TN 23 (12-17)

NL 00725.160 “CLO” UTIs – Closeout

CLOC01 Caption

Other Social Security Benefits

CLOC06 Caption

Others Who May Be Eligible For Benefits

CLO001 General Closeout for Disallowances

 (1)  not due any other Social Security benefits. In the future, if you think  (2)  may qualify for benefits from us,  (3)  will need to apply again.

Fill-ins:

(1) “You are”/'He is”/”She is”

(2) “you”/“he”/“she”

(3) “you”/“he”/“she”

CLO002 General Closeout for Awards

 (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-ins:

(1) “This benefit is the only benefit”/“These benefits are the only benefits”

(2) “you”/“he”/“she”

(3) “you”/“he”/“she”

(4) “you”/“he”/“she”

CLO003 Closeout for Lump Sum Awards

We checked to see if  (1)  for any other Social Security benefit on  (2)  record. We found that this is the only one  (3)  can receive from us at this time. In the future, if you think  (4)  might qualify for another benefit from us,  (5)  will need to apply again.

Fill-ins:

(1) “you qualify”/“he qualifies”/ “she qualifies”

(2) NH's FN

(3) “you”/“he”/ “she”

(4) “you”/“he”/“she”

(5) “you”/“he”/“she”

CLO036

 (1)   (2)  may now be eligible for benefits on  (3)  record.  (4)  named the following  (5)  when  (6)  applied for benefits:

Fill-ins:

(1) “Your”/Beneficiary's name (possessive)/

(2) “child”/ “children”

(3) “your”/“his”/ “her”

(4) “You”/“He”/“She”

(5) “child”/“children”

(6) “you”/“he”/ “she”

CLO037

  •  (1) 

  •  (2) 

  •  (3) 

  •  (4) 

  •  (5) 

  •  (6) 

  •  (7) 

  •  (8) 

  •  (9) 

  •  (10) 

Fill-ins:

(1) First child named on DEPC screen

(2) Second child named on DEPC screen

(3) Third child named on DEPC screen

(4) Fourth child named on DEPC screen

(5) Fifth child named on DEPC screen

(6) Sixth child named on DEPC screen

(7) Seventh child named on DEPC screen

(8) Eighth child named on DEPC screen

(9) Ninth child named on DEPC screen

(10) Tenth child named on DEPC screen

CLO038

If  (1)  not filed an application for benefits for the  (2)  , please contact us.

(1) “you have”/“he has”/”she has”

(2) “child”/ “children”

CLOR05 Award Closeout When Second Claim Pending

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-ins:

(1) type of benefit currently being awarded, e.g., retirement *

(2) “you”/“him”/“her”

(3) “you are”/“he is”/“she is”

(4) type of benefit pending, e.g., retirement *

(5) “You”/“He”/“She”

(6) “you”/“he”/“she”

(*) indicates that the fill-ins are manual

CLOR06 Award Closeout When DIB Pending

The  (1)  benefit is the only one to which  (2)   (3)  entitled, with the possible exception of a disability benefit. We will let you know as soon as we decide whether  (4)   (5)  disabled. We will send you another letter to tell you what we decide about  (6)  disability claim.

Fill-ins:

(1) type of benefit currently being awarded *

(2) “you”/SN

(3) “are”/“is”

(4) “you”/“she”/“he”

(5) “are”/“is”

(6) “your”/“her”/“his”

(*) indicates that the fill-ins are manual

CLOR07 Closeout – Other Benefit Possible

We are still looking to see if  (1)  can receive  (2)  benefits.  (3)  cannot receive any other type of benefits based on the application  (4)  filed.

Fill-ins:

(1) “you”/“he”/“she”

(2) type of benefit, e.g., retirement benefit *

(3) “You”/“He”/“She”

(4) “you”/“he”/“she”

(*) indicates that the fill-ins are manual

CLOR11 Closeout of Potential Benefit

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-ins:

(1) type of benefit*

(2) “you”/FN

(3) “are”/“is”

(4) type of benefit *

(5) type of benefit*

(6) “for”/null

(7) SN/null

(8) type of benefit *

(9) “for him”/“for her”/null

(10) type of benefit*

(11) type of benefit *

(*) indicates that the fill-ins are manual

CLOR12 Closeout – Family Benefits Involved

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-ins:

(1) “retirement”/“disability”

(2) “you and your family”/NHFN

(3) “and his”/“and her”/null

(4) “wife's”/“husbands”/“child's” *

(5) “retirement”/“disability”

(6) “for”/null

(7) NHSN/null

(8) “you/your wife”/“your husband”/ “your child” *

(9) “wife's”/“husband's”/“child's” *

(10) “you change your”/“your wife changes her”/“your husband changes his”/“your child changes his/her” *

(11) “you need”/“she needs”/“he needs” *

(12) “you apply”/“your wife applies”/“your husband applies”/“your child applies” *

(13) “retirement”/“disability”

(14) “for”/null

(15) NHSN/null

(16) “wife's”/“husband's”/“child's” *

(*) indicates that the fill-ins are manual

CLOR13 Lump-Sum – Closeout to Other 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-ins:

(1) “you”/FN

(2) “are”/“is”

(3) type of benefit *

(4) “for”/null

(5) SN/null

(6) type of benefit *

(7) “for him”/“for her”/null

(8) type of benefit *

(*) indicates that the fill-ins are manual

CLOR20 Auxiliary Claimant Not Insured On Own Record

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-ins:

(1) required QCs *

(2) acquired QCs *

(*) indicates that the fill-in is manual


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900725160
NL 00725.160 - "CLO" UTIs - Closeout - 12/21/2017
Batch run: 12/21/2017
Rev:12/21/2017