BASIC (10-00)

Exhibit - Due Process Notice -- CDR Cessation for Whereabouts Unknown

We are writing to you about your Social Security disability payments. We've been carefully reviewing the facts in your case. You now have a chance to give us more information about your case.

If you disagree with our plans explained below, you should contact us within 10 days and ask us to look at your case again. If you have any new information or concerns, you may call, write, or visit the Social Security office nearest you. The telephone number and address are shown at the     (1)     this letter.

What We Plan To Do

Based on the facts in your file, we plan to stop your disability payments in       (2)      . This is because     (3)    . Before we do this, we're giving you a chance to give us more information about your case. We will look at any new information you give us before we decide whether to stop your payments.

What You Should Do

Let us know right away if you have more information about

     (4)     .

If You Have Any Questions

    (5)     

Fill-ins:

(1) a. end (If sent from PC/DDS)

    b. top (If sent from FO)

(2) month/year of suspension, in format; July 1993

(3) a. our records show that you are working

      b. we cannot locate you at the last address that we have

      c. we have not received the information we requested from you

     d. we received information that your health has improved and you are able to work

(4) a. your work and earnings

     b. your current address

      c. your health

     d. [Dictated language for other information we requested from the beneficiary (e.g., the          reason you did not complete the form, the reason you did not furnish the information          we requested).]

(5) a. Use option a. if sent from PC/DDS

If you have any questions, you may call us toll-free at 1-800-772-1213, or call your local Social Security office at (fill- in from TRIDE). We can answer most questions over the phone. You can also write or visit any Social Security office. The office that serves your area is located at:

• Street Address
• 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. This will help us serve you more quickly.

b. Use option b. if sent from FO.

If you have any questions, you should call, write or visit any Social Security office. If you call or visit our office, please have this letter with you and ask for (name of claims representative). The telephone number is shown above.