TN 30 (03-96)
NL 00703.925 Benefits to Spouse, Mother/Father, or Child Terminate Because of Marriage or Divorce — Domestic
Document Identifier for Word Processor: E3925
A. Exhibit letter
We are writing to let you know that (1) entitlement to benefits ended as of (2) . We based this on information that (3) (4) in (5) .
| ||(To Be Used When Last Child-In-Care Marries)|
|3925A||We can pay (1) benefits only when you have a child in your care, under age 16 or disabled, who is entitled to Social Security benefits.|
(If there is an overpayment, follow instructions in NL 00703.920 on what paragraphs to include.)
Other Social Security benefits
When benefits are terminated during the year, you must file an annual report if you earn over $ (6) . In this report include your earnings for the entire year both before and after your benefits were terminated.
If you disagree with the decision1
If you want help with your appeal2
If you have any questions
1 If there is an overpayment, omit this paragraph.
2 If the person has an attorney, omit this paragraph
B. Requesting instructions
Send when spouse, child, mother/father marries or divorces and benefits are terminated. Also, send when mother/father benefits end because the child-in-care marries.
Use paragraph 3922E when benefits to mother/father terminate because last child-in-care marries. Use paragraph 3922F when benefits to young spouse terminate because last child-in-care marries. Use Paragraph ALS020 (except when there is an overpayment), 3100E and 3901C in all cases.
Refer to NL 00703.180 for ALS020 text. Refer to NL 00703.100 for 3100E text. Refer to NL 00703.005E. for 3901C text.
your, full name of beneficiary, possessive format
last month/year of entitlement e.g., May 1993
you/he/she, name of beneficiary when parent's entitlement ends due to marriage of child-in-care
was married/were married/were divorced/was divorced
month/year e.g., June 1993
exempt amount for year of termination.
C. Typing instructions
Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Information for this notice will be shown on Form SSA-573.