Report a Rep Payee Issue

How can I report an issue?

You can report an issue related to a beneficiary or representative payee by filling out the form below. This form is only intended to report issues relating to a representative payee or beneficiary. 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
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Representative Payee Phone
Beneficiary Name*
First Last
Beneficiary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Beneficiary Phone
Reporter Name*
First Last
Reporter Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reporter Phone
Reporter Email
Issue Area
Brief Explanation of the Problem*

We will not inform you of the status of your report or whether any further action is taken by DRC-NH.

To report abuse or neglect of a person with a disability, contact Bureau of Elderly and Adult Services or local law enforcement.

This was published at U.S. taxpayer expense and does not constitute an official communication from any funder listed above.