NL 00720: Manual Adjustment, Credit and Award Process (MADCAP) Beneficiary Notice Print Program
BASIC (05-11)
WDS002 WORK DEDUCTIONS FOR 1995 AND 1996 - NO READJUSTMENT UNTIL 1996 (W78)
(Requested)
Caption: Your Benefits
Because (1) (2) not due benefits, benefits to other members of the household should be increased. However, for months before January 1996 we will pay (3) instead of increasing the benefits to other family members. Since this money is really due the other members of the household, it should be used only for their needs.
For benefits payable beginning January 1996, we can no longer pay you the increase due other family members. We must pay them directly because of a change in the law.
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: you
Choice 2: Beneficiary's Name
Fill-in (2) - Systems Generated
Choice 1: is
Choice 2: are
Fill-in (3) - Systems Generated
Choice 1:you
Choice 2: her
Choice 3: him
WDS016 (WC2) BOND
(Requested)
Caption: Your Benefits
(1) offset period this year is (2) .
We determine how much to reduce (3) benefit payments for each month in the offset period under the $1 for $2 offset based on an estimate of (4) BOND countable earnings for that period. To get this estimate, we use (5) estimate of total earnings for the offset period and subtract (6) estimate of the amount of allowable deductions for that period. The resulting amount is the estimate of (7) BOND countable earnings for the offset period. Some allowable deductions include the following:
The amount of any sick or vacation pay,
The amount of any subsidy paid by an employer who pays more in wages than the actual value of the work, and
Amounts (8) for items or services related to (9) disability that are needed to work. Some examples are prescription drugs, personal attendant, job coach, or a wheelchair.
After allowable deductions, (10) of BOND countable earnings for (11) offset period this year is (12) .
Since (13) offset period is less than the calendar year, we prorate the BOND yearly amount based on the number of months in (14) offset period and use that prorated amount to figure the benefit offset. We subtract the prorated BOND yearly amount from the estimate of (15) BOND countable earnings for the offset period and divide the remaining amount by two. We then divide that amount by the number of months in (16) offset period to determine the monthly offset amount. The monthly offset amount is the amount by which (17) benefits for each month in the offset period are reduced under the benefit offset. Based on the (18) of (19) BOND countable earnings and the computations above, (20) monthly offset amount for (21) offset period this year is (22) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Your
Choice 2: Name possessive
Fill-in (2) - Requested As A Date In Format Shown Below
Choice 1: MM/CCYY
Choice 2: MM/CCYY through MM/CCYY
Fill-in (3) - System Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (4) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (5) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (6) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (7) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (8) - Systems Generated
Choice 1: you pay
Choice 2: Name + pays
Fill-in (9) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (10) - Requested As A One Position Alpha Character
Choice 1: (A) your estimate
Choice 2: (A) Name possessive + estimate
Choice 3: (B) your revised estimate
Choice 4: (B) Name possessive + revised estimate
Fill-in (11) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (12) - Requested As A Money Amount In Format $$$$$.¢¢
Estimate/revised estimate of BOND countable earnings for offset period this year
Fill-in (13) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (14) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (15) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (16) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (17) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (18) - Systems Generated from fill-in (10)
Choice 1: (A) estimate
Choice 2: (B) revised estimate
Fill-in (19) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (20) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (21) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (22) - Requested As A Money Amount In Format $$$$$.¢¢
Monthly offset amount
WDS017 (WA1) BOND
(Requested)
Caption: Benefit Offset National Demonstration (BOND)
The BOND project offers qualified individuals a more generous treatment of earnings than under the current rules. A qualified individual is provided an opportunity to work and earn over (1) and benefit from having only $1 of benefits withheld for every $2 earned over this amount. Under current Social Security rules, the same qualified individual working and earning over (2) generally has his or her benefits stopped.
Fill-in values:
Fill-in (1)
BOND yearly amount
Fill-in (2)
BOND yearly amount
WDS018 (WC1) BOND
(Requested)
Caption: Your Benefits
(1) offset period this year is the entire calendar year.
We determine how much to reduce (2) benefit payments for each month in the year under the $1 for $2 offset based on an estimate of (3) BOND countable earnings for the year. To get this estimate, we use (4) estimate of total earnings for the year and subtract (5) estimate of the amount of allowable deductions for the year. The resulting amount is the estimate of (6) BOND countable earnings for the year. Some allowable deductions include the following:
The amount of any sick or vacation pay,
The amount of any subsidy paid by an employer who pays more in wages than the actual value of the work, and
Amounts (7) for items or services related to (8) disability that are needed to work. Some examples are prescription drugs, personal attendant, job coach, or a wheelchair.
