Ssa 1372 Form – Fill Out and Use This PDF

The SSA-1372 form serves as an advanced notification for the termination of a child's benefits under the Social Security Administration, highlighting the conditions under which an individual aged 18 or older can continue to receive benefits. This form is crucial for full-time students and those qualifying for childhood disability benefits, ensuring their support doesn't halt due to age alone. To maintain benefits post-18, filling out and submitting the SSA-1372 form correctly is vital. Click the button below to commence the completion of your form.

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The Social Security Administration's Form SSA-1372-BK-FC plays a critical role in determining the continuation of benefits for children beneficiaries as they approach the age of majority. This document is essential for those who, upon turning 18, might still be eligible for benefits either as full-time students in an elementary or secondary-level school, or due to a qualifying disability. The form consists of several parts, designed to gather comprehensive information about the student's school attendance, plans for future schooling, any existing disabilities, marital status, and even work history outside the United States. For students studying outside the U.S., the completion and certification of this form by their educational institution are necessary to prevent the automatic cessation of their Social Security benefits. Moreover, it outlines the steps and documentation required to apply for childhood disability benefits, signifying the form’s crucial role in ensuring ongoing support for eligible beneficiaries. The SSA-1372 form also includes provisions for students and school officials to notify the Social Security Administration of any change in the student's educational status, further emphasizing the importance of accurate and timely information in maintaining benefit eligibility.

Question	Answer
Form Name	Ssa 1372 Form
Form Length	8 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	2 min
Other names	ssa 1372 bk, ssa 1372 pdf, form ssa 1372 bk fc, ssa 1372 printable form

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Form SSA-1372-BK-FC (01-2018)
Discontinue Prior Editions	Page 1 of 8
Social Security Administration	OMB No. 0960-0105

ADVANCE NOTICE OF TERMINATION OF CHILD'S BENEFITS

NAME AND ADDRESS

SOCIAL SECURITY CLAIM NUMBER

NAME OF CHILD BENEFICIARY TO WHOM THIS NOTICE APPLIES

DATE CHILD BECOMES AGE 18

YOUR BENEFITS WILL AUTOMATICALLY STOP AT AGE 18 UNLESS:

●You are a full-time student at an elementary or secondary - level school (as defined by the jurisdiction in which the school is located), or

●You qualify for childhood disability benefits.

Your benefits will end with the payment for the month before the month in which you become age 18. You become age 18 on the day before your 18th birthday. This is important when your birthday is on the first day of the month. For example, if your 18th birthday is June 1, you become age 18 on May 31. If you are neither a full-time student nor disabled in May, benefits would not be payable for May. The last benefit payment to which you would be entitled would be the one received in May, which represents your payment for April.

FOR YOU TO RECEIVE STUDENT BENEFITS AFTER AGE 18, YOU MUST:

1.Complete the form, STUDENT'S STATEMENT REGARDING SCHOOL ATTENDANCE OUTSIDE THE UNITED STATES (pages 2 and 3).

2.Take the form to the school for a school official to certify on page 4 the information you provide on pages 2 and 3.

3.Leave the form, NOTICE OF CESSATION OF FULL-TIME SCHOOL ATTENDANCE (pages 5 and 6), with the school official.

4.Take or mail the completed pages 2, 3, and 4 of this form to one of the following offices,

●If you live in Canada, Samoa or the British Virgin Islands, the nearest U.S. Social Security Office;

●If you live in any other country, the Social Security Administration, Division of International Operations, P.O. Box 17769, Baltimore, MD 21235-7769 or your Federal Benefits Unit. For a list of Federal Benefits Units, visit www.socialsecurity.gov/foreign/foreign.htm.

TO RECEIVE CHILDHOOD DISABILITY BENEFITS, YOU MUST CONTACT ONE OF THE OFFICES SHOWN ABOVE AND HAVE THE FOLLOWING INFORMATION:

1.A history of the disabling condition, including names and addresses of medical record sources (such as doctors and hospitals) and schools attended. If you have worked you must also furnish your work history.

