TN 3 (10-05)

A. Procedure - Use of Form

Provide SSN card applicants with written notice when the SSN application cannot be processed per RM 10205.090 and RM 10215.110. An application cannot be processed when the applicant does not have all the required evidentiary documents or presents documents that do not meet SSA’s evidentiary requirements (e.g., uncertified photocopies or documents based on the applicant’s allegations) per RM 10205.020. Additionally, use the SSA-L676 when you are still unable to process an SSN application after the applicant previously received an SSA-L669 or SSA-L670 requesting evidence or an interview (see RM 00299.005 and RM 00299.010).

Provide the SSA-L676, either in person or by mail, to an applicant for an SSN when:

• The Social Security number application cannot be processed because the applicant refuses to come in for an interview, has failed to submit required evidence, or has immigration documents indicating that the current status will expire within 14 days.

• A replacement SSN card cannot be issued because the NH has exceeded either the yearly (three cards) or the lifetime (ten cards) limits on replacement SSN cards and a valid exception reason was not provided. (See RM 10205.400 for further information about limits on replacement cards.)

• The issuing agency is unable to verify the status of an applicant based on a document submitted with the SSN card application, but the document is not identified as fraudulent (e.g., an I-94 (Arrival/Departure Record) does not verify through the Systematic Alien Verification for Entitlements (SAVE) Program per RM 10214.000.

• An SSN has been assigned but you cannot issue a replacement card because the NH does not have current work authorization or a current valid reason for obtaining a non-work Social Security card (including F-1 students who do not have current evidence of on-campus employment per RM 10211.235).

  NOTE: Always establish the identity of the NH before offering to provide third party verification (RM 10225.005) when we cannot issue a replacement card; or before updating Numident data (RM 10211.600).

• The SSN application cannot be processed for other reasons (e.g., a new, different SSN request is not approved, or the SSN application was not submitted by the proper applicant).

IMPORTANT: We only verify evidence with the issuing agency when we can issue a card. The SSA-L676 cannot be used as evidence of citizenship or alien work status. Similarly, DO NOT use this form to confirm that a person was never assigned an SSN.

B. Procedure - Preparation of Form

1. Enter FO address, hours, and phone number.

2. Enter the name or unit of the employee providing the letter.

3. Enter applicant’s mailing address.

4. Check the appropriate block(s).

NOTE: This letter is also available in Spanish as SSA-L676-SP. This form is available in SSNAP and field offices should continue to use that version. The form is available on DOCS (General) and on eForms.

C. Exhibit - Form SSA-L676 - Refusal to Process SSN Application

See OS 15010.317 for Form SSA-L676 - Refusal to Process SSN Application