Send when the entire amount of conserved benefits returned by the former representative
payee is being paid to the new payee or to the beneficiary.
Fill-ins:
-
(1)
Leave blank in direct pay cases. Otherwise, show:
“for name of beneficiary” in the format, for John Davies
-
(2)
Amount of conserved fund payment
-
(3)
month, day, year payment is due in the format of July 3, 1992
-
(4)
your, beneficiary first name, possessive in the format, John's, if child; if adult,
“Mr.” or “Ms.” last name, possessive, in format Mr. Davis'
-
Optional Paragraph 3350A:
-
(1)
Beneficiary's first name, if child; “Mr.” or “Ms.” last name if adult.
Use paragraph 3350A only when we pay the conserved benefits to a representative payee
and the type of payee code (TYP) is not SLM.
See NL 00703.005E. for 3901C and D text and fill-in.