2.Your U.S. Social Security Number.

Please keep the attached sheet, INFORMATION ABOUT BENEFITS PAST AGE 18 (page 7), for your records. It contains important information about eligibility for student benefits and reporting responsibilities.

Form SSA-1372-BK-FC(01-2018)	Page 2 of 8
Social Security Administration	OMB No. 0960-0105

STUDENT'S STATEMENT REGARDING SCHOOL ATTENDANCE

OUTSIDE THE UNITED STATES

NAME AND ADDRESS

The information requested on this form is sought pursuant to the authority granted by law (42 U.S.C. 402 and 405). While you are not required to respond, your cooperation is needed to confirm your past and/or continuing entitlement to student benefits.

SOCIAL SECURITY CLAIM NUMBER	(To change or correct the address, line through the old
	(To change or correct the address, line through the old
	address and insert the new address.)

1. Current School Year

(a). Are you now in full-time attendance?

Yes

(Note: If you are completing this form during a summer break period and you were in full-time attendance prior to the break and will continue school in the fall, you should answer YES to question 1(a). You should show the beginning date of the fall semester/term for question 1(b). See question 2 for past school attendance information.)

(b). Print the following information about the school you attend.			School Year Began	School Year Will End
			(Month, Day, Year)	(Month, Day, Year)
			(Month, Day, Year)	(Month, Day, Year)

	Name

	Street Address

	City and State or Province

(c).Show the type of school:
	High School (including "gymnasium,"	Preparatory School (including "preparatoria").
	"lycee," "secundaria," or other secondary	Other (Specify)
	level school).	Other (Specify)
	level school).

(d). Show the number of hours you are scheduled to attend (e). Show the grade in which you are enrolled. each week.

(f). Show your EXPECTED graduation date from SECONDARY school, (e.g. high school).

Month, Year

(g). What months between now and your expected graduation will you not be in full-time attendance for the full month? (For example months of summer vacation).

2.Last School Year

(a). Print the name and address of the school you attended in the last school year. (If it is the same as the school shown in question 1, show "Same" and go to (b).)

	(b). Date the school year began (Month, Day, Year).	Date the school year ended (Month, Day, Year).

	(c). Show the number of hours you were scheduled to	(d). Show the grade in which you were enrolled.
	attend each week.

3.Next School Year

(a). Do you intend to be in full-time attendance at a school in the next school year?

Yes

Undecided

(If "No" or "Undecided" go to question 4. If "Yes", go to (b) .)

Form SSA-1372-BK-FC(01-2018)	Page 3 of 8

(b). Print the name and address of the school you will attend. (If it is the same as the school shown in question 1, show "Same" and go to (c).)

	(c). Date the school year will begin (Month, Day, Year).	Date the school year will end (Month, Day, Year).

	(d). Show the number of hours you will be scheduled to	(e). Show the grade in which you will be enrolled.
	attend each week.

4.	Are you disabled?	Yes	No

5.	Are you married?	Yes	No
	If "Yes," show the date you were married.

6.(a). Have you worked in employment or self-employment outside the United States during any of the past 13 months, including the present month? (See the information on page 7.)

Yes

(b). If "Yes," give the following information about your apprenticeship, employment or self- employment outside the United States.

Name and Address of Employer

(If self-employed, show "self" and address at which the trade or business was conducted.)

Type of Business

Date Employment (or self- employment) Began.

Date Employment (or self-employment) Ended. (If not ended, leave blank.)

(c). Will you work in employment or self-employment in the next school year?

Yes

7.If you are, or will be, paid by your employer to attend school, give your employer's name and address. (If it is the same as in question 6, write "same as above.")

