Ssa-l8552-u3

SOCIAL SECURITY ADMINISTRATION
REGIONAL OFFICE OF QUALITY ASSURANCE
Assistance and Insurance Program Quality Branch
(800) 521-3365

P.O. Box 31208 Oakland, CA 94604
FAX (510) 970-0041
Form Approved
OMB NO. 0960-0189

Date: February 21, 2008
Claim Number:
Beneficiary:
for

Dear

,

Every month the Social Security Administration asks a few people who get benefit
checks to help us make sure that we pay everyone the right amount of money. This
month, we picked
, for whom you are representative payee by chance, NOT
because of any other reason.
To make sure the amount you are receiving is correct; I would like to visit you and
at your home on:

What Will Happen When I Visit You
•

I will show you a badge with my picture on it to prove that I am from Social Security.

•

I will ask you some questions about
’s benefits. Enclosed with this letter is an
explanation of the Social Security law that allows me to visit and ask you questions.

How You Can Get Ready For My Visit
I will need to look at some of
‘s papers. The enclosed page shows the kinds of
papers I need to look at when I visit people. I have checked the things I would like you
to show me when I visit you.
Also enclosed with this letter is a copy of the earnings record for the account on which
filed. Please review the earnings with
and compare them with any
available records. I will discuss this with you when I visit.

FORM SSAL-8552-U3

Please Return The Enclosed Form To Me
Please complete the enclosed form and mail it back to me in the envelope I have
provided. You do not need to put a stamp on the envelope. The form is to let me know
that you received this letter and whether or not you will be available for my visit.
If you have any questions, you may call me at my office between
a.m. and
p.m. My telephone number is (800) 521-3365 ext.
. Thank you for your
help.
Sincerely,

Quality Reviewer
Enclosures:

THE EARNINGS RECORD

Benefits are computed by giving credit for any earnings, since 1937, that were covered
under the Social Security Act. As part of our review, we check the record for accuracy.
The earnings record shows yearly amounts for 1951 through recent years. In the years
not shown, no earnings were reported to Social Security. Earnings during 1937 -- 1950
are shown as a separate total.
Please compare the earnings amounts to any records you have. Pay particular attention
to:
•

Years with no earnings

•

Years with earnings much higher than the ones before and after them

•

Years with earnings much lower than the ones before and after them

If you disagree with any of these earnings, please have your records available at
the time of the interview. W2 forms are the best evidence of wages. Tax returns
and proof of payment of the taxes are the best evidence of self-employment
earnings.

Privacy Act Statement
Collection And Use Of Information
The Social Security Administration is authorized by law to collect the information in these reviews.
The authorization is in sections 205(a) and 1631(d)(1) and (e) of the Social Security Act. Giving
us the information is voluntary. However, your cooperation will make the review go more
smoothly.
How The Information Is Used
Information you give us, along with the information we get from other people we interview, helps
us to know where there are problems in the programs for which the Social Security Administration
is responsible. It also helps us to resolve these problems and recommend changes in the law.
Information we obtain about changes in your situation will be sent to your Social Security office.
The people there will decide if your payments will be affected. We may routinely give out the
information we obtain without your consent if:
1. We need to get more information to decide eligibility for benefits;
2. An agency needs this information to decide eligibility for a health or income program such
as Supplemental Security Income (SSI), State supplementary payments, food stamps,
Medicaid, emergency assistance, Veterans benefits, railroad unemployment insurance,
or Basic Educational Opportunity Grants;
3. A Federal law requires that we give out this information;
4. Your congressman or the President’s Office needs this information to answer questions
you ask them;
5. Someone needs this information to do statistical research or audit reports for us related
to the Social Security programs; or,
6. The Department of Justice needs the information to represent the Federal Government in
a court suit related to the SSI program.
These and other reasons why information about you may be used or given out are explained in
the Federal Register. If you would like more information about this, get in touch with any Social
Security office.

Paperwork Reduction Act Statement - This information collection meets the requirements of 44
U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not
need to answer these questions unless we display a valid Office of Management and Budget
control number. We estimate that it will take about 40-50 minutes to read the instructions, gather
the facts, and answer the questions. SEND OR BRING THE COMPLETED FORM TO YOUR
LOCAL SOCIAL SECURITY OFFICE. The office is listed under U. S. Government agencies
in your telephone directory or you may call Social Security at 1-800-772-1213 (TTY 1-800325-0778). You may send comments on our time estimate above to: SSA, 6401 Security Blvd,
Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this
address, not the completed form.