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  • The Open Door Rep Payee Form

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Case Manager Email REPRESENTATIVE PAYEE PROGRAM T. O. D., Inc. P.O. Box 99243 Pittsburgh, PA 15233 (412) 231-2178 CLIENT INFORMATION II Behavioral/Mental Health Illness: Please List Diagnoses:.

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2 To become a representative payee a person must apply and be appointed by the Social Security Administration.

§ 416.622 Who may not serve as a representative payee? A representative payee applicant may not serve if he/she: (a) Has been convicted of a violation under section 208, 811 or 1632 of the Social Security Act. (b) Has been convicted of an offense resulting in imprisonment for more than 1 year.

Visit .socialsecurity.gov/myaccount and select sign in or create an account. Your Representative Payee Portal will automatically appear. for yourself including estimating your future benefits or requesting a replacement Social Security card (in qualifying states).

Once you've sent the application form and the new payee has sent the letter to SSA, the change in payee should take effect in about a month. You and your new payee should each receive a written notice of this before any benefits are paid to the new payee.

SSA-623: Representative Payee Report (Adult Beneficiaries)

Payees who are under 18 must complete the paper version. Individual payees who are 18 or older can complete it online by logging in to their my Social Security account.

Representative payees can fill out the form and return it to Social Security by mail, or conveniently file it online at .ssa.gov/myaccount/rep-payee.html. Organizational representative payees are able to complete their Representative Payee Report online by using Business Services Online.

You must complete form SSA-11 (Request to be selected as payee) and show us documents to prove your identity. You will need to provide your social security number, or if you represent an organization, the organization's employer identification number.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232