Someone help me to write an application for not paying pension insurance, thank you

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For reference:

Application for one-time treatment for termination of basic pension insurance relationship by insured person

The Bureau of Labor and Social Security of XX City, XX Province:

My personal social security number is □□□□□□□□□□,ID card number is □□□□□□□□□□□□□□□□□□, due to (□ go abroad (realm) to settle □ do not meet the conditions for receiving monthly I am applying for termination of basic pension insurance relationship for one-time treatment due to (□ going abroad (in the country) for settlement □ not meeting the conditions for receiving monthly pension □ already retired in other organizations).

This application is divided into upper and lower couplets, both of which should be faithfully filled out and stamped

Applicant (signature and fingerprints):

Contact telephone number:

Year and month