TN 4 (08-12)

NL 00720.145 ENT Entitlement

ENT001 STUDENT ENFORCEMENT (B22)

(System Generated)

Caption: Your Responsibility

We are writing to let you know that  (1)   (2)  for child's payments as a student. Based on the information we have,  (3)  benefits will continue through  (4)  . We will send another letter when we stop  (5)  benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: you

Choice 2: Beneficiary's Name possessive

Fill-in (2) - Systems Generated

Choice 1: qualify

Choice 2: qualifies

Fill-in (3) - Systems Generated

Choice 1: your

Choice 2: her

Choice 3: his

Fill-in (4) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

Fill-in (5) - Systems Generated

Choice 1: your

Choice 2: her

Choice 3: his

ENT015 RIB ALLOWANCE SUBSEQUENT DIB DENIAL (J17)

(Requested)

Caption: Other Social Security Benefits

Although  (1)  cannot receive disability benefits,  (2)  still entitled to retirement benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Last Name

Choice 2: you

Fill-in (2) - Systems Generated

Choice 1: she is

Choice 2: he is

Choice 3: you are

ENT027 DUAL ENTITLEMENT AWARD — PRIMARY AND AUXILIARY/SURVIVOR BENEFITS AWARDED SIMULTANEOUSLY — ONE NOTICE SENT (A38)

(Requested)

Caption: None

 (1)  entitled to monthly  (2)  benefits beginning  (3)  .  (4)  also entitled to  (5)  benefits on claim number  (6)  beginning  (7)  .

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: You are

Choice 2: He is

Choice 3: She is

Fill-in (2) - Systems Generated

Choice 1: disability

Choice 2: retirement

Fill-in (3) - Systems Generated

Choice 1: Date

Fill-in (4) - Systems Generated

Choice 1: You are

Choice 2: He is

Choice 3: She is

Fill-in (5) - Systems Generated

Choice 1: disability

Choice 2: retirement

Fill-in (6) - Requested As A Language

Choice 1: Dual entitlement other account SSN

Fill-in (7) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

ENT028 DUAL ENTITLEMENT - PRIMARY AWARD - SIMULTANEOUS ENTITLEMENT TO AUXILIARY/SURVIVOR BENEFITS - SEPARATE PAYMENTS (A40)

(Requested)

Caption: Your Benefits

 (1)  also entitled to  (2)  benefits on claim number  (3)  beginning  (4)  . We are sending  (5)  another letter about these benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: You are

Choice 2: He is

Choice 3: She is

Fill-in (2) - Systems Generated

Choice 1: disability

Choice 2: retirement

Fill-in (3) - Requested As A Language

Choice 1: Dual entitlement other account SSN

Fill-in (4) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

Fill-in (5) - Systems Generated

Choice 1: you

Choice 2: her

Choice 3: him

ENT029 DUAL ENTITLEMENT AUXILIARY/SURVIVOR AWARD - SIMULTANEOUS ENTITLEMENT ON PRIMARY RECORD - SEPARATE PAYMENTS (A41)

(Requested)

Caption: Your Benefits

 (1)  also entitled to benefits on  (2)  own earnings record beginning  (3)  . We are sending  (4)  another letter about these benefits.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: You are

Choice 2: He is

Choice 3: She is

Fill-in (2) - Systems Generated

Choice 1: your

Choice 2: her

Choice 3: his

Fill-in (3) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

Fill-in (4) - Systems Generated

Choice 1: you

Choice 2: her

Choice 3: him

ENT038 BENEFITS REDUCED TO ZERO UNDER DIB FAMILY MAXIMUM PROVISIONS (J74)

(Requested/Generated)

Caption: Your Benefits

We have approved  (1)  application for  (2)  benefits.  (3)  entitlement date is  (4)  . However, we cannot pay  (5)  any benefits because all of the money we can pay on this record is already being paid to  (6)  .

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Your

Choice 2: Full name possessive

Fill-in (2) - Requested As A One Position Alpha Character

Choice 1: (A) spouse's

Choice 2: (B) child's

Choice 3: (C) parent's

Fill-in (3) - Systems Generated

Choice 1: His

Choice 2: Her

Choice 3: Your

Fill-in (4) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY (DOEC)

Fill-in (5) - Systems Generated

Choice 1: you

Choice 2: her

Choice 3: him

Fill-in (6) - Requested As A Language

Choice 1: Number holders full name

ENT048 ACCRUED BENEFITS TEMPORARILY WITHHELD PENDING FINAL RECOMMENDATION (B23)

(Requested)

Caption: Your Benefits

We are withholding payment for  (1)  until we decide the best way

to make payments.

