SUSC02 – CAPTION
We May Be Able To Pay (1) Again
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
You
|
SUS013 – SUSPENSION HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
WAIVER OF BENEFIT PAYMENTS (WAIVER)
If (1) to receive (2) benefits, we will pay benefits beginning with the month we receive
a signed statement from you (3) asking for the benefits.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) plus “decides”
|
Choice 2
|
you decide
|
Fill-in (2)
|
|
Choice 1
|
his
|
Choice 2
|
her
|
Choice 3
|
your
|
Fill-in (3)
|
|
Choice 1
|
“or” plus Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
Null
|
SUS014 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF NO
CHILD IN CARE (NOCICS)
We cannot pay (1) because (2) not taking care of a child who (3) entitled to Social
Security benefits.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he is
|
Choice 2
|
she is
|
Choice 3
|
you are
|
Choice 4
|
he was
|
Choice 5
|
she was
|
Choice 6
|
you were
|
Fill-in (3)
|
|
Choice 1
|
is
|
Choice 2
|
are
|
SUS025 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
PAYEE DEVELOPMENT (DEVPYE) OR DEATH OF PAYEE (DTHPYE) - NO DAA BENEFICIARY OR
SUSPENSION HRFST OF PAYEE IS A FUGITIVE FELON (RPFUGF)
The person who received your payments will no longer be your representative payee.
We are looking for another qualified person to receive your payments and use them
for your needs.
SUS026 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
PAYEE DEVELOPMENT (DEVPYE) - NO DAA BENEFICIARY
We have determined that you need help managing your payments. We will be selecting
a qualified person to receive your payments. We call this person a representative
payee. It will be your payee's duty to manage your (1) payments for you and use them
for your needs.
Fill-in values:
|
|
Fill-in (1)
|
Social Security
|
SUS027 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
PAYEE DEVELOPMENT (DEVPYE) OR DEATH OF PAYEE (DTHPYE)
When we begin your (1) payments again, you will be paid all the money that is due
you. When we make a decision about your payee, we will send you another letter. This
letter will explain what you can do if you disagree with our payee decision.
Fill-in values:
|
|
Fill-in (1)
|
Social Security
|
SUS035 – AUXILIARY (AUX) SUSPENDED - HISTORY REASON FOR
SUSPENSION OR TERMINATION (HRFST) OF DEVDIB DUE TO NUMBER
HOLDER'S (NH) CDR OR AUX SUSPENDED - HRFST OF CDRFTC DUE TO NH'S FAILURE TO
COOPERATE OR PIC B/E SUSPENDED HRFST OF CDRFTC DUE TO PIC C (CDB) FAILURE TO
COOPERATE OR AUX SUSPENDED - HRFST OF MISC DUE TO NH'S REQUEST FOR
MEDICARE ONLY STATUTORY BENEFIT CONTINUATION DURING AN APPEAL OF A DIBCESS DECISION
We cannot pay further benefits until we can study the facts and decide whether (1)
still meets the requirements to receive disability benefits. We will let you know
when we make this decision and will tell you whether we can start (2) benefits again.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
NH-NAME
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) for PIC C with the
BCLM-CEC = B (disabled)
|
Fill-in (2)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Choice 2
|
your
|
SUS040 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
TREASURY BARRED (BARRED)
We cannot pay (1) benefits because the rules of the United States Treasury Department
do not allow payment while (2) (3) in (4). We will let you know if the tax rules change.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (3)
|
|
Choice 1
|
lives
|
Choice 2
|
live
|
Fill-in (4)
|
|
Choice 1
|
Cuba
|
Choice 2
|
North Korea
|
SUS041 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
FOREIGN ENFORCEMENT REPORT NOT RETURNED (FORENF)
We cannot pay (1) benefits because (2) (3) not returned the form, “Report to United
States Social Security Administration.” We need the information requested on this
form to decide if (4) can receive benefits again.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (3)
|
|
Choice 1
|
has
|
Choice 2
|
have
|
Fill-in (4)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
SUS045 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
ENTITLEMENT TO HIGHER BENEFITS ON ANOTHER ACCOUNT (T5NENT) OR TECHNICAL ENTITLEMENT
(TECENT)
We cannot pay benefits because (1) (2) eligible for a higher benefit on another record.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
is
|
Choice 2
|
are
|
SUS047 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
GOVERNMENT PENSION OFFSET (GPOOFF)
We cannot pay benefits because (1) (2) eligible for a government pension that is equal
to or greater than the monthly Social Security benefit.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
is
|
Choice 2
|
are
|
SUS052 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
DOMESTIC WORK (DOMWRK) OR FOREIGN WORK (FORWRK)
We cannot pay benefits because of (1) work.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
your
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Choice 3
|
NH’s Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
SUS054 – HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF NON-RESPONDER
TO RECONTACT FORM (RECONT) OR TERMINATION BASED ON NON-RESPONSE TO RECONTACT NOTICE
(RECONM) FOR PIC E OR PIC C AND NO PAYEE INVOLVED
We cannot pay (1) benefits because (2) (3) not returned the form, SSA-1588 “Beneficiary
Recontact Report”. We need the information requested on this form to decide if (4)
can receive benefits again.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (3)
|
|
Choice 1
|
has
|
Choice 2
|
have
|
Fill-in (4)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
SUS055 – HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF NON-RESPONDER
TO RECONTACT FORM (RECONT) OR TERMINATION BASED ON NON-RESPONSE TO RECONTACT NOTICE
(RECONM) FOR PIC C AND PAYEE INVOLVED
We cannot pay (1) benefits because (2) (3) not returned the Form SSA-1587 “Beneficiary
Recontact Report.” We need the information requested on this form to decide if (4)
can receive benefits again.
