SSA Initial Claim -- Wrong Form

May 19, 1993
3801 Connecticut Ave., NW
#136
Washington, DC  20008

Fay E. Peterson
District of Columbia
Rehabilitation Services Admin.
Disability Determination Division
P.O. Box 37608
Washington, DC  20013

RE: Disability Claim xxx-xx-xxxx

Dear Ms. Peterson:

I am returning the enclosed form uncomplated regarding "seizures and spells," which was mailed by mistake.

I spoke with a Ms. Brown, a supervisory employee at the Rehabilitation Services Administration on Wednesday May 19, 1993, who told me to discard the form, and that a correct form would be forwarded to me.

Thank you.

Sincerely,

Gary Freedman