The regional office (RO) will send an EAP closeout notice if the claimant fails to respond or refuses to sign the EAP agreement. The field office (FO) must follow proper steps in GN 03107.150D.1 and GN 03107.150D.5 before the RO makes a last attempt to resolve the EAP request by sending this closeout notice to the claimant and representative, if any.

For more information on RO responsibilities when a claimant fails to respond or refuses to sign the EAP agreement, see GN 03107.250B.5.b.

On *F1, we contacted you to sign the expedited appeals process (EAP) agreement. It has been over 30 days and we have not received the signed agreement.

If We Do Not Hear From *F2

It is important that *F3*F4 the agreement to a local field office within 30 days from the date of this notice. If *F5 do not sign and return the agreement or request a hearing to pursue further administrative review, within 30 days, we will cancel your EAP request. Our *F6 reconsideration decision will be our final decision on *F7 case. *F8 will have no further appeal rights within the administrative appeals process or in federal court.

• •

  The 30 days start the day after you receive this notice. We assume you got this notice 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• •

  You must have a good reason for waiting more than 30 days to ask for a review.

• •

  If you want to request a hearing, you can file your appeal online, or use our HA-501, “Request for Hearing” form, available at www.ssa.gov/forms. You can also contact us to request the form or if you need help filling it out.

Suspect Social Security Fraud?

If you suspect Social Security Fraud, please visit https://oig.ssa.gov/report or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101)

Need more help?

1. 1. 

   Visit www.ssa.gov for fast, simple, and secure online service.

2. 2. 

   Call us at 1-800-772-1213, weekdays from 8:00 am to 7:00 pm. If you are deaf or hard of hearing, call TTY 1-800-325-0778. Please mention this letter when you call.

3. 3. 

   You may also call your local office at *F9 .

   *F10

How are we doing? Go to www.ssa.gov/feedback to tell us.

Fill-in choices:

*F1-1 Date FO contacted the claimant to sign the EAP agreement

*F2-1 you

*F2-2 Client Name

*F3-1 you

*F3-2 Client Name

*F4-1 sign and return

*F4-2 signs and returns

*F5-1 you

*F5-2 they

*F6-1 Date of the reconsideration determination

*F7-1 your

*F7-2 their

*F8-1 You

*F8-2 They

*F9-1 Local FO’s phone number

*F10-1 Local FO’s address