“Thank you for (your/name of donor other than writer) (gift/bequest) to the (name
                  of trust fund/Department of Health and Human Services/part or officer thereof) on
                  behalf of the United States. The law permits us to accept only unconditional money
                  gifts and bequests. Although we appreciate your kind (gift/bequest), we are returning
                  it to you because it is not clear that you intended it to be unconditional, and under
                  the law, we cannot accept (gifts/ bequests) that are conditional.
               
               “If the (gift/bequest) is intended to be unconditional, we will be happy to accept
                  it provided it is accompanied by a written statement that the (gift/ bequest) is unconditional.
                  For your convenience, we have enclosed a statement to that effect should you decide
                  that the (gift/bequest) is to be unconditional. Should you require any further assistance,
                  please phone or visit (this office/any Social Security office).”
               
               (Use an SSA-795 and obtain the statement. See GN 02413.003. Do not designate a trust fund.)