NL 00701.740 Form SSA-L4967-U2 — Reconsideration — Affirmation of Cessation

A. Sample form

Reverse Side

B. Purpose/Use

This section contains a new form notice which is to be used in reconsideration affirmation of cessation title II cases. Prepare two form notices - one for the claimant and one for the claimant's folder.

NOTE: Personalized disability notice procedures implemented July 1, 1981, require the Forms SSA-4268-U6/C6 be attached to unfavorable disability form notices. In addition to preparing this form notice according to instructions, the typist must:

  1. 1. 

    Type the personalized and technical rationales on the Form SSA-4268-U6 or SSA-4268-C6.

  2. 2. 

    Prepare appropriate rider (or include paragraphs on form notice if there is room).

  3. 3. 

    Assemble form notice, personalized rationale and the rider stapled together in that order, with envelope for mailing.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900701740
NL 00701.740 - Form SSA-L4967-U2 — Reconsideration — Affirmation of Cessation - 03/18/1995
Batch run: 04/14/2014
Rev:03/18/1995