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Form Approved OMB No 0960-0744 SOCIAL SECURITY ADMINISTRATION Request for Reinstatement - Title XVI Eligible Individual SSN Eligible Spouse I request reinstatement of my Supplemental Security Income SSI Disability benefits. Socialsecurity. gov or at your local Social Security office. reprinting requirements of 44 U.S.C. 3507 as amended by section 2 of the Paperwork Reduction Act of 1995. To enable a third party or an agency to assist Social Security in determining eligibility to SSI payments...
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