Agreement and Fees

Engagement for Social Security Assistance-Individual

I agree to the assistance of Social Security Solutions LLC , aka Dennis M. Heywood under the following terms:

We (Social Security Solutions LLC) will review the information in your case and provide options in regards to Social Security benefits and administrative procedures.

We will start the online claim process and send the information to Social Security for disability, retirement, Medicare, and spousal claims and provide you a copy of all documents submitted to Social Security.

Our assistance in no way guarantees the approval of your claim for Social Security benefits.

Our fees are as follows:

• Retirement analysis: individual-$300, couple-$550
• Retirement/spousal/Medicare claim: $200 each
• Disability claim: $750
• Other issues: $250/hr.

All fees are due at the time service is provided

All documents and financial information will be secured and safeguarded according to the Privacy Act. Personal information will be shredded and/or deleted after a one-year retention period.

You understand I am not your appointed representative with the Social Security Administration unless you formally appoint me as such by completing an SSA-1696.

I appreciate the opportunity to assist you in this important engagement.