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Instruction: This is a model letter. Adapt to fit your facts and circumstances. Date Name Social Security Administration Address Line City, State Zip Code Re: Letter Disputing Amount of Entitlement (Social Security) Dear Sir or Madam: On {date}, I received a letter from the Social Security Department sta ting that my monthly Social Security Benefits would be reduced because {state reason}. I am w riting to appeal this reduction. Please take into consideration {state reasons} and reconsider thi s reduction. A reduction would be detrimental to my household. Thank you for your time and assistance. Sincerely, N A M E Return address: Name Address Line 1 Address Line 2 City, State Zip Code

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Fill and Sign the Letter Disputing Amount of Entitlement Social Security Form