Fill-in values:

Fill-in (1) - Requested As A Date In Format Shown Below

Choice 1: MM/YYYY

Choice 2: MM/YYYY and MM/YYYY

Choice 3: MM/YYYY through MM/YYYY

ENT051 HI DATE OF ENTITLEMENT (H10)

(Requested/Generated)

Caption: Information About Medicare

You are entitled to hospital insurance under Medicare beginning  (1)  .

Fill-in values:

Fill-in (1) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

ENT052 SMI DATE OF ENTITLEMENT (H12)

(Requested/Generated))

Caption: Information About Medicare

You are entitled to medical insurance under Medicare beginning  (1)  .

Fill-in values:

Fill-in (1) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

ENT056 NO PAYMENT AWARD ENTITLED TO AN EQUAL OR LARGER BENEFIT ON ANOTHER RECORD (B41)

(Requested)

Caption: Your Benefits

We approved  (1)  claim for  (2)  benefits. However, we cannot pay  (3)  on  (4)  record because  (5)  entitled to an equal or larger benefit on another Social Security record.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Fill-in (2) - Requested As A One Position Alpha Character

Choice 1: (A) wife's

Choice 2: (B) husband's

Choice 3: (C) widow's

Choice 4: (D) widower's

Choice 5: (E) mother's

Choice 6: (F) father's

Choice 7: (G) disabled widow's

Choice 8: (H) disabled widower's

Choice 9: (I) disabled divorced widow's

Choice 10: (J) disabled divorced widower's

Choice 11: (K) child's

Fill-in (3) - Systems Generated

Choice 1: him

Choice 2: you

Choice 3: her

Fill-in (4) - Requested As A Language

Choice 1: Number holder name

Fill-in (5) - Systems Generated

Choice 1: you are

Choice 2: he is

Choice 3: she is

ENT062 MONTH OF ENTITLEMENT CONFIRMED (A52)

(Requested)

Caption: Your Benefits

We reviewed  (1)  record. When  (2)  applied,  (3)  asked us to start  (4)  benefits in  (5)  . We found that  (6)  is still the month when benefits should start.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary Name possessive

Choice 2: your

Fill-in (2) - Systems Generated

Choice 1: he

Choice 2: she

Choice 3: you

Fill-in (3) - Systems Generated

Choice 1: he

Choice 2: she

Choice 3: you

Fill-in (4) - Systems Generated

Choice 1: his

Choice 2: her

Choice 3: your

Fill-in (5) - Requested As A Date In Format Shown Below

Choice 1: MM/CCYY

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

Choice 1: MM/CCYY

ENT063 BENEFICIARY ENTITLED ON TWO ACCOUNTS A BENEFITS (PREVIOUSLY AWARDED) TO BE COMBINED WITH WIDOW(ER)'S BENEFITS AND PAYMENT OF LUMP-SUM (B07)

(Requested)

Caption: What We Will Pay

The check, which includes the money  (1)  due through  (2)  , will also include a lump-sum payment of  (3)  . This is a one-time payment we make because of a worker's death.

After that, we will send  (4)  benefits in one check each month. The check will include  (5)  which  (6)  due on  (7)  own Social Security record and  (8)  which  (9)  due on the other record.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: you are

Choice 2: Beneficiary Name is

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

Choice 1: MM/CCYY

Fill-in (3) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount of lump-sum

Fill-in (4) - Systems Generated

Choice 1: you

Choice 2: him

Choice 3: her

Fill-in (5) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount MBP

Fill-in (6) - Systems Generated

Choice 1: you are

Choice 2: he is

Choice 3: she is

Fill-in (7) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her

Fill-in (8) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount MBP

Fill-in (9) - Systems Generated

Choice 1: you are

Choice 2: he is

Choice 3: she is

ENT064 UNDERPAYMENT PAID TO OTHER BENEFICIARY (B08)

(Requested)

Caption: What We Will Pay

Your  (1)  check includes  (2)  which we owed  (3)  .

Fill-in values:

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

Choice 1: (A) next

Choice 2: (B) first

Fill-in (2) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount of underpayment

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

Choice 1: (A) your wife

Choice 2: (B) your husband

Choice 3: (C) your father

Choice 4: (D) your mother

Choice 5: name of beneficiary

ENT065 SIMULTANEOUS A AND AB AWARDS (B17)

(Requested)

Caption: Other Social Security Benefits

We are still working on  (1)   (2)  claim for spouse's benefits. When we decide whether or not  (3)  is entitled to benefits, we will send  (4)  a letter.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: your

Choice 2: Beneficiary name possessive

Fill-in (2) - Requested As A One Position Alpha Character

Choice 1: (A) wife's

Choice 2: (B) husband's

Fill-in (3) - Systems Generated

Choice 1: he

Choice 2: she

Fill-in (4) - Systems Generated

Choice 1: him

Choice 2: her

ENT066 AUXILIARY CLAIM PENDING (C07)

