We are writing to let you know that your entitlement to benefits ended as of  (1)
                . We based this on information that  (2)  became age 16 in  (3)  .
         
         
            
               
                  
                  
               
               
                  
                  
                     
                     | Paragraph | Language | 
               
               
                  
                  
                     
                     | 3927A | We can pay  (1)  benefits only when you have  (2)
                            child in your care, under age 16 or disabled, who is entitled to Social Security
                        benefits. | 
                  
                     
                     | 3927B | We can pay  (1)  benefits only when you have a child in your care, under age 16 or disabled, who is
                        entitled to benefits on  (2)  Social Security record. | 
               
            
          
         (If there is an overpayment, follow instructions in NL 00703.920 on what paragraphs to include.)
         
          
         Other Social Security benefits 
         
            
               
                  
                  
               
               
                  
                  
                     
                     | Paragraph | Language | 
               
               
                  
                  
                     
                     | 3922E | You may be able to get  (1)  benefits at age 60, or at age 50 if you are disabled. The people in any Social Security
                        office will be glad to help you at that time. | 
                  
                     
                     | 3922F | You may be able to get benefits again when you are age 62. The people in any Social
                        Security office will be glad to help you at that time. | 
               
            
          
          
         Your responsibilities 
         When benefits are terminated during the year, you must file an annual report if you
            earn over $ (4)  . In this report, include your earnings for the entire year both before and after
            your benefits were terminated.
         
         If you disagree with the decision1
               
         ALS020
         If you want help with your appeal2
               
         3100E
         If you have any questions 
         3901C
         1 If there is an overpayment, omit this paragraph.
         
         2 If the person has an attorney, omit this paragraph.