TN 1 (07-11)

NL 00720.055 AWD Award

AWD010 PIC “D” AWARD BETWEEN AGE 62 AND FULL RETIREMENT AGE (G05)

(Generated)

Caption: Other Social Security Benefits

Please get in touch with us 3 months before  (1)   (2)   (3)  to find out whether  (4)  for retirement benefits.

Fill-in values:

Fill-in (1)

Choice 1: you reach

Choice 2: beneficiary name reaches

Fill-in (2)

Choice 1: age 65

Choice 2: full retirement age

Fill-in (3)

Choice 1: NULL

Choice 2: real retirement age from FRA utility in below format:

(i.e., 66 and 2 months)

Fill-in (4)

Choice 1: you qualify

Choice 2: he qualifies

Choice 3: she qualifies

AWD011 OPENING PARAGRAPH FOR OTHER THAN “PIC-O” AWARDS IN “LAF-S” (OTHER THAN SD) (G09)

(System Generated)

Caption: None

We are writing to let you know that we have approved  (1)  application for  (2)  benefits. The rate is  (3)  beginning  (4)  , but  (5)  will not receive regular monthly checks at this time.

Fill-in values:

Fill-in (1)

Choice 1: your

Choice 2: Beneficiary's Name possessive

Fill-in (2)

Choice 1: disability

Choice 2: retirement

Choice 3: wife’s

Choice 4: husband’s

Choice 5: child’s

Choice 6: widow’s

Choice 7: widower’s

Choice 8: mother’s

Choice 9: father’s

Choice 10: disabled widow’s

Choice 11: disabled widower’s

Choice 12: disabled divorced widow’s

Choice 13: disabled divorced widower’s

Choice 14: NULL

Fill-in (3)

Amount

Fill-in (4)

MM/CCYY

Fill-in (5)

Choice 1: you

Choice 2: he

Choice 3: she

AWD012 INTRODUCTORY STATEMENT CHANGE OF PAYEE AWARD BENEFICIARY OWN PAYEE (G48)

(System Generated)

Caption: None

We are writing to tell  (1)  that beginning  (2)  we will begin to send  (3)  checks directly. The rest of this letter will give  (4)  more information about this change.

Fill-in values:

Fill-in (1

Choice 1: you

Choice 2: Beneficiary's Name

Fill-in (2)

MM/CCYY

Fill-in (3)

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (4)

Choice 1: you

Choice 2: him

Choice 3: her

AWD013 INTRODUCTORY STATEMENT AWARDS (EXCEPT “PIC-O” OR “LAF-S") (G49)

(System Generated)

Caption: None

We are writing to let you know that  (1)  entitled to monthly  (2)  benefits from Social Security beginning  (3)  .

Fill-in values:

Fill-in (1)

Choice 1: you are

Choice 2: Beneficiary's name is

Fill-in (2)

Choice 1: disability

Choice 2: retirement

Choice 3: wife's

Choice 4: husband's

Choice 5: child's

Choice 6: widow's

Choice 7: widower's

Choice 8: mother's

Choice 9: father's

Choice 10: disabled widow's

Choice 11: disabled widower's

Choice 12: disabled divorced widow's

Choice 13: disabled divorced widower's

Choice 14: null

Fill-in (3)

MM/CCYY

AWD014 MBA Paragraph (B30)

(Requested/Generated)

Caption: Your Benefits

The following chart shows  (1)  benefit amount(s) before any deductions or rounding. The amount  (2)  may differ from  (3)  full benefit amount. When we figure how much to pay  (4)  , we must deduct certain amounts, such as Medicare premiums and worker's compensation offset. We must also round down to the nearest dollar.

