NL 00720: Manual Adjustment, Credit and Award Process (MADCAP) Beneficiary Notice Print Program
BASIC (05-11)
CLO002 GENERAL CLOSEOUT FOR AWARDS (G19)
(System Generated)
Caption: Other Social Security Benefits
(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-in values:
Fill-in (1) - Systems Generated
Choice 1: This benefit is the only benefit
Choice 2: These benefits are the only benefits
Fill-in (2) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (3) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (4) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
CLO029 AD, B TO D, AND AB TO AD CONVERSION HIGHER BENEFITS POSSIBLE ON PRIOR SPOUSE'S RECORD (B35)
(Requested)
Caption: Other Social Security Benefits
If (1) married more than once, please contact us. (2) may be able to get a higher benefit on the record of a prior spouse.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you were
Choice 2: he was
Choice 3: she was
Fill-in (2) - Systems Generated
Choice 1: You
Choice 2: He
Choice 3: She
CLOR05 CLOSE OUT ANOTHER CLAIM PENDING (B56)
(Requested)
Caption: Other Social Security Benefits
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-in values:
Fill-in (1) - Requested As A One Position Alpha Character
Choice 1: (A) retirement
Choice 2: (B) wife
Choice 3: (C) husband
Choice 4: (D) widow
Choice 5: (E) widower
Choice 6: (F) mother
Choice 7: (G) father
Choice 8: (H) child
Choice 9: (I) children
Choice 10: (J) parent
Fill-in (2) - Systems Generated
Choice 1: you
Choice 2: him
Choice 3: her
Fill-in (3) - Systems Generated
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (4) - Requested As A One Position Alpha Character
Choice 1: (A) retirement
Choice 2: (B) wife
Choice 3: (C) husband
Choice 4: (D) widow
Choice 5: (E) widower
Choice 6: (F) mother
Choice 7: (G) father
Choice 8: (H) child
Choice 9: (I) children
Choice 10: (J) parent
Fill-in (5) - Systems Generated
Choice 1: You
Choice 2: He
Choice 3: She
Fill-in (6) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
CLOR11 AWARD CLOSEOUT OTHER POTENTIAL CLAIM GIVEN 6-MONTH CLOSEOUT (B11)
(Requested)
Caption: Other Social Security Benefits
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-in values:
Fill-in (1) - Systems Generated
Choice 1: retirement
Choice 2: disability
Fill-in (2) - Systems Generated
Choice 1: you
Choice 2: Beneficiary name
Fill-in (3) - Systems Generated
Choice 1: are
Choice 2: is
Fill-in (4) - Requested As A One Position Alpha Character
Choice 1: (A) retirement
Choice 2: (B) disability
Choice 3: (C) spouse’s
Choice 4: (D) widow’s
Choice 5: (E) widower’s
Choice 6: (F) mother’s
Choice 7: (G) father’s
Choice 8: (H) child’s
Choice 9: (I) parent’s
Choice 10: (J) disabled widow’s
Choice 11: (K) disabled widower’s
Choice 12: (L) disabled divorced widow’s
Choice 13: (M) disabled divorced widower’s
Fill-in (5) - Systems Generated
Choice 1: retirement
Choice 2: disability
Fill-in (6) - Systems Generated
Choice 1: for
Choice 2: null
Fill-in (7) - Systems Generated
Choice 1: Beneficiary name
Choice 2: null
Fill-in (8) - Requested As A One Position Alpha Character
Choice 1: (A) retirement
Choice 2: (B) disability
Choice 3: (C) spouse’s
Choice 4: (D) widow’s
Choice 5: (E) widower’s
Choice 6: (F) mother’s
Choice 7: (G) father’s
Choice 8: (H) child’s
Choice 9: (I) parent’s
Choice 10: (J) disabled widow’s
Choice 11: (K) disabled widower’s
Choice 12: (L) disabled divorced widow’s
Choice 13: (M) disabled divorced widower’s
Fill-in (9) - Systems Generated