8.Do you have an unsatisfied warrant, over 30 days old, issued for your arrest because you were charged with a crime that carries a penalty of death or confinement of over one year, or because you violated a condition of Federal or State probation or parole?

Yes

I agree to promptly notify the Social Security Administration if I marry, go to work, or if there is any change in my school attendance. I agree to return any benefit payment to which I am not entitled. I know that anyone who makes or causes to make a false statement or representation of material fact for use in determining a right to payment under the Social Security Act commits a crime punishable under Federal law by fine, imprisonment or both. I affirm that all of the information that I have given in this document is true. I also certify that I have read the detached information sheet. I authorize my school to disclose to the Social Security Administration any information concerning my status as a student as it pertains to past, current or future Social Security student benefits.

SIGNATURE OF STUDENT

First Name, Middle Initial, Last Name (Write in ink)

Mailing Address

Student's Own U.S. Social Security Number

Telephone No.

Date

Form SSA-1372-BK-FC(01-2018)	Page 4 of 8
Social Security Administration	OMB No. 0960-0105

CERTIFICATION BY SCHOOL OFFICIAL

NAME OF STUDENT

SOCIAL SECURITY NUMBER

Please review the information on pages 2 and 3, answer the questions below, annotate the student's expected graduation date on page 5 and sign the form in the space provided. You should give the originals of pages 2, 3, and 4 to the student to return to the U.S. Social Security Administration and keep copies in the school's files as a record of the student's attendance that you certified. Please retain page 5 for reporting if the student's full-time attendance ends, or the student graduates before the date shown on page 2.

1.All information entered in items 1, 2 and 3 on pages 2 and 3 is correct according to the school's records.

Yes

2. Is the school's course of study of at least 13 weeks duration?

Yes

3. Please indicate which of the following applies to the school's operating basis?

Yearly

Quarterly/Semester-No Reenrollment Required

Quarterly/Semester-Reenrollment Required

4.	I received pages 5 and 6 of this form for reporting changes in the	Yes	No
	student's attendance.	Yes	No
	student's attendance.

5.	I annotated page 5 of this form with the student's expected graduation	Yes	No
	date as reported on page 2 of this form.	Yes	No
	date as reported on page 2 of this form.

I know that anyone who makes or causes to be made a false statement or representation of material fact in an application or for use in determining a right to payment under the U.S. Social Security Act commits a crime punishable under Federal law and/or State law. I affirm that all information I have given in this document is true.

SCHOOL OFFICIAL SIGNS

Title

Printed Name

Date

Phone Number

Form SSA-1372-BK-FC (01-2018)	Page 5 of 8
Social Security Administration	OMB No. 0960-0105

	SCHOOL SHOULD RETAIN THIS FORM

SOCIAL SECURITY ADMINISTRATION

Division of International Operations

P.O. Box 17769

Baltimore, MD 21235-7769 USA

NOTICE OF CESSATION OF FULL-TIME SCHOOL ATTENDANCE

NAME OF SOCIAL SECURITY BENEFICIARY

DATE OF BIRTH SOCIAL SECURITY CLAIM NUMBER

Individual identified above ceased to be a full time student at this school on, (Month, Day, Year).

REASON:

1. Withdrawal, suspension or expulsion.

2. Changed to PART-TIME status.

3. Failed to continue in full-time attendance at start of new term (or new school year).

4. Other (Explain).

Name and address of school

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.

Signature (or facsimile) of school official

Printed Name

Title

Date

IMPORTANT INFORMATION ABOUT THIS FORM

This form contains the name, date of birth and U.S. Social Security claim number of a child beneficiary who tells us that he/ she is (or will be when school resumes) a full-time student at your school. One of the conditions a child between 18 and 19 must meet to receive Social Security Benefits is that he/she be a full-time student.

