TN 35 (11-21)
Social Security Administration
Retirement, Survivors, and Disability
Insurance
Claim Information
Miscellaneous
Program Service Center
225
E. Oak Street
Central
City, ST 00000
Date:
BNC:
21MS123J45678-A
JASON SMITH
1010 MAIN STREET
ANYTOWN, ST 00001
We cannot process the application you filed for Social Security benefits on behalf
of JOHN G. BENEFICIARY because you are not the proper person to apply for benefits
on Mr. BENEFICIARY’S behalf.
If You Have Any Questions
If you have any question, you may call us at 1-800-2345-SSA. We can answer most questions
over the phone. You can also write any Social Security office. The office that serves
your area is located at:
Street address
City, State Zip
If you do call or visit an office, please have this letter with you. It will help
us answer your questions. Also, if you plan to visit an office, you may call ahead
to make an appointment at the office. This will help us serve you more quickly when
you arrive at the office.
Social Security Administration