TN 30 (03-96)

NL 00703.353 Accrued Benefits Paid in Monthly Installments to Beneficiary

(GN 00603.085)

Document Identifier for Word Processor: E3353

A. EXHIBIT LETTER

We are writing to tell you about extra money we are sending you.

 

What We Will Pay and When

  • You are due $(1) from (2) through (3) .

  • You will get this money over a period of months.

  • We will send you $(4) each month in addition to the regular check you already get.

  • These checks will start (5) and end when all of the extra money is paid to you.

     

If You Disagree With The Decision

3180A - Domestic

3180B - Foreign

 

If You Want Help With Your Appeal1

3100E

 

If You Have Any Questions

3901C - Domestic

3901D - Foreign

 

1 If the person lives outside the U.S. or has an attorney, omit this paragraph.

B. REQUESTING INSTRUCTIONS

Send when accrued benefits were withheld at the time benefits were awarded and the withheld amount will now be paid to the beneficiary in monthly installments.

 

Fill-ins:

  1. total amount of money due the beneficiary

  2. first month and year of accrued benefits were withheld in the format, May 1992

  3. last month and year accrued benefits were withheld

  4. Amount to be paid in each installment

  5. month, day, year the first installment payment will be made in the format of August 3, 1992

See NL 00703.005E. for 3901C and D text and fill-in. See NL 00703.180 for 3180A and 3180B text. See NL 00703.100 for 3100E text.

C. TYPING INSTRUCTIONS

Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Information for this notice will be shown on Form SSA-573.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900703353
NL 00703.353 - Accrued Benefits Paid in Monthly Installments to Beneficiary - 03/11/1996
Batch run: 01/27/2009
Rev:03/11/1996