SSA-561 Form: Field-by-Field

**1. Name of Claimant:** Clifford Ray Hackett

**2. Claimant’s Social Security Number:** 522270084

**3. Issue Being Appealed:**

WRONGFUL benefits stoppage

**4. I Do Not Agree With The SSA’s Determination Because:**

Even though recertification should not be required, recertification package was done and personally delivered and there is video of the delivery

**5. I Want This Decision Reconsidered Because:**

This is ongoing retaliation because I videoed employee CRIMES!. BUT my disability is permanent and deteriorating

**6. Signature:**

**7. Mailing Address:** Clifford RAY Hackett General delivery Barrigada, Guam 96913

**8. Phone Number:** 671-787-2345

COVER LETTER

**Clifford Ray Hackett** General Delivery Barrigada, Guam 96913 Phone: (671) 787-2345

**To:** Social Security Administration

**Subject: Urgent Reconsideration Request & Pattern of Misconduct**

To Whom It May Concern,

I am requesting immediate reconsideration of the wrongful termination of my Social Security Disability benefits. I am permanently disabled, my condition is worsening, and I personally delivered my recertification package— while recording video , yet my benefits were stopped without justification.

This is not an isolated incident. I am the only person blocked from my online account every time I go to Social Security to get access, it stops working as soon as I leave the premises. These repeated, extreme actions are targeted persecution, not just errors!

I respectfully demand reinstatement of my benefits and a formal inquiry into the individuals responsible for these ongoing injustices.

Sincerely, Clifford Ray Hackett