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)
||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
If you disagree with the decision1
If you have any questions
1 If there is an overpayment, omit this paragraph.