3)
(full name of beneficiary)