We are writing to tell you about the claim you filed on (1) Social Security record.

The record shows that (2) worked for the railroad industry. When we checked with the Railroad Retirement Board, they said that they may be able to pay you because of (3) railroad employment.

We are sending your claim to the Railroad Retirement Board, which is located at 844 Rush Street, Chicago, Illinois 60611-2092. They will pay you any money you are due, including any Social Security benefits. You should hear from the Railroad Retirement Board soon.

If You Have Any Questions

3901C - Domestic

3901D - Foreign

• •

  When an award or disallowance action has been taken on a survivor's claim which is being transferred to RRB because RRB has jurisdiction, the benefit authorizer will notify the survivor by sending the above notice that the claim has been transferred to RRB.

• •

  When the DO receives a “Notice of RRB Jurisdiction” notify the survivor claimant or inquirer that RRB has jurisdiction of the survivor claim and that any claim or claims material is being transferred to RRB. Use the above notice to notify the survivor of the transfer and that he/she will hear from RRB.

   

Fill-ins:

1. (1) 

   full name of number holder, possessive

2. (2) 

   he, she

3. (3) 

   his, her

Use Form SSA-2000-C2 (Universal Notice) and follow new notice standards. Information for this letter will be shown on Form SSA-573.

The FO's will use standard FO letterhead.