Effective Dates: 07/14/2026 - Present Previous | Next

TN 177 (07-26)

GN 00204.014 The SSA-L566-U2 Title II Application Cover Notice

A. Procedure - when to use the SSA-L566-U2

Use the SSA-L566-U2 Title II application cover notice to transmit a Title II application to the applicant for wet signature, request any needed information/evidence to either adjudicate the application or close out the protective filing for the unsigned application.

NOTE: The preprinted notice is also available in Spanish (SSA-L566-U2 SP). Both the English and Spanish versions are available on the Document Processing System (DPS). For the Title XVI application cover notices see SI 00601.040.

B. Procedure - how to complete the notice

1. Identifying information

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Addressee: Enter the claimant's name and address
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Office Address: Enter the field office (FO) address
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Date: Enter the date you issue the notice
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BNC#: Enter the Beneficiary Notice Control Number (BNC#)

2. First paragraph

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Fill-in 1: Enter the date of the interview (mm/dd/yyyy)
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Fill-in 2: Enter as appropriate: you, or name of applicant
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Fill-in 3: Enter as appropriate: your, or name of applicant (possessive)

3. What you need to do

Fill-in 4: Select "or bring us the form(s) and requested information with this letter" or "the form to us at the address shown at the top of this letter"

4. If we don't hear from you

Fill-in 5: Enter as appropriate: you are, or name of claimant (possessive)

a. Option 1

Check option 1 if no previous closeout notice was issued or one was issued, but the protective filing period has expired.

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Fill-in 6: Enter the protective filing closeout date in format (mm/dd/yyyy) that is 6 months from the date of the notice.
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Fill-in 7: Enter the protective filing date in format (mm/dd/yyyy).

b. Option 2

Check option 2 if a closeout notice was issued based on a prior protective filing date and the closeout period has not expired.

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Fill-in 8: Enter the protective filing closeout date shown in the prior closeout notice in format (mm/dd/yyyy).
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Fill-in 9: Enter the protective filing closeout date in format (mm/dd/yyyy) that is 6 months from the date of the notice.
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Fill-in 10: Enter the date of the application interview in format (mm/dd/yyyy).

5. Things we need

Select the appropriate option(s) for the information or evidence needed. As an option, you may enter "for" followed by the individual's name for whom you need the evidence and the year(s) needed, as appropriate.

6. If you have any questions

Fill-in 11: Enter the contact person's telephone number in the space provided.

Fill-in 12: Enter the name of the contact person in the space provided.

C. Procedure - documentation

1. Modernized Claim System (MCS) applications

Annotate the MCS Development Worksheet (DWO1) screen with the SSA-L566-U2 issue date to establish a systems record that the applicant was advised of the protective filing closeout period. Store the SSA-L566-U2 notice in the Online Retrieval System (ORS).

2. Non-MCS applications

Include the file copy of the SSA-L566-U2 in the claims folder as documentation of the evidence requested and the protective filing closeout date. Once the application is effectuated, store a copy of the mailed SSA-L566-U2 in Evidence Portal (EP). See GN 01010.001 for the definitions of effectuate and adjudicate.

NOTE: If the valid application is never received, store all protective filing documentation in EP, including the SSA-L566-U2.

D. Exhibit - SSA-L566-U2

Social Security Administration

Retirement, Survivors and Disability Insurance

Office Address:

Date:

BNC#:

Claimant's Name

Claimant's Address

Dear Claimant

On (1), we talked with (2) about your eligibility for Social Security benefits. We filled out the enclosed application form based on (3) statements. However, we cannot decide if you are eligible until you sign the form and give us more information.

What You Need To Do

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Answer any questions circled on the form.
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Correct any information on the form that is wrong and initial the changes you make.
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Sign and date the form in the space called "Signature." If your husband or wife is also applying, please have him or her sign in the space called "Signature."
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Mail (4). Please use the enclosed envelope.

If We Don't Hear From You

It is important that you sign the application and return it to us within 10 days of the date of receipt of this notice. The sooner we get the signed application, the sooner we can decide if (5) eligible. IF WE RECEIVE THE SIGNED APPLICATION AFTER ANY OF THE DATES SHOWN BELOW, YOU MAY LOSE BENEFITS.

__If we receive the signed application by (6), we will use the date we talked to you about possible entitlement to benefits, (7) as the filing date.

__If we receive the signed application after (8), but no later than (9), we will use the date of the application interview, (10), as the filing date.

Things We Need

You must send us the original documents, unless noted. If you do not have the original, you must send a copy certified by the person who is the custodian of the original record. Do not send copies signed by a notary public. For proof of earnings, we can accept a photocopy of a W-2 form or a tax return (1040, Schedule C, Schedule SE, etc.). Do not delay sending us your application if you do not have the records.

Suspect Social Security Fraud?

If you suspect Social Security Fraud, please visit https://oig.ssa.gov/report or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

See Next Page

If you have any questions about your claim please call (11) and ask for (12).