TN 35 (11-21)
NL 00725.006 Notice of Award (NOA) Letter
Survivors, and Disability Insurance
Notice of Award
Miscellaneous Program Service Center
225 E. Oak Street
Central City, ST 00000
JOHN G. BENEFICIARY
101 MAIN STREET
ANYTOWN, ST 00001
You are entitled to monthly retirement benefits beginning March 1992.
What We Will Pay And When
You will receive $1,121.00 for March 1992 around April 3, 1992.
After that you will receive $1,121.00 each month.
Information About Medicare
You are entitled to Medicare hospital and medical insurance beginning March 1992.
We will send your Medicare card in about 4 weeks. You should take this card with you
when you need medical care. If you need medical care before you receive the card,
use this letter as proof that you are covered by Medicare.
Other Social Security Benefits
The benefits described in this letter is the only one you can receive from Social
Security. If you think you might qualify for another kind of Social Security benefit
in the future, you will have to file another application.
Do You Think We Are Wrong?
If you think we are wrong, you have the right to appeal. We will correct any mistakes
and will look at any new facts you have. A person who did not make the first decision
will decide your case.
You have 60 days to ask for an appeal.
The 60 days start the day after you get this letter.
You must have a good reason if you wait more than 60 days to ask for an appeal.
Your benefits are based on the information you gave us. If this information changes,
it could affect your benefits. For this reason, it is important that you report changes
to us right away.
We have enclosed a pamphlet, “When You Get Social Security, Retirement or Survivors
Benefits...What You Need To Know.” It tells you what you must be reported and how
to report. Please be sure to read the part of the pamphlet which explains how work
could changes your payments.
If You Have Any Questions
If you have any questions, you may call us at 1-800-2345-SSA. We can answer most questions
over the phone. You can also write any Social Security office. The office that serves
your area is located at:
City, State Zip
If you do call or visit an office, please have this letter with you. It will help
us answer your questions. Also, if you plan to visit an office, you may call ahead
to make an appointment at the office. This will help us serve you more quickly when
you arrive at the office.