TN 26 (03-92)
SI 02305.814 SSA-L3074-U2, Supplemental Security Income Notice of Appointment
Social Security Administration
Supplemental Security Income
Notice of Appointment
Social Security Number:
This is a very important letter about keeping your Supplemental Security Income (SSI) case active. Please read it carefully. If there is anything you do not understand, please get in touch with us right away.
You Have An Appointment
We must regularly review the cases of people who get SSI. We need information from you to make sure you are still eligible.
We have set up an appointment for you on at . On that date:
Call us at and ask for .
We will call you at . Let us know if this number is wrong.
Come to see us at and ask for .
Your representative payee must come with you to the appointment.
If you can't keep your appointment, please call us. We will make another appointment for you.
If We Do Not Hear From You
We may stop your SSI if you don't respond to this request or contact us by to tell us why. If we stop your SSI, you could also lose any Medicaid you have now.
Before we stop your SSI, we will send you another letter to explain our decision. The letter will also explain your right to appeal the decision and how to continue getting SSI during the appeal.
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Things We Need for the Appointment
When you talk with us, please try to have all of the items checked for to the present. Even if you don't have all of the information, we need to hear from you. We will help you get anything you do not have.
Bank statements: savings and checking accounts, and any other bank statements for
Pension records from: the Department of Veterans Affairs, Railroad Retirement Board, Civil Service, State, military, private pensions for
Pay stubs from work since for
For self-employment, last year's income tax return; if not available, all records that show last year's business income and expenses for
Unemployment compensation payment records for
Worker's compensation award letter for
Life insurance policies for
Burial contract agreement for
We must see the original document(s) or a certified copy of these item(s). We cannot accept photocopies. We will return these items to you.
When you call or come in, please have this letter with you.
If You Have Any Questions
If you have any questions or need help, please call us at and ask for .