Fill-in values:
|
|
Fill-in (1)
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Fill-in (2)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Fill-in (3)
|
|
Choice 1
|
has
|
Choice 2
|
have
|
Fill-in (4)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
SUS068 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF NO
CHILD IN CARE (NOCICS)
Please let us know if you are taking care of a child again who is entitled to benefits
and under 16 or disabled. We may be able to pay you again.
SUS069 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
SUSPENSION FOR CDR (DEVDIB) (HA, CDB, WIDOW'S DIB) NO DAA
We cannot pay (1) benefits because our records show that (2):
-
•
did not return information we asked for; or
-
-
-
•
(5) could not be located.
We cannot pay benefits because we must study the facts and decide whether (6) still
(7) the requirements to receive disability benefits.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (3)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (4)
|
|
Choice 1
|
his
|
Choice 2
|
her
|
Choice 3
|
your
|
Fill-in (5)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (6)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (7)
|
|
Choice 1
|
meets
|
Choice 2
|
meet
|
SUS070 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
WHEREABOUTS UNKNOWN (WHEREU), ADDRESS DEVELOPMENT (DEVADD), AGE DEVELOPMENT
(DEVAGE), PENDING DISABILITY DETERMINATION (DISDET), DUAL ENTITLEMENT POTENTIAL
WIDOW (CERTEL)
We cannot pay (1) starting (2). We need more information before we can start (3) payments
again.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
you
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Fill-in (2)
|
Date of Suspension
|
Fill-in (3)
|
|
Choice 1
|
your
|
Choice 2
|
his
|
Choice 3
|
her
|
SUS071 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
BARRED (SSA)
We cannot pay benefits because Social Security rules do not allow payment while a
beneficiary lives or lived in a barred country.
SUS072 – SUSPENSION LEAD - FOLLOW BY SPECIFIC UTI
Based on the information we have, we cannot pay benefits (1) (2) (3) (4).
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
beginning
|
Choice 2
|
for
|
Fill-in (2)
|
|
Choice 1
|
Date of Suspension or Termination (DOST) that corresponds to the ongoing suspension
in the format Month CCYY
|
Choice 2
|
NA-HIST-START date in the format Month CCYY
|
Fill-in (3)
|
|
Choice 1
|
and
|
Choice 2
|
through
|
Choice 3
|
Null
|
Fill-in (4)
|
|
Choice 1
|
NA-HIST-STOP date in the format Month CCYY
|
Choice 2
|
Null
|
SUS073 – RESUMPTION OR REINSTATEMENT OF BENEFITS
Based on the information we have, we can pay benefits (1) (2) (3) (4).
