TN 37 (12-23)
GN 00304.115 Language Exhibits for Erroneous Death Cases
NOTE: "Erroneous Death Case Notice" & "Erroneous Death Case - Third Party Contact" notices
in these exhibits are available on the document processing system (DPS) under the
"General" menu selection.
Exhibit 1A
USE:
When a number holder (NH) notifies us that our records incorrectly show them as being
deceased; use this language to obtain their consent to notify third parties that we
gave incorrect information and ask them to change their records.
LANGUAGE:
We are responding to your request that we correct our records. We removed incorrect
information from our records that showed you as deceased. If you want us to ask (organization's
name and address) to correct their records, please sign the tear-off portion of this
letter and return it to us at the address shown above.
We are sorry for any inconvenience this incorrect information may have caused you.
I give the Social Security Administration my consent to use my Social Security number
to let the (organization's name and address) know that I am not deceased. My Social
Security number is (Social Security number).
Signature Date
Exhibit 1B
USE:
Use when an NH alleges that our records incorrectly show them as deceased but our
records are correct. We will notify the agency that used the information that the
individual is alive if the individual gives their consent.
LANGUAGE:
We are responding to your request that we correct our records. Our records are correct
and do not show you as deceased. However, if you want us to ask (organization's name
and address) to correct their records, please sign the tear-off portion of this letter
and return it to us at the address shown above.
We are sorry for any inconvenience this may have caused you.
I give the Social Security Administration my consent to use my Social Security number
to let the (organization's name and address) know that I am not deceased. My Social
Security number is (Social Security number).
Signature Date
Exhibit 2A
USE:
Do not use this notice until we have the NHs consent. Use this language to notify
third parties that we gave erroneous information and ask them to change their records.
LANGUAGE:
We are writing to let you know about a correction in our records for (NHs full name),
whose Social Security number is (Social Security number). Our records incorrectly
showed (him or her) as deceased. However, we have since found that (he or she) is
alive.
Please change your records to show the correct information. We are sorry for any inconvenience
the incorrect information may have caused you.
cc: (NHs Name)
Exhibit 2B
USE:
Do not use this notice until we have the NHs consent. Use this language when our records
are correct but the NH says a third party's records shows them as deceased. Use to
notify the third party that the NH is alive and to ask them to change their records.
LANGUAGE:
We are writing to let you know that (NHs full name), whose Social Security number
is (Social Security number), is alive. (NHs full name) has informed us that your records
show (he or she) is deceased.
Please change your records to show the correct information. We are sorry for any inconvenience
this may have caused you.
cc: (NH's Name)