Beneficiary Recontact Report

Post-Entitlement Online System (POS) screen shots for the Beneficiary Recontact process. Please note these screens are labled as Sensitive Not To Be Shared With The Public.

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FACSIMILE:  PECI - POS CHILD IN CARE ISSUES

POS                    POS CHILD IN CARE ISSUES                              PECI

[1-D]                             [2-D]                                 [3-D]

NH: SSSSSSSSS SSSSS SSSSSSSSSS    BN: SSSSSSSSS SSSSS SSSSSSSSSS        PIC: SSS

 [4-D]

[ SCREEN                                                             CHOOSE (Y)

[5-M]

| DEPENDENT CHILD IN CARE                                             X

| DEPENDENT CHILD LEFT CARE - SUSPENSION/REINSTATEMENT (LAF-S4)       X

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FACSIMILE:  DCLC - DEPENDENT CHILD LEFT CARE

COMM                       DEPENDENT CHILD LEFT CARE                  DCLC

[1-D]                            [2-D]                                 [3-D]

NH: SSSSSSSSS SSSSS SSSSSSSSSS   BN: SSSSSSSSS SSSSS SSSSSSSSSS        PIC: SSS

 

                             LEFT CARE

ALL ENTITLED CHILDREN OF N H UNDER AGE 16 OR DISABLED LEFT CLAIMANT’S CARE

  [4-M]

  LEFT CARE EFFECTIVE MONTH (MMCCYY): 999999

                           RETURN TO CARE

ENTITLED CHILD OF N H UNDER AGE 16 OR DISABLED RETURNED TO CLAIMANT’S CARE

[5-O]

RETURN TO CARE EFFECTIVE MONTH (MMCCYY): 999999

                 RESUMPTION OF CHILD IN CARE

[6-O]

RESUME IN CARE EFFECTIVE WITH FIRST LEFT CARE MONTH (Y): X

[7-O]

REMARKS: XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXx

[8-O]

DELETE THIS OCCURRENCE OF DATA (Y/N): X

[9-O]                                    [10-O]

ADD NEW OCCURRENCE (Y/N): X              REVIEW PRIOR OCCURRENCES (Y/N): X

[11-D]                                                       [12-O]

PF1 HELP AVAILABLE                                           TRANSFER TO: XXXX

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FACSIMILE:  BMAR-BENEFICIARY MARRIAGE

COMM                        BENEFICIARY MARRIAGE                          BMAR

[1-D]                            [2-D]                                [3-D]

NH:  SSSSSSSSS SSSSS SSSSSSSSSS   BN:  SSSSSSSSS SSSSS SSSSSSSSSS     PIC: SSS

[4-M]                                   [5-M]     [6-M]

*SPOUSE’S FIRST NAME: XXXXXXXXXXXXXXX   MIDDLE: X *LAST: XXXXXXXXXXXXXXXXXXXX

[7-O]

SPOUSE’S SSN: XXXXXXXXX

[8-O]                                     [9-O]

SPOUSE’S BIRTHDATE (MMDDCCYY): 99999999   iF BIRTHDATE UNKNOWN, AGE: 999

[10-M]                                 [11-M]

*MARRIAGE DATE (MMDDCCYY): 99999999    *PROOF (Y/N): x

[12-O]                                 [13-O]

MARRIAGE CITY: XXXXXXXXXXXXXXX         MARRIAGE STATE/FOREIGN COUNTRY: XX

[14-M]

*SELECT MARRIAGE TYPE: 9   1=CLERGY/PUBLIC OFFICIAL    3=OTHER CEREMONIAL

                           2=COMMON LAW              4=DEEMED.

[15-O]

SELECT SPECIAL RELATIONSHIP: 9   1=216B1  2=216F1  3=202C2  4=216K  5=216C2/G2.

[16-O]

PROTECTED MARRIAGE (Y/N): x

[17-O]                                      [18-C]

MARRIAGE END DATE (MMDDCCYY): 99999999      PROOF (Y/N): x

[19-C]

SELECT MARRIAGE END REASON: 9

1=DEATH   2=DIVORCE   3=ANNULMENT OF VOIDABLE   4=PUTATIVE   5=VOID/VOIDED.

[20-O]                                 [21-C]

MARRIAGE ENDED CITY: XXXXXXXXXXXXXXX   MARRIAGE ENDED STATE/FOREIGN COUNTRY: XX

[22-O]

IF SPOUSE DECEASED, DATE OF DEATH (MMDDCCYY): 99999999

[23-M]

*OTHER MARRIAGES (Y/N): x

[24-O]

DELETE THIS OCCURRENCE OF DATA (Y/N): x

[25-O]                                      [26-O]

ADD NEW OCCURRENCE (Y/N): x                 REVIEW PRIOR OCCURRENCES (Y/N): x

[27-D]                                                     [28-O]

PF1 HELP AVAILABLE                                         TRANSFER TO: XXXX

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FACSIMILE:  RQUD - RECONTACT

COMM                                   RECONTACT                          Rqud

[1-D]                             [2-D]                               [3-D]

NH:  SSSSSSSSS SSSSS SSSSSSSSSS   BN:  SSSSSSSSS SSSSS SSSSSSSSSS     PIC: SSS

[4-D]                                 [5-D]

ACTION TYPE: ssssssssssssssssssss     ACTION DATE: ssssss

[6-C]

RESPONSE RECEIVED DATE: SSSSSS

[7-M]

Select ACTION: 9         1=RESPONSE RECEIVED              3=s9 SUSPENSION

                         2=UNDELIVERABLE                  4=T3 TERMINATION.

[8-C]

SUSPENSION/TERMINATION eFFECTIVE dATE: SSSSSS

[9-D]                                                [10-0]

PF1 HELP AVAILABLE                                   TRANSFER TO: XXXX