Current SSA-1587-OCR-SM

1587
Beneficiary Recontact Report
Social Security Administration, P.O. Box 5887, Wilkes-Barre, PA 18767-5887
SOCIAL SECURITY NUMBER
FORM DATE
Payee's Name and Address

FORM APPROVED
OMB NO.0960-0536
RIC

PIC

BENEFICIARY

RQC

DOB

TYPE

PC

If change of address, correct and check box.

WHAT YOU NEED TO DO: We need you to fill out this form because we have found that some children do marry
before age 18. We must stop payments to a child who marries. While we know that most children do not
marry before age 18, we need you to tell us if your child is married or not. If your child has not
married, we will continue to send payments.

1. A.

Has

YES

NO

MONTH

YEAR

married?

If YES, go to question 1. B. BELOW.
If NO, STOP HERE. Sign and date the
form where indicated below.

1. B.

Enter the month and year the child married.
(Show the month and year in numbers.)
EXAMPLE: MAY 1994 > 05 1994

INSTRUCTIONS
• Use black ink or a No. 2 pencil to complete this report.
• Keep your numbers and ''X's'' inside the boxes.
• Try to make your numbers look like these:

0
0 123 45 67 8 9

• Complete the report and send it to us in the provided envelope within 30 days.
Please return the entire form to SSA for processing.
I declare under penalty of perjury that I have examined all the information on this form, and on any
accompanying statements or forms, and it is true and correct to the best of my knowledge.

SIGN HERE

Daytime Telephone Number (Include

Date Signed

Form SSA-1587-SM (07-2007)

Area Code)

Privacy Act/Paperwork Reduction Act Notice
Section 202(d) of the Social Security Act and regulations 20 CFR 404.703 and
20 CFR 404.705 authorize us to ask you to complete this report because you receive benefits
for a child under age 18. The child may continue to be entitled to benefits as long as he/
she is unmarried. We must ask you to complete this report on behalf of the child when he/
she receives Social Security benefits. Giving us the information on this report is mandatory.
Sometimes the law requires us to give out the facts on this report without your consent.
We may release this information to another person or government agency if Federal law
requires that we do so or to do the research and the audits needed to administer or improve
our program.
We may also use the information you give us when we match records by computer.
Matching programs compare our records with those of other Federal, State, or local
government agencies. Many agencies may use matching programs to find or prove that a
person qualifies for benefits paid by the Federal government. The law allows us to do this
even if you do not agree to it.
These and other reasons why information about the child may be used or given out are
explained in the Federal Register. If you want to learn more about this, contact any Social
Security office.
This information collection meets the clearance requirements of 44 U.S.C. §3507, as
amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to
answer these questions unless we display a valid Office of Management and Budget
control number. We estimate that it will take you about 3 minutes to read the instructions,
gather the facts and answer the questions. SEND THE COMPLETED FORM TO YOUR
LOCAL SOCIAL SECURITY OFFICE. To find the nearest office, call
1-800-772-1212. Send only comments on our time estimate above to: SSA, 1338 Annex
Building, Baltimore, MD 21235-0001.

If You Have Any Questions
If you have any questions, call us at 1-800-772-1213. We can answer most questions over
the phone. If you prefer to visit one of our offices, please check the local telephone directory
for the office nearest you. Or call us and we can give you the office address. Please have
this letter with you if you call or visit an office. It will help us to answer your questions.

Form SSA-1587-SM (7-2007)