We are writing to let you know that we are stopping your Social Security benefits in
(1) . This is the check you would normally get in (2) . Your benefits are stopping because you told us that you are working outside the U.S. more than 45 hours per month.

 

Information We Need From You

Let us know right away if you are no longer working more than 45 hours per month. We need this information so that we can pay you the right amount of benefits.

Also, please read the enclosed pamphlet, “Your Social Security Checks - While You Are Outside The U.S..” It explains the kinds of things you need to tell us.

 

If You Have Any Questions

3901D

 

Enclosure:

SSA Pub. No. 05-10137

This notice is used when a child beneficiary reports that he/she is working over 45 hours per month and has a new address. His/her work does not permit reinstatement during the current calendar year. Development of a proper payee has been deferred until a notice is received that the child is no longer working and has not returned to the payee's care. The notice is sent to the child at his/her new address. See NL 00703.005E. for 3901D text and Fill-ins.

 

Fill-ins:

1. (1) 

   month/year; e.g., July 1992

2. (2) 

   month/year; e.g., August 1992

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