Fillable Form SSA-521, 10-2012 - Request for Withdrawal of Application - Social Security Administration - ssa
SOCIAL SECURITY ADMINISTRATION
REQUEST FOR WITHDRAWAL OF APPLICATION
Form Approved OMB No. 0960-0015
Do not write in this space
IMPORTANT NOTICE - This is a request to cancel your application. If we approve it, the decision we made on your application will have no legal effect. You will forfeit all rights attached to an application, including the rights of appeal. You will have to return any...
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