Beginning Benefit

Date Amount Reason

 (5)   (6)   (7) 

NOTE: This UTI is flexible, to allow multiple repetitions of the three fill-ins. This allows it to be used once, and provide as many benefit amount, dates and reasons as are needed to explain the action, or more than once with the benefit amount, date and reason. An example of how to input this in the ENB is:

C*AWD014,12/2012,848.70,a,01/2013,871.90,a,12/2013,885.00,a. OR
C*AWD014,07/2013,910.40,a*AWD017,12/2013,924.10,a*AWD014,01/2014,925.10,a.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: your

Choice 2: Beneficiary's name, possessive

Fill-in (2) - Systems Generated

Choice 1: you actually receive

Choice 2: he actually receives

Choice 3: she actually receives

Fill-in (3) Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (4) Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (5) - Requested As A Date In Format MM/CCYY

Date displayed in format “September 2010”

Fill-in (6) - Requested As A Money Amount In Format Shown Below

Money amount displayed in format “$$$$$.¢¢”

Fill-in (7) - Requested As A One Position Alpha Character

Choice 1 (A): Entitlement began

Choice 2 (B): Cost of living adjustment

Choice 3 (C): Credit for additional earnings

Choice 4 (D): Benefits to another person began or ended

Choice 5 (E): Your own benefit increased

Choice 6 (F): His own benefit increased

Choice 7 (G): Her own benefit increased

Choice 8 (H): You became entitled to your own benefit

Choice 9 (I): He became entitled to his own benefit

Choice 10 (J): She became entitled to her own benefit

AWD015 (B30 and B33 Detail Line)

(System Generated)

Caption: Your Benefits

(1) (2) (3)

  1.  (1)   (2) 

Fill-in values:

Fill-in (1) - Requested As A Date In Format MM/CCYY

Date displayed in format “September 2010”

Fill-in (2) - Requested As A Money Amount In Format Shown Below

Money amount displayed in format “$$$$$.¢¢”

Fill-in (3) - Requested As A One Position Alpha Character

Choice 1 (A): Entitlement began

Choice 2 (B): Cost of living adjustment

Choice 3 (C): Credit for additional earnings

Choice 4 (D): Benefits to another person began or ended

Choice 5 (E): Your own benefit increased

Choice 6 (F): His own benefit increased

Choice 7 (G): Her own benefit increased

Choice 8 (H): You became entitled to your own benefit

Choice 9 (I): He became entitled to his own benefit

Choice 10 (J): She became entitled to her own benefit

AWD016 MBA Paragraph (B33)

(Requested)

Caption: Your Benefits

The following charts show  (1)  disability benefit amount(s) before any deductions or rounding. The first chart shows the amount(s) on  (2)  own record and the second chart shows  (3)  benefit amount(s) as a childhood disability beneficiary. The amount  (4)  may differ from  (5)  full benefit amount. When we figure how much to pay  (6)  , we must deduct certain amounts, such as Medicare premiums and worker's compensation offset. We must also round down to the nearest dollar.

Beginning Benefit

Date Amount Reason

 (7)   (8)   (9) 

NOTE: This UTI is flexible, to allow multiple repetitions of the three fill-ins. This allows it to be used once, and provide as many benefit amount, dates and reasons as are needed to explain the action, or more than once with the benefit amount, date and reason. An example of how to input this in the ENB is:

C*AWD016,12/2012,848.70,a,01/2013,871.90,a,12/2013,885.00,a. OR
C*AWD016,07/2013,910.40,a*AWD016,12/2013,924.10,a*AWD0167,01/2014,925.10,a.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: your

Choice 2: Beneficiary's name, possessive

Fill-in (2) – Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (3) – Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (4) – Systems Generated

Choice 1: you actually receive

Choice 2: he actually receives

Choice 3: she actually receives

Fill-in (5) – Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (6) – Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (7) - Requested As A Date In Format MM/CCYY

Date displayed in format “September 2010”

Fill-in (8) - Requested As A Money Amount In Format Shown Below

Money amount displayed in format “$$$$$.¢¢”

Fill-in (9) - Requested As A One Position Alpha Character

Choice 1 (A): Entitlement began

Choice 2 (B): Cost of living adjustment

Choice 3 (C): Credit for additional earnings

Choice 4 (D): Benefits to another person began or ended

Choice 5 (E): Your own benefit increased

Choice 6 (F): His own benefit increased

Choice 7 (G): Her own benefit increased

Choice 8 (H): You became entitled to your own benefit

Choice 9 (I): He became entitled t