We are writing to let you know that we are stopping your Social Security benefits in

(1) . This is the payment you would normally get about (2) . Your payments are stopping because of your deportation or removal from the United States under one of the following sections of the Immigration and Nationality Act (INA):

• •

  section 241(a) of the INA in effect prior to April 1997;

• •

  section 237(a); or

• •

  section 212(a)(6)(A).

 

This is based on information from the U.S. Department of Homeland Security.

 

Information We Need From You

Please contact us if in the future you are permitted to return to the United States as a lawful permanent resident. We may be able to pay benefits at that time.

 

ALSC04

ALS020

 

If You Have Any Questions

3901D

This notice is used to notify an insured individual that his/her benefits are being suspended because of his/her deportation or removal from the United States.

 

Fill-ins:

1. (1) 

   month/year; e.g., July 2004

2. (2) 

   month, day, year; e.g., August 3, 2004

See NL 00703.005E. for 3901D text and fill-in. Refer to NL 00703.180 for ALS020 text.

Information for this notice will be shown on SSA-573. Use SSA-L2000-C2 (Universal Notice) and follow the new notice standards.