BASIC (05-11)

NL 00720.095 CLO Closeout

CLO002 GENERAL CLOSEOUT FOR AWARDS (G19)

(System Generated)

Caption: Other Social Security Benefits

 (1)     (2)  can receive from us at this time. In the future, if you think  (3)  might qualify for another benefit from us,  (4)  will need to apply again.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: This benefit is the only benefit

Choice 2: These benefits are the only benefits

Fill-in (2) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (3) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

Fill-in (4) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

CLO029 AD, B TO D, AND AB TO AD CONVERSION HIGHER BENEFITS POSSIBLE ON PRIOR SPOUSE'S RECORD (B35)

(Requested)

Caption: Other Social Security Benefits

If  (1)  married more than once, please contact us.  (2)  may be able to get a higher benefit on the record of a prior spouse.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: you were

Choice 2: he was

Choice 3: she was

Fill-in (2) - Systems Generated

Choice 1: You

Choice 2: He

Choice 3: She

CLOR05 CLOSE OUT ANOTHER CLAIM PENDING (B56)

(Requested)

Caption: Other Social Security Benefits

This  (1)  benefit is the only benefit we can pay  (2)  at this time. We will let you know if  (3)  eligible for  (4)  benefits.  (5)  cannot receive any other type of benefits based on the application  (6)  filed.

Fill-in values:

Fill-in (1) - Requested As A One Position Alpha Character

Choice 1: (A) retirement

Choice 2: (B) wife

Choice 3: (C) husband

Choice 4: (D) widow

Choice 5: (E) widower

Choice 6: (F) mother

Choice 7: (G) father

Choice 8: (H) child

Choice 9: (I) children

Choice 10: (J) parent

Fill-in (2) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (3) - Systems Generated

Choice 1: you are

Choice 2: he is

Choice 3: she is

Fill-in (4) - Requested As A One Position Alpha Character

Choice 1: (A) retirement

Choice 2: (B) wife

Choice 3: (C) husband

Choice 4: (D) widow

Choice 5: (E) widower

Choice 6: (F) mother

Choice 7: (G) father

Choice 8: (H) child

Choice 9: (I) children

Choice 10: (J) parent

Fill-in (5) - Systems Generated

Choice 1: You

Choice 2: He

Choice 3: She

Fill-in (6) - Systems Generated

Choice 1: you

Choice 2: he

Choice 3: she

CLOR11 AWARD CLOSEOUT OTHER POTENTIAL CLAIM GIVEN 6-MONTH CLOSEOUT (B11)

(Requested)

Caption: Other Social Security Benefits

The  (1)  benefit is the only kind of benefit  (2)   (3)  entitled to receive, with the possible exception of  (4)  benefits. You told us when you applied for  (5)  benefits  (6)   (7)  that you did not wish to apply for  (8)  benefits  (9)  at that time.

If you change your mind, you need to apply for these benefits. The application date can make a difference in the amount we pay. If you apply within 6 months of the date of this letter, we may be able to use the date of your application for  (10)  benefits as the date of your application for  (11)  benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: retirement

Choice 2: disability

Fill-in (2) - Systems Generated

Choice 1: you

Choice 2: Beneficiary name

Fill-in (3) - Systems Generated

Choice 1: are

Choice 2: is

Fill-in (4) - Requested As A One Position Alpha Character

Choice 1: (A) retirement

Choice 2: (B) disability

Choice 3: (C) spouse’s

Choice 4: (D) widow’s

Choice 5: (E) widower’s

Choice 6: (F) mother’s

Choice 7: (G) father’s

Choice 8: (H) child’s

Choice 9: (I) parent’s

Choice 10: (J) disabled widow’s

Choice 11: (K) disabled widower’s

Choice 12: (L) disabled divorced widow’s

Choice 13: (M) disabled divorced widower’s

Fill-in (5) - Systems Generated

Choice 1: retirement

Choice 2: disability

Fill-in (6) - Systems Generated

Choice 1: for

Choice 2: null

Fill-in (7) - Systems Generated

Choice 1: Beneficiary name

Choice 2: null

Fill-in (8) - Requested As A One Position Alpha Character

Choice 1: (A) retirement

Choice 2: (B) disability

Choice 3: (C) spouse’s

Choice 4: (D) widow’s

Choice 5: (E) widower’s

Choice 6: (F) mother’s

Choice 7: (G) father’s

Choice 8: (H) child’s

Choice 9: (I) parent’s

Choice 10: (J) disabled widow’s

Choice 11: (K) disabled widower’s

Choice 12: (L) disabled divorced widow’s

Choice 13: (M) disabled divorced widower’s

Fill-in (9) - Systems Generated

Choice 1: for him

Choice 2: for her

Choice 3: null

Fill-in (10) - Systems Generated

Choice 1: retirement

Choice 2: disability

Fill-in (11) - Requested As A One Position Alpha Character

Choice 1: (A) retirement

Choice 2: (B) disability

Choice 3: (C) spouse’s

Choice 4: (D) widow’s

Choice 5: (E) widower’s

Choice 6: (F) mother’s

Choice 7: (G) father’s

Choice 8: (H) child’s

Choice 9: (I) parent’s

Choice 10: (J) disabled widow’s

Choice 11: (K) disabled widower’s

Choice 12: (L) disabled divorced widow’s

Choice 13: (M) disabled divorced widower’s

CLOR12 AWARD CLOSEOUT POTENTIAL AUXILIARY AND FAMILY CLAIM GIVEN 6-MONTH CLOSEOUT (B12)

