Current SSA-L8553-U3

SOCIAL SECURITY ADMINISTRATION
OFFICE OF QUALITY REVIEW

Form Approved
OMB No. 0960-0189

Date:

Claim Number:

Dear
Each month the Social Security Administration (SSA) asks a few people, who get
benefit payments, to help us make sure we pay everyone the correct amount of
money. We picked you this month by chance, not for any other reason.
To make sure you receive the correct amount, I would like to telephone you at
your home on
at
.
I am with the Office of Quality Review, which is a special reviewing section in
SSA, and is separate from the office that processed your claim. If you would like
to verify that this is a legitimate letter, you can call SSA. The national toll-free
number is (800) 772-1213.

··
·
··

What Will Happen When I Call You
I will identify myself by name as shown at the bottom of this letter.
I will ask you some questions about your benefits.
The Social Security Act that allows this review is enclosed.

How You Can Get Ready For My Call
I have enclosed a form with the items checked that you should have available when I call.
You may have a friend or relative present to help you during my call.

Please Return the Enclosed Form to Me

Please complete and sign forms SSA 8552 and SSA 2935-U3, and mail them to me in
the enclosed envelope. You do not need a stamp.
If you have any questions, you may call me between
My telephone number is

Enclosures:

and
. Thank you.

.

Sincerely,
Quality Reviewer

Form SSA-L8553 (03-2015)
Destroy Prior Editions

Paperwork Reduction Act Statement - This information collection meets the requirements of 44
U.S.C. § 3507, as amended by section 2 of the Paper 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. You may send comments on our time estimate about to: SSA, 6401
Security Blvd., Baltimore, MD 21235-6401. Send only comments relating to our time estimate
to this address, not the complete form.

Form SSA-L8553 (03-2015)