NL 00701: Form Notices
A. Sample form
B. Purpose/Use
The SSA-L679 is used to inform student beneficiaries of the date their benefits will terminate, based on information supply by the student on from SSA-1389.
C. Preparation of form
The name of the beneficiary, claim number and address can be obtained from the source document, SSA-1389, Report of Student Beneficiary About to Attain Age 22. An “X” must be shown in the appropriate box to denote the reason for the action.