Fillable Form SSA-521, 04-2009 - Request for Withdrawal of Application - Social Security - ssa
SOCIAL SECURITY ADMINISTRATION
Form Approved OMB No. 0960-0015
REQUEST FOR WITHDRAWAL OF APPLICATION
IMPORTANT NOTICE. - This is a request to cancel your application. If it is approved, the decision we made on your application will have no legal effect, all rights attached to an application, including the rights of reconsideration, hearing, and appeal will be forfeited, and any payments we made...
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