HI 00815.208 Buy-In Form for Railroad Annuitants - Sample

A sample of the buy-in form for railroad annuitants appears on the revserse side of this form may be locally reproduced.

 

G-HI 00815.208

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http://policy.ssa.gov/poms.nsf/lnx/0600815208
HI 00815.208 - Buy-In Form for Railroad Annuitants - Sample - 09/29/1995
Batch run: 01/27/2009
Rev:09/29/1995