ENT004 – MATURING ACTION – LEDGER ACCOUNT FILE (LAF) C TO LAF S FOR LESSDO FOR
SUPPLEMENTAL MEDICAL INSURANCE
We told you earlier that when we started paying you benefits, we would adjust them
for medical insurance premiums.
ENT007 – MATURING ACTION – SUPPLEMENTAL MEDICAL INSURANCE DEDUCTED FROM
BENEFITS
You will get benefits starting (1). We told you earlier that when we started paying
your benefits, we would adjust them for medical insurance premiums.
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Fill-in values:
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Fill-in (1)
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Current Operating Month (COM) in the format Month CCYY
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ENT009 – LUMP SUM DEATH PAYMENT (LSDP) PAID TO WIDOW(ER) – NUMBER HOLDER (NH)
DIED
You are entitled to a Social Security payment of (1) because of the death of (2) (3).
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Fill-in values:
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Fill-in (1)
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Lump Sum Amount Paid (LSAP) in the format $$$$$.¢¢
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Fill-in (2)
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NH-NAME
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Fill-in (3)
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Null
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ENT083 – FOR CERTAIN AWARDS, FULL RETIREMENT AGE (FRA), ENTITLEMENT
CONVERSIONS
You are entitled to monthly (1) benefits beginning (2).
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Fill-in values:
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Fill-in (1)
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Choice 1
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father's
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Choice 2
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mother's
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Choice 3
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child's
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Choice 4
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retirement
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Choice 5
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widower's
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Choice 6
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widow's
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Fill-in (2)
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Historical Date of Entitlement Start (BCLM-DOE-START-REL)
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ENT036 – BENEFICIARY IDENTIFICATION CODE (BIC) B OR E TERMINATED DUE TO LAST CHILD
IN
CARE
You may be able to receive payments once more if you again taking care of a child
of (1). The child must be under age 16 or disabled and qualify for child's payments.
If you start to do this, you should get in touch with us again.
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Fill-in values:
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Fill-in (1)
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Number Holder’s Name (NH-NAME)
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ENT039 – STUDENT TERMINATION PRIOR TO AGE 19
You may be able to receive payments again if you attend an elementary or secondary
level school full-time during any month before age 19. If this happens, you should
get in touch with us again.
ENT041 – BENEFICIARY IDENTIFICATION CODE (BIC) B2 TO B BASED ON AGE
You were entitled to spouse benefits based on having a child in your care for (1).
Beginning (2), you became entitled to spouse benefits based on your age.
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Fill-in values:
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Fill-in (1)
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Choice 1
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Historical Date of Entitlement Start (BCLM-DOE-START-REL) date in format Month CCYY
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Choice 2
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Historical Date of Entitlement Start (BCLM-DOE-START-REL) date plus “and” plus the
BCLM-DOE-START-REL plus 1 month in the format Month CCYY and Month CCYY
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Choice 3
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Historical Date of Entitlement Start (BCLM-DOE-START-REL) plus “through” plus the
Historical Date of Entitlement Termination (BCLM-DOE-TERM-REL) date minus 1 month
in the format Month CCYY through Month CCYY
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Fill-in (2)
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Historical Date of Entitlement Start (BCLM-DOE-START-REL) for the new Beneficiary
Claim Data (BCLM) occurrence for PIC B
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ENT047 – STUDENT AWARD OR STUDENT CHILDHOOD DISABILITY BENEFIT (CDB) AWARD
You qualify for child's payments as a student beginning (3).
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Fill-in values:
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Fill-in (3)
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Historical Date of Entitlement Start (BCLM-DOE-START-REL) in the Beneficiary Claim
Data (BCLM) occurrence with the Historical Current Entitlement Code (BCLM-CEC) = Student
(S)
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ENT049 – STUDENT AWARD OR STUDENT REINSTATEMENT
Based on the information we have, your entitlement will continue through (1). We will
send you another letter when your entitlement ends.
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Fill-in values:
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Fill-in (1)
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Choice 1
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No Longer in Full-Time Attendance Date (SRD-NLFTA-REL) in the format Month CCYY
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Choice 2
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End of Full-Time Attendance Date (SRD-EFTA-REL) in the format Month CCYY
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Choice 3
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Student Entitlement High School Graduation Date (SRD-HSGRAD-REL) in the format Month
CCYY
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Choice 4
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End of Full-Time Attendance Date (SRD-EFTA-REL) in the format Month CCYY
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ENT053 – MONTHLY BENEFIT AMOUNT (MBA) EQUAL ZERO DUE TO DISABILITY MAXIMUM (DMAX)
-
(HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF TECHNICAL ENTITLEMENT
(TECENT)
We cannot pay benefits because all of the money we can pay on this record is already
being paid to (1).
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Fill-in values:
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Fill-in (1)
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Number Holder Name (NH-NAME)
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ENT060 – B TO D CONVERSION WHEN NUMBER HOLDER DIES
We have not determined the amount of your monthly (1) benefit payment. When we complete
our review of your record, you will receive another notice explaining your entitlement
to (2) benefits.
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Fill-in values:
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Fill-in (1)
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Choice 1
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widower's
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Choice 2
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widow's
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Fill-in (2)
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Choice 1
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widower's
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Choice 2
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widow's
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ENT061 – STUDENT TERMINATION PRIOR TO AGE 19
You also may be able to receive payments again if you become disabled before age 22
and have not married since your last entitlement, unless the marriage is void or annulled.
If this happens, you should get in touch with us again.
ENT062 – NO CHANGE IN THE MONTH OF ELECTION (MOEL) DATA BASED ON THE ANNUAL REPORT
DATA
We reviewed your record. When you applied, you asked us to start your benefits in
(1). We found that (2) is still the month when benefits should start.
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Fill-in values:
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Fill-in (1)
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Pre-MBR Historical Date of Entitlement Start (BCLM-DOE-START-REL)
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Fill-in (2)
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Post-MBR Historical Date of Entitlement Start (BCLM-DOE-START-REL)
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ENT070 – DISABILITY INSURANCE BENEFITS (DIB) TO RETIREMENT INSURANCE BENEFITS (RIB)
AT
FULL RETIREMENT AGE (FRA) WHEN PAYMENT IDENTIFICATION CODE (PIC) A CONFIRMS DATE OF
BIRTH
Based on the information given to us, you were born on (1).
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Fill-in values:
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Fill-in (1)
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Payment Identification Code (PIC) A's date of birth in the format Month DD, CCYY
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ENT071 – DISABILITY INSURANCE BENEFITS (DIB) TO RETIREMENT INSURANCE BENEFITS (RIB)
AT
FULL RETIREMENT AGE (FRA) FOR PIC A
We are changing the type of benefit you receive from Social Security. Beginning (2),
you were entitled to retirement benefits. You are no longer entitled to disability
benefits because you have reached full retirement age.