TN 50 (02-06)

Document Identifier for Word Processor: E3160

A. Exhibit Letter

We are writing to tell you about a change in (1) Social Security benefits. Earlier we stopped (2) benefits temporarily because (3) . However, based on information we have, we should have stopped (4) benefits permanently beginning (5) .

Why Benefits Will Stop

We recently matched computer records with the Railroad Retirement Board and learned that (6) enough railroad earnings (120 railroad service months or 60 railroad service months after 1995) to qualify for railroad benefits. Because of this, we can no longer use the railroad earnings to figure Social Security benefits. Without these earnings, (7) not insured for Social Security benefits. (8)

What You Can Do

Please let us know right away if any of this information is wrong. We cannot use this information to change Social Security benefits until we give you time to check it. You will also need to give us any proof you have that shows that our information is wrong.

If We Do Not Hear From You

If we do not hear from you within 30 days from the date of this letter, we will assume the information in this letter is correct and use it to stop (9) benefits.

We will send another letter at that time. It will explain the change in benefits, the amount of any overpayment, and how to appeal our decision.

• You will have 60 days to ask for an appeal.

• The 60 days will start the day after you receive the next letter.

If You Have Any Questions

3901C - Domestic
3901D - Foreign

B. Requesting Instructions

The PC will send this notice to a beneficiary in deferred or suspense status whose benefits will be terminated because the number holder (NH) attains 120 RR service months and as a result loses insured status.

Refer to NL 00703.005E. for 3901C and 3901D text and fill-ins.

Fill-ins:

1. your/beneficiary full name, (possessive)/the children's

2. your/his/her/their

3. reason for deferred/suspension status

4. your/his/her/their

5. month and year of termination

6. you have/(railroad worker's name) has

7. you are/(railroad worker's name) is

8. If sending the notice to an auxiliary, add the following sentence:

   Since (he/she) is not insured, we cannot pay any benefits on (his/ her) record.

9. your/beneficiary's title and surname, possessive/child's first name, possessive (if one child beneficiary)/the children's

C. Typing Instructions

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