Form SSA-1372-BK-FC Advance Notice of Termination of Child's Benefits

What Is Form SSA-1372?

Form SSA-1372-BK-FC, Advanced Notice of Termination of Child's Benefits (Foreign Claims) is a document the Social Security Administration (SSA) sends you warning you about your child's benefits terminating at the age of 18. Fill out this form if your child is a full-time student at an elementary- or secondary school or if you qualify for childhood disability benefits.

The form - also known as SSA Form 1372-BK-FC - was issued by the SSA in January 2018. All previous editions of the form are obsolete. A fillable Form SSA-1372-BK-FC can be downloaded below. It can also be found at the SSA official website.

Form SSA-1372-BK, Advanced Notice of Termination of Child's Benefits is a related document is used to determine if a child attending a U.S. school is eligible to receive student benefits.

ADVERTISEMENT
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)
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
address and insert the new address.)
1. Current School Year
(a). Are you now in full-time attendance?
Yes
No
(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.)
School Year Began
School Year Will End
(b). Print the following information about the school you attend.
(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).
(d). Show the number of hours you are scheduled to attend
(e). Show the grade in which you are enrolled.
each week.
Month, Year
(f). Show your EXPECTED graduation date from SECONDARY school, (e.g. high school).
(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
No
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
Yes
No
States during any of the past 13 months, including the present month?
(See the information on page 7.)
(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
No
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
Yes
No
confinement of over one year, or because you violated a condition of Federal
or State probation or parole?
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
Yes
No
according to the school's records.
2. Is the school's course of study of at least 13 weeks duration?
Yes
No
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.
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.
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.

Download Form SSA-1372-BK-FC Advance Notice of Termination of Child's Benefits

1280 times
Rate
4.8(4.8 / 5) 89 votes
ADVERTISEMENT

SSA-1372-BK-FC Instructions

Three months before the age 18 you will receive advance notice of termination of the child's benefits ​sent by the SSA. It means that your benefits will stop automatically at age 18. However, if you are a full-time student attending an elementary or secondary school, or if you are a disabled child, you may continue to receive the Social Security benefits. To confirm your eligibility, you need to:

  • Complete appropriate pages of Form SSA-1372-BK-FC;
  • Take them to your school for certification by a school official;
  • Provide the school with the form Notice of Cessation of Full-Time School Attendance (on pages 5 and 6);
  • Take or mail the completed pages to an SSA office.

Moreover, if you request childhood disability benefits, you must have a full history of the disabling conditions. The history should include names and addresses of doctors, hospitals, and schools attended. If you have ever been working, attach your work history as well.

Detailed SSA-1372-BK-FC instructions, information about benefits you may be entitled to past age 18 and 19, and a list of your responsibilities are provided in the form. Read them carefully before completing the document. Detach pages 7 and 8 and keep them for your future references.

How to Fill out Form SSA-1372-BK-FC?

Most fields in the Social Security Termination of Child Benefits Form are self-explanatory. The document should be completed as follows:

  1. Provide detailed information about your current school year including all required dates;
  2. Enter the information about your last school year. If you attended the same school you attend now, type "Same";
  3. Indicate the information about your next school year. If your answer to question 3a is "No" or "Undecided", skip to question 4;
  4. Specify if you are disabled;
  5. Specify if you are married. Enter the marriage date if applicable;
  6. If you have worked in employment or self-employment outside the United States during the last 13 months, provide the requested employment information;
  7. If your employer pays for your school, provide the employer's name and address;
  8. Specify if you have any unsatisfied warrant over 30 days old;
  9. Sign and date the document.

Take the document to an authorized school official for certification. The school official has to review pages 2 and 3, and complete page 4 to certify the information you provided is correct according to school records. The school official has to keep pages 5 and 6, the remaining sheets should be returned to you.

Where to Send Form SSA-1372-BK-FC?

The completed SSA-1372-BK-FC form is mailed depending on the country you attend school at. For Canada, the British Virgin Island or Samoa, take or mail the filled out pages to the nearest U.S. Social Security office. For all the other countries, submit your form to the Federal Benefits Unit or to the following address: Social Security Administration, Division of International Operations, P.O. Box 17769, Baltimore, MD 21235-7769 USA.

Page of 8