TN 42 (03-23)

NL 00725.420 “SSA” UTIs – Headings and Signatures

SSAH01 First and Second Line Headings

Social Security Administration

Retirement, Survivors and Disability Insurance

SSAH02 Third Line Heading

Notice of Award

SSAH03 Third Line Heading

Notice of Disapproved Claim

SSAH04 Third Line Heading

Claim Information

SSAH05 Third Line Heading

Important Information

SSAH16 Third Line Heading


HDR030 Third Line Heading



SSAH30 Payment Name and Address


SSAH40 Return Address

Northeastern Program Service Center

155-10 Jamaica Avenue

Jamaica, New York 11432-3898

SSAH41 Return Address

Mid-Atlantic Program Service Center

300 Spring Garden Street

Philadelphia, Pennsylvania 19123-2992

SSAH42 Return Address

Southeastern Program Service Center

1200 Rev. Abraham Woods, Jr. Blvd

Birmingham, Alabama 35285-0001

SSAH43 Return Address

Great Lakes Program Service Center

600 West Madison Street

Chicago, Illinois 60661-2474

SSAH44 Return Address

Western Program Service Center

P.O. Box 2000

Richmond, California 94802-1000

SSAH45 Return Address

Mid-America Program Service Center

601 East Twelfth Street

Kansas City, Missouri 64106-2859

SSAH46 Return Address

Office of Central Operations

6401 Security Boulevard

Baltimore, Maryland 21235-6401

SSAH47 Return Address

Office of Central Operations

P.O. Box 17769

Baltimore, Maryland 21235-7769 U.S.A.

Fill-ins for SSAH40 - SSAH47


(2) Actual telephone number in format ###-###-#### if number is available and if fill-in (1) = TELEPHONE CONTACT, otherwise null.

SSAS01 Signature

(Signature of Commissioner of Social Security)

First Name Last Name

Commissioner of Social Security

SSAS02 Signature

Social Security Administration

SSAS03 Signature

Social Security Administration

SSAS04 Signature

Social Security Administration

SSAS05 Signature

Social Security Administration

SSAS06 Signature

Social Security Administration

SSAS07 Signature

Social Security Administration

SSAS08 Signature

Social Security Administration

SSAS09 Signature

Social Security Administration

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NL 00725.420 - <Quote>SSA</Quote> UTIs &ndash; Headings and Signatures - 03/02/2023
Batch run: 03/02/2023