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
beginning
|
Choice 2
|
for
|
Fill-in (2)
|
|
Choice 1
|
First Effective Date (EFD) in History data that corresponds to the reinstatement period
|
Choice 2
|
NH-HIST-START date in the format Month CCYY for the embedded reinstatement period
|
Fill-in (3)
|
|
Choice 1
|
and
|
Choice 2
|
through
|
Choice 3
|
Null
|
Fill-in (4)
|
|
Choice 1
|
NA-HIST-STOP date for the embedded reinstatement period in the format Month CCYY
|
Choice 2
|
Null
|
SUS074 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
NOT LAWFULLY PRESENT (NOTLAW)
We cannot pay (1) benefits because (2) not lawfully present in the U.S.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he is
|
Choice 2
|
she is
|
Choice 3
|
you are
|
SUS075 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
NOT A U.S. CITIZEN (NOUSCP)
We cannot pay (1) benefits because (2) not a U.S. citizen.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he is
|
Choice 2
|
she is
|
Choice 3
|
you are
|
SUS076 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
LEF U.S. ALIEN SUSPENSION (ALNSUS)
We cannot pay (1) benefits because (2) not a United States citizen and (3) been outside
the United States for more than 6 months.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he is
|
Choice 2
|
she is
|
Choice 3
|
you are
|
Fill-in (3)
|
|
Choice 1
|
has
|
Choice 2
|
have
|
SUS077 – ONGOING VOLUNTARY SUSPENSION TO EARN DELAYED RETIREMENT CREDITS (VOLDRC
or LEGIS1)
We received (1) request to suspend (2) retirement benefits to earn delayed retirement
credits. Suspending these benefits will also stop payments to (3) on any other record
on which (4) entitled. We will restart (5) benefits at the earlier of:
-
-
•
The month after (7) for payments to restart.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
your
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Fill-in (2)
|
|
Choice 1
|
your
|
Choice 2
|
his
|
Choice 3
|
her
|
Fill-in (3)
|
|
Choice 1
|
you
|
Choice 2
|
him
|
Choice 3
|
her
|
Fill-in (4)
|
|
Choice 1
|
you are
|
Choice 2
|
he is
|
Choice 3
|
she is
|
Fill-in (5)
|
|
Choice 1
|
your
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Fill-in (6)
|
|
Choice 1
|
you reach
|
Choice 2
|
he reaches
|
Choice 3
|
she reaches
|
Fill-in (7)
|
|
Choice 1
|
you ask
|
Choice 2
|
he asks
|
Choice 3
|
she asks
|
SUS078 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
MONTHLY BENEFIT AMOUNT (MBA) < $1.00 (LESSDO) AND HIB225 OR HIB226 NOT
USED
We cannot pay (1) beginning (2) because (3) monthly payment is less than a dollar.
At the end of the year, we will adjust (4) record and pay all money (5) due.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
Effective Date (EFD) in History (HIST) Data on the post-MBR that corresponds to the
HRFST LESSDO in format Month CCYY
|
Fill-in (3)
|
|
Choice 1
|
his
|
Choice 2
|
her
|
Choice 3
|
your
|
Fill-in (4)
|
|
Choice 1
|
his
|
Choice 2
|
her
|
Choice 3
|
your
|
Fill-in (5)
|
|
Choice 1
|
he is
|
Choice 2
|
she is
|
Choice 3
|
you are
|
SUS079 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
WAIVER
We are withholding (1) benefits because (2) requested us to do so.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Choice 2
|
your
|
Fill-in (2)
|
|
Choice 1
|
he has
|
Choice 2
|
she has
|
Choice 3
|
you have
|
SUS080 – SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF
PREDATOR (PREDTR)
We cannot pay (1) because:
-
•
(2) convicted of a crime and confined in a jail or prison;
-
•
The crime included sexual activity, and
-
•
When (3) completed (4) sentence, (5) immediately sent by court order to an institution
at public expense.
-
•
The court decided (6) a sexually dangerous person.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
He was
|
Choice 2
|
She was
|
Choice 3
|
You were
|
Fill-in (3)
|
|
Choice 1
|
he
|
Choice 2
|
she
|
Choice 3
|
you
|
Fill-in (4)
|
|
Choice 1
|
his
|
Choice 2
|
her
|
Choice 3
|
your
|
Fill-in (5)
|
|
Choice 1
|
he was
|
Choice 2
|
she was
|
Choice 3
|
you were
|
Fill-in (6)
|
|
Choice 1
|
he is
|
Choice 2
|
she is
|
Choice 3
|
you are
|
SUS084 – HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST) OF VOLUNTARY
SUSPENSION TO EARN DELAYED RETIREMENT CREDIT (VOLDRC or LEGIS1) FOR AN EMBEDDED
PERIOD OF SUSPENSION
We received (1) request to suspend (2) retirement benefits for (3) to earn delayed
retirement credits. Suspending these benefits will also stop payments to (4) on any
other record on which (5) entitled. We will restart (6) benefits for (7) in (8), unless
(9) us to restart (10) benefits earlier.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
your
