NL 00701.198 Form SSA-L679 — Student Not Eligible for Benefits After Age 22
A. Sample form
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The SSA-L679 is used to inform student beneficiaries of the date their benefits will terminate, based on information supply by the student on from SSA-1389.
C. Preparation of form
The name of the beneficiary, claim number and address can be obtained from the source document, SSA-1389, Report of Student Beneficiary About to Attain Age 22. An “X” must be shown in the appropriate box to denote the reason for the action.