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] | |
[Representative's First Name, Middle Initial and Last
Name]
[Address]
[City, State
Zip]
Dear [Mr./Ms. [Representative's Last Name]]:
Re: [Claimant's Name and Address]
Enclosed is a typed transcript of the hearing. [If refund is due, insert the following: The transcript was [insert pages] pages shorter than our earlier estimate. Another office will soon send you a refund in the amount of $ [insert amount].
We Will Not Act For 25 Days
If you have more information, you must send it to us within 25 days of the date of this letter. We will not allow more time to send information except for very good reasons.
Our address and FAX number are:
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ADDRESS: |
Appeals Council Office of Hearings and Appeals ATTN: Branch [#], Suite [#] 5107 Leesburg Pike Falls Church, VA 22041-3255 |
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FAX: |
[FAX #], Attn: Branch [#]. |
Put the Social Security Number shown at the top of this letter on your request.
If you send us anything by fax, do not send duplicates by mail. That may delay processing your claim.
What Happens Next
If we do not hear from you within 30 days, we will assume that you do not want to send us more information. We will then proceed with our action based on the record we have.
If You Have Any Questions
If you have any questions, you may call or write the Appeals Council. Our telephone number and address are shown at the top of this letter. If you do call, please have this notice with you.
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[Name] | |
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[Branch Chief] OR [Hearings and Appeals Analyst] OR [Paralegal Support Technician] OR [Legal Assistant] |
Enclosures:
[Typed Transcript]
Self-addressed
envelope
cc:
[Claimant's
Name]
[Address]
[City, State
Zip]
Travel and Payroll
Suite 406 Skyline Tower
[If claimant is unrepresented, letter will be addressed to claimant and “Re” line and “cc” will be deleted.]