(Requested)

Caption: Other Social Security Benefits

The  (1)  benefit is the only kind of benefit  (2)   (3)  family are entitled to receive, with the possible exception of  (4)  benefits. You told us when you applied for  (5)  benefits  (6)   (7)  that  (8)  did not wish to apply for  (9)  benefits at that time.

If  (10)  mind,  (11)  to apply for these benefits. The application date can make a difference in the amount we pay. If  (12)  within 6 months of the date of this letter, we may be able to use the date of the application for  (13)  benefits  (14)   (15)  as the date of application for  (16)  benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: retirement

Choice 2: disability

Fill-in (2) - Systems Generated

Choice 1: you and your family

Choice 2: Number Holder's Fullname

Fill-in (3) - Systems Generated

Choice 1: and his

Choice 2: and her

Choice 3: null

Fill-in (4) - Requested As A One Position Alpha Character

Choice 1: (A) wife's

Choice 2: (B) husbands

Choice 3: (C) child's

Fill-in (5) - Systems Generated

Choice 1: retirement

Choice 2: disability

Fill-in (6) - Systems Generated

Choice 1: for

Choice 2: null

Fill-in (7) - Systems Generated

Choice 1: Number Holder's fullname

Choice 2: null

Fill-in (8) - Requested As A One Position Alpha Character

Choice 1: (A) you

Choice 2: (B) your wife

Choice 3: (C) your husband

Choice 4: (D) your child

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

Choice 1: (A) wife's

Choice 2: (B) husbands

Choice 3: (C) child's

Fill-in (10) - Requested As A One Position Alpha Character

Choice 1: (A) you change your

Choice 2: (B) your wife changes her

Choice 3: (C) your husband changes his

Choice 4: (D) your child changes his

Choice 5: (E) your child changes her

Fill-in (11) - Systems Generated

Choice 1: you need

Choice 2: he needs

Choice 3: she needs

Fill-in (12) - Requested As A One Position Alpha Character

Choice 1: (A) you apply

Choice 2: (B) your wife applies

Choice 3: (C) your husband applies

Fill-in (13) - Systems Generated

Choice 1: retirement

Choice 2: disability

Fill-in (14) - Systems Generated

Choice 1: for

Choice 2: null

Fill-in (15) - Systems Generated

Choice 1: Number Holder's Surname

Fill-in (16) - Requested As A One Position Alpha Character

Choice 1: (A) wife's

Choice 2: (B) husbands

Choice 3: (C) child's

CLOR13 LUMP-SUM DEATH PAYMENT AWARD CLOSEOUT OTHER POTENTIAL CLAIM GIVEN 6-MONTH CLOSEOUT (B13)

(Requested)

Caption: Other Social Security Benefits

The lump-sum death payment is the only kind of payment  (1)   (2)  entitled to receive, with the possible exception of  (3)  benefits. You told us when you applied for the lump-sum death payment  (4)   (5)  that you did not wish to apply for  (6)  benefits  (7)  at that time.

If you change your mind, you need to apply for these benefits. The application date can make a difference in the amount we pay. If you apply within 6 months of the date of this letter, we may be able to use the date of the application for  (8)  benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: you

Choice 2: Fullname

Fill-in (2) - Systems Generated

Choice 1: are

Choice 2: is

Fill-in (3) - Systems Generated

Choice 1: retirement

Choice 2: disability

Fill-in (4) - Systems Generated

Choice 1: for

Choice 2: null

Fill-in (5) - Systems Generated

Choice 1: Surname

Choice 2: null

Fill-in (6) - Systems Generated

Choice 1: wife's

Choice 2: husbands

Choice 3: child's

Fill-in (7) - Systems Generated

Choice 1: for him

Choice 2: for her

Choice 3: null

Fill-in (8) - Systems Generated

Choice 1: wife's

Choice 2: husbands

Choice 3: child's

CLOR20 AUXILIARY CLAIMANT NOT INSURED ON OWN RECORD (Q04)

(Requested)

Caption: Your Benefits

Benefits are not payable on your own record because you have not worked long enough under Social Security. To qualify, you need credit for  (1)  calendar quarters of work. You now have  (2)  . If you earn the additional quarters, please contact any Social Security office.

Fill-in values:

Fill-in (1) - Requested As A Number

Choice 1: required QCs

Fill-in (2) - Requested As A Number

Choice 1: acquired QCs


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900720095
NL 00720.095 - CLO Closeout - 09/29/2014
Batch run: 09/29/2014
Rev:09/29/2014