Full-Time Attendance

For Social Security purposes, a student is one who is attending an elementary or secondary-level school, and is enrolled in a day or evening non-correspondence course of at least 13 weeks in duration. The attendance must be at grade/year 12 or lower. In addition, the student must be scheduled to attend at the rate of at least 20 hours weekly, and be carrying a subject load which is considered full-time for day students under the school's standards and practices. If there is any question as to whether the student's attendance is full or part-time, please apply your school's usual criteria.

What to Report

Please hold this form until the student is no longer a full-time student at your school (whether this is during the current school year, at the start of the next school year, or any time after that). Then, enter the date he/she stopped being a full- time student, check the appropriate box above and return the completed form to the Social Security office shown above or your Federal Benefits Unit. For a list of Federal Benefits Units, visit www.socialsecurity.gov/foreign/foreign.htm.

You should not return the form to report that attendance stopped for a scheduled break (e.g., summer break) unless you do not expect the student to return after the break. You should report if the student stops attending school full-time, or graduates, earlier than the date shown above.

The people in the above offices will be glad to help you with any questions concerning this form or any other questions you have about Social Security.

Thank you for your cooperation.

Form SSA-1372-BK-FC(01-2018)	Page 6 of 8

Privacy Act Statement

Collection and Use of Personal Information

Sections 202(d) and 205(a) of the Social Security Act, as amended, allow us to collect this information. Furnishing us this information is voluntary. However, failing to provide all or part of the information may prevent an accurate and timely decision on your claim.

We will use the information to verify your school attendance and eligibility for student benefits. We may also share your information for the following purposes, called routine uses:

1.To applicants, claimants, prospective applicants or claimants, other than the data subject, their authorized representative payees to the extent necessary to pursue Social Security claims and to representative payees when the information pertains to individuals for whom they serve as representative payees, for the purpose of assisting SSA in administering its representative payment responsibilities under the Social Security Act and assisting the representative payees in performing their duties as payees, including receiving and accounting for benefits for individuals for whom they serve as payees; and

2.To the Department of State and its agents for administering the Social Security Act in foreign countries through facilities and services of that agency.

In addition, we may share this information in accordance with the Privacy Act and other Federal laws. For example, where authorized, we may use and disclose this information in computer matching programs, in which our records are compared with other records to establish or verify a person's eligibility for Federal benefit programs and for repayment of incorrect or delinquent debts under these programs.

A list of additional routine uses is available in our Privacy Act System of Records Notice (SORN) 60-0089, entitled Claims Folders System. Additional information and a full listing of all our SORNs are available on our website at www.socialsecurity.gov/foia/bluebook.

Paperwork Reduction Act

This information collection meets the 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 (OMB) control number. We estimate that it will take about 3 minutes to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401.

Form SSA-1372-BK-FC(01-2018)	Page 7 of 8

STUDENT SHOULD KEEP THIS INFORMATION FOR FUTURE REFERENCE

INFORMATION ABOUT BENEFITS PAST AGE 18

If you qualify for Social Security benefits because you are a full-time student, you can start receiving benefits as early as age 18 and usually through the month you graduate from the 12th grade, or the month before you become age 19, whichever is earlier. Your benefits will be paid in your own name beginning at age 18, either by direct deposit or by mail. Generally, we consider you to be a full-time student if you are in full-time attendance at a school that provides education at the secondary (grade 12) level or below. Full-time attendance means you are scheduled to attend classes at the rate of 20 hours each week, or at the rate determined by your school to be full-time (if higher).

INFORMATION ABOUT BENEFITS PAST AGE 19

Your benefits may continue past age 19 if you are in actual full-time attendance at a school that provides elementary or secondary education in the month you become age 19. If the school operates on a yearly basis, then payment may be continued after age 19 up through the earlier of (1) the month you complete the course in which you are enrolled full-time or (2) the second month after the month you become age 19. If the school requires re-enrollment on other than a yearly basis, benefits may continue through the month ending the term that is in progress when you become age 19. Note that payments beyond age 19 cannot be made if you become age 19 in a month of nonattendance (for example, you become age 19 in a month when you are on summer vacation).

