Ssa-9779

Social Security Administration

Retirement, Survivors and Disability Insurance
Important Information

SOCIAL SECURITY ADMINISTRATION
PO BOX 9779
WILKES-BARRE PA 18767-9779
Date: August 14, 2013
Claim Number: 123-45-6789 D

SS9779ER-0000001 T-00348
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We need updated information about your work to make sure that we pay you the
right amount of Social Security benefits. Earlier, you told us that your earnings this
year would be about $32,659 We want to review your estimate since your plans may
have changed. We also need to know about your work plans for 2015
What You Need To Do
Please complete the enclosed form to tell us about your work. Please return it as soon as
possible in the enclosed envelope. If we do not receive it by October 1, 2014, we will use
your 2014 earnings estimate to decide how much we will pay you in the first part of 2015.
Thank you for taking the time to complete the form. We may contact you again if we need
more information to process this form.
If You Have Questions
If you have any questions, please:
· Visit our website at www.socialsecurity.gov to find general information about Social
Security.
· Call us toll-free at 1-800-772-1213 or call your local office at
. We can answer
most questions over the phone. If you are deaf or hard of hearing, our toll-free TTY
number is 1-800-325-0778.
· Write or visit any Social Security office. If you plan to visit an office, you may call
ahead to make an appointment. The office that serves your area is located at:
[FO ADDRESS1]
[FO ADDRESS2]
[FO ADDRESS3]
[FO ADDRESS4]
[FO CITY STATE ZIP]
.

.

[phone]

(OVER)

Form SSA-L9779-SM-SUP (7-2014)

Please have this letter with you if you call or visit an office. If you write, please include a
copy of the first page of this letter. It will help us answer your questions.
Sincerely,
Carolyn W. Colvin
Acting Commissioner of
Social Security
Enclosures:
Earnings Estimate Form SSA-L9779-SM
Envelope

Form SSA-L9779-SM-SUP (7-2014)

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123-45-6789 D

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• You will reach full retirement age in JANUARY 2017.

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05/12 01/17
TOE 220 861006 P2

you told us you will earn $32,659 this year.
1. Earlier,
How much do you now think you will earn in 2014?

123-45-6789
NONE (THIS MEANS THAT OUR RECORDS INDICATE YOU ARE WORKING IN
EVERY MONTH IN 2013)

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123-45-6789 D

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123-45-6789 D

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