AA-21 - Application for Survivor Benefits - Receipt for Claim

All Possible

United States of America
Railroad Retirement Board

Form AA-21rec (10-18)

Application for Survivor Benefits - Receipt for Claim

NAME
ADDRESS
ADDRESS
ADDRESS
ADDRESS
Employee’s Name
Application Filing Date
Your application for has been released and
will be processed as quickly as possible. If you do not receive notification about your
application by (Filing Date plus 65 days) you should contact the field office shown below.
If you change your address, or if there is some other change that may affect your claim, you or
your representative should report the change.
If you have any questions, we will be glad to help you. You can report changes either by
telephone, mail, or in person, whichever you prefer. Most Railroad Retirement Board offices are
open to the public from 9:00 AM to 3:30 PM, Monday, Tuesday, Thursday, Friday and 9:00 AM
to 12:00 PM Wednesday. To report any changes or ask questions, you should contact:

If for some reason you are unable to contact that office, you should contact:
U.S. Railroad Retirement Board
844 N Rush Street
Chicago, Illinois 60611-1275
http://www.rrb.gov