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We consider every order an obligation to give satisfaction. Our
flowers and plants are of the very freshest and finest quality available.
Please phone us AT ONCE if these flowers or plants do not meet
your expectations - whether or not you purchased them.
Zf you are pleased with our service and quality of work, our friendly
and courteous staff would be happy to handle all your future J70ral
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Social Security Administration
Retirement, Survivors, and Disability Insurance
Important Information
1629
Mid-Atlantic Program Service Center
300 Spring Garden Street
Philadelphia 1 Pennsylvania 19123
Date: February 31 2004
Claim Number: 189-52-7272G1
0130 MAD,PC2,l,PH, TOO9,8S8
ELIZABETH M BARTH
20435 MOSS BEND CT
LUTZ FL 33558-5139
0OO0016n 01 MB 0.309
I. .11.. .lInl.I.. 1.1. Inln 1.1....11., II. I .In.. 11..1.1.111111
We are sorry to learn of your recent loss.
sympathy.
Please accept our sincere
-
-
-
You are entitled to a Social Security payment because of the death of ~
D M GROSS. You will receive this payment soon. ;
The amount of the check is $255.00.
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You will soon receive a check for $255.00. This is a one-time
payment we make because of a worker's death. It is the only money
you are due now.
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This payment will go to the financial institution you selected.
What We Will Pay
Other Social Security Benefits
The benefits described in this letter are the only ones you can
receive from Social Security. If you think that you might qualify
for another kind of Social Security benefit in the future 1 you will
have to file another application.
Do You Think We Are Wrong?
If you disagree with this decisionl you have the right to appeal. We
will review your case and consider any new facts you have. A person
who diq not make the first decision will decide your case. We will
correct any mistakes. We will review those parts of the decision
which you believe are wrong and will look at any new facts you have.
We may also review those parts which you believe are correct and may
make them unfavorable or less favorable to you.
ENCLOSURE:
PUB. NO. 05-10Q58
C "
SEE NEXT PAGE
7+17
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189-52-7272G1
1629
2
· You have 60 days to ask for an appeal.
· The 60 days start the day after you get this letter. We
assume you got this letter 5 days after the date on it
unless you show us that you did not get it within the 5-day
period.
· You must have a good reason for waiting more than 60
days to ask for an appeal.
· You have to ask for an appeal in writing. We will ask
you to sign a form SSA-561-U2, called "Request for
Reconsideration". Contact one of our offices if you
want help.
Please read the enclosed pamphlet, "Your right to Question the
Decision Made on Your Social Security Claim". It contains
more information about the appeal.
If You Have Any Questions
We invite you to visit our. website at www.socialsecurity.gov on
the Internet to find general information about Social Security.
If you have any specific questions, you may call us toll free at
1-800-772-1213, or call your local Social Security office at
1-813-269-0223. We can answer most questions over the phone. If
you are deaf or hard of hearing, you may call our -TTY number,
1-800~s25-0778. You can also write or visit any Social Security
office. The office that serves your area is located at:
SOCIAL SECURITY
SUITE 120
14497 N DALE MABRYHWY
TAMPA FL 33618
If you do call or visit an office, please have this letter with
you. It will help us answer your questions. Also, if you plan
to visit an office, you may call ahead to make an appointment.
This will help us serve you more quickly when you arrive at the
office.
C
.~.
-r~6:Z>~~
Steven G. DeMarco
Assistant Regional Commissioner,
Processing Center Operations
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