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Fill-in (2)
|
|
Choice 1
|
your
|
Choice 2
|
his
|
Choice 3
|
her
|
Fill-in (3)
|
|
Choice 1
|
If one month of suspension, show the Effective Date (EFD) in History Data that corresponds
to the embedded month of VOLDRC or LEGIS1 suspension in Month CCYY format
|
Choice 2
|
If two or more months of suspension, show the first Effective Date (EFD) in History
Data that corresponds to the embedded period of VOLDRC or LEGIS1 suspension in Month
CCYY format plus the word “through” and ending with the last Effective Date (EFD)
in History Data that corresponds to the embedded period of VOLDRC or LEGIS1 in Month
CCYY format
|
Fill-in (4)
|
|
Choice 1
|
you
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (non-possessive)
|
Fill-in (5)
|
|
Choice 1
|
you are
|
Choice 2
|
he is
|
Choice 3
|
she is
|
Fill-in (6)
|
|
Choice 1
|
your
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Fill-in (7)
|
Show the first Effective Date (EFD) in History Data after the embedded period where
VOLDRC or LEGIS1 suspension is not present in Month CCYY format
|
Fill-in (8)
|
Show the first Effective Date (EFD) in History Data after the embedded period where
VOLDRC or LEGIS1 suspension is not present plus one month in Month CCYY format
|
Fill-in (9)
|
|
Choice 1
|
you ask
|
Choice 2
|
he asks
|
Choice 3
|
she asks
|
Fill-in (10)
|
|
Choice 1
|
your
|
Choice 2
|
his
|
Choice 3
|
her
|
SUS087 – PIC A SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION (HRFST)
OF DEPORTATION (DEPORT) – ONGOING OR EMBEDDED PERIOD OF SUSPENSION
We cannot pay (1) benefits because (2) deported or removed from the United States
under one of the following sections of the Immigration and Nationality Act (INA):
-
•
Section 241(a) of the INA in effect prior to April 1, 1997;
-
-
This is based on information from the U.S. Department of Homeland Security. Please
get in touch with us if in the future (3) permitted to return to the United States
as a lawful permanent resident. Benefits may again be payable at that time.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
|
Choice 1
|
he was
|
Choice 2
|
she was
|
Choice 3
|
you were
|
Fill-in (3)
|
|
Choice 1
|
he is
|
Choice 2
|
she is
|
Choice 3
|
you are
|
SUS088 – AUXILIARY SUSPENSION - HISTORY REASON FOR SUSPENSION OR TERMINATION
(HRFST) OF DEPORTATION (DEPORT) – ONGOING OR EMBEDDED PERIOD OF
SUSPENSION
No benefits are payable to (1) because (2) was deported or removed from the United
States. Please get in touch with us if (3) a U.S. citizen or (4) in the United States
for a full calendar month or more without leaving for any period, no matter how short.
Benefits may again be payable at that time.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
|
Choice 2
|
you
|
Fill-in (2)
|
NH-NAME
|
Fill-in (3)
|
|
Choice 1
|
BGN plus “becomes”
|
Choice 2
|
you become
|
Fill-in (4)
|
|
Choice 1
|
he stays
|
Choice 2
|
she stays
|
Choice 3
|
you stay
|
SUS099 –SUSPENSION – DIRECT DEPOSIT FRAUD
We stopped (1) Social Security benefits because of possible fraud on (2) record. Please
contact us right away. We need to verify your direct deposit information before we
can resume (3) benefits.
Fill-in values:
|
|
Fill-in (1)
|
|
Choice 1
|
your
|
Choice 2
|
Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Fill-in (2)
|
|
Choice 1
|
your
|
Choice 2
|
his
|
Choice 3
|
her
|
Fill-in (3)
|
|
Choice 1
|
your
|
Choice 2
|
his
|
Choice 3
|
her
|
SUS100 –SUSPENSION OF AUXILIARY’S BENEFITS - NUMBER HOLDER (NH) REQUESTS
VOLUNTARY SUSPENSION TO EARN DELAYED RETIREMENT CREDITS (LEGIS1)
We received (1) request to suspend (2) benefits to earn delayed retirement credits.
As a result, we must suspend the benefits (3) on (4) record. We will restart (5) benefits
with the earlier of:
-
•
The month (6) reaches age 70, or
-
•
The month after (7) asks for payments to restart.
Fill-in values:
|
|
Fill-in (1)
|
Number Holder (NH) Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
(possessive)
|
Fill-in (2)
|
|
Choice 1
|
his
|
Choice 2
|
her
|
Choice 3
|
Null
|
Fill-in (3)
|
|
Choice 1
|
you receive
|
Choice 2
|
Auxiliary Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) receives
(not possessive)
|
Fill-in (4)
|
Number Holder (NH) Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
(possessive)
|
Fill-in (5)
|
|
Choice 1
|
your
|
Choice 2
|
Auxiliary Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) (possessive)
|
Fill-in (6)
|
Number Holder (NH) Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
(not possessive)
|
Fill-in (7)
|
Number Holder (NH) Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN)
(not possessive)
|