Use this cover letter to request a handwriting analysis from the Treasury in limited payability cases per GN 02401.910. Include the technician’s name, address and phone number for contact purposes.

NOTE: You must include this cover notice to complete the package you send to Treasury. If this notice is omitted, Treasury will return the entire package.

Request for Handwriting Examination

  

To: Date:

Department of the Treasury

Bureau of Fiscal Service

National Payment Integrity and Resolution Center

13000 Townsend Rd

Philadelphia, PA 19154

  

From:

  

Agency Case Contact Information

  

  

Name Phone Fax

 

Return Address

 

LIMITED PAYABILITY CASE

We are referring this case to you for a handwriting analysis in order to decide if SSA should take action on this individual’s record.

Payee Name and Account/ID Number:

Questioned Items (Please list individually):

Standard (Please list individually):

Any Other Instructions: