Report a Rep Payee Issue – Disability Law Center

How can I report an issue?

You can report an issue related to a beneficiary or representative payee by filling out the form below.

Visit our Contact Us page if you have a general inquiry, want to get involved, think that your rights have been violated, or if you wish to speak with an attorney about a non representative payee disability-related legal issue.

Rep Payee Report Form

Representative Payee Name *

First

Last

Representative Payee Address

Address Line 1

Address Line 2

City

State

Zip Code

Representative Payee Phone

Beneficiary Name *

First

Last

Beneficiary Address

Address Line 1

Address Line 2

City

State

Zip Code

Beneficiary Phone

Reporter Name *

First

Last

Reporter Address

Address Line 1

Address Line 2

City

State

Zip Code

Reporter Phone

Problem Area *

Brief Explanation of the Problem *

Email