BASIC (02-02)

DI 55099.075 SSA-L1364 (Ticket Termination Notice for the Representative Payee, Legal Guardian, or Authorized Representative)

Social Security Administration

Important Information

Social Security Administration

P.O. Box 1433

Alexandria, VA 22313

Date:

Claim Number:

John Doe

Address

Bar Code

We are sending this letter to you because you receive benefits on behalf of (name of beneficiary/recipient). The following is the exact text of a letter we have sent to (name of beneficiary/recipient).

We are writing to tell you that you no longer qualify for the Ticket to Work program because your ticket (ticket number) has terminated. We terminated your ticket because our records show one of the following things has happened:

  • You were getting Social Security or Supplemental Security Income (SSI) benefits based on disability or blindness and your entitlement to these benefits ended for reasons other than your work or earnings;

  • You get widow's or widower's benefits based on disability and have reached age 65; or

  • You get SSI benefits based on disability or blindness and have reached age 65.

(Situation 1a—TRIDE/DORS can identify local FO)

We invite you to visit our website at www.ssa.gov on the Internet to find general information about Social Security. If you have any specific questions, you may call us toll free at 1-800-772-1213, or call your local Social Security office at:

(telephone number of local Social Security office)

We can answer most questions over the phone. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. You can also write or visit any Social Security office. The office that serves your area is located at:

(address of local Social Security office)

If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly when you arrive at the office.

(Situation 2a—TRIDE/DORS cannot identify local FO)

We invite you to visit our website at www.ssa.gov on the Internet to find general information about Social Security. If you have any specific questions, you may call us toll free at 1-800-772-1213. We can answer questions over the phone. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. If you prefer to visit one of our offices, please check the local telephone directory for the office nearest you. Or call us and we can give you the office address. Please have this letter with you if you call or visit an office. It will help us answer your questions.

Deputy Commissioner

for Operations


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0455099075
DI 55099.075 - SSA-L1364 (Ticket Termination Notice for the Representative Payee, Legal Guardian, or Authorized Representative) - 02/05/2002
Batch run: 01/27/2009
Rev:02/05/2002