IMPORTANT RESPONSIBILITIES

YOU MUST NOTIFY THE SOCIAL SECURITY ADMINISTRATION PROMPTLY IF:

•YOU MARRY

•YOU STOP ATTENDING SCHOOL

•YOU REDUCE YOUR SCHOOL ATTENDANCE BELOW FULL-TIME

•YOU CHANGE SCHOOLS

•YOUR EMPLOYER PAYS YOU TO ATTEND SCHOOL (either at his request or as a requirement of employment)

•AN UNSATISFIED WARRANT, OVER 30 DAYS OLD, WAS ISSUED FOR YOUR ARREST BECAUSE YOU WERE CHARGED WITH A CRIME THAT CARRIES A PENALTY OF DEATH OR CONFINEMENT OVER ONE YEAR, OR BECAUSE YOU VIOLATED A CONDITION OF FEDERAL OR STATE PROBATION OR PAROLE.

Your benefits may end if any of the above occur. You must report each of these events even if you believe your benefit should not end. We will tell you about how your benefits may be affected.

YOU MUST ALSO NOTIFY THE SOCIAL SECURITY ADMINISTRATION PROMPTLY IF:

•YOU MOVE OR CHANGE YOUR MAILING ADDRESS

•YOU WORK IN EMPLOYMENT OR SELF-EMPLOYMENT

When you are awarded Social Security benefits as a student, you will receive a booklet that further covers your responsibilities. It is important for you to read that booklet.

HOW WORK OUTSIDE THE UNITED STATES AFFECTS YOUR BENEFITS

If your earnings are not subject to U.S. Social Security taxes, a 45-hour test applies. Under this test, if you are employed (or self-employed) for more than 45 hours in a month, you are not eligible to receive a benefit for that month. How much you earn and how many days you work in a month does not matter. A person is employed if he/she performs services for someone else and receives cash payment or other compensation for these services. This includes part-time work, and work as an apprentice.

Failure to report employment in the United States or outside the United States can result in the loss of additional benefits.

Form SSA-1372-BK-FC(01-2018)

Page 8 of 8

Privacy Act Statement

Collection and Use of Personal Information

We will use the information to verify your school attendance and eligibility for student benefits. We may also share your information for the following purposes, called routine uses:

2.To the Department of State and its agents for administering the Social Security Act in foreign countries through facilities and services of that agency.

Paperwork Reduction Act

This information collection meets the 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 (OMB) control number. We estimate that it will take about 8 minutes to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate to: SSA, 6401 Security Blvd, Baltimore, MD 21235-6401.

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ssa 1372 termination fill completion process explained (part 1)

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3. This step is normally hassle-free - fill in all the fields in NAME AND ADDRESS, The information requested on this, SOCIAL SECURITY CLAIM NUMBER, Current School Year, To change or correct the address, a Are you now in fulltime, Yes, Note If you are completing this, b Print the following information, School Year Began Month Day Year, School Year Will End, Month Day Year, Name, Street Address, and City and State or Province in order to complete this process.

ssa 1372 termination fill conclusion process explained (stage 3)

4. The fourth paragraph comes with all of the following fields to look at: cShow the type of school, High School including gymnasium, Preparatory School including, Other Specify, d Show the number of hours you are, e Show the grade in which you are, each week, f Show your EXPECTED graduation, Month Year, g What months between now and your, For example months of summer, Last School Year, a Print the name and address of, and shown in question show Same and.

ssa 1372 termination fill conclusion process outlined (part 4)

5. As a final point, this last part is what you need to wrap up before finalizing the PDF. The fields at issue include the following: b Date the school year began Month, Date the school year ended Month, c Show the number of hours you, d Show the grade in which you were, attend each week, Next School Year, a Do you intend to be in fulltime, If No or Undecided go to question, Yes, and Undecided.

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