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Get Social Security Form 0960 0105

U.S. SSA Form ssa-ssa-1372 Form Approved OMB No. 0960-0105 SOCIAL SECURITY ADMINISTRATION ADVANCE NOTICE OF TERMINATION OF CHILD S BENEFITS NAME AND ADDRESS NAME OF CHILD BENEFICIARY TO WHOM THIS STATEMENT APPLIES DATE CHILD ATTAINS AGE 18 YOUR BENEFITS WILL AUTOMATICALLY STOP AT AGE 18 UNLESS You are a full-time student at an elementary or secondary school a secondary school is a school at or below the high school level or You qualify for childhood disability benefits. Your benefits will end with the payment for the month before the month in which you attain age 18. You attain age 18 on the day before your 18th birthday. This is important when your birthday is on the first day of the month. For example if your 18th birthday is June 1 you attain that age on May 31. If you are neither a full-time student nor disabled in May benefits would not be payable for May. The last benefit check to which you would be entitled would be the one received in May which represents your payment for April* FOR YOU TO RECEIVE STUDENT BENEFITS AFTER AGE 18 YOU MUST 1. Complete the form STUDENT S STATEMENT REGARDING SCHOOL ATTENDANCE page 2. 2. Take the form to the school for a school official to certify the information you provide. 3. Leave the form NOTICE OF CESSATION OF FULL-TIME SCHOOL ATTENDANCE page 3 with the school official* 4. Bring the completed form STUDENT S STATEMENT REGARDING SCHOOL ATTENDANCE to a Social Security office or return it in the enclosed envelope fold page 2 so the address on back shows through window envelope prior to the age 18 attainment month shown above. 5. For direct deposit bring or mail a voided check or a copy of a bank statement. Your name must be on the account. NOTE If you mail the form you will be contacted by a Social Security representative to discuss your rights and responsibilities as a student. This discussion must take place before we can process your student award. TO RECEIVE CHILDHOOD DISABILITY BENEFITS YOU MUST CONTACT ANY SOCIAL SECURITY OFFICE AND HAVE THE FOLLOWING INFORMATION 1. A history of the disabling condition including names and addresses of medical record sources such as doctors and hospitals and schools attended* If you have worked you must also furnish work history. 2. Your Social Security Number. Please keep the attached sheet INFORMATION ABOUT BENEFITS PAST AGE 18 page 5 for your records. It contains important information about eligibility for student benefits and reporting responsibilities. Your benefits will end with the payment for the month before the month in which you attain age 18. You attain age 18 on the day before your 18th birthday. This is important when your birthday is on the first day of the month. For example if your 18th birthday is June 1 you attain that age on May 31. This is important when your birthday is on the first day of the month. For example if your 18th birthday is June 1 you attain that age on May 31. If you are neither a full-time student nor disabled in May benefits would not be payable for May. The last benefit check to which you would be entitled would be the one received in May which represents your payment for April* FOR YOU TO RECEIVE STUDENT BENEFITS AFTER AGE 18 YOU MUST 1.

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