All Forms Must be Printed, Filled out, Signed and Returned to S.N.E.S.A.A. Via Fax or Email.
If you have any questions or would like a list of references, please call 774-365-4441 or email info@snesaa.org.
Documentation Requirements - As a suggestion, you may want to post these in your office as a quick reference.
New Client Referral Forms:
- New Client Referral Forms - Contact Kim Santos, for each new client, by phone 774-365-4441 or email, info@snesaa.org, before starting the new client forms. This is a fillable PDF. Type in responses, print, sign and fax or email us.
- SSA Form 787 Required if Client Has NOT previously retained the services of a Rep Payee. This form is to be filled out by a physician explaining why the client is unable to manage their fiscal funds.
Existing SNESAA Clients:
- Check Request - This is a fillable PDF. Type in responses, print, sign and fax or email us.
- Client Contract - This is a fillable PDF. Type in responses, print, sign and fax or email us.
- Attestation Letter Directions - for missing or lost receipts.
- Authorization for Release of Information - This is a fillable PDF. Type in responses, print, sign and fax or email us.
- Moves Form - This is a fillable PDF.
- Client Work Information - Please notify S.N.E.S.A.A when a Client starts and/or stops working because it can directly affect their benefits. This is a fillable PDF.
- Best Practices Documentation Template - Documentation to be collected for all S.N.E.S.A.A. Clients on a Monthly Basis - Bank Statements, Earned Income, Incarceration, Death, Vital Documents (Name Change, Marriage/Divorce/Birth/Change in Guardianship), Hospitalization.
- Lay Person Letter - All new client referral forms submitted to S.N.E.S.A.A. need to include a Lay Person Letter. This letter is a requirement by the S.S.A.
- Suggestons to obtain a Certified Appointment of Guardian Decree - All new referrals with a legal guardian,will need to submit a Certified Appointment of Guardian Decree with raised seal via MAIL to S.N.E.S.A.A.’s P.O. Box.