This form is a sample letter in Word format covering the subject matter of the title of the form.
[Your Name] [Your Address] [City, State, ZIP Code] [Phone Number] [Email Address] [Date] [Social Security Administration Office] [Address] [City, State, ZIP Code] Subject: Notification of Representation in an Appeal for Disability Benefits — [Social Security Number] Dear [Social Security Administration Office], I am writing to inform you that I, [Your Name], will be representing [Applicant's Name] in their appeal for disability benefits. [Applicant's Name] resides in Fulton, Georgia, and is seeking assistance for their disability claim under the Social Security Disability Insurance (SDI) and/or Supplemental Security Income (SSI) programs. As the legal representative for [Applicant's Name], it is my duty to ensure their rights are protected and that all necessary documentation and evidence are submitted accurately and on time. I have been authorized by [Applicant's Name] to act on their behalf, communicate with the Social Security Administration, and access their case information. Please find attached the signed Form SSA-1696, "Appointment of Representative," granting me the authority to represent [Applicant's Name]. Additionally, I have enclosed a copy of [Applicant's Name]'s Notice of Disapproved Claim as well as any other relevant paperwork related to their disability claim for your reference. I kindly request that all future correspondence, including notices, updates, and requests for additional information, be directed to my attention. Please note my contact information indicated above for ease of communication. I assure you that any required documentation or responses will be promptly provided to the Social Security Administration. Furthermore, I am currently in the process of gathering any additional medical, vocational, or other supporting evidence that may strengthen [Applicant's Name]'s claim. I kindly request your assistance in informing me of any specific documents or forms that should be submitted for this appeal process. I appreciate your attention to this matter and look forward to working closely with you in securing the disability benefits that [Applicant's Name] rightfully deserves. If there are any further steps or requirements that must be followed in Fulton, Georgia, during this appeal process, please provide the necessary guidance to ensure a smooth and successful resolution. Thank you for your understanding and cooperation. Should you require any additional information or have any questions, please do not hesitate to contact me at your earliest convenience. I am available to discuss [Applicant's Name]'s case and address any concerns you may have. Sincerely, [Your Name] [Your Title/Position, if applicable] [Your Law Firm/Organization, if applicable]
[Your Name] [Your Address] [City, State, ZIP Code] [Phone Number] [Email Address] [Date] [Social Security Administration Office] [Address] [City, State, ZIP Code] Subject: Notification of Representation in an Appeal for Disability Benefits — [Social Security Number] Dear [Social Security Administration Office], I am writing to inform you that I, [Your Name], will be representing [Applicant's Name] in their appeal for disability benefits. [Applicant's Name] resides in Fulton, Georgia, and is seeking assistance for their disability claim under the Social Security Disability Insurance (SDI) and/or Supplemental Security Income (SSI) programs. As the legal representative for [Applicant's Name], it is my duty to ensure their rights are protected and that all necessary documentation and evidence are submitted accurately and on time. I have been authorized by [Applicant's Name] to act on their behalf, communicate with the Social Security Administration, and access their case information. Please find attached the signed Form SSA-1696, "Appointment of Representative," granting me the authority to represent [Applicant's Name]. Additionally, I have enclosed a copy of [Applicant's Name]'s Notice of Disapproved Claim as well as any other relevant paperwork related to their disability claim for your reference. I kindly request that all future correspondence, including notices, updates, and requests for additional information, be directed to my attention. Please note my contact information indicated above for ease of communication. I assure you that any required documentation or responses will be promptly provided to the Social Security Administration. Furthermore, I am currently in the process of gathering any additional medical, vocational, or other supporting evidence that may strengthen [Applicant's Name]'s claim. I kindly request your assistance in informing me of any specific documents or forms that should be submitted for this appeal process. I appreciate your attention to this matter and look forward to working closely with you in securing the disability benefits that [Applicant's Name] rightfully deserves. If there are any further steps or requirements that must be followed in Fulton, Georgia, during this appeal process, please provide the necessary guidance to ensure a smooth and successful resolution. Thank you for your understanding and cooperation. Should you require any additional information or have any questions, please do not hesitate to contact me at your earliest convenience. I am available to discuss [Applicant's Name]'s case and address any concerns you may have. Sincerely, [Your Name] [Your Title/Position, if applicable] [Your Law Firm/Organization, if applicable]