NL 00720: Manual Adjustment, Credit and Award Process (MADCAP) Beneficiary Notice Print Program
TN 2 (09-11)
TER001 CHILD TERMINATED AGE 18 OR 19(T01)
(System Generated)
Caption: Your Benefits
(1) (2) no longer entitled to Social Security benefits beginning (3) . (4) benefits are stopping because in that month (5) . (6) years old, and not disabled, and not a full-time elementary or secondary level school student.
Fill-in values:
Fill-in (1)
Choice 1: Beneficiary's full Name
Choice 2: You
Fill-in (2)
Choice 1: is
Choice 2: are
Fill-in (3)
Month of termination
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
Fill-in (6)
Choice 1: 18
Choice 2: 19
TER002 CHILD TERMINATED NOT IN FULL-TIME ATTENDANCE (T02)
(System Generated)
Caption: Your Benefits
(1) (2) no longer entitled to Social Security benefits beginning (3) . (4) benefits are stopping in that month because: (5) not a full-time elementary or secondary level school student, and (6) not disabled.
Fill-in values:
Fill-in (1)
Choice 1: Beneficiary's Name
Choice 2: You
Fill-in (2)
Choice 1: is
Choice 2: are
Fill-in (3)
Month/Year
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
Fill-in (6)
Choice 1: he is
Choice 2: she is
Choice 3: you are
TER003 CHILD TERMINATED AFTER AGE 19(T04)
(Requested/Generated)
Caption: Your Benefits
(1) (2) no longer entitled to student benefits beginning (3) . Student benefits normally end with the payment before the month the student turns 19. But, (4) met an exception which allowed benefits to continue past that month. The exception allows benefits to continue
for two months after the student turns 19, or
until the end of the school term, whichever comes first.
However, if the school requires a student to reenroll each quarter or semester, benefits may continue until that quarter or semester ends. (5) no longer (6) the exception beginning (7) , so (8) student benefits end that month.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Beneficiary's name
Choice 2: You
Fill-in (2) - Systems Generated
Choice 1: is
Choice 2: are
Fill-in (3) - Requested As A Date In Format Shown Below
MM/CCYY (Month of termination)
Fill-in (4) - Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Choice 4: they
Fill-in (5) - Systems Generated
Choice 1: You
Choice 2: He
Choice 3: She
Choice 4: They
Fill-in (6) - Systems Generated
Choice 1: meet
Choice 2: meets
Fill-in (7) - Requested As A Date In Format Shown Below
MM/CCYY (Month of termination)
Fill-in (8) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Choice 4: their
TER010 SPOUSE OR SURVIVING DIVORCED MOTHER/FATHER TERMINATED CHILD AGE 16/18 NOT DISABLED (T03) (T36)
(Requested)
Caption: Your Benefits
(1) no longer entitled to Social Security benefits beginning (2) . To be entitled, (3) must be taking care of a child who is entitled to benefits. That child must be under age 16 or disabled. In (4) , (5) child (6) (7) .
Fill-in values:
Fill-in (1) – Systems Generated
Choice 1: Beneficiary's Name is
Choice 2: You are
Fill-in (2) – Systems Generated
TERM date in the format MMCCYY
Fill-in (3) – Systems Generated
Choice 1: he
Choice 2: she
Choice 3: you
Fill-in (4) – Systems Generated
TERM date in the format MMCCYY
Fill-in (5) – Systems Generated
Choice 1: his
Choice 2: her
Choice 3: your
Fill-in (6) - Requested As A One Position Alpha Character
Choice 1: (A) became age 16
Choice 2: (B) is no longer disabled
Choice 3: (C) longer qualifies for Social Security disability benefits
Fill-in (7) – Systems Generated
Null
TER016 STEPCHILD'S BENEFITS TERMINATED - NATURAL PARENT AND STEPPARENT DIVORCED (T05)
(Requested)
Caption: Your Benefits
We can no longer pay (1) because (2) and (3) were divorced in (4) .
