Ssa-l8553-u3

SOCIAL SECURITY ADMINISTRATION
OFFICE OF QUALITY REVIEW
«RGN_ADDR»

Date:
Claim Number: XXX-XX«BENE_ADDRESS»
Dear

,

«STANDARD_SNO_TEXT»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
.
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 on 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 at my office between
telephone number is
. Thank you for your help.

and

Sincerely,
Quality Reviewer
Enclosures:
SSA-8552
SSA-2935-U3
SSA-85
Envelope

Form SSA-L8553 (03/2015)

. My

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.