BASIC (11-81)

7100. Informal Reconsideration

You express dissatisfaction with our recent determination.

Our decision was based upon all the information in your file from which we concluded that you are not entitled to (a) insurance benefits because (b), (c), (d), or (e)

(a)

type of benefit.

(b)

you are not fully insured. You have only        quarters of coverage towards the necessary        required.

(c)

you do not have the necessary relationship to the insured worker.

(d)

the evidence you submitted does not establish that you have reached age (60, 62, or 65)

(e)

the evidence you submitted does not establish        .

7100.1 RECONSIDERATION PARAGRAPH

If you believe this decision is not correct, you have until (a) to request that the decision be reexamined. You may request this by writing to us at the above address. If additional evidence is available, you should submit it with your request.

(a)

60 days from the date you receive this notice.

7100.2 NO ADDITIONAL INFORMATION

Your earlier claim was denied (a), (b), (c), (d) , or (e) because (f) reason for disallowance . Your present claim for benefits is based on the same facts as your earlier claim. Therefore, your present claim has also been denied.

(a)

on reconsideration

(b)

by the

(c)

Administrative Law Judge

(d)

Appeals Council

(e)

Court

7100.3 DUPLICATE CLAIM

This claim is a duplicate of your earlier claim which was disallowed because (a) . That denial was correct and still applies, since there are no new facts in your current claim.

(a)

reason of disallowance