Fill-in values:
Fill-in (1) – Systems Generated
Choice 1: you
Choice 2: Beneficiary's Name
Fill-in (2) – Systems Generated
Choice 1: your father
Choice 2: her father
Choice 3: his father
Choice 4: your mother
Choice 5: her mother
Choice 6: his mother
Fill-in (3) – Systems Generated
NH First + NH Last Name
Fill-in (4) – Systems Generated
Date
TER039 TERMINATION NOTICE - LEAD-IN (G54)
(System Generated)
Caption: None
We are writing to tell (1) that (2) for (3) benefits beginning (4) .
Fill-in values:
Fill-in (1)
you
Fill-in (2)
Choice 1: you no longer qualify
Choice 2: Beneficiary's name + no longer qualifies
Fill-in (3)
Choice 1: disability
Choice 2: retirement
Choice 3: wife’s
Choice 4: husband’s
Choice 5: child’s
Choice 6: widow’s
Choice 7: widower’s
Choice 8: mother’s
Choice 9: father’s
Choice 10: disabled widow’s
Choice 11: disabled widower’s
Choice 12: disabled divorced widow’s
Choice 13: disabled divorced widower’s
Choice 14: NULL
Fill-in (4)
MM/CCYY
TER040 CATEGORY D NOTICE LEAD-IN (G55)
(System Generated)
Caption: None
We are writing to tell (1) that beginning (2) we are stopping the (3) benefits which (4) received.
Fill-in values:
Fill-in (1)
Choice 1: you
Fill-in (2)
MM/CCYY
Fill-in (3)
Choice 1: disability
Choice 2: retirement
Choice 3: survivor
Fill-in (4)
Choice 1: you
Choice 2: Beneficiary's name
TER041 MARRIAGE OF BENEFICIARY (T11)
(System Generated)
Caption: Your Benefits
We can no longer pay (1) because (2) married in that month.
Fill-in values:
Fill-in (1)
Choice 1: you
Choice 2: Beneficiary's name
Fill-in (2)
Choice 1: you
Choice 2: he
Choice 3: she
Choice 4: Beneficiary's name
TER042 DIVORCE OF BENEFICIARY (T12)
(Requested)
Caption: Your Benefits
We can no longer pay (1) because (2) and (3) were divorced in that month.
Fill-in values:
Fill-in (1) – Systems Generated
Choice 1: you
Choice 2: Beneficiary's name non-possessive
Fill-in (2) – Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (3) – Systems Generated
NH's full name
TER043 DATE OF TERMINATION FOR AWARD LETTERS (T14)
(Requested)
Caption: Your Benefits
(1) no longer (2) for benefits beginning (3) .
Fill-in values:
Fill-in (1) – Systems Generated
Choice 1: You
Choice 2: Beneficiary's name
Fill-in (2) – Systems Generated
Choice 1: qualify
Choice 2: qualifies
Fill-in (3) Requested As A Date in Format Shown Below
MM/CCYY
TER044 WIDOW/WIDOWER CLAIMANT TERMINATED CHILD AGE 16 AND NOT DISABLED (T15)
(Requested)
Caption: Your Benefits
To be entitled to benefits as (1) (2) , (3) must be taking care of (4) child. And, that child must be under age 16 or disabled, and entitled to child's benefits from Social Security.
Fill-in values:
Fill-in (1) – Systems Generated
NH's name (possessive)
Fill-in (2) Requested As A One Position Alpha Character
Choice 1: (A) widow
Choice 2: (B) widower
Fill-in (3) – Systems Generated
Choice 1: you
Choice 2: he
Choice 3: she
Fill-in (4) – Systems Generated
Choice 1: his
Choice 2: her
TER045 DIB/CDB CESSATION WORK ACTIVITY NO TRIAL WORK PERIOD (T21)
(Requested)
Caption: Your Benefits
After reviewing all the information carefully, we have decided that (1) now able to work. (2) no longer disabled according to our rules as of (3) .
(4) entitled to checks for that month and the next two months. The last month for which (5) entitled to a check is (6) .
