TN 30 (03-96)
NL 00703.928 Benefits to Mother/Father, or Wife, Husband, Former Wife or Former Husband Terminate — Child Attains Age 16 -Foreign
Document Identifier for Word Processor: E3928
A. Exhibit letter
We are writing to let you know that your entitlement to benefits ended as of (1) . We based this on information that (2) became age 16 in (3) .
Other Social Security benefits
If you disagree with the decision1
If you have any questions
1 If there is an overpayment, omit this paragraph.
B. Requesting instructions
Send to terminated parent when youngest child-in-care attains age 16.
Use paragraphs 3927A and 3923A when benefits to mother/father terminate. Use paragraphs 3927B and 3923B when benefits to wife, husband, former wife, former husband terminate. See NL 00703.005E. for 3901D text and fill-in. Refer to NL 00703.180 for ALS020 text. Refer to NL 00703.927 for 3927A and 3927B text and fill-ins. Refer to NL 00703.923 for 3923A and 3923B text and fill-ins.
last month/year of entitlement e.g., May 1993
full name of child beneficiary
month/year e.g., June 1993
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.