We are writing to let you know that your entitlement to benefits ended as of (1) . We based this on information that you are not a full-time elementary or high school student.

(If there is an overpayment, follow instructions in NL 00703.920 on what paragraphs to include.)

 

Your responsibilities

3929A

 

If you disagree with the decision¹

      

ALS020

            

 

If you want help with your appeal²

3100E

 

If you have any questions

3901C

3901D

¹ If there is an overpayment, omit this paragraph.

² If the person lives outside the U.S. or has a representative, omit this paragraph.

• •

  Send when we terminate a student who is not in full-time attendance.

• •

  Use paragraph 3929A in domestic cases. Use paragraph ALS020 in domestic and foreign cases.

• •

  See NL 00703.005E. for 3901C and 3901D text and fill-in. Refer to NL 00703.180 for ALS020 text. Refer to NL 00703.100 for 3100E text. Refer to NL 00703.929 for 3929A text and fill-ins.

   

Fill-in:

1. (1) 

   month/year

Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Information for this notice will be shown on Form SSA-573.