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.
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•
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.
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You must have a good reason for waiting more than 30 days to ask for a review.
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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?
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1.
Visit www.ssa.gov for fast, simple, and secure online service.
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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.
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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