TN 2 (05-11)
NL 00719.030 Annotations on the MADCAP Output Form
The “Additional Payment Information” block on form SSA-3926 (Determination of Benefit
Adjustment) will contain the following:
Notice category (e.g., CAT A or CERT 30)
Letter completion indicator (e.g., C,H,I,B,N)
UTI indicators and their fill-ins do not show in the block. Complete MADCAP notices
are retrieved from the Online Retrieval System (ORS).