After allowable deductions, (9) of BOND countable earnings for this year is (10) . .
Next, we subtract the BOND yearly amount from the estimate of (11) BOND countable earnings for the year and divide the remaining amount by two. We then divide that amount by twelve to determine the monthly offset amount. The monthly offset amount is the amount by which (12) benefits for each month in the year are reduced under the benefit offset. Based on the (13) of (14) BOND countable earnings and the computations above, (15) monthly offset amount this year is (16) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: Your
Choice 2: Name possessive
Fill-in (2) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (3) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (4) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (5) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Choice 3: his
Choice 4: her
Fill-in (6) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (7) - Systems Generated
Choice 1: you pay
Choice 2: Name + pays
Fill-in (8) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (9) - Requested As A One Position Alpha Character
Choice 1: (A) your estimate
Choice 2: (A) Name possessive + estimate
Choice 3: (B) your revised estimate
Choice 4: (B) Name possessive + revised estimate
Fill-in (10) - Requested As A Money Amount In Format $$$$$.¢¢
Estimate/revised estimate of BOND countable earnings for this year
Fill-in (11) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (12) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (13) - Systems Generated from Fill-in (9)
Choice 1: (A) estimate
Choice 2: (B) revised estimate
Fill-in (14) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (15) - Systems Generated
Choice 1: your
Choice 2: Name possessive
Fill-in (16) - Requested As A Money Amount In Format $$$$$.¢¢
Monthly offset amount
WDS019 PERMANENT DEDUCTIONS/PRIMARYWORKING/ ADJUSTMENT LETTER
TO AUXILIARY(W82)(W03)
(Requested)
Caption: Your Benefits
Based on (1) earnings for (2) , (3) of (4) benefits for that year should have been withheld. Since (5) of the benefits were withheld, (6) paid correctly.
Fill-in values:
Fill-in (1) Systems Generated
Choice 1: your
Choice 2: Beneficiary Name possessive
Fill-in (2) Requested As A Year In Format Shown Below
CCYY
Fill-in (3) Requested As A One Position Alpha Character
Choice 1: (A) all
Choice 2: (B) some
Fill-in (4) Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (5) Requested As A One Position Alpha Character
Choice 1: (A) all
Choice 2: (B) some
Fill-in (6) Systems Generated
Choice 1: you were
Choice 2: he was
Choice 3: she was
WDS020 PERMANENT DEDUCTIONS/PRIMARYWORKING/ ADJUSTMENT LETTER TO AUXILIARY(W84)(W03)
(Requested)
Caption:
Based on (1) earnings for (2) , (3) of (4) benefits for that year should have been withheld. Since (5) of the benefits were withheld, (6) overpaid (7) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: your
Choice 2: Beneficiary Name possessive
Fill-in (2)- Requested As A Year In Format Shown Below
CCYY
Fill-in (3) - Requested As A One Position Alpha Character or Money Amount
Choice 1 (A): all
Choice 2 (B): none
Choice 3 (C): some
Choice 4: money amount
Fill-in (4) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (5) - Requested As A One Position Alpha Character
Choice 1 (A): all
Choice 2 (B): none
Choice 3:(C) some
Fill-in (6) - Systems Generated
Choice 1: you were
Choice 2: he was
Choice 3: she was
Fill-in (7)- Requested As A Money Amount In Format $$$$$.¢¢
Amount of overpayment
WDS021 PERMANENT DEDUCTIONS/PRIMARYWORKING/ ADJUSTMENT LETTER TO AUXILIARY (W87) (W03)
(Requested)
Caption:
Based on (1) earnings for (2) , (3) of (4) benefits for that year should have been withheld. Since (5) of the benefits were withheld, (6) due (7) .
Fill-in values:
Fill-in (1) - Systems Generated
Choice 1: your
Choice 2: Beneficiary Name possessive
Fill-in (2)- Requested As A Year In Format Shown Below
CCYY
Fill-in (3) - Requested As A One Position Alpha Character or Money Amount
Choice 1 (A): all
Choice 2 (B): none
Choice 3 (C): some
Choice 4: money amount
Fill-in (4) - Systems Generated
Choice 1: your
Choice 2: his
Choice 3: her
Fill-in (5) - Requested As A One Position Alpha Character
Choice 1: (A) all
Choice 2: (B) none
Choice 3: (C) some
Fill-in (6) - Systems Generated
Choice 1: you are
Choice 2: he is
Choice 3: she is
Fill-in (7) - Requested As A Money Amount In Format $$$$$.¢¢
Amount of underpayment