TN 1 (06-88)
This section describes how to complete item 12 of the SSA-101-U3 for UP awards
This chart shows how to complete fields in item 12 for UPs.
Note:Do notenter UP data in item 12 if UP is combined with a survivors monthly benefit award.
Key:The #is the number of the field in the exhibit above.
Show BIC of deceased plus letter U
Example:Deceased received DIB. Show HAU.
Assign subscripts to multiple UP payees. Enter symbols vertically.
NAME AND ADDRESS
For each SYMBOL, enter
basis of payment
Note:When paying a divided UP when address is unknown for a UP recipient, show “UNKNOWN” as address.
Reference:GN 01061.025, How to Instruct BAs to Pay Underpayments
DATE OF ENTITLEMENT
Enter total shareof total UP
Round to nearest penny.
Allocate any extra pennies to lower subscripts
Example:UP payees are AU1, AU2, AU3. Total UP = $740.00. One-third of $740.00 = $246.666.
Enter 246.67 eachfor AU1, AU2 and 246.66 for AU3.
Is the UP recipient also entitled to the LSDP?
If yes, enter 255.00
If no, leave blank