TN 42 (03-23)
NL 00725.420 “SSA” UTIs – Headings and Signatures
SSAH01 First and Second Line Headings
Social Security Administration
Retirement, Survivors and Disability Insurance
SSAH02 Third Line Heading
Notice of Award
SSAH03 Third Line Heading
Notice of Disapproved Claim
SSAH04 Third Line Heading
Claim Information
SSAH05 Third Line Heading
Important Information
SSAH16 Third Line Heading
BNC#:
HDR030 Third Line Heading
Date:
BNC#:
SSAH30 Payment Name and Address
Addressee
SSAH40 Return Address
Northeastern Program Service Center
155-10
Jamaica Avenue
Jamaica, New York 11432-3898
SSAH41 Return Address
Mid-Atlantic Program Service Center
300 Spring
Garden Street
Philadelphia, Pennsylvania 19123-2992
SSAH42 Return Address
Southeastern Program Service Center
1200 Rev.
Abraham Woods, Jr. Blvd
Birmingham, Alabama 35285-0001
SSAH43 Return Address
Great Lakes Program Service Center
600 West
Madison Street
Chicago, Illinois 60661-2474
SSAH44 Return Address
Western Program Service Center
P.O. Box 2000
Richmond, California 94802-1000
SSAH45 Return Address
Mid-America Program Service Center
601 East
Twelfth Street
Kansas City, Missouri 64106-2859
SSAH46 Return Address
Office of Central Operations
6401 Security Boulevard
Baltimore,
Maryland 21235-6401
SSAH47 Return Address
Office of Central Operations
P.O. Box 17769
Baltimore, Maryland 21235-7769 U.S.A.
Fill-ins for SSAH40 - SSAH47
(1) TELEPHONE CONTACT/CERTIFIED MAIL/null
(2) Actual telephone number in format ###-###-#### if number is available and if fill-in
(1) = TELEPHONE CONTACT, otherwise null.
(Signature of Commissioner of Social Security)
First Name Last Name
Commissioner of Social Security
Social Security Administration
Social Security Administration
Social Security Administration
Social Security Administration
Social Security Administration
Social Security Administration
Social Security Administration
Social Security Administration