Example of language used for notice
You (1) meet all of the eligibility rules for Supplemental Security Income (SSI) except for
resources. You (2) signed an agreement to sell (3) so that you could (4) receive SSI. You (5) also agreed to repay the SSI you receive while you are trying to sell this property.
The agreement is effective (6) . You (7) must begin to try to sell the property within 30 days of this date.
We value the property at (8) . If you (9) believe it is worth less, you (10) can give us information that proves a lower value.
(11)
We will be in touch with you (12) in 30 to 35 days to check on your progress in selling the property. At that time,
we will need to see proof of your efforts to sell.
You (13) need to let us know right away if you (14):
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stop trying to sell the property; or
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refuse an offer to buy the property.
We will decide then whether you can still get SSI.
For you to receive SSI, the resources that you (15) own cannot be worth more than (16). We call this amount the limit on resources. Resources are the things that you (17) own such as cash, stocks, bank accounts, certain types of life insurance, buildings,
and land on which you do not live. We do not include as resources the home in which
you (18) live, one car used for necessary activities, and some other things.
Fill-Ins:
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1.
Choice 1 - null
Choice 2 - and your spouse
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2.
Choice 1 - null
Choice 2 - and your spouse
Choice 3 - and (the names of any deemors on the record)
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3.
(Description of the property; for example, the house at 46 Oak Avenue)
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4.
Choice 1 - null
Choice 2 - continue to
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6.
Month/Day/Year (if mailed, 5 days after the date on the notice; in person, the day
notice is received)
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8.
(CMV of the property that is on the SSA-8060, the conditional agreement)
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11.
Choice 1 - You (1A) cannot refuse a reasonable offer to buy this property. Since the property is worth
(2A), we consider an offer of at least (3A) to be reasonable. If you (4A) do not accept an offer of at least (5A), you must prove to us why the offer was unreasonable or we may stop your SSI payments.
(1A)Same as fill-in 2
(2A)Same as fill-in 8
(3A)(Two-thirds of the CMV in (8))
(4A)Same as fill-in 2
(5A)Same as fill-in (3A)
Choice 2 - null (if other than real property)
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16.
Choice 1 - $2,000 in Month/Year
Choice 2 - $3,000 in Month/Year
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