Fill-in values:
Fill-in (1) – Systems Generated
Choice 1: you are
Choice 2: Beneficiary's name is
Fill-in (2) – Systems Generated
Choice 1: You are
Choice 2: He is
Choice 3: She is
Fill-in (3) Requested As A Date In Format Shown Below
MM/CCYY
Fill-in (4) – Systems Generated
Choice 1: You are
Choice 2: He is
Choice 3: She is
Fill-in (5) – Systems Generated
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (6) Requested As A Date In Format Shown Below
MM/CCYY
TER046 DIB OR CDB CESSATION WHEREABOUTS UNKNOWN OR FAILURE TO COOPERATE REQUESTED INFORMATION NOT SUBMITTED (T23)
(Requested)
Caption: Your Benefits
We asked (1) to help us get information we need to decide if (2) still disabled because of health problems. (3) not (4) which we requested. Therefore, we have found that (5) not disabled according to our rules as of (6) .
(7) entitled to checks for that month and the next two months. The last month for which (8) entitled to a check is (9) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Beneficiary's name is
Fill-in (2) - Systems Generated
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (3) - Systems Generated
Choice 1: you have
Choice 2: he has
Choice 3: she has
Fill-in (4) - Requested As A One Position Alpha Character
Choice 1: (A) given us the information
Choice 2: (B) taken the medical examination
Fill-in (5) - Systems Generated
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (6) - Requested As A Date In Format MM/CCYY
Choice 1: MM/CCYY
Fill-in (7) - Systems Generated
Choice 1: You are
Choice 2: He is
Choice 3: She is
Fill-in (8) - Systems Generated
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (9) - Requested As A Date In Format MM/CCYY
Choice 1: MM/CCYY
TER047 INDIVIDUAL UNDER AGE 62 (T27)
(System Generated)
Caption: Things To Remember
If (1) (2) are again disabled according to our rules before (3) (4) (5) , (6) should apply again for disability benefits.
Fill-in values:
Fill-in (1)
Choice 1: you think
Choice 2: Beneficiary's name thinks
Fill-in (2)
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (3)
Choice 1: you reach
Choice 2: he reaches
Choice 3: she reaches
Fill-in (4)
Choice 1: age 65
Choice 2: full retirement age
Fill-in (5)
Choice 1: 66 and 2 months
Choice 2: null
Fill-in (6)
Choice 1: you
Choice 2: he
Choice 3: she
TER048 DIB CESSATION AUXILIARIES IN A SEPARATE HOUSEHOLD N/H NO LONGER DISABLED (T30)
(Requested)
Caption: Your Benefits
We recently reviewed (1) disability case. After reviewing all the information carefully, we decided (2) is no longer disabled according to our rules as of (3) .
You are entitled to checks for that month and the next two months. The last month for which you are entitled to a check is (4) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: N/H's name (possessive)
Fill-in (2) - Systems Generated
Choice 1: he
Choice 2: she
Fill-in (3) - Requested As A Date In Format Shown Below
Choice 1: MM/CCYY
Fill-in (4) - Requested As A Date In Format Shown Below
Choice 1: MM/CCYY
TER049 CESSATION AUXILIARIES IN SAME HOUSEHOLD N/H NO LONGER DISABLED (T31)
(Requested)
Caption: Your Benefits
Your (1) last check will be for the same months.
Fill-in values:
Fill-in (1) - Requested As A One Position Alpha Character
Choice 1: (A) family's
Choice 2: (B) wife's
Choice 3: (C) husband's
Choice 4: (D) children's
Choice 5: (E) child's
TER050 CDB REENTITLEMENT (T32)
(Requested)
Caption: Things To Remember
If your health gets worse and you think you are disabled again within 7 years, you might qualify again for benefits on (1) Social Security record. The 7-year period begins with the month after your last disability check on this record was due. After the period ends, you could only receive disability benefits if you worked long enough to qualify on your own Social Security record.
Fill-in values:
Fill-in(1) - Systems Generated
N/H's name (possessive)