NL 00725.008 Notice of Disapproved Claim
Social Security Administration
Retirement, Survivors, and Disability Insurance
Notice of Disapproved Claim
Program Service Center
E. Oak Street
City, ST 00000
JOHN G. BENEFICIARY
101 MAIN STREET
ANYTOWN, ST 00001
We have considered your application and find that you are not entitled to any Social
Why We Cannot Pay You
You do not qualify for retirement benefits now because, based on your correct date
of birth was, January 17, 1927, you are not yet age 62.
Your Date of Birth
Based on the evidence we have, we have decided that your correct date of birth was
January 17, 1927.
Do You Think We Are Wrong?
If you think we are wrong, you have the right to appeal. We will correct any mistakes
and will look at any new facts you have. A person who did not make the first decision
will decide your case.
You have 60 days to ask for an appeal.
The 60 days start the day you get this letter.
You must have a good reason if you wait more than 60 days to ask for an appeal.
Other Social Security Benefits
You are not entitled to any other Social Security benefits based on the application
you filed. In the future, if you think you may be entitled to benefits, you will need
to apply again.
If You have Any Questions
If you have any questions, 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:
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.