TN 23 (12-17)
DEPR07 Disallowance – Child not Dependent
(1) not qualify for benefits as a child on (2) Social Security record (3) . To qualify, (4) must have been living with or receiving contributions from (5) when:
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(6) applied for benefits, or
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•
(8) became entitled to benefits, or
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The facts we have do not show that any of these requirements is met.
Fill-ins:
(1) “PN does”/“You do”
(2) NH name possessive
(3)
“because she was adopted by someone else”/“because he was adopted by someone else”/
“because you were adopted by someone else”/null
(4) “you”/“she”/he”
(5) SN of NH
(6) “you”/“she”/“he”
(7) SN of NH
(8) SN of NH
(9) “she”/“he”
DEPR08 Disallowance – Adopted Child
(1) not qualify for benefits as an adopted child on (2) Social Security record because (3) did not live with or receive at least half (4) support from (5) for the last year before (6) adoption became final.
Fill-ins:
(1) “You do”/“She does”/“He does”
(2) NH's name
(3) “you”/“she”/“he”
(4) “your”/“her”/“his”
(5) SN of NH
(6) “your”/“her”/“his”
DEPR09 Dependency Requirement - Disallowance
To qualify for child's benefits as a dependent grandchild or step grandchild on (1) Social Security record, (2) must have:
begun living with (3) before age 18; and
lived with (4) in the United States and received one-half support from (5) throughout the year before (6) (7) .
The facts we have do not show that these requirements are met.
Fill-ins:
(1) NH's name
(2) “you”/FN
(3) “her/him”
(4) “her/him”
(5) “her/him”
(6) “she/he”
(7) “became entitled to disability benefits”/”became entitled to retirement benefits/died/became
disabled” *
(*) indicates that fill-in is manual
DEP010 Claims Where a Child is Adopted by the Number Holder's Surviving Spouse but the Dependency
Requirement is not Met
(1) not qualify for child's benefits on (2) Social Security record because (3) not living with (4) or receiving at least one-half support from (5) when (6) died.
Fill-ins:
(1) “She does”/“He does”/“You do”
(2) NH-NAME possessive
(3) “she was”/“he was”/“you were”
(4) Ms. Plus NH's SURNAME/Mr. Plus NH's SURNAME
(5) Ms. Plus NH's SURNAME/Mr. Plus NH's SURNAME
(6) “she”/“he”
DEP011 Disallowance – Child Not Living With
(1) not qualify for child's benefits on (2) Social Security record because (3) not living in (4) household when (5) died.
Fill-ins:
(1) “You do”/“She does”/“He does”
(2) NH's name possessive
(3)
“[3a] natural mother was” or “PN was”
[3a] “your”/“her”/“his”
(4) SN of NH
(5) “she”/“he”
DEPR12 Disallowance – Grandchild Adopted by Surviving Spouse
(1) not qualify for child's benefits on (2) Social Security record because:
(3) parent or stepparent was living in the same household as (4) , and
(5) receiving support from (6) parent or stepparent when (7) died.
Fill-ins:
(1) “You do”/“She does”/ “He does”
(2) NH's name
(3) “your”/“her”/“his”
(4) SN of NH
(5) “You were”/“she was”/“he was”
(6) “your”/“her”/“his”
(7) NHSN
DEPR13 Disallowance - Grandchild
To qualify for benefits as a grandchild or step grandchild on (1) Social Security record, (2) natural or adoptive parents must have been deceased or disabled when:
(3) became disabled, or
(4) became entitled to benefits, or
(5) died.
The facts we have do not show that any of these requirements is met.
Fill-ins:
(1) NH's name
(2) “your”/“her”/“his”
(3) NH's surname
(4) “she”/“he”
(5) “she”/“he”
DEP015 Parent Disallowance – Proof Not Within Time Limit
(1) not qualify for parent's benefits because we did not receive proof within the time
limit that (2) received half of (3) support from (4) . We needed this proof within 2 years of either the:month (5) applied for disability, or date (6) died.The facts we have do not show that either requirement is met.
Fill-ins:
(1) “You do”/“She does”/ “He does”
(2) “you”/“she”/“he”
(3) “your”/“her”/“his”
(4) NH's name
(5) “she”/“he”
(6) “she”/“he”
DEP016 Parent Disallowance - Support
(1) not qualify for parent's benefits because (2) not receiving at least half (3) support from (4) when (5) became disabled or died.
The facts we have do not show that any of these requirements is met.
Fill-ins:
(1) “You do”/“She does”/ “He does”
(2) “you were”/“she was”/“he was”
(3) “your”/“her”/“his”
(4) NH's name
(5) “she/he”
DEP020 Auxiliary Stepchild Disallowance – Dependency Requirements Not Met
To qualify for benefits on a stepparent's record, a child must have been receiving
at least one half of his or her support from the stepparent. The child must have been
receiving this support (1) or, if the stepparent was disabled until entitlement to retirement or disability
benefits, when that parent:
last became disabled; or
last became entitled to disability benefits; or
became entitled to retirement insurance benefits.
Fill-in:
(1) when the stepparent died/when he or she applied for benefits