TN 30 (03-96)

Document Identifier for Word Processor: E3917

A. Exhibit letter

We have considered your application for Social Security (1) benefits. You are not entitled to benefits at this time because you do not meet the age requirement.

Why we can not pay you

You can not receive benefits now because you are not (2) years old. Based on the information in your file, your date of birth is (3) . When you reach age (4) you can get benefits and should file a new claim.

Other Social Security benefits

3901E

If you disagree with the decision

ALS020

New application

3900A

If you want help with your appeal¹

3100E

If you have any questions

3901C - Domestic

3901D - Foreign

¹ If the person lives outside the U.S. or has an attorney, omit this paragraph.

B. Requesting instructions

• Send this notice when the claimant does not meet the age requirement for entitlement.

• Use 3901E, ALS020 and 3900A in all cases. Refer to NL 00703.901 for 3901E text. Refer to NL 00703.900 for ALS020 and 3900A text and NL 00703.100 for 3100E text.

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

   

Fill-ins:

1. type of benefit, e.g., “widow's”

2. required age, e.g., “60”

3. established date of birth, e.g., “January 12, 1934”

4. required age, e.g., “60”

C. Typing instructions

Use Form SSA-L2000-C2 (Universal Notice). Refer to Form SSA-3428-U2, Determination of Disallowance Coding Sheet, “Name and Address Information” field in block 2 for completing the name and address. Because the fill-ins may vary according to different situations, follow the requestor's typing instructions carefully.