HI 00825.909 Transmittal Used by OCRO to Forward Earnings Statements to PSC
From : PSC
ATTN : Health Insurance and Inquiries Examiner
From : OCRO
The enclosed earnings statement is forwarded for your examination and action because
□The request includes a question that can be answered only from data in the claims
□Our records indicate that the individual whose earnings record is involved is deceased.
Furnish data only if permitted by Reg. No. 1.