TN 3 (03-20)

RM 03254.011 Information on the Form SSA-L99-C1, Potential Private Retirement Benefit Information

A. When to access form SSA-L99-C1

If the ERISA request results in a finding that there is incorrect information on the Form SSA-L99-C1 (Potential Private Retirement Benefit Information), then obtain the L99-C1 for retype of the correct information.

B. Corrections to form SSA-L99-C1

Type the information onto a blank Form SSA-L99-C1 exactly as shown on the SSA-L99-C1 to be retyped.

NOTE: Refer to the ERISA microfilm to get the necessary information to complete the Form SSA-L99-C1.

The necessary information for a completed Form SSA-L99-C1 includes:

  • Worker's SSN and name.

  • Plan identifying information.

  • Annuity information.

  • SSA message and any codes at the bottom of the notice.

Forward to control for mail-out.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0103254011
RM 03254.011 - Information on the Form SSA-L99-C1, Potential Private Retirement Benefit Information - 03/04/2020
Batch run: 03/04/2020
Rev:03/04/2020