UPT003 – TELLS THE BENEFICIARY HIS OR HER UNDERPAYMENT AMOUNT
(1), we owe you (2).
Fill-in values:
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Fill-in (1)
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Choice 1
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As a result
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Choice 2
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After all adjustments
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Fill-in (2)
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Prior Monthly Accrual (PMA) amount
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UPT006 – WIDOW(ER)'S INCREASE IN BENEFITS DUE TO THE DECEASED NUMBER HOLDER'S DELAYED
RETIREMENT CREDIT (DRC) OR ADJUSTMENT OF REDUCTION FACTOR (ARF). THIS UTI CAN APPEAR
ONLY ON A WIDOW(ER)'S NOTICE.
We have refigured and increased the monthly benefit (1) on (2) deceased spouse's Social
Security record to (3). This increase is for (4) on. This means that we owe (5) money
dating back to this time.
Fill-in values:
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Fill-in (1)
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Choice 1
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Beneficiary’s Given Name (BGN) plus Beneficiary’s Last Name (BLN) plus “receives”
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Choice 2
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you receive
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Fill-in (2)
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Choice 1
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his
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Choice 2
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her
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Choice 3
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your
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Fill-in (3)
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Post-MBR Monthly Benefit Amount (MBA) associated with the Effective Date of the MBA
change in the format $$$$$$.¢¢
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Fill-in (4)
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Effective Date (EFD) on the post-MBR associated with the Monthly Benefit Amount (MBA)
change in the format Month CCYY
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Fill-in (5)
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Choice 1
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him
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Choice 2
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her
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Choice 3
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you
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