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Report a Representative Payee Issue

You can report an issue related to a beneficiary or representative payee to P&A 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.

If you or someone you support has been abused, neglected, or exploited, please click here for more information on reporting this abuse. If you or someone you support is in immediate danger, call 911.

Representative Payee Name and Contact Information
First Name*
Last Name*
Representative Payee Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Beneficiary's Name and Contact Information
First Name*
Last Name*
Beneficiary Address*
Street Address Address Line 2 City State ZIP Code
Phone Number*
Reporter's Name and Contact Information (optional)
First name
Last Name
Phone Number
Brief Explanation of the Problem
Brief Explanation of the Problem*
- Misuse of Funds/Fraud
- Withholding Funds
- Unpaid Bills
- Record Keeping
- Fees and Charges
Message*

Protection & Advocacy for People with Disabilities, Inc.

Report a Representative Payee Issue

Representative Payee Name and Contact Information

Beneficiary's Name and Contact Information

Reporter's Name and Contact Information (optional)

Brief Explanation of the Problem

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