Effective Dates: 03/17/1995 - Present Previous | Next

Basic (11-81)

NL 00701.114 Form SSA-L412 — Reconsideration — Initial Interim Notice — Additional Evidence is Being Obtained

A. Sample form

B. Purpose/Use

This form notice is used as an initial interim notice when additional evidence is being obtained.

This notice does not require any fill-ins.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701114
NL 00701.114 - Form SSA-L412 — Reconsideration — Initial Interim Notice — Additional Evidence is Being Obtained - 03/17/1995
Batch run: 04/25/2016
Rev:03/17/1995