This form is used to establish a date on which a claimant's eligibility for benefit payments is determined (sometimes called the protective filing date). An application must be filed with the Social Security Administration before one can be entitled to Social Security payments or Supplemental Security Income (SSI). A letter, filed with the SSA, may serve as an application if all of the necessary requirements are met.
Subject: San Jose, California — Establishing Claimant's Date of Eligibility for Social Security Benefits Dear Social Security Administration, I am writing to request your assistance in establishing the date of eligibility for Social Security benefits for [Claimant’s Full Name]. The following information provides a detailed description of the situation and includes all necessary documents in support of the claim. 1. Introduction to San Jose, California: San Jose, located in the heart of Silicon Valley, is the largest city in Northern California and the third-largest in the state. Known for its technological advancements, San Jose is home to numerous high-tech companies, research institutions, and a diverse population. Its excellent weather, cultural attractions, and vibrant economy make it an appealing place to live and work. 2. Purpose of the Letter or Statement: The purpose of this letter is to establish the claimant's date of eligibility for Social Security benefits. Please find below the different types of letters or statements that may be relevant to this matter: a. Employment Verification Letter: This letter provides details regarding the claimant's work history, including their previous and current employers, job titles, and periods of employment. It serves as a crucial document to determine the length of the claimant's contribution to the Social Security program. b. Medical Records or Disability Letter: In cases where the claimant is seeking disability benefits, medical records or a disability letter from a healthcare professional should be included. These documents help substantiate the claimant's need for Social Security benefits due to a disabling condition that hinders their ability to work. c. Proof of Residency: To establish eligibility, providing proof of residency in San Jose, California, is necessary. This may include utility bills, lease agreements, or other official documents that verify the claimant's primary address in the city. d. W-2 Forms and Tax Returns: W-2 forms and tax returns are additional proofs of income and employment history, which can support the claimant's eligibility for Social Security benefits based on their earnings record. 3. Supporting Documents: To facilitate the evaluation of the claimant's eligibility, we have enclosed the following supporting documents: — A signed Employment Verification Form (Form SSA-89) authorizing the release of employment history information. — Certified copies of medical records, including diagnosis reports and treatment history. — Proof of residency documents such as a copy of a utility bill or lease agreement. — Copies of W-2 forms and tax returns for the past five years. — Any other relevant documents related to the claimant's eligibility for Social Security benefits. We kindly request the Social Security Administration to review these documents thoroughly and assist in establishing the claimant's date of eligibility for benefits. Please notify us if any additional information or documentation is required to complete the evaluation process promptly. Thank you for your attention to this matter. Should you have any questions or require further clarifications, please do not hesitate to contact me at [Your Contact Information]. Sincerely, [Your Name] [Claimant's Representative, if applicable] [Your Address] [City, State, ZIP Code]Subject: San Jose, California — Establishing Claimant's Date of Eligibility for Social Security Benefits Dear Social Security Administration, I am writing to request your assistance in establishing the date of eligibility for Social Security benefits for [Claimant’s Full Name]. The following information provides a detailed description of the situation and includes all necessary documents in support of the claim. 1. Introduction to San Jose, California: San Jose, located in the heart of Silicon Valley, is the largest city in Northern California and the third-largest in the state. Known for its technological advancements, San Jose is home to numerous high-tech companies, research institutions, and a diverse population. Its excellent weather, cultural attractions, and vibrant economy make it an appealing place to live and work. 2. Purpose of the Letter or Statement: The purpose of this letter is to establish the claimant's date of eligibility for Social Security benefits. Please find below the different types of letters or statements that may be relevant to this matter: a. Employment Verification Letter: This letter provides details regarding the claimant's work history, including their previous and current employers, job titles, and periods of employment. It serves as a crucial document to determine the length of the claimant's contribution to the Social Security program. b. Medical Records or Disability Letter: In cases where the claimant is seeking disability benefits, medical records or a disability letter from a healthcare professional should be included. These documents help substantiate the claimant's need for Social Security benefits due to a disabling condition that hinders their ability to work. c. Proof of Residency: To establish eligibility, providing proof of residency in San Jose, California, is necessary. This may include utility bills, lease agreements, or other official documents that verify the claimant's primary address in the city. d. W-2 Forms and Tax Returns: W-2 forms and tax returns are additional proofs of income and employment history, which can support the claimant's eligibility for Social Security benefits based on their earnings record. 3. Supporting Documents: To facilitate the evaluation of the claimant's eligibility, we have enclosed the following supporting documents: — A signed Employment Verification Form (Form SSA-89) authorizing the release of employment history information. — Certified copies of medical records, including diagnosis reports and treatment history. — Proof of residency documents such as a copy of a utility bill or lease agreement. — Copies of W-2 forms and tax returns for the past five years. — Any other relevant documents related to the claimant's eligibility for Social Security benefits. We kindly request the Social Security Administration to review these documents thoroughly and assist in establishing the claimant's date of eligibility for benefits. Please notify us if any additional information or documentation is required to complete the evaluation process promptly. Thank you for your attention to this matter. Should you have any questions or require further clarifications, please do not hesitate to contact me at [Your Contact Information]. Sincerely, [Your Name] [Claimant's Representative, if applicable] [Your Address] [City, State, ZIP Code]
