Basic (05-11)

NL 00720.195 LIS Lead In Statement

LIS004 INTRODUCTORY STATEMENT A 20, A21, A 22 ADJUSTMENT NOTICE (G52)

(System Generated)

Caption: None

We are writing to give you new information about the  (1)  benefits which  (2)  on this Social Security record.


Fill-in values:
Fill-in (1) - Systems Generated
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: Medicare
Choice 15: null
Fill-in (2) - Systems Generated
Choice 1: you receive
Choice 2: Beneficiary Name receives

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900720195
NL 00720.195 - LIS Lead In Statement - 03/02/2016
Batch run: 03/29/2017
Rev:03/02/2016