| SOCIAL SECURITY ADMINISTRATION
1234 Somestreet Drive
Sometown, NC 23406
I have made the enclosed decision in your case. Please read this notice and the decision carefully.
This Decision Is Fully Favorable to You
The Appeals Council May Review the Decision on Its Own
If You Disagree With the Decision
How to File An Appeal
Time to File An Appeal
Time to Submit New Evidence
How an Appeal Works
If No Appeal and No Appeals Council Review
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