We have decided that it would be best for you if (1) continues to be your representative payee. This means that your (2) checks will still be paid to (3) to use for your needs.
Do You Disagree With The Decision?
If you think you should get your own checks or that someone else should help you manage
your checks, you have the right to appeal. We will review your case again and consider
any new facts you have. (4) Then a person who did not make the first decision will decide your case again.
You have 60 days to ask for an appeal.
The 60 days start the day after you get this letter. We assume you got this letter
5 days after the date on it unless you show us that you did not get it within the
You will have to have a good reason for waiting more than 60 days to ask for an appeal.
To appeal, you must fill out a form called “Request
for Reconsideration.” The form number is SSA-561-U2. To get this form, contact one of our offices. We can
help you fill out the form.
How To Appeal
There are two ways to appeal. You can pick the one you want. If you meet with us in
person, it may help us decide your case.
Case Review. You have a right to review the facts in your file. You can give us more facts to add
to your file. Then we will decide your case again. We will not meet with the person
who decides your case.
Informal Conference. You will meet with the person who decides your case. You can tell that person why
you think you are right. You can give us more facts to help prove you are right. You
can bring other people to help explain your case.
You Want Help With Your Appeal
If You Have Any Questions
3901C - Domestic
3901D - Foreign
Pamphlet No. SSA-05-10058
1 Delete this sentence for foreign cases.