SOCIAL SECURITY ADMINISTRATION
Form Approved OMB No. 0960-0105
ADVANCE NOTICE OF TERMINATION OF CHILD'S BENEFITS
NAME AND ADDRESS SOCIAL SECURITY CLAIM NUMBER
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. 2. 3. 4. Complete the form, STUDENT'S STATEMENT REGARDING SCHOOL ATTENDANCE (page 2). Take the form to the school for a school official to certify on page 3 the information you provide on page 2. Leave page 4, NOTICE OF CESSATION OF FULL-TIME SCHOOL ATTENDANCE, and page 5 with the school official. Bring pages 2 (STUDENT'S STATEMENT REGARDING SCHOOL ATTENDANCE) and 3 (CERTIFICATION BY SCHOOL OFFICIAL) to a Social Security office or return them 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. For Direct Deposit, bring or mail a voided check or a copy of a bank statement. Your name must be on the account.
TO RECEIVE CHILDHOOD DISABILITY BENEFITS, YOU MUST CONTACT ANY SOCIAL SECURITY OFFICE AND HAVE THE FOLLOWING INFORMATION:
1. 2. A history of the disabling condition, including names and addresses of...