We are writing to tell you that we stopped the Social Security benefits you receive
for (1) beginning with the check you would have received in (2) .
Why The Benefits Stopped
We stopped the benefits because we cannot pay benefits after (3) been outside the United States for more than 6 months in a row. Our records show
that (4) left the U.S. in
(5) , and (6) not returned.
3296A |
We cannot pay benefits now because (1) , and (2) not meet any of the special conditions that would allow us to pay benefits after
(3) been outside the United States for 6 months. These conditions are explained in the
enclosed booklet.
|
OR 3296B
|
We cannot pay benefits now because (1) did not reside in the United States for at least 5 years. The enclosed booklet explains
the special conditions that would allow us to pay benefits after (2) been outside the United States for 6 months.
|
OR 3296C
|
We cannot pay benefits now because (1) and (2) adopted outside the U.S. The enclosed booklet explains the special conditions that
would allow us to pay benefits after (3) been outside the United States for 6 months.
|
When We Can Start Your Benefits Again
We can start paying benefits again if (7) back to the United States. (8) will have to be here for a full month before we can start the benefits again.
If (9) to the United States, please get in touch with any Social Security office. Bring
(10) passport with you so we can verify the date of return to the U.S.
If You Disagree With The Decision
3180B
If You Have Any Questions
3901D
Enclosure:
SSA Pub. No. 05-10137