If possible, translate all items related to the same issue on a single form SSA-533, (Translation Request), OS 15010.165. Show the exact type of evidence submitted.

Number each receipt and show the corresponding number on the translation form.

Indicate:

1. a. 

   The name of the individual and the date expenses were incurred;

2. b. 

   An itemized account of the goods and/or services rendered and the cost of each;

3. c. 

   The name, address, and occupation of the person who supplied the goods and/or services;

4. d. 

   The total amount paid;

5. e. 

   The date paid; and

6. f. 

   The name of the payer.