Send when the conserved amount returned by the former payee is paid to the new representative
payee in monthly installments.
Fill-ins:
-
(1)
Full name of beneficiary in the format, Joan Sands
-
(2)
First and last name of beneficiary
-
(3)
amount returned by the former payee
-
(4)
amount of each monthly installment
-
(5)
month, day, year the first installment will be paid in the format, August 10, 1992.
Optional Paragraph 3350A:
-
(1)
Beneficiary's first name, if child or adult, with last name
Use paragraph 3350A when the type of payee code (TYP) is not SLM.
See NL 00703.005E. for 3901C and D text and fill-in.