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SOCIAL SECURITY ADMINISTRATION _____________________________________________________________ | |
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Refer to: TAHB [SSN] [XSSN] |
Office of Hearings and Appeals 5107 Leesburg Pike Falls Church, VA 22041-3255] | |
Last Update: 9/1/05 (Transmittal II-6-13)
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SOCIAL SECURITY ADMINISTRATION _____________________________________________________________ | |
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Refer to: TAHB [SSN] [XSSN] |
Office of Hearings and Appeals 5107 Leesburg Pike Falls Church, VA 22041-3255] | |
NOTICE OF ORDER OF APPEALS COUNCIL
DISMISSING REQUEST FOR
HEARING
[Claimant's First Name, Middle Initial and Last Name]
[Address]
[City, State Zip]
What This Order Means
We have dismissed your request for hearing. In the enclosed order, we explain why we did this. Our action is final and not subject to further review.
If You Have Any Questions
If you have any questions, you may call, write, or visit any Social Security office. If you do call or visit an office, please have this notice with you. The telephone number of the local office that serves your area is [Insert area code and number of servicing Field Office]. Its address is:
[Field Office Address]
[City, State ZIP]
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[Name] |
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Administrative Appeals Judge |
cc:
[If there is a representative, insert:]
[Representative's Name]
[Address]
[City, State Zip]