II-6-2-4. DIS 1D Notices of AC Dismissal of Request for Review - Claimant/Representative and Improper Party (All Titles)

Last Update: 9/1/05 (Transmittal II-6-13)

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SOCIAL SECURITY ADMINISTRATION

_____________________________________________________________

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 REVIEW

[Claimant's First Name, Middle Initial and Last Name]

[Address]

[City, State Zip]

What This Order Means

We have dismissed a request for review filed by [User keys in name of person filing request for review]. In the enclosed order, we explain why we did this.

Under our rules, the dismissal of a request for review 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 phone number of servicing Field Office]. Its address is:

[Field Office Address]
[City, State ZIP]

[Name]

Administrative Appeals Judge

cc:

[If there is a representative, insert:]

[Representative's Name]

[Address]

[City, State Zip]

ssalogo.gif

SOCIAL SECURITY ADMINISTRATION

_____________________________________________________________

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 REVIEW

[Person Filing Request for Review First Name, Middle Initial and Last Name]

[Address]

[City, State Zip]

What This Order Means

We have dismissed your request for review. In the enclosed order, we explain why we did this.

Under our rules, the dismissal of a request for review 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 phone number of servicing Field Office]. Its address is:

[Field Office Address]
[City, State ZIP]

[Name]

Administrative Appeals Judge