We are sorry to learn of your recent loss. Please accept our sincere sympathy.

We are writing to tell you that we are not processing the application for Social Security benefits for (1) . This is because (2) could not have been entitled to benefits for any month before (3) death on (4) .

If You Have Any Questions

3901C

• •

  Send this notice for abatements when the claimant died in or before the first entitlement month or during the DIB waiting period and was not entitled to HI or SMI. Do not send this notice on a DIB claim when the NH died in the first month of entitlement. A freeze award would be proper in that case.

   

• •

  Fill-ins:

  1. (1) 

     name of deceased

  2. (2) 

     he/she

  3. (3) 

     his/her

  4. (4) 

     date of death