(Requested)

Caption: Things To Remember

We are still working on  (1)  claim. When we decide whether or not  (2)  entitled to benefits, we will send another letter to give our decision.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's Name possessive

Choice 2: your

Fill-in (2) - Systems Generated

Choice 1: he is

Choice 2: she is

Choice 3: you are

ENT067 UNDERPAYMENT DUE TO DEATH OF BENEFICIARY SHARED WITH INDIVIDUAL(S) OF EQUAL ENTITLEMENT (C09)

(Requested)

Caption: What We Will Pay

This check includes  (1)  , which is part of the money which was due  (2)  . Each person who is eligible for part of this money will get an equal share. The amount shown above is  (3)  share.

Fill-in values:

Fill-in (1) - Requested As A Money Amount In Format $$$$$.¢¢

Choice 1: Amount

Fill-in (2) - Requested As A Language

Choice 1: Name of deceased individual

Fill-in (3) - Systems Generated

Choice 1: your

Choice 2: Beneficiary name possessive

ENT068 RIGHTS AND RESPONSIBILITIES DOMESTIC CONVERSION FROM DIB (G14)

(System Generated)

Caption: Your Responsibilities

It is important that you report changes that could affect  (1)  benefits to us right away. To explain these changes, we have enclosed a pamphlet, When You Get Social Security Retirement or Survivor Benefits. What You Need To Know. It will tell you what must be reported and how to report. Please be sure to read the part of the pamphlet which explains how earnings from work could change  (2)  payments.

Fill-in values:

Fill-in (1)

Choice 1: your

Choice 2: Beneficiary name possessive

Fill-in (2)

Choice 1: your

Choice 2: Beneficiary name possessive

ENT069 RIGHTS AND RESPONSIBILITIES FOREIGN CONVERSION FROM DIB (G15)

(System Generated)

Caption: Your Responsibilities

It is important that you report changes that could affect  (1)  benefits to us right away. To explain these changes, we have enclosed a pamphlet, Your Social Security Checks While You Are Outside the United States. It will tell you what must be reported and how to report. The pamphlet explains that we may not pay  (2)  if  (3)  more than 45 hours in a month.

Fill-in values:

Fill-in (1)

Choice 1: your

Choice 2: Beneficiary name possessive

Fill-in (2)

Choice 1: you

Choice 2: Beneficiary's name

Fill-in (3)

Choice 1: you work

Choice 2: he works

Choice 3: she works

ENT070 DATE OF BIRTH ESTABLISHED DIFFERENT FROM THAT ALLEGED OR DATE ESTABLISHED BEFORE ATTAINMENT OF RETIREMENT AGE (C08)

(Requested/Generated)

Caption: The Basis For Our Decision

Based on the information given to us,  (1)  born on  (2)  .

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: Beneficiary's name + was

Choice 2: you were

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

MM/DD/CCYY

ENT071 DIB TO RIB CONVERSION (GA3)

(System Generated)

Caption: Your Benefits

We are changing the type of benefit  (1)  from Social Security. Beginning  (2)  ,  (3)  entitled to retirement benefits.  (4)  no longer entitled to disability benefits because  (5)  reached full retirement age.

Fill-in values:

Fill-in (1)

Choice 1: Name + receives

Choice 2: you receive

Fill-in (2)

Choice 1: MM/CCYY

Fill-in (3)

Choice 1: he is

Choice 2: she is

Choice 3: you are

Fill-in (4)

Choice 1: He is

Choice 2: She is

Choice 3: You are

Fill-in (5)

Choice 1: he has

Choice 2: she has

Choice 3: you have

ENT075 NEW BENEFICIARY ENTITLED TO BENEFITS (J79)

(Requested)

Caption: Your Benefits

Since  (1)  now entitled to benefits, we changed the amount we can pay  (2)  beginning  (3)  . We will continue to pay this new monthly amount as long as  (4)   (5)  payments.

Fill-in values:

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

Choice 1: (A) name of terminated beneficiary is

Choice 2: (B) names of terminated beneficiaries are

Choice 3: (C) you are

Fill-in (2) - Systems Generated

Name (or names) of previously entitled beneficiary (or beneficiaries)

Fill-in (3) - Requested As A Date In Format Shown Below

MM/CCYY (date of adjustment)

Fill-in (4) - Systems Generated

Choice 1: Beneficiary's Name + receives

Choice 2: you receive

Fill-in (5) - Requested As A One Position Alpha Character

Choice 1: (A) workers' compensation

Choice 2: (B) public disability

Choice 3: (C) workers' compensation and public disability


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900720145
NL 00720.145 - ENT Entitlement - 12/12/2012
Batch run: 12/12/2012
Rev:12/12/2012