Choice 1: for him
Choice 2: for her
Choice 3: null
Fill-in (10) - Systems Generated
Choice 1: retirement
Choice 2: disability
Fill-in (11) - Requested As A One Position Alpha Character
Choice 1: (A) retirement
Choice 2: (B) disability
Choice 3: (C) spouse’s
Choice 4: (D) widow’s
Choice 5: (E) widower’s
Choice 6: (F) mother’s
Choice 7: (G) father’s
Choice 8: (H) child’s
Choice 9: (I) parent’s
Choice 10: (J) disabled widow’s
Choice 11: (K) disabled widower’s
Choice 12: (L) disabled divorced widow’s
Choice 13: (M) disabled divorced widower’s
CLOR12 AWARD CLOSEOUT POTENTIAL AUXILIARY AND FAMILY CLAIM GIVEN 6-MONTH CLOSEOUT (B12)
(Requested)
Caption: Other Social Security Benefits
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-in values:
Fill-in (1) - Systems Generated
Choice 1: retirement
Choice 2: disability
Fill-in (2) - Systems Generated
Choice 1: you and your family
Choice 2: Number Holder's Fullname
Fill-in (3) - Systems Generated
Choice 1: and his
Choice 2: and her
Choice 3: null
Fill-in (4) - Requested As A One Position Alpha Character
Choice 1: (A) wife's
Choice 2: (B) husbands
Choice 3: (C) child's
Fill-in (5) - Systems Generated
Choice 1: retirement
Choice 2: disability
Fill-in (6) - Systems Generated
Choice 1: for
Choice 2: null
Fill-in (7) - Systems Generated
Choice 1: Number Holder's fullname
Choice 2: null
Fill-in (8) - Requested As A One Position Alpha Character
Choice 1: (A) you
Choice 2: (B) your wife
Choice 3: (C) your husband
Choice 4: (D) your child
Fill-in (9) - Requested As A One Position Alpha Character
Choice 1: (A) wife's
Choice 2: (B) husbands
Choice 3: (C) child's
Fill-in (10) - Requested As A One Position Alpha Character
Choice 1: (A) you change your
Choice 2: (B) your wife changes her
Choice 3: (C) your husband changes his
Choice 4: (D) your child changes his
Choice 5: (E) your child changes her
Fill-in (11) - Systems Generated
Choice 1: you need
Choice 2: he needs
Choice 3: she needs
Fill-in (12) - Requested As A One Position Alpha Character
Choice 1: (A) you apply
Choice 2: (B) your wife applies
Choice 3: (C) your husband applies
Fill-in (13) - Systems Generated
Choice 1: retirement
Choice 2: disability
Fill-in (14) - Systems Generated
Choice 1: for
Choice 2: null
Fill-in (15) - Systems Generated
Choice 1: Number Holder's Surname
Fill-in (16) - Requested As A One Position Alpha Character
Choice 1: (A) wife's
Choice 2: (B) husbands
Choice 3: (C) child's
CLOR13 LUMP-SUM DEATH PAYMENT AWARD CLOSEOUT OTHER POTENTIAL CLAIM GIVEN 6-MONTH CLOSEOUT (B13)
(Requested)
Caption: Other Social Security 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-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Fullname
Fill-in (2) - Systems Generated
Choice 1: are
Choice 2: is
Fill-in (3) - Systems Generated
Choice 1: retirement
Choice 2: disability
Fill-in (4) - Systems Generated
Choice 1: for
Choice 2: null
Fill-in (5) - Systems Generated
Choice 1: Surname
Choice 2: null
Fill-in (6) - Systems Generated
Choice 1: wife's
Choice 2: husbands
Choice 3: child's
Fill-in (7) - Systems Generated
Choice 1: for him
Choice 2: for her
Choice 3: null
Fill-in (8) - Systems Generated
Choice 1: wife's
Choice 2: husbands
Choice 3: child's
CLOR20 AUXILIARY CLAIMANT NOT INSURED ON OWN RECORD (Q04)
(Requested)
Caption: Your Benefits
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-in values:
Fill-in (1) - Requested As A Number
Choice 1: required QCs
Fill-in (2) - Requested As A Number
Choice 1: acquired QCs