Effective Dates: 07/06/2012 - Present Previous | Next

TN 1 (09-84)

NL 00711.315 Sample Letters

A. Italian Election Notice

Obtaining Election for Italy)

Claimant Entitled to Regular RSDI Benefits—U.S. Totalized Benefit is Lower—Guaranteed Minimum May Apply Claimant Entitled to Regular RSDI Benefits—U.S. Totalized Benefit is Lower—Guaranteed Minimum Considered But Does Not Apply
IE-l IE-2
17000 17000
17139A 17139A
17139B 17139B
17143 17143
17103 17103
17141 17141
17142 17144
17144
Claimant Not Insured for Regular RSDI Benefits—Guaranteed Minimum Applies Claimant Not Insured for Regular RSDI Benefits—Guaranteed Minimum Does Not Apply
IE-4 IE-5
17000 17000
17035 17035
17141 17141
17142 17145
17145
Claimant Has Filed for Italian Benefits Only Claimant Entitled to Regular RSDI Benefits—U.S. Totalized Benefit is Lower, But Earlier Month of Entitlement is Possible—Guaranteed Minimum Does Not Apply
IE-6 IE-7
17000 17000
17141 17139A
17145 17140
​ 17143
​ 17103
​ 17141
​ 17144

B. Italian Election Notice-U.S. Benefits Only

17000

17139A

17139B

17139C

17103

C. Response to Request For Agreement Information

17002

17040

17111

D. Request For Consent

17047

E. Claims Package Sent - Foreign Earnings Record Requested

17000

17055

17058

17130 (Optional)

F. Claims Package Sent - Foreign Earnings Record Not Requested

17000

17057*

17061*17174 or 17175 may be used for German claims. 17183 may be used for Swiss claims

G. Denial - Claimant Entitled to RSDI Benefits

17000

17073

17100

17103

17053

H. Denial Based on Application Filed With Agreement Country

17074

  •  

    (Reason for denial)

17053

17000*

17103

17021*Omit if 17075 used above.

I. Denial—Claimant Not Insured With Foreign Earnings

17000

17071

17100

17103

17072

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900711315
NL 00711.315 - Sample Letters - 07/06/2012
Batch run: 07/06/2012
Rev:07/06/2012